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Clinical studies have demonstrated that the γ-aminobutyric acid type A (GABAA) receptor complex plays a central role in the modulation of anxiety. Conditioned fear and anxiety-like behaviors have many similarities at the neuroanatomical and pharmacological levels. The radioactive GABA/BZR receptor antagonist, fluorine-18-labeled flumazenil, [18F]flumazenil, behaves as a potential PET imaging agent for the evaluation of cortical damage of the brain in stroke, alcoholism, and for Alzheimer disease investigation. The main goal of our study was to investigate a fully automated nucleophilic fluorination system, with solid extraction purification, developed to replace traditional preparation methods, and to detect underlying expressions of contextual fear and characterize the distribution of GABAA receptors in fear-conditioned rats by [18F]flumazenil. A carrier-free nucleophilic fluorination method using an automatic synthesizer with direct labeling of a nitro-flumazenil precursor was implemented. The semi-preparative high-performance liquid chromatography (HPLC) purification method (RCY = 15–20%) was applied to obtain high purity [18F]flumazenil. Nano-positron emission tomography (NanoPET)/computed tomography (CT) imaging and ex vivo autoradiography were used to analyze the fear conditioning of rats trained with 1–10 tone-foot-shock pairings. The anxiety rats had a significantly lower cerebral accumulation (in the amygdala, prefrontal cortex, cortex, and hippocampus) of fear conditioning. Our rat autoradiography results also supported the findings of PET imaging. Key findings were obtained by developing straightforward labeling and purification procedures that can be easily adapted to commercially available modules for the high radiochemical purity of [18F]flumazenil. The use of an automatic synthesizer with semi-preparative HPLC purification would be a suitable reference method for new drug studies of GABAA/BZR receptors in the future. [ABSTRACT FROM AUTHOR]

Cardiovascular toxicity has emerged as the leading cause of death in patients undergoing cancer treatment. Thus, cardio-oncology (CO) care must also focus on the prevention and management of related cardiovascular (CV) complications caused by cancer therapy. Neutrophil extracellular traps (NETs)—entities with released DNA, proteases, proinflammatory and prooxidative substances from blasted neutrophils—play an important role in cancer proliferation, propagation metastasis, and incident CV events (acute coronary syndrome, thromboembolic events, and heart failure). Although NETs have been shown to be involved in cancer progression and incident CV events, little is known about their relationship with cardio-oncology, especially on cancer treatment-related cardiovascular toxicity (CTRCT). This review aims to explore the evidence of the impact of NETs on cancer, CV events, and CTRCT, and the possible solutions based on the mechanism of NETs activation and NETs released toxic substances. [ABSTRACT FROM AUTHOR]

