Ligand and metal-centred reactivity in 2,6-bis(imino)-1,4-dihydropyridinate Zn(II) alkyls: the dual behaviour of an intriguing type of complex.

Dihydropyridines, either free or metal-coordinated, are organic hydride transfer reductants that perform on the same premises as the natural redox cofactor NAD(P)+/NAD(P)H. 1-Bn and 1-Me are alkylzinc complexes containing dihydropyridinate-based pincer ligands that have been synthesized through different routes involving the addition of ZnR2 (R = Bn, Me) to the 2,6-bis(imino)-pyridine and 2,6-bis(imino)-4-Bn-dihydropyridine (iPrBIP and 4-BniPrBIPH2) ligands, respectively. The alkyls complexes 1-R react with fluorinated alcohols RFOH (RF = C6F5 or t-C4F9) yielding isolable fluoroalkoxides 2-F5 and 2-F9, in which the reactive 1,4-dihydropyridinate ligand remains unchanged. The crystal structure of 2-F5 shows the shortest Zn⋯F-C interaction reported so far, involving one of the o-F atoms of the C6F5 group. However, the mechanism of the alcoholysis reactions is not straightforward, as NMR monitoring revealed that acidic RFOH first protonates the dihydropyridine nitrogen, releasing the dihydropyridine base 4-BniPrBIPH2 and a highly reactive Zn(R)(ORF) species that re-captures the dihydropyridine in a subsequent step, eliminating the corresponding alkane (R-H). Depending on the mixing conditions, the pincer dihydropyridinate ligand may undergo aromatization to produce the new Zn(II) dialkoxides 3-F5 and 3-F9 stabilised by a neutral iPrBIP ligand [(4R-iPrBIP)Zn(ORF)2]. These protonation and hydride transfer reactions illustrate the dual reactivity of the pincer 1,4-dihydropyridinate zinc entity.

Analysis of spurious peaks at series resonance in solidly mounted resonators by combined BVD-Mason modelling.

Solidly Mounted Resonators (SMRs) for high frequency RF filters and sensing applications often display spurious resonances that distort their frequency response. In this work, we try to identify the origin of spurious resonances accompanying the main series resonances in AlN-based SMRs with the help of modified Butterworth Van Dyke (BVD) and Mason's models. By manufacturing SMRs of different sizes and shapes and studying the influence of the position of the electrical probing spot, we have demonstrated both theoretically and experimentally that devices with larger areas are more likely to display these additional peaks. Our updated models accurately simulate the frequency response of the SMRs, revealing that spurious peaks are mostly related to the resistance of the electrodes. Our study clarifies the origin of the spurious resonances and offers solutions for both, the optimal design and measurement method of SMRs.

Evidence of Partial Seniority Conservation in the πg_{9/2} Shell for the N=50 Isotones.

The reduced transition probabilities for the 4_{1}^{+}→2_{1}^{+} and 2_{1}^{+}→0_{1}^{+} transitions in ^{92}Mo and ^{94}Ru and for the 4_{1}^{+}→2_{1}^{+} and 6_{1}^{+}→4_{1}^{+} transitions in ^{90}Zr have been determined in this experiment making use of a multinucleon transfer reaction. These results have been interpreted on the basis of realistic shell-model calculations in the f_{5/2}, p_{3/2}, p_{1/2}, and g_{9/2} proton valence space. Only the combination of extensive lifetime information and large scale shell-model calculations allowed the extent of the seniority conservation in the N=50 g_{9/2} orbital to be understood. The conclusion is that seniority is largely conserved in the first πg_{9/2} orbital.

Electroactive calcium-alginate/polycaprolactone/reduced graphene oxide nanohybrid hydrogels for skeletal muscle tissue engineering.

