Long-Term Performance of Modern Coronary Sinus Leads in Cardiac Resynchronization Therapy

Background

Cardiac resynchronization therapy (CRT) has become an important pillar of contemporary heart failure therapy. The efficacy of CRT, however, critically relies on proper LV lead placement and performance, which is why data regarding the long-term performance of CS leads are of considerable interest. Available studies are limited by a restricted variety of lead vendors, earlier lead models and / or very short follow-up periods. In the current study, we therefore investigated the long-term performance of modern LV leads in a large "real world" cohort of patients undergoing CRT implantation.

Methods and Results

All 193 patients who had successfullyundergone CRT implantation at the University Hospital Zurich between September 2003 and January 2010 were included in the study. An overall stable course of stimulation energy was observed over time; neither ischemic etiology, lead configuration, or severely reduced EF had an influence on the evolution of energy thresholds over time. Interestingly, patients with a high energy threshold at baseline experienced a significant reduction during follow-up. In contrast, a significant drop in impedance was seen following implantation, followed by a steady course for the rest of the observation period. Only 15 patients (9.7%) showed an impedance > 1000 Ohm at any time during their follow-up. Seven lead dislocations were observed during follow up.

Conclusion

The current comprehensive analysis of long-term performance of modern coronary sinus leads demonstrates excellent stability, performance and safety. These data may have important implications for physicians involved in biventricular pacemaker implantations and in the follow-up care of these patients.     

Multiple Protein Biomarker Assessment for Recombinant Bovine Somatotropin (rbST) Abuse in Cattle

Biomarker profiling, as a rapid screening approach for detection of hormone abuse, requires well selected candidate biomarkers and a thorough in vivo biomarker evaluation as previously done for detection of growth hormone doping in athletes. The bovine equivalent of growth hormone, called recombinant bovine somatotropin (rbST) is (il)legally administered to enhance milk production in dairy cows. In this study, first a generic sample pre-treatment and 4-plex flow cytometric immunoassay (FCIA) were developed for simultaneous measurement of four candidate biomarkers selected from literature: insulin-like growth factor 1 (IGF-1), its binding protein 2 (IGFBP2), osteocalcin and endogenously produced antibodies against rbST. Next, bovine serum samples from two extensive controlled rbST animal treatment studies were used for in vivo validation and biomarker evaluation. Finally, advanced statistic tools were tested for the assessment of biomarker combination quality aiming to correctly identify rbST-treated animals. The statistical prediction tool k-nearest neighbours using a combination of the biomarkers osteocalcin and endogenously produced antibodies against rbST proved to be very reliable and correctly predicted 95% of the treated samples starting from the second rbST injection until the end of the treatment period and even thereafter. With the same biomarker combination, only 12% of untreated animals appeared false-positive. This reliability meets the requirements of Commission Decision 2002/657/EC for screening methods in veterinary control. From the results of this multidisciplinary study, it is concluded that the osteocalcin – anti-rbST-antibodies combination represent fit-for-purpose biomarkers for screening of rbST abuse in dairy cattle and can be reliably measured in both the developed 4-plex FCIA as well as in a cost-effective 2-plex microsphere-based binding assay. This screening method can be incorporated in routine veterinary monitoring programmes: in the European Union for detection of rbST abuse and in the control of rbST-free dairy farms in the United States of America and other countries.     

Opposing effects of heat stress on male versus female reproductive success in Bicyclus anynana butterflies

In ectothermic organisms, reproductive success and survival are vitally affected by temperature. Here, we analyzed the effects of a short-time exposure to heat stress (1 h at 40 °C versus controls) on reproductive success and longevity in Bicyclus anynana butterflies. After having applied heat stress or a control treatment, individuals were mated in all four possible sexes by treatment combinations. Heat exposure of females caused a subsequent reduction in longevity, fecundity, egg size and concomitantly reproductive investment. Heat exposure of males also reduced longevity, but had in general little effect on the reproduction of female mates. However, females having mated with heat-stressed males showed surprisingly an increased rather than decreased early fecundity, which may indicate an increased investment in current reproduction in stressful environments. Heat stress had no significant effect on egg hatching success, time to copulation and copulation duration. Our results suggest that a short period of heat stress may substantially reduce longevity and reproductive output, with striking differences among sexes. We found no evidence for males being more strongly affected by heat stress than females.     