Objective: Calcium channel blockers (CCBs) have been proved to have beneficial effects on cardiovascular (CV) outcomes, especially in stroke. Lercanidipine, a highly lipophilic CCB, lacks data regarding long-term outcomes including: CV, stroke, renal and all-cause mortality. This retrospective cohort study aims to clarify this.Patients and Methods: A total of 144,630 newly diagnosed hypertension (HTN) patients (age: 18-65 years) in 2005 from the Taiwan's National Health Insurance Research Database were enrolled in this observational study. A pure hypertension population was fetched by excluding all chronic diseases in the Charlson Comorbidities Index. Patients were stratified into the lercanidipine group (n = 1303) and the propensity-score-matched comparative group (nifedipine, amlodipine or felodipine, n = 15,301).Results: Compared to other CCBs, lercanidipine didn't have a significant difference on the study endpoints. In individual head-to-head comparisons, lercanidipine was shown to be superior to nifedipine in incident stroke with an adjusted HR with 95% CI of 0.526 (0.347-0.797) (p = .0025). The key limitations were that personal variables, such as smoking habits, alcohol intake, body mass index and physical activity and blood pressure profiles were not available in the nationwide registry database.Conclusion: In newly diagnosed patients with hypertension, lercanidipine was superior to nifedipine in the six-year period when the analyzed endpoint was stroke. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) confers increased risks of cardiovascular disease (CVD). Both vitamin D3 and adipocytokines (especially adiponectin and leptin) have a great impact on CVD and MetS. In vitamin D3 metabolism, the vitamin D3 25-hydroxylase (CYP27A1) and 25-hydroxyvitamin D3 1-alpha-hydroxylase (CYP27B1) are two key enzymes. This study aimed to examine the influence of vitamin D3 CYP27 single nucleotide polymorphisms (SNPs) on adipocytokines and MetS. Cross-sectional data and DNA samples were collected from male volunteers (n=649, age: 55.7 ± 4.7 years). Two tagging SNPs, CYP27A1 rs4674344 and CYP27B1 rs10877012, were selected from the HapMap project. MetS was significantly associated with the CYP27A1 rs4674344 SNP (P=0.04) and the ratio of adiponectin/leptin (A/L ratio) was most correlated to the CYP27A1 rs4674344 SNP, appearing to be significantly lower in T-carriers than in AA subjects (3.7 ± 4.0 versus 5.1 ± 6.0, P=0.001) and significantly negatively associated after adjustment. For each MetS component associated with the CYP27A1 rs4674344 SNP, the A/L ratios were significantly negative in preclinical stage (condition not meeting the individual criteria), except the blood pressure. In conclusion, CYP27A1 rs4674344 SNP, A/L ratio, and MetS are significantly associated and T-carriers might have a higher risk of developing MetS due to low A/L ratios in the preclinical stage. [ABSTRACT FROM AUTHOR]

In addition to adipocytokines, estradiol (E2) and vitamin D have been reported to affect insulin sensitivity, glucose homeostasis and body weight. However, studies about the impact of E2 and vitamin D on metabolic syndrome (MetS) are still limited. The aim of this study is to clarify the roles of circulating E2 and vitamin D on the risk of MetS in middle-aged Taiwanese males. A total of 655 male volunteers, including 243 subjects with MetS (mean age: 56.7±5.8 years) and 412 normal controls (mean age: 55.1±3.6 years), were evaluated. Subjects with MetS had significantly lower circulating E2, 1,25(OH)2D3, and adiponectin, and higher leptin than those without MetS (P<0.001 for all comparisons). E2 and 1,25(OH)2D3 were significantly associated with 4 individual components of MetS; more than adiponectin and leptin that were only associated with 3 individual components. In multivariate regression analysis, E2 (beta = −0.216, P<0.001) and 1,25(OH)2D3 (beta = 0.067, P = 0.045) were still significant predictors of MetS independent of adiponectin and leptin. Further large studies are needed to confirm our preliminary results and elucidate the possible mechanism. [ABSTRACT FROM AUTHOR]

Abstract: The reactions of 2-hydroxyphenylethanone oxime (Me-H2salox) and (2-hydroxy-phenyl)-phenyl-methanone oxime (Ph-H2salox) with Mn(ClO4)2·6H2O in MeOH afford trinuclear manganese complexes of [Mn3O(Me-salox)3(MeOH)3(ClO4)]·MeOH (1·MeOH) and [Mn3O(Ph-salox)3(MeOH)3(ClO4)]·2MeOH (2·2MeOH), respectively. X-ray analysis shows that both complexes contain a manganese triangle core, [MnIII 3O]7+. The structural distortion from the twisting of the oxime ligands dominates the ferromagnetic interactions within the three Mn ions in both compounds and results in an S = 6 ground state. The frequency dependence of out-of-phase signals in the alternating current (AC) magnetic susceptibility measurements and the temperature-dependent and sweep-rate-dependent hysteresis loops are indicative of single-molecule magnet behavior. Moreover, both complexes show step-wise magnetization, indicating the occurrence of quantum tunneling of magnetization (QTM). Interestingly, a tail to tail arrangement in the crystal packing of complex 1·MeOH results in strong intermolecular H-bonding interactions and leads to the exchange-bias effect from the antiferromagnetic interaction between the adjacent Mn3 molecules. In contract, QTM steps of complex 2·2MeOH show an absence of the exchange-bias effect due to a weak intermolecular interaction from a head to tail arrangement. [Copyright &y& Elsevier]