Graphene derivatives such as reduced graphene oxide (rGO) are used as components of novel biomaterials for their unique electrical properties. Electrical conductivity is a crucial factor for muscle cells, which are electrically active. This study reports the development of a new type of semi-interpenetrated polymer network based on two biodegradable FDA-approved biomaterials, sodium alginate (SA) and polycaprolactone (PCL), with Ca2+ ions as SA crosslinker. Several drawbacks such as the low cell adhesion of SA and weak structural stability can be improved with the incorporation of PCL. Furthermore, this study demonstrates how this semi-IPN can be engineered with rGO nanosheets (0.5% and 2% wt/wt rGO nanosheets) to produce electroactive nanohybrid composite biomaterials. The study focuses on the microstructure and the enhancement of physical and biological properties of these advanced materials, including water sorption, surface wettability, thermal behavior and thermal degradation, mechanical properties, electrical conductivity, cell adhesion and myogenic differentiation. The results suggest the formation of a complex nano-network with different interactions between the components: bonds between SA chains induced by Ca2+ ions (egg-box model), links between rGO nanosheets and SA chains as well as between rGO nanosheets themselves through Ca2+ ions, and strong hydrogen bonding between rGO nanosheets and SA chains. The incorporation of rGO significantly increases the electrical conductivity of the nanohybrid hydrogels, with values in the range of muscle tissue. In vitro cultures with C2C12 murine myoblasts revealed that the conductive nanohybrid hydrogels are not cytotoxic and can greatly enhance myoblast adhesion and myogenic differentiation. These results indicate that these novel electroactive nanohybrid hydrogels have great potential for biomedical applications related to the regeneration of electroactive tissues, particularly in skeletal muscle tissue engineering.

Store-independent Orai1-mediated Ca2+ entry and cancer.

Ca2+ channels play an important role in the development of different types of cancer, and considerable progress has been made to understand the pathophysiological mechanisms underlying the role of Ca2+ influx in the development of different cancer hallmarks. Orai1 is among the most ubiquitous and multifunctional Ca2+ channels. Orai1 mediates the highly Ca2+-selective Ca2+ release-activated current (ICRAC) and participates in the less Ca2+-selective store-operated current (ISOC), along with STIM1 or STIM1 and TRPC1, respectively. Furthermore, Orai1 contributes to a variety of store-independent Ca2+ influx mechanisms, including the arachidonate-regulated Ca2+ current, together with Orai3 and the plasma membrane resident pool of STIM1, as well as the constitutive Ca2+ influx processes activated by the secretory pathway Ca2+-ATPase-2 (SPCA2) or supported by physical and functional interaction with the small conductance Ca2+-activated K+ channel 3 (SK3) or the voltage-dependent Kv10.1 channel. This review summarizes the current knowledge concerning the store-independent mechanisms of Ca2+ influx activation through Orai1 channels and their role in the development of different cancer features.

Bioactive triterpenoids from the caffeine-rich plants guayusa and maté.

Unlike all other caffeinated plants, guayusa (Ilex guayusa Loes.) and maté (Ilex paraguariensis A. St. Hill) contain high amounts of pentacyclic triterpenoid acids and alcohols. A phytochemical investigation on these plants revealed a similar triterpenoid profile and a content of ursolic acid (0.7-1%) and amyrin esters (up to 0.5%), quite unusual for dietary plants. The major constituent of the amyrin complex from both plants is α-amyrin palmitate (2a), accompanied by lower amounts of its corresponding palmitoleate (2b) and by the corresponding constitutional isomers from the ß-series (3a and 3b, respectively). Ursolic acid (1) was identified as the responsible for the activity of maté and guayusa extracts in the activation of TGR5, a nuclear receptor of relevance for the prevention and management of diabetes and metabolic syndrome because of its involvement in the regulation of energy expenditure and insulin sensitivity.

