Effects of In-Exercise Carbohydrate Supplementation on Prolonged High-Intensity Exercise Performance in Oral Contraceptive Users

PURPOSE

To examine the impact of oral contraceptive (OC) phases on performance, physiological, and subjective responses to prolonged, intensive exercise when carbohydrate (CHO) stores are reduced.

METHODS

Ten well-trained female cyclists using monophasic OC completed 4 identical trials (>150 min) under conditions of in-trial 60-g·h-1 CHO supplementation (CHO+) or placebo (CHO-) during the sugar- (SUG) and active-pill (ACT) phases of their OC cycle. Each trial comprised two 400-kcal time trials (TT) separated by 1 hour of submaximal cycling at first ventilatory threshold.

RESULTS

Change in completion time from TT1 to TT2 was minimized in CHO+ compared with CHO- (4.06 [2.55] vs 6.08 [5.33] min; P = .019, effect size = -0.36). An interaction effect of OC and CHO was observed for time to complete TT (P = .006), mean TT power (P = .002), mean TT heart rate (P = .002), and posttrial emotional balance (P = .020) and negative emotional state (P = .033). In ACT, mean TT power and heart rate were higher in CHO+ when compared with CHO-, resulting in faster TTs in CHO+ and improved posttrial emotional well-being. When CHO was not supplemented, TT power and heart rate were higher in SUG when compared with ACT, resulting in faster TTs in SUG and improved posttrial emotional balance.

CONCLUSION

CHO depletion during ACT negatively influenced TT performance and emotional well-being when compared with SUG. Irrespective of OC pill phase, CHO supplementation should be prioritized to sustain performance and improve postexercise recovery-stress balance.

A Millimeter-Wave Broadband Multi-Mode Substrate-Integrated Gap Waveguide Traveling-Wave Antenna with Orbit Angular Momentum

Orbit angular momentum (OAM) has been considered a new dimension for improving channel capacity in recent years. In this paper, a millimeter-wave broadband multi-mode waveguide traveling-wave antenna with OAM is proposed by innovatively utilizing the transmitted electromagnetic waves (EMWs) characteristic of substrate-integrated gap waveguides (SIGWs) to introduce phase delay, resulting in coupling to the radiate units with a phase jump. Nine "L"-shaped slot radiate elements are cut in a circular order at a certain angle on the SIGW to generate spin angular momentum (SAM) and OAM. To generate more OAM modes and match the antenna, four "Π"-shaped slot radiate units with a 90° relationship to each other are designed in this circular array. The simulation results show that the antenna operates at 28 GHz, with a -10 dB fractional bandwidth (FBW) = 35.7%, ranging from 25.50 to 35.85 GHz and a VSWR ≤ 1.5 dB from 28.60 to 32.0 GHz and 28.60 to 32.0 GHz. The antenna radiates a linear polarization (LP) mode with a gain of 9.3 dBi at 34.0~37.2 GHz, a l = 2 SAM-OAM (i.e., circular polarization OAM (CP-OAM)) mode with 8.04 dBi at 25.90~28.08 GHz, a l = 1 and l = 2 hybrid OAM mode with 5.7 dBi at 28.08~29.67 GHz, a SAM (i.e., left/right hand circular polarization (L/RHCP) mode with 4.6 dBi at 29.67~30.41 GHz, and a LP mode at 30.41~35.85 GHz. In addition, the waveguide transmits energy with a bandwidth ranging from 26.10 to 38.46 GHz. Within the in-band, only a quasi-TEM mode is transmitted with an energy transmission loss |S21| ≤ 2 dB.