Abstract: The reaction of salicylaldoxime (H2salox) with Mn(ClO4)2 ·6H2O, NaN(CN)2 and NEt3 in MeOH affords a MnIII 6 hexanuclear complex of [Mn6O2(salox)6(MeOH)6(NCNCONH2)2] (1), while reaction of H2salox with MnCl2 ·4H2O and NEt4OH in EtOH affords a MnIII 6 hexanuclear complex of [Mn6O2(salox)6(EtOH)4(H2O)2Cl2] (2). Both complexes 1 and 2 contain a [MnIII 6(μ3-O)2]14+ core, which is a known structural type in the family of Mn6 complexes. Variable temperature magnetic susceptibilities and magnetization measurement of complexes 1 and 2 have been carried out. Exchange interactions of metal centers for complexes 1 and 2 are fitted by a full diagonalization matrix method. The fitting results indicate that both complexes 1 and 2 have the ground-state spin value of S =4, and the ground state of complex 1 has the much closer energy to low-lying spin states than that of complex 2. Magnetization measurements at 2.0–4.0K and 10–70kG confirm that the ground state is S =4, with significant magnetoanisotropy as gauged by the D value of −0.82cm−1 and −1.18cm−1, for 1 and 2, respectively. The frequency dependence of the out-of-phase component in alternating current magnetic susceptibilities for both complexes 1 and 2 indicates the slow magnetic relaxation of superparamagnetic behaviour with a U eff of 27.0(1)K and τ 0 =3.8(2)×10−9 s for complex 1, and U eff of 25.1(6)K and τ 0 =4.6(1)×10−8 s for complex 2. [Copyright &y& Elsevier]

Studies of the neurobiological causes of anxiety disorders have suggested that the γ-aminobutyric acid (GABA) system increases synaptic concentrations and enhances the affinity of GABAA (type A) receptors for benzodiazepine ligands. Flumazenil antagonizes the benzodiazepine-binding site of the GABA/benzodiazepine receptor (BZR) complex in the central nervous system (CNS). The investigation of flumazenil metabolites using liquid chromatography (LC)-tandem mass spectrometry will provide a complete understanding of the in vivo metabolism of flumazenil and accelerate radiopharmaceutical inspection and registration. The main goal of this study was to investigate the use of reversed-phase high performance liquid chromatography (PR-HPLC), coupled with electrospray ionization triple-quadrupole tandem mass spectrometry (ESI-QqQ MS), to identify flumazenil and its metabolites in the hepatic matrix. Carrier-free nucleophilic fluorination with an automatic synthesizer for [18F]flumazenil, combined with nano-positron emission tomography (NanoPET)/computed tomography (CT) imaging, was used to predict the biodistribution in normal rats. The study showed that 50% of the flumazenil was biotransformed by the rat liver homogenate in 60 min, whereas one metabolite (M1) was a methyl transesterification product of flumazenil. In the rat liver microsomal system, two metabolites were identified (M2 and M3), as their carboxylic acid and hydroxylated ethyl ester forms between 10 and 120 min, respectively. A total of 10–30 min post-injection of [18F]flumazenil showed an immediate decreased in the distribution ratio observed in the plasma. Nevertheless, a higher ratio of the complete [18F]flumazenil compound could be used for subsequent animal studies. [18F] According to in vivo nanoPET/CT imaging and ex vivo biodistribution assays, flumazenil also showed significant effects on GABAA receptor availability in the amygdala, prefrontal cortex, cortex, and hippocampus in the rat brain, indicating the formation of metabolites. We reported the completion of the biotransformation of flumazenil by the hepatic system, as well as [18F]flumazenil's potential as an ideal ligand and PET agent for the determination of the GABAA/BZR complex for multiplex neurological syndromes at the clinical stage. [ABSTRACT FROM AUTHOR]

