Elevated Heart Research Articles

Staunch the Age Related Decline into Dementia, Cancer, Autoimmunity (Long Covid), Obesity, and Other Diseases with a Prebiotic, Probiotic, Postbiotic Triple Play

“All diseases originate in the gut.” Hippocrates (400 BC) A healthy gut microbiome via the gut-brain-axis elevates heart rate variability (HRV), a general measure of health and well-being. A dysbiotic gut microbiome, low in biodiversity and butyrate producers, can alter tryptophan metabolism (ATM) and increase the kynurenine to tryptophan ratio (KTR) with release of proinflammatory cytokines, predominantly TNF-α, IL-6, and IL-1β. These also characterize chronic inflammation, oxidative stress, and a multitude of diseases. Also proposed is the gut-lung dysbiosis concept and consequent degradation of ACE2 (richest in lungs and gut). Leaky gut (and lung) induced autoantibodies (AAs) related to G-protein coupled receptors (GPCRs) in combination with increased Ang II further potentiate oxidative stress. The underappreciated pathogenic role of Candida is explored. The efficacy of fecal microbiome transplantation (FMT) in treating dementia, cancer, and autoimmunity supports the plausibility of success with “FMT-lite”. This triple play of prebiotic (d-mannose), probiotic (bifidobacteria and lactobacilli), and postbiotic (butyrate) might improve intestinal barrier integrity, oppose entry of GPCR antigens, suppress the inflammatory cytokine triad, balance IFN-γ and TGF-β, suppress oxidative stress, depress KTR, elevate HRV, and extend lifespan and its quality.

Effect of pacifier and pacifier with dextrose in reducing pain during orogastric tube insertion in newborns: a randomized controlled trial*

ObjectiveThis study aimed to assess the efficacy of pacifier use, with and without 25% dextrose, in reducing pain during orogastric tube insertion in newborns.Study designIn a randomized controlled trial involving 60 newborns at a public hospital from April to December 2019, participants were divided into three groups: pacifier (n = 20), pacifier with 25% dextrose (n = 20), and control (n = 20). A pacifier, with and without dextrose, was used for the experimental groups, while the control group performed a routine procedure. Neonatal infant pain scale, crying duration, heart rate (HR), and oxygen saturation (SpO2) were evaluated.ResultsResults indicated that the control group experienced significantly higher pain levels, elevated HRs, decreased SpO2, and prolonged crying. Conversely, the pacifier with 25% dextrose group showed a notable reduction in crying duration.ConclusionA pacifier, with and without 25% dextrose, effectively reduces pain and improves physiological and behavioral parameters during orogastric tube insertion.Clinical trial numberNCT05462964Clinical trial registrationThe protocol for this randomized controlled experimental trial is registered on ClinicalTrials.gov. The clinical trial registration number is https://clinicaltrials.gov; NCT05462964.

Plant‐Inspired Dual‐Functional Sensor for Monitoring Pulse and Sweat Volume

AbstractWearable health monitoring sensors, when employed to monitor pulse and sweat volume in real‐time during human physical activity, serve as an effective preventative measure against abnormal health conditions, such as elevated heart rate or excessive dehydration. Herein, a dual‐functional sensor based on a sandwich structure composed of polyvinylidene fluoride hexafluoropropylene / conductive carbon black perforated film (named PCp film) and corncob sponge is designed to monitor pulse and sweat volume. The PCp film prepared by the breath figure method serves as a piezoresistive sensor with high sensitivity (0.06 kPa−1), a fast response time (0.9 ms), and high reusability for pulse monitoring. Furthermore, the PCp film has excellent water permeability (27.3 L m−2 h−1); thus, the sweat permeating through the PCp film can be absorbed by the corncob sponge. The sandwich‐structured capacitive sensor is also highly sensitive (6.021 pF nL−1) to the absorbed sweat and is highly reusable. In addition, the dual‐functional sensor is successfully integrated into a sports bracelet system to display real‐time pulse and sweat‐volume data of the wearer. This approach provides a dependable foundation for the advancement of multifunctional sensors in the field of sports monitoring.

