Right Ventricular Function Quantification in Takotsubo Cardiomyopathy Using Two-Dimensional Strain Echocardiography

Aims

This study sought to characterize global and regional right ventricular (RV) myocardial function in patients with Takotsubo cardiomyopathy (TC) using 2D strain imaging.

Methods

We compared various parameters of RV and left ventricular (LV) systolic function between 2 groups of consecutive patients with TC at initial presentation and upon follow-up. Group 1 had RV involvement and group 2 did not have RV involvement.

Results

At initial presentation, RV peak systolic longitudinal strain (RVPSS) and RV fractional area change (RVFAC) were significantly lower in group 1 (−13.2±8.6% vs. −21.8±5.4%, p = 0.001; 30.7±9.3% vs. 43.5±6.3%, p = 0.001) and improved significantly upon follow-up. Tricuspid annular plane systolic excursion (TAPSE) did not differ significantly at initial presentation between both groups (14.8±4.1 mm vs. 17.9±3.5 mm, p = 0.050). Differences in regional systolic RV strain were only observed in the mid and apical segments. LV ejection fraction (LVEF) and LV global strain were significantly lower in group 1 (36±8% vs. 46±10%, p = 0.006 and −5.5±4.8% vs. −10.2±6.2%, p = 0.040) at initial presentation. None of the parameters were significantly different between the 2 groups upon follow-up. A RVPSS cut-off value of >−19.1% had a sensitivity of 85% and a specificity of 71% to discriminate between the 2 groups.

Conclusion

In TC, RVFAC, RVPSS, LVEF and LV global strain differed significantly between patients with and without RV dysfunction, whereas TAPSE did not. 2 D strain imaging was feasible for the assessment of RV dysfunction in TC and could discriminate between patients with and without RV involvement in a clinically meaningful way.     

Marine Protected Area Networks: Assessing Whether the Whole Is Greater than the Sum of Its Parts

Anthropogenic impacts are increasingly affecting the world''s oceans. Networks of marine protected areas (MPAs) provide an option for increasing the ecological and economic benefits often provided by single MPAs. It is vital to empirically assess the effects of MPA networks and to prioritize the monitoring data necessary to explain those effects. We summarize the types of MPA networks based on their intended management outcomes and illustrate a framework for evaluating whether a connectivity network is providing an outcome greater than the sum of individual MPA effects. We use an analysis of an MPA network in Hawai''i to compare networked MPAs to non-networked MPAs to demonstrate results consistent with a network effect. We assert that planning processes for MPA networks should identify their intended outcomes while also employing coupled field monitoring-simulation modeling approaches, a powerful way to prioritize the most relevant monitoring data for empirically assessing MPA network performance.     

Uncertainties in Ecosystem Service Maps: A Comparison on the European Scale

Safeguarding the benefits that ecosystems provide to society is increasingly included as a target in international policies. To support such policies, ecosystem service maps are made. However, there is little attention for the accuracy of these maps. We made a systematic review and quantitative comparison of ecosystem service maps on the European scale to generate insights in the uncertainty of ecosystem service maps and discuss the possibilities for quantitative validation. Maps of climate regulation and recreation were reasonably similar while large uncertainties among maps of erosion protection and flood regulation were observed. Pollination maps had a moderate similarity. Differences among the maps were caused by differences in indicator definition, level of process understanding, mapping aim, data sources and methodology. Absence of suitable observed data on ecosystem services provisioning hampers independent validation of the maps. Consequently, there are, so far, no accurate measures for ecosystem service map quality. Policy makers and other users need to be cautious when applying ecosystem service maps for decision-making. The results illustrate the need for better process understanding and data acquisition to advance ecosystem service mapping, modelling and validation.     

Intraosseous Vascular Access through the Anterior Mandible – A Cadaver Model Pilot Study

Background

Several insertion sites have been described for intraosseous puncture in cases of emergencies when a conventional vascular access cannot be established. This pilot study has been designed to evaluate the feasibility of the mandibular bone for the use of an intraosseous vascular access in a cadaver model.

Methodology/Principal Findings

17 dentistry and 16 medical students participating in a voluntary course received a short introduction into the method and subsequently used the battery powered EZ-IO system with a 15 mm cannula for a puncture of the anterior mandible in 33 cadavers. The time needed to perform each procedure was evaluated. India ink was injected into the accesses and during the anatomy course cadavers were dissected to retrace the success or failure of the puncture. Dental students needed 25.5±18.9(mean±standard deviation)s and medical students 33±20.4 s for the procedure (p = 0.18). Floor of mouth extravasation occurred in both groups in 3 cases. Success rates were 82 and 75% (p = 0.93).

