B-type natriuretic peptide: powerful predictor of endstage chronic heart failure in individuals with systolic dysfunction of the systemic right ventricle

Aim To assess whether B-type natriuretic peptide (BNP) can serve as a predictor of end-stage chronic heart failure (CHF) in patients with severe systolic dysfunction of the systemic right ventricle (SRV). Methods We performed a retrospective analysis in 28 patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) who were evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. The primary endpoints of the study (end-stage CHF) were progressive CHF, urgent HTx, and ventricular assist device (VAD) implantation. Plasma BNP levels were measured using a chemiluminescent immunoassay. Results During median follow-up of 29 months (interquartile range, 9-50), 3 patients died of progressive CHF, 5 patients required an urgent HTx, and 6 patients underwent VAD implantation. BNP was a strong predictor of end-stage CHF (hazard ratio per 100 ng/L: 1.079, 95% confidence interval, 1.042-1.117, P<0.001). The following variables with corresponding areas under the curve (AUC) were identified as the most significant predictors of end-stage CHF: BNP (AUC 1.00), New York Heart Association functional class class III or IV (AUC 0.98), decompensated CHF in the last year (AUC 0.96), and systolic dysfunction of the subpulmonal ventricle (AUC 0.96). Conclusion BNP is a powerful predictor of end-stage CHF in individuals with systolic dysfunction of the SRV

Imaging and impact of myocardial fibrosis in aortic stenosis

Aortic stenosis is characterized both by progressive valve narrowing and the left ventricular remodeling response that ensues. The only effective treatment is aortic valve replacement, which is usually recommended in patients with severe stenosis and evidence of left ventricular decompensation. At present, left ventricular decompensation is most frequently identified by the development of typical symptoms or a marked reduction in left ventricular ejection fraction <50%. However, there is growing interest in using the assessment of myocardial fibrosis as an earlier and more objective marker of left ventricular decompensation, particularly in asymptomatic patients, where guidelines currently rely on non- randomized data and expert consensus. Myocardial fibrosis has major functional consequences, is the key pathological process driving left ventricular decompensation, and can be divided into 2 categories. Replacement fibrosis is irreversible and identified using late gadolinium enhancement on cardiac magnetic resonance, while diffuse fibrosis occurs earlier, is potentially reversible, and can be quantified with cardiac magnetic resonance T1 mapping techniques. There is a substantial body of observational data in this field, but there is now a need for randomized clinical trials of myocardial imaging in aortic stenosis to optimize patient management. This review will discuss the role that myocardial fibrosis plays in aortic stenosis, how it can be imaged, and how these approaches might be used to track myocardial health and improve the timing of aortic valve replacement

Development and optimization of the process of decarboxylation of tetrahydrocannabinoic acid, followed by FTIR detection of tetrahydrocannabinol in medicinal Cannabis

Aim of the study: Conversion of tetrahydrocanabinoic acid (THCA) to tetrahydrocannabinol (THC), is the main reaction essential for the use of cannabis,Cannabis indica L. buds in medicinal purposes. Therefore, the aim of this study was to develop and optimize the thermal treatment of Cannabis buds, required for the reaction of decarboxylation of THCA to THC followed by FTIR technique. Materials and methods: Cannabis buds were heated on aluminum shelves,programmed by heating oven POL EKO SL 400. Temperature program was strictly monitored and changes were recorded on every 5 minutes. Mid Infrared spectra were collected for each sample and temperature, respectively, using Perkin Elmer Spectrum Two™ coupled to an UATR accessory in spectral range of 400-4000 cm-1. Results: Changes in the infrared spectra indicated that the required elimination of water and appropriate conversion of THCA to THC were established, as the reaction progressed. Reaction of decarboxylation has occurred in temperature range from 85-120° C. Conversion of THCA to THC contributed for obtaining of high concentrations of THC which ranged 38-80% w/w. The progress of the decarboxylation enhanced the obtaining of THC. Conclusion: Monitoring of the process of decarboxylation with FTIR technique presents a fast and plausible method for controlling the conversion of acidic forms of cannabinoids to their neutral forms. The thermal treatment has shown a high yield of THC up to 80% w/w. It should be stressed out that these two methods could be ideally suited to everyday analysis because of their high performances

Arrhythmias in the developing heart

Abstract Prevalence of cardiac arrhythmias increases gradually with age; however, specific rhythm disturbances can appear even prior to birth and markedly affect foetal development. Relatively little is known about these disorders, chiefly because of their relative rarity and difficulty in diagnosis. In this review, we cover the most common forms found in human pathology, specifically congenital heart block, pre-excitation, extrasystoles and long QT syndrome. In addition, we cover pertinent literature data from prenatal animal models, providing a glimpse into pathogenesis of arrhythmias and possible strategies for treatment

[Photograph 2012.201.B1349.0885]

Photograph used for a newspaper owned by the Oklahoma Publishing Company. Caption: "War, Persian Gulf, Operation Desert Storm, Support Rally, 858 pound American flag cake

Adenylyl Cyclase Signaling in the Developing Chick Heart: The Deranging Effect of Antiarrhythmic Drugs

The adenylyl cyclase (AC) signaling system plays a crucial role in the regulation of cardiac contractility. Here we analyzed the key components of myocardial AC signaling in the developing chick embryo and assessed the impact of selected β-blocking agents on this system. Application of metoprolol and carvedilol, two commonly used β-blockers, at embryonic day (ED) 8 significantly downregulated (by about 40%) expression levels of AC5, the dominant cardiac AC isoform, and the amount of Gsα protein at ED9. Activity of AC stimulated by forskolin was also significantly reduced under these conditions. Interestingly, when administered at ED4, these drugs did not produce such profound changes in the myocardial AC signaling system, except for markedly increased expression of Giα protein. These data indicate that β-blocking agents can strongly derange AC signaling during the first half of embryonic heart development

Wood pulp industry by-product valorization for acrylate synthesis and bio-based polymer development via Michael addition reaction

It is crucial to adapt the processing of forest bio-resources into biochemicals and bio-based advanced materials in order to transform the current economic climate into a greener economy. Tall oil, as a by-product of the Kraft process of wood pulp manufacture, is a promising resource for the extraction of various value-added products. Tall oil fatty acids-based multifunctional Michael acceptor acrylates were developed. The suitability of developed acrylates for polymerization with tall oil fatty acids-based Michael donor acetoacetates to form a highly cross-linked polymer material via the Michael addition was investigated. With this novel strategy, valuable chemicals and innovative polymer materials can be produced from tall oil in an entirely new way, making a significant contribution to the development of a forest-based bioeconomy. Two different tall oil-based acrylates were successfully synthesized and characterized. Synthesized acrylates were successfully used in the synthesis of bio-based thermoset polymers. Obtained polymers had a wide variety of mechanical and thermal properties (glass transition temperature from –12.1 to 29.6 °C by dynamic mechanical analysis, Young's modulus from 15 to 1 760 MPa, and stress at break from 0.9 to 16.1 MPa). Gel permeation chromatography, Fourier-transform infrared (FT-IR) spectroscopy, matrix-assisted laser desorption/ionization-time of flight mass spectrometry, and nuclear magnetic resonance were used to analyse the chemical structure of synthesized acrylates. In addition, various titration methods and rheology tests were applied to characterize acrylates. The chemical composition and thermal and mechanical properties of the developed polymers were studied by using FT-IR, solid-state nuclear magnetic resonance, thermal gravimetric analysis, differential scanning calorimetry, dynamic mechanical analysis, and universal strength testing apparatus