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Acute Exercise-Induced Changes in Cardiac Function Relates to Right Ventricular Remodeling Following 12-weeks Hypoxic Exercise Training.

J Appl Physiol (1985) 2021 Jun 10. Epub 2021 Jun 10.

Research Institute for Sport and Exercise Sciences, grid.4425.7Liverpool John Moores University, United Kingdom.

Repeated ventricular exposure to alterations in workload may relate to subsequent cardiac remodeling. We examined whether baseline acute changes in right (RV) and left ventricular (LV) function relate to chronic cardiac adaptation to 12-week exercise training. Twenty-one healthy individuals performed 12-week high-intensity endurance running training under hypoxia (fraction of inspired oxygen: 14. Read More

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Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke.

Front Physiol 2021 17;12:666171. Epub 2021 May 17.

School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

Background: Stroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. Read More

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The differential activation of cardiovascular hormones across distinct stages of portal hypertension predicts clinical outcomes.

Hepatol Int 2021 May 21. Epub 2021 May 21.

Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background And Aims: The cardiovascular hormones renin/angiotensin/aldosterone (RAA), brain-type natriuretic peptide (BNP)and arginine-vasopressin (AVP) are key regulators of systemic circulatory homeostasis in portal hypertension (PH). We assessed (i) the activation of renin, BNP and AVP across distinct stages of PH and (ii) whether activation of these hormones correlates with clinical outcomes.

Methods: Plasma levels of renin, proBNP and copeptin (AVP biomarker) were determined in 663 patients with advanced chronic liver disease (ACLD) undergoing hepatic venous pressure gradient (HVPG) measurement at the Vienna General Hospital between 11/2011 and 02/2019. Read More

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Temporal Analysis of Tachycardia During Catheter Directed Thrombolysis for Acute Pulmonary Embolism.

Vasc Endovascular Surg 2021 May 19:15385744211017109. Epub 2021 May 19.

Department of Vascular and Interventional Radiology, Christiana Care, Newark, DE, USA.

Purpose: To evaluate the effect of catheter directed thrombolysis (CDT) on heart rate (HR) in patients with sinus tachycardia and acute pulmonary embolism (PE).

Methods: A retrospective chart review was performed for patients who underwent CDT with tPA for acute massive or submassive PE between 12/2009 and 2/2020. Included were patients who presented with tachycardia at the time of initiation of CDT. Read More

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Agreement between wireless and standard measurements of vital signs in acute exacerbation of chronic obstructive pulmonary disease: a clinical validation study.

Physiol Meas 2021 Jun 17;42(5). Epub 2021 Jun 17.

Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.

Wireless sensors for continuous monitoring of vital signs have potential to improve patient care by earlier detection of deterioration in general ward patients. We aimed to assess agreement between wireless and standard (wired) monitoring devices in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Paired measurements of vital signs were recorded with 15 min intervals for two hours. Read More

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Severe Bradycardia Increases the Incidence and Severity of Torsade de Pointes Arrhythmias by Augmenting Preexistent Spatial Dispersion of Repolarization in the CAVB Dog Model.

Front Physiol 2021 26;12:642083. Epub 2021 Apr 26.

Department of Medical Physiology, Universitair Medisch Centrum Utrecht, Utrecht, Netherlands.

Introduction: Torsade de pointes arrhythmias (TdP) in the chronic atrioventricular block (CAVB) dog model result from proarrhythmic factors, which trigger TdP and/or reinforce the arrhythmic substrate. This study investigated electrophysiological and arrhythmogenic consequences of severe bradycardia for TdP.

Methods: Dofetilide (25 μg/kg per 5 min) was administered to eight anesthetized, idioventricular rhythm (IVR) remodeled CAVB dogs in two serial experiments: once under 60 beats per minute (bpm), right ventricular apex paced (RVA60) conditions, once under more bradycardic IVR conditions. Read More

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Patient profiling in heart failure for tailoring medical therapy. A consensus document of the Heart Failure Association of the European Society of Cardiology.

