心源性猝死一级预防植入心律转复除颤器前非持续室性心动过速与植入后恰当治疗的关系

目的探讨植入型心律转复除颤器(implantable cardioverter defibrillator,ICD)用于心源性猝死一级预防时,植入前发生非持续性室性心动过速(non-sustained ventricular tachycardia,NSVT)与植入后ICD恰当治疗的关系。方法本研究为单中心回顾性队列研究,连续纳入2006年1月至2017年12月在北京协和医院住院植入ICD用于一级预防的心脏病患者,患者在住院期间ICD植入前均完善Holter检查。根据Holter检查是否出现NSVT,将患者分为NSVT组及无NSVT组。门诊或电话随访至2018年8月,随访事件包括全因死亡、植入后ICD放电治疗及抗心动过速起搏(antitachycardia pacing,ATP)治疗情况。结果纳入60例符合入选和排除标准的患者,随访时间37 (14～61)个月,KaplanMeier生存曲线及Log-Rank检验提示,NSVT组与无NSVT组相比,全因死亡率无统计学差异(P=0. 108),NSVT组恰当治疗的风险高于无NSVT组(P=0. 033),NSVT和左心室射血分数与ICD恰当治疗独立相关(NSVT:HR=5. 099,95%CI:1. 399～18. 588,P=0. 014;左心室射血分数:HR=1. 077,95%CI:1. 013～1. 145,P=0. 018)。结论 ICD一级预防患者植入前出现NSVT提示接受ICD恰当治疗的风险增加。     

核素心室造影舒张早期功能测定对冠心病估价

用平衡法核素心室造影自动左心室功能测定法检查了２３例正常人、３７例无心肌梗塞（ＣＡＤ－ＮＭＩ）和１４例有心肌梗塞（ＣＡＤ－ＭＩ）冠心病人左心室功能。结果表明，ＰＦＲ反映心肌缺血改变比其他心功能参数敏感。ＣＡＤ－ＮＭＩ组与正常对照组比较，ＰＦＲ的灵敏度为９４．５９％，Ｐ〈０．００１，其他参数的灵敏度依次为ＴＰＦＲ５４．０５％，Ｐ〈０．０１；ＰＥＲ５４．０５，Ｐ〈０．０１；ＴＰＥＲ４９．９５％，Ｐ〈０     

Suboptimal Exposure to Facial Expressions When Viewing Video Messages From a Small Screen: Effects on Emotion, Attention, and Memory.

The authors examined the effects of suboptimally presented facial expressions on emotional and attentional responses and memory among 39 young adults viewing video (business news) messages from a small screen. Facial electromyography (EMG) and respiratory sinus arrhythmia were used as physiological measures of emotion and attention, respectively. Several congruency priming effects were found. In particular, happy facial primes prompted increased (a) pleasure ratings, (b) orbicularis oculi EMG activity, (c) perceived trustworthiness, and (d) recognition memory for video messages with a positive emotional tone. Emotional and other responses to video messages presented on a small screen can be modified with suboptimal affective primes, but even small differences in the emotional tone of the messages should be allowed for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"The association between emotional upset and cardiac arrhythmia during daily life": Correction to Carels et al. (2003).

Reports an error in the original article by R. A. Carels et al (Journal of Consulting & Clinical Psychology, 2003[Jun], Vol 71[3], 613-618). On page 615, Lines 18, 20, 22, of Table 1, the data in the rows that read "Tachycardia in min per hr," "Repetitive PVCs per hr," and "PVCs per hr" are incorrectly reported in the n and % columns. They should have been reported in the M and SD columns. The corrected table is provided. (The following abstract of this article originally appeared in record 2003-00756-023.) Ventricular arrhythmia exhibits considerable within-subject variability that cannot be attributed to clinical status alone. This investigation examined the extent to which cardiac arrhythmia was associated with psychological and physical factors assessed during the hour preceding arrhythmic or nonarrhythmic activity. Approximately twice hourly, 46 patients randomly completed a diary assessing mood and physical symptoms during 24-hr electrocardiographic monitoring. Greater negative emotion was associated with increased arrhythmia. Additionally, greater negative emotion was significantly associated with increased arrhythmia among participants in a low left ventricular ejection fraction group (LVEF). However, this relationship between negative emotion and arrhythmia was not... (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

iPSC-Cardiomyocyte Models of Brugada Syndrome—Achievements,Challenges and Future Perspectives

Brugada syndrome (BrS) is an inherited cardiac arrhythmia that predisposes to ventricular fibrillation and sudden cardiac death. It originates from oligogenic alterations that affect cardiac ion channels or their accessory proteins. The main hurdle for the study of the functional effects of those variants is the need for a specific model that mimics the complex environment of human cardiomyocytes. Traditionally, animal models or transient heterologous expression systems are applied for electrophysiological investigations, each of these models having their limitations. The ability to create induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), providing a source of human patient-specific cells, offers new opportunities in the field of cardiac disease modelling. Contemporary iPSC-CMs constitute the best possible in vitro model to study complex cardiac arrhythmia syndromes such as BrS. To date, thirteen reports on iPSC-CM models for BrS have been published and with this review we provide an overview of the current findings, with a focus on the electrophysiological parameters. We also discuss the methods that are used for cell derivation and data acquisition. In the end, we critically evaluate the knowledge gained by the use of these iPSC-CM models and discuss challenges and future perspectives for iPSC-CMs in the study of BrS and other arrhythmias.     