Experimental study on thermo-physiological differences between children and adults during indoor sedentary conditions

Previous research has shown that children prefer cooler environments and have lower thermal sensitivity than adults. This disparity may be attributed to physiological differences between these age groups. However, studies are scarce that specifically measure children's physiological parameters. In this study, we measured the physiological parameters of children aged 6–9 years and their parents, concurrently collecting their thermal comfort votes. Measured physiological parameters include metabolic rate, blood flow, body composition, core temperature, blood oxygen, heart rate, skinfold thickness, and skin temperature.We found that the average metabolic rate of the measured children was 1.20 met, 39% higher than the measured adults who had their average metabolic rate as 0.86 met. Children consistently exhibited higher metabolic rates than their own parents. Children were observed to have less body fat and thinner skin folds compared to adults. Additionally, children exhibited higher skin temperatures in core areas, elevated heart rates, and quicker recovery of skin blood flow and local skin temperature after experiencing cold exposure on hand compared to adults. These characteristics reveal children's superior thermoregulatory abilities, explaining their preference for cooler environments and reduced thermal sensitivity. Besides, no gender difference was observed in the thermal physiology of the measured children.All of the distinctive thermal physiological traits of children underscore the necessity of specific criteria for evaluating the thermal comfort of children.

Carotidynia: Overview of an uncommon identification for unilateral neck pain.

Carotidynia, also known as Fay Syndrome, manifests as an atypical facial neuralgia characterized by an unusual neck pain extending towards the head and associated with carotid artery tenderness. Diagnostic criteria include neck tenderness, elevated carotid pulse without anatomical abnormalities, and neck distension. It was initially classified as a vascular headache but later re-evaluated and reclassified as a nonentity-a general condition caused by nonvascular factors. The etiology has not been extensively elucidated. We present two cases characterized by dysphagia, intermittent discomfort, and numbness in the throat and cervical region. Although the neurological examinations yielded no abnormalities, the diagnosis of carotidynia was ultimately established among the differential diagnoses upon the identification of wall thickening and inflammatory alterations through neuroimaging. Carotidynia is consistent with idiopathic vasculitis near the distal common carotid artery. Inflammatory processes trigger sympathetic plexus stimulation, causing discomfort in the head and neck. Neuroimaging resolves ambiguities in idiopathic unilateral neck pain, detecting soft tissue growth near the carotid artery. "Carotidynia" now refers to a diagnostic symptom and clinical entity encompassing a variety of disorders; therefore, approach to definition remains controversial. This report aims to raise healthcare awareness by highlighting two different cases of carotidynia.

Development and external validation of a dynamic risk score for early prediction of cardiogenic shock in cardiac intensive care units using machine learning.

Myocardial infarction and heart failure are major cardiovascular diseases that affect millions of people in the US with the morbidity and mortality being highest among patients who develop cardiogenic shock. Early recognition of cardiogenic shock allows prompt implementation of treatment measures. Our objective is to develop a new dynamic risk score, called CShock, to improve early detection of cardiogenic shock in cardiac intensive care unit (ICU). We developed and externally validated a deep learning-based risk stratification tool, called CShock, for patients admitted into the cardiac ICU with acute decompensated heart failure and/or myocardial infarction to predict onset of cardiogenic shock. We prepared a cardiac ICU dataset using MIMIC-III database by annotating with physician adjudicated outcomes. This dataset that consisted of 1500 patients with 204 having cardiogenic/mixed shock was then used to train CShock. The features used to train the model for CShock included patient demographics, cardiac ICU admission diagnoses, routinely measured laboratory values and vital signs, and relevant features manually extracted from echocardiogram and left heart catheterization reports. We externally validated the risk model on the New York University (NYU) Langone Health cardiac ICU database that was also annotated with physician adjudicated outcomes. The external validation cohort consisted of 131 patients with 25 patients experiencing cardiogenic/mixed shock. CShock achieved an area under the receiver operator characteristic curve (AUROC) of 0.821 (95% CI 0.792-0.850). CShock was externally validated in the more contemporary NYU cohort and achieved an AUROC of 0.800 (95% CI 0.717-0.884), demonstrating its generalizability in other cardiac ICUs. Having an elevated heart rate is most predictive of cardiogenic shock development based on Shapley values. The other top ten predictors are having an admission diagnosis of myocardial infarction with ST-segment elevation, having an admission diagnosis of acute decompensated heart failure, Braden Scale, Glasgow Coma Scale, Blood urea nitrogen, Systolic blood pressure, Serum chloride, Serum sodium, and Arterial blood pH. The novel CShock score has the potential to provide automated detection and early warning for cardiogenic shock and improve the outcomes for the millions of patients who suffer from myocardial infarction and heart failure.