Eur J Heart Fail 2021 May 1. Epub 2021 May 1.

Department Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Despite guideline recommendations and available evidence, implementation of treatment in heart failure (HF) is poor. The majority of patients are not prescribed drugs at target doses that have been proven to positively impact morbidity and mortality. Among others, tolerability issues related to low blood pressure, heart rate, impaired renal function or hyperkalaemia are responsible. Read More

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[HYPERTENSION AMONG HEMODIALYSIS PATIENTS, NOT NECESSARILY HYPERVOLEMIA].

Harefuah 2021 Apr;160(4):215-220

Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.

Background: Hypertension in dialysis patients is common. In daily practice, it is not always clear whether adjustment of dry weight or vasodilatory medication should be administered and treatment strategy is often based on clinical impression. We used a whole-body bio-impedance based, non-invasive, hemodynamics monitoring technology to acquire hemodynamic data in order to evaluate the incidence and causes of hypertension in dialysis patients. Read More

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Dysautonomia: A Forgotten Condition - Part 1.

Arq Bras Cardiol 2021 04;116(4):814-835

Serviço de Eletrofisiologia do Vitória Apart Hospital, Vitória, ES - Brasil.

Dysautonomia covers a range of clinical conditions with different characteristics and prognoses. They are classified as Reflex Syndromes, Postural Orthostatic Tachycardia Syndrome (POTS), Chronic Fatigue Syndrome, Neurogenic Orthostatic Hypotension (nOH) and Carotid Sinus Hypersensitivity Syndrome. Reflex (vasovagal) syndromes will not be discussed in this article. Read More

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Efficacy of ivabradine in HIV-associated dilated cardiomyopathy.

Recenti Prog Med 2021 Apr;112(4):311-314

UOC Farmacia Ospedaliera, PO "Annunziata", Azienda Ospedaliera di Cosenza, Italy.

Ivabradine is a pure heart rate-lowering drug that acts directly on the sinus node and does not affect atrioventricular or intraventricular conduction times, myocardial contractility or ventricular repolarization. Ivabradine is used in the treatment of adults with New York Heart Association (NYHA) class II-IV chronic heart failure (CHF) with systolic dysfunction, in sinus rhythm, with a heart rate of ≥75 beats per minute (bpm). This report describes the beneficial effect of ivabradine on clinical parameters in a HIV-infected patient with dilated cardiomyopathy presenting with NYHA class III CHF symptoms. Read More

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Effects of selective heart rate reduction with ivabradine on LV function and central hemodynamics in patients with chronic coronary syndrome.

Int J Cardiol Heart Vasc 2021 Jun 23;34:100757. Epub 2021 Mar 23.

Department of Internal Medicine III, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany.

Objectives: We assessed left ventricular (LV) function and central hemodynamic effects in patients with a heart rate (HR) at rest of ≥70 beats per minute (bpm) and chronic coronary syndrome (CCS) after long-term treatment with ivabradine compared to placebo by cardiac magnetic resonance (CMR) imaging.

Methods And Results: In a randomized, double-blinded, prospective cross-over design, 23 patients (18 male, 5 female) were treated with ivabradine (7.5 mg bid) or placebo for 6 months. Read More

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DDD mode-switching and loss of atrioventricular synchrony evokes heart failure: A rare but possible trigger of pacing-induced cardiomyopathy.

J Cardiol Cases 2021 Apr 21;23(4):158-162. Epub 2020 Nov 21.

Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan.

Pacing-induced cardiomyopathy (PICM), defined as left ventricular dysfunction, occurs in the setting of chronic, high burden right ventricular pacing. We describe an unusual case of PICM. A 64-year-old man underwent a medical check-up and was diagnosed with complete atrioventricular block (AVB) with regular and slow ventricular contractions at 38 beats/min (bpm). Read More

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Nocturnal Heart Rate and Cardiac Repolarization in Lowlanders With Chronic Obstructive Pulmonary Disease at High Altitude: Data From a Randomized, Placebo-Controlled Trial of Nocturnal Oxygen Therapy.

