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Bimodal distribution of QRS complex duration in patients with dilated cardiomyopathy undergoing an ICD implant procedure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
In patients with heart failure with reduced ejection fraction (HFrEF), QRS duration is of the uttermost importance. Substantial proportion of patients with HFrEF and sufficiently prolonged QRS complex, especially those with left bundle branch block (LBBB), may significantly benefit from cardiac resynchronization therapy.
Purpose
The aim of the study was to analyse the distribution of the QRS durations in patients with HFrEF undergoing ICD implant procedure to better understand the phenomenon of QRS prolongation.
Methods
All patients undergoing the implant procedure in our centre between January 2017 and December 2021 for HFrEF caused by coronary artery disease (CAD) or dilated cardiomyopathy (DCM) were analysed for the inclusion into the study. The exclusion criteria were (1) coincidence of CAD with DCM, (2) upgrade from any other cardiac rhythm management device, (3) unavailability of the ECG recording or ECG recording with insufficient quality before the implant procedure, (4) more than one ventricular premature beat in the recording. The study used automatically measured QRS duration by Mortara EKG machines (299 recordings with ELI350, 98 with ELI380, and 10 with ELI250). Statistical analysis was performed in R software [1] with the function locmodes for the visualisation of probability density and excess mass test [2] for assessing statistical significance, both from the multimode package.
Results
The study included 407 patients. In 113 patients with DCM and 177 patients with CAD, the implantation was based on primary prevention (PP) indications, and 24 and 93 patients with DCM and CAD were implanted for secondary prevention (SP) indications. The distribution of QRS durations in the CAD-PP, as well as CAD-SP was unimodal (p=ns). In the DCM-PP group, the distribution was bimodal (p=0.012), in the DCM-SP group, the trend was non-significantly bimodal (p=0.076). Both DCM groups taken together had clearly bimodal distribution (p=0.002 – probability density curve according to locmodes function in the figure). The values between 139 and 142 ms were not present in this group. Below this border zone, two other patients fulfilled the criteria of LBBB, both with the duration close to the border zone (137 and 138 ms). Above this zone, 8 patients had right bundle branch block, the rest had LBBB.
Conclusions
Bimodal distribution of QRS duration values in patients with DCM supports the idea of sudden change of left bundle conduction rather than slow progression of local changes. In CAD, scars and other local impairments in conduction may hide these changes and no clear border zone can be set. With the well-known differences in the measurements of main ECGmachine manufacturers, criteria for bundle branch block in DCM could be set with high accuracy.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Charles University Research Program “Cooperatio – Cardiovascular Science” and the Ministry of Health of the Czech Republic Conceptual Development of Research Organization
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P5476Right ventricular - pulmonary vascular interaction predicts left ventricular remodelling after CRT: A prospective pressure volume loop study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kardiale MR Bildgebung an einem offenen 1,0T System - ein Vergleich mit 1,5T. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Myokardiale „First-Pass“ Adenosin Perfusion mittels k-t BLAST in einem offenen MR-System:. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kardiale Vitalitätsdiagnostik an einem offenen 1.0T MR-System - Vergleich von 3D Inversion Recovery und Phasen-Sensitiven Inversion Recovery Sequenzen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Myokardiale „First-Pass“ Adenosin Perfusion mittels k-t BLAST in einem offenen MR-System: Erste Ergebnisse und Vergleich mit FFR Messungen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kardiale Vitalitätsdiagnostik an einem offenen 1.0T MR-System – Vergleich von3D Inversion Recovery und Phasen-Sensitiven Inversion Recovery Sequenzen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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The elevated interferon gamma production is an important immunological marker in HAM/TSP pathogenesis. Scand J Immunol 2009; 70:403-7. [PMID: 19751276 DOI: 10.1111/j.1365-3083.2009.02291.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is the agent of the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), which may occur in >5% of patients during their lifetime. HTLV-1-infection causes disturbances in the immune system, and the viral load may also play an important role in the pathogenesis of HAM/TSP. Some cytokines are involved in the pathogenesis of this disorder. We have determined IL-2, IL-4, IL-10, IL-12 p70, IFN-gamma and TNF-alpha production among HTLV-1-infected subjects from our HTLV-out Clinic in Institute of Infectious 'Emílio Ribas' in Sao Paulo city, Brazil. PBMC obtained from healthy controls (n = 32), asymptomatic HTLV-1 carriers (n = 68) and HAM/TSP patients (n = 44) were grown in the absence and in the presence of phytohaemagglutinin (PHA), and the supernatants' fluids were measured for cytokines production. IL-2 levels were increased in the asymptomatic HTLV-1 carriers, and IFN-gamma was increased in both groups of patients (asymptomatic HTLV-1 carriers and more significantly among HAM/TSP patients). IL-4, IL-10, TNF-alpha and IL-12 p70 levels were not significantly increased on both groups of patients, as compared with controls. The major finding of this study is that IFN-gamma was an important cytokine for the HAM/TSP pathogenesis. Therefore, immune modulation of IFN-gamma may be critical to treat of HAM/TSP patients.
