Significant Changes In Heart Rate Research Articles

Screening of Cardiac Rhythm Disorders in Women Working at Information Technology Sector Using Continuous Ambulatory Wireless Cardiac Monitoring – A Community-Based Study

Objectives: The role of screening cardiac arrhythmias provides continuum of care to rediscover the causes and prevention strategies. This study was taken up to screen women working in the information and technology sector for cardiac rhythm disorders using continuous ambulatory cardiac monitoring and asses various risk factors along with work-related stress. Materials and Methods: A cross-sectional study was taken up at the workplace to screen women for cardiac rhythm disorders using wireless continuous ambulatory cardiac monitoring. Various risk factors and work-related stress were assessed using a standardized questionnaire. Differences in ECG parameters such as heart rate, heart rate variability (HRV), and frequency corrected QT (QTc) were compared on working and non-working days. Results: A total of 109 women were screened to find a proportion of 4.58% having cardiac arrhythmias. We found two cases of second-degree AV block (type 1), two cases of atrial tachycardia in the age group of 21–30 years, and one case of sinus pauses. Risk factors such as alcohol usage were statistically associated with cardiac arrhythmias. Others included a sedentary lifestyle, being underweight, a lesser number of sleep hours, no physical activity, work-related stress, and the presence of past-COVID-19 infection, but these were not statistically significant. There were significant changes in heart rate, HRV, and QTc prolongation on working day compared to non-working days. Among the domains of work-related stress, the influence at work and perceived stress due to individual demands and commitments contributed the highest mean score. Moreover, those with higher work-related stress scores were at 3.66 times the increased risk of QTc prolongation. Conclusion: The present study implies the combination of the need for the screening tool in younger age groups and lifestyle factors with more elucidation of work-related stress on autonomic cardiac function.

Acute and chronic changes in porcine rete mirabile after embolization with the Menox system: angiographic and histopathological analyses.

To evaluate acute and chronic changes seen on angiographic and histopathological studies of porcine rete mirabile, comparing those treated with the Menox liquid embolic system (LES) and those treated with the Onyx LES. Five pigs, each weighing approximately 35 kg, were submitted to rete mirabile embolization under general anesthesia and fluoroscopic guidance, with the Menox LES or Onyx LES. Four animals were treated with the Menox LES and underwent cerebral angiography, followed by euthanasia, at 1, 30, 60, and 90 days after embolization. One animal was treated with the Onyx LES underwent the same procedures at 30 days after embolization. In a subsequent histopathological analysis, we compared the Menox LES and Onyx LES in terms of the acute and chronic changes observed. We observed no significant changes in blood pressure, heart rate, or electrocardiographic parameters that could be attributed to the super-selective infusion of dimethyl sulfoxide or the Menox embolic agent. Fluoroscopy showed adequate material opacity, appropriate progression to the center of the rete mirabile and complete unilateral embolization. Microcatheters were uneventfully detached from the embolized nidus. We observed mild to moderate intravascular and extravascular inflammatory responses, without histological evidence of necrotizing arteritis. There were no adverse neurovascular events. The Menox LES appears to be safe and effective, as well as being apparently equivalent to the Onyx LES in terms of the postprocedure angiographic and histopathological findings.

The Efficacy of Erythrocyte Transfusion in Very Low Birth Weight Infants with Premature Anemia

Objective: This study aimed to determine the clinical efficacy of erythrocyte transfusion (ET) in premature infants. Material and Methods: Very low birth weight (VLBW) infants with gestational age (GA) < 32 weeks and/or birth weight (BW) <1500 g and hospitalized in neonatal intensive care unit (NICU) between 2012-2018 were retrospectively evaluated. ET was performed according to Ohls 2007 and Turkish Neonatalogy Society Blood Products Transfusion Guidelines. Results: 72 infants included in this study. Mean BW was 1325 g (680-2290 g), GA was 30 weeks (25-32), median postnatal age was 36.7±26.9 days (8-129), number of ET during hospitalization was 2±1.2 (1-6). There were no significant changes in mean heart rates (p=0.183) and median respiratory rates before and after ET (p=0.123). Weight gain (16 g/day-11 g/day) was statistically similar before and after ET (p=0.861). A significant decrease in apnea, non-invasive ventilation (NIV) and caffeine therapy requirements after ET was determined (p<0.001, p=0.016 and p=0.016). Serum lactate (2.9-1.5) levels were decreased by ET (p=0.017). Conclusion: Premature infants should closely follow-up for anemia and related symptoms during NICU stay. ET may help to decrease frequency of apnea of prematurity, requirements of caffeine therapy and NIV. ET improves tissue oxygenation in VLBW infants with anemia. Decision of ET should be made according to severity of symptoms, and should be performed according to international, national or local transfusion guidelines.