Using Phase Difference Information to Detect Errors in the Flip Angle Measured with Actual Flip Angle Imaging at 7T

Flip angle (FA) measurements using the actual flip angle imaging (AFI) method may induce significant errors in ultrahigh fields. We aimed to develop a method for detecting errors in FA measurements using phase information at 7 tesla. We performed computer simulations to elucidate the relationship between the FA calculation errors and the phase difference between the two AFI source images. We then examined whether a method based on the phase difference could detect FA calculation errors and determine the prescribed nominal FA of the scanner for accurate measurements in phantoms and healthy volunteers. The simulations confirmed that the calculated FA values erroneously decreased when the longitudinal magnetization and phase in one of the source images were inverted. Tests on phantoms and human subjects demonstrated that the phase difference information between the source images with a cut-off of 90° could readily detect FA calculation errors in the AFI method.

Torque response of seated human body to sinusoidal lateral and roll dual-axis vibration

The biodynamic response of 14 subjects to sinusoidal dual-axis vibration in lateral and roll directions is studied. The root mean square of human response is detected by measuring the torque at the seat pan. The effects of phase difference, magnitude, and frequency on the biodynamic responses are investigated. The consistency between human responses to dual-axis and single-axis is studied. With increasing phase difference, human response is found to reach the maximum when the vibrations are anti-phase and then decrease to the minimum when they are in-phase. Besides, the dominance of the lateral excitation is confirmed in the dual-axis vibration. Finally, the principle of equivalence between lateral-roll dual-axis vibration and roll single-axis vibration is established. With the equivalence method, the biodynamic characteristics of the human body to multi-axis vibration are expected to be measured and represented with a much simpler test and dynamic model. Practitioner summary: Proposed equivalence uses one index to evaluate the compound discomfort caused by the roll and lateral vibration. Overestimation of discomfort due by summing the effects of them calculated separately can be avoided. After the equivalence, evaluation of discomfort and modelling of the human body can be carried out only in roll direction.

A Single-Phase High-Impedance Ground Faulty Feeder Detection Method for Small Resistance to Ground Systems Based on Current-Voltage Phase Difference

At present, the small resistance to ground system (SRGS) is mainly protected by fixed-time zero-sequence overcurrent protection, but its ability to detect transition resistance is only about 100 Ω, which is unable to detect single-phase high resistance grounding fault (SPHIF). This paper analyzes the zero-sequence characteristics of SPHIF for SRGS and proposes a SPHIF feeder detection method that uses the current–voltage phase difference. The proposed method is as follows: first, the zero-sequence current phase of each feeder is calculated. Second, the phase voltage root mean square (RMS) value is used to determine the fault phase and obtain its initial phase as the reference value. The introduction of the initial phase of the fault phase voltage can highlight the fault characteristics and improve the sensitivity and reliability of feeder detection, and then CVPD is the difference between each feeder ZSC phase and the reference value. Finally, the magnitude of CVPD is judged. If the CVPD of a particular feeder meets the condition, the feeder is detected as the faulted feeder. Combining the theoretical and practical constraints, the specific adjustment principle and feeder detection logic are given. A large number of simulations show that the proposed method can be successfully detected under the conditions of 5000 Ω transition resistance, –1 dB noise interference, and 40% data missing. Compared with existing methods, the proposed method uses phase voltages that are easy to measure to construct SPHIF feeder detection criteria, without adding additional measurement and communication devices, and can quickly achieve local isolation of SPHIF with better sensitivity, reliability, and immunity to interference.

Dynamic Time Warping Identifies Functionally Distinct fMRI Resting State Cortical Networks Specific to VTA and SNc: A Proof of Concept

