Acute aldosterone antagonism improves cardiac vagal control in humans.

Objectives: We have examined the acute effects (<45 min) of aldosterone antagonism on heart rate variability and baroreflex sensitivity, markers of cardiac vagal control, in 13 healthy subjects.

Background: Evidence for the beneficial effects of aldosterone antagonists comes from studies showing increased survival rates following their addition to standard heart failure therapy. Many mechanisms have been suggested for this action, including effects upon the autonomic nervous system.

Effects of nitroglycerin treatment on cardiac autonomic control in heart failure.

There is substantial animal data suggesting that nitric oxide (NO) has an important role as a modulator of cardiac autonomic control with a net vagotonic and sympatholytic role. Recent human work would support this concept. This study investigated the effects of the NO donor glyceryl trinitrate (GTN) upon measures of cardiac vagal activity in heart failure.

Nitric oxide and cardiac muscarinic control in humans.

Cardiac parasympathetic activity reduces susceptibility to potentially lethal ventricular arrhythmias in heart failure and ischemic heart disease. This influence is mediated in large part by antagonism of the adverse cardiac effects of sympathetic overactivity ("indirect" parasympathetic activity) in addition to the "direct" effects of muscarinic stimulation. Nitric oxide modulates parasympathetic cardiac signaling in some animal models, but human data are lacking.

Inflammation, endothelial dysfunction, and platelet activation in patients with chronic kidney disease: the chronic renal impairment in Birmingham (CRIB) study.

Background: Studies in the general population suggest that low-grade inflammation, endothelial dysfunction, and platelet activation are associated with an increased risk of cardiovascular events.

Methods: Markers of inflammation, endothelial dysfunction, and platelet activation were measured in 334 patients with chronic kidney disease (serum creatinine >1.47 mg/dL [>130 micromol/L] at screening) and compared with 2 age- and sex-matched control groups, 1 comprising 92 patients with coronary artery disease and the other comprising 96 apparently healthy individuals with no history of cardiovascular or kidney disease.

Why cardiologists should be interested in air pollution.

Despite major improvements in air quality resulting from increasingly stringent legislation, there remains a strong association between daily mortality and current levels of air pollution. Growing epidemiological evidence suggests that many, perhaps the majority, of these deaths are caused by cardiovascular disease.

Cardiovascular risk factors in predialysis patients: baseline data from the Chronic Renal Impairment in Birmingham (CRIB) study.

Background: Patients with end-stage kidney failure have a greatly increased risk of developing premature cardiac and vascular disease. However, little is known about the evolution of cardiovascular diseases in individuals with less severely impaired kidney function.

Methods: The prevalence of cardiovascular diseases and of suspected cardiovascular risk factors was studied in a group of 369 individuals (median age, 63 years, 67% male) with various degrees of impaired kidney function (calculated creatinine clearances 6 to 105 mL/min), in 103 patients with angiographically proven coronary artery disease, and in 103 apparently healthy individuals.

GABAergic mechanisms involved in the vagally mediated heart rate response to muscle contraction as revealed by studies with benzodiazepines.

The aim of this study was to determine if central GABA mechanisms are involved in the cardiac vagal withdrawal at the beginning of exercise in man. We tested whether GABA-enhancing effects of a benzodiazepine could be observed in the HR change (R-R interval) immediately following the onset of a brief (10s) isometric contraction (60 % maximum) of the biceps muscle. The difference between the change in R-R interval occurring during the same phase of respiration was compared for placebo (Pla) and 10 mg oral diazepam (Dz) treatment in a double blind, crossover trial.

Diffuse endothelial dysfunction is common to ANCA associated systemic vasculitis and polyarteritis nodosa.

Background: Excess cardiovascular mortality complicates systemic rheumatic disease, suggesting an accelerated atheromatous process, which it has been proposed relates to the vascular inflammation common in such diseases. Impaired endothelium dependent vasodilatation is an early marker of atheromatous disease. It has previously been shown that such endothelial cell dysfunction (ECD) occurring in the brachial artery can complicate primary systemic necrotising vasculitis (SNV).

Mortality, cardiac vagal control and physical training--what's the link?

There is little doubt that regular exercise results in increases in life expectancy and protects against adverse cardiac events in both healthy subjects and patients with cardiovascular disease. The mechanism of action of physical training remains unclear but a variety of evidence points towards an enhancement in cardiac vagal activity protecting against lethal arrhythmias. Just how physical training increases cardiac vagal activity is an area that is ill understood but plausible mechanisms include mediation via angiotensin II or NO.

The role of endothelial cell dysfunction in the cardiovascular mortality of RA.

Rheumatoid patients present clinically with chronic inflammatory immune arthritis but die of the same cardiovascular (CVS) disease as the normal population. Recent studies emphasize the increased frequency and earlier development of CVS involvement in RA. The mechanisms of this accelerated atherosclerosis are the subject of active research.

Cardiac vagal response to water ingestion in normal human subjects.

