Articles de revues : « Cardiac RM »

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Ryan, Paul, Caitriona McGrath, Iain Lawrie, Caoimhe Fitzsimons, Jack O’Shea et Aoife De BrÚn. « Enhancing efficiency in a cardiac investigations department by increasing remote patient monitoring ». International Journal for Quality in Health Care 31, Supplement_1 (décembre 2019) : 29–34. http://dx.doi.org/10.1093/intqhc/mzz065.

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Abstract Objective Remote monitoring (RM) of patients with cardiac rhythm management devices enables healthcare teams to effectively and efficiently monitor patients with heart problems without the requirement in-person patient visits. RM has been associated with safer and higher quality care but was not being used to its full potential in this setting. Cardiac rhythm management had observed an average implant rate of 295 devices per year over the past 13 years, resulting in a five-fold growth in patient follow-up in clinics. This increased demand was becoming unmanageable, with impacts on care quality. This study aimed to enhance the enrolment of eligible patients to RM. Design A pre-post design. Setting A 600-bed city centre teaching hospital in Dublin, Ireland. Participants Hospital staff and patients eligible for RM. Interventions Lean Six Sigma methods were used to develop patient education materials on RM and the clinic area was redesigned to enable RM enrolment and monitoring. Main outcomes measures Number of unscheduled attendances to clinic and RM enrolment. Results At baseline, the clinic was processing 102 RM follow-up checks with 140 unscheduled attendances on average per month. Following implementation, RM enrolment increased to 335 RM follow-up checks (194% increase), with 41 unscheduled attendances on average per month (70% decrease). These results were sustained one-year post-implementation. Conclusions These process changes have streamlined workflow by reducing the number of unscheduled attendances to clinic and increased the use of RM among the eligible patient population. This has meant safer, more timely responses to cardiac events and enhanced care quality.

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Ahn, Jeonghoon, Kim Eung Ju, Justin Yoo, Irene Colangelo, Loredana Morichelli et Renato Pietro Ricci. « OP64 Economic Impact Of Cardiac Device Remote Monitoring In South Korea ». International Journal of Technology Assessment in Health Care 33, S1 (2017) : 28. http://dx.doi.org/10.1017/s0266462317001477.

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INTRODUCTION:The reduction of healthcare costs and societal cost due to remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been demonstrated in several countries; however, to the best of our knowledge it does not exist for South Korea. This work aims at providing an estimation of the potential benefit of RM versus standard care (SC) of CIEDs in term of healthcare costs in South Korea, in order to provide additional substance to the currently ongoing societal debate about the value of telemedicine.METHODS:Healthcare resource consumption was taken from the results of the TARIFF study, a prospective, non-randomized, multicenter clinical trial designed in Italy to assess the economic benefits of RM follow-up in comparison with standard follow-up in 209 patients (107 SC, 102 RM). The main results demonstrated that RM reduced healthcare resource consumption by 54 percent from a healthcare services perspective (SC: EUR1,044.89±1,990.47 versus RM: EUR482.87±2488.10, p<.0001 (1).In order to perform a cost analysis from the perspective of the South Korean healthcare payer, the following unit costs were assigned to resources collected in TARIFF (hospitalizations, visits, examinations): fee-for-service tariffs, emergency tariffs and outpatient tariffs. Remote follow-up costs were considered as zero.RESULTS:From the perspective of the South Korean healthcare payer, the overall mean annual cost/patient in the RM group is 53 percent lower than in SC group (SC: EUR405,439±40,135 versus RM: EUR189,96±725,52, p<.0001) (SC: KRW 497,145±49,2137 versus RM: KRW 232,936±890,181, p<.0001). This is mainly due to a significant cost reduction in device-related hospitalizations, examination tests and visits in the follow-up period.CONCLUSIONS:RM of CIED patients is cost-saving from the perspective of the South Korean healthcare system. Introducing appropriate reimbursement for remote monitoring of CIED is not likely to change this result and should make RM sustainable for the provider and encourage widespread adoption of RM.

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Ricci, Renato Pietro, Loredana Morichelli et Niraj Varma. « Remote Monitoring for Follow-up of Patients with Cardiac Implantable Electronic Devices ». Arrhythmia & ; Electrophysiology Review 3, n^o 2 (2014) : 123. http://dx.doi.org/10.15420/aer.2014.3.2.123.

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Follow-up of patients with cardiac implantable electronic devices is challenging due to the increasing number and technical complexity of devices coupled to increasing clinical complexity of patients. Remote monitoring (RM) offers the opportunity to optimise clinic workflow and to improve device monitoring and patient management. Several randomised clinical trials and registries have demonstrated that RM may reduce number of hospital visits, time required for patient follow-up, physician and nurse time, hospital and social costs. Furthermore, patient retention and adherence to follow-up schedule are significantly improved by RM. Continuous wireless monitoring of data stored in the device memory with automatic alerts allows early detection of device malfunctions and of events requiring clinical reaction, such as atrial fibrillation, ventricular arrhythmias and heart failure. Early reaction may improve patient outcome. RM is easy to use and patients showed a high level of acceptance and satisfaction. Implementing RM in daily practice may require changes in clinic workflow. To this purpose, new organisational models have been introduced. In spite of a favourable cost:benefit ratio, RM reimbursement still represents an issue in several European countries.

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Pluta, Sławomir, Ewa Piotrowicz, Ryszard Piotrowicz, Ewa Lewicka, Wojciech Zaręba, Monika Kozieł, Ilona Kowalik et al. « Remote Monitoring of Cardiac Implantable Electronic Devices in Patients Undergoing Hybrid Comprehensive Telerehabilitation in Comparison to the Usual Care. Subanalysis from Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomised Clinical Trial ». Journal of Clinical Medicine 9, n^o 11 (20 novembre 2020) : 3729. http://dx.doi.org/10.3390/jcm9113729.

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Background: The impact of cardiac rehabilitation on the number of alerts in patients with remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is unknown. We compared alerts in RM and outcomes in patients with CIEDs undergoing hybrid comprehensive telerehabilitation (HCTR) versus usual care (UC). Methods: Patients with heart failure (HF) after a hospitalization due to worsening HF within the last 6 months (New York Heart Association (NYHA) class I-III and left ventricular ejection fraction (LVEF) ≤40%) were enrolled in the TELEREH-HF study and randomised 1:1 to HCTR or UC. Patients with HCTR and CIEDs received RM (HCTR-RM). Patients with UC and CIEDs were offered RM optionally (UC-RM). Data from the initial 9 weeks of the study were analysed. Results: Of 850 enrolled patients, 208 were in the HCTR-RM group and 62 in the UC-RM group. The HCTR-RM group was less likely to have alerts of intrathoracic impedance (TI) decrease (p < 0.001), atrial fibrillation (AF) occurrence (p = 0.031) and lower mean number of alerts per patient associated with TI decrease (p < 0.0001) and AF (p = 0.019) than the UC-RM group. HCTR significantly decreased the occurrence of alerts in RM of CIEDs, 0.360 (95%CI, 0.189–0.686; p = 0.002), in multivariable regression analysis. There were two deaths in the HCTR-RM group (0.96%) and no deaths in the UC-RM group (p = 1.0). There were no differences in the number of hospitalised patients between the HCTR-RM and UC-RM group (p = 1.0). Conclusions: HCTR significantly reduced the number of patients with RM alerts of CIEDs related to TI decrease and AF occurrence. There were no differences in mortality or hospitalisation rates between HCTR-RM and UC-RM groups.

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McGee, Michael J., Max Ray, Stepehn C. Brienesse, Shanathan Sritharan, Andrew J. Boyle, Nicholas Jackson, James W. Leitch et Aaron L. Sverdlov. « Remote monitoring in patients with heart failure with cardiac implantable electronic devices : a systematic review and meta-analysis ». Open Heart 9, n^o 2 (novembre 2022) : e002096. http://dx.doi.org/10.1136/openhrt-2022-002096.

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BackgroundRemote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is now the standard of care, but whether the demonstrated benefits of RM translate into improvements in heart failure (HF) management is controversial. This systematic review addresses the role of RM in patients with HF with a CIED.Methods and resultsA systematic search of the literature for randomised clinical trials in patients with HF and a CIED assessing efficacy/effectiveness of RM was performed using MEDLINE, PubMed and Embase. Meta-analysis was performed on the effects of RM of CIEDs in patients with HF on mortality and readmissions. Effects on implantable cardiac defibrillator (ICD) therapy, healthcare costs and clinic presentations were also assessed.607 articles were identified and refined to 10 studies with a total of 6579 patients. Implementation of RM was not uniform with substantial variation in methodology across the studies. There was no reduction in mortality or hospital readmission rates, while ICD therapy findings were inconsistent. There was a reduction in patient-associated healthcare costs and reduction in healthcare presentations.ConclusionRM for patients with CIEDs and HF was not uniformly performed. As currently implemented, RM does not provide a benefit on overall mortality or the key metric of HF readmission. It does provide a reduction in healthcare costs and healthcare presentations.PROSPERO REGISTRATION NUMBERCRD42019129270.

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Kumar, Sharath, Jason Davis, Bernard Thibault, Iqwal Mangat, Benoit Coutu, Matthew Bennett, Francois Philippon et al. « Canadian Registry of Electronic Device Outcomes : remote monitoring outcomes in the Abbott battery performance alert—a multicentre cohort ». EP Europace 23, n^o 8 (20 février 2021) : 1319–23. http://dx.doi.org/10.1093/europace/euab025.