Front Med (Lausanne) 2021 1;8:557369. Epub 2021 Mar 1.

Department of Respiratory Medicine, Sleep Disorders Center, University Hospital of Zurich, Zurich, Switzerland.

Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular disease. We investigated whether sleeping at altitude increases nocturnal heart rate (HR) and other markers of cardiovascular risk or arrhythmias in lowlanders with COPD and whether this can be prevented by nocturnal oxygen therapy (NOT). Twenty-four COPD patients, with median age of 66 years and forced expiratory volume in 1 s (FEV) 55% predicted, living <800 m underwent sleep studies at Zurich (490 m) and during 2 sojourns of 2 days each at St. Read More

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[Study on the value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 and growth differentiation factor-15 in the diagnosis of sepsis: test results from the patients of a multicenter study].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Feb;33(2):180-185

Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China. Corresponding author: Yan Jing, Email:

Objective: To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.

Methods: Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. Read More

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February 2021

Regional differences in office and self-measured home heart rates in Asian hypertensive patients: [email protected] study.

J Clin Hypertens (Greenwich) 2021 Mar 10;23(3):606-613. Epub 2021 Mar 10.

Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.

Increased heart rate is a predictor of cardiovascular disease, heart failure, and all-cause mortality. In those with high heart rates, interventions for heart rate reduction have been associated with reductions in coronary events. Asia is a diverse continent, and the prevalences of hypertension and cardiovascular disease differ among its countries. Read More

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Markers of cardiovascular risk and their reversibility with acute oxygen therapy in Kyrgyz highlanders with high altitude pulmonary hypertension.

Pulmonology 2021 Mar 2. Epub 2021 Mar 2.

Pulmonary Division and Sleep Disorders Center, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. Electronic address:

Background: High altitude pulmonary hypertension (HAPH), a chronic altitude related illness, is associated with hypoxemia, dyspnea and reduced exercise performance. We evaluated ECG and pulse wave-derived markers of cardiovascular risk in highlanders with HAPH (HAPH+) in comparison to healthy highlanders (HH) and lowlanders (LL) and the effects of hyperoxia.

Methods: We studied 34 HAPH+ and 54 HH at Aksay (3250m), and 34 LL at Bishkek (760m), Kyrgyzstan. Read More

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Effects of Post-Exertional Malaise on Markers of Arterial Stiffness in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Int J Environ Res Public Health 2021 02 28;18(5). Epub 2021 Feb 28.

School of Sport, Exercise and Nutrition, Massey University, Palmerston North 4442, New Zealand.

Evidence is emerging that individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may suffer from chronic vascular dysfunction as a result of illness-related oxidative stress and vascular inflammation. The study aimed to examine the impact of maximal-intensity aerobic exercise on vascular function 48 and 72 h into recovery. ME/CFS ( = 11) with gender and age-matched controls ( = 11) were randomly assigned to either a 48 h or 72 h protocol. Read More

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February 2021

Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: a cross-sectional analysis.

Ann Phys Rehabil Med 2021 Mar 1:101501. Epub 2021 Mar 1.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. Electronic address:

Background: The cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD) has been poorly studied.

Objectives: We aimed to 1) describe the cardiac autonomic function assessed by heart rate recovery (HRR) and chronotropic response (CR) during a 6-min walk test (6MWT) and afterward and 2) estimate the association of physical activity with HRR and CR in COPD patients.

Methods: This cross-sectional analysis included 320 patients with mild to very severe COPD. Read More

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Heart rate recovery in asthmastic children and adolescents after clinical field test.

BMC Pulm Med 2021 Feb 19;21(1):61. Epub 2021 Feb 19.

Post Graduate Programa in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, SP, 01525-000, Brazil.

Background: Inflammation caused by chronic lung disease in childhood may lead to delayed heart rate recovery (HRR) however, there is lack of evidence on HRR in this population. The aim was to assess HRR after functional capacity testing in asthmatic children and adolescents and to compare with severity and disease control.

