The properties of ASCs that make them particularly interesting to

The properties of ASCs that make them particularly interesting to the transplant surgeon will then be covered. These properties include regeneration of native tissue, support of microvasculature,

and immunomodulation. These properties will undoubtedly expand the future utility of these cells.

Recent findings

Recent literature demonstrates that ASCs are able to differentiate into phenotypes resembling hepatic and pancreatic lineages. In addition, several groups have shown that ASCs possess immunomodulatory properties similar to bone marrow-derived mesenchymal ACY-241 chemical structure stem cells. Several clinical case reports also suggest that ASCs are an effective treatment option for graft-versus-host disease.


Due to their ability to differentiate into pertinent target lineages, their ability to enhance angiogenesis, and their ability to impact immunologic responses,

ASCs may prove clinically useful for the transplant surgeon.”
“Purpose of reviewTo buy 17DMAG detail recent developments linking modifiable youth risk factors with preclinical markers of cardiovascular disease such as carotid artery intima-media thickness, pulse-wave velocity (PVW) and large artery stiffness, brachial artery flow-mediated dilatation, left ventricular geometry, and coronary artery calcification in adulthood.Recent findingsPopulation-based data from prospective cohort studies beginning in youth with follow-up into adulthood have shown that the modifiable youth risk factors of elevated blood lipids, blood pressure, and adiposity, smoking (active and passive), metabolic disorders, physical inactivity, low cardiorespiratory fitness, and diet associate with preclinical markers of cardiovascular disease in adulthood. The data suggest that, in some instances, those who amend their trajectory by not maintaining these risk factors into adulthood experience reductions

in preclinical markers to levels associated with never having had the risk factor.SummaryThough avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. Health-enhancing changes in the rates of active and passive smoking, adiposity, increased physical activity, accentuated fitness, modified diet, and socioeconomic position in the transition from youth to adulthood might be important in modifying an individual’s trajectory from high risk in youth to low risk in adulthood.”
“Three new flavonol glycosides, nervilifordizins A-C (1-3), were isolated from the whole plant of Nervilia fordii.

31 +/- 0 90 N), followed by the stud (5 77 +/- 1 81 N) and the bu

31 +/- 0.90 N), followed by the stud (5.77 +/- 1.81 N) and the buckle (7.78 +/- 1.58 N). For the hook (8.98 +/- 1.02 N) and screw (9.98 +/- 2.01 N), all the models tore through. The 12-mm point required the greatest force to tear through (17.31 +/- 2.33 N), followed by the 8- (13.64

+/- 2.42 N) and 4-mm points (9.98 +/- 2.01 N).

Conclusion The 4-mm point is recommended for hoops, buckles, and studs, and the 8-mm point or higher is recommended for screws and hooks.”
“Study Design. Blinded.

Objective. Examination of a new radiologic interpretation technique for distinguishing osteoporotic fractures from Scheuermann disease.

Study of Background Data. Osteoporotic vertebral fractures are a major clinical problem. A variety of empirically-derived standards have been suggested for their recognition,

but the accepted limits for normal variation have been somewhat arbitrary. This report presents and examines a new radiologic Selleck MK-8931 technique for distinguishing osteoporotic thoracic vertebral fractures from Scheuermann disease.

Methods. Vertebral KPT-8602 body height measurements (anterior, middle, and posterior) of thoracic vertebrae T6-T10 in 44 individuals with osteoporotic fractures, 28 individuals with Scheuermann disease and a control group of 120 individuals with unaffected vertebrae, were taken from lateral chest radiographs and measured by a digital caliper. For each vertebra, 4 indexes were calculated: 3 primary derivatives; anterior height/posterior

height; anterior height/mid height (A/M); mid height/ posterior height (M/P); and a secondary derivate index (A/M)/(M/P). Qualitative analysis was subsequently carried out, using lateral spine radiographs of individuals with osteoporotic vertebral fractures and individuals with Scheuermann disease. Statistical analysis included analysis of variance, paired see more t tests and t tests.

Results. The second derivative (A/M)/(M/P) indexes of thoracic vertebrae T6-T10 were significantly greater in the osteoporosis group than in the control and Scheuermann groups (P < 0.05). Contrary to the control and Scheuermann groups, the M/P indexes (T6 – T10) were significantly smaller than the A/M indexes in the osteoporosis group. The anterior height/ posterior height indexes (T6 – T10) in all 3 groups were statistically indistinguishable. Qualitative analysis showed that the intersection of an anterior-midpoint line and a posterior-midpoint line drawn on the superior vertebral body surface (T6 – T10) created an “”angle of depression”" in the osteoporosis group whereas an “”angle of elevation”" was identified in the Scheuermann group.

