Pumping Ability Research Articles

Understanding the Etiopathogenesis of Cardiomyopathies: New Insights

Background Cardiomyopathy, a rare heart disease, is characterized by abnormalities in cardiac wall thickness and chamber size, leading to impaired contraction, relaxation, conduction, rhythm, and reduced pumping ability. Aim This review aims to provide a comprehensive understanding of cardiomyopathy by examining its various aspects Method A literature survey was conducted using online databases such as PubMed, Google Scholar, and Web of Science, covering publications from January 1995 to July 2023. Result Genetic mutations in key muscle contraction genes (MYH7, MYL2, MYL3, MYBPC3, TNNT2, TPM1, TNNI3, ACTC) contribute to cardiomyopathy. Additionally, epigenetic markers in genes like FKBP5, TBX5, HAND1, POLA2, PLAAT3, and CCDC88B, along with environmental factors such as alcohol addiction, smoking, and stress, significantly influence disease risk. Genetic testing, including whole exome/genome sequencing, has revolutionized diagnosis, enabling early detection and intervention. Familial genetic testing facilitates personalized management. Conclusion Cardiomyopathy is a complex disease with genetic and environmental influences. Various techniques, including genetic testing, aid in its identification and management. Furthermore, machine learning (ML) techniques have emerged as valuable tools in understanding and predicting cardiomyopathy outcomes.

Multi-objective optimization design of a sewage pump based on non-dominated sorting genetic algorithm III

Accumulation of sanitary refuse, such as flexible cloth-like structures or the so-called rags, inflows through sewage pumps are prone to tangling, ultimately leading to clogging and wear. To prevent this, the ability of sewage pumps to handle wet wipes, rags, and similar flexible materials is a key feature that must be considered as the pumps are designed. Therefore, this paper proposed a multi-objective optimization strategy based on the fluid–structure interaction simulation, Support Vector Regression (SVR), and non-dominated sorting genetic algorithm III (NSGA-III). First, the values of the optimization objectives were obtained by a Coupled Computational Fluid Dynamics-Discrete Element Method (CFD-DEM) approach. Then, SVR was utilized to establish an approximate model between the design variables and the optimization objectives. The NSGA-III was applied to search the Pareto front. Finally, the improved impeller model was selected by adopting technique for order preference by similarity to an ideal solution (TOPSIS) with entropy weight. The results show that the multi-objective optimization method is suitable for the optimization design of sewage pumps. Comparing the numerical calculations of the original pump and the optimized pump, the results show that the optimized head and efficiency increased by 9.7% and 7.13%, respectively. The optimized pump improves the passage rate of the rag and effectively improves the clogging behavior. The wear amount of the optimized pump is significantly reduced by 32.54%.

MYH11 rare variant augments aortic growth and induces cardiac hypertrophy and heart failure with pressure overload.

Smooth muscle cell-specific myosin heavy chain, encoded by MYH11, is selectively expressed in smooth muscle cells (SMCs). Pathogenic variants in MYH11 predispose to a number of disorders, including heritable thoracic aortic disease associated with patent ductus arteriosus, visceral myopathy, and megacystis-microcolon-intestinal hypoperistalsis syndrome. Rare variants of uncertain significance occur throughout the gene, including MYH11 p.Glu1892Asp, and we sought to determine if this variant causes thoracic aortic disease in mice. Genomic editing was used to generate Myh11 E1892D/E1892D mice. Wild-type (WT) and mutant mice underwent cardiovascular phenotyping and with transverse aortic constriction (TAC). Myh11 E1892D/E1892D and WT mice displayed similar growth, blood pressure, root and ascending aortic diameters, and cardiac function up to 13 months of age, along with similar contraction and relaxation on myographic testing. TAC induced hypertension similarly in Myh11 E1892D/E1892D and WT mice, but mutant mice showed augmented ascending aortic enlargement and increased elastic fragmentation on histology. Unexpectedly, male Myh11 E1892D/E1892D mice two weeks post-TAC had decreased ejection fraction, stroke volume, fractional shortening, and cardiac output compared to similarly treated male WT mice. Importantly, left ventricular mass increased significantly due to primarily posterior wall thickening, and cardiac histology confirmed cardiomyocyte hypertrophy and increased collagen deposition in the myocardium and surrounding arteries. These results further highlight the clinical heterogeneity associated with MYH11 rare variants. Given that MYH11 is selectively expressed in SMCs, these results implicate a role of vascular SMCs in the heart contributing to cardiac hypertrophy and failure with pressure overload.