Functional connectivity (FC) is determined by similarity between functional magnetic resonance imaging (fMRI) signals from distinct brain regions. However, traditional FC analyses ignore temporal phase differences. Here, we addressed this limitation, using dynamic time warping (DTW) within a machine-learning framework, to study cortical FC patterns of 2 spatially adjacent but functionally distinct subcortical regions, namely Substantia Nigra Pars Compacta (SNc) and ventral tegmental area (VTA). We evaluate: 1) the influence of pair of brain regions considered, 2) the influence of warping window sizes, 3) the classification efficacy of DTW, and 4) the uniqueness of features identified. Whole brain 7 Tesla resting state fMRI scans from 81 healthy participants were used. FC between 2 subcortical regions of interests (ROIs) and 360 cortical parcels were computed using: 1) Pearson correlations (PCs), 2) dynamic time-warped PCs (DTW-PC). The separability of SNc-cortical and VTA-cortical network was validated on 40 participants and tested on the remaining 41, using a support vector machine (SVM). The SVM separated the SNc-cortical versus VTA-cortical network with 74.39 and 97.56% test accuracy using PC and DTW-PC, respectively. SVM-recursive feature elimination yielded 20 DTW-PC features that most strongly contributed to the separation of the networks and revealed novel VTA versus SNc preferential connections (P < 0.05, Bonferroni-Holm corrected).

Tandem-wing interactions on aerodynamic performance inspired by dragonfly hovering

Dragonflies possess two pairs of wings and the interactions between forewing (FW) and hindwing (HW) play an important role in dragonfly flight. The effects of tandem-wing (TW) interactions on the aerodynamic performance of dragonfly hovering have been investigated. Numerical simulations of single-wing hovering without interactions and TW hovering with interactions are conducted and compared. It is found that the TW interactions reduce the lift coefficient of FW and HW by 7.36% and 20.25% and also decrease the aerodynamic power and efficiency. The above effects are mainly caused by the interaction between the vortex structures of the FW and the HW, which makes the pressure of the wing surface and the flow field near the wings change. During the observations of dragonfly flight, it is found that the phase difference (γ) is not fixed. To explore the influence of phase difference on aerodynamic performance, TW hovering with different phase differences is studied. The results show that at γ = 22.5°, dragonflies produce the maximum lift which is more than 20% of the body weight with high efficiency; at γ = 180°, dragonflies generate the same lift as the body weight.

Performance Degradation in Cross-Eye Jamming Due to Amplitude/Phase Instability between Jammer Antennas

Cross-eye gain in cross-eye jamming systems is highly dependent on amplitude ratio and the phase difference between jammer antennas. It is well known that cross-eye jamming is most effective for the amplitude ratio of unity and phase difference of 180 degrees. It is assumed that the instabilities in the amplitude ratio and phase difference can be modeled as zero-mean Gaussian random variables. In this paper, we not only quantitatively analyze the effect of amplitude ratio instability and phase difference instability on performance degradation in terms of reduction in cross-eye gain but also proceed with analytical performance analysis based on the first order and second-order Taylor expansion.

Faith-based investments and the Covid-19 pandemic: Analyzing equity volatility and media coverage time-frequency relations

We perform time-frequency wavelet-based analysis to explore how the media coverage of the Covid-19 pandemic influenced the volatility of the Islamic equity indices, covering various sectors of economic activity. Our results show that the coherence between the Media Coverage Index and the moves of the Islamic stocks varies from low and medium to high levels. We attribute the intervals of low coherence to the diversification potential of Islamic equity investments during a systemic pandemic such as Covid-19. We document differences in the patterns exhibited by various indices per sector, showing their potential role for designing hedging strategies across sectors, based on stocks of companies which comply with Shariah.

A Self-Powered Vector Angle/Displacement Sensor Based on Triboelectric Nanogenerator

Recently, grating-structured triboelectric nanogenerators (TENG) operating in freestanding mode have been the subject of intensive research. However, standard TENGs based on interdigital electrode structures are unable to realize real-time sensing of the direction of the freestanding electrode movement. Here, a newly designed TENG, consisting of one group of grating freestanding electrodes and three groups of interdigitated induction electrodes with the identical period, has been demonstrated as a self-powered vector angle/displacement sensor (SPVS), capable of distinguishing the real-time direction of the freestanding electrode displacement. Thanks to the unique coupling effect between triboelectrification and electrostatic induction, periodic alternating voltage signals are generated in response to the rotation/sliding movement of the top freestanding electrodes on the bottom electrodes. The output peak-to-peak voltage of the SPVS can reach as high as 300 V at the rotation rate of 48 rpm and at the sliding velocity of 0.1 m/s, respectively. The resolution of the sensor reaches 8°/5 mm and can be further enhanced by decreasing the width of the electrodes. This present work not only demonstrates a novel method for angle/displacement detection but also greatly expands the applicability of TENG as self-powered vector sensors.