Pseudospin Symmetry and Microscopic Origin of Shape Coexistence in the

Lifetime measurements of excited states of the light N=52 isotones ^{88}Kr, ^{86}Se, and ^{84}Ge have been performed, using the recoil distance Doppler shift method and VAMOS and AGATA spectrometers for particle identification and gamma spectroscopy, respectively. The reduced electric quadrupole transition probabilities B(E2;2^{+}→0^{+}) and B(E2;4^{+}→2^{+}) were obtained for the first time for the hard-to-reach ^{84}Ge. While the B(E2;2^{+}→0^{+}) values of ^{88}Kr, ^{86}Se saturate the maximum quadrupole collectivity offered by the natural valence (3s, 2d, 1g_{7/2}, 1h_{11/2}) space of an inert ^{78}Ni core, the value obtained for ^{84}Ge largely exceeds it, suggesting that shape coexistence phenomena, previously reported at N≲49, extend beyond N=50. The onset of collectivity at Z=32 is understood as due to a pseudo-SU(3) organization of the proton single-particle sequence reflecting a clear manifestation of pseudospin symmetry. It is realized that the latter provides actually reliable guidance for understanding the observed proton and neutron single particle structure in the whole medium-mass region, from Ni to Sn, pointing towards the important role of the isovector-vector ρ field in shell-structure evolution.

_{36}

Prompt γ-ray spectroscopy of the neutron-rich ^{96}Kr, produced in transfer- and fusion-induced fission reactions, has been performed using the combination of the Advanced Gamma Tracking Array and the VAMOS++ spectrometer. A second excited state, assigned to J^{π}=4^{+}, is observed for the first time, and a previously reported level energy of the first 2^{+} excited state is confirmed. The measured energy ratio R_{4/2}=E(4^{+})/E(2^{+})=2.12(1) indicates that this nucleus does not show a well-developed collectivity contrary to that seen in heavier N=60 isotones. This new measurement highlights an abrupt transition of the degree of collectivity as a function of the proton number at Z=36, of similar amplitude to that observed at N=60 at higher Z values. A possible reason for this abrupt transition could be related to the insufficient proton excitations in the g_{9/2}, d_{5/2}, and s_{1/2} orbitals to generate strong quadrupole correlations or to the coexistence of competing different shapes. An unexpected continuous decrease of R_{4/2} as a function of the neutron number up to N=60 is also evidenced. This measurement establishes the Kr isotopic chain as the low-Z boundary of the island of deformation for N=60 isotones. A comparison with available theoretical predictions using different beyond mean-field approaches shows that these models fail to reproduce the abrupt transitions at N=60 and Z=36.

Transcatheter closure of paravalvular leaks: state of the art.

Paravalvular leak (PVL) is a serious complication after surgical valve replacement or after transcatheter aortic valve replacement. Approximately 1-5% of PVLs can lead to serious clinical consequences, including congestive heart failure and/or haemolytic anaemia. For years, surgical re-intervention has been considered the treatment of choice for symptomatic patients with PVLs. However, surgical re-intervention is associated with a high risk of morbidity and mortality. Transcatheter PVL (TPVL) closure is a less invasive alternative to surgical re-intervention. The safety and feasibility of TPVL closure has been confirmed in several registries and a meta-analysis.In this review, we discuss the clinical implications and diagnosis of PVLs, technical considerations for TPVL, execution of the procedure and assessment of the results.

Electrical burns in times of economic crisis: A new epidemiologic profile.

Electrical injuries and especially those of high voltage still remain a source of high morbidity. Over the past few years, a change in the epidemiologic profile of these lesions was noticed at the Vall d'Hebron University Hospital Burn Unit, corresponding to an increase in cases out of the legal framework. It is our aim to describe this particular subset, to determine the extent of their injuries and to understand the reason for their increased incidence. We think this was favoured by the rise in the unemployment rate, along with higher copper prices.