Purpose: This study surveyed the novel autoantigens expressed in the orbital fat tissue of patients with Graves’ orbitopathy (GO) and explored the possibility of the autoantibodies against novel autoantigens as biomarkers for GO.Methods: We used immuno-proteomic methods to survey novel autoantigens expressed in the orbit fat tissue of GO patients and confirmed by enzyme-linked immunosorbent assay (ELISA).Results: One protein spot (aldehyde dehydrogenase 2 (ALDH2)) revealed high reactivity with the GO serum than did the healthy control serum and was further verified by ELISA. We found that the plasma anti-ALDH2 antibody level was increased in GO patients compared to healthy control donors. In addition, anti-ALDH2 antibody level was correlated with GO activity classified by clinical activity score(r = 0.588, p < 0.001, using Pearson’s correlation).Conclusions: These increased levels of anti-ALDH2 antibody in GO serum suggested that ALDH2 could attribute target autoantigen in GO, and anti-ALDH2 autoantibody might serve as a biomarker for GO and help to predict disease activity. [ABSTRACT FROM AUTHOR]

Abstract: This paper studies the effect of doping on BON-based resistive switching characteristics. Typical bipolar resistive switching behavior can be observed in Pt/BON/TiN and Pt/BON:Gd/TiN devices. The conductive path(s) of the Pt/BON/TiN is vacancy-dominated while the Pt/BON:Gd/TiN is metal-dominated. Additionally, there is an atypical bipolar resistive switching in the Gd-doping device. This atypical characteristic has not only a size effect, but also a lower operating current. The resistance transitions are due to the variation in conductance of the switching layer, which is clearly influenced by the different area size. A mechanism is proposed to explain this atypical characteristic. [Copyright &y& Elsevier]

Objectives: Non‐alcoholic fatty liver disease (NAFLD) is suggested to be a precursor of metabolic syndrome (MetS) and could influence the risk of testosterone deficiency (TD). Fatty liver index (FLI) is a simple and useful screening tool for NAFLD. We determined the association between the risk of NAFLD assessed by FLI and TD in aging Taiwanese men, especially those without MetS. Materials and Methods: A free health screening program was conducted for men (age: >40 years) in a medical center in Kaohsiung, Taiwan. All participants underwent a physical examination; answered a questionnaire assessing demographics, medical history, and clinical symptoms of TD; and provided 20‐mL whole blood samples for biochemical, adipocytokine, and hormonal evaluations. The risk of NAFLD was evaluated using FLI. The presence of NAFLD was ruled out if FLI value was <25 and ruled in if FLI value was ≥35. Results: A total of 552 men (mean age: 54.7 ± 7.7 years) were enrolled. The prevalence rates of TD and MetS were significantly higher among men with NAFLD than those without NAFLD (both p < 0.001). FLI was significantly correlated with total testosterone (TT) and adipocytokines associated with insulin resistance, such as adiponectin, leptin, and retinol‐binding protein‐4 (RBP‐4) levels, respectively (all p < 0.001). Among men without MetS, those at risk of and with NAFLD had a 3.82 and 8.50 times higher risk of TD, respectively, than those without NAFLD after adjusting for potential covariates. Conclusion: The FLI is associated with the risk of TD in aging Taiwanese men, especially in those without MetS. Our findings also suggest that insulin resistance may be an important link among the inter‐relationships of NAFLD, MetS, and TD. Further population‐based studies with larger sample sizes of different ethnicities are warranted to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