A new type of brachyuran seminal receptacle in the masked crab Ethusa mascarone (Brachyura,Ethusidae)

The reproductive system of the female Ethusa mascarone was studied with a combination of histological and MRI‐techniques. The study reveals a completely new type of eubrachyuran seminal receptacle. This receptacle consists of two largely separate chambers that engage with each other in a manner similar to shaking hands. One chamber facing the medial axis is lined by cuticle while the second chamber consists of a thick holocrine epithelium. Both chambers are connected by two openings of a unique structure. First, the glandular chamber opens ventro‐laterally to the cuticle chamber via a laterally flattened connective duct that is lined by a highly folded cuticle. A second opening connects both chambers dorsally with the oviduct orifice. A distinct character is the cuticular hook‐like projection that is situated in between the connection of oviduct opening, the glandular chamber and the cuticle chamber of the seminal receptacle. The complete seminal receptacle exhibits a combination of plesiomorphic and apomorphic characters. The arrangement of the receptacles featured in two separate chambers, including the ventro‐lateral connection of the glandular chamber to the cuticle chamber, presumably reflects an early evolutionary stage of an eubrachyuran receptacle. In contrast, the dorso‐lateral opening between both chambers, including the hook‐like projection, appears to be an apomorphic character of at least E. mascarone. J. Morphol. 277:1497–1508, 2016. © 2016 Wiley Periodicals, Inc.     

Not only for males: the pleon‐holding mechanism in female calappids (Crustacea: Decapoda: Brachyura)

Adult female Calappidae were examined with light microscopy and microcomputed tomography for the presence of a pleon‐holding mechanism. A typical press‐button consisting of a protrusion on the fifth thoracic sternite and a socket on the sixth pleon segment was found in species of the genera Calappa, Calappula, Cycloes, Mursia, and Paracyclois. Within the genus Calappa, 15 of 17 species showed a complete press‐button mechanism, whereas in two species only a sternal button or none of the holding structures could be observed. The functionality of the mechanism was assessed by manually flexing and opening the pleon. This revealed a lack of function in species with fully developed holding structures, while others exhibited full function. Additionally, signs of abrasive wear could be identified with scanning electron microscopy on the surface of the holding structures of Calappa hepatica. The documentation of pleon‐holding structures of varying degrees of functionality in adult female eubrachyurans provides new insight into a morphological characteristic known exclusively from Brachyura.     

Cleavage of trehalose-phosphate in Bacillus subtilis is catalysed by a Phospho-α-(1–1)-glucosidase encoded by the treA gene

A 2.5 kb DNA fragment contain a gene encoding a phospho-α-(1–1)-glucosidase (phosphotrehalase), designated treA, was isolated from a Bacillus subtilis chromosomal library by complementation of the tre-12 mutation. The major TreA activity was found in the cytoplasm. TreA exhibits high sequence similarity to thermostable oligo 1,6 β-glucosidases of several species and the trehalose-6-phosphate hydrolase TreC of Escherichia coli. TreA activity is induced by trehalose and repressed by glucose, fructose or mannitol. Induction by trehalose and repression by glucose are concentration dependent. The highest activity of TreA occurs 90min before the end of the exponential growth phase in crude cell extracts. The enzyme is able to cleave para-nitrophenyl-glucopyranoside and trehalose-6-phosphate but not trehalose. These results indicate that treA encodes a specific phospho-α-(1–1)-giucosidase which cleaves trehalose-6-phosphate in the cytoplasm after transport and phosphorylation of trehalose. The 5′ flanking region of treA contains an open reading frame which was partially sequenced, whose product shows about 40% identity to sucrose Enzyme II of the phospho-transferase transport system from several organisms.     

Investigation of ion binding to the cytoplasmic binding sites of the Na,K-pump

A dual-wavelength fluorimeter was constructed, which used two light emitting diodes (LEDs) to excite the fluorescence dye RH 421 alternately with two different wavelengths. The ratio of the emissions at the two excitation wavelengths provided a drift-insensitive signal, which allowed detection of very small changes of the fluorescence intensity. Those small changes were induced by ion binding and release in conformation E₁ of the Na,K-ATPase. Titration experiments were performed to determine equilibrium dissociation constants (± standard deviation) for each step in the complete binding and release sequence: 0.12 ± 0.01 mM (E₂(K₂) KE₁), 0.08 ± 0.01 mM (KE₁ E₁), 3.0 ± 0.2 mM (NaE₁ E₁), 5.2 ± 0.4 mM (Na₂E₁ NaE₁) and 6.5 ± 0.4 m_M (Na₃E₁ Na₂E₁) at pH 7.2 and T=16°C. These numbers show that the affinities of the binding sites exposed to the cytoplasm, are higher for K⁺ than for Na⁺ ions, similar to what was found on the extracellular side. The physiological requirement for extrusion of Na⁺ from the cytoplasm, and for import of K⁺ from the extracellular medium seems to be facilitated not by favorable binding affinities in state E₁ but by the two ATP-driven reaction steps of the cycle, E₂(K₂) + ATP K₂E₁ · ATP and Na₃E₁ · ATP (Na₃) E_l-P, which border the ion exchange reactions at the binding sites in conformation E₁. Correspondence to: H.-J. Apell