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Abstract Aims Cardiac implantable electronic devices with device advisories have the potential of device malfunction. Remote monitoring (RM) of devices has been suggested to allow the identification of abnormal device performance and permit early intervention. We sought to describe the outcomes of patients with and without RM in devices subject to the Abbott Premature Battery Depletion (PBD) advisory with data from a Canadian registry. Methods and results Patients with an Abbott device subject to the PBD advisory from nine implantable cardioverter defibrillator (ICD) implanting centres in Canada were included in the registry. The use of RM was identified from baseline and follow-up data in the registry. The primary outcome was detection of PBD and all-cause mortality. A total of 2666 patients were identified with a device subject to the advisory. In all, 1687 patients (63.2%) had RM at baseline. There were 487 deaths during follow-up. At a mean follow-up of 5.7 ± 0.7 years, mortality was higher in those without a remote monitor compared with RM at baseline (24.7% vs. 14.5%; P < 0.001). Pre-mature battery depletion was identified in 36 patients (2.1%) with RM vs. 7 (0.7%) without RM (P = 0.004). Time to battery replacement was significantly reduced in patients on RM (median 5 vs. 13 days, P = 0.001). Conclusion The use of RM in patients with ICD and cardiac resynchronization therapy under advisory improved detection of PBD, time to device replacement, and was associated with a reduction in all-cause mortality. The factors influencing the association with mortality are unknown and deserve further study.

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Maines, Massimiliano, Pietro Palmisano, Maurizio Del Greco, Donato Melissano, Silvana De Bonis, Stella Baccillieri, Gabriele Zanotto et al. « Impact of COVID-19 Pandemic on Remote Monitoring of Cardiac Implantable Electronic Devices in Italy : Results of a Survey Promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing) ». Journal of Clinical Medicine 10, n^o 18 (10 septembre 2021) : 4086. http://dx.doi.org/10.3390/jcm10184086.

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The COVID-19 pandemic has had a profound impact on the organisation of health care in Italy, with an acceleration in the development of telemedicine. To assess the impact of the COVID-19 pandemic on the spread of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) in Italy, a survey addressed to cardiologists operating in all Italian CIED-implanting centres was launched. A total of 127 cardiologists from 116 Italian arrhythmia centres took part in the survey, 41.0% of all 283 CIED-implanting centres operating in Italy in 2019. All participating centres declared to use RM of CIEDs. COVID-19 pandemic resulted in an increase in the use of RM in 83 (71.6%) participating centres. In a temporal perspective, an increase in the median number of patients per centre followed up by RM was found from 2012 to 2017, followed by an exponential increase from 2017 to 2020. In 36 participating centres (31.0%) a telehealth visits service was activated as a replacement for in-person outpatient visits (in patients with or without CIED) during the COVID-19 pandemic. COVID-19 pandemic has caused an acceleration in the use of RM of CIEDs and in the use of telemedicine in the clinical practice of cardiology.

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Giannola, Gabriele, Riccardo Torcivia, Riccardo Airò Farulla et Tommaso Cipolla. « Outsourcing the Remote Management of Cardiac Implantable Electronic Devices : Medical Care Quality Improvement Project ». JMIR Cardio 3, n^o 2 (17 décembre 2019) : e9815. http://dx.doi.org/10.2196/cardio.9815.

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Background Remote management is partially replacing routine follow-up in patients implanted with cardiac implantable electronic devices (CIEDs). Although it reduces clinical staff time compared with standard in-office follow-up, a new definition of roles and responsibilities may be needed to review remote transmissions in an effective, efficient, and timely manner. Whether remote triage may be outsourced to an external remote monitoring center (ERMC) is still unclear. Objective The aim of this health care quality improvement project was to evaluate the feasibility of outsourcing remote triage to an ERMC to improve patient care and health care resource utilization. Methods Patients (N=153) with implanted CIEDs were followed up for 8 months. An ERMC composed of nurses and physicians reviewed remote transmissions daily following a specific remote monitoring (RM) protocol. A 6-month benchmarking phase where patients’ transmissions were managed directly by hospital staff was evaluated as a term of comparison. Results A total of 654 transmissions were recorded in the RM system and managed by the ERMC team within 2 working days, showing a significant time reduction compared with standard RM management (100% vs 11%, respectively, within 2 days; P<.001). A total of 84.3% (551/654) of the transmissions did not include a prioritized event and did not require escalation to the hospital clinician. High priority was assigned to 2.3% (15/654) of transmissions, which were communicated to the hospital team by email within 1 working day. Nonurgent device status events occurred in 88 cases and were communicated to the hospital within 2 working days. Of these, 11% (10/88) were followed by a hospitalization. Conclusions The outsourcing of RM management to an ERMC safely provides efficacy and efficiency gains in patients’ care compared with a standard in-hospital management. Moreover, the externalization of RM management could be a key tool for saving dedicated staff and facility time with possible positive economic impact. Trial Registration ClinicalTrials.gov NCT01007474; http://clinicaltrials.gov/ct2/show/NCT01007474

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Khalikova, M. A., D. A. Tsaregorodtsev, M. M. Beraya, A. V. Sedov et S. S. Vasyukov. « Advantages of using a portable cardiac monitor in outpatients with paroxysmal atrial fibrillation ». Cardiovascular Therapy and Prevention 21, n^o 6 (7 juillet 2022) : 3225. http://dx.doi.org/10.15829/1728-8800-2022-3225.

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Aim. To study the advantages of using a portable electrocardiographic (ECG) monitor in outpatients with paroxysmal atrial fibrillation (AF).Material and methods. We examined 88 patients (26 men, 62 women, mean age, 63 [57;68] years) with paroxysmal AF with an average frequency of arrhythmia episodes of 1,0 [0.3;3.75] per month. Forty three (49%) patients were included in the remote monitoring (RM) group using the ECG Dongle monitor, and 45 (51%) patients were included in the conventional monitoring (CM) group. Patients underwent scheduled examinations 2, 6 and 12 months after the start of therapy. Unscheduled consultations were carried out in case of AF recurrence. Patients from the RM group, using portable cardiac monitor, additionally self-registered ECG 1 time per week and in case of symptoms suggestive of AF. ECG strips were sent to the clinical investigator for analysis.Results. With the help of portable cardiac monitor, 2477 ECG strips were collected and analyzed: 2159 (87,2%) — sinus rhythm, 318 (12,8%) — AF and atypical atrial flutter. Forty four episodes of AF in 3 patients were asymptomatic. In addition, 211 (8,5%) sinus rhythm ECG strips were recorded by 13 patients with symptoms suggestive of AF. In the RM group, 7 (16%) patients were hospitalized due to recurrent AF, while in the CM group, 20 (44%) patients (p=0,004). The total number of emergency hospitalizations was 8 and 29 in the RM and CM groups, respectively. The number of patients who called an ambulance was significantly lower in the RM group: in the CM group, 37 calls for an ambulance were made by 22 patients, while in the RM group — 12 patients made 15 calls (p=0,044). The proportion of calls followed by hospitalization (40 vs 70%, p=0,043) was significantly lower in the RM group.Conclusion. Remote ECG monitoring using the ECG Dongle system is a useful way to monitor patients with paroxysmal AF, which make it possible to register asymptomatic AF episodes, differentiate the causes of palpitations, and significantly reduce the frequency of emergency calls and hospitalizations.

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Ruzycki, Shannon Marie, et Michael Prystajecky. « Point-Counterpoint : Perioperative Cardiac Biomarkers ». Canadian Journal of General Internal Medicine 14, n^o 4 (19 novembre 2019) : e14-e22. http://dx.doi.org/10.22374/cjgim.v14i4.347.

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In the following review article, we present arguments for and against the use of postoperative troponin surveillance and preoperative natriuretic peptide testing. This article covers the evidence that informed the CCS 2016 perioperative guidelines and research published since then. This review is based on the debate held at the Canadian Society of Internal Medicine/American College of Physicians Rocky Mountain Chapter Annual Meeting (CSIM/ACP RM) held in October 2018 in Banff, Alberta. Resume Dans l'article de synthèse qui suit, nous présentons des arguments pour et contre l'utilisation de la surveillance postopératoire de la troponine et des tests préopératoires de peptides natriurétiques. Cet article porte sur les données probantes qui ont éclairé les lignes directrices périopératoires de la SCC 2016 et les recherches publiées depuis lors. Cet examen est fondé sur le débat qui a eu lieu à l'assemblée annuelle de la section des Rocheuses de la Société canadienne de médecine interne et de l'American College of Physicians (CSIM/ACP RM) tenue en octobre 2018 à Banff, en Alberta.

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Zoppo, Franco, Antonio Lupo, Giacomo Mugnai et Francesca Zerbo. « Cardiac implantable electronic device remote monitoring in a large cohort of patients and the need for planning ». Future Cardiology 16, n^o 5 (septembre 2020) : 447–56. http://dx.doi.org/10.2217/fca-2019-0039.

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Aim: The remote monitoring (RM) of cardiac implantable electronic devices (CIED) is standard of care. We describe an organizational and projection RM workload model. Methods: At the time of the analysis (2015), 3995 CIED patients were followed-up; 1582 (40.5%) with RM. All RM transmissions (Tx) have been gathered in five event types. Results: We received 10,406 Tx, classified as: 128 (1.2%) red alerts, 141 (1.3%) atrial fibrillation episodes, 1944 (18.6%) yellow alerts, 403 (3.9%) lost Tx (disconnected/noncompliant patients) and 7790 (75.0%) Tx ‘OK' (un-eventful Tx). At the time of 100% of remote CIED managed, we can expect a total of 25,990 Tx/year. Conclusion: We provide a descriptive analysis of remote monitoring management and workload estimation in a large cohort of CIED patients.

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Nichols, E. H., et S. Mittal. « RM of Implantable Cardiac Devices is Associated with Improved Survival ». MD Conference Express 14, n^o 9 (1 juillet 2014) : 16–17. http://dx.doi.org/10.1177/155989771409007.