Sexualidad saludable en nuestros jóvenes. Un programa de intervención escolar / Healthy sexuality in our teenagers. A school intervention program

Introducción: el objetivo principal de este trabajo es realizar una valoración de los conocimientos sobre sexualidad antes de impartir el Programa de Intervención en Educación Sexual (PIES) para adaptar los talleres; y una posterior para evaluar la eficacia de dichos talleres. Material y métodos: se realiza un cuestionario a 96 alumnos de 3.o de Educación Secundaria Obligatoria de un instituto del Departamento 14 de Salud Xátiva-Ontinyent (Valencia) en horario de tutorías. Posteriormente se imparten los talleres por personal sanitario. Resultados: entre los resultados cabe destacar el desconocimiento de los alumnos en algunos temas de sexualidad, que mejoran claramente tras los talleres de educación sexual. Conclusiones: con una adaptación de estos programas según los resultados de las encuestas previas, se pueden mejorar la eficacia y la eficiencia de dichos planes de intervención para los jóvenes (AU)

Introduction: the main objective of this study is to make an assessment about sexuality knowledge previous to the Sex Education Program in order to adapt the workshops in the school; and another one afterwards to evaluate their effectiveness. Material and method: we passed a questionnaire to 96 students of third year of secondary education in the Department Xátiva-Ontinyent (Valencia) in guardianships. Then, the doctor and nurse performed the sexuality workshops. Results: among the results, there is a great lack of knowledge about sexuality but it improves after the workshops. Conclusions: if we adapt the workshops to the needs of the teenagers according to the initial survey, we could have better results (AU)

[Severe burns related to steam inhalation therapy]. / Quemaduras graves relacionadas con la terapia inhalatoria con vahos.

INTRODUCTION: Despite lack of proven effectiveness and its potential to cause severe burns, steam inhalation therapy (SIT) is still used as a treatment for benign respiratory conditions. OBJECTIVE: To characterize cases of burns related to steam inhalation therapy (BRSIT) in order to formulate appropriate preventive criteria. PATIENTS AND METHODS: A review was conducted on cases of BRSIT admitted to a Burns Unit between 2006 and 2012, analysing epidemiological data, clinical aspects, severity and course. RESULTS: A total of 530 patients were admitted; 375 (70%) with scalds, and 15 with BRSIT (2.8% of burns; 4% of scalds). SIT was indicated in most cases for mild upper airway infections. The median age of patients was 7 years (2.5m-14 y). The burned area (BA) was ≥10% in 60% of cases (max. BA 22%). Injuries involved trunk, genital area, and extremities; only in one case was the face affected. The mean hospital length-of-stay was 14 days (3-30 d). Five patients (33%) were admitted to the PICU, most of them (60%) younger than 3 years. Eight patients (53%) underwent surgical treatment (skin grafting). In a 12-year-old patient whooping cough was diagnosed in the Burns Unit, and a 2.5-year-old patient developed staphylococcal toxic shock syndrome. No patient died. The final course was satisfactory in all patients. CONCLUSIONS: BRSIT can be severe and cause significant use of health resources. Professionals caring for children, particularly paediatricians, should seriously consider their prevention, avoiding treatments with SIT, and educating parents in order not to use it on their own.

Flow cytometry analysis of Nosema species to assess spore viability and longevity.

Nosema apis and Nosema ceranae are microsporidia which present resistant spores for the transmission stage (environmental spores) that play an important role for epidemiology and for laboratory studies of honey bee microsporidiosis. In this study, the long-term longevity of N. apis and N. ceranae spores exposed to 4 °C, room temperature (mean 25 °C) and 35 °C for 6-month long and to -20 °C for 10-month long has been assessed by flow cytometry. Storage temperature and the length of storage duration had adverse effects on spore viability of both Nosema spores, with significant differences between the two species. The greatest increase in spore mortality was observed in N. apis spores stored at 33 °C (64, 89%) and in N. ceranae spores at -20 °C (53.55%) and at 33 °C (51.97%). For N. ceranae spores at -20 °C, the loss in viability was very quick, getting an increase over 20% just after 6 days of exposure. Results on viability were confirmed by the infectivity tests where the lowest infectivity for N. ceranae was observed with spores stored for 10 months at -20 °C (79%; P < 0.05) and for N. apis with spores stored at 33 °C (71%; P < 0.05). For both Nosema species, the best storage temperatures were 25 and 4 °C, especially for N. apis that was almost unaffected at those temperatures.