Heart rate variability and its association with symptoms of orthostatic hypotension in spinal cord injury

Context/objective To assess differences in autonomic function using heart rate variability (HRV) parameters between people with and without orthostatic hypotension (OH), and to determine symptoms of OH in people with spinal cord injury (SCI). Methods R-R interval and blood pressure (BP) data were recorded using Finometer PRO® in both the supine position and at a 60-degree tilt using a tilt table, each lasting for 6 minutes. R-R interval data were processed using the Kubios HRV analysis software to convert R-R interval into time and frequency domains for further analysis. Results Compared to the non-OH group, the SCI group with OH exhibited lower values for root mean square of the successive differences (RMSSD) and standard deviation of normal-to-normal interval (SDNN), along with an elevated heart rate during tilt-up. Participants with OH symptoms had a lower average heart rate in the supine and 60-degree positions compared to asymptomatic participants. Logistic regression analysis indicated that SDNN in the supine position correlated with the presence of OH, and that the mean heart rate in the 60-degree position was related to the presence of symptoms. Conclusions Differences in HRV parameters were observed in people with SCI and OH, suggesting a reduced parasympathetic activity in the supine position, likely as a response to maintain homeostasis in BP regulation. Despite the presence or absence of OH symptoms, there was no difference in HRV parameters. This finding suggests that autonomic function may not be the primary determinant of these symptoms, with other factors likely being more influential.

The Effect of Sex on the Risk of Long-COVID and Cardiovascular Complications in Healthy Patients without Comorbidities: Data from a Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study.

Background: The prevalence of long-COVID (LC) presents a significant challenge to healthcare systems globally. There are still some discrepancies on the role of sex as an independent risk factor of LC complications. Thus, we aimed to determine the differences in clinical and cardiovascular complications between males and females without comorbidities after COVID-19. Methods: Clinical data on the course of the disease with the accompanying symptoms and post-COVID-19 symptoms were compiled from both male and female subjects with a minimum 12-week interval after COVID-19 recovery. Next, the patients were followed for 12 months. ECG, echocardiography, 24 h ECG monitoring, 24 h ambulatory blood pressure monitoring (ABPM), and selected biochemical tests were performed. LC was diagnosed based on the World Health Organization (WHO) definition. To reduce the impact of confounders, i.e., body mass index (BMI) and age, on the results of the study, the nearest neighbour (NN) propensity score matching (PSM) method with a 1:1 ratio was used. Results: The results were obtained following the removal of cases with comorbidities from the database consisting of 1237 males and 2192 females, and PSM of the new database included 886 cases (443 males and 443 females). At both the 3-month and 1-year post-recovery marks, females consistently reported a higher frequency of LC symptoms compared to males (p < 0.001 for both comparisons). Moreover, after 1 year of follow-up, females exhibited a higher prevalence of LC compared to males, with rates of 14% versus 8.3%, respectively (p = 0.013). The symptoms that significantly differed between females and males in the 12-month follow-up were hair loss (5.4 vs. 0.7%, p < 0.001), memory and concentration disturbances (8.4 vs. 4.3%, p = 0.013), and headaches (4.3 vs. 1.4%, p = 0.008). Females presented lower mean arterial pressure (MAP) [89 (83-95) mmHg versus (vs.) 94 (89-100); p < 0.001] and lower pulse pressure (PP) [46 (42-52) mmHg vs. 51 (48-57); p < 0.001] in 24 h ABPM and more elevated heart rates (HRs) in 24 h ECG monitoring as well as arrhythmia (p < 0.001 and p = 0.018, respectively). Males had a higher occurrence of ECG abnormalities such as QRS >= 120 ms, ST-T changes, T inversion, arrhythmia, and QRS fragmentation (27.3% vs. 19.2%; p = 0.004). No significant differences were observed between males and females concerning physical activity levels, stress, fatigue, alcohol consumption, and smoking habits. Conclusions: One year post-COVID-19 recovery, regardless of age and BMI, healthy females more often suffered from LC symptoms than males. They had lower MAP and PP in 24 h ABPM, more often had higher HRs and arrhythmia in 24 h ECG monitoring, and fewer ECG abnormalities than males.

