We tested the hypothesis that arterial compliance changes during each cardiac cycle, and that these instantaneous changes are beneficial for energy conservation. Using an adaptive identification procedure, we were able to obtain an instantaneous impulse-response representation of the arterial system. By assuming a three-element windkessel model, we obtained the instantaneous compliance. The arterial compliance remained relatively constant during diastole but increased during systole. The calculated time trajectory was compared with an optimal compliance calculation based on minimum ventricular ejection energy criteria. The two compliance trajectories followed similar paths. We conclude that increases in arterial compliance during systole reduce the energy demands on the left ventricle.
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http://dx.doi.org/10.1152/ajpheart.1994.267.1.H24 | DOI Listing |
Clin Transplant
January 2025
Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Canada.
Introduction: Preclinically, 24-hour continuous Ex-Situ Lung Perfusion (ESLP) is the longest duration achieved in large animal models and rejected human lungs. Here, we present our 36-hour Negative Pressure Ventilation (NPV)-ESLP protocol applied to porcine and rejected human lungs.
Methods: Five sets of donor domestic pig lungs (45-55 kg) underwent 36-hour NPV-ESLP.
Cureus
December 2024
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, USA.
Vasculitides represent a range of disorders marked by inflammation of blood vessels, often posing significant diagnostic challenges due to their diverse clinical presentations and involvement of multiple organ systems. We present the case of a 26-year-old woman who arrived with hemoptysis and a background of exertional dyspnea, chest pain, and occasional visual disturbances. Initial investigations showed elevated perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCAs) and myeloperoxidase antibodies (MPOs), indicative of microscopic polyangiitis (MPA).
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December 2024
Gastroenterology, Northwell Health, Bay Shore, USA.
Background: Liver transplant (LT) patients face various challenges, including an increased risk of coronary artery disease (CAD) for a variety of reasons, with 70% of LT recipients having one cardiovascular event. Coronary artery bypass grafting (CABG) remains one of the most commonly performed major surgical procedures in the United States, with 20-30% of LT patients requiring a CABG. Many studies have analyzed when to perform a CABG and CAD workup pre-LT, but this population remains a problem.
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December 2024
Gastroenterolgy, Sindh Institute of Urology and Transplantation, Karachi, PAK.
Background Heart failure (HF) is commonly managed by addressing water and sodium (Na) balance, with arterial circulation playing a major role in influencing renal Na and water excretion. Recently, chloride (Cl) has been recognized as an important factor in HF, associated with volume regulation and its modulation of renin-angiotensin-aldosterone system (RAAS) activity through macula densa signaling, which impacts Na retention and neurohormonal activation. Acetazolamide, a carbonic anhydrase inhibitor, can enhance decongestion in HF by increasing urinary Na and Cl excretion when added to loop diuretics, a mechanism supported by prior studies demonstrating improved urine output and decongestion.
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December 2024
Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Our case report characterizes a rare presentation of mid-ventricular Takotsubo cardiomyopathy (TTC) in a patient with suspected myocarditis as an underlying cause. Mid-ventricular TTC is a rare variant of TTC presenting with overlapping symptoms and physical exam findings of acute coronary syndrome, which often leads to misdiagnosis as myocardial infarction. Our case is of a 77-year-old female patient with a history of hyperlipidemia, right breast ductal carcinoma in situ, and diverticular disease who presented to the emergency department for evaluation of chest pain radiating to the jaw with associated nausea and vomiting.
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