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Chronic Vagus Nerve Stimulation – Effects on Heart Rate and Heart Rate Variability Corroborate Clinical Improvement. J Card Fail 2009. [DOI: 10.1016/j.cardfail.2009.06.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patterns of In vitro Lymphoproliferative Responses Among HTLV-1-infected Subjects: Upregulation by HTLV-1 During HIV-1 Co-infection. Scand J Immunol 2007; 65:577-80. [PMID: 17523951 DOI: 10.1111/j.1365-3083.2007.01941.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study evaluated the in vitro response to different mitogens and a candidin antigen (CMA) in Human T-cell lymphotropic virus type 1 (HTLV-1) and co-infected HIV-1/HTLV-1 patients, to identify if this co-infection may modify the spontaneous lymph proliferative response. Peripheral blood mononuclear cells from 72 healthy seronegative controls, 75 asymptomatic HTLV-1-infected carriers, 42 HAM/TSP cases, 33 solely HIV-1-infected subjects and 24 HIV-1/HTLV-1 patients were assayed in the presence and absence of mitogens (PHA, PWM and OKT3) and CMA. The HAM/TSP group had the highest proliferation rate at 3 and 6 days after culture. HAM/TSP cases showed decreased response to PHA, compared with asymptomatic HTLV-1 subjects, and most important, the co-infected HIV-1/HTLV-1 cases presented a similar response to HTLV-1-infected subjects after 3 days of culture. The singles HIV-1-infected group had decreased in vitro response. It appears that during co-infection, the HTLV-1 regulatory proteins overwhelm the action of HIV-1 regulatory proteins.
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Minimal invasive surgical approach for implantation of the paracor ventricular support system (PVSS) in heart failure patients. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shear device for measurement of wall friction in designing granular moving bed filters. ADV POWDER TECHNOL 2006. [DOI: 10.1163/156855206775123520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Incidence of dementia in a community-dwelling Brazilian population. Alzheimer Dis Assoc Disord 2004; 18:241-6. [PMID: 15592138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The authors report the incidence of dementia in a community-dwelling Brazilian population. In 1997, 1656 individuals aged 65 years or more, the majority being of very low educational level, were screened at their homes in Catanduva, Brazil, and dementia was diagnosed in 118 cases. The remaining 1538 individuals were rescreened 3.25 years later applying a health questionnaire, the Mini-Mental State Examination (MMSE) and the Pfeffer Functional Activities Questionnaire (PFAQ). According to PFAQ and MMSE scores, selected subjects were submitted to clinical, neurologic, and cognitive evaluations. The subjects diagnosed with dementia underwent laboratory tests and brain computed tomography. A total of 1119 individuals were rescreened and 50 incident cases of dementia (28 with Alzheimer disease [AD]) were identified. The incidence rate of dementia was 13.8 and of AD was 7.7 per 1000 person-years for individuals aged 65 years or older. The incidence rates of dementia almost doubled with every 5 years of age. There was no difference according to gender, but women had a higher incidence of dementia, predominantly AD, in very old age. There was a trend for higher incidence of dementia in illiterates (p = 0.07), but multivariate analysis disclosed significant association only between age and higher incidence of dementia. The incidence rates of dementia in this Brazilian community are comparable to those reported in Western and Asian studies.