Cerebellar Lobulus Simplex and Crus I Differentially Represent Phase and Phase Difference of Prefrontal Cortical and Hippocampal Oscillations

The cerebellum has long been implicated in tasks involving precise temporal control, especially in the coordination of movements. Here we asked whether the cerebellum represents temporal aspects of oscillatory neuronal activity, measured as instantaneous phase and difference between instantaneous phases of oscillations in two cerebral cortical areas involved in cognitive function. We simultaneously recorded Purkinje cell (PC) single-unit spike activity in cerebellar lobulus simplex (LS) and Crus I and local field potential (LFP) activity in the medial prefrontal cortex (mPFC) and dorsal hippocampus CA1 region (dCA1). Purkinje cells in cerebellar LS and Crus I differentially represented specific phases and phase differences of mPFC and dCA1 LFP oscillations in a frequency-specific manner, suggesting a site- and frequency-specific cerebellar representation of temporal aspects of neuronal oscillations in non-motor cerebral cortical areas. These findings suggest that cerebellar interactions with cerebral cortical areas involved in cognitive functions might involve temporal coordination of neuronal oscillations.

The cerebellum has long been implicated in tasks involving precise temporal control, especially in the coordination of movements. McAfee et al. show that the cerebellar principal neurons, Purkinje cells, represent precise temporal information about the phase and phase differences of neuronal oscillations occurring in two non-motor-related cerebral cortical structures.

Mixed Incoherent Far-Field and Near-Field Source Localization under Uniform Circular Array

A high-accuracy algorithm is presented for the localization of mixed incoherent near-field and far-field narrow-band sources under uniform circular array (UCA). Herein, considering that it is difficult to classify the mixed sources, we first decouple mixed sources’ angles and ranges by calculating centro-symmetric sensors’ phase differences. Then, as the phase differences including only sources’ angles can be transformed as indefinite equations, each source’s azimuth angle and elevation angle are obtained by performing the least squares method. After that, on the basis of the estimated angles of the mixed sources, one-dimensional (1-D) multiple signal classification (MUSIC) method and corresponding spatial spectrum are utilized to identify the mixed sources and estimate the ranges of the near-field sources. Finally, simulation and comparison results verify the superior performance of our proposed algorithm.

Moving Object Localization Based on UHF RFID Phase and Laser Clustering

RFID (Radio Frequency Identification) offers a way to identify objects without any contact. However, positioning accuracy is limited since RFID neither provides distance nor bearing information about the tag. This paper proposes a new and innovative approach for the localization of moving object using a particle filter by incorporating RFID phase and laser-based clustering from 2d laser range data. First of all, we calculate phase-based velocity of the moving object based on RFID phase difference. Meanwhile, we separate laser range data into different clusters, and compute the distance-based velocity and moving direction of these clusters. We then compute and analyze the similarity between two velocities, and select K clusters having the best similarity score. We predict the particles according to the velocity and moving direction of laser clusters. Finally, we update the weights of the particles based on K clusters and achieve the localization of moving objects. The feasibility of this approach is validated on a Scitos G5 service robot and the results prove that we have successfully achieved a localization accuracy up to 0.25 m.