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Swami, Vimarsha, et Lorraine E. Chalifour. « Bisphenol A impacts cardiomyocyte differentiation in vitro by modulating cardiac protein expression ». McGill Science Undergraduate Research Journal 5, n^o 1 (31 mars 2010) : 42–48. http://dx.doi.org/10.26443/msurj.v5i1.83.

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introduction: Bisphenol A (BPA) is an environmental toxin commonly found in plastics and is able to mimic the actions of endogenous steroid hormones. BPA binds and activates intracellular estrogen receptors (eRα and eRβ) and estrogen related receptor γ (eRRγ), all of which are present in cardiomyocytes. however, it is unclear how BPA impacts the heart. We hypothesized that BPA modulates the expression of proteins regulating cardiac structure, energy and calcium homeostasis during cardiomyocyte differentiation in vitro. Methods: We differentiated h9C2 cells into cardiomyocytes in hormone-replete (Rm) or hormone-depleted (hD) media. We co-treated the cells with graded amounts of Bpa and pure anti-estrogen ICI 182,780, which blocks eRα and eRβ activity. Immunoblotting measured the expression of the structural protein β-myosin heavy chain (βmhC), calcium homeostasis protein sarcoendoplasmic reticulum calcium aTpase (seRCa2a), and the cardiac energy-producing protein creatine kinase (CK). results: expression of these proteins was hormone-dependent during cardiomyocyte differentiation, with expression highest in Rm media after 72 or 96 hours of differentiation. adding 10-8 m BPA to hD media increased cardiac structural (βmhC), energy (CK), and calcium homeostasis (seRCa2a) protein expression. Conversely, 10-7 m BPA added to Rm media decreased protein expression. Co-treatment with ICI 182,780 reduced Bpa-mediated induction of seRCa2a and CK expression in hD media. discussion: BPA modulates cardiac structure, calcium and energy homeostasis protein expression during cardiomyocyte differention in vitro. moreover, the data suggest that BPA mediates these changes in protein expression through activation of cardiomyocyte eRα, eRβ, or eRRγ.

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Benvenuto, Simone, Gabriele Simonini, Sara Della Paolera, Sarah Abu-Rumeileh, Maria Vincenza Mastrolia, Alessandra Manerba, Daniela Chicco et al. « Ruolo della RM cardiaca nel follow-up a lungo termine della MIS-C ». Medico e Bambino Pagine elettroniche 25, n^o 5 (31 mai 2022) : 110–11. http://dx.doi.org/10.53126/mebxxvmg110.

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In this retrospective multicentre study based on cardiac MR, the cardiological outcome of MIS-C patients does appear favourable regardless of severity of the cardiac involvement during the acute phase.

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Leary, S. C., C. N. Lyons, A. G. Rosenberger, J. S. Ballantyne, J. Stillman et C. D. Moyes. « Fiber-type differences in muscle mitochondrial profiles ». American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 285, n^o 4 (octobre 2003) : R817—R826. http://dx.doi.org/10.1152/ajpregu.00058.2003.

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Although striated muscles differ in mitochondrial content, the extent of fiber-type specific mitochondrial specializations is not well known. To address this issue, we compared mitochondrial structural and functional properties in red muscle (RM), white muscle (WM), and cardiac muscle of rainbow trout. Overall preservation of the basic relationships between oxidative phosphorylation complexes among fiber types was confirmed by kinetic analyses, immunoblotting of native holoproteins, and spectroscopic measurements of cytochrome content. Fiber-type differences in mitochondrial properties were apparent when parameters were expressed per milligram mitochondrial protein. However, the differences diminished when expressed relative to cytochrome oxidase (COX), possibly a more meaningful denominator than mitochondrial protein. Expressed relative to COX, there were no differences in oxidative phosphorylation enzyme activities, pyruvate-based respiratory rates, H2O2 production, or state 4 proton leak respiration. These data suggest most mitochondrial qualitative properties are conserved across fiber types. However, there remained modest differences (∼50%) in stoichiometries of selected enzymes of the Krebs cycle, β-oxidation, and antioxidant enzymes. There were clear differences in membrane fluidity (RM > cardiac, WM) and proton conductance (H+/min/mV/U COX: WM > RM > cardiac). The pronounced differences in mitochondrial content between fiber types could be attributed to a combination of differences in myonuclear domain and modest effects on the expression of nuclear- and mitochondrially encoded respiratory genes. Collectively, these studies suggest constitutive pathways that transcend fiber types are primarily responsible for determining most quantitative and qualitative properties of mitochondria.

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Jadhav, Ashok, et Joseph Fomusi Ndisang. « Heme Arginate Suppresses Cardiac Lesions and Hypertrophy in Deoxycorticosterone Acetate-Salt Hypertension ». Experimental Biology and Medicine 234, n^o 7 (juillet 2009) : 764–78. http://dx.doi.org/10.3181/0810-rm-302.

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Schwab, Joerg O., Herbert Nägele, Hanno Oswald, Gunnar Klein, Oliver Gunkel, Andreas Lang, Wolfgang R. Bauer, Paul Korb et Tino Hauser. « Clinical Course of Dual-Chamber Implantable Cardioverter-Defibrillator Recipients followed by Cardiac Remote Monitoring : Insights from the LION Registry ». BioMed Research International 2018 (4 novembre 2018) : 1–8. http://dx.doi.org/10.1155/2018/3120480.

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Patients receiving dual-chamber implantable cardioverter-defibrillator (DR-ICD) therapy are at risk of developing atrial arrhythmia because of the increased rate of ventricular pacing and the progression of heart failure. Remote monitoring (RM) may identify the patients at highest risk of adverse events such as atrial arrhythmias. A total of 283 patients with 91,632 remote transmissions during a 15-month follow-up (FU) period enrolled in the LION registry were analysed. The parameters retrieved included the pacing mode, lower rate limit, percentage of atrial (%AP) and ventricular pacing (%VP), and percentage of atrial arrhythmia burden (%AB). In 92.7% of patients, the devices were initially programmed in DDD(R) or DDI(R), with changes of the pacing mode in 19.3% only. The lower rate limit remained stable in 80.4% of patients. At the first transmission, 8.7% of patients suffered from RM-detected atrial arrhythmia, which reached 36% during FU. The %AP was not associated with increased AB (p = 0.67), but the %VP was different in patients developing RM-detected atrial arrhythmia (26.9% vs. 13.7%, p < 0.00001). The %VP increased in 105 patients (significance level of α = 0.05), and 11 patients crossed the border of 50% VP. The LION substudy supports the concept of using RM in a real-world DR-ICD population. Remote monitoring of DR-ICDs allows for the quantification of the course of the pacing parameters and AB. Based on these observations, device parameters can be adjusted and optimized.

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Feigl, Eric O. « Berne's adenosine hypothesis of coronary blood flow control ». American Journal of Physiology-Heart and Circulatory Physiology 287, n^o 5 (novembre 2004) : H1891—H1894. http://dx.doi.org/10.1152/classicessays.00003.2004.

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This essay looks at the historical significance of an APS classic paper that is freely available online: Berne RM. Cardiac nucleotides in hypoxia: possible role in regulation of coronary blood flow. Am J Physiol 204: 317–322, 1963 ( http://ajplegacy.physiology.org/cgi/reprint/204/2/317 ).

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Russo, Vincenzo, Antonio Rapacciuolo, Pia Clara Pafundi, Marcello de Divitiis, Mario Volpicelli, Antonio Ruocco, Anna Rago et al. « Cardiac implantable electronic devices replacements in patients followed by remote monitoring during COVID-19 lockdown ». European Heart Journal - Digital Health 2, n^o 1 (11 janvier 2021) : 171–74. http://dx.doi.org/10.1093/ehjdh/ztaa018.

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Abstract Aims Following coronavirus disease (COVID-19) outbreak, the Italian government adopted strict rules of lockdown and social distancing. The aim of our study was to assess the admission rate for cardiac implantable electronic devices (CIEDs) replacement procedures in Campania, the 3rd-most-populous region of Italy, during COVID-19 lockdown. Methods and results Data were sourced from 16 referral hospitals in Campania from 10 March to 4 May 2020 (lockdown period) and during the same period in 2019. We retrospectively evaluated consecutive patients hospitalized for CIEDs replacement procedures during the two observational periods. The number and type of CIEDs replacement procedures among patients followed by remote monitoring (RM), the admission rate, and the type of hospital admission between the two observational periods were compared. In total, 270 consecutive patients were hospitalized for CIEDs replacement procedures over the two observation periods. Overall CIEDs replacement procedures showed a reduction rate of 41.2% during COVID-19 lockdown. Patients were equally distributed for sex (P = 0.581), and both age [median 76 years (IQR: 68–83) vs. 79 years (IQR: 68–83); P = 0.497]. Cardiac implantable electronic devices replacement procedures in patients followed by RM significantly increased (IR: +211%; P < 0.001), mainly driven by the remarkable increase rate trend of both PM (IR: +475%; P < 0.001) and implantable cardiac defibrillator replacement procedures (IR: +67%, P = 0.01), during COVID-19 lockdown compared with 2019 timeframe. Conclusions We showed a significant increase trend rate of replacement procedures among CIEDs patients followed by RM, suggesting the hypothesis of its increased use to closely monitoring and to optimize the hospital admission time during COVID-19 lockdown.

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Kumar, Srinivasan Dinesh, Sook-Kwin Yong, S. Thameem Dheen, Boon-Huat Bay et Samuel Sam-Wah Tay. « Cardiac Malformations Are Associated with Altered Expression of Vascular Endothelial Growth Factor and Endothelial Nitric Oxide Synthase Genes in Embryos of Diabetic Mice ». Experimental Biology and Medicine 233, n^o 11 (novembre 2008) : 1421–32. http://dx.doi.org/10.3181/0806-rm-186.