Predictive Factors for First-Pass Intubation Failure in Trauma Patients.

The primary objective of this study was to elucidate risk factors for multiple intubation attempts (MIA) in trauma patients requiring emergent tracheal intubation (ETI). Risk factors for mortality, intensive care unit (ICU) admission, and prolonged ventilation were assessed as secondary outcomes. The association between multiple intubation attempts and adverse outcomes has been well described in the literature. Though previous studies have identified anatomical risk factors for difficult airways, no study to date has investigated predictors for MIA in a trauma setting. The retrospective study involved 174 adult patients who required ETI and who presented to a Level 1 Trauma Center's emergency department between January 2019 and December 2022. Comorbidities, demographic information, triage vitals, intubation characteristics, and patient outcomes were identified to ascertain predictive risk factors for MIA. Variables were assessed for statistical significance on unadjusted analysis. Significant variables were entered into multivariate logistic regression models to test for adjusted associations, with p≤.0.05 as statistically significant, and presented as adjusted odds ratios with 95% confidence intervals. Twenty-six (14.9%) of the 174 patients required multiple intubation attempts. There were no significant associations between MIA and patient gender, age, BMI, race, injury mechanism, or specific body region injuries. On univariate analysis, the MIA group had a statistically significant elevation in mean systolic blood pressure (151.71 ± 45.96 vs 133.55 ± 32.11, p = 0.019) and heart rate (106.30 ± 34.92 vs 93.35 ± 24.82, p < 0.032) compared to subjects with first-pass success. Elevation in systolic blood pressure (SBP) (151.71 ± 45.96 vs 133.55 ± 32.11, aOR 1.03 (1.01-1.06), p < 0.015) was an independent predictor of multiple intubation attempts. Elevation in SBP was a significant predictor of multiple intubation attempts. Critical appraisal of patients requiring ETI with elevated SBP may mitigate risk in trauma settings.

Predictors of mortality among hospitalized hypertensive patients with COVID-19 during third and fourth waves in Pakistan.

Hypertension significantly contributes to the severity and mortality of COVID-19 patients. It has also been a risk factor for prolonged hospitalization and the need for intensive care. However, the data is still evolving. Therefore, this study investigated the predictors of mortality among hypertensive COVID-19 patients. A single-center cohort study was performed at Indus Hospital and Health Network, Karachi, Pakistan, between April 1, 2021, and October 31, 2021. This study included 333 hospitalized hypertensive COVID-19 patients and evaluated their clinical characteristics and survival outcomes. A multivariate logistic regression model was applied in IBM SPSS 27.0 to determine the predictors of mortality. The majority of patients were females (54.7%), the median age was 62 [55-70] years, with co-existing diabetes (56.5%) and severely ill (52.6%). The independent predictors of mortality identified were age ≥ 65 years (aOR 20.89, 95% CI, 5.81-75.15; p < 0.001), pulse rate (aOR 1.03, 95% CI 1.01-1.63; p = 0.006), serum creatinine (aOR 1.34, 95% CI 1.11-1.63; p = 0.002), use of antibiotics (aOR 3.40, 95% CI 1.29-8.98; p = 0.014)), corticosteroid (aOR 49.68, 95% CI 1.83-1350.31; p = 0.020), and who needed high flow oxygen supply (aOR 13.08, 95% CI 1.70-100.54; p < 0.001), non-invasive mechanical ventilation (aOR 229.01, 95% CI 29.30-1789.71; p < 0.001) and invasive mechanical ventilation (aOR 379.54, 95% CI 36.60-3935.87; p < 0.001). Our study suggests that older age, elevated pulse rate, serum creatinine, use of antibiotics and corticosteroids, and the need for mechanical ventilation predict mortality among hypertensive COVID-19.