Relationship Between the Cortisol-Estradiol Phase Difference and Affect in Women

Affective disorders impact women's health, with a lifetime prevalence of over twelve per cent. They have been correlated with reproductive cycle factors, under the regulation of hormonal circadian rhythms. In affective disorders, circadian rhythms may become desynchronized. The circadian rhythms of cortisol and estradiol may play a role in affective disorders. The purpose of this study was to explore the temporal relationship between the rhythms of cortisol and estradiol and its relationship to affect. It was hypothesized that a cortisol-estradiol phase difference (PD) exists that correlates with optimal affect. A small scale, comparative, correlational design was used to test the hypothesis. Twenty-three women were recruited from an urban university. Salivary samples were collected over a twenty-four-hour period and fitted to a cosinor model. Subjective measures of affect were collected. Relationships between the cortisol-estradiol PD and affect were evaluated using a second-degree polynomial equation. Results demonstrated a significant correlation in affect measures (p < 0.05). An optimal PD was identified for affect to be 3.6 hours. The phase relationship between cortisol and estradiol may play a role in the development of alterations in affective disorders.

Simulation of the simultaneous dual-frequency resonance excitation of ions in a linear ion trap

The process of ion resonance dipolar excitation in a linear ion trap by 2 ejection waveforms with close frequencies is studied. The physical mechanism of increasing the resolving power using the ion excitation is a nonlinearity of the electric radio frequency fields caused by space charge. Using 2 resonance forces with 2 close frequencies leads to the completion of 2 excitation processes. In the case of the perfect quadrupole electric field, the ion motion equations are linear, and as a result, the respondent ion ensemble is also a linear and valid superposition principle. Nevertheless, the resolution increases (20%) in the case of lack of a space charge in an operating mode with a dual-frequency. The numerical simulations show that the mass shift is removed, and the mass resolution is increased via dual-frequency resonance excitation when the frequency difference (approximately 2.5 kHz) is relatively small and the phase difference of 2 harmonic signals is 0-π3 even at a high linear ion density of up to 50 000 ions per radius field r₀ .

Closed-Form Algorithm for 3-D Near-Field OFDM Signal Localization under Uniform Circular Array

Due to its widespread application in communications, radar, etc., the orthogonal frequency division multiplexing (OFDM) signal has become increasingly urgent in the field of localization. Under uniform circular array (UCA) and near-field conditions, this paper presents a closed-form algorithm based on phase difference for estimating the three-dimensional (3-D) location (azimuth angle, elevation angle, and range) of the OFDM signal. In the algorithm, considering that it is difficult to distinguish the frequency of the OFDM signal's subcarriers and the phase-based method is always affected by errors of the frequency estimation, this paper employs sparse representation (SR) to obtain the super-resolution frequencies and the corresponding phases of subcarriers. Further, as the phase differences of the adjacent sensors including azimuth angle, elevation angle and range parameters can be expressed as indefinite equations, the near-field OFDM signal's 3-D location is obtained by employing the least square method, where the phase differences are based on the average of the estimated subcarriers. Finally, the performance of the proposed algorithm is demonstrated by several simulations.

Identification of Heschl's gyrus on phase difference enhanced imaging

Background The white matter in the Heschl's gyrus (HG-WM) may appear differently to the other gyri on phase difference enhanced imaging (PADRE), which can enhance the myelin density. Purpose To evaluate the signal intensity (SI) of HG-WM using the PADRE technique and to compare the images with susceptibility-weighted imaging (SWI)-like images. Material and Methods The participants included 19 normal controls (38 HGs; mean age, 60.1 years; age range, 28-80 years). Coronal PADRE and SWI-like images were acquired using a 3T magnetic resonance (MR) system. The SI of the HG-WM was classified into three grades based on a comparison with the SI of the superior temporal gyrus: Grade 1, isointense; Grade 2, slightly hypointense, and Grade 3, markedly hypointense. Results In the assessment of the SI of the HG-WM, the HG-WM appeared hypointense in all 38 sites of the 19 participants; the hypointensity corresponded to Grade 2 in 13 (34%) images and Grade 3 in 25 (66%) images. On the other hand, the HG-WM was classified as Grade 1 (isointense) in all of the SWI-like images. Conclusion The HG-WM appears hypointense on PADRE, which probably reflects the higher myelin content. PADRE may be useful for identifying the HG through the assessment of the SI of the HG-WM.