Effect of short-term use of FFP2 (N95) masks on the salivary metabolome of young healthy volunteers: a pilot study.

The use of face masks has become an integral part of public life in the post-pandemic era. However, the understanding of the effect of wearing masks on physiology remains incomplete and is required for informing public health policies. For the first time, we report the effects of wearing FFP2 masks on the metabolic composition of saliva, a proximal matrix to breath, along with cardiopulmonary parameters. Un-induced saliva was collected from young (31.2 ± 6.3 years) healthy volunteers (n = 10) before and after wearing FFP2 (N95) masks for 30 minutes and analyzed using GCMS. The results showed that such short-term mask use did not cause any significant change in heart rate, pulse rate or SpO2. Three independent data normalization approaches were used to analyze the changes in metabolomic signature. The individuality of the overall salivary metabotype was found to be unaffected by mask use. However, a trend of an increase in the salivary abundance of L-fucose, 5-aminovaleric acid, putrescine and phloretic acid was indicated irrespective of the method of data normalization. Quantitative analysis confirmed increases in concentrations of these metabolites in saliva of paired samples amid high inter-individual variability. The results showed that while there was no significant change in measured physiological parameters and individual salivary metabotypes, mask use was associated with correlated changes in these metabolites plausibly originating from altered microbial metabolic activity. These results might also explain the change in odour perception reported to be associated with mask use. Potential implications of these changes on mucosal health and immunity warrants further investigation to evolve more prudent mask use policies.

The Impact of Social Isolation and Environmental Deprivation on Blood Pressure and Depression-Like Behavior in Young Male and Female Mice

Background: Social isolation (SI) and loneliness are major adult and adolescent health concerns, particularly in the coronavirus disease 2019 (COVID-19) era. Recent prospective cohort studies indicate that older women who experienced both SI and loneliness had a significantly higher risk of cardiovascular disease (CVD). Hypertension, a well-established risk factor for CVD, is more prevalent in elderly women than men. Furthermore, a lack of social relationships is strongly associated with an increased risk of hypertension in middle-aged and elderly women compared to men. Although this has not been extensively studied, adolescents and young adults who experience loneliness or SI may also be at risk for CVD and depression. The purpose of this study was to examine the effect of SI on blood pressure and depression-like behavior in young male and female mice. Methods: Weaned C57BL/6 mice were randomly assigned (n = 6/group/sex) to either group housing (GH) or SI. Animals in the SI group were housed in individual cages for 8 weeks with no view of other animals. The cages were kept in ventilated racks to prevent pheromone exposure and socially isolated animals had no cage enrichment. Results: SI increased systolic, diastolic, and mean arterial blood pressure in females and elevated heart rate in both sexes. Body weight gain was dramatically increased in socially isolated females but tended to decrease in socially isolated males. In the forced swim test, which detects depression-like behavior, there was no difference between groups in total immobility time. The latency to immobility, however, was significantly decreased in socially isolated females. Serum concentrations of corticosterone and metanephrine did not differ between socially isolated and group-housed females, but corticosterone levels were significantly reduced in socially isolated males. Conclusions: Our results indicate that 8 weeks of SI leads to significant changes in blood pressure and heart rate and mild changes in depression-like behavior in young mice, with females affected more than males.

Extremity tourniquets raise blood pressure and maintain heart rate

BackgroundTourniquets have been modified and used for centuries to occlude blood flow to control hemorrhage. More recently, the occlusion of peripheral vessels has been linked to resultant increases in blood pressure, which may provide additional therapeutic potential, particularly during states of low cardiac output. ObjectiveThe objective of this study was to investigate a causal relationship between tourniquet application and blood pressure in healthy adults. MethodsHealthy adult volunteers were recruited to participate in this IRB-approved study. Each participant met inclusion criteria and demonstrated baseline normotension. Brachial cuff blood pressure and heart rate were recorded pre- and post-tourniquet application to the bilateral legs. ResultsTwenty-seven adults aged 22 to 35 years participated and were included in analysis. The average systolic blood pressure was 122 ± 7 mmHg, diastolic blood pressure was 72 ± 9 mmHg, and heart rate was 70 ± 13 bpm. Following bilateral tourniquet application over the femoral vasculature, we observed a statistically significant increase in systolic (7 mmHg, p < 0.001) and diastolic (4 mmHg, p = 0.05) blood pressures with no significant change in heart rate (2 bpm, p > 0.05). ConclusionsThe elevations in systolic and diastolic blood pressures establish a dependent relationship between tourniquet application to the lower extremities and blood pressure elevation. These results may support new indications for tourniquet-use or extremity vessel occlusion in settings of hemodynamic instability.