LEVERAGING LEAN SIX SIGMA TECHNIQUES FOR ACCELERATED ON-SITE CASTING: FACTORS AND STRATEGIES

In the construction industry, issues such as excessive waste, rising costs, and strained relationships are prevalent. A pressing matter of plunged casting time during mass concreting activities has engulfed numerous construction contracting firms around the world. The increased time of concrete utilization not only risks the commencement of the heat of hydration but also initiates the setting time of concrete. The use of admixtures has often been a boon to curb this situation but human errors are almost impossible to escape from as inappropriate dosage of the admixtures can result in changing the properties of the concrete, affects the quality and pumping ability, which ultimately reducing the speed of casting and elapsed schedules. Other factors on site, though minor, vastly affect the pumping efficiency and causes considerable delays in the casting which not only affects the schedules but also causes time overrun and affects the productivity at site. The focus of this study is to address the issues encountered at the site that directly affect the speed of on-site casting and corrective actions.

Transforming Industry Through Hydraulic Solutions, Enhancing Productivity

This study investigates the workings of such systems in Indonesia, focusing on the flow and pressurization of oil from reservoirs through pumps to working cylinders. Hydraulic systems are crucial in transforming oil fluid pressure into mechanical work, particularly in injection molding machines. Findings indicate that the pump's ability to convert and transmit mechanical energy effectively is pivotal in enhancing machine efficiency. These insights highlight potential areas for improvement in system design and operation, suggesting that optimizing filtration and pressurization could significantly boost industrial productivity and sustainability. Highlights: Hydraulic systems in Indonesia studied for oil flow and pressurization. Pump efficiency crucial for enhancing machine productivity. Optimization of filtration and pressurization can boost industrial sustainability. Keywords: Hydraulic System, Injection Molding Machine, System Works

Congestive Coronary Heart Failure

Congestive heart failure (CHF) is a continual condition characterized by the heart's inability to pump blood efficiently, which is essential for the buildup of fluid within the lungs and distinctive components of the body. It is a critical and regular health problem globally, affecting hundreds of thousands of people, primarily the elderly. CHF can cease owing to several underlying reasons, including coronary artery sickness, excessive blood strain, heart valve troubles, and cardiomyopathy. This summary aims to define CHF together with its pathophysiology, threat elements, clinical manifestations, analysis, and control. The pathophysiology of CHF includes weakening of the coronary heart muscle, which can also occur because of harm from preceding coronary heart attacks, extended high blood pressure, or special elements affecting coronary heart features. Because the pumping ability of the heart diminishes, blood glide in critical organs becomes inadequate, leading to symptoms, shortness of breath, fatigue, and fluid retention. Numerous risk factors contribute to the development of CHF, including age, coronary heart sickness, obesity, diabetes, smoking, and a sedentary lifestyle. Early diagnosis of CHF is critical for saving the patient from improving and decorating consequences. Diagnostic methods may additionally include medical records, physical examinations, imaging checks such as echocardiography, and blood tests to evaluate coronary heart characteristics and discover the underlying functionality. CHF control aims to alleviate signs and symptoms, sluggish sickness development, and enhance the pleasantness of life. Treatment strategies usually involve lifestyle changes such as adopting a coronary heart-wholesome diet, engaging in regular exercise, and quitting smoking. Medicinal pills such as diuretics, ACE inhibitors, beta-blockers, and angiotensin receptor blockers are prescribed to enhance coronary heart characteristics and decrease signs and signs. In severe cases, surgical interventions, such as coronary artery pass grafting or coronary heart transplantation, can be considered. As CHF is a continual condition, affected individual education and regular compliance with healthcare carriers are vital to display the ailment's improvement and regulate remedies. With improvements in scientific treatment plans and early detection, CHF analysis has advanced over the years. However, it remains a vast public health challenge, necessitating continuous research and cognizance efforts to beautify affected person consequences and decrease the load of this situation on affected human beings and healthcare systems.

