71 research outputs found
Myocardial changes in incident haemodialysis patients over 6-months:an observational cardiac magnetic resonance imaging study
Patients commencing on haemodialysis (HD) have an increased risk of cardiovascular events in the first year after starting HD compared to those patients established on HD longer. Left ventricular (LV) hypertrophy and abnormal myocardial strain predict mortality. There may be changes in the myocardium of incident HD patients over a 6-month period of HD which may explain changes in cardiovascular risk. We used CMR to consider changes in LV mass, myocardial strain and T1 mapping. We examined changes in pre-dialysis highly sensitive troponin T. 33 patients undergoing HD for <12 months were recruited. Participants underwent CMR at baseline and after 6-months of standard care. 6-months of HD was associated with reduction in LV mass index (Baseline: 78.8âg/m2 follow up: 69.9âg/m2, pâ=â<0.001). LV global longitudinal strain also improved (Baseline: â17.9%, follow up: â21.6%, pâ=â<0.001). Change in T1 time was not significant (Baseline septal T1 1277.4âms, follow up 1271.5 pâ=â0.504). Highly sensitive troponin T was lower at follow up (Baseline 38.8âpg/L, follow up 30.8âpg/L pâ=â0.02). In incident HD patients, 6-months of HD was associated with improvements in LV mass, strain and troponin. These findings may reflect improvement in known cardiac tissue abnormalities found in patients over the first year of HD
Discovery of os cordis in the cardiac skeleton of chimpanzees (Pan troglodytes)
Cardiovascular diseases, especially idiopathic myocardial fibrosis, is one of the most significant causes of morbidity and mortality in captive great apes. This study compared the structure and morphology of 16 hearts from chimpanzees (Pan troglodytes) which were either healthy or affected by myocardial fibrosis using X-ray microtomography. In four hearts, a single, hyperdense structure was detected within the right fibrous trigone of the cardiac skeleton. High resolution scans and histopathology revealed trabecular bones in two cases, hyaline cartilage in another case and a focus of mineralised fibro-cartilaginous metaplasia with endochondral ossification in the last case. Four other animals presented with multiple foci of ectopic calcification within the walls of the great vessels. All hearts affected by marked myocardial fibrosis presented with bone or cartilage formation, and increased collagen levels in tissues adjacent to the bone/cartilage, while unaffected hearts did not present with os cordis or cartilago cordis. The presence of an os cordis has been described in some ruminants, camelids, and otters, but never in great apes. This novel research indicates that an os cordis and cartilago cordis is present in some chimpanzees, particularly those affected by myocardial fibrosis, and could influence the risk of cardiac arrhythmias and sudden death
Diffuse left ventricular interstitial fibrosis is associated with sub-clinical myocardial dysfunction in Alström Syndrome: an observational study
Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world
Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic.
Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality.
Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States.
Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis.
Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection
Micro-RNA-21 (biomarker) and global longitudinal strain (functional marker) in detection of myocardial fibrotic burden in severe aortic valve stenosis: a pilot study
Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease
BACKGROUND:
The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease.
METHODS:
In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina.
RESULTS:
At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91).
CONCLUSIONS:
Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)
Geoaesthetics Redux: Book Reviews
Oft mentioned, seldom discussed: such is the status of aesthetic(s), adjective and noun, in much of human geography today. It is a term which beguiles; we like to think that we know what the term means. Korenâs (2010) Which âAestheticsâ do you mean? Ten definitions. Point Reyes, CA: Imperfect Publishing.) light-hearted text, Which âAestheticsâ Do you Mean, offers something of an antidote to such beguilement. Promising to address the âostensible vacuity and confusionâ surrounding aesthetics, Koren offers an origin of the term before listing no fewer than 10 different definitions or versions: appearance, style, taste, philosophy of art, thesis or exegesis, artistic, beauty, beautification, cognitive mode and language. These may all seem familiar to readers but point to the difficulty in outlining any coherent or straightforward notion of aesthetics. Indeed, for my own part, aesthetics was originally a term that featured in my thesis title but, by the end, had fallen away in large part due to my exasperation with it. Accordingly, two recently published books that undertake detailed conceptual work on the term and how it relates to space and/or Geography are to be warmly commended
Geoaesthetics redux
ft mentioned, seldom discussed: such is the status of aesthetic(s), adjective and noun, in much of human geography today. It is a term which beguiles; we like to think that we know what the term means. Korenâs (2010) light-hearted text, Which âAestheticsâ Do you Mean, offers something of an antidote to such beguilement. Promising to address the âostensible vacuity and confusionâ surrounding aesthetics, Koren offers an origin of the term before listing no fewer than ten different definitions or versions: appearance, style, taste, philosophy of art, thesis or exegesis, artistic, beauty, beautification, cognitive mode, and language. These may all seem familiar to readers but point to the difficulty in outlining any coherent or straightforward notion of aesthetics. Indeed, for my own part, aesthetics was originally a term that featured in my thesis title but, by the end, had fallen away in large part due to my exasperation with it. Accordingly, two recently published books which undertake detailed conceptual work on the term, and how it relates to space and/or Geography, are to be warmly commended. The first, Mustafa Dikeçâs (2015) Space, Politics and Aesthetics examines a trio of thinkers â all of whom are indebted to Kant â and highlights how their political aesthetic is tethered to particular understandings of space and spatialisation. The second, Geographical Aesthetics, a volume edited by Harriet Hawkins and Elizabeth Straughan (2015), explores Geographyâs uneasy relationship with aesthetics and seeks to renew and rework a geographical imaginary of the aesthetic. </p
Endurance, exhaustion and the lure of redemption
This is the author accepted manuscriptThis paper is concerned with the lure of redemption in contemporary academic and accounts of exhaustion, endurance and biopolitical life. Drawing on, and contributing to recent work on negativity in cultural geography, the paper analyses how optimism and redemption find their way in to academic writing on the contemporary condition. It interrogates the optimism in these literatures, paying attention to the genealogical roots of the drive to redeem accounts of slow and attritional violence and biopolitical subjectivity. In particular, we chart the implicit politics and ethics at play in the invocation of the Deleuzian âotherwiseâ which haunts many accounts of the transformatory potential of exhaustion, and the remnants of dialectical historicism and Christian morality at the heart of redemption narratives in accounts of endurance. The paper ends by questioning the motives behind such hopeful readings, and asks whether we have a responsibility not to redeem tales of violence with optimistic glimmers of another world
A lovesick note to the impractical
In this brief response we thank the commentators for their provocations, give-in to a certain lovesickness, sing-a-long with Alanis Morisette and conclude with a little tender contempt
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