292 QTC CORRECTION IN ATRIAL FIBRILLATION

Abstract Background QT interval varies with the heart rate (HR), so a correction in QT calculation is needed (QTc). Atrial fibrillation (AF) is associated with elevated heart rate (HR) and beat-to-beat variation in the length of the QT and RR interval making correction of the QT interval challenging. Aim to evaluate which correction formula better correlates with QTc in sinus rhythm after electrical cardioversion (ECV). Methods During a 3-month period, we considered patients who underwent 12-lead ECG recording for standard clinical indications and received an AF diagnosis. Exclusion criteria were the following: a QRS duration &amp;gt;120 ms, chronical therapy with QT prolonging drugs, a rate control strategy, a non-electrical cardioversion. The final population was composed by 60 patients. The QT interval was measured in V2 lead as the 10-beat average and corrected using Bazzett's, Framingham, Fridericia and Hodges formulas during the last ECG taken during AF and the first one immediately after ECV. Moreover, QTc mean was calculated as mQTc (average of 10 QTc calculated beat per beat) and as QTcM (QTc calculated from the average of 10 raw QT and RR for each beat). Results Population was composed by 26 women (43%) with a mean age was 79 ± 11 years. Good correlations between mQTc and QTcM are present for each formula, even in atrial fibrillation or sinus rhythm. Comparing atrial fibrillation and sinus rhythm a significant change in HR was seen (63,9 ± 14,9 vs 99,5 ± 27,9, p&amp;lt;0,001). Bazett's formula shown a significant change in mean QTc value between the two rhythms (421,5 ± 33,9 vs 446,1 ± 31,9; p&amp;lt; 0,001 for mQTc and 420,9 ± 34,1 vs 441,8 ± 30,9; p = 0.003 for QTcM). On the contrary, QTc assessed by the Framingham, Fridericia, and Hodges formulas was similar to that in AF (Figure). Conclusion In ECG during atrial fibrillation, due its high heart rate, Bazzett's formula, although the most used, seems to be the most imprecise in QTc estimation.

Prevalence and associated risk factors of musculoskeletal disorders (MSDs) and physiological stress among the female brick molders of West Bengal, India

Objective: Women play a significant role in the Indian economy and are regarded as the backbone of the brickfield industry where they face a variety of stressors that predispose them to increased risk of developing musculoskeletal disorders. The present study aimed to estimate the prevalence of upper limb musculoskeletal disorders and physiological stress compared to a control group. Methods: The Nordic Modified Questionnaire (NMQ) was completed by 85 women brick molders to assess feelings of discomfort (pain) in different parts of the body. Furthermore, the Rapid Upper Limb Assessment (RULA) posture analysis tool explored the risk of upper-limb musculoskeletal disorders (ULMSDs). Handgrip strength was also measured using a handgrip dynamometer, and cardiovascular stresses were assessed by measuring heart rate, blood pressure and lung function parameters. Results: The results of the study revealed that upper limb MSDs are a significant problem among women brick molders, primarily involving the hand (97.6%), shoulder (94.1%), wrist (72.9%) and fingers (56.5%). Subjective discomfort ratings among the brick molders indicated pain (96.5%), followed by tingling (90.6%), numbness (88.2%) and stiffness (61.2%) in their hands. The detailed analysis of the RULA score revealed that the upper arms, lower arms and wrists were high-risk areas for MSDs. Soon after completion of work, the participants experienced reductions in the hand-grip strength compared to the control group. Heart rate brick molders as higher in comparison to control group, just after the completion of work. However, there was no significant change in maximum Heart rate (HRmax) and Heart Rate Reserve (HRR) between the two groups, but significant associations were observed in net cardiac cost (NCC) and relative cardiac cost (RCC). Blood pressure measures were higher in the brick molders after work as well Conclusion: Women brick molders engaged continuously in highly repetitive hand-intensive jobs and suffered from discomfort in the upper extremities. The RULA posture analysis results indicated that the working posture of women brick molders were at high risk for MSDs, which requires changes immediately. Female brick molders also presented with reduced lung function values compared to the controls Findings of this study highlight the need for various ergonomic interventions that can be applied to improve the safety of the molders and workplace conditions of the brickfield during molding activities.

Challenges for Management of Dilated Cardiomyopathy during COVID-19 Pandemic-A Telemedicine Application.