In healthy young subjects there is direct evidence for sympathetic vasoconstrictor activation after drinking water, but this is not accompanied by an increase in arterial blood pressure. A marked pressor response to water ingestion has, however, been observed in elderly subjects and in patients with autonomic failure. We examined the effect of water ingestion on haemodynamic variables and heart rate variability (HRV) markers of cardiac vagal control in ten healthy young subjects and four cardiac transplant recipients with confirmed persistent cardiac vagal denervation.

Management of pregnancy in women with pulmonary hypertension secondary to SLE and anti-phospholipid syndrome.

Pulmonary hypertension is found in about 10% of patients with systemic lupus erythematosis (SLE). Pulmonary hypertension may be present at the time of diagnosis or may develop after the diagnosis of SLE or anti-phospholipid syndrome (APS). It often presents in the reproductive years and has a significant impact on pregnancy outcome, being a significant cause of indirect maternal deaths.

The angiotensin-converting enzyme gene I/D polymorphism and heart rate variability following acute myocardial infarction.

Aims: Heart rate variability (HRV) is a measure of cardiac autonomic control and is therefore subject to regulation by the renin-angiotensin system. The primary objective of this study was to determine the effect of an insertion/deletion polymorphism within the angiotensin-converting enzyme (ACE) gene on HRV in the early stages after a myocardial infarction at a time when cardiac autonomic control is deranged. The secondary objective was to determine whether this polymorphism affected the HRV response to inhibition of ACE.

Chronotropic effects of nitric oxide in the denervated human heart.

Nitric oxide synthase is expressed in the sino-atrial node and animal data suggests a direct role for nitric oxide on pacemaker activity. Study of this mechanism in intact humans is complicated by both reflex and direct effects of nitric oxide on cardiac autonomic control. Thus, we have studied the direct effects of nitric oxide on heart rate in human cardiac transplant recipients who possess a denervated donor heart.

Mapping QTLs associated with drought avoidance in upland rice grown in the Philippines and West Africa.

Localizing genes that contribute to drought avoidance in a quantitative way should enable the exploitation of these genes in breeding through marker-assisted selection, and may lead to the discovery of gene identity and function. Between 110 and 176 F6 recombinant inbred lines from a mapping population derived from a cross of upland rice varieties Bala and Azucena have been evaluated for indicators of drought avoidance in sites in the Philippines and West Africa over two dry seasons. A molecular map with 102 RFLP, 34 AFLP and six microsatellite markers has been used to map (by composite interval mapping) quantitative trait loci (QTLs) for the visual scores of leaf rolling and leaf drying and leaf relative water content.

Heart rate variability--a therapeutic target?

Reduced heart rate variability (HRV) is a powerful and independent predictor of an adverse prognosis in patients with heart disease and in the general population. The HRV is largely determined by vagally mediated beat to beat variability, conventionally known as respiratory sinus arrhythmia. Thus, HRV is primarily an indicator of cardiac vagal control.

Nitric oxide and cardiac parasympathetic control in human heart failure.

Cardiac parasympathetic control has prognostic significance in heart failure, but the control mechanisms of this system remain poorly defined. We have demonstrated previously a facilitatory role for nitric oxide (NO) in the parasympathetic control of heart rate in young healthy human subjects. In view of the complex abnormalities of regional NO activity observed in chronic heart failure, we now aim to establish if this mechanism is active in subjects with this condition.

A multistage perceptual quality assessment for compressed digital angiogram images.

This paper describes a multistage perceptual quality assessment (MPQA) model for compressed images. The motivation for the development of a perceptual quality assessment is to measure (in)visible differences between original and processed images. The MPQA produces visible distortion maps and quantitative error measures informed by considerations of the human visual system (HVS).

L-arginine augments cardiac vagal control in healthy human subjects.

Cardiac vagal control has prognostic significance in cardiac disease, but the control mechanisms of this system remain poorly understood. We have previously demonstrated a role for NO in promoting vagal control of heart rate in humans. Here we examine the influence of L-arginine, the substrate for NO synthase, on this mechanism in healthy human subjects.

Riparian zone influence on stream water chemistry at different spatial scales: a GIS-based modelling approach, an example for the Dee, NE Scotland.

A geographical information system (GIS-ARC/INFO) was used to collate existing spatial data sets on catchment characteristics to predict stream water quality using simple empirical models. The study, based on the river Dee catchment in NE Scotland, found that geological maps and associated geochemical information provided a suitable framework for predicting chemical parameters associated with acidification sensitivity (including alkalinity and base cation concentrations). In particular, it was found that in relatively undisturbed catchments, the parent material and geochemistry of the riparian zone, when combined with a simple hydrological flow path model, could be used to accurately predict stream water chemistry at a range of flows (Q95 to > Q5) and spatial scales (1-1000 km2).

The effects of hypothermia on human left ventricular contractile function during cardiac surgery.

Objectives: We investigated the interaction of heart rate (HR), temperature and contractility using a validated load independent method.

Background: Temperature manipulation is an integral part of cardiac surgery, and postoperative hypothermia is extremely common. Myocardial contraction is a series of enzymatic and physico-chemical reactions that may be differentially affected by temperature.