Tissue Doppler echocardiographic quantification. Comparison to coronary angiography results in Acute Coronary Syndrome patients

BACKGROUND: Multiples indices have been described using tissue Doppler imaging (DTI) capabilities. The aim of this study was to assess the capability of one or several regional DTI parameters in separating control from ischemic myocardium. METHODS: Twenty-eight patients with acute myocardial infarction were imaged within 24-hour following an emergent coronary angioplasty. Seventeen controls without any coronary artery or myocardial disease were also explored. Global and regional left ventricular functions were assessed. High frame rate color DTI cineloop recordings were made in apical 4 and 2-chamber for subsequent analysis. Peak velocity during isovolumic contraction time (IVC), ejection time, isovolumic relaxation (IVR) and filling time were measured at the mitral annulus and the basal, mid and apical segments of each of the walls studied as well as peak systolic displacement and peak of strain. RESULTS: DTI-analysis enabled us to discriminate between the 3 populations (controls, inferior and anterior AMI). Even in non-ischemic segments, velocities and displacements were reduced in the 2 AMI populations. Peak systolic displacement was the best parameter to discriminate controls from AMI groups (wall by wall, p was systematically < 0.01). The combination IVC + and IVR< 1 discriminated ischemic from non-ischemic segments with 82% sensitivity and 85% specificity. CONCLUSION: DTI-analysis appears to be valuable in ischemic heart disease assessment. Its clinical impact remains to be established. However this simple index might really help in intensive care unit routine practice

The ischemic preconditioning effect of adenosine in patients with ischemic heart disease

<p>Abstract</p> <p>Introduction</p> <p><it>In vivo </it>and <it>in vitro </it>evidence suggests that adenosine and its agonists play key roles in the process of ischemic preconditioning. The effects of low-dose adenosine infusion on ischemic preconditioning have not been thoroughly studied in humans.</p> <p>Aims</p> <p>We hypothesised that a low-dose adenosine infusion could reduce the ischemic burden evoked by physical exercise and improve the regional left ventricular (LV) systolic function.</p> <p>Materials and methods</p> <p>We studied nine severely symptomatic male patients with severe coronary artery disease. Myocardial ischemia was induced by exercise on two separate occasions and quantified by Tissue Doppler Echocardiography. Prior to the exercise test, intravenous low-dose adenosine or placebo was infused over ten minutes according to a randomized, double blind, cross-over protocol. The LV walls were defined as ischemic if a reduction, no increment, or an increment of < 15% in peak systolic velocity (PSV) was observed during maximal exercise compared to the baseline values observed prior to placebo-infusion. Otherwise, the LV walls were defined as non-ischemic.</p> <p>Results</p> <p>PSV increased from baseline to maximal exercise in non-ischemic walls both during placebo (<it>P </it>= 0.0001) and low-dose adenosine infusion (<it>P </it>= 0.0009). However, in the ischemic walls, PSV increased only during low-dose adenosine infusion <it>(P </it>= 0.001), while no changes in PSV occurred during placebo infusion (<it>P </it>= NS).</p> <p>Conclusion</p> <p>Low-dose adenosine infusion reduced the ischemic burden and improved LV regional systolic function in the ischemic walls of patients with exercise-induced myocardial ischemia, confirming that adenosine is a potential preconditioning agent in humans.</p

Source apportionment of fine particulate matter in Houston, Texas: insights to secondary organic aerosols

