Theory and Comments on Standard Dilatometric Back Analysis

Summary The robust analytical solution was carried out to describe the stress state in the massive round boreholes. It gives the chance for complex back analysis of dilatometric in situ measurements. The main goal of this presentation is to present the incorporating phenomenon of influence zone around the boreholes. The analytical solution gives the chance to describe the progress of plastic zone around the hole

Motion estimation of vortical blood flow within the right atrium in a patient with atrial septal defect

Copyright © 2007 IEEEPatients with an atrial septal defect (ASD) have a left to right shunt with associated complications. Currently, various imaging modalities, including echocardiography and invasive cardiac catheterization, are utilized in the management of these patients. Cardiac magnetic resonance (CMR) imaging provides a novel and non-invasive approach for imaging patients with ASDs. A study of vortices generated within the right atrium (RA) during the diastolic phase of the cardiac cycle can provide useful information on the change in the magnitude of vorticity pre-and post-ASD closure. The motion estimation of blood applied to CMR is performed. In this study we present, a two dimensional (2D) visualization of in-vivo right atrial flow. This is constructed using flow velocities measured from the intensity shifts of turbulent blood flow regions in MRI. In particular, the flow vortices can be quantified and measured, against controls and patients with ASD, to extend medical knowledge of septal defects and their haemodynamic effects.Kelvin K.L. Wong, P. Molaee, P. Kuklik, Richard M. Kelso, S.G Worthley, P. Sanders, J. Mazumdar and D. Abbot

Cardiovascular magnetic resonance of total and atrial pericardial adipose tissue: A validation study and development of a 3 dimensional pericardial adipose tissue model

BACKGROUND Recently pericardial adipose tissue (PAT) has been shown to be an independent predictor of atrial fibrillation (AF). Atrial PAT may influence underlying atrial musculature creating a substrate for AF. This study sought to validate the assessment of total and atrial PAT by standard cardiovascular magnetic resonance (CMR) measures and describe and validate a three dimensional atrial PAT model. METHODS 10 merino cross sheep underwent CMR using a 1.5 Tesla system (Siemens, Sonata, Erlangen, Germany). Atrial and ventricular short axis (SA) images were acquired, using ECG -gated steady state free precession sequences. In order to quantify total volume of adipose tissue, a three dimensional model was constructed from consecutive end-diastolic images using semi-automated software. Regions of adipose tissue were marked in each slice followed by linear interpolation of pixel intensities in spaces between consecutive image slices. Total volume of adipose tissue was calculated as a total volume of the three dimensional model and the mass estimated from volume measurements. The sheep were euthanized and pericardial adipose tissue was removed and weighed for comparison to the corresponding CMR measurements. RESULTS All CMR adipose tissue estimates significantly correlated with autopsy measurements (ICC > 0.80; p < 0.03). Intra- observer reliability in CMR measures was high, with 95% levels of agreement within 5.5% (ICC = 0.995) for total fat mass and its individual atrial (95% CI ± 8.3%, ICC = 0.993) and ventricular components (95% CI ± 6.6%, ICC = 0.989). Inter- observer 95% limits of agreement were within ± 10.7% (ICC = 0.979), 7.4% (ICC = 0.991) and 7.2% (ICC = 0.991) for atrial, ventricular and total pericardial adipose tissue, respectively. CONCLUSION This study validates the use of a semi-automated three dimensional atrial PAT model utilizing standard (clinical) CMR sequences for accurate and reproducible assessment of atrial PAT. The measurement of local cardiac fat stores via this methodology could provide a sensitive tool to examine the regional effect of fat deposition on atrial substrate which potentially may influence AF ablation strategies in obese patients.Rajiv Mahajan, Pawel Kuklik, Suchi Grover, Anthony G Brooks, Christopher X Wong, Prashanthan Sanders and Joseph B Selvanayaga

Analysis of electrogram complexity during atrial fibrillation for ablation duration assessment

The aim of this study was to assess the reliability of the complexity analysis of single electrogram as an estimator of the length of the ablation procedure necessary for AF termination. Left and right atrial endocardial bipolar electrograms were recorded during ablation procedure of AF in 27 patients. Up to 30 second electrogram samples were measured at baseline, after each stage of ablation (LP V, roof, CFAE etc.) and prior to termination. For each electrogram, algorithmic complexity was calculated. Electrograms had significantly lower algorithmic complexity for patients who had two or less ablation stages performed than for patients for whom more than two ablation stage was performed (p < 0.001). ROC analysis showed 100% statistical sensitivity for 81% statistical specificity. These results show that algorithmic complexity increases with a number of ablation stages needed to terminate AF, which is related with the duration of the ablation procedure.Katarzyna Kośna, Piotr Podziemski, Lauren Wilson, Simon Stocman, Prashanthan Sanders, Jan Gieraltowski, Jan J Zebrowski, Pawel Kukli