Inclined Weight-Loaded Walking at Different Speeds: Pelvis-Shoulder Coordination, Trunk Movements and Cost of Transport

Although studied at level surface, the trunk kinematics and pelvis-shoulder coordination of incline walking are unknown. The aim of this study was to evaluate the speed effects on pelvis-shoulder coordination and trunk movement and the cost of transport (C) during unloaded and loaded (25% of body mass) 15% incline walking. We collected 3-dimensional kinematic and oxygen consumption data from 10 physically active young men. The movements were analyzed in the sagittal plane (inclination and range of trunk motion) and the transverse plane (range of shoulder and pelvic girdle motion and phase difference). The rotational amplitude of the shoulder girdle decreased with load at all speeds, and it was lower at the highest speeds. The rotational amplitude of the pelvic girdle did not change with the different speeds. The phase difference was greater at optimal speed (3 km.hr^-1, at the lowest C) in the loaded and the unloaded conditions. The trunk inclination was greater with load and increased with speed, whereas the range of trunk motion was lower in the loaded condition and decreased with increasing speed. In conclusion, the load decreased the range of girdles and trunk motion, and the pelvis-shoulder coordination seemed to be critical for the incline walking performance.

Phase Difference between Model Cortical Areas Determines Level of Information Transfer

Communication between cortical sites is mediated by long-range synaptic connections. However, these connections are relatively static, while everyday cognitive tasks demand a fast and flexible routing of information in the brain. Synchronization of activity between distant cortical sites has been proposed as the mechanism underlying such a dynamic communication structure. Here, we study how oscillatory activity affects the excitability and input-output relation of local cortical circuits and how it alters the transmission of information between cortical circuits. To this end, we develop model circuits showing fast oscillations by the PING mechanism, of which the oscillatory characteristics can be altered. We identify conditions for synchronization between two brain circuits and show that the level of intercircuit coherence and the phase difference is set by the frequency difference between the intrinsic oscillations. We show that the susceptibility of the circuits to inputs, i.e., the degree of change in circuit output following input pulses, is not uniform throughout the oscillation period and that both firing rate, frequency and power are differentially modulated by inputs arriving at different phases. As a result, an appropriate phase difference between the circuits is critical for the susceptibility windows of the circuits in the network to align and for information to be efficiently transferred. We demonstrate that changes in synchrony and phase difference can be used to set up or abolish information transfer in a network of cortical circuits.

Birefringence-Directed Raman Selection Rules in 2D Black Phosphorus Crystals

The incident and scattered light engaged in the Raman scattering process of low symmetry crystals always suffer from the birefringence-induced depolarization. Therefore, for anisotropic crystals, the classical Raman selection rules should be corrected by taking the birefringence effect into consideration. The appearance of the 2D anisotropic materials provides an excellent platform to explore the birefringence-directed Raman selection rules, due to its controllable thickness at the nanoscale that greatly simplifies the situation comparing with bulk materials. Herein, a theoretical and experimental investigation on the birefringence-directed Raman selection rules in the anisotropic black phosphorus (BP) crystals is presented. The abnormal angle-dependent polarized Raman scattering of the Ag modes in thin BP crystal, which deviates from the normal Raman selection rules, is successfully interpreted by the theoretical model based on birefringence. It is further confirmed by the examination of different Raman modes using different laser lines and BP samples of different thicknesses.