The 2019 coronavirus pandemic (COVID-19) represented a significant challenge for the medical community. The first aim of this study was to examine the COVID-19 impact on the follow-up of patients with dilated cardiomyopathy (DCM) and to establish the advantages of multiparametric home monitoring. Also, we tried to establish the main prognostic predictors at 2-years follow-up and the value of LV diastolic filling pattern (LVDFP) in increasing mortality and morbidity. We conducted a prospective study of 142 patients with DCM assessed by in-patient visit in the pre-pandemic period and hybrid (face-to-face, online consultation and telemedicine home monitoring with a dedicated application) during the pandemic period. The statistical analysis compared the strategy used in the pre-pandemic with management during the pandemic, in terms of clinical assessment, hospitalizations/emergency room visits due to HF exacerbation and total mortality. We did not observe significant changes in blood pressure (BP), heart rate (FC), weight and symptoms or an increased rate of adverse drug events between the two periods. We successfully titrated HF medications with close monitoring of HF decompensations, which were similar in number, but were mostly managed at home during the pandemic. There was also no statistically significant difference in emergency room visits due to severe decompensated HF. Mortality in the first and second year of follow-up was between 12.0 and 13%, similar in the pre-pandemic and pandemic periods, but significantly higher in patients with restrictive LVDFP. Clinical improvement or stability after 2 years was more frequent in patients with nonrestrictive LVDFP. The main prognostic predictors at 1 and 2-years follow-up were: the restrictive LVDFP, significantly dilated LV, comorbidities (DM, COPD), older age, associated severe mitral regurgitation and pulmonary hypertension. The pandemic restrictions determined a marked decrease of the healthcare use, but no significant change in the clinical status of DCM patients under multiparametric home monitoring. At 2-years follow-up, the presence of the restrictive LVDFP was associated with an increased risk of death and with a worse clinical status in DCM patients.

A Prospective Evaluation of Arrhythmias in a Large Tertiary Neonatal Intensive Care Unit.

Arrhythmias in the neonatal period are common and can be classified as bradyarhythmias and tachyarrhythmias and as benign or non-benign. Neonatal arrhythmias are further differentiated between those with abnormalities in generation (non-sinus) and those with abnormalities in propagation. Because the neonatal myocardium is immature and operates at the peak of the Starling curve, significant changes in heart rate can result in a decline in cardiac output and compromise end-organ perfusion. This is especially true for premature neonates, those critically ill, or those with concomitant congenital heart disease. While sustained arrhythmias are frequently witnessed and recorded in tertiary neonatal intensive care units (NICU) very little data exist on the observance of non-sustained brady- or tachyarrhythmias in this cohort. No prospective study has been performed on all neonates admitted to a large tertiary NICU throughout their entire stay. The purpose of this study was to prospectively evaluate the prevalence and type of arrhythmias in a large NICU population from admission to discharge. All neonates admitted to the NICU at Inova Children's Hospital at Inova Fairfax Medical Campus between January 1, 2021 and April 1, 2021 were prospectively evaluated from admission to hospital discharge via continuous bedside monitoring reviewed every 24h. Concerning telemetry strips were reviewed by two team members as well as the senior electrophysiologist. Two-hundred and one neonates (mean gestational age = 344/7weeks) were enrolled in the study. Admission length ranged from 1 to 195days (total of 5624 patient days, median 16days). Overall, 68% (N = 137) of admissions had one or more arrhythmias, the most common of which was sinus tachycardia (65%, N = 130), followed by sinus bradycardia (30%, N = 60). Clinically relevant arrhythmias were diagnosed in 6.5% of neonates. During the study period there were four deaths, none of which were directly attributable to a primary arrhythmia. Approximately 68% of neonates exhibited at least one arrhythmia. Although the vast majority of these arrhythmias were benign, clinically relevant arrhythmias were observed in 6.5%. Patients admitted to the NICU appear to have a relatively high burden of benign arrhythmias, but a relatively low burden of pathologic arrhythmias.

Abstract 14679: Electrocardiogram Findings From Athletic Adaptation and COVID-19 Infection in Collegiate Football Players

Introduction: Improved criteria have enhanced the sensitivity and specificity of the 12-lead ECG to identify underlying cardiovascular conditions predisposing to sudden cardiac death or morbidity. However, the impacts of chronic high-intensity exercise and especially ethnicity on changes in longitudinal ECG remain unknown. Furthermore, given the ongoing pandemic, we must consider how COVID19 infection may impact ECG findings. We analyzed collegiate student athlete ECGs over time to determine whether longitudinal training, race, and post-COVID19 status impact the ECG findings with the goal of informing future interpretation criteria. Methods: We included twenty-two NCAA Division I football players from January 2018 to January 2021. Ten athletes contracted COVID19 during this period. We compared pre-season ECGs prior to the first and third years of athletic participation as well as any within 34 days after confirmed COVID19 infection. Heart rate, QRS duration, QT interval, and any International Criteria findings were identified. The ECGs acquired prior to the athlete’s first-year of participation served as the baseline for comparison for the third-year and post-COVID19 ECG. T-tests and two-sample z-tests were used as appropriate for statistical analysis. Results: Compared to matched first-year baseline, the QRS duration of post-COVID19 ECGs was significantly longer (102 ± 26 ms vs 100 ± 31 ms, p = 0.01, 95% CI 0.62-3.77), which was not seen when compared to matched third-year ECGs. There were no other significant differences between white and black athletes, or those of third-year ECGs compared to the matched first-year baseline. Conclusions: In this small cohort of 22 athletes, there was no significant change in heart rate, QRS duration, QT interval, or International Criteria classifications, including early repolarization and voltage, between first- and third-year ECGs of white and black athletes. Although the post-COVID19 QRS duration was significantly increased compared to first-year ECGs, the range was still within normal; there was no increase with respect to third-year ECGs. Further analysis of a larger sampling of athletes of different sexes and sports that also considers the impact of training on the post-COVID ECG is ongoing.