The NOS3 G894T (rs1799983) and-786T/C (rs2070744) polymorphisms are associated with elite swimmer status

Endothelial nitric oxide synthase (NOS3) generates nitric oxide in blood vessels and is involved in the regulation of vascular function, metabolism and muscle fibre type transformations. Evidence suggests that the NOS3 G894T (rs1799983) and -786T/C (rs2070744) polymorphisms are associated with athletic performance. The purpose of this study was to determine the association between the NOS3 G894T and -786T/C polymorphisms with elite swimmer status in Polish athletes. One hundred and ninety-seven Polish swimmers (104 males and 93 females), who competed in national and international events, and 379 healthy control subjects (222 males and 157 females) were recruited for this study. The swimmers were divided into two groups: short distance swimmers (SDS; n=147; 50-200 m) and long distance swimmers (LDS; n=49; more than 500 m). As expected, the frequencies of the -786T/C T allele (77.0 vs. 63.1%, p = 0.0085) and G-T haplotype (63.7 vs. 52.0, p=0.025) were significantly higher in the LDS group in comparison with controls. Compared with the -786T/C CC genotype, the chance of being a long distance swimmer was 8.49 times higher (CI=1.14-62.78, p=0.023) for the carriers of -786T/C T allele than in control subjects. On the other hand, the Asp allele frequency was significantly higher in the female SDS group compared with controls (34.3 vs. 18.5%, p=0.00043). In conclusion, our results demonstrate that the T allele and the G-T haplotype of the -786T/C and G894T polymorphisms may be beneficial for long distance swimmers

Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis

Background: In the past decade, catheter ablation has become an established therapy for symptomatic atrial fibrillation (AF). Until very recently, few data have been available to guide the clinical community on the outcomes of AF ablation at ≥3 years of follow‐up. We aimed to systematically review the medical literature to evaluate the long‐term outcomes of AF ablation. Methods and Results: A structured electronic database search (PubMed, Embase, Web of Science, Cochrane) of the scientific literature was performed for studies describing outcomes at ≥3 years after AF ablation, with a mean follow‐up of ≥24 months after the index procedure. The following data were extracted: (1) single‐procedure success, (2) multiple‐procedure success, and (3) requirement for repeat procedures. Data were extracted from 19 studies, including 6167 patients undergoing AF ablation. Single‐procedure freedom from atrial arrhythmia at long‐term follow‐up was 53.1% (95% CI 46.2% to 60.0%) overall, 54.1% (95% CI 44.4% to 63.4%) in paroxysmal AF, and 41.8% (95% CI 25.2% to 60.5%) in nonparoxysmal AF. Substantial heterogeneity (I2>50%) was noted for single‐procedure outcomes. With multiple procedures, the long‐term success rate was 79.8% (95% CI 75.0% to 83.8%) overall, with significant heterogeneity (I2>50%).The average number of procedures per patient was 1.51 (95% CI 1.36 to 1.67). Conclusions: Catheter ablation is an effective and durable long‐term therapeutic strategy for some AF patients. Although significant heterogeneity is seen with single procedures, long‐term freedom from atrial arrhythmia can be achieved in some patients, but multiple procedures may be required.Anand N. Ganesan, Nicholas J. Shipp, Anthony G. Brooks, Pawel Kuklik, Dennis H. Lau, Han S. Lim, Thomas Sullivan, Kurt C. Roberts‐Thomson and Prashanthan Sander

Polygenic Study of Endurance-Associated Genetic Markers NOS3 (Glu298Asp), BDKRB2 (-9/+9), UCP2 (Ala55Val), AMPD1 (Gln45Ter) and ACE (I/D) in Polish Male Half Marathoners

The purpose of this study was to investigate individually and in combination the association between the ACE (I/D), NOS3 (Glu298Asp), BDKRB2 (-9/+9), UCP2 (Ala55Val) and AMPD1 (Gln45Ter) variants with endurance performance in a large, performance-homogenous cohort of elite Polish half marathoners. The study group consisted of 180 elite half marathoners: 76 with time 100 minutes. DNA of the subjects was extracted from buccal cells donated by the runners and genotyping was carried out using an allelic discrimination assay with a C1000 Touch Thermal Cycler (Bio-Rad, Germany) instrument with TaqMan® probes (NOS3, UCP2, and AMPD1) and a T100™ Thermal Cycler (Bio-Rad, Germany) instrument (ACE and BDKRB2). We found that the UCP2 Ala55Val polymorphism was associated with running performance, with the subjects carrying the Val allele being overrepresented in the group of most successful runners (100 min group (84.2 vs. 55.8%; OR = 4.23, p 100 min group (73.7 vs. 51.9%; OR = 2.6, p = 0.0034). These data suggest that the likelihood of becoming an elite half marathoner partly depends on the carriage of a high number of endurance-related alleles