Impact of cardiac power output, invasively measured by right heart catheterization, on exercise capacity and clinical outcomes in patients with chronic heart failure

Abstract Background Cardiac power output (CPO) is a novel hemodynamics parameter that is derived from both flow and pressure, and therefore it represents the cardiac pumping ability. CPO is strongly associated with outcomes in patients with cardiogenic shock. Nevertheless, less data is available about the impact of CPO on exercise capacity or clinical outcomes in patients with chronic heart failure (CHF). Purpose The present study aimed to investigate the impact of CPO on exercise intolerance or morbidity and mortality in patients with CHF who underwent invasive right heart catheterization. Methods The study enrolled 280 consecutive patients with CHF who underwent cardiopulmonary exercise testing and right heart catheterization between 2013 and 2018. The primary outcome was composite of heart failure hospitalization and death. CPO was calculated as (mean arterial pressure × cardiac output [CO])/451. Study population was divided into 2 groups according to the established cut-off value of CPO (= 0.53 W). Results Patients with low CPO (n = 99) were older and lower body mass index and displayed poorer kidney function, higher plasma brain natriuretic peptide (BNP) levels and lower left ventricular ejection fraction (LVEF) as compared to patients with high CPO (n = 181). CPO was correlated with peak oxygen consumption (Peak V̇O2), peak workload achievement, and ventilatory efficiency (V̇E/V̇CO2 slope) (Figure 1), while each of CO or mean arterial pressure was not. There were 48 patients with events over a median follow-up period of 3.5 (Interquartile range 1.0-6.0) years. Patients with low CPO had a 2.0-fold higher risk of events as compared to those with high CPO (HR 1.97; 95%CI, 1.12-3.48, P = 0.02, Figure 2). In multivariable Cox regression, 0.1-decreased in CPO was associated with 19% increased adverse events even after adjustment for gender, BNP, renal function, LVEF, and pulmonary capillary wedge pressure (HR 0.81; 95%CI, 0.67-0.99, P = 0.04). Conclusions CPO was associated with reduced exercise capacity and poor clinical outcomes, suggesting that CPO is useful for risk stratification in patients with CHF. Further study is required to identify therapies targeting CPO to improve the exercise capacity or clinical outcomes in patients with CHF.Figure1Figure2

Sustainable bio-inspired water pump using a thermo-pneumatic phenomenon with a blinking light

In the natural world, the irradiance intensity of sunlight on the ground changes periodically due to diurnal motion. Here, inspired by natural trees, we propose a water pump using a thermo-pneumatic phenomenon with a blinking light. Specifically, we demonstrate that by the periodic irradiation of 110 W/m2 for the intrinsic irradiation area of ∼15 cm2, a Y-shaped bio-inspired pump having three chambers with two check valves can suck up water from a water source and expel it from the outlet at a 30 cm height with an average volume flow rate of ∼2.1 cm3/h (∼0.7 cm3/cycle). Surprisingly, the pumping ability of our pump is ∼20.4 times higher than that of the recent high-performance artificial tree in a simple comparison. Our findings should contribute to the sustainable transport of water and understanding of the transportation mechanism of natural trees in the future.

Synthesis, anti-aging and mechanism of magnolol derivatives.