Method: This was a study secondary to a randomized control trial. Read More

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February 2021

SAR340835, a Novel Selective Na/Ca Exchanger Inhibitor, Improves Cardiac Function and Restores Sympathovagal Balance in Heart Failure.

J Pharmacol Exp Ther 2021 05 18;377(2):293-304. Epub 2021 Feb 18.

Cardiovascular and Metabolism TSU (M.P., F.B., C.D., T.L., S.M., G.T., L.L., Ph.B., M.-P.P.-H., P.J., F.C.-G.) and Integrated Drug Discovery (Pa.B.), Sanofi R&D, Chilly Mazarin, France; Preclinical Safety, Sanofi R&D, Alfortville, France (L.L.-N., V.B., J.-M.G., M.T.); Sanofi R&D, Industriepark Höchst, Frankfurt, Germany (K.S., K.W., H.G., P.A., N.R., J.W.); and Integrated Drug Discovery, Sanofi R&D, Vitry sur Seine, France (G.M.)

In failing hearts, Na/Ca exchanger (NCX) overactivity contributes to Ca depletion, leading to contractile dysfunction. Inhibition of NCX is expected to normalize Ca mishandling, to limit afterdepolarization-related arrhythmias, and to improve cardiac function in heart failure (HF). SAR340835/SAR296968 is a selective NCX inhibitor for all NCX isoforms across species, including human, with no effect on the native voltage-dependent calcium and sodium currents in vitro. Read More

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Acute effects of noninvasive ventilation on sleep physiology in patients with moderate to severe stable chronic obstructive pulmonary disease: a pilot study.

Sleep Med 2021 Apr 30;80:118-125. Epub 2021 Jan 30.

Respiration Laboratory (RespLab), Department of Medical Sciences, Federal University of Ceará (UFC), 13165 Coronel Nunes de Melo, Rodolfo Teófilo, 60430270, Fortaleza, CE, Brazil.

Objective/background: Changes in sleep architecture in patients with Chronic Obstructive Pulmonary Disease (COPD) can be explained by a combination of physiological changes in breathing during sleep, with impairment of respiratory mechanics and reduction of arterial oxygenation. This study aimed to evaluate the acute effects of noninvasive ventilation (NIV) - compared to spontaneous breathing - on sleep latency and stages, and on the occurrence of sleep-related respiratory events, nocturnal hypoxemia, and changes in heart rate (HR) in patients with moderate to severe stable COPD.

Patients/methods: Patients completed two polysomnography (PSG) studies: one during spontaneous breathing and one while receiving NIV in bilevel mode and with backup respiratory rate (RR. Read More

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[Effect of early goal directed sedation on cerebral oxygen metabolism in patients with acute brain injury].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Jan;33(1):79-83

Department of Emergency, the First Medical Center of the PLA General Hospital, Beijing 100853, China. Corresponding author: Zhu Haiyan, Email:

Objective: To observe the effect of early goal directed sedation (EGDS) on cerebral oxygen metabolism in patients with acute brain injury.

Methods: A prospective cohort study was conducted. A total of 108 patients with acute brain injury admitted to the intensive care unit (ICU) of the Third Medical Center of the PLA General Hospital from January 2015 to December 2019 were enrolled. Read More

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January 2021

Blood lead and mercury levels are associated with low resting heart rate in community adolescent boys.

Int J Hyg Environ Health 2021 Apr 5;233:113685. Epub 2021 Feb 5.

University of Pennsylvania, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA.

While the neurotoxic effects of heavy metals at even low levels have been well-studied, few studies have examined the cardiovascular effects of heavy metals on resting heart rate and these have focused on adult populations. The present study aimed to examine the association between low-level environmental lead and mercury exposure and resting heart rate in community adolescents. As part of the China Jintan Cohort Study, 532 adolescents aged 12 years (SD = 0. Read More

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Noiseless Variable-Pressure Neck Chamber Device to Assess the Carotid Baroreflex Function.

