Impact of Atrial Fibrillation on Cognitive Function,Psychological Distress,Quality of Life,and Impulsiveness

Objective

Atrial fibrillation is the most common cardiac arrhythmia and a known risk factor for cerebrovascular stroke. Atrial fibrillation and longstanding hypertension may produce ischemic lesions leading to progressive cognitive impairment. The impact of atrial fibrillation alone on cognitive impairment has not been evaluated. Our objective was to compare cognitive function, quality of life, psychological distress, and impulsiveness in people with atrial fibrillation and a matched control group.

Quantitative assessment of transient left ventricular asynergy in coronary artery disease

The purpose of this study was to determine the diagnostic value of quantitative two-dimensional echocardiography during transesophageal atrial pacing in assessing the presence and severity of coronary artery disease. Apical four- and two-chamber views were registered at rest and at different pacing rates. Computerized quantitative evaluation of left ventricle wall motion was performed. On the basis of left ventricle wall motion analysis data of 22 individuals with no coronary pathology, as assessed by angiography and with negative exercise ECG and transesophageal atrial pacing ECG test, nomograms for assessment of wall motion abnormalities and for calculation of asynergy area as a measure of wall motion abnormality extent were obtained. The method revealed new transient wall motion abnormalities during pacing or exacerbation of old ones present at rest in 83 of the 89 patients with angiographically proven coronary artery stenosis greater than or equal to 70% and in 3 of the 32 controls with no changes in their coronary angiograms. Thus, it showed high sensitivity (93%), specificity (91%), predictive value of positive result (96%), predictive value of negative result (83%), and efficiency of the test (93%). These values appeared to be higher than those calculated for transesophageal atrial pacing ECG, recorded simultaneously with echocardiographic images (81, 87, 95, 62, and 83%, respectively) and for exercise ECG test which was performed in 66 coronary patients and in 29 controls (68, 86, 92, 54, and 74%, respectively). The extent of pacing-induced left ventricular regional wall motion abnormalities appeared to be directly correlated to the extent of coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)     

Immobilization of Hexavalent Chromium Using Self-Compacting Soil Technology

A study of immobilization of hexavalent chromium in the form of Na₂CrO₄ salt by self-compacting soils (SCS) is presented. Carbofill E additive was used as SCS binder. The efficiency of immobilization of Cr (VI) was evaluated by washing out chromium compounds from SCS samples. The influence of the nature of the soil and the content of Carbofill E and Na₂CrO₄ in the SCS samples on the efficiency of Cr (VI) immobilization was studied. It was found that the nature of the soil and the content of Carbofill E in the SCS samples affect the immobilization of Cr (VI). Moreover, increasing the Carbofill E content in SCS samples further increases Cr (VI) immobilization. X-ray diffraction studies of the samples with immobilized hexavalent chromium showed that part of the sample transforms from a readily soluble form of salt into oxide forms of chromium and calcium-chromium, which are practically insoluble in water.     

Analysis of micronuclei in blue mussels and fish from the Baltic and North Seas

Micronuclei (MN) were analyzed in erythrocytes of flounder (Platichthys flesus) and wrasse (Symphodus melops) and in gill cells of blue mussels (Mytilus edulis). The organisms were collected from three study stations in the Baltic Sea and from seven stations in the North Sea (Karmsund area, Norway) 4 times. The statistically significant differences obtained were related to the season, sex of the fish, and sampling locality. Higher MN frequencies were found in fish and mussels collected from the most polluted study stations in the North Sea. The same tendency could be described in the Baltic Sea; however, it was masked by the recent oil spill from the Butinge oil terminal. Our results showing higher MN frequencies in presumably what were the most polluted study locations suggest that MN tests in fish and mussels may be used for the detection of genotoxic effects in a marine environment. The endpoint is well characterized and can be easily recognized, and the technique is convenient to use in field samplings following standard procedures and protocols.     

Echocardiographic Parameters in Athletes of Different Sports

Competitive athletics is often associated with moderate left ventricular (LV) hypertrophy, and it has been hypothesized that training mode and type of exercise modulates long-term cardiac adaptation. The purpose of the study was to compare cardiac structure and function among athletes of various sports and sedentary controls. Standard transthoracic two-dimensional M-mode and Doppler echocardiography was performed at rest in Caucasian male canoe/kayak paddlers (n = 9), long distance runners (LDR, n = 18), middle distance runners (MDR, n = 17), basketball players (BP, n = 31), road cyclists (n = 8), swimmers (n = 10), strength/power athletes (n = 9) of similar age (range, 15 to 31 yrs), training experience (4 to 9 years), and age-matched healthy male sedentary controls (n = 15). Absolute interventricular septum (IVS) thickness and LV wall thickness, but not LV diameter, were greater in athletes than sedentary controls. Left ventricular mass of all athletes but relative wall thickness of only BP, swimmers, cyclists, and strength/power athletes were higher as compared with controls (p < 0.05). Among athletes, smaller IVS thickness was observed in MDR than BP, cyclists, swimmers or strength/power athletes, while LDR had higher body size-adjusted LV diameter as compared to BP, cyclists and strength/power athletes. In conclusion, relative LV diameter was increased in long distance runners as compared with basketball players, cyclists, and strength/power athletes. Basketball, road cycling, strength/power, and swimming training were associated with increased LV concentricity as compared with paddling or distance running.