Magnolol (M), a hydroquinone containing an allyl side chain, is one of the major active components of Houpoea officinalis for antioxidation and anti-aging. To enhance the antioxidant activity of magnolol, the different sites of magnolol were structurally modified in this experiment, and a total of 12 magnolol derivatives were obtained. Based on the preliminary exploration of the anti-aging effect of magnolol derivatives in a Caenorhabditis elegans (C. elegans) model. Our results indicate that the active groups of magnolol exerting anti-aging effects were allyl groups and hydroxyl on the phenyl. Meanwhile, the anti-aging effect of the novel magnolol derivative M27 was found to be significantly superior to that of magnolol. To investigate the effect of M27 on senescence and the potential mechanism of action, we investigated the effect of M27 on senescence in C. elegans. In this study, we investigated the effect of M27 on C. elegans physiology by examining body length, body curvature and pharyngeal pumping frequency. The effect of M27 on stress resistance in C. elegans was explored by acute stress experiments. The mechanism of M27 anti-aging was investigated by measuring ROS content, DAF-16 nuclear translocation, sod-3 expression, and lifespan of transgenic nematodes. Our results indicate that M27 prolonged the lifespan of C. elegans. Meanwhile, M27 improved the healthy lifespan of C. elegans by improving pharyngeal pumping ability and reducing lipofuscin accumulation in C. elegans. M27 increased resistance to high temperature and oxidative stress in C. elegans by reducing ROS. M27 induced DAF-16 translocation from cytoplasm to nucleus in transgenic TJ356 nematodes and upregulated the expression of sod-3 (a gene downstream of DAF-16) in CF1553 nematodes. Furthermore, M27 did not extend the lifespan of daf-16, age-1, daf-2, and hsp-16.2 mutants. This work suggests that M27 may ameliorate aging and extend lifespan in C. elegans through the IIS pathway.

Developmental and cardiac toxicity assessment of Ethyl 3-(N-butylacetamido) propanoate (EBAAP) in zebrafish embryos

Ethyl 3-(N-butylacetamido) propanoate (EBAAP) is one of the most widely used mosquito repellents worldwide, and is also commonly used to produce cosmetics. Residues have recently been detected in surface and groundwater in many countries, and their potential to harm the environment is unknown. Therefore, more studies are needed to fully assess the toxicity of EBAAP. This is the first investigation into the developmental toxicity and cardiotoxicity of EBAAP on zebrafish embryos. EBAAP was toxic to zebrafish, with a lethal concentration 50 (LC50) of 140 mg/L at 72 hours post fertilization (hpf). EBAAP exposure also reduced body length, slowed the yolk absorption rate, induced spinal curvature and pericardial edema, decreased heart rate, promoted linear lengthening of the heart, and diminished cardiac pumping ability. The expression of heart developmental-related genes (nkx2.5, myh6, tbx5a, vmhc, gata4, tbx2b) was dysregulated, intracellular oxidative stress increased significantly, the activities of catalase (CAT) and superoxide dismutase (SOD) decreased, and malondialdehyde (MDA) content increased significantly. The expression of apoptosis-related genes (bax/bcl2, p53, caspase9, caspase3) was significantly upregulated. In conclusion, EBAAP induced abnormal morphology and heart defects during the early stages of zebrafish embryo development by potentially inducing the generation and accumulation of reactive oxygen species (ROS) in vivo and activating the oxidative stress response. These events dysregulate the expression of several genes and activate endogenous apoptosis pathways, eventually leading to developmental disorders and heart defects.

The Mechanism of Tigecycline Resistance in Acinetobacter baumannii Revealed by Proteomic and Genomic Analysis.

The mechanism of tigecycline resistance in A. baumannii remains largely unclear. In this study, we selected a tigecycline-resistant and a tigecycline-susceptible strain from a tigecycline-susceptible and a resistant strain, respectively. Proteomic and genomic analyses were performed to elucidate the variations associated with tigecycline resistance. Our study showed proteins associated with efflux pump, biofilm formation, iron acquisition, stress response, and metabolic ability are upregulated in tigecycline resistant strains, and efflux pump should be the key mechanism for tigecycline resistance. By genomic analysis, we found several changes in the genome that can explain the increased level of efflux pump, including the loss of the global negative regulator hns in the plasmid and the disruption of the hns gene and acrR gene on the chromosome by the insertion of IS5. Collectively, we not only revealed the phenomenon that the efflux pump is mainly responsible for tigecycline resistance, but also highlighted the mechanism at the genomic level, which will help in understanding the resistance mechanism in detail and provide clues for the treatment of clinical multiple drug-resistant A. baumannii.