Front Physiol 2020 20;11:613311. Epub 2021 Jan 20.

Biological Signals Processing Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil.

: The blood pressure responses to baroreflex perturbations can be assessed only using the variable-pressure neck chamber technique. However, the application of this approach in hospital environments is limited owing to the loud noise emitted during its operation. This study was aimed at developing a noiseless neck suction chamber device (NCD) that could stimulate the baroreceptors located in the carotid sinus in humans. Read More

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January 2021

Hemodynamic Changes Associated With Transcervical Laryngeal Injection of Botulinum Toxin.

J Voice 2021 Feb 1. Epub 2021 Feb 1.

Department of Otolaryngology Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address:

Purpose: Laryngeal dystonia is a chronic neurologic disorder characterized by intention-induced spasms of the vocal folds driven by aberrant central motor processing. The use of in-office transcervical botulinum toxin injection for the treatment of laryngeal disorders, such as laryngeal dystonia, has been deemed safe and efficacious. There is, however, no available data outlining the hemodynamic changes experienced by patients undergoing this frequently performed procedure. Read More

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February 2021

Asystole episodes and bradycardia in patients with end-stage renal disease.

Nephrol Dial Transplant 2021 Feb 2. Epub 2021 Feb 2.

Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland.

Background: Knowledge of arrhythmias in patients with end-stage renal disease (ESRD) is mainly based on ambulatory electrocardiography (ECG) studies and observations during haemodialysis. We used insertable cardiac monitors to define the prevalence of arrhythmias, focusing on bradyarrhythmias, in ESRD patients treated with several dialysis modes including home therapies. Moreover, we assessed whether these arrhythmias were detected in baseline or ambulatory ECG recordings. Read More

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February 2021

Thrombocytopenia Preceding Urosepsis in an Otherwise Asymptomatic Patient After Bilateral Retrograde Intrarenal Surgery.

J Endourol Case Rep 2020 29;6(4):256-259. Epub 2020 Dec 29.

Department of Urology, University of California, Irvine, Orange, California, USA.

Urosepsis is commonly predicted by the systematic inflammatory response syndrome (SIRS) criteria. We report a case of urosepsis preceded only by thrombocytopenia. : An 80-year-old Caucasian female presented with recurrent urinary tract infections, type 1 second-degree heart block (Mobitz I), and chronic deep venous thrombosis for which she was taking apixaban. Read More

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December 2020

Clinical Evaluation of Respiratory Rate Measurements on COPD (Male) Patients Using Wearable Inkjet-Printed Sensor.

Sensors (Basel) 2021 Jan 11;21(2). Epub 2021 Jan 11.

Research Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, UK.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that causes long-term breathing problems. The reliable monitoring of respiratory rate (RR) is very important for the treatment and management of COPD. Based on inkjet printing technology, we have developed a stretchable and wearable sensor that can accurately measure RR on normal subjects. Read More

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January 2021

Short-term hypoxia does not promote arrhythmia during voluntary apnea.

Physiol Rep 2021 01;9(1):e14703

Neurovascular Health Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.

The presence of bradycardic arrhythmias during volitional apnea at altitude may be caused by chemoreflex activation/sensitization. We investigated whether bradyarrhythmic episodes became prevalent in apnea following short-term hypoxia exposure. Electrocardiograms (ECG; lead II) were collected from 22 low-altitude residents (F = 12; age=25 ± 5 years) at 671 m. Read More

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January 2021

Ability of a novel shock index that incorporates invasive hemodynamics to predict mortality in patients with ST-elevation myocardial infarction.

Catheter Cardiovasc Interv 2021 Jan 9. Epub 2021 Jan 9.

Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Objective: To determine whether the use of invasively measured hemodynamics improves the prognostic ability of a shock index (SI).

Background: SI such as Admission-SI, Age-SI, Modified SI (MSI), and Age-MSI predict short-term mortality in ST-elevation myocardial infarction (STEMI).

Methods: Single-center study of 510 patients who underwent primary percutaneous coronary intervention. Read More

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January 2021