Abstract 9515: Cariporide, a Selective Na+-H+ Exchange Inhibitor, Enhances Cardiac Positive Inotropic and Lusitropic Responses to Dobutamine in Heart Failure: Assessment by Pressure-Volume Analysis

Background: Inability of failing hearts to respond to positive inotropic agents such as dobutamine (DOB) represents a major clinical problem. We have shown previously that in addition to intracellular acidosis, various signaling pathways such as endothelin-1 and angiotensin II also activate cardiac Na + -H + exchange (NHE). In heart failure (HF), increased stimulation of NHE decreases myocardial calcium sensitivity. We hypothesized that blocking NHE with cariporide (CAR), a NHE-1-selective inhibitor, may improve β-adrenergic inotropic responsiveness in HF and enhance left ventricle (LV) positive inotropic and lusitropic responses of DOB. Methods: We compared the effect of clinically relevant doses of CAR (3.5 μg/kg, iv) on LV functional performance and LV contractile response to DOB (6 μg/kg/min, iv, 10 min) in 6 instrumented, conscious dogs after pacing-induced HF. LV contractile performance was measured by pressure (P)-volume (V) analysis. Animals received DOB first. After stopping DOB for 30 minutes, both DOB and CAR were infused. Results: After HF, DOB caused a 17% increase in E ES (5.3 ±1.5 vs 4.4±0.8 mmHg/ml), a16% increase in M SW (53.8±4.9 vs 45.3±3.7 mmHg), and an 11% decrease in the time constant of LV relaxation (τ) (40.4±2.6 vs 45.8±2.5 ms). DOB followed by CAR resulted in significantly greater effects with a 42% increase in E ES (6.1±2.3 vs 4.3±1.9 mmHg/ml) and a 37% increase in M SW (61.4±5.9 vs 45.1±3.2 mmHg), and a 23 % decrease in τ (34.1±3.6 vs 44.5±2.4 ms). Compared with DOB alone, DOB plus CAR caused no significant changes in heart rate (126±11 vs 130±12 bpm) and LV end-systolic P (110±8.6 vs 112±6.5 mmHg), but significantly decreased mean left atrial P (27.2±5.0 vs 32.9±5.4 mmHg), and increased stroke volume (32%, 13.3±1.7 vs 10.1±2.7 ml). DOB plus CAR also produced about 28% increased LV mechanical efficiency, measured as the ratio of stroke work to total P-V area (0.59±0.15 vs 0.46±0.17) ( p &lt;0.05). Conclusions: In pacing-induced HF, Na + -H + exchange inhibition by cariporide enhances LV positive inotropic and lusitropic responses to DOB. This suggests that combination therapy with intravenous cariporide and DOB may be appropriate in HF, thus providing a potential method of enhancing β-adrenergic responsiveness of the failing myocardium.

Wearing a KN95/FFP2 facemask induces subtle yet significant brain functional connectivity modifications restricted to the salience network

BackgroundThe use of facemasks is one of the consequences of the coronavirus disease 2019 (COVID-19) pandemic. We used resting-state functional magnetic resonance imaging (fMRI) to search for subtle changes in brain functional connectivity, expected notably related to the high-level salience network (SN) and default mode network (DMN).MethodsProspective crossover design resting 3-T fMRI study with/without wearing a tight FFP2/KN95 facemask, including 23 community-dwelling male healthy controls aged 29.9 ± 6.9 years (mean ± standard deviation). Physiological parameters, respiration frequency, and heart rate were monitored. The data analysis was performed using the CONN toolbox.ResultsWearing an FFP2/KN95 facemask did not impact respiration or heart rate but resulted in a significant reduction in functional connectivity between the SN as the seed region and the left middle frontal and precentral gyrus. No difference was found when the DMN, sensorimotor, visual, dorsal attention, or language networks were used as seed regions. In the absence of significant changes of physiological parameter respiration and heart rate, and in the absence of changes in lower-level functional networks, we assume that those subtle modifications are cognitive consequence of wearing facemasks.ConclusionsThe effect of wearing a tight FFP2/KN95 facemask in men is limited to high-level functional networks. Using the SN as seed network, we observed subtle yet significant decreases between the SN and the left middle frontal and precentral gyrus. Our observations suggest that wearing a facemask may change the patterns of functional connectivity with the SN known to be involved in communication, social behavior, and self-awareness.