Conclusions/Significance

Despite floor of mouth extravasation of injected fluid into a mandibular intraosseous access might severely complicate this procedure, the anterior mandible may be helpful as an alternative to other intraosseous and intravenous insertion sites when these are not available in medical emergencies.     

Intracellular and Extracellular Carbonic Anhydrases Cooperate Non-enzymatically to Enhance Activity of Monocarboxylate Transporters

Proton-coupled monocarboxylate transporters (MCTs) are carriers of high-energy metabolites such as lactate, pyruvate, and ketone bodies and are expressed in most tissues. It has previously been shown that transport activity of MCT1 and MCT4 is enhanced by the cytosolic carbonic anhydrase II (CAII) independent of its catalytic activity. We have now studied the influence of the extracellular, membrane-bound CAIV on transport activity of MCT1/4, heterologously expressed in Xenopus oocytes. Coexpression of CAIV with MCT1 and MCT4 resulted in a significant increase in MCT transport activity, even in the nominal absence of CO₂/HCO₃⁻. CAIV-mediated augmentation of MCT activity was independent of the CAIV catalytic function, since application of the CA-inhibitor ethoxyzolamide or coexpression of the catalytically inactive mutant CAIV-V165Y did not suppress CAIV-mediated augmentation of MCT transport activity. The interaction required CAIV at the extracellular surface, since injection of CAIV protein into the oocyte cytosol did not augment MCT transport function. The effects of cytosolic CAII (injected as protein) and extracellular CAIV (expressed) on MCT transport activity, were additive. Our results suggest that intra- and extracellular carbonic anhydrases can work in concert to ensure rapid shuttling of metabolites across the cell membrane.     

Analysis of Covariation of Grain Yield and Dry Matter Yield for Breeding Dual Use Hybrid Rye

Winter rye (Secale cereale L.) is becoming increasingly important as substrate for biogas production in Central Europe. Dry matter yield has evolved as a breeding goal comparably important to the traditional grain yield. We analyzed the covariation between both traits and tested other agronomic traits for their correlation to dry matter yield that could be used for prediction of biomass yield. A set of 258 experimental hybrids were tested for dry matter yield harvested at late milk stage and grain yield harvested at full ripening at three to four locations in Germany in 2011 and 2012. We observed a wide range of dry matter yield (10–24 Mg ha^?1) and grain yield (6–15 Mg ha^?1) among testcross progenies. Genetic variances were significantly (P?<?0.01) different from zero for all traits. High entry-mean heritabilities (0.92–0.94) were found for plant height measurements and moderate heritabilities for grain and dry matter yield (0.52 and 0.49, respectively). Relative efficiencies for selection of dry matter yield estimated by second (EC 51–55) and third (EC 73) measurements of plant height were 1.24 and 0.98 respectively, compared to 0.52 for grain yield. Indirect selection for high dry matter yield using late plant height measurements should be successful. Using grain yield for indirect selection was less effective. The observed broad genetic variation for biomass yield in elite hybrid rye gives good prospects for the use as a resource of renewable energy. Plant height is a good predictor of dry matter yield but should be selected together with improved lodging resistance.     

Cloning of a Picea abies monosaccharide transporter gene and expression – analysis in plant tissues and ectomycorrhizas

Ectomycorrhizas are formed between certain soil fungi and fine roots of woody plants. An important feature of this symbiosis is the supply of photoassimilates to the fungus. Hexoses, formed from sucrose in the common apoplast at the root/fungus interface, can be taken up by both plant and fungal monosaccharide transporters. Recently we characterised a monosaccharide transporter from the ectomycorrhizal fungus Amanita muscaria. This transporter was up-regulated in mycorrhizas, thus increasing the hexose uptake capacity of the fungal partner in symbiosis. In order to characterise host (Picea abies) root monosaccharide transporters, degenerate oligonucleotide primers, designed to match conserved regions from known plant hexose transporters, were used to isolate a cDNA fragment of a transporter by PCR. This fragment was used to identify a presumably full length clone (PaMST1) in a P. abies/A. muscaria mycorrhizal cDNA library. The entire cDNA code for an open reading frame of 513 amino acids, revealing best homology to H⁺/monosaccharide transporters from Ara- bidopsis, Saccharum and Ricinus. PaMST1 was highly expressed in the hypocotyl and in roots of P. abies seedlings, but not in needles. Mycorrhiza formation led to a slight reduction of PaMST1 expression. The results are discussed with special reference to carbon allocation in ectomycorrhizas. Received: 9 October 1999 / Accepted: 22 December 1999