Conclusion. Second derivative indexes of vertebral body height parameters allow identification of vertebrae with osteoporotic compression fractures and their distinction from vertebrae with Scheuermann disease.”
“Phenol-urea-formaldehyde (PUF) resins were synthesized by reacting mixture Of methylolureas (MMU), phenol, and formaldehyde.

Through this investigation of PLGA/rifampin electrospun webs, we

Through this investigation of PLGA/rifampin electrospun webs, we found that the in vitro degradation AZD6094 datasheet reached approximately 60% in 10 days, and the drug release from the webs showed a fast and constant profile suitable for wound-dressing applications. Also, we observed that both the web-degradation rate and the drug-release rate increased as the drug concentration in the PLGA/rifampin electrospun webs and the content level of glycolide units in the PLGA polymer matrix increased. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“PURPOSE: To evaluate

the visual and refractive outcomes and quality of life after implantation of a multifocal intraocular lens (IOL) with a surface-embedded near section.

SETTING: Private practice, United Kingdom.

DESIGN: Case series.

METHODS: This study comprised patients who had implantation of a Lentis Mplus multifocal IOL after phacoemulsification. The main outcome measures were refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities

(logMAR), uncorrected (UNVA) and corrected (CNVA) near visual acuities (M notation), reading speed (Radner reading chart), contrast sensitivity (Pelli-Robson), and Quality of Life Impact of Refractive Correction (QIRC) questionnaire scores. A +3.00 diopter (D) reading addition (add) IOL was placed in the nondominant eye and a +1.50 D add IOL in the dominant eye.

RESULTS: The study enrolled 44 eyes of 22 patients (mean age 59.9 years). The mean values 3 months postoperatively selleck kinase inhibitor were UDVA, 0.04 logMAR +/- 0.25 (SD); contrast sensitivity, 1.57 +/- 0.13 logCS; near vision, M0.75 +/- 0.33 at 32 cm and M0.90 +/- 0.27 at 66 cm; reading speed, PD98059 manufacturer 161.74 words/minute; sphere, 0.08 +/- 0.58 D; astigmatism, -0.60 +/- 0.50 D; CDVA, -0.08 +/- 0.07 logMAR. With best correction, intermediate (66 cm) and near (32 cm) vision were M0.89 +/- 0.26 and M0.74 +/- 0.32, respectively. The mean binocular UNVA

at the preferred viewing distance was M0.57 +/- 0.18, improving to M0.54 +/- 0.19 with distance correction. The mean QIRC score improved from 42.15 +/- 4.66 to 51.14 +/- 8.22.

CONCLUSIONS: Postoperative visual acuity was good with high-level contrast sensitivity, producing significant improvement in quality of life.”
“Purpose: The aim of this study is to assess the effect of comorbidities on risk of readmission to an intensive care unit (ICU) and the excess hospital mortality associated with ICU readmissions.

Materials and Methods: A cohort study used clinical data from a 22-bed multidisciplinary ICU in a university hospital and comorbidity data from the Western Australian hospital morbidity database.

Results: From 16 926 consecutive ICU admissions between 1987 and 2002, and 654 (3.9%) of these patients were readmitted to ICU readmissions within the same hospitalization.

“This article gives an overview of some of the ongoing cha

“This article gives an overview of some of the ongoing challenges that are faced in the prevention, diagnosis and treatment of malaria.

Malaria causes approximately 881,000 deaths every year, with nine out of ten deaths occurring in sub-Saharan Africa. In addition to the human burden of malaria, the economic burden is vast. It is thought to cost African

countries more than US$12 billion every year in direct losses.

However, great progress in malaria control has been made in some highly endemic countries. Vector control is assuming a new importance with the significant PF-6463922 reductions in malaria burden achieved using combined malaria control interventions in countries such as Zanzibar, Zambia and Rwanda.

The proportion of patients treated for malaria who have a confirmed diagnosis is low in Africa compared with other regions of the world, with the result that anti-malarials

could be used to treat patients without malaria, NSC 19893 especially in areas where progress has been made in reducing the malaria burden and malaria epidemiology is changing. Inappropriate administration of anti-malarials could contribute to the spread of resistance and incurs unnecessary costs.