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Determination of normal concentration levels of Cd, Cr, Cu, Hg, Pb, Se and Zn in hair of the child population in the Czech Republic. Cent Eur J Public Health 2003; 11:184-6. [PMID: 14768779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Knowledge of normal levels of concentrations of trace elements (Cd, Cr, Cu, Hg, Pb, Se and Zn) in the population serve, among others, in the designing of regulations of exposure limits and prevention of diseases caused by deficiency in essential trace elements. Concentrations of the named elements in the hair of children in the Czech population were determined by means of atomic absorption spectrometry. The samples of hair were collected during 1994- 2001 from 3,556 children (1,741 boys and 1,815 girls, average age 9.9 years). Mineralization in a microwave digestion system was used following a washing procedure. The accuracy of results was checked by means of the control materials CRM Human Hair GBW 07601. Values of concentrations of the trace elements in hair found for children were (in medians) 0.14 microg Cd.g(-1), 0.22 microg Cr.g(-1), 12 microg Cu.g(-1), 0.19 microg Hg.g(-1), 1.6 microg Pb.g(-1), 0.22 microg Se.g(-1) and 124 microg Zn.g(-1), respectively. Statistically significant differences between boys and girls were found for Cd, Cu and Zn. Concentrations of the elements under study correspond to the published values for the non-exposed population.
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The flow patterns and stresses on the wall in a symmetric louvered-wall moving granular filter bed. POWDER TECHNOL 2003. [DOI: 10.1016/s0032-5910(02)00344-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Viscosity behavior of solutions of sodium tetraphenylboron and its glyme complexes in ethereal solvents. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100639a003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Effect of ion-pair solvation on the paramagnetic solvent shift of aromatic radical anion solutions. Spin density of solvating molecules. J Am Chem Soc 2002. [DOI: 10.1021/ja00718a050] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Intramolecular ionic interactions in bolaform electrolytes of .alpha.,.omega.-bis(9-fluorenyl)polymethylenes. J Am Chem Soc 2002. [DOI: 10.1021/ja00786a026] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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THE DIRECT DETERMINATION OF THE ABSOLUTE CO-POLYMERIZATION RATE CONSTANT IN ANIONIC POLYMERIZATION1. J Am Chem Soc 2002. [DOI: 10.1021/ja01474a047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kinetic Studies of Anionic Polymerization of Polystyryl Salts in Tetrahydropyran and 2-Methyltetrahydrofuran. Macromolecules 2002. [DOI: 10.1021/ma60012a004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Studies of Ions and Ion Pairs in Tetrahydrofuran Solution. Alkali Metal Salts of Tetraphenylboride. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100886a042] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Contact and solvent-separated ion pairs of carbanions. V. The role of solvent structure in alkali ion solvation. J Am Chem Soc 2002. [DOI: 10.1021/ja01019a025] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Contact and solvent-separated ion pairs of carbanions. VI. Conductivities and thermodynamics of dissociation of fluorenyl alkali salts in tetrahydrofuran and dimethoxyethane. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100842a044] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Studies of Contact and Solvent-Separated Ion Pairs of Carbanions. I. Effect of Temperature, Counterion, and Solvent. J Am Chem Soc 2002. [DOI: 10.1021/ja00954a024] [Citation(s) in RCA: 287] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The Absolute Rate Constants of Anionic Co-polymerization in the System Styrene-α-Methylstyrene. The Effect of Polymer Structure on the Rate of Polymerization. J Am Chem Soc 2002. [DOI: 10.1021/ja00888a010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Solute binding and catalytic effects in aqueous solutions of poly(vinyl crown ethers). J Am Chem Soc 2002. [DOI: 10.1021/ja00853a058] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Reactivities of ion pairs and free ions in proton abstraction reactions. Reaction between polystyryl carbanion salts and triphenylmethane. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100649a017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ion-pair aggregation in solutions of complexes of carbanion salts and macrocyclic polyethers. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100659a015] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Solvent Effects in Anionic Polymerization. The Behavior of Living Polystyrene in Tetrahydrofuran-Dioxane Mixtures. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100873a024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Conductivities and thermodynamics of dissociation of fluorenyl salts and their complexes with dimethyldibenzo-18-crown-6. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100570a008] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alternative Paths in Anionic Propagation of Ion Pairs. Effect of Solvent and Counterion. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100886a044] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Studies of Contact and Solvent-Separated Ion Pairs of Carbanions. II. Conductivities and Thermodynamics of Dissociation of Fluorenyllithium, -sodium, and -cesium. J Am Chem Soc 2002. [DOI: 10.1021/ja00954a025] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Studies of Solvation Phenomena of Ions and Ion Pairs in Dimethoxyethane and Tetrahydrofuran. J Am Chem Soc 2002. [DOI: 10.1021/ja00952a005] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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