基于模糊免疫PID的左心室辅助装置控制系统仿真

为了提高左心室辅助装置运行的稳定性,研究了模糊免疫PID控制在左心室辅助装置控制系统中的应用.首先,分析了辅助装置的工作原理及其系统建模;其次,对模糊免疫PID控制算法进行分析;最后,进行了基于模糊免疫PID左心室辅助装置控制的仿真.仿真结果表明,模糊免疫PID控制技术比常规PID控制具有更好的控制稳定性.     

Functional and metabolic evaluation of the hypertrophied heart using MRI and31P-MRS

4. Conclusions Diastolic LV function and myocardial HEP metabolism are impaired only when LVH is caused by permanent pressure or volume overload, and not by a temporary increase in cardiac workload during part of the day as in elite athletes. Therefore, training-induced and pressure/volume-overload-induced LVH seem to represent different phenotypes of LVH, possibly related to genetic reprogramming which only occurs during permanent cardiac overload [17]. Moreover, there is an association between impaired LV diastolic function and altered myocardial HEP metabolism in patients with hypertension and in patients with aortic valve disease. Finally we did not find a correlation between myocardial HEP metabolism and LV mass in any of the groups studied. The latter indicates that LVH should be regarded as an epiphenomenon to cardiac overload, and not as a primary factor causing abnormal HEP metabolism.     

混合型径向基函数神经网络检测PVC

采用径向基函数（ＲＢＦ）神经网络作为室性早搏（ＰＶＣ）的检测器,将ＱＲＳ波的模板以及其他不同物理意义的特征参数综合在一个检测网络中,构成一种由Ｇａｕｓｓ函数和Ｓｉｇｍｏｉｄ函数作为隐层点基函数的混合型ＲＢＦ网络,并且给出确定网络结构参数的方法。用ＭＩＴ心电数据库对算法进行验证,单层心电信号的室性早搏检出率达到９８．４６％。     

QT间期离散度与急性心肌梗死患者预后的关系

通过观察急性心肌梗死(AMI)患者QT间期离散度(QTd)变化,探讨其与临床关系。应用体表同步十二导联心电图对168例AMI患者进行心电图QTd和校正QT间期离散度(QTcd)测定,并与168例正常人做对照。结果表明:AMI患者入院后心电图的QTd、QTcd均明显长于对照组(P<0.01);室性心律失常组、心衰组、死亡组QTd、QTcd均明显长于非心律失常组、非心衰组、生存组(P<0.01);前壁组QTd、QTcd明显长于下后壁组(P<0.01);AMI组中QTmax存在于梗死或缺血区导联163例,占97%。AMI中发生室性心律失常组QTd增加均>60 ms,其中6例室颤QTd均>100 ms。综上得出结论:AMI患者QTd、QTcd明显延长,为AMI发生室性心律失常、心力衰竭和猝死简单而实用的重要预测指标。QTd>60 ms可以作为预测心肌梗死患者发生室性心律失常的指标,而QTd>100 ms是识别高危心律失常的敏感指标。     

Computational approaches to understand the adverse drug effect on potassium,sodium and calcium channels for predicting TdP cardiac arrhythmias

Ion channels play a crucial role in the cardiovascular system. Our understanding of cardiac ion channel function has improved since their first discoveries. The flow of potassium, sodium and calcium ions across cardiomyocytes is vital for regular cardiac rhythm. Blockage of these channels, delays cardiac repolarization or tend to shorten repolarization and may induce arrhythmia. Detection of drug risk by channel blockade is considered essential for drug regulators. Advanced computational models can be used as an early screen for torsadogenic potential in drug candidates. New drug candidates that are determined to not cause blockage are more likely to pass successfully through preclinical trials and not be withdrawn later from the marketplace by manufacturer. Several different approved drugs, however, can cause a distinctive polymorphic ventricular arrhythmia known as torsade de pointes (TdP), which may lead to sudden death. The objective of the present study is to review the mechanisms and computational models used to assess the risk that a drug may TdP. Key points: There is strong evidence from multiple studies that blockage of the L-type calcium current reduces risk of TdP. Blockage of sodium channels slows cardiac action potential conduction, however, not all sodium channel blocking antiarrhythmic drugs produce a significant effect, while late sodium channel block reduces TdP. Interestingly, there are some drugs that block the hERG potassium channel and therefore cause QT prolongation, but they are not associated with TdP. Recent studies confirmed the necessity of studying multiple distinctionic ion channels which are responsible for cardiac related diseases or TdP, to obtain an improved clinical TdP risk prediction of compound interactions and also for designing drugs.