Parasite resistance to almost all commonly used anti-malarials has been observed in the most lethal parasite species, Plasmodium falciparum. This has presented a major barrier to successful disease management in malaria-endemic areas.

ACT (artemisinin-based combination therapy) has made a significant contribution to malaria control and to reducing disease transmission through reducing gametocyte carriage. Administering ACT to infants and small children can be difficult and time consuming. Specially formulating anti-malarials for this vulnerable population

is vital to ease administration and help ensure that an accurate dose is received.

Education of healthworkers and communities about malaria prevention, diagnosis and treatment is a vital component of effective case management, especially as diagnostic policies change. Preventing resistance emerging to both BMS-777607 cost ACT and insecticides used in vector control remains an ongoing challenge in an era of changing malaria epidemiology.”

Repeat treatments of nonpermanent dermal fillers are used in the long-term treatment of wrinkles and folds and to volumize.


To determine the safety and effectiveness of a nonanimal-sourced hyaluronic acid (HA) (which uses a cohesive polydensified matrix (CPM) technology [CPMHA]) for the treatment of nasolabial folds (NLFs) during an 18-month open-label extension trial.


Ninety-five of 118 subjects continued with this optional open-label extension of a split-face, double-blind trial. All subjects received CPMHA in both NLFs at 24 weeks after treatment in this study and were assessed at weeks 32, 48, 72, and 96. Touch-ups were allowed for optimal correction.

Isotherm studies revealed that the adsorption of metal ions onto

Isotherm studies revealed that the adsorption of metal ions onto CCS better followed the Langmuir isotherm and the DubininRadushkevich NU7026 inhibitor isotherm with adsorption maximum capacities of about 80.0 and 47.0 mg/g for Pb(II) and Cd(II) ions, respectively. The mean free energies of adsorption were found to be between 8 and 16 kJ/mol for Pb(II) and Cd(II) ions; this suggested that the adsorption of Pb(II) and Cd(II) ions onto CCS occurred with an ion-exchange process. For two-target heavy-metal ion adsorption, a pseudo-second-order model and intraparticle diffusion seem significant in the rate-controlling step, but the pseudo-second-order

chemical reaction kinetics provide the best correlation for the experimental data. The enthalpy change for the process was found to be exothermic, and the ?S? values were calculated to be negative for the adsorption of Pb(II) and Cd(II) ions onto CCS. Negative free enthalpy change values indicated that the adsorption process was feasible. The studies of the kinetics, isotherm, and thermodynamics indicated that the adsorption of CCS was more effective for Pb(II) ions than for Cd(II) ions. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2011″
“We describe a case of oral hairy leukoplakia that presented with an atypical appearance in a patient on long-term anticonvulsant

treatment with an aromatic antiepileptic, lamotrigine. Recent medical history was also significant for recurrent respiratory tract infections requiring treatment β-Nicotinamide research buy with oral antibiotics. Immunologic investigations revealed inverted CD4/CD8 ratio, mild hypogammaglobulinemia, and poor specific antibody titers. Combined immune deficiency caused by long-term treatment with lamotrigine Selleckchem Belnacasan was suspected after other known factors and conditions (including retroviral infection) leading to acquired immune deficiency were excluded.

Withdrawal of lamotrigine resulted in complete resolution of oral hairy leukoplakia. There was no significant improvement in immunoglobulin levels. The effect of lamotrigine and other aromatic antiepileptics on the immune system should be considered in a patient presenting with otherwise unexplained oral hairy leukoplakia. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:e17-e23)”
“Genetic characterization of wild-type measles viruses (MVs) is an important component of laboratory surveillance of measles. In this study, a phylogenetic analysis was performed of the nucleoprotein gene sequences of 228 MVs isolated in the Russian Federation between 2003 and 2007. Five genotypes, D4, D5, D6, D8, and H1, were detected. From 1999 through the first 6 months of 2003, the most prevalent genotype in the European part of Russia was D4. All genotype D4-type viruses were closely related to each other (with overall sequence diversity of <= 0.9%), suggesting the presence of a single endemic MV strain.