Online and offline measurements of ambient particulate matter (PM) near the urban and industrial Houston Ship Channel in Houston, Texas, USA, during May 2015 were utilized to characterize its chemical composition and to evaluate the relative contributions of primary, secondary, biogenic, and anthropogenic sources. Aerosol mass spectrometry (AMS) on nonrefractory PM1 (PM  ≤  1&thinsp;µm) indicated major contributions from sulfate (averaging 50&thinsp;% by mass), organic aerosol (OA, 40&thinsp;%), and ammonium (14&thinsp;%). Positive matrix factorization (PMF) of AMS data categorized OA on average as 22&thinsp;% hydrocarbon-like organic aerosol (HOA), 29&thinsp;% cooking-influenced less-oxidized oxygenated organic aerosol (CI-LO-OOA), and 48&thinsp;% more-oxidized oxygenated organic aerosol (MO-OOA), with the latter two sources indicative of secondary organic aerosol (SOA). Chemical analysis of PM2.5 (PM  ≤  2.5&thinsp;µm) filter samples agreed that organic matter (35&thinsp;%) and sulfate (21&thinsp;%) were the most abundant components. Organic speciation of PM2.5 organic carbon (OC) focused on molecular markers of primary sources and SOA tracers derived from biogenic and anthropogenic volatile organic compounds (VOCs). The sources of PM2.5 OC were estimated using molecular marker-based positive matric factorization (MM-PMF) and chemical mass balance (CMB) models. MM-PMF resolved nine factors that were identified as diesel engines (11.5&thinsp;%), gasoline engines (24.3&thinsp;%), nontailpipe vehicle emissions (11.1&thinsp;%), ship emissions (2.2&thinsp;%), cooking (1.0&thinsp;%), biomass burning (BB, 10.6&thinsp;%), isoprene SOA (11.0&thinsp;%), high-NOx anthropogenic SOA (6.6&thinsp;%), and low-NOx anthropogenic SOA (21.7&thinsp;%). Using available source profiles, CMB apportioned 41&thinsp;% of OC to primary fossil sources (gasoline engines, diesel engines, and ship emissions), 5&thinsp;% to BB, 15&thinsp;% to SOA (including 7.4&thinsp;% biogenic and 7.6&thinsp;% anthropogenic), and 39&thinsp;% to other sources that were not included in the model and are expected to be secondary.This study presents the first application of in situ AMS-PMF, MM-PMF, and CMB for OC source apportionment and the integration of these methods to evaluate the relative roles of biogenic, anthropogenic, and BB-SOA. The three source apportionment models agreed that  ∼ &thinsp;50&thinsp;% of OC is associated with primary emissions from fossil fuel use, particularly motor vehicles. Differences among the models reflect their ability to resolve sources based upon the input chemical measurements, with molecular marker-based methods providing greater source specificity and resolution for minor sources. By combining results from MM-PMF and CMB, BB was estimated to contribute 11&thinsp;% of OC, with 5&thinsp;% primary emissions and 6&thinsp;% BB-SOA. SOA was dominantly anthropogenic (28&thinsp;%) rather than biogenic (11&thinsp;%) or BB-derived. The three-model approach demonstrates significant contributions of anthropogenic SOA to fine PM. More broadly, the findings and methodologies presented herein can be used to advance local and regional understanding of anthropogenic contributions to SOA.</p

A palaeoenvironmental reconstruction of the Middle Jurassic of Sardinia (Italy) based on integrated palaeobotanical, palynological and lithofacies data assessment

During the Jurassic, Sardinia was close to continental Europe. Emerged lands started from a single island forming in time a progressively sinking archipelago. This complex palaeogeographic situation gave origin to a diverse landscape with a variety of habitats. Collection- and literature-based palaeobotanical, palynological and lithofacies studies were carried out on the Genna Selole Formation for palaeoenvironmental interpretations. They evidence a generally warm and humid climate, affected occasionally by drier periods. Several distinct ecosystems can be discerned in this climate, including alluvial fans with braided streams (Laconi-Gadoni lithofacies), paralic swamps and coasts (Nurri-Escalaplano lithofacies), and lagoons and shallow marine environments (Ussassai-Perdasdefogu lithofacies). The non-marine environments were covered by extensive lowland and a reduced coastal and tidally influenced environment. Both the river and the upland/hinterland environments are of limited impact for the reconstruction. The difference between the composition of the palynological and palaeobotanical associations evidence the discrepancies obtained using only one of those proxies. The macroremains reflect the local palaeoenvironments better, although subjected to a transport bias (e.g. missing upland elements and delicate organs), whereas the palynomorphs permit to reconstruct the regional palaeoclimate. Considering that the flora of Sardinia is the southernmost of all Middle Jurassic European floras, this multidisciplinary study increases our understanding of the terrestrial environments during that period of time