3D right ventricular ejection fraction and longitudinal strain are independent predictors of major adverse cardiovascular events in patients with rrhythmogenic right ventricular cardiomyopathy

Introduction

Evaluation of right ventricular (RV) function is essential in the follow up of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Role of advance echocardiography including 3D transthoracic echocardiography (3DTTE) for evaluation of 3D RV function and RV longitudinal strain in predicting prognosis in ARVC patients, has not been well investigated.

Purpose

We aimed to evaluate 3DTTE parameters in predicting major advance cardiovascular events (MACE) defined as ventricular arrhythmia, cardiac hospitalization, heart transplantation, and death in ARVC patients.

Methods

Forty-eight definite ARVC subjects based on the 2010 Task force criteria were evaluated with standard 2D transthoracic echocardiography (2DTTE) and 3DTTE. Patients with poor image quality were excluded. RV function was evaluated by 2D and 3D TTE including: fractional area change (FAC), RV global and free wall longitudinal strain (RV2DGLS and RV2DFWLS) and 3D RV ejection fraction (RV3DEF), RV global and free wall longitudinal strain (RV3DGLS, and RV3DFWLS). The patients were followed up for a median period of 12 months (6–18 months) to record MACE.

Results

Forty-eight patients with mean age =38.5±14 years; 79.2% male, and mean RV3DEF =30.33%, were included. During the mean follow up 12 months, 12 patients (25%, with mean RV3DEF = 24.8±9%) experienced MACE whereas mean RV3EF in patient without any cardiovascular events during follow up was 34.21±9%. The most common causes of hospitalization were arrhythmia, right-sided heart failure, and RV clot as the following: Ventricular arrhythmia in 7 patients (14.6%, with mean RV3DEF = 29.01±8.82%), RV clot in 2 cases (4.2%, with mean RV3DEF = 20.2%), right-sided heart failure in 3 patients (6.3%, with mean RV3DEF = 16.83±3.6%) that 2 of them (2.1%, with mean RV3DEF = 14.58±0.63) underwent heart transplantation.

Logistic regression analysis revealed RV3DTTE (p-value = 0.03, OR=0.90, CI: 0.82–0.99), RV3DGLS (p-value = 0.05, OR=1.27, CI: 0.99–1.61) and RV3DFWLS (p-value = 0.01, OR=1.29, CI: 1.05–1.59), predicted cardiac adverse events, but there were no significant association between RV2DGLS, RV2DEWLS and FAC with MACE.

Conclusion

RV3DEF, RV3DGLS, and RV3DFWLS were powerful predictors of morbidity and mortality and can be useful as a valuable method in the prediction of major cardiovascular complications in ARVC patients.

Funding Acknowledgement

Type of funding source: None

Cardiac screening of intact Drosophila melanogaster larvae under exposure to aqueous and gaseous toxins in a microfluidic device

We present a semi-automated microfluidic chip for orientation, immobilization, chemical exposure, and cardiac screening of 3rd instar Drosophila melanogaster larvae.

Intersectoral collaboration to develop health equity indicators in iran

BACKGROUND

Health equity is considered as one of the main objectives of health care systems. This study was carried out with the aim of determining health equity indicators in Iran. Through consideration of these indicators, differences in health status of different social groups and different geographical areas can be shown in different periods and based on that, effective interventions can be designed. This study is carried out through a main workshop and expert panels and final consensus on selected indicators. The first draft of indicators and inequity stratifying variables were prepared and then revised by working groups consisting of experts inside and outside Health system. Finally ideas were accepted or rejected after presenting enough reasons and deep examination through the Consensus-Oriented Decision-Making (COMD) model. Fifty two indicators have been determined as health equity indicators in five areas including health, social and human development, economic development, physical environment and infrastructure and governance. Furthermore, for each indicator the proper and practical stratifying variables of inequity were identified. By calculating such indicators, it becomes possible to determine differences in health status of different social groups and different geographical areas.

In vitro comparison of egg yolk-based and soybean lecithin-based extenders for cryopreservation of ram semen

Substitution of egg yolk with soybean lecithin may reduce hygienic risks in extenders. Though a few studies have been performed on the effect of soybean lecithin in bull, to date evaluation of ram semen in vitro fertility after cryopreservation with use of soybean lecithin has not been studied. This study assessed the effect of 1% or 2% (wt/vol) soybean lecithin (L1 or L2) or 15% or 20% (vol/vol) egg yolk (E15 or E20) supplemented with 5% or 7% glycerol (G5 or G7) in a Tris-based medium for cryopreservation of ram (Oviss arries) semen. Although no significant difference was observed in pattern of capacitation, the best results in terms of sperm motility, viability postthaw, and cleavage rates were observed with L1G7 (51.9+/-4.8%, 48.1+/-3.5%, and 79.6+/-3.9%, respectively) and E20G7 (51.8+/-2.9%, 46.7+/-4.0%, and 72.9+/-6.4%, respectively). Our results also showed that 1% lecithin and 20% egg yolk was superior to 2% lecithin and 15% egg yolk. In terms of cleavage rate, 7% glycerol was superior to 5% glycerol. No significant difference was obtained between groups in terms of blastocysts rate per cleaved embryo. Therefore, we concluded that the optimal concentration of lecithin and egg yolk is 1% and 20%, respectively, along with 7% glycerol. In addition, our results suggest that lecithin can be used as a substitute for egg yolk.

Physiological responses of Dunaliella salina and Dunaliella tertiolecta to copper toxicity

Species differences in heavy metal tolerance were investigated by comparing the responses of Dunaliella tertiolecta and Dunaliella salina to elevated concentrations of CuCl2. Although both species showed reduced cell number ml(-1) of algal culture, D. salina was more affected by increase in CuCl2. This reflects higher sensitivity of D. salina to CuCl2 compared to D. tertiolecta. Total chlorophyll in terms of microg ml(-1) was higher in D. tertiolecta at all tested CuCl2 levels, but in terms of microg cell(-1) no significant difference was observed between the two species. Total carotenoids in microg cell(-1) increased with increase in CuCl2 in both species and it was about five times higher in D. salina at all CuCl2 concentrations. While both species showed significant increase in lipid peroxidation at elevated CuCl2, the malondialdehyde content of D. salina cells was about three times higher at most CuCl2 concentrations. Although ascorbate peroxidase (APX) activity increased with increase in CuCl2 levels in both species, higher activity was observed in D. tertiolecta at all tested CuCl2 concentrations. Cu content of D. salina cells was higher than D. tertiolecta which may be due to larger volume of D. salina cells. In conclusion, since hydroxyl radical (HO*) produced from H2O2 by Cu2+ (Haber-Weiss cycle) is involved in lipid peroxidation, higher ascorbate peroxidase activity in D. tertiolecta may partly account for lower sensitivity of this species to CuCl2 compared to D. salina.