Primary efficacy variable was change from baseline in UUI episode

Primary efficacy variable was change from baseline in UUI episodes/week at week 12. Urodynamic assessments at baseline and weeks 12 and 36 included maximum cystometric capacity (MCC) and volume at first involuntary detrusor contraction (IDC). Results: 76.0% of patients had

baseline DO. Changes from baseline in MCC and volume at first IDC with onabotulinumtoxinA >= 100 U were superior to placebo at week 12, generally decreasing by week 36. Significant dose-dependent increases in MCC were observed for all onabotulinumtoxinA doses at week 12, and for 150, 200, and 300 U at week 36. Data suggested a dose-response relationship. At week 12 on diary, 15.9% of placebo and 29.8-57.1% of onabotulinumtoxinA 50-300 U recipients, respectively, did not demonstrate UUI.

OnabotulinumtoxinA doses > 150 U were more commonly associated with post-void residual urine volumes AS1842856 > 200 ml. Conclusions: Improvements in urodynamic parameters and clinical outcomes generally trended together following onabotulinumtoxinA treatment. This therapy improved key urodynamic parameters in patients with idiopathic OAB and UUI, with no differences in outcomes between those with and those without baseline DO. Therefore, successful idiopathic OAB treatment with onabotulinumtoxinA does not appear to be related to pretreatment finding of DO. Neurourol. Urodynam. 30:556-562, 2011. (C) 2011 Wiley-Liss, Inc.”
“Purpose: To evaluate in vitro (using human hepatoma HepG2 cells) and in vivo (using mouse liver with diethlynitrosamine (DEN)-induced hepatocarcinogenesis) effect of a standardized decoction on the expression of p53 (tumour suppressor) and p21 (cyclin kinase Selleckchem MS-275 inhibitor) genes with the long-term goal of Napabucasin developing the formulation into a globally acceptable therapy for hepatocellular carcinoma (HCC).

Methods: The effect of the decoction on (a) mRNA and (b) protein expression of p53 and p21 genes in HepG2 cells and mouse livers with DEN-induced early

hepatocarcinogenesis were evaluated by (a) reverse transcription PCR (RT-PCR) and (b) immunohistochemical and Western blot analysis, respectively.

Results: The results demonstrated that the decoction significantly (p < 0.001) enhanced the expression of p53 and p21 genes in a time- and dose-dependent manner in HepG2 cells. A dose of 75 mu g/ml significantly increased p53 mRNA at 24 and 48 h and p21 mRNA at 12, 24, 48 h of incubation with the decoction (p < 0.01). Induction of hepatocarcinogenesis in mice significantly increased hepatic expression of both p53 and p21 compared to distilled water control (p < 0.001), while treatment with the decoction further enhanced expression of both genes in DEN-induced hepatocarcinogenesis (p < 0.01).

Conclusion: Overall, the findings demonstrate that the decoction may mediate its reported antihepatocarcinogenic effect, at least in part, through the modulating activities of genes involved in tumour suppression and cell cycle arrest.

The aim of the study was to use non-invasive thoracic electrical

The aim of the study was to use non-invasive thoracic electrical bioimpedance (TEB) to evaluate hemodynamic modulators and subsequent hemodynamic status in uncontrolled hypertensive patients, receiving at least two antihypertensive drugs. A number of 134 uncontrolled hypertensive patients with essential hypertension were evaluated in nine European Hypertension Excellence centers by means of TEB (the HOTMAN (R) System). Baseline office systolic and diastolic BP averaged 156/92 mmHg. Hemodynamic measurements show that almost all patients (98.5%) presented at least one altered hemodynamic modulator: intravascular hypervolemia (96.4%) and/or hypoinotropy (42.5%) and/or

see more vasoconstriction (49.3%). Eleven combinations of hemodynamic modulators were present in the study population, the most common being concomitant hypervolemia, hypoinotropy and vasoconstriction in 51(38%) patients. Six different hemodynamic states (pairs of mean arterial pressure and stroke index) were found. Data suggest that there is a strong relation between hypertension and abnormal hemodynamic modulators. This method might be helpful for treatment individualization of hypertensive patients.”
“Aims To determine predictors of health care utilization in women

with urinary incontinence (UI) from the population to specialty care. Methods: The General Longitudinal Overactive Bladder Evaluation- UI is a population- based study on the natural history of UI in women >= 40 years of age. Prevalence of UI was estimated using SNX-5422 order the Bladder Health Survey (BHS). Survey data were linked with electronic health records (EHRs) to examine factors associated with a clinical UI diagnosis using logistic regression. Risk factors analyzed EVP4593 manufacturer included: UI symptoms, subtypes, bother, severity, duration, and effect on quality of life, and demographic and other health characteristics. All statistical tests were twosided with a P-value < 0.05 being significant. Results: The overall prevalence of any UI based on responses to the BHS was