Analysis of intra-abdominal hypertension in severe burned patients: the Vall d'Hebron experience.

Although severely burned patients are at a high risk of developing intra-abdominal hypertension (IAH: IAP>12 mmHg) and Abdominal Compartment Syndrome (ACS) (IAP ≥ 20 mmHg), few data about its incidence and prevalence is available. Our aim was to determine the incidence and prevalence of IAH and ACS in patients with severe burns in our geographical setting. A pilot prospective, observational study was performed at the Burns Unit of the Plastic Surgery Department in Vall d'Hebron University Hospital (Barcelona), during a 12-month period. All patients with age ≥ 18 years old and burns >20% of the total body surface area (TBSA) were considered for inclusion. Patients who did not require urinary catheterization via the urethra were excluded. All patients included were followed during the first five days from their admission. Results are expressed as median (interquartile range) or frequency (percentage). During the study period, 303 patients were admitted to the Burns Unit. Twenty-five patients were included in the study (21 [84%] male, 4 [16%] female; age 42 [30-69 years]; TBSA burned 33 [25-58]%; all patients presented deep second-degree and/or third-degree burns). Eighteen (72%) patients met criteria for IAH, but only one (4%) developed ACS. The incidence of IAH and ACS was 0.56 and 0.04 cases/patient-day, respectively. Patients with IAH presented higher number of organs failure (2 [0-2.2] vs 0 [0-0]; p = 0.03). Patients with >20% TBSA burned presented a very high prevalence of IAH. Development of organ failure occurred even at moderately increased values of IAP. In this scenario, monitoring of IAP is the first step for establishing the importance of IAH/ACS in this patient population.

Quantification by UHPLC of total individual polyphenols in fruit juices.

The present work proposes a new UHPLC-PDA-fluorescence method able to identify and quantify the main polyphenols present in commercial fruit juices in a 28-min chromatogram. The proposed method improve the IFU method No. 71 used to evaluate anthocyanins profiles of fruit juices. Fruit juices of strawberry, American cranberry, bilberry, sour cherry, black grape, orange, and apple, were analysed identifying 70 of their main polyphenols (23 anthocyanins, 15 flavonols, 6 hydroxybenzoic acids, 14 hydroxycinnamic acids, 4 flavanones, 2 dihydrochalcones, 4 flavan-3-ols and 2 stilbenes). One standard polyphenol of each group was used to calculate individual polyphenol concentration presents in a juice. Total amount of polyphenols in a fruit juice was estimated as total individual polyphenols (TIP). A good correlation (r(2)=0.966) was observed between calculated TIP, and total polyphenols (TP) determined by the well-known colorimetric Folin-Ciocalteu method. In this work, the higher TIP value corresponded to bilberry juice (607.324 mg/100mL fruit juice) and the lower to orange juice (32.638 mg/100mL fruit juice). This method is useful for authentication analyses and for labelling total polyphenols contents of commercial fruit juices.

Altered regulation of Akt signaling with murine cerebral malaria, effects on long-term neuro-cognitive function, restoration with lithium treatment.