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The aim of this study was to investigate the role of nitric oxide (NO), and the expression of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) genes in developing hearts at embryonic day 13.5 of embryos from diabetic mice. The protein and mRNA expression levels of eNOS and VEGF were significantly altered in the developing hearts of embryos from diabetic mice. The NO level was significantly decreased, whereas the VEGF concentration was significantly increased in the developing hearts of the embryos from diabetic mice. In vitro study showed a significant reduction in eNOS expression and cell proliferation in cardiac myoblast cells exposed to high glucose concentrations. Further, high glucose induced apoptosis in myoblast cells. Ultrastructural changes characteristics of apoptosis, including cell blebbing, aggregation of ribosomes and vacuoles in the cytoplasm were also evident in myoblast cells exposed to high glucose. It is suggested that hyperglycemia alters the expression of eNOS and VEGF genes that are involved in the regulation of cell growth and vasculogenesis, thereby contributing to the cardiac malformations seen in embryos from diabetic mice.

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Bonamini, M., M. Gallucci, L. Simonetti, M. G. Alagia, O. Gagliardo, G. Cardone, G. B. Minio Paluello et M. Castrucci. « Idrocefalo normoteso : Valutazione comparativa tra studi di dinamica liquorale mediante TC e RM ». Rivista di Neuroradiologia 10, n^o 2_suppl (octobre 1997) : 196–98. http://dx.doi.org/10.1177/19714009970100s288.

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Aim of this study was to evaluate the sensitivity of MR dynamic Bolus Tracking technique versus CT-cysterno graphy in Normal Pressure Hydrocephalus (NPH). Seven patients (age 64–76 yrs), clinically suspected of NPH, were retrospectively evaluated. They had been submitted to CT-cysternography, MR dynamic Bolus Tracking technique in the acqueduct (cardiac-gated flow direction evaluation by means of 12–16 FFE T2*-w acquisitions per cardiac cycle, on sagittal plane along the acqueduct, with presaturation perpendicular to the acqueduct) and finally to surgical evaluation and subsequent ventriculo-peritoneal shunt. MR showed in all cases altered cerebrospinal fluid (CSF) dynamics: 5 patients showed CSF reflux in the third ventricle during all cardiac cycle, in 2 patients an increased ejection rate through the acqueduct and into the cisterna magna was found. CT-cysternography showed CSF dynamics alterations only in 4 cases. MR dynamic Bolus Tracking technique has proven to be more sensitive than CT-cysternography in the evaluation of NPH. Even though this study has to be considered preliminary, we believe that this simple and noninvasive technique should be recommended when NPH is suspected.

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Choi, Hyun Ju, Mi Ra Seon, Soon Sung Lim, Jong-Sang Kim, Hyang Sook Chun et Jung Han Yoon Park. « Hexane/Ethanol Extract ofGlycyrrhiza uralensisLicorice Suppresses Doxorubicin-Induced Apoptosis in H9c2 Rat Cardiac Myoblasts ». Experimental Biology and Medicine 233, n^o 12 (décembre 2008) : 1554–60. http://dx.doi.org/10.3181/0807-rm-221.

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Holcomb, Mark R., Marcella C. Woods, Ilija Uzelac, John P. Wikswo, Jonathan M. Gilligan et Veniamin Y. Sidorov. « The Potential of Dual Camera Systems for Multimodal Imaging of Cardiac Electrophysiology and Metabolism ». Experimental Biology and Medicine 234, n^o 11 (novembre 2009) : 1355–73. http://dx.doi.org/10.3181/0902-rm-47.

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Kambic, Tim, Nejc Šarabon, Vedran Hadžić et Mitja Lainscak. « High-Load and Low-Load Resistance Exercise in Patients with Coronary Artery Disease : Feasibility and Safety of a Randomized Controlled Clinical Trial ». Journal of Clinical Medicine 11, n^o 13 (21 juin 2022) : 3567. http://dx.doi.org/10.3390/jcm11133567.

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Resistance exercise (RE) remains underused in cardiac rehabilitation; therefore, there is insufficient evidence on safety, feasibility, and hemodynamic adaptations to high-load (HL) and low-load (LL) RE in patients with coronary artery disease (CAD). This study aimed to compare the safety, feasibility of HL-RE and LL-RE when combined with aerobic exercise (AE), and hemodynamic adaptations to HL and LL resistance exercise following the intervention. Seventy-nine patients with CAD were randomized either to HL-RE (70–80% of one-repetition maximum [1-RM]) and AE, LL-RE (35–40% of 1-RM) and AE or solely AE (50–80% of maximal power output) as a standard care, and 59 patients completed this study. We assessed safety and feasibility of HL-RE and LL-RE and we measured 1-RM on leg extension machine and hemodynamic response during HL- and LL-RE at baseline and post-training. The training intervention was safe, well tolerated, and completed without any adverse events. Adherence to RE protocols was excellent (100%). LL-RE was better tolerated than HL-RE, especially from the third to the final mesocycle of this study (Borgs’ 0–10 scale difference: 1–2 points; p = 0.001–0.048). Improvement in 1-RM was greater following HL-RE (+31%, p < 0.001) and LL-RE (+23%, p < 0.001) compared with AE. Participation in HL-RE and LL-RE resulted in a decreased rating of perceived exertion during post-training HL- and LL-RE, but in the absence of post-training hemodynamic adaptations. The implementation of HL-RE or LL-RE combined with AE was safe, well tolerated and can be applied in the early phase of cardiac rehabilitation for patients with stable CAD.

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Shi, Xiangrong, Frederick A. Schaller, Nancy Tierney, Patrick Chanthavong, Shande Chen, Peter B. Raven et Michael L. Smith. « Physically Active Lifestyle Enhances Vagal-Cardiac Function but Not Central Autonomic Neural Interaction in Elderly Humans ». Experimental Biology and Medicine 233, n^o 2 (février 2008) : 209–18. http://dx.doi.org/10.3181/0704-rm-106.

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Liang, Gui-You, Qing-Yong Cai, Yi-Ming Niu, Hong Zheng, Zhen-Yu Gao, Da-Xing Liu et Gang Xu. « Cardiac Glucose Uptake and Suppressed Expression/Translocation of Myocardium Glucose Transport-4 in Dogs Undergoing Ischemia-Reperfusion ». Experimental Biology and Medicine 233, n^o 9 (septembre 2008) : 1142–48. http://dx.doi.org/10.3181/0801-rm-33.

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Mason, Peggy, Keming Gao et Jonathan R. Genzen. « Serotonergic Raphe Magnus Cell Discharge Reflects Ongoing Autonomic and Respiratory Activities ». Journal of Neurophysiology 98, n^o 4 (octobre 2007) : 1919–27. http://dx.doi.org/10.1152/jn.00813.2007.

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Serotonergic cells are located in a restricted number of brain stem nuclei, send projections to virtually all parts of the CNS, and are critical to normal brain function. They discharge tonically at a rate modulated by the sleep–wake cycle and, in the case of medullary serotonergic cells in raphe magnus and the adjacent reticular formation (RM), are excited by cold challenge. Yet, beyond behavioral state and cold, endogenous factors that influence serotonergic cell discharge remain largely mysterious. The present study in the anesthetized rat investigated predictors of serotonergic RM cell discharge by testing whether cell discharge correlated to three rhythms observed in blood pressure recordings that averaged >30 min in length. A very slow frequency rhythm with a period of minutes, a respiratory rhythm, and a cardiac rhythm were derived from the blood pressure recording. Cross-correlations between each of the derived rhythms and cell activity revealed that the discharge of 38 of the 40 serotonergic cells studied was significantly correlated to the very slow and/or respiratory rhythms. Very few serotonergic cells discharged in relation to the cardiac cycle and those that did, did so weakly. The correlations between serotonergic cell discharge and the slow and respiratory rhythms cannot arise from baroreceptive input. Instead we hypothesize that they are by-products of ongoing adjustments to homeostatic functions that happen to alter blood pressure. Thus serotonergic RM cells integrate information about multiple homeostatic activities and challenges and can consequently modulate spinal processes according to the most pressing need of the organism.

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Borghi-Silva, Audrey, Cláudia Carrascosa, Cristino Carneiro Oliveira, Adriano C. Barroco, Danilo C. Berton, Debora Vilaça, Edgar B. Lira-Filho, Dirceu Ribeiro, Luiz Eduardo Nery et J. Alberto Neder. « Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure ». American Journal of Physiology-Heart and Circulatory Physiology 294, n^o 6 (juin 2008) : H2465—H2472. http://dx.doi.org/10.1152/ajpheart.91520.2007.

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Blood flow requirements of the respiratory muscles (RM) increase markedly during exercise in chronic heart failure (CHF). We reasoned that if the RM could subtract a fraction of the limited cardiac output (QT) from the peripheral muscles, RM unloading would improve locomotor muscle perfusion. Nine patients with CHF (left ventricle ejection fraction = 26 ± 7%) undertook constant-work rate tests (70-80% peak) receiving proportional assisted ventilation (PAV) or sham ventilation. Relative changes (Δ%) in deoxy-hemoglobyn, oxi-Hb ([O2Hb]), tissue oxygenation index, and total Hb ([HbTOT], an index of local blood volume) in the vastus lateralis were measured by near infrared spectroscopy. In addition, QT was monitored by impedance cardiography and arterial O2 saturation by pulse oximetry (SpO2). There were significant improvements in exercise tolerance (Tlim) with PAV. Blood lactate, leg effort/Tlim and dyspnea/Tlim were lower with PAV compared with sham ventilation ( P < 0.05). There were no significant effects of RM unloading on systemic O2 delivery as QT and SpO2 at submaximal exercise and at Tlim did not differ between PAV and sham ventilation ( P > 0.05). Unloaded breathing, however, was related to enhanced leg muscle oxygenation and local blood volume compared with sham, i.e., higher Δ[O2Hb]% and Δ[HbTOT]%, respectively ( P < 0.05). We conclude that RM unloading had beneficial effects on the oxygenation status and blood volume of the exercising muscles at similar systemic O2 delivery in patients with advanced CHF. These data suggest that blood flow was redistributed from respiratory to locomotor muscles during unloaded breathing.