Tramadol as local anesthetic drug for maxillary sinuses trephination in equine species

This project was designed to study the incidence, onset, duration and potency of tramadol, in donkeys can be evaluated as local anesthetic drug by infiltration in maxillary sinus for trephination. In this study, five adult donkeys of both sexes of local breed were used for induce trephination of maxillary sinus that was given 2% xylazine hydrochloride intravenously followed by local infiltration of 5% tramadol with aseptic technique. Parameters were used for evaluation, physical and clinical examination which includes: degree of chewing, degree of pain during palpation, measuring of anesthetic time, secretion of lacrimal gland was measured after induction of anesthetic drug locally. The results demonstrated that there are no any significant changes in heart rate, respiratory rate and rectal body temperature .While the anesthetic parameters showed no any significant changes about pain during palpation and absent of chewing movement with secretion of lacrimal gland was seen. Increase in anesthesia duration time from 30-45 minute and with the potency and recovery was excellent after surgical operation.

The music therapy effectiveness in hypertensive patients with acute myocardial infarction after previous coronary artery bypass surgery; 18-year experience of the MUSIC study

Abstract Patients who have clinical evidence of hypertension (HT) after coronary artery bypass surgery (CABS) have a poor prognosis in expression of acute myocardial infarction (AMI), as one of the MACE. Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. The purpose of this study was to evaluate the effectiveness of music therapy on prognosis of patients with HT and AMI, after CABS. Methods 314 patients (males 78.4%, mean age 59.8±1.2 yrs) with AMI after previous CABS have been selected from the patients consecutively submitted from January 2003 to January 2019. HT was registered in 166 (53.0%) pts with AMI after previous CABS. All patients with HT were randomized and divided in 2 groups: Study group of 83 patients treated with music therapy and Control group of 83 patients with no music therapy. Each patient in study group underwent two sessions of medical therapy (12 minutes) in a day. Both groups were similar in baselines, post-AMI characteristics and post-AMI medical therapy. The plasma cytokine and catecholamine were measured in both groups. Results In the Study group, heart rate was significantly decreased by music therapy (p=0.0196). In the Control group, there were no significant changes in heart rate. Among cytokines (p=0.0160), plasma interleukin-6 (IL-6) (p=0.0179) in the Study group was significantly lower than those in the Control group, as well as plasma adrenaline (p=0.0162) and noradrenalin (p=0.0218) levels. Conclusion This study provides support for the use of musical therapy in patients with HT and AMI after previous CABS. The positive effects of music therapy, in these patients, are probably because of enhanced of parasympathetic activities and reduction of plasma cytokine and catecholamine levels. Funding Acknowledgement Type of funding sources: None.

Evaluation of a prescribing pharmacist-led heart failure (HF) up-titration clinic

Abstract Background/Introduction Pharmacotherapy is considered the cornerstone of treatment for patients with heart failure with reduced ejection fraction (HFrEF). Modulation of the renin-angiotensin-aldosterone (RAAS) and sympathetic nervous system have been shown to improve survival, reduce the risk of heart failure (HF) hospitalisations and improve quality of life. Unless contraindicated or not tolerated, these patients should be prescribed angiotensin-converting enzyme inhibitor (ACEi)/angiotensin-receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), beta-blocker, mineralocorticoid receptor antagonist (MRA) and sodium-glucose co-transporter 2 (SGLT2) inhibitor and up-titrated to guideline directed dosages.1 Despite the availability of effective treatments, patients are often sub-optimally dosed and experience a prolonged optimisation process. Pharmacist-led clinics can complement existing services and increase uptake of guideline directed medical therapies (GDMT). Purpose To evaluate the effectiveness of pharmacist-led heart failure clinics in the Princess of Wales Hospital, supported by the Heart Failure team, in optimisation of patients with HFrEF. Methods Patients who attended HF pharmacist led clinic between November 2020 and November 2021 were included in the analysis. Baseline demographics, left ventricular ejection fraction (LVEF), biomarkers, vital signs and medications were documented at baseline and after optimisation of GDMT. Number of clinics appointments and rate of hospitalisation and mortality were captured during the study period. Results 76 patients were reviewed over a total of 318 consultations (34% virtual), averaging 4 consultations per patient. The mean age was 71 years, 36% of patients were female, mean LVEF was 32% and NT-proBNP 3078ng/L with 15% of patients on “quadruple therapy” at baseline. 93% of patients were referred by cardiologists and the average time from referral to first appointment was 42 days. Post-optimisation, 67% of patients were receiving “quadruple therapy”, with increased uptake of ACEi/ARB/ARNI, beta-blocker, MRA and SGLT2i from baseline (100%, 77%, 93% and 90% respectively). Mean LVEF increased to 42% and mean NT-proBNP reduced to 1695ng/L. No significant changes in creatinine clearance, blood pressure, heart rate or serum potassium (sK+) were recorded. The hospitalisation rate was 11% for heart failure, 6% for other cardiovascular causes and the mortality rate was 7%. Conclusions The pharmacist-led HF clinic demonstrated a high uptake of optimally dosed GDMT and improvements in NT-proBNP and LVEF. Pharmacist-led clinics can enhance the provision of existing heart failure services to improve patient outcomes and heart failure care. Funding Acknowledgement Type of funding sources: None.

