Abstract Funding Acknowledgements Type of funding sources: None. Background Left ventricular thrombi (LVT) after an anterior ST elevation myocardial infarction (STEMI) are usually classified as protruding or laminar according to their morphological characteristics. However, it is unknown whether this morphology has any clinical implication. Purpose Determine prognostic between laminar or protruding LVT in the community of anterior STEMI. Methods An observational cohort study on patients with LVT after anterior STEMI detected by echocardiography between 2008 and 2019 was conducted. Laminar LVT was defined as those protruding <5mm inside the cavity. Results Of 1.215 anterior STEMI patients, 121 (10%) cases presented LVT: 86 (71%) were protruding and 35 (29%) laminar. Mean follow-up was 323 ± 116 days. No differences in baseline clinical and echocardiographic characteristics were detected between both groups. However, protruding LVT patients were more frequently treated with triple therapy (71% vs 40%; p < 0.001). Laminar LVT patients presented a lower stroke rate (3% vs 16%; P = 0.042) and embolism-related rate (3% vs 19%; p = 0.024) than protruding LVT cases (see Figure). Laminar LVT was associated with lower embolism-related events during follow-up independently than left ventricular ejection fraction (LVEF) and age (OR = 0.11; 95% CI,0.12-0.94; p = 0.045). No differences were observed in laminar LVT patients in embolism-related events during follow-up between those treated with or without triple therapy (7% vs 0%; p = 0.400). Conclusions Laminar LVT after anterior STEMI presented a lower rate of embolism-related complications during follow-up compared with protruding LVT regardless of LVEF, age and even with a lower rate of triple therapy. Abstract Figure.
Pollination is crucial for biodiversity and food security. Heterogeneous agricultural landscapes have a positive effect on pollinator abundance and enhance crop production and quality. In this study, we explored the effects of three landscape features (past crop diversity measured as the Equivalent Richness of crop functional Groups in the previous year [ERGp], semi-natural habitat percentage [SNH], and mean field size [MFS]) and pollinator densities (wild bees [WB] and honey bees [HB]) on pollination and seed quantity and quality in rapeseed crops. Surveying the pollinator density in 20 rapeseed fields revealed a positive relationship with ERGp in the landscape. A pollinator exclusion experiment compared bagged and open-pollinated self-compatible rapeseed plants and revealed insect pollination effectiveness (fruits per flower and number of seeds per pod) and seed quality (oil content). Seed parameters were evaluated in relation to pollinator density (WB-HB) and landscape characteristics. The ERGp emerged as a crucial landscape feature that positively impacted WB density. When insect pollinators were excluded, plants exhibited reduced pollination effectiveness and seed quality. Analysis of open-pollinated plants highlighted ERGp as the most influential variable, positively affecting both sets of parameters. The MFS and SNH showed different but important relationships. Total tocopherol and α-tocopherol were positively correlated with pollinator density in HB, whereas WB showed a positive correlation with γ-tocopherol levels. Increased ERGp positively affected pollinator density and pollination effectiveness, thereby improving oilseed rape production quantity and quality. This study provides new insights into agroecosystem management and pollinator-friendly practices.
Abstract Background Atrial morphological parameters may influence the presence of atrial thrombus, a factor strongly associated with cardiac thromboembolism, independently of those included in the CHA2DS2-VASc risk estimation scale in patients with a history of atrial fibrillation (AF). The aim of our study was to evaluate this possible association by transthoracic echocardiography (TTE). Methods Prospective multicenter study including 401 patients with a history of AF, in which a TTE and a transesophageal echocardiogram (TEE) were performed for evaluation of atrial thrombus between 2016-2019. The parameters included in the CHA2DS2-VASc scale, the heart rhythm at the time of the study and the anticoagulant treatment performed, as well as the atrial morphological parameters were collected. Results Twenty-three patients (6%) presented with atrial thrombus in TEE. The left atrial area (28 ± 6cm2 vs 33 ± 6cm2; p < 0.001), the presence of AF during the study (83% vs 17%; p = 0.002) and CHA2DS2-VASc (1.7 ± 1.5cm2 vs 3.0 ± 1.3cm2; p < 0.001) were associated with the presence of atrial thrombus. The left atrial area was a diagnostic predictor of atrial thrombus (area under the curve = 73%; p = 0.001): a value >30cm2 presented a sensitivity of 79% and a specificity of 70% to detect its presence. Logistic regression analysis, including heart rhythm during the study and anticoagulant treatment, showed that CHA2DS2-VASc (OR = 1.5; CI95%=1.1-1.9; p = 0.003) and left atrial area >30cm2 (OR = 5.2;CI 95% =1.7-16.0; p = 0.004) were independent predictors of atrial thrombus presence. Conclusions The left atrial area is associated with the presence of atrial thrombus in patients with a history of AF independently of the CHA2DS2-VASc scale, heart rhythm during the study, and anticoagulant treatment. This parameter should be evaluated to be included in the cardioembolic risk scales.