1,618/4,064 (40%). Of the 1,618 women with UI, there were only 398 (25%) women with EHR (clinical) diagnosis of UI. Women with UI versus those without UI were more likely to be have a BMI > 25 kg/m(2) (70% vs. 58%), more likely to be parous (91% vs. 87%) and college educated (54% vs. 46%), P < 0.001. After adjusting for confounders in the model, variables significantly associated with clinical UI diagnosis included: older age (OR 1.96), higher parity (> 1 birth) (OR 1.76), higher urgency UI (OR 1.08), adaptive behavior (OR 1.2), and UI bother scores (OR 1.01), as well as more frequent outpatient visits (OR 1.03), P < 0.05. Conclusions: UI is a highly prevalent condition with only a minority of women seeking care.

Longer duration of bisphosphonate therapy is associated with a hi

Longer duration of bisphosphonate therapy is associated with a higher risk of atypical femur fractures. Combination therapy with teriparatide and denosumab appears to increase bone mineral density to a greater extent than either therapy alone in postmenopausal women at high risk for fracture. There are several novel therapies under investigation for the treatment of osteoporosis, which are in various stages of development. Nonadherence to osteoporosis therapies continues to be a major problem in selleck chemicals clinical practice.SummaryThere are numerous effective pharmacologic treatment

options for postmenopausal osteoporosis. Bisphosphonate drug holidays continue to be an area of significant debate.”
“BackgroundMany patients treated with oral anticoagulants for atrial fibrillation undergo percutaneous stent implantation, where dual antiplatelet therapy (DAPT) is also recommended. The current evidence to support triple oral antithrombotic

buy MGCD0103 therapy (TOAT) in these patients is limited, and new strategies are being discussed to optimize outcomes.

HypothesisThere will be variation in antithrombotic strategies in patients with atrial fibrillation needing stenting.

MethodsWe surveyed US-based cardiologists serving as clinical investigators in academic sites and posted an online question of the month on .

ResultsSeventy-five (10.7%) responses were received to the email survey and 119 to the online question. Bare-metal stenting (BMS) was a priori preferred over drug-eluting stenting (DES) for 50.6% of patients. Only 8.8% of the responders chose newer anticoagulants in addition to DAPT as the preferred oral anticoagulant. For duration of TOAT, 79.4% of physicians recommended stopping

DAPT at 1 month when BMS was used in patients presenting without acute coronary syndrome (ACS) vs 57.4% in patients with ACS. In patients implanted learn more with a DES, 73.5% and 76.5% preferred stopping DAPT at 6 to 12 months (no ACS vs ACS, respectively). When asked which of the 2 antiplatelet agents they would recommend stopping after the above durations, 50% chose to quit aspirin.

ConclusionsThe survey highlights an interest in the new strategy of dropping aspirin, but the lack of concrete evidence triggers undesired diversity in clinical approaches. High-quality data on the efficacy and safety of such interventions are needed to further consolidate these approaches.”
“Purpose of review

To examine recent advances in the pathophysiology and therapy of pediatric vasculitis.

Recent findings

The past 2 years have been marked by significant progress in extending novel techniques to the investigation of the two most common pediatric vasculitis syndromes, Henoch-Schonlein purpura. and Kawasaki disease. Study of other vasculitides, such as Wegener granulomatosis, Churg-Strauss syndrome, and microscopic polyangiitis, is impeded by the small number of pediatric patients.

Most of these experimental animals will be in private production

Most of these experimental animals will be in private production herds and flocks, even when work is publicly funded. 5) The trend toward more interdisciplinary research will continue, especially considering interactions among reproduction, health, nutrition, selective breeding,

management factors, and societal concerns; reductionist research probing deeper into cellular and molecular mechanisms will remain important, as will whole-animal approaches. 6) Agricultural animals are a product of evolution plus selective breeding. Insights drawn from the former will aid progress in the latter. One focus of research in physiology and endocrinology will be understanding heterosis, inbreeding depression, and epigenetic see more effects as it becomes possible to manipulate and identify the allelic structure of Selleck Alvocidib individual animals. 7) Additional insightful concepts will evolve that will simplify thinking in some respects, such as the maternal to embryonic shift in transcribed RNA in early embryos; however, animal biology will turn out to be even more complex than most of us currently imagine.”
“The electronic structure of Vanadium pentoxide (V2O5), a transition metal oxide with an exceedingly large work function of