Effect of temperature reduction of the prefrontal area on accuracy of visual sustained attention

Objectives. Detection of sensitive signs in many work environments with automated systems (aviation industry, flight safety tower, maritime industry, monitoring in the military industry, etc.) is essential and requires constant visual attention. Therefore, the aim of this study was to investigate the effect of forehead cooling on the accuracy of stable visual attention. Methods. This interventional study was performed on 34 male students. The sampling method was a randomized block design. Subjects were assessed by demographic questionnaire, Snellen chart, Spielberger state-trait anxiety inventory (STAI) and physiological and cognitive measurements. Results. Prefrontal cortex (PFC) cooling caused significant changes in sublingual temperature during four measurements in the intervention group. There were no significant changes in heart rate, diastolic blood pressure and saturation of peripheral oxygen (%SpO2) between the two groups. The critical flicker frequency (CFF) as an indicator of cognitive fatigue showed that cognitive improvement after PFC cooling occurred following a reduction in cognitive fatigue. Conclusions. Considering the importance of choosing non-invasive methods to improve the operator’s cognitive skills while performing cognitive tasks in the field of neuroergonomics, it can be concluded that PFC cooling is an effective and safe way to improve some cognitive skills such as visual attention.

Abstract P003: Chemerin Supports Basal Blood Pressure In Both Male And Female Dahl SS Rats

Evidence supports that Antisense oligonucleotides (ASO) against the adipokine chemerin reduce the blood pressure of the normal male Sprague Dawley rat and, to a greater magnitude, the hypertensive Dahl SS rat fed a high fat diet. In the Dahl SS rat, chemerin protein concentration in white adipose tissue [mesenteric perivascular adipose tissue (Mes PVAT)] was significantly higher in females vs males. We hypothesized that female Dahl SS rats would be more dependent on chemerin for blood pressure maintenance than males because of the Mes PVAT’s proximity to blood vessels that control total peripheral resistance. Age-matched male and female Dahl SS rats on a standard chow (0.2% NaCl, 6.2% fat) diet were used. Radiotelemeters were implanted to measure blood pressure (MAP) and heart rate (bpm). Following a two-week recovery period after implantation, one week of baseline measures were collected. Knockdown of whole body chemerin was achieved by subcutaneous injections of scrambled control ASO or whole-body ASO against chemerin (both 25 mg/kg) on days 0, 7, 14, and 21. On day 23, the rats were euthanized, and samples were collected for western blot and qPCR of the chemerin gene Rarres2 . Plasma chemerin was abolished in both male and female rats given the ASO against chemerin vs that of rats receiving the control ASO. In males and females, respectively, chemerin mRNA expression (2 -ΔCT ) was reduced from 0.53 to 0.001 ± 0.002 and 0.23 to 0.001 ± 0.02 in liver, 0.05 to 0.01 ± 0.005 and 0.07 to 0.005 ± 0.02 in RP fat, and 0.09 to 0.01 ± 0.003 and 0.05 to 0.001 ± 0.02 in epididymal/uterine fat. MAP in control ASO rats showed no significant change from baseline measurements (M:137.4 ± 3.0 /F: 130.6 ± 1.5 mmHg), while males and females treated with whole-body ASO dropped by 10.7 ± 1.6 and 10.9 ± 2.1 mmHg respectively after four injections, with no significant change in heart rate. Pulse pressure also decreased by 5.6 ± 1.3 and 6.8 ± 1.3 mmHg in whole-body ASO males and females, respectively, with no significant changes from baseline in the control animals. These data suggest, contrary to our hypothesis, that chemerin plays a similar role in basal blood pressure regulation in males and females. This indicates that males and females may be equally dependent on chemerin for high fat diet-induced hypertension.