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Barreto Bittencourt, Joana, Adna Keyne et Jorge Andion Torreão. « Fatores Associados à Ressonância Magnética Cardíaca (RMC) em Acidente Vascular Cerebral Isquêmico (AVCI) de Causa Indeterminada ». Revista Científica Hospital Santa Izabel 3, n^o 2 (8 mai 2020) : 119–20. http://dx.doi.org/10.35753/rchsi.v3i2.28.

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Resumo do Artigo: Neri LR, Torreão JA, Porto LM, Gonçalves BMM, Andrade ALA, Pereira CB, Garcia KO, Catto MB, Muinos PJR, Maia RM, Silva TC, Jesus PAP, Rocha-Filho JA, Oliveira-Filho Factors associated with abnormal cardiac magnetic resonance imaging in embolic stroke of undetermined source. JInternational Journal of Stroke. First Published March 29, 2019 Letter. https://doi.org/10.1177/1747493019840928

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Jin, Yong Chun, Kil Jung Kim, Young Min Kim, Yu Mi Ha, Hye Jung Kim, Ui Jung Yun, Ki Hwan Bae et al. « Anti-Apoptotic Effect of Magnolol in Myocardial Ischemia and Reperfusion Injury Requires Extracellular Signal-Regulated Kinase1/2 Pathways in Rat In Vivo ». Experimental Biology and Medicine 233, n^o 10 (octobre 2008) : 1280–88. http://dx.doi.org/10.3181/0803-rm-79.

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Magnolol, an active component extracted from Magnolia officinalis, has been reported to have protective effect on ischemia and reperfusion (I/R)-induced injury in experimental animals. The aim of the present investigation was to further evaluate the mechanism(s) by which magnolol reduces I/R-induced myocardial injury in rats in vivo. Under anesthesia, left anterior descending (LAD) coronary artery was occluded for 30 min followed by reperfusion for 24 h (for infarct size and cardiac function analysis). In some experiments, reperfusion was limited to 1 h or 6 h for analysis of biochemical and molecular events. Magnolol and DMSO solution (vehicle) were injected intra-peritoneally 1 h prior to I/R insult. The infarct size was measured by TTC technique and heart function was monitored by Millar Catheter. Apoptosis related events such as p-ERK, p-Bad, Bcl-xl and cytochrome c expression were evaluated by Western blot analysis and myocardial caspase-3 activity was also measured. Magnolol (10 mg/kg) reduced infarct size by 50% ( P < 0.01 versus vehicle), and also improved I/R-induced myocardial dysfunction. Left ventricular systolic pressure and positive and negative maximal values of the first derivative of left ventricular pressure (dP/dt) were significantly improved in magnolol-treated rats. Magnolol increased the expression of phosphor ERK and Bad which resulted in inhibition of myocardial apoptosis as evidenced by TUNEL analysis and DNA laddering experiments. Application of PD 98059, a selective MEK1/2 inhibitor, strongly antagonized the effect of magnolol. Taken together, we concluded that magnolol inhibits apoptosis through enhancing the activation of ERK1/2 and modulation of the Bcl-xl proteins which brings about reduction of infarct size and improvement of cardiac function in I/R-induced injury.

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Nick, Hanspeter, Peter R. Allegrini, Lucy Fozard, Ursula Junker, Lisa Rojkjaer, Rishard Salie, Vera Niederkofler et Terrence O’Reilly. « Deferasirox Reduces Iron Overload in a Murine Model of Juvenile Hemochromatosis ». Experimental Biology and Medicine 234, n^o 5 (mai 2009) : 492–503. http://dx.doi.org/10.3181/0811-rm-337.

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Mutations in hemojuvelin (HJV) cause severe juvenile hemochromatosis, characterized by iron loading of the heart, liver, and pancreas. Knockout (KO) mice lacking HJV (Hjv−/−) spontaneously load with dietary iron and, therefore, present a model for hereditary hemochromatosis (HH). In HH, iron chelation may be considered in noncandidates for phlebotomy. We examined the effects of deferasirox, an oral chelator, in Hjv−/− mice. Hepatic, cardiac, splenic, and pancreatic iron were determined by measuring elemental iron and scoring histological sections. Heart and liver iron levels were also determined repeatedly by quantitative R2* magnetic resonance imaging (MRI). The time course of iron loading without intervention was followed from Week 8 of age (study start) to Week 20, when once-daily (5×/ week) deferasirox was administered, to Week 28. At 8 weeks, liver iron of KO mice was already markedly elevated versus wild-type mice ( P < 0.001) and reached a plateau around Week 14. In contrast, Week 8 cardiac and pancreatic iron levels were similar in both KO and wild-type mice and, compared with the liver, showed a delayed but massive iron loading up to Week 20. Contrary to the liver, heart, and pancreas, the KO mice spleen had lower iron content versus wild-type mice. In Hjv−/− mice, liver and heart iron burden was effectively reduced with deferasirox 100 mg/kg ( P < 0.05). Although deferasirox was less efficacious at this dose in the pancreas, over the observed time period, a clear trend toward reduced organ iron load was noted. There was no noticeable effect of deferasirox upon splenic iron in Hjv−/− mice. Quantitative R2* MRI demonstrated the ability to assess iron concentrations in the liver and myocardial muscle accurately and repetitively. Hepatic ( R = 0.86; P = 3.2*10− 12) and delayed myocardial ( R = 0.81; P = 2.9*10− 10) iron accumulation could be followed noninvasively with high agreement to invasive methods.

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Yeh, Che-Chung, Hongzhe Li, Deepak Malhotra, Mei-Chuan Huang, Bo-Qing Zhu, Edward J. Goetzl, Donald A. Vessey, Joel S. Karliner et Michael J. Mann. « Sphingolipid signaling and treatment during remodeling of the uninfarcted ventricular wall after myocardial infarction ». American Journal of Physiology-Heart and Circulatory Physiology 296, n^o 4 (avril 2009) : H1193—H1199. http://dx.doi.org/10.1152/ajpheart.01032.2008.

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The sphingosine kinase (SphK)/sphingosine 1-phosphate (S1P) pathway, known to determine the fate and growth of various cell types, can enhance cardiac myocyte survival in vitro and provide cardioprotection in acute ex vivo heart preparations. However, the relevance of these findings to chronic cardiac pathology has never been demonstrated. We hypothesized that S1P signaling is impaired during chronic remodeling of the uninfarcted ventricle during the evolution of post-myocardial infarction (MI) cardiomyopathy and that a therapeutic enhancement of S1P signaling would ameliorate ventricular dysfunction. SphK expression and activity were measured in the remote, uninfarcted myocardium (RM) of C57Bl/6 mice subjected to coronary artery ligation. The mRNA expression of S1P receptor isoforms was also measured, as was the activation of the downstream S1P receptor mediators. A cardioprotective role for S1P1 receptor agonism was tested via the administration of the S1P1-selective agonist SEW2871 during and after MI. As a result, the expression data suggested that a dramatic reduction in SphK activity in the RM early after MI may reflect a combination of posttranscriptional and posttranslational modulation. SphK activity continued to decline gradually during chronic post-MI remodeling, when S1P1 receptor mRNA also fell below baseline. The S1P1-specific agonism with oral SEW2871 during the first 2-wk after MI reduced apoptosis in the RM and resulted in improved myocardial function, as reflected in the echocardiographic measurement of fractional shortening. In conclusion, these results provide the first documentation of alterations in S1P-mediated signaling during the in situ development of cardiomyopathy and suggest a possible therapeutic role for the pharmacological S1P receptor agonism in the post-MI heart.

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Menêses, Annelise Lins, Cláudia Lúcia de Moraes Forjaz, Gleyson Queiroz de Moraes Silva, Aluisio Henrique Rodrigues de Andrade Lima, Breno Quintella Farah, Ozéas de Lima Lins Filho, Gustavo Henrique Correia de Lima et Raphael Mendes Ritti-Dias. « Post exercise cardiovascular effects of different resistance exercise protocols for trunk and upper limbs ». Motriz : Revista de Educação Física 17, n^o 4 (décembre 2011) : 667–74. http://dx.doi.org/10.1590/s1980-65742011000400011.

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Objective: to analyze the post exercise cardiovascular effects of different resistance exercise protocols for trunk and upper limbs. Methods: Fifteen males (22.3 ± 0.9 years) underwent three experimental sessions randomly: control session (C), resistance exercise session at 50% of one repetition maximum (1-RM) (E50%), and resistance exercise session at 70% of 1-RM (E70%). Three sets of 12, 9 and 6 repetitions were performed for each exercise. Blood pressure (BP), heart rate (HR) and rate pressure product (RPP) were measured before and during 90 minutes after each session. Results: Systolic BP decreased (P<.05) and diastolic BP increased (P<.05) similarly after C, E50% and E70%. However, HR and RPP decreased after C (P<.01), maintained after E50%, and increased after E70% (P<.01). Conclusions: The resistance exercise intensity did not influence post-exercise BP responses, however, cardiac overload was greater after E70%

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Ahmed, Ryan, Tammy Toscos, Romisa Rohani Ghahari, Richard J. Holden, Elizabeth Martin, Shauna Wagner, Carly Daley, Amanda Coupe et Michael Mirro. « Visualization of Cardiac Implantable Electronic Device Data for Older Adults Using Participatory Design ». Applied Clinical Informatics 10, n^o 04 (août 2019) : 707–18. http://dx.doi.org/10.1055/s-0039-1695794.