Investigations on a bubble-pump-aided diffusion absorption heat transformer using deep eutectic solvent for harvesting and upgrading thermal energy

Absorption heat transformer shows promising potential in thermal energy harvesting and upgrading, while the corrosion and crystallization risks of existing working substance restrict its promotion. A bubble-pump-aided diffusion absorption heat transformer using deep eutectic solvent is proposed in this study. The influence of operating parameters of bubble pump is analyzed, indicating that motive head should be as large as possible while diffusion gas flow rate has the optimum. Because of worse pumping ability, deep eutectic solvent has narrower normal operating range compared with LiBr, but the optimal energy performance shows little difference. Ethaline exhibits the best performance among deep eutectic solvents. With heat source of 90 ℃, COP and ηEX of 0.401 and 48.9% can be reached to output thermal energy of 120 ℃, leading to a CO2 emission reduction of 20.1 Mt per year. Parametric analysis demonstrates that single-stage diffusion absorption heat transformer using ethaline can realize temperature lift up to 50 ℃, which delivers comparative performance against existing AHT systems, except for operating range. Approaches are discussed to enlarge its operating range and further improve its performance as well. The results in this paper contribute to: 1) providing a promising absorption heat transformer configuration for large-scale and long-term use; 2) quantitatively demonstrating the prospect of deep eutectic solvent; 3) enlightening insights in the recovery of industrial waste heat, the upgrading of thermal energy and the reduction of CO2 emission.

Mechanism of charge injection-based electrohydrodynamic pump with interdigitated electrodes

The mechanisms of a charge injection-induced electrohydrodynamic pump using the lattice Boltzmann method are numerically investigated in this paper. The pump is composed of a dielectric liquid layer and two substrate layers with embedded electrodes. There are three possible flow modes found, which are associated with the generation of local convective rolls for different electrode arrangements, namely, modes associated with one and two vortices and an irrotational mode. For different flow modes, results are presented for both the transient development of the flow field and the steady-state total flow rate and pressure. A distinct four-state transition can be observed in the temporal record of the velocity field. Regarding pumping ability, it is found that the irrotational mode can lead to optimal performance, while the single-vortex flow mode gives the worst performance.

OCT classification of choroidal nevi

The study aims to determine the types of OCT patterns of CN and to evaluate their prognostic value. The study included 50 patients with CN (53 nevi). The height of 19 nevi evaluated with ultrasonography was 1.33±0.43 mm, diameter - 5.47±1.68 mm. CN is an area of local increase in reflectivity of the choroid; its widening and elevation of the tomographic section were observed in 72% of nevi. In more than half of all cases a distinct hyperreflective border was revealed between the CN and adjacent choroid. In two thirds of all cases the choriocapillaris layer was preserved and visualized mainly along the edge of lesion. Analysis of OCT scans showed distinct differences, which allowed designation of four OCT types of CN: 1) nevi with typical OCT pattern; 2) nevi with changes in retinal pigment epithelium (RPE); 3) nevi with neuroepithelial detachment; 4) nevi with atypical OCT pattern. Based on the analysis of OCT images of the determined types of nevi, it can be assumed that all of them initially had typical OCT pattern. With enlargement of the nevi and increase in the duration of its presence in the choroid, dystrophic processes in the adjacent retina and changes in RPE begin to occur. Disturbed pumping ability of the damaged RPE results in disruption of the trophism of adjacent retina, which leads to development of atrophic changes. Nevi with atypical OCT pattern should be considered as a sign of long-term benign process in the choroid that will cause atrophic changes in the choroid and adjacent retina, while nevi with changes in RPE and with neuroepithelial detachment - as a risk factor for transition to choroidal melanoma.

