Cold Pressor Testing and Sympathetic Nervous System Contribution to Ischemia with No Obstructive Coronary Artery Disease: Results from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction Project.

Study Objective: Cold Pressor Testing (CPT) is a known stimulus of the sympathetic nervous system (SNS). To better understand sympathetic contribution to coronary blood flow regulation in women with suspected ischemia and no obstructive coronary arteries (INOCA), we compared myocardial perfusion reserve during CPT stress cardiac magnetic resonance (CMR) imaging between women with suspected INOCA and reference subjects. Design: Prospective cohort. Setting: Academic hospital. Participants: 107 women with suspected INOCA and 21-age-matched reference women. Interventions: CPT stress CMR was performed with measurement of myocardial perfusion reserve index (MPRI), adjusted for rate pressure product (MPRIRPP). Invasive coronary function testing in a subset of INOCA women (n=42) evaluated for endothelial dysfunction in response to acetylcholine, including impaired coronary diameter response ≤0% and coronary blood flow response (ΔCBF) <50%. Main Outcome Measure: MPRIRPP. Results: Compared to reference women, the INOCA group demonstrated higher resting RPP (p=0.005) and CPT MPRIRPP (1.09±0.36 vs 0.83±0.18, p=0.002). Furthermore, INOCA women with impaired ΔCBF (n=23) had higher CPT MPRIRPP (p=0.044) compared to reference women despite lower left ventricular ejection fraction (64±7 % vs 69±2 %, p=0.005) and mass-to-volume ratio (0.79±0.15 vs 0.62±0.09, p<0.0001). These differences in CPT MPRIRPP did not persist after adjusting for age, body mass index, and history of hypertension. CPT MPRIRPP among INOCA women did not differ based on defined acetylcholine responses. Conclusions: Myocardial perfusion reserve to CPT stress is greater among women with INOCA compared to reference subjects. CPT induced a higher MPRIRPP also in women with coronary endothelial dysfunction, suggesting a greater contribution of the SNS to coronary flow than endothelial dysfunction. Further investigation in a larger cohort is needed.

Coronary atheroma burden predicts flow reserve in women with ischemia and nonobstructive coronary artery disease.

Background: Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) with reduced coronary flow reserve (CFR), and compensatory coronary remodeling. Angiographic measurements of epicardial coronary anatomy (AMCA) may improve understanding of relations between CFR and atherosclerosis. We investigated AMCA and CFR in women evaluated for CMD. Methods: Women consecutively enrolled in the Women's Ischemia Syndrome Evaluation CVD Continuation (NCT00832702) were included. All underwent clinically indicated coronary function testing measuring CFR. AMCA included coronary angiographic atheroma burden (AB), percent diameter stenosis (PDS), and tapering reference diameter Z score (RDZ), derived for the left main and left anterior descending coronary epicardial segments. Results: The 51 women were aged 55.8 ±â€¯10.8 years, with 19(38%) hypertensive, 10(20.4%) hyperlipidemic, 4(7.8%) diabetic, 13(25.5%) prior smokers, and mean CFR 3.0 ±â€¯0.8. Both average and maximal AB negatively correlated with CFR (r = -0.30 and -0.31, with p = 0.04 for both), as did average and maximal PDS (r = -0.38 and -0.41 with p = 0.009 and p = 0.005) while average RDZ was directly related (r = 0.37, p = 0.01). Multiple linear regression analyses revealed that both average PDS (Units of CFR -0.03 95% CI: -0.06, -0.002, p = 0.023) and maximal PDS (-0.04 95% CI -0.07, -0.01, p = 0.007) were negatively related to CFR. Conclusions: Measures of epicardial coronary atheroma burden, size and tapering are related to CFR, suggesting that atherosclerotic anatomical findings may contribute to or be a consequence of CMD, with further work is needed to investigate these measures as treatment targets.

Altering the Optical Properties of GaAsSb-Capped InAs Quantum Dots by Means of InAlAs Interlayers.

In this work, we investigate the optical properties of InAs quantum dots (QDs) capped with composite In0.15Al0.85As/GaAs0.85Sb0.15 strain-reducing layers (SRLs) by means of high-resolution X-ray diffraction (HRXRD) and photoluminescence (PL) spectroscopy at 77 K. Thin In0.15Al0.85As layers with thickness t = 20 Å, 40 Å, and 60 Å were inserted between the QDs and a 60-Å-thick GaAs0.85Sb0.15 layer. The type II emissions observed for GaAs0.85Sb0.15-capped InAs QDs were suppressed by the insertion of the In0.15Al0.85As interlayer. Moreover, the emission wavelength was blueshifted for t = 20 Å and redshifted for t ≥ 40 Å resulting from the increased confinement potential and increased strain, respectively. The ground state and excited state energy separation is increased reaching 106 meV for t = 60 Å compared to 64 meV for the QDs capped with only GaAsSb SRL. In addition, the use of the In0.15Al0.85As layers narrows significantly the QD spectral linewidth from 52 to 35 meV for the samples with 40- and 60-Å-thick In0.15Al0.85As interlayers.

Self-planarized quantum-disks-in-nanowires ultraviolet-B emitters utilizing pendeo-epitaxy.

The growth of self-assembled, vertically oriented and uniform nanowires (NWs) has remained a challenge for efficient light-emitting devices. Here, we demonstrate dislocation-free AlGaN NWs with spontaneous coalescence, which are grown by plasma-assisted molecular beam epitaxy on an n-type doped silicon (100) substrate. A high density of NWs (filling factor >95%) was achieved under optimized growth conditions, enabling device fabrication without planarization using ultraviolet (UV)-absorbing polymer materials. UV-B (280-320 nm) light-emitting diodes (LEDs), which emit at ∼303 nm with a narrow full width at half maximum (FWHM) (∼20 nm) of the emission spectrum, are demonstrated using a large active region ("active region/NW length-ratio" ∼50%) embedded with 15 stacks of AlxGa1-xN/AlyGa1-yN quantum-disks (Qdisks). To improve the carrier injection, a graded layer is introduced at the AlGaN/GaN interfaces on both p- and n-type regions. This work demonstrates a viable approach to easily fabricate ultra-thin, efficient UV optoelectronic devices on low-cost and scalable silicon substrates.