Substrate Utilization by the Failing Human Heart by Direct Quantification Using Arterio-Venous Blood Sampling

Metabolic substrate utilization of the human failing heart is an area of controversy. The purpose of this study is to directly quantify myocardial substrate utilization in moderately severe heart failure, type 2 diabetes and healthy controls using simultaneous coronary sinus and arterial blood sampling. Patients with heart failure (n = 9, mean NYHA 2.7±0.5), with type 2 diabetes (n = 5) and with normal heart function (n = 10) were studied after an overnight fast in connection with electrophysiological investigations/treatments

High-absorption curcumin reduces BNP in hypertensive heart disease

Aims Hypertension is a strong risk factor for heart failure with preserved ejection fraction. Curcumin has p300-specific histone acetyltransferase inhibitory activity, suppresses cardiomyocyte hypertrophy and fibrosis, and significantly reduces myocardial brain natriuretic peptide (BNP) expression without altering blood pressure in a rat model of hypertensive heart disease. This double-blind, placebo-controlled, randomized study, for the first time, aimed to examine the efficacy of a high-absorption curcumin for the prevention of hypertensive heart disease in humans. Methods and results Patients exhibiting initial signs of hypertensive heart disease with left ventricular ejection fraction ≥60% and stable blood pressure <140/90 mmHg orally took a double-blinded capsule (either a 90 mg curcumin capsule or placebo) twice daily for 24 weeks. The primary endpoint was per cent changes in left ventricular diastolic function (E/E′) from baseline to 6 months after administration. The secondary endpoint was the per cent change in plasma BNP levels. The E/E′ ratio per cent change from baseline to 6 months after administration was similar between the placebo (n = 69) and the curcumin (n = 73) groups. The per cent change in plasma BNP levels was significantly lower in the curcumin group than in the placebo group. In patients <65 years, BNP per cent changes were significantly lower in the curcumin group than in the placebo group, but similar between groups in ≥65 years (<65 vs. ≥65 years: P for interaction = 0.011). Conclusions A high-absorption curcumin agent did not affect the E/E′ ratio, rather it significantly inhibited the increase in plasma BNP levels in patients with initial signs of hypertensive heart disease

DC Arc Plasma Treatment for Defect Reduction in WC-Co Granulated Powder

Tungsten carbide&ndash;cobalt (WC&ndash;Co) agglomerated powder is widely used for additive manufacturing and spray coating, and a reduction in internal gaps in the powder is required to obtain a product of high quality. In this paper, we investigate plasma effects on agglomerated powder when WC&ndash;12%Co powder is directly subjected to direct current (DC) arc plasma treatment to reduce gaps in the WC&ndash;Co powder. We obtain a plasma-treated powder with reduced gaps among WC particles. Furthermore, plasma-treatment improves the sphericity of the powder particles, due to the spheroidization effect, so that the percentage of plasma-treated particles exceeding 95% sphericity is 50%, which is 1.7 times that of raw powder. Concern regarding the possible generation of W2C by plasma treatment is unfounded, with W2C levels kept very low according to X-ray diffraction (XRD) analysis, showing a value of 0.0075 for the area ratio W2C(002)/WC(100). XRD analysis also reveals that plasma treatment relaxes residual strains in the powder. From these results, the DC plasma treatment of WC agglomerated powder produces a spherical powder with fewer gaps and strains in the powder, making it more suitable for additive manufacturing while suppressing decarburization

Postcardiac injury syndrome following vascular interventional radiofrequency ablation for paroxysmal atrial fibrillation

Postcardiac injury syndrome (PCIS) occurs following a pericardial or myocardial injury. On the other hand, PCIS following cardiac catheter intervention is rare and can be difficult to diagnose because of its delayed onset. A 24-year-old man underwent radiofrequency ablation (RFA) for paroxysmal atrial fibrillation and suffered from general fatigue and left-sided pleural effusion three months after the procedure. His symptoms and effusion were effectively treated within a month by administrating nonsteroidal anti-inflammatory drugs. However, seven months later, he developed left-sided chest pain and low-grade fever. Computed tomography showed a thickening of the parietal pleura and reccurence of the pleural effusion. Pleural biopsy by video-assisted thoracoscopy demonstrated chronic pleuritis with a non-necrotizing granulomatous reaction. Given the previous RFA, and in the absence of infection or malignant disease, he was diagnosed with PCIS and treated with colchicine

Contributions of different substrates to myocardial O₂ consumption.

<p>Oxygen extraction ratios were summed and adjusted to a total of 100%. Lower, white bar: sum of non-esterified fatty acids and triacylglycerol (i.e. fatty acid oxidation); solid black, glucose; diagonal hatched, lactate; cross-hatched, 3-hydroxybutyrate; think solid line at top, pyruvate. Con, control group; HF, heart failure group; DM, Type 2 diabetes group.</p

Fractional extraction (%) of non-esterified fatty acids (NEFA), triacylglycerol, glucose, pyruvate, lactate and 3-hydroxybutyrate across the heart in patients with heart failure, controls and type 2 diabetes.

<p>Values are mean±SD.</p

Baseline description of heart failure, control and type 2 diabetes groups.

<p>Values are mean±SD except for BNP which is shown as median (range).</p>#<p>p<0.05 vs control,</p><p>* p<0.01 vs control,</p>$<p>p<0.001 vs control,</p>†<p>p<0.01 vs DM using Student's t-test, except for BNP where Mann-Whitney U-test was used.</p

Impact of Chronic Kidney Disease on the Associations of Cardiovascular Biomarkers With Adverse Outcomes in Patients With Suspected or Known Coronary Artery Disease: The EXCEED‐J Study

Background The impact of chronic kidney disease (CKD) on the prognostic utility of cardiovascular biomarkers in high‐risk patients remains unclear. Methods and Results We performed a multicenter, prospective cohort study of 3255 patients with suspected or known coronary artery disease (CAD) to investigate whether CKD modifies the prognostic utility of cardiovascular biomarkers. Serum levels of cardiovascular and renal biomarkers, including soluble fms‐like tyrosine kinase‐1 (sFlt‐1), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), high‐sensitivity cardiac troponin‐I (hs‐cTnI), cystatin C, and placental growth factor, were measured in 1301 CKD and 1954 patients without CKD. The urine albumin to creatinine ratio (UACR) was measured in patients with CKD. The primary outcome was 3‐point MACE (3P‐MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all‐cause death, cardiovascular death, and 5P‐MACE defined as a composite of 3P‐MACE, heart failure hospitalization, and coronary/peripheral artery revascularization. After adjustment for clinical confounders, sFlt‐1, NT‐proBNP, and hs‐cTnI, but not other biomarkers, were significantly associated with 3P‐MACE, all‐cause death, and cardiovascular death in the entire cohort and in patients without CKD. These associations were still significant in CKD only for NT‐proBNP and hs‐cTnI. NT‐proBNP and hs‐cTnI were also significantly associated with 5P‐MACE in CKD. The UACR was not significantly associated with any outcomes in CKD. NT‐proBNP and hs‐cTnI added incremental prognostic information for all outcomes to the model with potential clinical confounders in CKD. Conclusions NT‐proBNP and hs‐cTnI were the most powerful prognostic biomarkers in patients with suspected or known CAD and concomitant CKD