This study develops an ultrasensitive electrical device, the silicon nanowire-field effect transistor (SiNW-FET) for detection of cardiac troponin I (cTnI) in obesity induced myocardial injury. The biosensor device utilizes metal–oxide–semiconductor (MOS) compatible top-down methodology for the fabrication process. After fabrication, the surface of the SiNW is modified with the cTnI monoclonal antibody (Mab-cTnI) upon covalent immobilization to capture cTnI antigen. The sensitivity of the device is also examined using cTnI at different concentrations with the lowest detection limit of 0.016 ng/mL. The electrocardiogram (ECG), magnetic resonance imaging (MRI), and superior vena cave (SVC) provide more information about cardiac responses in a mouse model of acute myocardial infarction (AMI). Further, magnetic resonance imaging helps to evaluate the cardiac output of an obesity induced myocardial injury mouse model. These methods play an essential role in monitoring the obesity based cardiac injury and hence, these studies were carried out. This is the first report to use the ECG, MRI, and SVC sampling methods to study the obesity based cardiac injury involving Syrian hamsters as animal models. The proposed SiNW-FET in this study shows greater sensitivity than the previously developed devices and demonstrates great potential for future applications in point-of-care (POC) diagnosis. [ABSTRACT FROM AUTHOR]

The article focuses on the single-molecule magnet (SMMs), an anisotropy barrier enhanced by structural distortion. It mentions that the magnetic properties of an SMM develop from its high-spin ground state (S) split by a huge negative axial zero-field splitting (D). Moreover, SMMs depicts slow magnetization relaxation stage such as magnetization hysteresis loops and frequency-dependent out-of-phase alternating current (ac).

Abstract Background Hepatocyte nuclear factor-4α (HNF4A) can influence the risk of insulin resistance that is postulated to be an important link between metabolic syndrome (MetS) and testosterone deficiency (TD) in men. Aim To investigate the relationship between single-nucleotide polymorphisms (SNPs) of HNF4A and the risk of developing MetS and TD in a population of aging Taiwanese men. Methods A free health screening of men over 40 years of age was conducted in a medical center in Kaohsiung City, Taiwan. All participants underwent a physical examination, answered a questionnaire on demographics and medical history, completed the Androgen Deficiency in The Aging Male questionnaire to assess clinical symptoms of TD, and provided 20-mL whole blood samples for biochemical, hormonal, and genetic evaluation. Main Outcome Measure 3 common SNPs (rs11574736, rs1884613, and rs2144908) of HNF4A were selected and identified using a TaqMan 5' allelic discrimination assay. Results 559 men were enrolled for this study (mean age, 55.8± 4.9 years). Prevalence of TD was significantly higher (P =.031) in subjects with MetS (16.8%) than those without MetS (10.1%). In SNP rs1884613 of HNF4A, subjects with the C allele carried a 1.31- and 1.50-times higher risk of developing MetS and TD, respectively, compared to those with the G allele, after adjusting for potential covariates. In addition, subjects with the CC genotype were exposed to a 1.91- and 2.20-times higher risk of developing MetS and TD, respectively, compared to those with the GG genotype. Clinical Implications Our findings may point to the importance of the role played by insulin resistance in the link between MetS and TD. Strength & Limitations Our current work is the first report with adequate sample size to evaluate the role of genetic variants of HNF4A on the risk of both MetS and TD in men. The limitations included subjects enrolled from a free health screening and single measurement of serum testosterone levels. Conclusion The rs1884613 SNP marker of HNF4A is significantly associated with an increased risk for developing both MetS and TD in aging Taiwanese men. Further population-based studies utilizing larger samples of different ethnicities may be needed to confirm these preliminary results. Liu C-C, Lee Y-C, Hung S-P. Hepatocyte Nuclear Factor-4α P2 Promoter Variants Are Associated With the Risk of Metabolic Syndrome and Testosterone Deficiency in Aging Taiwanese Men. J Sex Med 2018;15:1527–1536. [ABSTRACT FROM AUTHOR]