Abstract Background Left ventricular thrombi (LVT) after an anterior ST elevation myocardial infarction (STEMI) are usually classified as protruding or laminar according to their morphological characteristics. However, it is unknown whether this morphology has any clinical implication. Purpose Determine prognostic between laminar or protruding LVT in the community of anterior STEMI. Methods An observational cohort study on patients with LVT after anterior STEMI detected by echocardiography between 2008 and 2019 was conducted. Laminar LVT was defined as those protruding <5mm inside the cavity. Results Of 1.215 anterior STEMI patients, 121 (10%) cases presented a LVT: 86 (71%) were protruding and 35 (29%) laminar. Mean follow-up was 323±116 days. No differences in baseline clinical and echocardiographic characteristics were detected between laminar or protruding LVT groups. However, protruding LVT patients were more frequently treated with triple therapy (71% vs 40%; p<0.001). Laminar LVT patients presented a lower stroke rate (3% vs 16%; P=0.042) and embolism-related rate (3% vs 19%; p=0.024) than protruding LVT cases. Kaplan-Meier analysis demonstrated significant differences in embolism-related event rate between the 2 groups (p=0.003) during the follow-up period. Laminar LVT was associated with lower embolism-related events during follow-up independently than left ventricular ejection fraction (LVEF) and age (HR=0.17; 95% CI,0.10–0.29; p<0.001). No differences were observed in laminar LVT patients in embolism-related events during follow-up between those treated with or without triple therapy (7% vs 0%; p=0.400). Conclusions Laminar LVT after anterior STEMI presented a lower rate of embolism-related complications during follow-up compared with protruding LVT regardless of LVEF, age and even with a lower rate of triple therapy. Figure 1. Kaplan-Meier curve showing cumulative probability of embolism-related event rate after anterior STEMI according to LVT morphology at 1 year. Funding Acknowledgement Type of funding source: None
Global change is exerting a major effect on plant communities, altering their potential capacity for adaptation. Here, we aimed at unveiling mechanisms of adaptation to high altitude in an endemic long-lived monocarpic, Saxifraga longifolia, by combining demographic and physiological approaches. Plants from three altitudes (570, 1100, and 2100 m above sea level [a.s.l.]) were investigated in terms of leaf water and pigment contents, and activation of stress defense mechanisms. The influence of plant size on physiological performance and mortality was also investigated. Levels of photoprotective molecules (α-tocopherol, carotenoids, and anthocyanins) increased in response to high altitude (1100 relative to 570 m a.s.l.), which was paralleled by reduced soil and leaf water contents and increased ABA levels. The more demanding effect of high altitude on photoprotection was, however, partly abolished at very high altitudes (2100 m a.s.l.) due to improved soil water contents, with the exception of α-tocopherol accumulation. α-Tocopherol levels increased progressively at increasing altitudes, which paralleled with reductions in lipid peroxidation, thus suggesting plants from the highest altitude effectively withstood high light stress. Furthermore, mortality of juveniles was highest at the intermediate population, suggesting that drought stress was the main environmental driver of mortality of juveniles in this rocky plant species. Population structure and vital rates in the high population evidenced lower recruitment and mortality in juveniles, activation of clonal growth, and absence of plant size-dependent mortality. We conclude that, despite S. longifolia has evolved complex mechanisms of adaptation to altitude at the cellular, whole-plant and population levels, drought events may drive increased mortality in the framework of global change.
Aorto-cavitary fistula is an infrequent complication in infective endocarditis as well as multiple fistula, being the most rare among intracardiac fistulas. The pronogsis of infective endocarditis worsens if there are fistulas associated, exceeding the mortality over 40% despite aggressive surgical treatment. Although transoesophageal echocardiography offers a better sensitivity and specificity, sometimes transthoracic echocardiography is enough to obtain these infrequent pictures that we present.
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The measurement of malondialdehyde (MDA) content has long been used as a lipid peroxidation marker in studies related to oxidative stress and redox signaling, particularly in those studies focused on plant responses to abiotic and biotic stresses. A search for “malondialdehyde” and
Besides stomata, the photosynthetic CO2 pathway also involves the transport of CO2 from the sub-stomatal air spaces inside to the carboxylation sites in the chloroplast stroma, where Rubisco is located. This pathway is far to be a simple and direct way, formed by series of consecutive barriers that the CO2 should cross to be finally assimilated in photosynthesis, known as the mesophyll conductance (gm). Therefore, the gm reflects the pathway through different air, water and biophysical barriers within the leaf tissues and cell structures. Currently, it is known that gm can impose the same level of limitation (or even higher depending of the conditions) to photosynthesis than the wider known stomata or biochemistry. In this mini-review, we are focused on each of the gm determinants to summarize the current knowledge on the mechanisms driving gm from anatomical to metabolic and biochemical perspectives. Special attention deserve the latest studies demonstrating the importance of the molecular mechanisms driving anatomical traits as cell wall and the chloroplast surface exposed to the mesophyll airspaces (Sc/S) that significantly constrain gm. However, even considering these recent discoveries, still is poorly understood the mechanisms about signaling pathways linking the environment a/biotic stressors with gm responses. Thus, considering the main role of gm as a major driver of the CO2 availability at the carboxylation sites, future studies into these aspects will help us to understand photosynthesis responses in a global change framework.