Determinantes del rendimientofísico y las respuestasfisiológicas durante una maratónoficial de bicicleta de montaña através del campo (XCM-MTB)

Introduction: The variables determinants of physical performance in cross-country marathon of mountain biking (XCM-MTB) are still unknown. Objective: We aimed to verify the training control variables and the physiological responses in an official XCM-MTB race. Material and methods: 13 athletes (11 men and 2 women; 33.3 ± 12.7 years of age) participated in this study. It was conducted during an official XCM-MTB in Brazil (route of 70 km). The heart rate (HR), altimetry, velocity, temperature, pacing, and power were obtained every 10 km travelled by the STRAVA application. Multiple linear regression analysis was performed to verify whether the variables could predict physical performance. Results: The athletes maintained constant HR elevation in the corresponding zone 80% HRmax. They also presented a variation in the pacing (F = 35.82; p &lt; 0.001; d = 0.66) and power (F = 7.20; p &lt; 0.001; d = 0.18) showing higher values in the last 10 km. Only pacing can be considered a predictor of the physical performance (β = 0.958; t = 7.30; p &lt; 0.001), specifically the one at 20 km (F = 10.23; p = 0.004; R2 = 0.82). Conclusion: The study concluded that the analyzed variables are reliable for the performance control in an official XCM-MTB race. HR and power are variables that can be used to prescribe and control training, as they change according to the requirements of the race. Power can also be used as a performance predictor as it is directly influenced by terrain

The pancreas does not contribute to the non-adrenergic-non-cholinergic stimulation of heart rate in digesting pythons

Vertebrates elevate heart rate when metabolism increases during digestion. Part of this tachycardia is due to a non-adrenergic-non-cholinergic (NANC) stimulation of the cardiac pacemaker, and it has been suggested these NANC factors are circulating hormones that are released from either gastrointestinal or endocrine glands. The NANC stimulation is particularly pronounced in species with large metabolic responses to digestion, such as reptiles. To investigate the possibility that the pancreas may release hormones that exert positive chronotropic effects on the digesting Burmese python heart, a species with very large postprandial changes in heart rate and oxygen uptake, we evaluate how pancreatectomy affects postprandial heart rate before and after autonomic blockade of the muscarinic and the beta-adrenergic receptors. We also measured the rates of oxygen consumption and evaluated the short-term control of the heart using the spectral analysis of heart rate variability and the baroreflex sequence method. Digestion caused the ubiquitous tachycardia, but the intrinsic heart rate (revealed after the combination of atropine and propranolol) was not affected by pancreatectomy and therefore hormones, such as glucagon and insulin, do not appear to contribute to the regulation of heart rate during digestion in Burmese pythons.

Prospects of using functional training in the process of physical training of cadets