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AbstractPatients with heart failure (HF) are commonly implanted with cardiac resynchronization therapy (CRT) devices as part of their treatment. Presently, they cannot directly access the remote monitoring (RM) data generated from these devices, representing a missed opportunity for increased knowledge and engagement in care. However, electronic health data sharing can create information overload issues for both clinicians and patients, and some older patients may not be comfortable using the technology (i.e., computers and smartphones) necessary to access this data. To mitigate these problems, patients can be directly involved in the creation of data visualization tailored to their preferences and needs, allowing them to successfully interpret and act upon their health data. We held a participatory design (PD) session with seven adult patients with HF and CRT device implants, who were presently undergoing RM, along with two informal caregivers. Working in three teams, participants used drawing supplies and design cards to design a prototype for a patient-facing dashboard with which they could engage with their device data. Information that patients rated as a high priority for the “Main Dashboard” screen included average percent pacing with alerts for abnormal pacing, other device information such as battery life and recorded events, and information about who to contact with for data-related questions. Preferences for inclusion in an “Additional Information” display included a daily pacing chart, health tips, aborted shocks, a symptom list, and a journal. These results informed the creation of an actual dashboard prototype which was later evaluated by both patients and clinicians. Additionally, important insights were gleaned regarding the involvement of older patients in PD for health technology.

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Brunt, Keith R., Matthew R. Tsuji, Joyce H. Lai, Robert T. Kinobe, William Durante, William C. Claycomb, Christopher A. Ward et Luis G. Melo. « Heme Oxygenase-1 Inhibits Pro-Oxidant Induced Hypertrophy in HL-1 Cardiomyocytes ». Experimental Biology and Medicine 234, n^o 5 (mai 2009) : 582–94. http://dx.doi.org/10.3181/0810-rm-312.

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Aims: Reactive oxygen species (ROS) activate multiple signaling pathways involved in cardiac hypertrophy. Since HO-1 exerts potent antioxidant effects, we hypothesized that this enzyme inhibits ROS-induced cardiomyocyte hypertrophy. Methods: HL-1 cardiomyocytes were transduced with an adenovirus constitutively expressing HO-1 (AdHO-1) to increase basal HO-1 expression and then exposed to 200 μM hydrogen peroxide (H2O2). Hypertrophy was measured using 3H-leucine incorporation, planar morphometry and cell-size by forward-scatter flow-cytometry. The pro-oxidant effect of H2O2 was assessed by redox sensitive fluorophores. Inducing intracellular redox imbalance resulted in cardiomyocyte hypertrophy through transactivation of nuclear factor kappa B (NF-κB). Results: Pre-emptive HO-1 overexpression attenuated the redox imbalance and reduced hypertrophic indices. This is the first time that HO-1 has directly been shown to inhibit oxidant-induced cardiomyocyte hypertrophy by a NF-κB–dependent mechanism. Conclusion: These results demonstrate that HO-1 inhibits pro-oxidant induced cardiomyocyte hypertrophy and suggest that HO-1 may yield therapeutic potential in treatment of

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Caminiti, Giuseppe, Marco Alfonso Perrone, Ferdinando Iellamo, Valentino D’Antoni, Matteo Catena, Alessio Franchini et Maurizio Volterrani. « Acute Left Atrial Response to Different Eccentric Resistance Exercise Loads in Patients with Heart Failure with Middle Range Ejection Fraction : A Pilot Study ». Journal of Personalized Medicine 12, n^o 5 (26 avril 2022) : 689. http://dx.doi.org/10.3390/jpm12050689.

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In this study, we aimed to assess acute changes occurring on atrial function following single bouts of eccentric resistance exercise (ECC-RE) performed at two different loads. Twenty-five patients with chronic heart failure with middle range ejection fraction (HFmrEF) participated in three experimental sessions in a randomized order and on separate days: two sessions of ECC RE at 20% (ECC-20) of one-repetition maximum (1-RM) and 50% (ECC-50) 1-RM, and one session of control, without exercise. Each session lasted three minutes. Before and immediately after the sessions, patients underwent echocardiography and blood pressure and heart rate measurement. Peak atrial longitudinal strain (PALS) and peak atrial contractile strain (PACS) significantly increased after both ECC-20 (+16.3%) and ECC-50 (+18.1%) compared to control (between sessions p = 0.022). Peak atrial contractile strain (PACS) significantly increased after ECC-50 (+28.4%) compared to ECC-20 (+17.0%) and control (between sessions p = 0.034). The ratio of transmitral and annular velocities (E/E’) increased significantly after ECC-20 (+10.4%) and ECC-50 (+19.0%) compared to control (between groups p = 0.003). EF, left ventricular longitudinal strain, and stroke volume did not change after ECC-RE sessions compared to control. Cardiac output increased significantly after ECC-20 and ECC-50 compared to control, (between groups p = 0.025). In conclusion, both ECC-RE sessions were well tolerated, and LA functional reserve was properly mobilized in response to ECC-RE in patients with HFmrEF. Cardiac output increased at the cost of an increased LV filling pressure, but no detrimental changes of LV function occurred.

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Caminiti, Giuseppe, Marco Alfonso Perrone, Ferdinando Iellamo, Valentino D’Antoni, Matteo Catena, Alessio Franchini et Maurizio Volterrani. « Acute Left Atrial Response to Different Eccentric Resistance Exercise Loads in Patients with Heart Failure with Middle Range Ejection Fraction : A Pilot Study ». Journal of Personalized Medicine 12, n^o 5 (26 avril 2022) : 689. http://dx.doi.org/10.3390/jpm12050689.

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In this study, we aimed to assess acute changes occurring on atrial function following single bouts of eccentric resistance exercise (ECC-RE) performed at two different loads. Twenty-five patients with chronic heart failure with middle range ejection fraction (HFmrEF) participated in three experimental sessions in a randomized order and on separate days: two sessions of ECC RE at 20% (ECC-20) of one-repetition maximum (1-RM) and 50% (ECC-50) 1-RM, and one session of control, without exercise. Each session lasted three minutes. Before and immediately after the sessions, patients underwent echocardiography and blood pressure and heart rate measurement. Peak atrial longitudinal strain (PALS) and peak atrial contractile strain (PACS) significantly increased after both ECC-20 (+16.3%) and ECC-50 (+18.1%) compared to control (between sessions p = 0.022). Peak atrial contractile strain (PACS) significantly increased after ECC-50 (+28.4%) compared to ECC-20 (+17.0%) and control (between sessions p = 0.034). The ratio of transmitral and annular velocities (E/E’) increased significantly after ECC-20 (+10.4%) and ECC-50 (+19.0%) compared to control (between groups p = 0.003). EF, left ventricular longitudinal strain, and stroke volume did not change after ECC-RE sessions compared to control. Cardiac output increased significantly after ECC-20 and ECC-50 compared to control, (between groups p = 0.025). In conclusion, both ECC-RE sessions were well tolerated, and LA functional reserve was properly mobilized in response to ECC-RE in patients with HFmrEF. Cardiac output increased at the cost of an increased LV filling pressure, but no detrimental changes of LV function occurred.

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Lamotte, Michel, Georges Niset et Philippe Van De Borne. « The Effect of Different Intensity Modalities of Resistance Training on Beat-to-Beat Blood Pressure in Cardiac Patients ». European Journal of Cardiovascular Prevention & ; Rehabilitation 12, n^o 1 (février 2005) : 12–17. http://dx.doi.org/10.1177/204748730501200103.

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Background Resistance training has been introduced in cardiac rehabilitation to give more benefit than traditional training. Haemodynamic evaluation of cardiac patients to resistance training has generally consisted of continuous HR monitoring and discontinuous blood pressure measurements. Design and Methods Blood pressure (BP) and heart rate (HR) responses to resistance training were evaluated using continuous monitoring (Finapres) during low (four sets of 17 repetitions at 40% of the one-repetition maximum strength [1-RM]) and high intensity resistance training (four sets of 10 repetitions at 70% of 1-RM) on a leg extension machine in 14 patients who participated in a rehabilitation programme. Work volume was identical in the low- and high-level resistance training. Results The HR and systolic blood pressure (SBP) during low intensity resistance training were always larger than during high intensity (P<0.001). Peak SBP increased from set 1 to set 3 and 4 during both low and high intensity resistance training (P<0.05). Peak HR was larger in set 4 (95 ± 11 bpm) than in set 1 only during low intensity resistance training (91 ± 12 bpm) (P<0.05). One-minute recovery periods did not allow a return to baseline HR and SBP during both low and high intensity modalities. Conclusions The SBP and HR responses to resistance training are related to the duration of exercise. Sets with ≥ 10 repetitions of high intensity should be preferred to longer sets with low intensity. Pauses between exercise sets should exceed 1 min. Blood pressure should be measured during the last repetitions of the exercise set. Eur J Cardiovasc Prev Rehabil 12:12-17 © 2005 The European Society of Cardiology

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Anetzberger, H., E. Thein, M. Becker, A. K. Walli et K. Messmer. « Validity of fluorescent microspheres method for bone blood flow measurement during intentional arterial hypotension ». Journal of Applied Physiology 95, n^o 3 (septembre 2003) : 1153–58. http://dx.doi.org/10.1152/japplphysiol.00299.2003.

