Attenuated cardiac sympathetic responsiveness during dynamic exercise in patients with heart failure

BACKGROUND: Cardiac norepinephrine (NE) spillover is increased in patients with chronic heart failure. This elevation is partly due to augmented NE release but also to reduced capacity for cardiac NE removal processes. In patients with mild to moderate heart failure, it is not known whether the described alteration in cardiac sympathetic function also affects cardiac NE spillover during intense sympathetic activation and whether other organs respond in proportion to the heart. METHODS AND RESULTS: Twenty-two patients with heart failure and 15 age-matched healthy subjects were studied. Whole-body and regional (NE) spillovers from the heart and kidneys were assessed at baseline and during supine cycling exercise (10 minutes) with the use of steady-state infusions of tritiated NE (isotope dilution). Cardiac performance was evaluated by means of catheterization of the right side of the heart. Cardiac NE spillover was higher (P < .05) at baseline in the patient group than in healthy subjects, whereas renal and whole-body NE spillovers were similar between the study groups. During exercise, cardiac NE spillover increased 13-fold (P < .05) in healthy subjects but only 5-fold (P < .05) in the cardiac failure group, the latter reaching a lower peak value (P < .05). In contrast, there was no difference between the study groups in either renal or whole-body NE spillover responsiveness to exercise. CONCLUSIONS: Patients with mild to moderate heart failure demonstrated a selective attenuation of cardiac sympathetic responsiveness during dynamic exercise. This attenuation may convey reduced inotropic and chronotropic support to the failing heart.     

Determination of interfacial tension between PA/PP and LCP/PP by IFR method and effect of compatibilization on interfacial tension

The dynamic imbedded fiber retraction (IFR) method was used to measure the interfacial tension between two molten polymers. The aim was to evaluate the applicability of this method for polypropylene (PP) used as matrix, and two polyamide (PA6, PA66) and thermotropic main-chain liquid crystalline polymer fibers. The effect on the interfacial properties of modifying the PP matrix with compatibilizers was studied as well. The IFR method was found to be suitable for evaluating the interfacial properties of these polymer blends. The measured interfacial tensions correlated well with the morphology and mechanical properties of the blends and values calculated from the harmonic mean equation. Although the measured interfacial tensions were generally lower than the theoretical ones, the order of the values for the different polymer pairs was similar. © 1995 John Wiley & Sons, Inc.     

Normalization of total body and regional sympathetic hyperactivity in heart failure after heart transplantation

BACKGROUND: Sympathetic nerve activity is increased in patients with severe heart failure. Whether this intense sympathoexcitation is normalized after heart transplantation, despite cyclosporine A treatment, is still unsettled. In the present study, regional sympathetic function in 12 patients with severe heart failure, awaiting heart transplantation, was compared with that in 15 heart transplant recipients and 12 healthy subjects. METHODS: Total and regional sympathetic activity in the heart and kidney were evaluated with isotope dilution, using steady-state infusion of [3H] norepinephrine. Sympathetic nerve traffic to skeletal muscle vascular bed was recorded intraneurally with microneurography. RESULTS: Total body, cardiac, and renal norepinephrine spillovers were high in the heart failure group (6792 +/- 455, 385 +/- 74, and 1554 +/- 114 pmol/min, respectively) as was muscle sympathetic nerve activity (82 +/- 5 bursts/min). Transplant recipients showed a marked reduction of total body (3200 +/- 307 pmol/min) and renal (747 +/- 169 pmol/min) norepinephrine spillovers and sympathetic nerve firing to skeletal muscle (22 +/- 6 bursts/min), none of which differed from healthy subjects. CONCLUSIONS: The augmentation of total body and regional sympathetic outflow to the kidney and skeletal muscle vascular beds, associated with a failing heart, was normalized after transplantation. Thus, sympathoexcitation in heart failure is reversible. Furthermore, because all heart transplant recipients received cyclosporine A, the findings do not support the concept that cyclosporine-induced hypertension is mediated by increased sympathetic nerve activity.     

Combustion engine optimization: a multiobjective approach

To simulate the physical and chemical processes inside combustion engines is possible by appropriate software and high performance computers. For combustion engines a good design is such that it combines a low fuel consumption with low emissions of soot and nitrogen oxides. These are however partly conflicting requirements. In this paper we approach this problem in a multi-criteria setting which has the advantage that it is possible to estimate the trade off between the different objectives and the decision of the optimal solution is postponed until all possibilities and limitations are known. The optimization algorithm is based on surrogate models and is here applied to optimize the design of a diesel combustion engine.