Neurological and cognitive impairment persist in more than 20% of cerebral malaria (CM) patients long after successful anti-parasitic treatment. We recently reported that long term memory and motor coordination deficits are also present in our experimental cerebral malaria model (ECM). We also documented, in a murine model, a lack of obvious pathology or inflammation after parasite elimination, suggesting that the long-term negative neurological outcomes result from potentially reversible biochemical and physiological changes in brains of ECM mice, subsequent to acute ischemic and inflammatory processes. Here, we demonstrate for the first time that acute ECM results in significantly reduced activation of protein kinase B (PKB or Akt) leading to decreased Akt phosphorylation and inhibition of the glycogen kinase synthase (GSK3ß) in the brains of mice infected with Plasmodium berghei ANKA (PbA) compared to uninfected controls and to mice infected with the non-neurotrophic P. berghei NK65 (PbN). Though Akt activation improved to control levels after chloroquine treatment in PbA-infected mice, the addition of lithium chloride, a compound which inhibits GSK3ß activity and stimulates Akt activation, induced a modest, but significant activation of Akt in the brains of infected mice when compared to uninfected controls treated with chloroquine with and without lithium. In addition, lithium significantly reversed the long-term spatial and visual memory impairment as well as the motor coordination deficits which persisted after successful anti-parasitic treatment. GSK3ß inhibition was significantly increased after chloroquine treatment, both in lithium and non-lithium treated PbA-infected mice. These data indicate that acute ECM is associated with abnormalities in cell survival pathways that result in neuronal damage. Regulation of Akt/GSK3ß with lithium reduces neuronal degeneration and may have neuroprotective effects in ECM. Aberrant regulation of Akt/GSK3ß signaling likely underlies long-term neurological sequelae observed in ECM and may yield adjunctive therapeutic targets for the management of CM.

Full face transplantation organization, development, and results--the Barcelona experience: a case report.

The initial experience in facial composite tissue allotransplantation has demonstrated that it is surgically feasible, safe, and reproducible. A robust team approach is necessary to warrant successful outcomes. We designed a specific face organ donation that limits facial donation requests followed by synchronous in situ dissection with the internal organs that has proved to be efficient and safe for face and solid organ procurement and transplantation. The first human full face transplantation in our institution was performed on March 27, 2010. The holistic team approach of donation and procurement proved to be effective and reproducible; the recipient showed excellent outcomes at 12 months.

Susceptibility of the cactus weevil Metamasius spinolae to Beauveria bassiana and Metarhizium anisopliae under laboratory and field conditions.

AIMS: To evaluate different entomopathogenic fungal isolates against the cactus weevil Metamasius spinolae under laboratory and field conditions, and select an isolate to be used as a tool in the management of this insect pest. METHODS AND RESULTS: Four experiments were carried out. The effect of temperature on the in vitro growth of eight isolates of entomopathogenic fungi (two Metarhizium anisopliae and six Beauveria bassiana) was assessed. The susceptibility of adult M. spinolae to the same isolates was evaluated. Using three selected isolates, the interaction between susceptibility and sex of the insect was studied. Finally, a field experiment was carried out to evaluate infection of adult M. spinolae by the same three isolates under natural abiotic conditions. Overall, growth rate was greatest at 25°C for all the isolates. In vitro growth of M. anisopliae was greater than B. bassiana. Mortality of adult M. spinolae was greater when inoculated with B. bassiana compared with isolates of M. anisopliae. Susceptibility had no interaction with the sex of the insect. The proportion of insects succumbing to infection was smaller when incubated under field conditions than when incubated under laboratory conditions. CONCLUSIONS: The experiments described here showed a complex interaction between entomopathogenic fungi and M. spinolae, and these data allows us to select isolate Bb107 as a first step towards its use in the management of this pest insect. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results showed that entomopathogenic fungi can be used for the control of M. spinolae, which may help reduce the use of chemical insecticides and, therefore, the exposure of Opuntia ficus-indica producers to pesticides.