7.0 eV, is studied via ultraviolet, inverse and x-ray photoemission spectroscopy. Very deep lying electronic states with electron affinity and ionization energy (IE) of 6.7 eV and 9.5 eV, respectively, are found. Contamination due to air exposure changes the electronic structure due to the partial reduction of vanadium to V+4 state. It is shown that V2O5 is a n-type material that can be used for efficient hole-injection into materials with an IE larger than 6 eV, such as 4,4′-Bis(N-carbazolyl)-1,1′-bipheny (CBP). The formation of an interface dipole and band bending is found to lead to a very small energy barrier between

the transport levels at the V2O5/CBP interface. (C) 2011 American Institute of Physics. [doi:10.1063/1.3611392]“
“Phosphatase AZD1208 mw and tensin homolog (PTEN) gene mutations are associated with a spectrum of clinical disorders characterized by skin lesions, macrocephaly, hamartomatous overgrowth of tissues, and an increased risk of cancers. Autism has rarely been described in association with these variable clinical features. At present, 24 patients with phosphatase and tensin homolog gene mutation, autism, macrocephaly, and some clinical findings described in phosphatase and tensin homolog syndromes have been reported in the literature. We describe a 14-year-old boy with autistic disorder, focal epilepsy, severe and progressive macrocephaly, and multiple papular skin lesions and palmoplantar punctate keratoses, characteristic of Cowden syndrome. The boy has a de novo phosphatase and tensin homolog gene mutation. Our patient is the first case described to present a typical Cowden syndrome and autism associated with epilepsy.”
“Eye injuries come at a high cost to society and are avoidable.

(C) 2011 American Institute of Physics [doi: 10 1063/1 3569847]“

(C) 2011 American Institute of Physics. [doi: 10.1063/1.3569847]“
“Esca is a destructive disease that affects vineyards leading to important losses in wine production. Information about the response of Vitis vinifera plants to this disease is scarce, particularly concerning changes in plant metabolism. In order to study the metabolic changes in Vitis plants affected by esca, leaves from both infected and non-affected cordons of V. vinifera cv. Alvarinho (collected in the Vinho Verde region, Portugal) were analysed. The metabolite composition of leaves from infected

cordons with visible symptoms [diseased leaves (dl)] and from asymptomatic cordons [healthy leaves (hl)] was evaluated by 1D and 2D

(1)H-nuclear magnetic GSI-IX phosphatase inhibitor resonance (NMR) spectroscopy. Principal component analysis (PCA) of the NMR spectra showed a clear separation between dl and hl leaves, indicating differential compound production due to the esca disease. NMR/PCA analysis allowed the identification of specific compounds characterizing each group, and the corresponding metabolic pathways are discussed. Altogether, the study revealed a significant increase of phenolic compounds in dl, compared with hl, accompanied by a decrease in carbohydrates, suggesting that dl are rerouting carbon and energy from primary to secondary metabolism. Other metabolic alterations detected comprised increased levels of methanol, alanine, and gamma-aminobutyric acid in dl, which might be the result of Acadesine chemical structure the activation of other defence mechanisms.”
“Background: The purpose of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) in terms

of outflow tract gradient reduction and functional improvement in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) requiring implantable cardioverter-defibrillator (ICD) implantation.

Methods: Eleven consecutive symptomatic HOCM patients with a significant (>= 40 mmHg) gradient and indications for ICD, but without indications for resynchronization, underwent CRT-D implantation. Nine of them (four female, median age of 50 years) in whom the procedure succeeded were screened for New York Heart Association (NYHA) class, outflow gradient, mechanical dyssynchrony, QRS-width change, and 6-minute walking distance (6MWD) and peak oxygen consumption (VO2peak) improvement after 6 months and remotely.

Results: After 6 months of pacing, NYHA class decreased (median 1 vs 2, respectively); peak (33 vs 84 mmHg) and mean (13 vs 38 mmHg) outflow tract gradients were reduced; and QRS width (143 vs 105 ms), intraventricular dyssynchrony (35 vs 55 ms), and VO(2)peak (19.5 vs 14.2 mL/kg/min) increased significantly (all P < 0.05) compared to baseline. In six of nine patients (67%), the peak gradient was reduced > 50% and reached < 40 mmHg.