Ultrafast active water pump driven by terahertz electric fields

A terahertz electric field (TEF) is employed to stimulate an active pump for water transportation by a bias applied in a nanochannel under no external pressure gradient. The excellent pumping ability is attributed to the resonance coupling between the TEF and water molecules. This proposed TEF-driven pump design will offer a guide in polar molecule transport through artificial or biological nanochannels, particularly in a controllable, noncontact, and large-scale process.

Mutations conferring SO42− pumping ability on the cyanobacterial anion pump rhodopsin and the resultant unique features of the mutant

Membrane transport proteins can be divided into two types: those that bind substrates in a resting state and those that do not. In this study, we demonstrate that these types can be converted by mutations through a study of two cyanobacterial anion-pumping rhodopsins, Mastigocladopsis repens halorhodopsin (MrHR) and Synechocystis halorhodopsin (SyHR). Anion pump rhodopsins, including MrHR and SyHR, initially bind substrate anions to the protein center and transport them upon illumination. MrHR transports only smaller halide ions, Cl- and Br-, but SyHR also transports SO42−, despite the close sequence similarity to MrHR. We sought a determinant that could confer SO42− pumping ability on MrHR and found that the removal of a negative charge at the anion entrance is a prerequisite for SO42− transport by MrHR. Consistently, the reverse mutation in SyHR significantly weakened SO42− pump activity. Notably, the MrHR and SyHR mutants did not show SO42− induced absorption spectral shifts or changes in the photoreactions, suggesting no bindings of SO42− in their initial states or the bindings to the sites far from the protein centers. In other words, unlike wild-type SyHR, these mutants take up SO42− into their centers after illumination and release it before the ends of the photoreactions.

Design of ultrathin TiO2 nanosheets coated Ti plate for enhanced interfacial solar driven water evaporation performance

Recently, nanosized titanium oxides have attracted much attention for the technology of interfacial solar driven water evaporation (ISDWE). Various titanium oxides, such as TiO 2 nanocage, Ti 2 O 3 nanoparticle, and TiO 2 nanotube, are favorable to provoke high water evaporation performance. In this work, ultrathin TiO 2 nanosheets coated Ti plates were developed and applied on ISDWE. The ultrathin TiO 2 nanosheet was obtained through hydrothermal treatment of Ti plate in aqueous NaOH solution, and C, N co-doping was realized through adding methionine in the solution. As the formation of nanosheet and C, N co-doping, the TiO 2 nanosheets coated Ti plate exhibited enhanced solar light absorbility, water pumping ability, and specific surface area. Molecular dynamics simulations also indicated that the water-water and TiO 2 -water interactions can be weakened by C, N co-doping. Owning to the above reason, a notable high water evaporation rate of 1.57 kg•m −2 •h −1 was achieved. Furthermore, the shape of Ti plate also affected the ISDWE performance, C, N co-doped TiO 2 nanosheets coated square Ti plate showed a higher water evaporation rate than other shapes. Lastly, the enhanced photocatalytic activity of C, N co-doped TiO 2 nanosheets coated Ti plate also enabled purification of unevaporated water and stable water evaporation rate during ISDWE experiment on RhB solution. This report highlights the advantages and potential of TiO 2 nanosheet in the application of ISDWE on water purification. • TiO 2 nanosheet revealed notable high solar driven water evaporation rate. • Nanosheet structure ensured excellent light absorbility and water pumping ability. • C, N-doping can weaken the interaction energy of water-water and water-TiO 2 . • Perimeter-area ratio of Ti plate affects solar driven water evaporation rate. • Purification on unevaporated water was attained by TiO 2 nanosheet.