Background Repeated evidence from animal models suggests a strong link between vascular endothelial growth factor (VGEF) and penile vasculature and erectile function because VEGF can alter the physiologic pathways involved in the regulation of penile vasomotor tone. Aim To investigate three VEGF polymorphisms and their link to erectile dysfunction (ED). Methods We enrolled 688 Taiwanese men with a mean age of 55.6 years (SD = 4.5) during a free health screening. All participants provided complete medical histories and underwent physical examinations. Fasting blood samples were obtained for biochemical analysis and hormone profiling. The allelic discrimination of three VEGF gene polymorphisms (460T/C [rs833061], 1154G/A [rs1570360], and 2578A/C [rs699947]) was performed using validated TaqMan single-nucleotide polymorphism genotyping assays. Outcomes Subjects underwent assessment using the simplified five-item International Index of Erectile Function to diagnose and assess ED severity. Results The results showed that diabetes mellitus (odds ratio [OR] = 3.27, P < .01), hypertension (OR = 3.47, P < .01), and having the VEGF 2578A allele (OR = 1.54, P = .01) were the three most independent risk factors for ED. In univariate analysis, all three VEGF polymorphisms (460C, 1154A, and 2578A) were significantly associated with a higher prevalence of coronary artery disease ( P < .01) and greater frequencies of hypertension were found in carriers of the 1154A allele and the 2578A allele ( P = .01). Multiple logistic regression analysis showed a significant association between VEGF 2578A allele carrier status and ED (OR = 1.54, 95% CI = 1.10∼2.15, P = .01). Furthermore, the prevalence and severity of ED were significantly increased with an increment of the 2578A allele number ( P < .05). Clinical Implications VEGF 2578C/A gene polymorphisms could be a genetic susceptibility factor for the development of ED. Strength and Limitation This is the first study to investigate the genetic susceptibility of VEGF polymorphisms to ED. This study was cross-sectional with a lack of functional and molecular production investigations. Data on the association among conditions might not allow definitive conclusions about causal links. Conclusion This study showed that VEGF 2578A allele carriers in a Taiwanese population are at greater risk for ED. Lee Y-C, Huang S-P, Tsai C-C, et al. Associations of VEGF Gene Polymorphisms With Erectile Dysfunction and Related Risk Factors. J Sex Med 2017;14:510–517 . [ABSTRACT FROM AUTHOR]

Aim The combination of anthracyclines ( AC) and trastuzumab ( TRZ) is highly effective in patients with aggressive HER-2 + breast cancer, but has a significant risk of cardiotoxicity ( CT). Trastuzumab-induced CT may be reversible. The aim of this study was to identify echocardiographic parameters associated with recovery of left ventricular ejection fraction ( LVEF) in patients who developed CT after AC and TRZ treatment. Methods and Results Women with newly diagnosed breast cancer treated with AC followed by TRZ and monitored with serial echocardiograms were retrospectively studied. Left ventricular end-diastolic and systolic volumes, LVEF, and global longitudinal strain ( GLS) were examined. Development and reversibility of CT were defined based on changes in LVEF according to the 2014 ASE/ EACVI recommendations. Cox analysis was used to determine the association of echocardiographic variables with the subsequent development and reversibility of CT. Ninety-five patients underwent 5 echocardiograms or more in a 17-month (13-28 months) follow-up period. Nineteen patients (20%) developed CT. Left ventricular volumes, LVEF, and GLS measured after AC completion identified the subsequent development of CT. Of the 19 patients with CT, the LVEF partially or fully recovered in 13 (68%). GLS at the time of CT diagnosis was associated with subsequent recovery of LVEF (P = 0.004). Conclusion In patients with breast cancer treated with AC and TRZ who develop CT, GLS at the time of CT diagnosis is associated with subsequent recovery of LVEF and may be useful for risk stratification and to guide treatment. [ABSTRACT FROM AUTHOR]

