Journal of heart health最新文献

{"title":"3D Printed Models Offer Superior Advantages in Medical Student Education","authors":"Zhonghua Sun","doi":"10.16966/2379-769x.152","DOIUrl":"https://doi.org/10.16966/2379-769x.152","url":null,"abstract":"each station before proceeding to the next one. When students arrived at the 3D printed model station, they were asked to complete a pre-and post-intervention survey with the aim of assessing their knowledge and understanding of cardiac lesions, as well as their opinion towards the educational benefit of each modality (presented at each station). Results showed that student’s knowledge was significantly improved for every cardiac lesion (p<0.001) after the use of 3D printed models. There was a strong positive correlation between the mean knowledge increase and improved understanding of the complexity of CHD (p=0.03). Regarding the preferred teaching tools in CHD, pathology, 3D printed models and spoken explanation were ranked as the most helpful teaching methods with 80.7%, 74.2% and 65% of students rating them as the top 3 choices, respectively. Further, students strongly agreed that 3D printed models increased their confidence in explaining and understanding congenital heart anatomy and disease when compared to other modalities (mean score: 4.24 ± 0.69 out of 5).","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67389971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of U-Shaped Association between Alcohol Intake and the Risk of Sudden Cardiac Death","authors":"Karagueuzian Hs, Demirdjian L","doi":"10.16966/2379-769X.149","DOIUrl":"https://doi.org/10.16966/2379-769X.149","url":null,"abstract":"Large cohort epidemiological studies have shown a U-shaped association between the relative risk of Sudden Cardiac Death (SCD) and the dose of alcohol consumed across both genders. The mechanisms of this relationship, i.e., too little or too high promoting SCD while moderate doses providing protection, remain elusive. In this brief review, we provide plausible electrophysiological and biochemical mechanisms of the U-shaped association of the dose of alcohol and the risk of SCD. At moderate doses alcohol causes partial cellular uncoupling “paradoxically” improves the conduction at narrow ventricular conducting pathways (source) that adjoins a large tissue mass (sink) eliminating preexisting Unidirectional Conduction (UCB) (from source-to-sink) and preventing re-entry formation. In contrast, higher doses of alcohol by further increasing cellular uncoupling cause conduction block at multiple ventricular sites (wavebreaks) in isolated tissues and patterned monolayers of cardiac myocytes leading to the formation of multiple reentrant and non-reentrant wave fronts simulating fibrillation-like state. In the absence of alcohol, the vulnerable narrow conducting pathways remain unchanged promoting UCB (i.e., conduction block from source-to-sink block) increasing the risk of reentry formation. Re-entry leads to Ventricular Fibrillation (VF), a major cause of SCD. Our hypothesis of U-shaped association between alcohol dose and SCD is based on the preponderance of clinical epidemiological data and on basic experimental studies using intact animal hearts and patterned monolayers of cardiac myocytes with vulnerable narrow strands of conducting pathways (source) abutting to a large tissue mass (sink). in 12 ounces of regular beer (~5% per volume alcohol), in five ounces of wine (~12% per volume alcohol) and 1.5 ounces of spirits (~40% alcohol). Therefore, up to 15 g/day is considered “light-to-moderate,” and greater than 30 g/day is considered “high” [3,4]. The potential benefits of light-to-moderate doses of alcohol consumption, however, has not received universal acceptance. A recent systematic review of epidemiological data by The Global Burden of Disease Study by Alcohol Collaborators challenged the health benefits of light-to-moderate levels of alcohol consumption. This meta-analysis concluded that the level of alcohol consumption that minimized harm “across all health outcomes particularly the risk of cancer, was zero” [10]. This seeming controversy stems from the fact that certain diseases like Atrial Fibrillation (AF), stroke, [11] hypertension, heart failure, cardiomyopathy, cancer, and liver disease do not manifest any benefit from alcohol, [5,12,13] while other diseases do. The potential mechanisms of the observed benefits of low-to-moderate alcohol consumption in CAD and SCD remain undefined because the observed epidemiologic data are associative and not causative, providing no mechanistic insight by which alcohol causes it’s beneficial or its ill ef","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67389841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of State Anxiety, Mindfulness on Cardiac Autonomic Variables in Healthy Adults: A Correlational Study","authors":"Kurian J, Bhat R","doi":"10.16966/2379-769x.150","DOIUrl":"https://doi.org/10.16966/2379-769x.150","url":null,"abstract":"The interest about mindfulness has been increased in the last decades. The