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In this study, we compared bone blood flow values obtained by simultaneously injected fluorescent (FM) and radiolabeled microspheres (RM) at stepwise reduced arterial blood pressure. Ten anesthetized female New Zealand White rabbits received simultaneous left ventricular injections of FM and RM at 90, 70, and 50 mmHg mean arterial blood pressure (MAP). After the experiments, both kidneys and long bones of all four limbs were removed and dissected in a standardized manner. Radioactivity (corrected for decay, background, and spillover) and fluorescence were determined, and blood flow values were calculated. Relative blood flow values estimated for each bone sample by RM and FM were significantly correlated ( r = 0.98, slope = 0.99, and intercept = 0.04 for 90 mmHg; r = 0.98, slope = 0.94, and intercept = 0.09 for 70 mmHg; r = 0.98, slope = 0.96, and intercept = 0.07 for 50 mmHg). Blood flow values (ml · min-1 · 100 g-1) of right and left bone samples determined at the different arterial blood pressures were identical. During moderate hypotension (70 mmHg MAP), blood flow in all bone samples remained unchanged compared with 90 mmHg MAP, whereas a significant decrease of bone blood flow was observed at severe hypotension (50 mmHg MAP). Our results demonstrate that the FM technique is valid for measuring bone blood flow. Differences in bone blood flow during altered hemodynamic conditions can be detected reliably. In addition, changes in bone blood flow during hypotension indicate that vasomotor control mechanisms, as well as cardiac output, play a role in setting bone blood flow.

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Palaniyandi, Suresh S., Yusuke Nagai, Kenichi Watanabe, Meilei Ma, Punniyakoti T. Veeraveedu, Paras Prakash, Fadia A. Kamal et al. « Chymase Inhibition Reduces the Progression to Heart Failure After Autoimmune Myocarditis in Rats ». Experimental Biology and Medicine 232, n^o 9 (octobre 2007) : 1213–21. http://dx.doi.org/10.3181/0703-rm-85.

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Chymase has been known as a local angiotensin II–generating enzyme in the cardiovascular system in dogs, monkeys, hamsters, and humans; however, recently it was reported that chymase also has various other functions. Therefore, we decided to examine whether the inhibition of chymase improves disease conditions associated with the pathophysiology of dilated cardiomyopathy in rats and its possible mechanism of action as rat chymase is unable to produce angiotensin II. We examined the effect of TY-51469, a novel chymase inhibitor (0.1 mg/kg/day [group CYI-0.1, n = 15] and 1 mg/kg/day [group CYI-1, n = 15]), in myosin-immunized postmyocarditis rats. Another group of myosin-immunized rats was treated with vehicle (group V, n = 15). Age-matched normal rats without immunization (group N, n = 10) were also included in the study. After 4 weeks of treatment, we evaluated cardiac function; area of fibrosis; fibrogenesis; levels of transforming growth factor (TGF)-β1 and collagen III; hypertrophy and its marker, atrial natriuretic peptide (ANP); and mast cell activity. Survival rate and myocardial functions improved dose-dependently with chymase inhibitor treatment after myosin immunization. A reduction in the percent area of myocardial fibrosis, fibrogenesis, myocardial hypertrophy, and mast cell activity along with a reduction in TGF-β1, collagen III, and ANP levels in the myocardium were noted in postmyocarditis rats that received chymase inhibitor treatment. The treatment also decreased myocardial aldosterone synthase levels in those animals. Inhibition of chymase reduces the pathogenesis of postmyocarditis dilated cardiomyopathy and progression to heart failure by preventing the pathological remodeling and residual inflammation in rats.

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Lin, Linda Li-Chuan, Yi-Ju Chen, Tai-You Lin et Ting-Chun Weng. « Effects of Resistance Training Intensity on Heart Rate Variability at Rest and in Response to Orthostasis in Middle-Aged and Older Adults ». International Journal of Environmental Research and Public Health 19, n^o 17 (25 août 2022) : 10579. http://dx.doi.org/10.3390/ijerph191710579.

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Objective: Aging and deficits related to decreased physical activity can lead to higher risks of autonomic nervous system (ANS) dysfunction. The aim of this study was to evaluate the effects of 24 weeks of resistance training (RT) at various intensities on hemodynamics as well as heart rate variability (HRV) at rest and in response to orthostatic tests in middle-aged and older adults. Methods: Forty adults were randomized into three groups: high-intensity (HEX) (80% 1-RM) (11 female, 4 male; 60 ± 4 years); low–moderate-intensity (LEX) (50% 1-RM) (nine female, four male; 61 ± 5 years); and a control group (CON) (eight female, four male; 60 ± 4 years). The RT program consisted of nine exercises, with two sets performed of each exercise two times per week for 24 weeks. Data collected included 1-RM, heart rate, and blood pressure and HRV at rest and in response to orthostasis. Results: Both the LEX (42–94%) and HEX (31.3–51.7%) groups showed increases in 1-RM (p < 0.01). The HEX group showed decreases in resting heart rate (−4.0%), diastolic blood pressure (−3.2 mmHg (−4.2%)), and low frequency/high frequency (LF/HF) (Ln ratio) (p < 0.05). Post-study, the HEX group had higher HF (Ln ms2) than the CON, adjusted for pre-study value and age (p < 0.05). Post-study, the supine–standing ratio (SSR) of LFn (normalized unit) in the HEX group was greater than that in the LEX and CON groups, while the SSR of LF/HF in the HEX group was greater than the CON (p < 0.05). In conclusion, high-intensity RT can improve resting heart rate and HRV by enhancing cardiac vagal control. High-intensity RT might also improve the orthostatic response in terms of HRV. High intensity RT might assist ANS modification and could perhaps decrease the risks of cardiovascular disease and orthostatic intolerance.

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Tan, Isabella, Hosen Kiat, Edward Barin, Mark Butlin et Alberto P. Avolio. « Effects of pacing modality on noninvasive assessment of heart rate dependency of indices of large artery function ». Journal of Applied Physiology 121, n^o 3 (1 septembre 2016) : 771–80. http://dx.doi.org/10.1152/japplphysiol.00445.2016.

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Studies investigating the relationship between heart rate (HR) and arterial stiffness or wave reflections have commonly induced HR changes through in situ cardiac pacing. Although pacing produces consistent HR changes, hemodynamics can be different with different pacing modalities. Whether the differences affect the HR relationship with arterial stiffness or wave reflections is unknown. In the present study, 48 subjects [mean age, 78 ± 10 (SD), 9 women] with in situ cardiac pacemakers were paced at 60, 70, 80, 90, and 100 beats per min under atrial, atrioventricular, or ventricular pacing. At each paced HR, brachial cuff-based pulse wave analysis was used to determine central hemodynamic parameters, including ejection duration (ED) and augmentation index (AIx). Wave separation analysis was used to determine wave reflection magnitude (RM) and reflection index (RI). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Pacing modality was found to have significant effects on the HR relationship with ED ( P = 0.01), central aortic pulse pressure ( P = 0.01), augmentation pressure ( P < 0.0001), and magnitudes of both forward and reflected waves ( P = 0.05 and P = 0.003, respectively), but not cfPWV ( P = 0.57) or AIx ( P = 0.38). However, at a fixed HR, significant differences in pulse pressure amplification ( P < 0.001), AIx ( P < 0.0001), RM ( P = 0.03), and RI ( P = 0.03) were observed with different pacing modalities. These results demonstrate that although the HR relationships with arterial stiffness and systolic loading as measured by cfPWV and AIx were unaffected by pacing modality, it should still be taken into account for studies in which mixed pacing modalities are present, in particular, for wave reflection studies.

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Long Yan, Julia Pettine, Srinjoy Mitra, Sunyoung Kim, Dong-Woo Jee, Hyejung Kim, Masato Osawa et al. « A 13 $\mu {\rm A}$ Analog Signal Processing IC for Accurate Recognition of Multiple Intra-Cardiac Signals ». IEEE Transactions on Biomedical Circuits and Systems 7, n^o 6 (décembre 2013) : 785–95. http://dx.doi.org/10.1109/tbcas.2013.2297353.

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Biagi, G. L., M. C. Guerra, A. M. Barbaro, A. Sapone et M. Recanatini. « Lipophilic character of cardiac glycosides : correlation between RM values and acute toxicity data in different animal species ». Journal of Chromatography A 547 (juin 1991) : 523–30. http://dx.doi.org/10.1016/s0021-9673(01)88683-0.

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Han, Cuihong, Li Lin, Weidong Zhang, Li Zhang, Shijun Lv, Qiang Sun, Hengyi Tao, John H. Zhang et Xuejun Sun. « Hyperbaric Oxygen Preconditioning Alleviates Myocardial Ischemic Injury in Rats ». Experimental Biology and Medicine 233, n^o 11 (novembre 2008) : 1448–53. http://dx.doi.org/10.3181/0801-rm-8.

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It has been shown that after ischemia-reperfusion, application of hyperbaric oxygen (HBO) reduces cardiac injury. In this study we tested the hypothesis that HBO preconditioning reduces injury to the ischemic myocardium. One hundred and eight adult male Sprague-Dawley rats (250–280 g) were randomly divided into four groups: normoxia + sham surgery (CS), normoxia + permanent occlusion of the left anterior descending (LAD) coronary artery (CMI), HBO preconditioning + sham surgery (HS), and HBO preconditioning + permanent LAD occlusion (HMI). Rats receiving HBO preconditioning were intermittently exposed to 100% O2 at 2.5 atmosphere absolute (ATA) for 60 min, twice daily for 2 days followed by 12 hrs of recovery in room air prior to the myocardial ischemic insult induced by LAD ligation. Rats in the normoxia group were time-matched with the HBO group and maintained under normoxic conditions prior to LAD occlusion. At 3 and 7 days after LAD occlusion, heart function parameters were measured by inserting a catheter into the left ventricle, infarct size was calculated using the method of TTC staining, myocardial capillary density was determined by immunohistochemical staining with a monoclonal anti-CD31/PECAM-1 antibody, and VEGF protein level was determined by Western blot analysis. At 3 days after LAD ligation, the infarct size of the HMI group was significantly smaller than that of the CMI group (26 ± 2.5% vs. 38 ± 3%, P < 0.05). The heart function parameters including left ventricular systolic pressure (LVSP), +dP/dtmax and −dP/dtmax were significantly improved in the HMI group compared to the CMI group at 3 and 7 days after LAD occlusion. Capillary density and VEGF protein levels were significantly increased in the ischemic myocardium pre-exposed to HBO. We conclude that HBO preconditioning alleviates myocardial ischemia in rat model.