AGTR2 and sprint/power performance: a case-control replication study for rs11091046 polymorphism in two ethnicities

We aimed to replicate, in a specific athletic event cohort (only track and field) and in two different ethnicities (Japanese and East European, i.e. Russian and Polish), original findings showing the association of the angiotensin-II receptor type-2 gene (AGTR2) rs11091046 A>C polymorphism with athlete status. We compared genotypic frequencies of the AGTR2 rs11091046 polymorphism among 282 track and field sprint/ power athletes (200 men and 82 women), including several national record holders and Olympic medallists (214 Japanese, 68 Russian and Polish), and 2024 control subjects (842 men and 1182 women) (804 Japanese, 1220 Russian and Polish). In men, a meta-analysis from the two combined cohorts showed a significantly higher frequency of the C allele in athletes than in controls (odds ratio: 1.62, P=0.008, heterogeneity index I 2 =0%). With regard to respective cohorts, C allele frequency was higher in Japanese male athletes than in controls (67.7% vs. 55.9%, P=0.022), but not in Russian/Polish male athletes (61.9% vs. 51.0%, P=0.172). In women, no significant results were obtained by meta-analysis for the two cohorts combination (P=0.850). The AC genotype frequency was significantly higher in Russian/Polish women athletes than in controls (69.2% vs. 42.1%, P=0.022), but not in Japanese women athletes (P=0.226). Our results, in contrast to previous findings, suggested by meta-analysis that the C allele of the AGTR2 rs11091046 polymorphism is associated with sprint/ power track and field athlete status in men, but not in women

The agt gene m235t polymorphism and response of power-related variables to aerobic training

© Journal of Sports Science and Medicine.The C allele of the M235T (rs699) polymorphism of the AGT gene correlates with higher levels of angiotensin II and has been associated with power and strength sport performance. The aim of the study was to investigate whether or not selected power-related variables and their response to a 12-week program of aerobic dance training are modulated by the AGT M235T genotype in healthy participants. Two hundred and one Polish Caucasian women aged 21 ± 1 years met the inclusion criteria and were included in the study. All women completed a 12-week program of low and high impact aerobics. Wingate peak power and total work capacity, 5 m, 10 m, and 30 m running times and jump height and jump power were determined before and after the training programme. All power-related variables improved significantly in response to aerobic dance training. We found a significant association between the M235T polymorphism and jump-based variables (squat jump (SJ) height, p = 0.005; SJ power, p = 0.015; countermovement jump height, p = 0.025; average of 10 countermovement jumps with arm swing (ACMJ) height, p = 0.001; ACMJ power, p = 0.035). Specifically, greater improvements were observed in the C allele carriers in comparison with TT homozygotes. In conclusion, aerobic dance, one of the most commonly practiced adult fitness activities in the world, provides sufficient training stimuli for augmenting the explosive strength necessary to increase vertical jump performance. The AGT gene M235T polymorphism seems to be not only a candidate gene variant for power/strength related pheno-types, but also a genetic marker for predicting response to training

Nonlinear oscillator model reproducing various phenomena in the dynamics of the conduction system of the heart

A dedicated nonlinear oscillator model able to reproduce the pulse shape, refractory time, and phase sensitivity of the action potential of a natural pacemaker of the heart is developed. The phase space of the oscillator contains a stable node, a hyperbolic saddle, and an unstable focus. The model reproduces several phenomena well known in cardiology, such as certain properties of the sinus rhythm and heart block. In particular, the model reproduces the decrease of heart rate variability with an increase in sympathetic activity. A sinus pause occurs in the model due to a single, well-timed, external pulse just as it occurs in the heart, for example due to a single supraventricular ectopy. Several ways by which the oscillations cease in the system are obtained (models of the asystole). The model simulates properly the way vagal activity modulates the heart rate and reproduces the vagal paradox. Two such oscillators, coupled unidirectionally and asymmetrically, allow us to reproduce the properties of heart rate variability obtained from patients with different kinds of heart block including sino-atrial blocks of different degree and a complete AV block (third degree). Finally, we demonstrate the possibility of introducing into the model a spatial dimension that creates exciting possibilities of simulating in the future the SA the AV nodes and the atrium including their true anatomical structure.J. J. Żebrowski, K. Grudziński, T. Buchner, P. Kuklik, J. Gac, G. Gielerak, P. Sanders, and R. Baranowsk