The professional activity of military personnel is always associated with high risk, which includes both psychological aspects and physical aspects. Work experience confirms that the quality of mastering combat techniques for use in extreme conditions depends on the level of development of mental preparedness and endurance. Including elements of functional training in physical training can significantly contribute to the development of endurance, strength, coordination, and psychological stability. Endurance as a physical quality is characterized by the ability to perform tasks for a long time. Modern conditions in which military personnel perform their tasks, despite the presence of the latest military equipment and vehicles, require them to have a high level of development of this quality in order to carry out foot crossings, overcome areas of terrain with various artificial and natural obstacles. In the course of functional training, strength endurance is developed, which allows you to perform physical tasks for a long period of time. This can be especially useful in military service or other situations where it is necessary to maintain a high level of physical activity for a long time.&#x0D; The basic idea of functional training is to use exercises that activate many muscle groups at the same time and imitate movement patterns that can be encountered in everyday life or during sports activities.&#x0D; Functional training also improves cardiovascular endurance by increasing the efficiency of the cardiovascular system and the body's ability to work at an elevated heart rate. Such training may include elements of exercises with weights, a functional simulator, aerobics and other forms of physical activity aimed at comprehensive development. This method of training can be useful for improving general physical fitness, particularly in the context of military-professional activities, as it promotes the development of functional strength endurance and adaptive readiness for various physical challenges.

Extended Use of Ivabradine in Heart Failure with Preserved Ejection Fraction and Inappropriate Sinus Tachycardia

Ivabradine has been used for over a decade in managing chronic coronary syndromes and heart failure (HF) with reducedejection fraction (HFrEF). HF with preserved ejection fraction (HFpEF) accounts for 50% of the total HF cases carrying equalmortality and morbidity risk as HFrEF. Increased heart rate (HR) in such cases has been shown to be associated with poorclinical outcomes. Clinical conditions like inappropriate sinus tachycardia (IST) manifest with elevated HR without anyspecific triggers. Beta-blockers have been the preferred treatment of choice for both HFpEF and IST but are often ineffective orpresent with side effects due to their negative ionotropic effects. Ivabradine, through its inhibitory action on funny current(Ifc), reduces HR without altering the inotropic mechanism. Few case reports and small case series have documented itsextended use and efficacy in reducing HR in these cardiac conditions. In this article, we present two cases who needed HRcontrol, one with HFpEF and another case of IST syndrome. Ivabradine was successfully used in both these cases to controlthe elevated HR.

Remote monitoring of atrial fibrillation recurrence using mHealth technology (REMOTE-AF).

This proof-of-concept study sought to evaluate changes in heart rate (HR) obtained from a consumer wearable device and compare against implantable loop recorder (ILR)-detected recurrence of atrial fibrillation (AF) and atrial tachycardia (AT) after AF ablation. REMOTE-AF (NCT05037136) was a prospectively designed sub-study of the CASA-AF randomized controlled trial (NCT04280042). Participants without a permanent pacemaker had an ILR implanted at their index ablation procedure for longstanding persistent AF. Heart rate and step count were continuously monitored using photoplethysmography (PPG) from a commercially available wrist-worn wearable. Photoplethysmography-recorded HR data were pre-processed with noise filtration and episodes at 1-min interval over 30 min of HR elevations (Z-score = 2) were compared with corresponding ILR data. Thirty-five patients were enrolled, with mean age 70.3 ± 6.8 years and median follow-up 10 months (interquartile range 8-12 months). Implantable loop recorder analysis revealed 17 out of 35 patients (49%) had recurrence of AF/AT. Compared with ILR recurrence, wearable-derived elevations in HR ≥ 110 beats per minute had a sensitivity of 95.3%, specificity 54.1%, positive predictive value (PPV) 15.8%, negative predictive value (NPV) 99.2%, and overall accuracy 57.4%. With PPG-recorded HR elevation spikes (non-exercise related), the sensitivity was 87.5%, specificity 62.2%, PPV 39.2%, NPV 92.3%, and overall accuracy 64.0% in the entire patient cohort. In the AF/AT recurrence only group, sensitivity was 87.6%, specificity 68.3%, PPV 53.6%, NPV 93.0%, and overall accuracy 75.0%. Consumer wearable devices have the potential to contribute to arrhythmia detection after AF ablation. ClinicalTrials.gov Identifier: NCT05037136 https://clinicaltrials.gov/ct2/show/NCT05037136.