Objectives: To determine the association between genetic variants on chromosome 4q25 and atrial fibrillation (AF) in a Taiwanese population. Methods: We enrolled 200 patients with AF (mean age: 67 ± 13 years) and 158 controls (mean age: 63 ± 10 years). The genotypes of five SNPs, RS2634073, RS2200733, RS13143308, RS2220427 and RS10033464, were determined using multiplex single base extension methods. Results: The distribution of the RS2200733 and RS10033464 genotypes did not significantly deviate from the Hardy-Weinberg equilibrium in the control group. The distribution of the RS2200733 genotypes differed significantly between the AF group and the controls (p = 0.03), whereas the distribution of the RS10033464 genotypes did not (p = 0.49). At RS2200733, patients with the CC genotype exhibited a 0.45 times higher risk of developing AF than those with the TT genotype (p = 0.02) and a recessive model was suggested (p = 0.01). After adjusting for various covariates, patients with the CC genotype remained recessively associated with a lower risk of developing AF than those with the TT genotype (odds ratio: 0.27, 95% confidence interval: 0.11–0.65; p < 0.01). Conclusions: In the Taiwanese, there is an association between SNP RS2200733 – but not RS10033464 – and the development of AF. Based on a recessive model of inheritance, individuals with SNP RS2200733 genotype CC are at a lesser risk of developing AF. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Mid-diastolic mitral annular motion may be driven by strain energy, an energy for myocardial recoil, stored during the previous systole. Hence, various patterns of mid-diastolic mitral annular motion may imply different left ventricular (LV) diastolic function. The purpose of this study is to compare LV diastolic properties among different types of mid-diastolic mitral annular motion. Two-hundred and three consecutive subjects underwent an echocardiographic examination at our outpatient clinic. Study subjects were classified into three groups according to mid-diastolic mitral annular motion patterns. Upward and downward La waves were defined, respectively, as a clear apically and atrially directed mid-diastolic annular motion on at least three consecutive beats with the average peak velocity ≥2 cm/s. Subjects with upward La wave, with downward but without upward La wave and without La wave were categorized as groups 1, 2 and 3, respectively. Early diastolic mitral annular velocity (Ea) was higher and the ratio of transmitral E wave velocity to Ea was lower in group 1 than in groups 2 and 3 (all p < 0.001). The diagnostic accuracy of upward La wave in prediction of normal diastolic function fell between 75% and 88%. In conclusion, patients with upward La wave had better LV diastolic function and lower LV filling pressure than patients without it. Upward La wave is useful in prediction of normal diastolic function. Therefore, analysis of mid-diastolic mitral annular motion may be complementary to other measures of LV diastolic function. (E-mail: wcvoon@giga.net.tw) [Copyright &y& Elsevier]

Abstract: The aim of this study is to evaluate whether isovolumic relaxation flow propagation velocity (IRFPV), a newly proposed relaxation parameter, is independent of load alterations. Thirty-nine uremic patients (21 men; age 62 ± 10 y) who underwent echocardiography 1 h before and 1 h after hemodialysis (HD) were included. After HD, body weight, systolic blood pressure, early transmitral filling wave velocity (E), early diastolic mitral annular velocity (Ea) and early diastolic inflow propagation velocity (EPV) decreased significantly (p ≤ 0.007), while IRFPV kept constant (p = 0.550). A subgroup analysis showed that in patients with body weight reduction <2.5 kg, E (p = 0.005) decreased significantly, but Ea (p = 0.078), EPV (p = 0.155) and IRFPV (p = 0.324) did not change after HD. In patients with body weight reduction ≥2.5 kg, E (p < 0.001), Ea (p = 0.001) and EPV (p = 0.001) decreased significantly but IRFPV (p = 0.715) was still constant after HD. In conclusion, IRFPV may be a load-independent parameter in assessing left ventricular diastolic function. However, Ea and EPV are load-independent only at minor load alterations. In evaluating left ventricular diastolic function in HD patients whose loading conditions frequently vary with time, IRFPV seems to be more adequate than Ea and EPV. (E-mail: wcvoon@giga.net.tw) [Copyright &y& Elsevier]