Key points

• The type of cardiac hypertrophy seems to be only moderately exercise-specific.
• Long-distance runners develop larger left ventricular dilation as compared with basketball players, cyclists, and strength/power athletes.
• Myocardial wall thickening is triggered by different sporting activities that involve large muscle groups.

Key words: Myocardial hypertrophy, left ventricle, echocardiography, athlete     

40 Hz Auditory Steady-State Response: The Impact of Handedness and Gender

The 40 Hz auditory steady-state response (ASSR) is a periodic response to a periodic stimulation. Its sources are located in the primary auditory cortex and the asymmetry of the planum temporale has previously been associated with hand preference and gender-related differences; thus subject’s handedness and gender could potentially influence ASSRs. Nevertheless, electrophysiological studies of ASSRs are mainly dominated by right-handed participants and the observed findings can only be generalized to the right-handed populations. However, for a potential use of 40 Hz ASSR as a translational biomarker of neuropsychiatric disorders, it is important to investigate the response in association to handedness and gender. We included an equal number of left-handed and right-handed males and females and recorded EEG responses during left-ear, right-ear and both ears stimulation. The results of the study suggest that the processing of 40 Hz auditory stimulation depends on the subjects’ gender and handedness: significantly lower phase-locking and strength of 40 Hz ASSRs were observed in left-handed females as compared to left-handed males, but right-handers did not differ in 40 Hz ASSRs. Our observation of the opposite impact of gender in the examined handedness groups stresses the importance of careful consideration of handedness and gender factors when evaluating the determinants of inter individual variability of 40 Hz ASSRs. This finding is of particular importance for clinical studies in psychiatry and neurology.     

An open-label study investigating the efficacy and safety of 12-96 weeks of telmisartan treatment in patients with hypertension

This open-label, multicentre, multinational trial evaluated the efficacy and safety of telmisartan used alone or as add-on therapy in 2121 adults with mild-to-moderate essential hypertension. Patients received telmisartan 40-80 mg once daily for 12 weeks and could participate in the study for up to 96 weeks, or until a marketed supply of telmisartan became available. Mean change from baseline in mean seated trough diastolic blood pressure (DBP) after 12 weeks' treatment, the primary endpoint, was -11.8 mmHg in the intent-to-treat population. The corresponding mean change in mean seated trough systolic blood pressure (SBP) was -20.2 mmHg. Both changes were statistically significant. Mean DBP and SBP reductions were apparent from week 4 and maintained throughout the treatment period. Telmisartan was well tolerated; the most common adverse events were headache (6%) and dizziness (3%), and 10% of adverse events were considered drug-related. In conclusion, telmisartan is an effective and well-tolerated drug when used as monotherapy or add-on treatment in this broad population of patients.     

The impact of systemic sclerosis on arterial wall stiffness parameters and endothelial function

Systemic sclerosis (SSc) is characterized by thickening and fibrosis of skin and internal organs that is associated with vascular damage. SSc may lead to arterial dysfunction and premature aging of the arteries. However, its relationship with parameters of arterial wall dysfunction has not been fully explored. To determine if carotid–radial pulse wave velocity (PWV), aortic augmentation index (AIx) and endothelial function are altered in SSc patients, 17 consecutive patients with SSc and 34 age- and gender-matched controls were included in our study. PWV and AIx were assessed non-invasively by applanation tonometry. The endothelium-dependent flow-mediated dilatation (FMD) test in a brachial artery was performed by the ultrasound system. The blood investigations included serum lipid profile, glucose, and high-sensitivity CRP (hsCRP) measurements. As compared to controls, SSc patients had significantly higher medians of the AIx (p = 0.002) and the PWV (p = 0.04) and the median of the FMD was significantly lower (p = 0.001). Stepwise linear regression including comorbid factors showed that SSc was a significant independent predictor of all arterial wall parameters measures. SSc patients have increased AIx and PWV and lower FMD as compared to control subjects. The relationship between SSc and measures of arterial wall parameters still remains unclear. Though replication of the results presented here is required, we conclude that SSc has a great impact on large and conduit arteries damage.