Gender differences in risk factor profile among elderly and its impact on total and cardiovascular mortality

Objective. To evaluate gender differences in the profile of a wide range of risk factors (RF) among men and women aged 65 years and older and its associations with cardiovascular and all-cause mortality. Design and methods. The present study was the part of the Survey on Stress, Aging, and Health in Russia. The sample size was 1,243 participants aged 65 years and older. Thirty RF were included in the analysis, including social, cardiometabolic, behavioural, physical and cognitive functioning, inflammation, and neuroendocrine biomarkers, as well as coronary heart disease (CHD), myocardial infarction, arterial hypertension, and acute stroke. The mean follow-up was 12 years, during which 534 participants died from various causes, including 324 from cardiovascular diseases (CVD). Results. Multivariate analysis showe that elevated heart rate, smoking, excessive alcohol consumption, elevated interleukin‑6, elevated leukocyte levels, reduced cognitive function (for CVD mortality), CHD and history of acute stroke contributed to allcause and CVD mortality among men 65 years and older. Elevated blood pressure and elevated high-sensitive C-reactive protein, impaired cognitive function, reduced muscle strength, reduced dehydroepiandrosterone sulfate levels, absence of children, and a history of acute stroke were associated with all-cause and CVD mortality among women 65 years and older. Conclusions. The present study identified gender difference in survival and RF profile for both total and CVD mortality in population of men and women aged 65 years and older. Aamong more than 30 RF and several CVD, 8 indicators were found to affect mortality in men and 7 RF affected mortality in women.

Comparison of Protective Effect of Tri-circulator and Coenzyme Q10 on Myocardial Injury and the Mechanism Study by Zebrafish Model.

Tri-Circulator (TC) is a product comprising coenzyme Q10 (CoQ10), Salvia miltiorrhiza, and Panax notoginseng. Individually, each of these constituents has demonstrated protective effects on myocardial injury. The purpose of this study is to evaluate the protective efficacy of TC on heart function and compare the differential effects between CoQ10 and TC. Two myocardial injury models of zebrafish, the hypoxia-reoxygenation model (H/R) and the isoproterenol (ISO, a β-receptor agonist) model, were used in this experiment. The zebrafish subjects were divided into 4 groups: control, H/R, TC, and CoQ10. Heart rate, stroke volume (SV), cardiac output (CO), ejection fraction (EF), fractional area change (FAC), and pericardial height were monitored to assess changes in heart function. The gene expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) was studied as markers of injury/stress. TC significantly suppresses elevated heart rate induced by H/R and prevents the decrease of heart rate induced by ISO. It alleviates the pericardial infusion induced by ISO, whereas CoQ10 does not possess a similar effect. Both TC and CoQ10 significantly inhibit the decline in SV, CO, EF, and FAC induced by H/R and ISO, and suppress the expression of ANP and BNP in cardiomyocytes induced by ISO. It is noteworthy that TC demonstrates a more pronounced effect on EF, FAC, ANP, and BNP gene expression compared to CoQ10. Both TC and CoQ10 have a protective effect on myocardial injury of zebrafish. However, TC exhibits a greater efficacy compared to CoQ10 alone in mitigating myocardial injury.

Stenosis severity and heart rate effects on left coronary artery hemodynamics and myocardial oxygen balance: A comprehensive assessment using pressure gradient

The estimation of pressure drop across stenotic arteries can provide valuable information about the hemodynamic features. Nevertheless, the temporal behavior of pressure in stenotic arteries is not well reported for realistic pulsatile flows. This research investigates the pressure drop across a left coronary artery model for different degrees of stenotic severity and heart rates. The zones prone to further atherogenic degeneration are identified using time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI). A unique attempt has been made to quantify the effect of stenosis severity and elevated heart rate on coronary perfusion pressure (CPP) and endocardial viability ratio (EVR), which is an indicator of myocardial oxygen supply-demand balance. We have predicted reductions in both CPP and EVR as stenosis severity increases. The aforementioned metrics exhibit a notable drop when confronted with a moderate stenosis at an increased heart rate, implying that the hemodynamic consequences of a moderate stenosis during an elevated heart rate may be comparable to those of a severe stenosis during a state of rest. The current computational investigation has the potential to reduce the need for in vivo hemodynamic assessments of stenosis. In addition, the wall shear stress-based mechanical parameters, such as TAWSS and OSI, can indicate the atherogenic and thrombogenic regions in the stenosed vessels.