epidemiological studies shows a hike from communicable diseases to non-communicable diseases indicating that the adults are more prone for anxiety related, mindfulness related and autonomic variables like heart rate, heart rate variability and related issues. State anxiety is a topic of discussion among all age groups and the way it reflects on sympathetic and parasympathetic nervous system is also eye catchy in the field of psycho physiological research. This study tired to understand the impact of state anxiety and mindfulness on cardiac autonomic regulation on heart rate variability. Eighty three subjects were assessed using state anxiety and mindfulness questionnaire and heart rate variability measurement in Biopac equipment. The result showed a negative correlation between mindfulness and state anxiety (r= -.942, P<0.001). State anxiety increases sympathetic activity (P<0.05) and decreases parasympathetic activity of Autonomic Nervous System (P<0.05). Whereas, mindfulness increases parasympathetic activity (P<0.05) and decreases sympathetic tone (P<0.05). The study could bring up the importance of improving the mindfulness, bringing down the anxiety, and there by balancing cardiac nerves of sympathetic and parasympathetic nervous system.","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67389895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of Heart Rate Variability in Childhood-Insights into the Biology of Heart Rate Regulation","authors":"R. Buchhorn, U Rakowski, C. Willaschek, C. Baumann","doi":"10.16966/2379-769x.151","DOIUrl":"https://doi.org/10.16966/2379-769x.151","url":null,"abstract":"The current doctrine of dual regulation of Heart Rate Variability (HRV) via the autonomic nervous system has many limitations, mostly in children of different ages and nutritional states. Methods: We analyzed 24-hour HRV in a group of 126 healthy children with a normal Body Mass Index (BMI) in addition to 146 obese children with a BMI >90% and 32 children with anorexia nervosa with a BMI <10%. We included the ratio of body weight to body surface area in our analysis to prove the impact of thermogenesis on HRV analysis. Results: The high impact of age on HRV in the 126 healthy children with a normal BMI disappeared after including children with high and low BMIs. Linear regression analysis showed that HRV in childhood is not a sign of age-dependent maturation of the autonomic nervous system; rather, it is related to the age-dependent changes in body surface area, height, and weight. The ratio of body weight to body surface area indicates two different systems to regulate the heart rate in children with a ratio >/<30 kg/m2. Conclusion: Our data indicate a third regulatory system that is important in HRV analysis in addition to the dual regulation of the vagus and sympathicus. This system is related to age-dependent changes in body surface area, height, and weight. These factors depend on nutrition and energy demands and are probably regulated by the HCN4 gene.","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67389958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation Initiated by Early Afterdepolarization-Mediated Triggered Activity during Acute Oxidative Stress: Efficacy of Late Sodium Current Blockade.","authors":"Arash Pezhouman,&nbsp;Hong Cao,&nbsp;Michael C Fishbein,&nbsp;Luiz Belardinelli,&nbsp;James N Weiss,&nbsp;Hrayr S Karagueuzian","doi":"10.16966/2379-769X.146","DOIUrl":"https://doi.org/10.16966/2379-769X.146","url":null,"abstract":"<p><strong>Background: </strong>The mechanism of Atrial Fibrillation (AF) that emerges spontaneously during acute oxidative stress is poorly defined and its drug therapy remains suboptimal. We hypothesized that oxidative activation of Ca-calmodulin dependent protein kinase (CaMKII) promotes Early Afterdepolarization-(EAD)-mediated triggered AF in aged fibrotic atria that is sensitive to late Na current (I_Na-L) blockade.</p><p><strong>Method and results: </strong>High-resolution voltage optical mapping of the Left and Right Atrial (LA & RA) epicardial surfaces along with microelectrode recordings were performed in isolated-perfused male Fisher 344 rat hearts in Langendorff setting. Aged atria (23-24 months) manifested 10-fold increase in atrial tissue fibrosis compared to young/adult (2-4 months) atria (P<0001. Spontaneous AF arose in 39 out of 41 of the aged atria but in 0 out of 12 young/adult hearts (P<001) during arterial perfusion of with 0.1 mm of hydrogen peroxide (H₂O₂). Optical Action Potential (AP) activation maps showed that the AF was initiated by a focal mechanism in the LA suggestive of EAD-mediated triggered activity. Cellular AP recordings with glass microelectrodes from the LA epicardial sites showing focal activity confirmed optical AP recordings that the spontaneous AF was initiated by late phase 3 EAD-mediated triggered activity. Inhibition of CaMKII activity with KN-93 (1 μM) (N=6) or its downstream target, the enhanced I_Na-L with GS-967 (1 μM), a specific blocker of I_Na-L (N=6), potently suppressed the AF and prevented its initiation when perfused 15 min prior to H₂O₂ (n=6).