Effectiveness of 99mTc-tetrofosmin for assessment of heart functions in micropigs

This study examined the suitability of a nuclear imaging technique using 99mTc-tetrofosmin as an agent to assess the heart functions of healthy micropigs. The mean age of the pigs was 360 days (male), and the mean body weight was 35.3 kg ranging from 34.5-36 kg. There were no significant perfusion defects in any of the reconstructed images. Gated single-photon emission computed tomography imaging can be used to calculate the ventricular volume and ejection fraction (EF). In this case, an EF of 79% was calculated from the ventricular volume of the end-systolic image (10 ml) subtracted from that of the end-diastolic volume (49 ml). A perfusion defect (particularly the apex, lateral wall) is unlikely because of the presence of a preserved wall motion in a segment with a defect. It is concluded that quantitative cardiac scintigraphy, using 99mTc-tetrofosmin is an adequate technique for estimating the heart functions of healthy micropigs

The Heart Failure Overweight/Obesity Survival Paradox : The Missing Sex Link

Objectives: This study sought to determine whether body mass index (BMI) has a differential impact on survival for females versus males with advanced systolic heart failure (HF). Background: Females have a survival advantage in HF, the mechanisms of which are unclear. There is also a proposed “obesity survival paradox” in which excess adiposity promotes HF survival. Methods: We reviewed 3,811 patients with left ventricular ejection fraction ≤40% who had undergone cardiopulmonary exercise testing between 1995 and 2011. The endpoint was all-cause mortality. Multivariable analysis was performed using a Cox proportional hazards model. Because of the nonlinearity of BMI, a restricted cubic spline was used. An interaction term was added to investigate the impact of BMI on mortality by sex. Results: The unadjusted data demonstrated an overall obesity survival paradox in HF. This survival paradox disappeared for males after adjustment for potential confounders, with overweight and obese males showing higher adjusted mortality hazard ratios compared with normal weight males. Conversely, females in the overweight BMI range (25.0 to 29.9 kg/m2) had the lowest adjusted mortality (hazard ratio: 0.84; 95% confidence interval: 0.77 to 0.93; p = 0.0005 compared with normal weight females) with a nadir in mortality hazard just below BMI 30 kg/m2. The multivariable model supported a differential impact of BMI on mortality in males versus females (p for interaction \u3c0.0001). Conclusions: In this advanced HF cohort, an unadjusted obesity survival paradox disappeared after adjustment for confounders. Overweight and obese males had higher adjusted mortality than normal weight males, whereas a BMI in the overweight range was associated with a significant survival benefit in females