Abstract TMP107: Persistent Beta-Blocker Use and Mortality Reduction in Acute Ischemic Stroke Patients

Background: The efficacy of beta-blockers in acute ischemic stroke remains ambiguous. Research targeting high-risk patients, especially those with elevated heart rates, is crucial. Methods: A comprehensive multicenter registry of acute ischemic stroke patients was integrated with the National Health Insurance Service database. We focused on patients exhibiting a heart rate of ≥100 bpm between days 3-7 post-symptom onset. These patients were categorized based on whether they received a beta-blocker prescription by day 8. To account for potential imbalances, we employed Cox’s proportional hazard model with inverse-probability of treatment weighting based on propensity score. The primary outcome was composite of stroke recurrence, myocardial infarction, and mortality within a year post-stroke. Recognizing the significant discontinuation rate of beta-blockers, we conducted an additional analysis on persistent users and landmark analysis at 2-month, 1-year, and 2-year intervals. Results: Out of 5,049 patients, 1,623 (32.1%) were prescribed with beta-blockers by the 8th day. Beta-blocker usage did not significantly influence the primary outcome within the first year (IPTW adjusted HR [95% CI], 0.98 [0.86-1.12]). However, patients who consistently used beta-blockers beyond 2 months exhibited a reduced mortality risk (adjusted HR, 0.88 [0.78-0.99]). Landmark analysis further revealed that consistent beta-blocker usage notably decreased mortality risk at 8-day to 2-month (IPTW adjusted HR [95% CI], 0.80 [0.69-0.93]) and 2-month to 1-year intervals (IPTW adjusted HR [95% CI], 0.80 [0.68-0.94]). Conclusion: Our findings suggest that beta-blockers can potentially reduce mortality in acute ischemic stroke patients, with consistent usage being a pivotal factor.

Trajectory Groups of 72-Hour Heart Rate After Mechanical Thrombectomy and Outcomes.

Elevated heart rate (HR) after mechanical thrombectomy (MT) was associated with an increased risk of adverse outcomes. However, optimal HR management after MT remains unclear. This study aimed to identify patient subgroups with distinct HR trajectories after MT and explore their association with outcomes. Acute ischemic stroke patients undergoing MT therapy were prospectively recruited from July 2020 to December 2022. Their heart rate indicators were collected every hour for 72 hours after MT procedure. Latent variable mixture modeling was used to separate subjects into five groups with distinct HR trajectories. The primary outcome was poor functional outcome (mRS score >2) at 3 months. Additional outcome was all-cause mortality (mRS score = 6) at 3 months. A total of 224 patients with large vessel occlusion were enrolled, with a mean age of 65.2+14.0 years. Eighty-seven patients had a good functional outcome, and 137 patients had a poor functional outcome. Five distinct HR trajectories were observed: low (19.2%), moderate (33.0%), rapidly stabilized HR group (20.5%), persistently high HR group (21.0%), and very high HR group (6.3%). After adjusting for potential confounders, the HR trajectory group was independently associated with poor functional outcome at 3 months (P for interaction = 0.022). The risk of having poor functional outcome was increased in the rapidly stabilized HR group (odds ratio, 3.18 [95% confidence interval, 1.10-9.19]), the persistently high HR group (odds ratio, 5.55 [95% confidence interval, 1.72-17.87]) and very high HR group (odds ratio, 18.32 [95% confidence interval, 2.20-95.52]) but not in the moderate group (odds ratio, 1.50 [95% confidence interval, 0.61-3.69]), when compared with the low HR group. No significant association was found between trajectory group and 3-month all-cause mortality. HR during the first 72 hours after MT may be categorized into distinct trajectory groups, which differ in relation to poor functional outcome event risks. The findings may help to recognize potential candidates for future HR control trials.