Adaptation of apparent frontal parallel plane and felt head position after short duration head turn

This was a study of the effects of prolonged head rotation on the apparent frontal parallel plane, and on kinesthetic jugment of the straight ahead position of the head. Both meaures were obtained before and after rotation periods of 30 seconds, 2 minutes, and 4 minutes, during which the head was deviated 20 degrees left, and no visual stimulation was allowed. The apparent frontal parallel plane judgments, pre and post adaptation, were made with the subject\u27s face congruent with the frontal plane of his body. The results indicate an adaptation of head position of under correction or adaptation towards the direction of deviation; the apparent frontal plane was rotated toward the subject on the side toward which his head had been rotated. A significant visual after-effect was detected in the 30 second period, and this increased significantly over the 2 and 4 minute periods. These are the shortest adapting periods yet demonstrated, to our knowledge

Assessment of Myocardial Scarring Improves Risk Stratification in Patients Evaluated for Cardiac Defibrillator Implantation

ObjectivesWe tested whether an assessment of myocardial scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation.BackgroundCurrent sudden cardiac death risk stratification emphasizes left ventricular ejection fraction (LVEF); however, most patients suffering sudden cardiac death have a preserved LVEF, and many with poor LVEF do not benefit from ICD prophylaxis.MethodsOne hundred thirty-seven patients undergoing evaluation for possible ICD placement were prospectively enrolled and underwent cardiac MRI assessment of LVEF and scar. The pre-specified primary endpoint was death or appropriate ICD discharge for sustained ventricular tachyarrhythmia.ResultsDuring a median follow-up of 24 months the primary endpoint occurred in 39 patients. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of left ventricular mass (hazard ratio [HR]: 5.2; 95% confidence interval [CI]: 2.0 to 13.3). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as a continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant scarring (>5%) had higher risk than those with minimal or no (≤5%) scarring (HR: 6.3; 95% CI: 1.4 to 28.0). Those with LVEF >30% and significant scarring had risk similar to patients with LVEF ≤30% (p = 0.56). Among patients with LVEF ≤30%, those with significant scarring again had higher risk than those with minimal or no scarring (HR: 3.9; 95% CI: 1.2 to 13.1). Those with LVEF ≤30% and minimal scarring had risk similar to patients with LVEF >30% (p = 0.71).ConclusionsMyocardial scarring detected by cardiac MRI is an independent predictor of adverse outcome in patients being considered for ICD placement. In patients with LVEF >30%, significant scarring (>5% LV) identifies a high-risk cohort similar in risk to those with LVEF ≤30%. Conversely, in patients with LVEF ≤30%, minimal or no scarring identifies a low-risk cohort similar to those with LVEF >30%