T-wave Inversion through Inhomogeneous Voltage Diffusion within the FK3V Cardiac Model

The heart beats due to the synchronized contraction of cardiomyocytes triggered by a periodic sequence of electrical signals called action potentials, which originate in the sinoatrial node and spread through the heart's electrical system. A large body of work is devoted to modeling the propagation of the action potential and to reproducing reliably its shape and duration. Connection of computational modeling of cells to macroscopic phenomenological curves such as the electrocardiogram has been also intense, due to its clinical importancce in analyzing cardiovascular diseases. In this work we simulate the dynamics of action potential propagation using the three-variable Fenton-Karma model that can account for both normal and damaged cells through spatially inhomogeneous voltage diffusion coefficient. We monitor the action potential propagation in the cardiac tissue and calculate the pseudo-electrocardiogram that reproduces the R and T waves. The R wave amplitude varies according to a double exponential law as a function of the (spatially homogeneous, for an isotropic tissue) diffusion coefficient. The addition of spatial inhomogeneity in the diffusion coefficient by means of a defected region representing damaged cardiac cells, may result in T-wave inversion in the calculated pseudo-electrocardiogram. The transition from positive to negative polarity of the T-wave is analyzed as a function of the length and the depth of the defected region.Comment: 12 pages, figures, 39 reference

Increased Migration of Monocytes in Essential Hypertension Is Associated with Increased Transient Receptor Potential Channel Canonical Type 3 Channels

Increased transient receptor potential canonical type 3 (TRPC3) channels have been observed in patients with essential hypertension. In the present study we tested the hypothesis that increased monocyte migration is associated with increased TRPC3 expression. Monocyte migration assay was performed in a microchemotaxis chamber using chemoattractants formylated peptide Met-Leu-Phe (fMLP) and tumor necrosis factor-α (TNF-α). Proteins were identified by immunoblotting and quantitative in-cell Western assay. The effects of TRP channel-inhibitor 2–aminoethoxydiphenylborane (2-APB) and small interfering RNA knockdown of TRPC3 were investigated. We observed an increased fMLP-induced migration of monocytes from hypertensive patients compared with normotensive control subjects (246±14% vs 151±10%). The TNF-α-induced migration of monocytes in patients with essential hypertension was also significantly increased compared to normotensive control subjects (221±20% vs 138±18%). In the presence of 2-APB or after siRNA knockdown of TRPC3 the fMLP-induced monocyte migration was significantly blocked. The fMLP-induced changes of cytosolic calcium were significantly increased in monocytes from hypertensive patients compared to normotensive control subjects. The fMLP-induced monocyte migration was significantly reduced in the presence of inhibitors of tyrosine kinase and phosphoinositide 3-kinase. We conclude that increased monocyte migration in patients with essential hypertension is associated with increased TRPC3 channels

Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women

Progression From Paroxysmal to Persistent Atrial Fibrillation. Clinical Correlates and Prognosis

Objectives: We investigated clinical correlates of atrial fibrillation (AF) progression and evaluated the prognosis of patients demonstrating AF progression in a large population. Background: Progression of paroxysmal AF to more sustained forms is frequently seen. However, not all patients will progress to persistent AF. Methods: We included 1,219 patients with paroxysmal AF who participated in the Euro Heart Survey on AF and had a known rhythm status at follow-up. Patients who experienced AF progression after 1 year of follow-up were identified. Results: Progression of AF occurred in 178 (15%) patients. Multivariate analysis showed that heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension were the only independent predictors of AF progression. Using the regression coefficient as a benchmark, we calculated the HATCH score. Nearly 50% of the patients with a HATCH score >5 progressed to persistent AF compared with only 6% of the patients with a HATCH score of 0. During follow-up, patients with AF progression were more often admitted to the hospital and had more major adverse cardiovascular events. Conclusions: A substantial number of patients progress to sustained AF within 1 year. The clinical outcome of these patients regarding hospital admissions and major adverse cardiovascular events was worse compared with patients demonstrating no AF progression. Factors known to cause atrial structural remodeling (age and underlying heart disease) were independent predictors of AF progression. The HATCH score may help to identify patients who are likely to progress to sustained forms of AF in the near future. \ua9 2010 American College of Cardiology Foundation

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice

LB I ceramic connections between Thera and Kos

No abstract available

The Kos Archaeological Survey Project and the Site of Ayios Panteleimon in the Northeast Koan Region

Questo articolo presenta i risultati preliminari delle campagne 2018 e 2019 del Kos Archaeological Survey Project - Еπιϕανειακή Έρευνα στο νησί της Κω (KASP). Particolare attenzione è riservata alla scoperta del sito, precedentemente inedito, di Ayios Panteleimon, il più grande insediamento preistorico mai identificato sull’isola di Coo. Gli esiti della ricognizione sono discussi in sei sezioni, concentrate sui seguenti argomenti: i principali temi delle ricerche in corso; la metodologia del progetto; il lavoro portato a termine nel 2018 e nel 2019 nella regione nord-orientale di Coo; Ayios Panteleimon e i materiali preistorici rinvenuti nell’area del sito; Ayios Panteleimon nel più ampio contesto delle traiettorie insediative e socio-culturali di Coo nel Tardo Bronzo (TB); i risultati preliminari del progetto e i piani per le indagini dei prossimi anni a Ayios Panteleimon. Le informazioni presentate in questo articolo dimostrano il ruolo di preminenza economica e politica esercitato da Ayios Panteleimon nella regione nordorientale di Coo durante il TB. I dati indicano che Ayios Panteleimon si distingue per le sue ricche e diverse relazioni culturali con altre aree del Mediterraneo orientale, tra cui il sudest dell’Egeo e le coste sudoccidentali dell’Anatolia, Creta, le Cicladi e la Grecia continentale. Particolarmente degne di nota sono le connessioni con le tradizioni ceramiche del Tardo Minoico (TM) IA e TM IB, che includono forme di origine cretese, importate o di manifattura locale, e vasi della cosiddetta classe Dipinta Semifine e Impasto Light on Dark e Dark on Light, appartenente alla tradizione mista di Coo. L’importanza di queste connessioni dimostra il carattere speciale di Ayios Panteleimon nel panorama di Coo durante le fasi iniziali del TB. Il loro significativo impatto sulla cultura materiale del sito suggerisce che Ayios Panteleimon ebbe un ruolo unico nelle relazioni con Creta, inaugurando quegli intensi processi di interazione con l’Egeo occidentale, che condussero alla creazione di una identità micenea a Coo nelle fasi tarde del II millennio a.C., in particolare dal Tardo Elladico (TE) IIIA2 al TE III

LB I ceramic connections between Thera and Kos

No abstract available

Managing Environmental Challenges with Anthropogenic Bedrock Modification: Archaeological Survey Evidence from the Upper Basin (USA) and the Island of Kos (Greece)

Human-environmental interaction studies typically focus on large-scale landscape modifications of vegetation or soils and rarely address smaller-scale human alterations to site settings. This approach is based on a broad concept of environment as “set” having spatially dispersed and regionally defined attributes, as opposed to something that is mutable at the scale of individual groups of humans living at a specific location. This paper examines how two prehistoric groups, the Final Neolithic to Early Bronze Age 2 occupants on the island of Kos, Greece and the Late Formative Period occupants in the Upper Basin, northern Arizona, selected and modified habitation locations involving exposed bedrock. Although chronologically separated by thousands of years and occupying different continents, these two groups share similarities in population size, socio-political complexity, and environmental challenges. In facing these challenges, both groups apply practical, but different, approaches that utilized one of the most prevalent globally available resources – limestone bedrock