Bioreactor-grown exo- and endo-β-glucan from Malaysian Ganoderma lucidum: An in vitro and in vivo study for potential antidiabetic treatment.

This study aims to identify the roles of exo-β-glucan (EPS-BG) and endo-β-glucan (ENS-BG) extracted from Ganoderma lucidum (GL) in inhibiting the alpha-glucosidase enzyme, a target mechanism for postprandial hyperglycaemia regulation. Upscale production of GL was carried out using a 10 L bioreactor. The zebrafish embryo toxicity test (ZFET) was carried out based on OECD guidelines. The hatching rate, survival rate, heart rate, morphological malformation, and teratogenic defects were observed and determined every 24 h from 0–120 h of post-exposure (hpe). For diabetes induction, adult zebrafish (3–4 months of age) were overfed and induced with three doses of 350 mg/kg streptozotocin (STZ) by intraperitoneal injection (IP) on three different days (days 1, 3, and 5). The oral sucrose tolerance test (OSTT) and anti-diabetic activity of EPS-BG and ENS-BG were evaluated (day 7) using the developed model (n = 15). This study showed that EPS is the most potent compound with the highest inhibitory effect toward the alpha-glucosidase enzyme with an IC50 value of 0.1575 mg/ml compared to ENS extracts (IC50 = 0.3479 mg/ml). Both EPS-BG and ENS-BG demonstrated a strong inhibition of alpha-glucosidase activity similar to the clinically approved alpha-glucosidase inhibitor, acarbose (IC50 = 0.8107 mg/ml). ENS-BG is non-toxic toward zebrafish embryos with LC50 of 0.92 mg/ml and showed no significant changes in ZE hatching and normal heart rate as compared to untreated embryos (161 beats/min). Teratogenic effects of ENS-BG (<1.0 mg/ml) on zebrafish embryonic development were not observed. The DM model of zebrafish was acquired after the third dose of STZ with a fasting BGL of 8.98 ± 0.28 mmol/L compared to the normal healthy group (4.23 ± 0.62 mmol/L). The BGL of DM zebrafish after 30 min treated with EPS-BG and ENS-BG showed a significant reduction (p < 0.0001). Both EPS-BG and ENS-BG significantly reduced DM zebrafish’s peak blood glucose and the area under the curve (AUC) in OSTT. Hence, EPS-BG and ENS-BG extracted from GL showed promising inhibition of the alpha-glucosidase enzyme and are considered non-toxic in ZE. Moreover, EPS-BG and ENS-BG reduced blood glucose levels and inhibited hyperglycemia in DM zebrafish.

Abstract P1109: Investigating The Role Of Human Conserved Microrna-193 In The Aging Drosophila Heart

MicroRNAs (miRNAs) are short, non-coding, RNAs that post-transcriptionally regulate gene expression and are ideal candidates for the regulation of the genes responsible in the heart. Profiling studies have shown circulating miRNAs to be implicated in human cardiovascular disease with the potential to be used as biomarkers for various cardiovascular pathologies. Highly conserved with Drosophila miR-193, human miR-193 is expressed in the heart and has been established as a biomarker to distinguish between patients with different types of heart failure, including HFPEF, hypertrophic cardiomyopathy, ischemia reperfusion injury, right ventricular remodeling, cardiac fibrosis, and congenital heart disease. However, without the mechanism and regulation of its target genes, the use of miR-193 as a biomarker or therapeutic is limited. We have characterized the impact of miR-193 loss on homoeostasis of heart morphology and function in drosophila during aging using a combination of null mutants and heart specific dysregulation of miR-193 expression. Using SOHA (semi-automated optical heartbeat analysis), we observed changes occurring to heart structure and function with a loss of miR-193. With miR-193 dysregulation, significant changes in heart rate, heart size (diastolic and systolic diameters), arrhythmia index, and diastolic/relaxation interval time, began at 10 days post-eclosion and continued as the flies aged. Understanding the role of miRNAs in specific tissues and disease states will ultimately depend on our ability to dissect the fundamental strategies and mechanisms by which miRNAs regulate cardiac biology. Using in silico analysis, we have identified multiple human conserved putative miRNA-target gene interactions to further characterize the molecular mechanisms underlying the observed phenotypes. Our results suggest that the human conserved Drosophila miR-193 is essential for normal cardiac function. In miR-193 loss of function, we see significant changes to heart rate, heart size, and interval time consistent with an early aging phenotype. The conservation of miR-193 and its predicted gene targets enable us to discover the molecular mechanisms that underlie miRNA dysregulation in cardiovascular disease.