Coherence between tissue oxygen indexes in vastus lateralis and gastrocnemius in repetition of impulse exercise with high intensity

The purpose of this study was to determine whether tissue oxygen indices (TOIs) in two muscle groups oscillated and were synchronized in repetition of impulse exercise with high intensity. Five impulse exercises of 400 watts for 10 s were repeated with intervals of 6 min. During this period, TOI was determined by near-infrared spectroscopy in the vastus lateralis and gastrocnemius muscles. TOIs in the two muscles oscillated at rest. The TOIs rapidly decreased during each impulse exercise and then recovered and overshot after each impulse. The TOIs oscillated during each interval period. During this test period, coherent and phase differences were determined. There was high coherence between TOIs in the two muscles with a peak value at 0.019 Hz. There was a phase difference of -45 ± 32.4 degrees between TOIs in the two muscles. This phase difference corresponded to about 6 s in time scale. It seemed from this time delay that impulse exercise was not a trigger factor for the starting point of TOIs in the two muscles. It has been concluded that TOIs oscillate and are synchronized between two muscles in repetition of impulse exercise with high intensity.

Evidence for stimulus-general impairments on auditory stream segregation tasks in schizophrenia

BACKGROUND

Auditory impairments in schizophrenia have been demonstrated previously, especially for tasks requiring precise encoding of frequency, although it is unclear the extent to which they have difficulty using pitch information and other cues to segregate sounds. We determined the extent to which those with schizophrenia have difficulty using pitch information and other auditory cues to segregate sounds that are presented sequentially.

METHODS

Ten participants with schizophrenia and nine healthy/normal control participants completed a battery of tasks that tested for the ability to perform sequential auditory stream segregation using pitch, amplitude modulation, or inter-aural phase difference as cues to segregation.

RESULTS

All three sequential segregation tasks showed reduced tendency for those with schizophrenia to perceive segregated sounds, compared to control participants.

CONCLUSIONS

These findings extend prior research by demonstrating a general impairment on sequential sound segregation tasks in schizophrenia, and not just on tasks that require precise encoding of frequency. Together, the pattern of results provide evidence that auditory impairments in schizophrenia result from selective abnormalities in neural circuits that carry out specific computations necessary for stream segregation, as opposed to an impairment in processing specific cues.

Effect of cibenzoline on regional left ventricular function in hypertrophic obstructive cardiomyopathy

BACKGROUND

Cibenzoline, a class Ia antiarrhythmic drug, can be used to relieve left ventricular (LV) outflow obstruction in hypertrophic obstructive cardiomyopathy (HOCM). However, the mechanism of this agent in HOCM has been controversial.

HYPOTHESIS

This study was designed to investigate the effect of cibenzoline on regional LV function and the acoustic properties in HOCM using ultrasonic integrated backscatter.

METHODS

Ten patients with HOCM and 16 healthy volunteers were examined. In patients with HOCM, wall thickening (%WT) and the magnitude of cyclic variation of integrated backscatter (mag-CVIBS) in the interventricular septum (IVS) and LV posterior wall were measured before and after oral administration of cibenzoline. To assess asynchrony of contractile elements, the phase difference between CVIBS and %WT were measured from the LV posterior wall. Pressure gradients at the LV outflow tract were estimated using continuous-wave Doppler echocardiography.

RESULTS

Although %WT decreased significantly in the LV posterior wall, %WT and mag-CVIBS remained unchanged in the IVS. The phase difference in the LV posterior wall was significantly greater in patients with HOCM than in healthy volunteers (HOCM:healthy volunteers, 1.57 +/- 0.23:1.00 +/- 0.03, p < 0.001) at baseline. After administration of cibenzoline, the phase difference shifted to normal value (from 1.57 +/- 0.23 to 1.28 +/- 0.27, p = 0.0382), and pressure gradients at the LV outflow tract decreased (from 109 +/- 55 to 58 +/- 48 mmHg, p = 0.0063). Changes in pressure gradients at the LV outflow tract and the phase difference were closely related.

CONCLUSIONS

Regional function and the acoustic properties of myocardium in HOCM were altered by cibenzoline in the LV posterior wall but remained unchanged in the IVS. The normalization of the phase difference in the LV posterior wall was closely related to the decrease in pressure gradients at the LV outflow tract. These findings suggest that negative inotropic action and the improvement of asynchrony in the LV posterior wall rather than in the IVS may contribute to the reduction of pressure gradients at the LV outflow tract in HOCM.