Angiotensin-converting enzyme 2 in dogs with Dirofilaria immitis.

BACKGROUND: Infection by the canine heartworm, Dirofilaria immitis, causes significant cardiopulmonary disease, with progression impacted by increasing parasite numbers and duration of infection. The renin-angiotensin-aldosterone system (RAAS) is an important mediator of cardiac and pulmonary disease. Angiotensin-converting enzyme 2 (ACE2) mitigates the maladaptive effects of angiotensin II by converting it to angiotensin (1-7). We hypothesized that circulating ACE2 activity would be altered in dogs with high heartworm infection intensities relative to dogs without heartworms. METHODS: Frozen serum samples (-80 °C) from 30 dogs euthanized at Florida shelters were analyzed for ACE2 activity using liquid chromatography-mass spectrometry/mass spectroscopy and a kinetics approach with and without an ACE2 inhibitor. A convenience sample of 15 dogs without heartworms (HW0) and 15 dogs with > 50 heartworms (HW>50) was included. Heartworm number and microfilariae presence were determined at necropsy. The effects of heartworm status, body weight, and sex on ACE2 were evaluated using regression analysis. Values of P < 0.05 were considered significant. RESULTS: All HW0 dogs were D. immitis microfilariae-negative and all HW>50 dogs were D. immitis microfilariae-positive with a median adult worm count of 74 (minimum = 63, maximum = 137). The ACE2 activity of HW>50 dogs (median = 28.2 ng/ml; minimum = 13.6, maximum = 76.2) was not different from HW0 dogs (median 31.9 ng/ml; minimum = 14.1, maximum = 139.1; P = 0.53). The ACE2 activity was higher in dogs with high body weight (median 34.2 ng/ml minimum = 14.1, maximum = 76.2) than in dogs with low weight (median 27.5 ng/ml; minimum = 16.4, maximum = 139.1; P = .044). CONCLUSIONS: Heartworm infection did not impact ACE2 activity in shelter dogs with or without heartworms, but heavier dogs had higher ACE2 activity compared to lighter dogs. Comprehensive RAAS evaluation and additional clinical information would aid in understanding how ACE2 activity relates to the entire cascade and clinical status in dogs with heartworm disease.

Cardiopulmonary assessment prior to returning to high-hazard occupations post-symptomatic COVID-19 infection: a position statement of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology.

This article provides an overview of the recommendations of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology on returning individuals to work in high-hazard occupations (such as flying, diving, and workplaces that are remote from healthcare facilities) following symptomatic Coronavirus Disease 2019 (COVID-19) infection. This process requires exclusion of significant underlying cardiopulmonary disease and this consensus statement (from experts across the field) outlines the appropriate screening and investigative processes that should be undertaken. The recommended response is based on simple screening in primary healthcare to determine those at risk, followed by first line investigations, including an exercise capacity assessment, to identify the small proportion of individuals who may have circulatory, pulmonary, or mixed disease. These individuals can then receive more advanced, targeted investigations. This statement provides a pragmatic, evidence-based approach for those (in all occupations) to assess employee health and capacity prior to a return to work following severe disease, or while continuing to experience significant post-COVID-19 symptoms (so-called 'long-COVID' or post-COVID-19 syndrome).

Physio6: A Sensor-Based Monitoring System for 6-Minute Walking Test in the Era of COVID-19

Coronavirus disease of 2019 (COVID-19) is still severe nowadays, and plentiful COVID-19 patients need careful rehabilitation. The 6-minute walking test (6MWT) is a common clinical trial that requires the patient to walk as far as possible in a corridor for 6 minutes, significantly indicating patients' cardiopulmonary disease conditions and rehabilitation. A traditional 6MWT provides the 6-minute walking distance (6MWD) as the primary result for clinical analysis. In this paper, we propose Physio6, a sensor-based monitoring system for 6MWT, which monitors one patient's various physiological signals and indicates her/his condition during the test. The system also provides the functions of early warning based on physiological signal monitoring and automatically or manually recording the adverse events, such as hypoxia or dyspnea. Moreover, Physio6 is able to communicate with the existing systems in hospitals, and to generate a comprehensive report that summarizes the performance of the patient in the current 6MWT and even in the past ones. Our system has been deployed in four hospitals. Compared with the conventional distance-based measurement, our preliminary validation reveals that the extracted physiological parameters are promisingly valuable for clinical decision-making. System quality and device comfort are also confirmed by questionnaires. The potential of leveraging this system to perform the remote 6MWT at home/in communities as a solution of COVID-19 patient rehabilitation monitoring is also discussed. © 2021 IEEE.