Análisis histológico de los injertos de cartílago autológos envueltos en fascia / Histologic analisis of autologous cartilage graft wrapping with fascia

Los injertos de cartílago son ampliamente utilizados en Cirugía Plástica; sin embargo, existe un riesgo potencial de reabsorción que puede comprometer los logros obtenidos. Algunos autores presentan resultados exitosos utilizando injertos de cartílago envueltos en fascia. El propósito del trabajo es aportar evidencia científica en relación a las posibles ventajas de los mismos. Realizamos un estudio descriptivo, prospectivo, experimental comparativo de 20 ratas blancas Sprague-Dawley, desde mayo a octubre del 2007. Las unidades de muestra fueron los cortes histológicos obtenidos del cartílagos tras ser implantados durante 8 semanas. Trabajamos con 2 grupos: grupo estudio, de 10 ratas con cartílago autológo envuelto en fascia y grupo control, de 10 ratas con cartílagosólo. Se realizó examen histológico e inmunohistoquímico determinando viabilidad, reacción inflamatoria, necrosis, reabsorción y capacidad de regeneración. Los injertos de cartílago autólogo envueltos en fascia resultaron menos fiables que los injertos de cartílago solos, mostrando una mayor reabsorción (80% frente a 60%),menor capacidad de regeneración (50% frente a 80%),mayor respuesta inflamatoria (80% frente a 30%), menor viabilidad (16% frente a 38%) y con necrosis (30%). El análisis estadístico no mostró diferencia significativa. En conclusión, la envoltura en fascia del injerto de cartílagoautólogo no aumentó su viabilidad, ni disminuyó su reabsorción, en animales de experimentación (AU)

Cartilage grafts are widely used in Plastic Surgery; however, there is a potential risk of reasorption that may affect the results obtained. Some authors report successful achievements using cartilage grafts wrapped in fascia. The purpose of this paper is to provide scientific evidence regarding the potential benefits of cartilage grafts wrapped with fascia. A descriptive, prospective, experimental and comparative study of some 20 white Sprague-Dawley rats was performed from May to October 2007. The sample units were obtained from histological sections of cartilage after implantation for 8 weeks. They were divided into 2 groups: study, 10 rats with autologous cartilage wrapped with fascia, and control, 10 rats with cartilage only. We performed histological and inmunohistochemical examination determining viability, inflammation, necrosis, reabsorption and regeneration capacity. The autologous cartilage grafts wrapped with fascia were less reliable than grafts alone showing greater cartilageresorption (80% vs. 60%), lower regeneration capacity(50% vs. 80%), increased inflammatory response (80% vs.30%), decreased viability (16% vs. 38 %), and necrosis(30%). Statistical analysis showed no significant difference. As a conclusion, the wrapping of autologous cartilage graft with fascia does not increase their viability or decrease their resorption in experimental animals (AU)

Epicardial fat volume in patients with left ventricular systolic dysfunction.

Epicardial adipose tissue has been linked to cardiovascular metabolism and inflammation and has been shown to predict prevalence and progression of coronary artery disease. Only limited data are available on the role of epicardial fat in patients with heart failure (HF). We analyzed cardiac adiposity and its relation to markers of morbidity and clinical outcome in patients with normal and impaired left ventricular (LV) function. Epicardial fat volume (EFV) and coronary artery calcium were measured in 381 patients (210 women and 171 men, mean age 55 ± 10 years) who underwent low-dose computed tomography. HF was defined by LV ejection fraction (EF) <55%. Three hundred twenty-one patients had an EF >55% (mean 63 ± 6) and 60 patients had an EF <55% (mean 41 ± 12). Subgroup analysis was performed according to degree of LV dysfunction in patients with HF (LVEF 35% to 55% or <35%). Mean EFVs were 114.5 ± 98.5 cm(3) in patients with normal EF and 83.5 ± 67.1 cm(3) in those with decreased EF (p <0.05). Mean EFVs were 96.1 ± 73.9 cm(3) in patients with moderate HF and 52.2 ± 29.7 cm(3) in patients with severe HF (p <0.05). Subgroup analysis revealed a persistently smaller EFV in patients with HF regardless of coronary artery calcium scores, markers of renal function, lipid metabolism, fasting blood glucose, or body mass index. In conclusion, our data demonstrate a stepwise decrease in EFV in patients with impaired cardiac function.