Diastolic mitral annular motion may terminate earlier in patients with higher left ventricular end-diastolic pressure (LVEDP). It was therefore hypothesized that the time interval measured from the end of the diastolic mitral annular velocity pattern to the onset of QRS (the AQ interval) would be a useful parameter in predicting LVEDP. The aim of this study was to evaluate the relation between the AQ interval and LVEDP. Forty-six patients with suspected coronary artery disease who underwent Doppler echocardiographic studies and cardiac catheterization were included. LVEDP was determined using a micromanometer-tipped catheter. On univariate analysis, the AQ interval had positive correlations with the PR interval (r = 0.405, p = 0.005), transmitral E-wave velocity (r = 0.502, p <0.001), isovolumic contraction time (r = 0.635, p <0.001), and LVEDP (r = 0.514, p <0.001) and a negative correlation with E-wave deceleration time (r = -0.430, p = 0.003). After stepwise multiple linear regression analysis, the PR interval, transmitral E-wave velocity, and LVEDP were the independent predictors of the AQ interval (beta = 0.234, p = 0.033; beta = 0.331, p = 0.004; and beta = 0.350, p = 0.003, respectively). In conclusion, the AQ interval is a novel, simple, and easily obtained index in the prediction of LVEDP. [ABSTRACT FROM AUTHOR]

Diastolic mitral annular motion may terminate earlier in patients with higher left ventricular end-diastolic pressure (LVEDP). It was therefore hypothesized that the time interval measured from the end of the diastolic mitral annular velocity pattern to the onset of QRS (the AQ interval) would be a useful parameter in predicting LVEDP. The aim of this study was to evaluate the relation between the AQ interval and LVEDP. Forty-six patients with suspected coronary artery disease who underwent Doppler echocardiographic studies and cardiac catheterization were included. LVEDP was determined using a micromanometer-tipped catheter. On univariate analysis, the AQ interval had positive correlations with the PR interval (r = 0.405, p = 0.005), transmitral E-wave velocity (r = 0.502, p <0.001), isovolumic contraction time (r = 0.635, p <0.001), and LVEDP (r = 0.514, p <0.001) and a negative correlation with E-wave deceleration time (r = −0.430, p = 0.003). After stepwise multiple linear regression analysis, the PR interval, transmitral E-wave velocity, and LVEDP were the independent predictors of the AQ interval (β = 0.234, p = 0.033; β = 0.331, p = 0.004; and β = 0.350, p = 0.003, respectively). In conclusion, the AQ interval is a novel, simple, and easily obtained index in the prediction of LVEDP. [Copyright &y& Elsevier]

Electronegative L5 low-density lipoprotein (LDL) level may be a useful biomarker for predicting cardiovascular disease. We determined the range of plasma L5 levels in healthy adults (n = 35) and examined the power of L5 levels to differentiate patients with coronary artery disease (CAD; n = 40) or patients with hyperlipidemia (HLP) without evidence of CAD (n = 35) from healthy adults. The percent L5 in total LDL (L5%) was quantified by using fast-protein liquid chromatography with an anion-exchange column. Receiver operating characteristic curve analysis was performed to determine cut-off values for L5 levels. The mean L5% and plasma concentration of L5 (ie, [L5]) were significantly higher in patients with HLP or CAD than in healthy adults (P < 0.001). The ranges of L5% and [L5] in healthy adults were determined to be <1.6% and <1.7 mg/dL, respectively. In individuals with L5% >1.6%, the odds ratio was 9.636 for HLP or CAD. In individuals with [L5] >1.7 mg/dL, the odds ratio was 17.684 for HLP or CAD. The power of L5% or [L5] to differentiate patients with HLP or CAD from healthy adults was superior to that of the LDL/high-density lipoprotein ratio. The ranges of L5% and [L5] in healthy adults determined here may be clinically useful in preventing and treating cardiovascular disease. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Paradox in Acute Myocardial Infarction-The Association With 30-Day In-Hospital Mortality" in the 2015 issue is presented.