Left ventricular remodelling in the year after myocardial infarction: an echocardiographic, haemodynamic, and radionuclide angiographic study.

BACKGROUND: The factors that influence infarct expansion early after myocardial infarction have been identified; however, there is less information about late-phase left ventricular enlargement. This study was designed to identify the clinical, haemodynamic, echocardiographic, and radionuclide angiographic criteria that predict the progress of left ventricular dilation after discharge for a first-anterior myocardial infarction. METHODS: Sixty-seven patients with first Q-wave acute anterior myocardial infarction not treated with thrombolytic agents underwent baseline echocardiographic, haemodynamic, and radionuclide angiographic evaluation 4-7 days after the onset of symptoms. The echocardiographic and radionuclide evaluations were repeated after 1 year in the 55 patients who completed the follow-up. By multivariate stepwise linear regression analysis, left ventricular end-diastolic volume after 1 year and change from baseline were modelled as a function of baseline left ventricular end-diastolic volume and other potential predictors. RESULTS: A model including left ventricular end-diastolic pressure, global wall motion score, baseline left ventricular end-diastolic volume, and a Thrombolysis in Myocardial Infarction (TIMI) score of 0-1 was able to predict 84% of the left ventricular end-diastolic volume at the follow-up; a TIMI score of 0-1, the transverse end-diastolic diameter, global wall motion score, and the number of coronary vessels with 70% stenosis accounted for 81% of the variation in left ventricular end-diastolic volume from baseline, while the transverse end-diastolic diameter was inversely related to this parameter. CONCLUSIONS: The results of this study demonstrate that after an anterior myocardial infarction, the patency of the infarct-related artery is the major determinant of late left ventricular dilation, while left ventricular end-diastolic pressure influences early left ventricular dilation and baseline end-diastolic volume. Therefore, to improve left ventricular remodelling, it appears necessary to increase the patency of the infarct-related artery and improve the diastolic loading of the left ventricle at an early stage in the infarction. The inverse relationship between baseline left ventricular transverse diameter and the change in left ventricular volume after discharge indicates that the higher the baseline left ventricular volume, the less it changed during the follow-up. The global wall motion score appears to be a non-invasive parameter that is useful for identifying patients with a high risk of progressive left ventricular dilation

The ADAHELI solar mission: Investigating the structure of Sun{\rsquos lower atmosphere}

ADAHELI (ADvanced Astronomy for HELIophysics) is a small-class (500 kg) low-budget (50 MEuro) satellite mission for the study of the solar photosphere and the chromosphere and for monitoring solar flare emission. ADAHELI’s design has completed its Phase-A feasibility study in December 2008, in the framework of ASI’s (Agenzia Spaziale Italiana) 2007 “Small Missions” Program (calling for two missions at 50 MEeuros each, plus the launch budget). ADAHELI’s main purpose is to explore Sun’s lower atmosphere in the near-infrared, a region so far unexplored by solar observations from space. ADAHELI will carry out observations of the solar photosphere and of the chromosphere at high-temporal rate and high spatial and spectral resolutions. ADAHELI will contribute to the understanding of Space Weather through the study of particle acceleration during flares. A radiometer operating in the millimeter radio band will continuously monitor the solar disk, throughout the spacecraft’s life time. ADAHELI’s baseline instruments are a 50-cm high–resolution telescope operating in the visible and the near-infrared, and a lightweight full-disk radiometer operating at millimeter wavelengths (90 GHz). The core of the telescope’s focal plane suite is the spectral imager based on two Fabry-Perot interferometers, flying for the first time on a solar mission. The instrument will return fast-cadence, full bi-dimensional spectral images at high-resolution, thus improving on current slit-scan, mono-dimensional architectures. Moreover, the possibility of working in polarized light will enable full 3D magnetic field reconstruction on the photosphere and the chromosphere. An optional instrumental package is also being proposed to further extend ADAHELI’s scope: a full-disk telescope for helioseismology based on a double Magneto-Optical Filter, a Neutral Particle Analyzer for magnetospheric research, an Extreme Ultraviolet imaging and spectro-radiometry instrument. These options fall outside the prescribed budget. ADAHELI, flying a Sun-Synchronous orbit at 800 km, will perform continuous, long-duration (4-h), daily acquisitions, with the possibility of extending them up to 24 h. ADAHELI’s operating life is two years, plus one extension year. Launch would be nominally planned for 2014

Does acute maternal stress in pregnancy affect infant health outcomes? Examination of a large cohort of infants born after the terrorist attacks of September 11, 2001

<p>Abstract</p> <p>Background</p> <p>Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results.</p> <p>Methods</p> <p>Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty military families. Infants were considered exposed if they were in utero on September 11, 2001, while the referent group included infants gestating in the same period in the preceding and following year (2000 and 2002). We investigated the association of this acute stress during pregnancy with the infant health outcomes of male:female sex ratio, birth defects, preterm birth, and growth deficiencies in utero and in infancy.</p> <p>Results</p> <p>No difference in sex ratio was observed between infants in utero in the first trimester of pregnancy on September 11, 2001 and infants in the referent population. Examination of the relationship between first-trimester exposure and birth defects also revealed no significant associations. In adjusted multivariable models, neither preterm birth nor growth deficiencies were significantly associated with the maternal exposure to the stress of September 11 during pregnancy.</p> <p>Conclusion</p> <p>The findings from this large population-based study suggest that women who were pregnant during the terrorist attacks of September 11, 2001 had no increased risk of adverse infant health outcomes.</p