</p><p><strong>Conclusions: </strong>Increased atrial tissue fibrosis combined with acute oxidative activation of CaMK II Initiate AF by EAD-mediated triggered activity. Specific block of the I_Na-L with GS-967 effectively suppresses the AF. Drug therapy of oxidative AF in humans with traditional antiarrhythmic drugs remains suboptimal; suppressing I_Na-L offers a potential new strategy for effective suppression of oxidative human AF that remains suboptimal.</p>","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36645681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wanted: Class VI Antiarrhythmic Drug Action; New Start for a Rational Drug Therapy.","authors":"Hrayr S Karagueuzian,&nbsp;Uwe Klein","doi":"10.16966/2379-769X.148","DOIUrl":"https://doi.org/10.16966/2379-769X.148","url":null,"abstract":"Since the discovery by a Dutch merchant in the early 20th Century that the drug quinine he was taking to prevent malaria during his frequent trips to the West Indies also prevented his Atrial Fibrillation (AF) [1], drug therapy of cardiac arrhythmias remained largely empirical and at best suboptimal [2]. Slowing of impulse conduction (akin to local anesthetic effects) and increased refractoriness of cardiac tissue as observed with quinidine (quinine’s isomer) still remain the two key parameters, among other mechanisms, that are targeted to control cardiac arrhythmias.","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37231885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergism between Enhanced Late Inward Currents and Tissue Fibrosis in the Initiation of Spontaneous Ventricular Tachyarrhythmias.","authors":"Karagueuzian Hs","doi":"10.16966/2379-769X.120","DOIUrl":"https://doi.org/10.16966/2379-769X.120","url":null,"abstract":"Sudden cardiac death (SCD) death is a major worldwide public health problem that often arises in patients with diverse cardiac diseases associated with enhanced cardiac tissue fibrosis and altered cardiac sarcolemmal ionic current conductances. It is now clear that the major cause of SCD is ventricular tachycardia (VT) degenerating to ventricular fibrillation (VF), although bradyarrhythmias may also promote the fatal event albeit, to a much lesser extent than the VT/VF [1]. SCD occurs in approximately 180,000–250,000 cases annually in the United States, and an estimated 4–5 million cases worldwide [2]. The prevalence of cardiovascular diseases potentially associated with lethal ventricular arrhythmia is estimated at approximately 13 million US individuals, which is about 5% of the middle-aged population [3]. Sarcolemmal ion channels of cardiac myocytes are responsible for the genesis of cardiac action potential (AP) and their genetic (channelopathy) or disease-induced alterations promote arrhythmogenic changes including triggered activity caused either by early or delayed after depolarizations (EAD and DAD respectively) predisposing the heart to life-threatening VT/VF. Four major classes of genetically-based ion channel abnormalities have been described that predispose the heart to VT/VF; the long QT syndrome (LQTS), short QT syndrome (SQTS), Brugada syndrome (BrS), and catecholaminergic polymorphic ventricular tachycardia (CPVT) [4]. Initially it was thought that patients at increased risk of VT/VF with genetic abnormalities in sarcolemmal ionic currents (i.e. channelopathies) had structurally normal hearts. However recent studies based on post-mortem histological analysis of patients with Na channelopathy (i.e. BrS), provided compelling evidence that these patients had focal areas of increased ventricular tissue fibrosis and reduced gap junctional connexin-43 (Cx43) indicating the potential dual contributions of fibrosis and channelopathy to the development of VT/VF [5]. Diverse etiological factors including myocardial infarction or drug-induced altered ion channel conductances are also thought to interact with cardiac tissue fibrosis to promote VT/VF [6]. In this article, I will make the case for the presence of a synergism between ionic current abnormality caused by enhanced late Na current so to mimic LQT3 and enhanced late Ca current as a surrogate of LQT8","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67389768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tacrolimus as a Possible Trigger of Tachycardias in a Heart-Transplanted Patient with Severe Diarrhea","authors":"C. Blockhaus, P. Waibler, J. Gulker, B. Kokturk, A. Bufe, D. Shin, Klues Hg","doi":"10.16966/2379-769X.158","DOIUrl":"https://doi.org/10.16966/2379-769X.158","url":null,"abstract":"Tacrolimus is a broadly used immunosuppressive agent in organ transplanted patients. It is known that it may induce arrhythmias. We here report on a heart transplanted patient with supraventricular and ventricular arrhythmias with an elevated tacrolimus trough serum level due to severe diarrhea.","PeriodicalId":91746,"journal":{"name":"Journal of heart health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67390053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}