Parallelisms between sea surface temperature changes in the western tropical Atlantic (Guiana Basin) and high latitude climate signals over the last 140 000 years

Sea surface temperatures (SST) in the Guiana Basin over the last 140 ka were obtained by measuring the C37 alkenone unsaturation index Uk'37 in the sediment core MD03-2616 (7° N, 53° W). The resulting data set is unique in the western tropical Atlantic region for this period. The SSTs range from 25.1 to 28.9 °C, i.e. glacial-interglacial amplitude of 3.8 °C, which is in the range of change of other tropical areas. During the last two interglacial stages (marine isotope stages; MIS1 and MIS5e) and warm long interstadials (MIS5d-a), a rapid transmission of climate variability from Arctic-tropical latitudes is recorded. During these periods, the MD03-2616 SSTs show a conspicuous parallelism with temperature changes observed in Greenland and SST records of North Atlantic mid-latitude cores (Iberian Margin 38° N, Martrat et al., 2007). The last deglaciation in the Guiana Basin is particularly revealing. MIS2 stands out as the coldest period of the interval analysed. The events recorded in Guiana parallel northern latitude events such as the Bølling-Allerød warming and the Younger Dryas cooling which ensued. These oscillations were previously documented in the δ18O of the Sajama tropical ice core (Bolivia) and are present in Guiana, with rates of ca. 6 °C ka-1 and changes of over 2 °C. During the glacial interval, significant abrupt variability is observed, e.g. oscillations of 0.5-1.2 °C during MIS3, which is about 30 % of the maximum glacial-interglacial SST change. In the MD03-2616 record, it is possible to unambiguously identify either the Dansgaard-Oeschger oscillations described in northern latitudes or the SST drops associated with the Heinrich events characteristic of North Atlantic records. Although these events form the background of the climate variability observed, what truly shapes SSTs in the Guiana Basin is a long-term tropical response to precessional changes, which is modulated in the opposite way to Northern Hemisphere variability. This lack of synchrony is consistent with other tropical records in locations to the north or south of the Guiana Basin and evidences an Arctic-tropical decoupling when a substantial reduction in the Atlantic meridional overturning circulation (AMOC) takes place. © Author(s) 2015. CC Attribution 3.0 License.Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Regional vegetation changes in the tropical Andes expressed as arboreal pollen (AP%), standardised ordination scores (DCA z-scores), and aquatic vegetation ratios (D/SS); files used for plots

We compare eight pollen records reflecting climatic and environmental change from the tropical Andes. Our analysis focuses on the last 50 ka, with particular emphasis on the Pleistocene to Holocene transition. We explore ecological grouping and downcore ordination results as two approaches for extracting environmental variability from pollen records. We also use the records of aquatic and shoreline vegetation as markers for lake level fluctuations, and precipitation change. Our analysis focuses on the signature of millennial-scale variability in the tropical Andes, in particular, Heinrich stadials and Greenland interstadials. We identify rapid responses of the tropical vegetation to this climate variability, and relate differences between sites to moisture sources and site sensitivity

Millennial-scale vegetation changes in the tropical Andes using ecological grouping and ordination methods

We compare eight pollen records reflecting climatic and environmental change from northern and southern sites in the tropical Andes. Our analysis focuses on the last 30 000 years, with particular emphasis on the Pleistocene to Holocene transition. We explore ecological grouping and downcore ordination results as two approaches for extracting environmental variability from pollen records. We also use the records of aquatic and shoreline vegetation as markers for lake level fluctuations and moisture availability. Our analysis focuses on the signature of millennial-scale climate variability in the tropical Andes, in particular Heinrich stadials (HS) and Greenland interstadials (GI). The pollen records show an overall warming trend during the Pleistocene-Holocene transition, but the onset of post-glacial warming differs in timing among records. We identify rapid responses of the tropical vegetation to millennial-scale climate variability. The signatures of HS and the Younger Dryas are generally recorded as downslope upper forest line (UFL) migrations in our transect, and are likely linked to air temperature cooling. The GI1 signal is overall comparable between northern and southern records and indicates upslope UFL migrations and warming in the tropical Andes. Our marker for lake level changes indicated a north-to-south difference that could be related to moisture availability. The air temperature signature recorded by the Andean vegetation was consistent with millennial-scale cryosphere and sea surface temperature changes but suggests a potential difference between the magnitude of temperature change in the ocean and the atmosphere. We also show that arboreal pollen percentage (AP %) and detrended correspondence analysis (DCA) scores are two complementary approaches to extract environmental variability from pollen records

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)