Cardiopoietic cell therapy for advanced ischemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort

Selective growth of CdTe on patterned CdTe/Si(211)

The authors have studied selective growth of cadmium telluride on Si(211) by molecular beam epitaxy (MBE). Patterned substrates were produced by optical lithography of MBE-grown CdTe/As/Si(211). Photoemission microscopy was used as the main tool to study selective growth. This is very powerful because Si or SiO2 can be very easily distinguished from areas covered with even small amounts of CdTe due to contrast from work function differences. It was found that CdTe grows on CdTe without sticking on bare Si areas if the temperature is sufficiently high. Based on the analysis of the temperature dependence of the growth rate of CdTe, we suggest that different physisorption energies on Si and CdTe are the main cause of this selective growth. (C) 2008 American Vacuum Society

Strain reduction in selectively grown CdTe by MBE on nanopatterned silicon on insulator (SOI) substrates

Silicon-based substrates for the epitaxy of HgCdTe are an attractive low-cost choice for monolithic integration of infrared detectors with mature Si technology and high yield. However, progress in heteroepitaxy of CdTe/Si (for subsequent growth of HgCdTe) is limited by the high lattice and thermal mismatch, which creates strain at the heterointerface that results in a high density of dislocations. Previously we have reported on theoretical modeling of strain partitioning between CdTe and Si on nanopatterned silicon on insulator (SOI) substrates. In this paper, we present an experimental study of CdTe epitaxy on nanopatterned (SOI). SOI (100) substrates were patterned with interferometric lithography and reactive ion etching to form a two-dimensional array of silicon pillars with similar to 250 nm diameter and 1 mu m pitch. MBE was used to grow CdTe selectively on the silicon nanopillars. Selective growth of CdTe was confirmed by scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). Coalescence of CdTe on the silicon nanoislands has been observed from the SEM characterization. Selective growth was achieved with a two-step growth process involving desorption of the nucleation layer followed by regrowth of CdTe at a rate of 0.2 angstrom s(-1). Strain measurements by Raman spectroscopy show a comparable Raman shift (2.7 +/- 2 cm(-1) from the bulk value of 170 cm(-1)) in CdTe grown on nanopatterned SOI and planar silicon (Raman shift of 4.4 +/- 2 cm(-1)), indicating similar strain on the nanopatterned substrates

Incidence, determinants, and prognostic impact of operative refusal or denial in octogenarians with severe aortic stenosis

BACKGROUND: Aortic stenosis (AS) is a common valve disease in octogenarians. Previous studies have shown that aortic valve replacement (AVR) is frequently not performed in these patients. This study investigated the incidence, determinants, and prognostic impact of AVR refusal or denial in these patients. METHODS: Between 2000 and 2007, 163 octogenarians (mean age, 84 ± 3 years) with severe AS and an indication for operation according to guidelines were prospectively included in an echocardiographic registry. Among these, 97 underwent AVR, and 66 were treated conservatively. RESULTS: Logistic regression analysis identified older age, a lower transaortic pressure gradient, a larger aortic valve area, and the presence of diabetes as independent predictors of AVR refusal or denial. Patients who underwent AVR had a 30-day mortality of 9%. Overall 5-year survival was 66% in AVR patients vs 31% in those treated conservatively (log rank p < 0.001 vs AVR). After adjustment for the propensity score, patients undergoing AVR still had a better outcome than conservatively treated patients (hazard ratio, 0.56; 95% confidence interval, 0.29 to 0.91; p = 0.022). In addition to the therapeutic decision, Cox regression analysis also identified low body weight, New York Heart Association class III/IV, and the logistic European System for Cardiac Operative Risk Evaluation as independent predictors of outcome in the overall series. CONCLUSIONS: About 40% of octogenarians with severe AS and a definite indication for operation either refuse or are denied AVR. AVR refusal or denial has a profound impact on long-term prognosis, resulting in a twofold excess mortality, even after adjustment for the propensity score. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved

Cardioprotection Using Strain-Guided Management of Potentially Cardiotoxic Cancer Therapy: 3-Year Results of the SUCCOUR Trial

Background: Global longitudinal strain (GLS) can predict cancer therapeutics–related cardiac dysfunction and guide initiation of cardioprotection (CPT). Objectives: In this study, the authors sought to determine whether echocardiography GLS-guided CPT provides less cardiac dysfunction in survivors of potentially cardiotoxic chemotherapy, compared with usual care at 3 years. Methods: In this international multicenter prospective randomized controlled trial, patients were enrolled from 28 international sites. All patients treated with anthracyclines with another risk factor for heart failure were randomly allocated to GLS-guided (>12% relative reduction in GLS) or ejection fraction (EF)–guided (>10% absolute reduction of EF to <55%) CPT. The primary end point was the change in 3-dimensional (3D) EF (DEF) from baseline to 3 years. Results: Among 331 patients enrolled, 255 (77%, age 54 12 years, 95% women) completed 3-year follow-up (123 in the EF-guided group and 132 in the GLS-guided group). Most had breast cancer (n ¼ 236; 93%), and anthracycline followed by trastuzumab was the most common chemotherapy regimen (84%). Although 67 (26%) had hypertension and 32 (13%) had diabetes mellitus, left ventricular function was normal at baseline (EF: 59% 6%, GLS: 20.7% 2.3%). CPT was administered in 18 patients (14.6%) in the EF-guided group and 41 (31%) in the GLS-guided group (P ¼ 0.03). Most patients showed recovery in EF and GLS after chemotherapy; 3-year DEF was 0.03% 7.9% in the EF-guided group and 0.02% 6.5% in the GLS-guided (P ¼ 0.99) group; respective 3-year EFs were 58% 6% and 59% 5% (P ¼ 0.06). At 3 years, 17 patients (5%) had cancer therapeutics–related cardiac dysfunction (11 in the EFguided group and 6 in the GLS guided group; P ¼ 0.16); 1 patient in each group was admitted for heart failure. Conclusions: Among patients taking potentially cardiotoxic chemotherapy for cancer, the 3-year data showed improvement of LV dysfunction compared with 1 year, with no difference in DEF between GLS- and EF-guided CPT.Tomoko Negishi ... Mitra Shirazi ... et al