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Acute graft versus host (aGVHD) is the second cause of death after allogeneic-hematopoietic stem cell transplant (allo-HSCT) underscoring the need for novel therapies. Based on previous work that endothelial cell dysfunction is present in aGVHD and that epidermal growth factor-like domain 7 (EGFL7) plays a significant role in decreasing inflammation by repressing endothelial cell activation and T cell migration, we hypothesized that increasing EGFL7 levels after allo-HSCT will diminish the severity of aGVHD. Here, we show that treatment with recombinant EGFL7 (rEGFL7) decreases aGVHD severity and improves survival in recipient mice after allogeneic transplantation with respect to controls without affecting graft versus leukemia effect. Histopathology analysis revealed higher amount of leukocyte infiltration in both large intestine and liver of PBS group compared to rEGFL7-treated mice. Furthermore, damage to the gut was reduced in EGFL7 treated mice. Finally, we showed that rEGFL7 treatment results in higher thymocytes, T, B and dendritic cells in recipient mice after allo-HSCT. This study constitutes a proof of concept of the ability of rEGFL7 therapy to reduce GHVD severity and mortality after allo-HSCT. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

The inclusion of dabigatran in the 2010 Canadian guidelines for stroke care,[1][1] and more recently in the updated practice guidelines from the American College of Cardiology Foundation, American Heart Association and Heart Rhythm Association,[2][2] is important because of the need for an

Vectorcardiograms (VCGs) of 44 patients with a Wolff-Parkinson-White (WPW) syndrome have been analyzed with the aim to correlate the QRS loop patterns with specific preexcitation sites. The VCG QRS loops were analyzed to determine whether conduction abnormalities and myocardial infarction (MI)-like patterns observed in the WPW syndrome could be related to specific preexcitation sites identified by surgery as well as by body surface potential mapping (BSPM). Left bundle branch block pattern was observed with anteroseptal (AS) preexcitation, anterior MI pattern was seen with lateral right ventricle (LRV) preexcitation, left anterior fascicular block was observed with posterior right ventricle (PRV) preexcitation, inferoposterior and strictly posterior MI pattern was found with posteroseptal (PS) and posterior left ventricle (PLV) preexcitation, right bundle branch block was seen in lateral left ventricle (LLV) preexcitation, and right bundle branch block was observed with left posterior fascicular block in anterior left ventricle (ALV) preexcitation. These VCG criteria seem to identify accurately the preexcitation sites as observed by delta wave BSPM and at surgery investigations. Consequently, they could be useful in localizing the preexcitation site in cases of ambiguous delta vector orientation.

Isoarea maps during the PQRST sequence were computed in 22 healthy subjects and 48 patients with Wolff-Parkinson-White (WPW) syndrome. Thirty-eight patients with WPW were on no medication and 10 were treated with class I, II, or III antiarrhythmic drugs. Seventeen isoarea maps were recorded before and 17 were recorded after accessory pathway ablation. One patient had intermittent preexcitation. Body surface maps from all healthy subjects were similar, although the magnitudes of the maxima and minima showed significant variability. In all patients with WPW who were on no medication and in those on class I and II agents, PQRST maps were normal. Two patients taking amiodarone had abnormal PQRST maps, as did patients early after surgery. In the patient with intermittent preexcitation, PQRST maps were very similar during normal and preexcited beats. In conclusion, our results support the theory that the PQRST time integral reflects intrinsic recovery properties of the heart and is independent of the activation sequence.

The accuracy of different computation techniques for the non-invasive localization of cardiac ectopic activity was evaluated. Body surface potentials were recorded from 63 leads in 14 patients with implanted pacemakers. The location, orientation and magnitude of a single moving dipole (SMD) were computed from the first eight terms of a truncated multipole expansion estimated from the body surface potentials. The SMD trajectories obtained during the QRS complex were plotted along with the heart outlines and pacing leads obtained independently from chest x-rays. The origin of the SMD trajectories was compared to the position of the pacing lead to evaluate the accuracy of the SMD. The optimum computation technique used a least-squares (LS) estimation of the multipole expansion truncated at 15 multipoles, in conjunction with a torso model that included regions of lower conductivity representing the lungs. With this method, the SMD trajectories originated near the pacing lead (25 +/- 12 mm) and adequately represented the progression of the ectopic wavefront across the entire heart silhouette. With the LS techniques using 8 or 24 multipoles, the spans of the trajectories were respectively too short, or too long to cover the heart, and the average distance between the SMD at QRS onset and the pacing lead was larger. With a surface integration technique, the SMD-pacing lead distances were similar, both for a finite homogeneous torso model with a fixed geometry, as well as for torso models adapted to the torso geometry of each patient. The SMD was found adequate to represent the progression of an ectopic wavefront, and to localize its origin in man.