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Scott, Jessica M., Ben T. A. Esch, Mark J. Haykowsky, Darren E. R. Warburton, Mustafa Toma, Anwar Jelani, Dylan Taylor et al. « Cardiovascular responses to incremental and sustained submaximal exercise in heart transplant recipients ». American Journal of Physiology-Heart and Circulatory Physiology 296, n^o 2 (février 2009) : H350—H358. http://dx.doi.org/10.1152/ajpheart.01100.2008.

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The cardiovascular response to exercise in heart transplant recipients (HTR) has been compared with that of healthy individuals matched to the recipient age (RM controls). However, no study has compared HTR with donor age-matched (DM) controls. Moreover, the cardiovascular response to sustained submaximal exercise in HTR requires further evaluation. We therefore examined cardiovascular responses during incremental exercise and sustained (1 h) submaximal aerobic exercise in 9 clinically stable HTR [63 ± 10 yr of age, 24.2 ± 10.9 ml·kg−1·min−1 peak O2 uptake (V̇o2peak)] and 11 healthy age-matched controls (60 ± 11 yr of age and 36.3 ± 10.7 ml·kg−1·min−1 V̇o2peak for 6 RM controls and 35 ± 8 yr of age and 51.1 ± 10.4 ml·kg−1·min−1 V̇o2peak for 5 DM controls). Heart rate (HR) and left ventricular systolic and diastolic volumes (2-dimensional echocardiography) indexed to body surface area [end-systolic and end-diastolic volume indexes (EDVI and ESVI)], cardiac output (CI), ejection fraction (EF), systemic vascular resistance (SVRI), end-systolic elastance index, and arterial elastance index were determined. Although systolic function was maintained during incremental exercise, peak CI was significantly reduced (6.7 ± 2.4 vs. 11.6 ± 1.4 l·min−1·m−2), secondary to blunted HR, EDVI, and increased peak SVRI, in HTR compared with DM controls. The lower peak CI in HTR than in RM controls was due to blunted peak EDVI (54.1 ± 13.2 vs. 68.6 ± 5.7 ml/m2). During sustained submaximal exercise, HTR exhausted their preload reserve, a response for which changes in ESVI, HR, or EF did not fully compensate. Thus it appears that HTR are limited by impaired preload reserve, HR reserve, and vascular reserve during exercise conditions.

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Kanegusuku, Hélcio, Andréia C. C. Queiroz, Valdo J. D. Silva, Marco T. de Mello, Carlos Ugrinowitsch et Cláudia L. M. Forjaz. « High-Intensity Progressive Resistance Training Increases Strength With No Change in Cardiovascular Function and Autonomic Neural Regulation in Older Adults ». Journal of Aging and Physical Activity 23, n^o 3 (juillet 2015) : 339–45. http://dx.doi.org/10.1123/japa.2012-0324.

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The effects of high-intensity progressive resistance training (HIPRT) on cardiovascular function and autonomic neural regulation in older adults are unclear. To investigate this issue, 25 older adults were randomly divided into two groups: control (CON, N = 13, 63 ± 4 years; no training) and HIPRT (N = 12, 64 ± 4 years; 2 sessions/week, 7 exercises, 2−4 sets, 10−4 RM). Before and after four months, maximal strength, quadriceps cross-sectional area (QCSA), clinic and ambulatory blood pressures (BP), systemic hemodynamics, and cardiovascular autonomic modulation were measured. Maximal strength and QCSA increased in the HIPRT group and did not change in the CON group. Clinic and ambulatory BP, cardiac output, systemic vascular resistance, stroke volume, heart rate, and cardiac sympathovagal balance did not change in the HIPRT group or the CON group. In conclusion, HIPRT was effective at increasing muscle mass and strength without promoting changes in cardiovascular function or autonomic neural regulation.

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Baban, Anwar, Valentina Lodato, Giovanni Parlapiano, Corrado di Mambro, Rachele Adorisio, Enrico Silvio Bertini, Carlo Dionisi-Vici, Fabrizio Drago et Diego Martinelli. « Myocardial and Arrhythmic Spectrum of Neuromuscular Disorders in Children ». Biomolecules 11, n^o 11 (25 octobre 2021) : 1578. http://dx.doi.org/10.3390/biom11111578.

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Neuromuscular disorders (NMDs) are highly heterogenous from both an etiological and clinical point of view. Their signs and symptoms are often multisystemic, with frequent cardiac involvement. In fact, childhood onset forms can predispose a person to various progressive cardiac abnormalities including cardiomyopathies (CMPs), valvulopathies, atrioventricular conduction defects (AVCD), supraventricular tachycardia (SVT) and ventricular arrhythmias (VA). In this review, we selected and described five specific NMDs: Friedreich’s Ataxia (FRDA), congenital and childhood forms of Myotonic Dystrophy type 1 (DM1), Kearns Sayre Syndrome (KSS), Ryanodine receptor type 1-related myopathies (RYR1-RM) and Laminopathies. These changes are widely investigated in adults but less researched in children. We focused on these specific topics due their relative frequency and their potential unexpected cardiac manifestations in children. Moreover these conditions present different inheritance patterns and mechanisms of action. We decided not to discuss Duchenne and Becker muscular dystrophies due to extensive work regarding the cardiac aspects in children. For each described NMD, we focused on the possible cardiac manifestations such as different types of CMPs (dilated-DCM, hypertrophic-HCM, restrictive-RCM or left ventricular non compaction-LVNC), structural heart abnormalities (including valvulopathies), and progressive heart rhythm changes (AVCD, SVT, VA). We describe the current management strategies for these conditions. We underline the importance, especially for children, of a serial multidisciplinary personalized approach and the need for periodic surveillance by a dedicated heart team. This is largely due to the fact that in children, the diagnosis of certain NMDs might be overlooked and the cardiac aspect can provide signs of their presence even prior to overt neurological diagnosis.

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Kambic, Tim, Vedran Hadžić et Mitja Lainscak. « Hemodynamic Response to High- and Low-Load Resistance Exercise in Patients with Coronary Artery Disease : A Randomized, Crossover Clinical Trial ». International Journal of Environmental Research and Public Health 18, n^o 8 (8 avril 2021) : 3905. http://dx.doi.org/10.3390/ijerph18083905.

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Low-load resistance exercise (LL-RE) is recommended as an adjunct therapy to aerobic exercise during cardiac rehabilitation in patients with coronary artery disease. The safety and hemodynamic response to high-load (HL) RE remain unknown. The aim of this study was to evaluate the hemodynamic response during both HL-RE and LL-RE prior to cardiac rehabilitation. Forty-three patients with coronary artery disease and/or percutaneous coronary intervention performed three sets of leg-press exercise using HL-RE (eight repetitions at the intensity of 80% of one repetition maximum (1-RM)) and LL-RE (16 repetitions at the intensity of 40% 1-RM) in a randomized crossover sequence. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rating of perceived exertion were measured at baseline, after each set of RE and post-exercise. No clinically relevant changes in HR and BP or in patient-reported symptoms were recorded during HL-RE or LL-RE. Compared with baseline, HR and SBP increased during LL-RE (from 66 bpm to 86 bpm, time effect: p < 0.001; from 129 mmHg to 146 mmHg, time effect: p < 0.001) and HL-RE (from 68 bpm to 86 bpm, time effect: p < 0.001; from 130 mmHg to 146 mmHg, time effect: p < 0.001). Compared with HL-RE, the increase in HR was greater after the final set of LL-RE (32% vs. 28%, p = 0.015), without significant differences in SBP and DBP between LL-RE and HL-RE. Rating of perceived exertion was higher after the 1st set of HL-RE compared with LL-RE (median (interquartile range): 6 (5–7) vs. 6 (5–6), p = 0.010). In patients with coronary artery disease, both HL-RE and LL-RE were safe and well-tolerated. Hemodynamic changes were similar and within the physiological response to RE.

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Asai, T., L. M. Shuba, D. J. Pelzer et T. F. McDonald. « PKC-independent inhibition of cardiac L-type Ca2+ channel current by phorbol esters ». American Journal of Physiology-Heart and Circulatory Physiology 270, n^o 2 (1 février 1996) : H620—H627. http://dx.doi.org/10.1152/ajpheart.1996.270.2.h620.

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Active and inactive phorbol esters were applied to guinea pig ventricular myocytes to study the responses of L-type Ca2+ (ICa,L) and L-type Na+ (INa,L) currents. Phorbol 12-myristate 13-acetate (PMA) (10-100 rM) never stimulated ICa,L or INa,L and frequently depressed them by 5-30% in a voltage-independent manner. However, the phorbol ester consistently activated delayed-rectifying K+ (IK) and Cl- currents. The inhibition of ICa,L occurred approximately 3 times faster than comonitored stimulation of IK, and ICa,L and INa,L were unaffected by two interventions that suppressed IK stimulation [pretreatment with 50 microM 1-(5-isoquinolinesulfonyl)-2-methylpiperazine (H-7) and dialysis with pCa 11 versus standard pCa 9 solution]. Inactive phorbol esters 4 alpha-phorbol 12,13-didecanoate (alpha-PDD) and 4 alpha-phorbol had little effect on IK, but alpha-PDD had a PMA-like inhibitory effect on Ca2+ channel currents. We conclude that, unlike the stimulation of IK by PMA, inhibition of Ca2+ channel current by phorbol esters is a protein kinase C-independent action.

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