Evaluation of critical problems of heavy fuel oil separators on ships by best-worst method

It is known that trade by ship is a cheaper way than airway, land, and rail trade. One of the most important reasons for this is that ships use heavy fuel oil (HFO), which is cheap but also poor quality fuel. This HFO used in ships needs to be cleaned with machines called separators (purifiers). Therefore, the separator is one of the vital auxiliary machines on the ship. A satisfactory separation should be done in order to get rid of the effects such as water in the fuel, sludge formation, pump ability, mixing of different grades in the tanks, abrasion, and corrosion, which are the most important risks in the burning of fuel oil. Many problems are encountered while trying to make good separation. Therefore, in this article, 20 important problems that are frequently encountered in ship HFO separators are evaluated with the best-worst method (BWM) by consulting marine experts. Results show that dirty separator discs (also fractured or broken), wrong gravity disc choice (or bad interface position), and unsatisfactory bowl work are the most important problems among 20 critical and frequent separator problems. Problems and results are very important in terms of smooth ship machinery operations and we think that this study will close this gap in the literature by ordering and identifying problems and also solution recommendations.

Рівень функціонування адаптаційних механізмів серцево-судинної системи в дітей із синкопе різного ґенезу

changes which in turn depend on the basic level of functional capabilities of the cardiovascular system and its adaptation mechanisms that determine the intensity and duration of adaptive responses. Purpose - to determine the level of cardiovascular adaptations in children with syncope; to assess their relationship with some clinical, anamnestic and instrumental parameters. Materials and methods. A total of 81 children with vasovagal syncope, 25 with syncope due to orthostatic hypotension, 19 with cardiogenic syncope (aged 8-17 years) were included in our study. The control group included 41 healthy children. All patients underwent a clinical and functional examination of the cardiovascular system to determine the level of its adaptative mechanisms. Results. Children with vasovagal syncope and syncope due to orthostatic hypotension had significantly higher values of cardiac output and systolic blood volume compared to control group (p<0.05), which indicated the intensity of pumping ability of the heart. Children with syncope due to orthostatic hypotension had marked decrease in the efficiency of the heart muscle, as low values of left ventricular rate, circulatory efficiency and cardiac index compared with healthy individuals (p<0.05), as well as the trend to economize hemodynamic responses, as indicated by a significant difference between the values of the Robinson index, a decreased systolic index and the index of functional changes compared with those without syncope (p<0.05). Children with cardiogenic syncope had a significantly reduced the circulatory efficiency coefficient (p<0.05). Significant correlations were detected between the parameters of a series of integrative indicators of the adaptive mechanisms of the cardiovascular system and anamnestic, clinical, and the reports of instrumental studies in children with syncope. Conclusions. Despite the fact that children with syncope of various types had normal values for most cardiovascular indicators at rest, the tension of pumping capacity of the heart was detected, the efficiency of the cardiac muscle and circulatory efficiency were reduced, which are signs of reduced compensatory responses in children of the study groups determined. The results of the study confirm the close combination of pathogenetic mechanisms of syncope with a decrease in the adaptive mechanisms of the cardiovascular system of this category of patients. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors. Key words: children, syncope, cardiovascular adaptations.

Alcohol Induced Cardiomyopathy in Non-Alcoholic Society: A Case Report of Determining the Etiology of Dilated Cardiomyopathy

Alcoholic cardiomyopathy (ACM) is a condition caused by excessive alcohol consumption, which causes a reduction in cardiac function and disturbance in heart pumping ability. Clinical manifestation ranges widely, from asymptomatic to acute fulminant heart failure, depending on the degree of deterioration of heart function. This is a case report of a 37-year-old man who presented to the emergency room, he was referred with the diagnosis of alcoholic cardiomyopathy. From echocardiography, we found reduced left ventricular function with ejection fraction Teich 41,8%, and left ventricular segmental analysis show global hypokinetic with eccentric left ventricular hypertrophy (LVH) which leads to diagnosis cardiomyopathy. Diagnosis of ACM is by exclusion. There is a two-step diagnosis process beginning with cardiac imaging and the second step involves laboratory tests To determining about the etiology of cardiomyophaty, we should depend on patient’s history. The diagnosis of alcoholic cardiomyopathy is based on structured history related to alcohol abuse in the long period. Obtaining information about history of alcohol abuse is challange in a non-alcoholic culture and environment. It dipending on the ability of the physicians to explore in-depth information concerning personal problem. Good anamnesis and another supporting examination can help the physicians to making differential diagnosis and makes the right treatment plan for the patient.