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Borsányi S, Fodor Z, Guenther JN, Kara R, Katz SD, Parotto P, Pásztor A, Ratti C, Szabó KK. Lattice QCD Equation of State at Finite Chemical Potential from an Alternative Expansion Scheme. Phys Rev Lett 2021; 126:232001. [PMID: 34170171 DOI: 10.1103/physrevlett.126.232001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
In this Letter, we introduce a novel scheme for extrapolating the equation of state of QCD to finite chemical potential that features considerably improved convergence properties and allows us to extend its reach to unprecedentedly high baryonic chemical potentials. We present continuum extrapolated lattice results for the new expansion coefficients and show the thermodynamic observables up to μ_{B}/T≤3.5. This novel expansion does not suffer from the shortcomings that characterize the traditional Taylor expansion method, such as difficulties inherent in performing such an expansion with a limited number of coefficients and the poor signal-to-noise ratio that affects Taylor coefficients determined from lattice calculations.
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Affiliation(s)
- S Borsányi
- University of Wuppertal, Department of Physics, Wuppertal D-42119, Germany
| | - Z Fodor
- University of Wuppertal, Department of Physics, Wuppertal D-42119, Germany
- Pennsylvania State University, Department of Physics, State College, Pennsylvania 16801, USA
- Institute for Theoretical Physics, ELTE Eötvös Loránd University, Pázmány Péter sétány 1/A, H-1117 Budapest, Hungary
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - J N Guenther
- Aix Marseille Université, Université de Toulon, CNRS, CPT, Marseille, France
| | - R Kara
- University of Wuppertal, Department of Physics, Wuppertal D-42119, Germany
| | - S D Katz
- Eötvös University, Budapest 1117, Hungary
| | - P Parotto
- University of Wuppertal, Department of Physics, Wuppertal D-42119, Germany
| | - A Pásztor
- Eötvös University, Budapest 1117, Hungary
| | - C Ratti
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - K K Szabó
- University of Wuppertal, Department of Physics, Wuppertal D-42119, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52425 Jülich, Germany
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2
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Borsanyi S, Fodor Z, Guenther JN, Hoelbling C, Katz SD, Lellouch L, Lippert T, Miura K, Parato L, Szabo KK, Stokes F, Toth BC, Torok C, Varnhorst L. Leading hadronic contribution to the muon magnetic moment from lattice QCD. Nature 2021; 593:51-55. [PMID: 33828303 DOI: 10.1038/s41586-021-03418-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 03/04/2021] [Indexed: 02/02/2023]
Abstract
The standard model of particle physics describes the vast majority of experiments and observations involving elementary particles. Any deviation from its predictions would be a sign of new, fundamental physics. One long-standing discrepancy concerns the anomalous magnetic moment of the muon, a measure of the magnetic field surrounding that particle. Standard-model predictions1 exhibit disagreement with measurements2 that is tightly scattered around 3.7 standard deviations. Today, theoretical and measurement errors are comparable; however, ongoing and planned experiments aim to reduce the measurement error by a factor of four. Theoretically, the dominant source of error is the leading-order hadronic vacuum polarization (LO-HVP) contribution. For the upcoming measurements, it is essential to evaluate the prediction for this contribution with independent methods and to reduce its uncertainties. The most precise, model-independent determinations so far rely on dispersive techniques, combined with measurements of the cross-section of electron-positron annihilation into hadrons3-6. To eliminate our reliance on these experiments, here we use ab initio quantum chromodynamics (QCD) and quantum electrodynamics simulations to compute the LO-HVP contribution. We reach sufficient precision to discriminate between the measurement of the anomalous magnetic moment of the muon and the predictions of dispersive methods. Our result favours the experimentally measured value over those obtained using the dispersion relation. Moreover, the methods used and developed in this work will enable further increased precision as more powerful computers become available.
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Affiliation(s)
- Sz Borsanyi
- Department of Physics, University of Wuppertal, Wuppertal, Germany
| | - Z Fodor
- Department of Physics, University of Wuppertal, Wuppertal, Germany. .,Jülich Supercomputing Centre, Forschungszentrum Jülich, Jülich, Germany. .,Department of Physics, Pennsylvania State University, University Park, PA, USA. .,Institute for Theoretical Physics, Eötvös University, Budapest, Hungary. .,Department of Physics, University of California, San Diego, La Jolla, CA, USA.
| | - J N Guenther
- Department of Physics, University of Regensburg, Regensburg, Germany.,Aix Marseille Université, Université de Toulon, CNRS, CPT, IPhU, Marseille, France
| | - C Hoelbling
- Department of Physics, University of Wuppertal, Wuppertal, Germany
| | - S D Katz
- Institute for Theoretical Physics, Eötvös University, Budapest, Hungary
| | - L Lellouch
- Aix Marseille Université, Université de Toulon, CNRS, CPT, IPhU, Marseille, France
| | - T Lippert
- Department of Physics, University of Wuppertal, Wuppertal, Germany.,Jülich Supercomputing Centre, Forschungszentrum Jülich, Jülich, Germany
| | - K Miura
- Aix Marseille Université, Université de Toulon, CNRS, CPT, IPhU, Marseille, France.,Helmholtz Institute Mainz, Mainz, Germany.,Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya, Japan
| | - L Parato
- Aix Marseille Université, Université de Toulon, CNRS, CPT, IPhU, Marseille, France
| | - K K Szabo
- Department of Physics, University of Wuppertal, Wuppertal, Germany.,Jülich Supercomputing Centre, Forschungszentrum Jülich, Jülich, Germany
| | - F Stokes
- Jülich Supercomputing Centre, Forschungszentrum Jülich, Jülich, Germany
| | - B C Toth
- Department of Physics, University of Wuppertal, Wuppertal, Germany
| | - Cs Torok
- Jülich Supercomputing Centre, Forschungszentrum Jülich, Jülich, Germany
| | - L Varnhorst
- Department of Physics, University of Wuppertal, Wuppertal, Germany.,Aix Marseille Université, Université de Toulon, CNRS, CPT, IPhU, Marseille, France
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Durr S, Fodor Z, Hoelbling C, Katz SD, Krieg S, Lellouch L, Lippert T, Metivet T, Portelli A, Szabo KK, Torrero C, Toth BC, Varnhorst L. Lattice Computation of the Nucleon Scalar Quark Contents at the Physical Point. Phys Rev Lett 2016; 116:172001. [PMID: 27176514 DOI: 10.1103/physrevlett.116.172001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Indexed: 06/05/2023]
Abstract
We present a QCD calculation of the u, d, and s scalar quark contents of nucleons based on 47 lattice ensembles with N_{f}=2+1 dynamical sea quarks, 5 lattice spacings down to 0.054 fm, lattice sizes up to 6 fm, and pion masses down to 120 MeV. Using the Feynman-Hellmann theorem, we obtain f_{ud}^{N}=0.0405(40)(35) and f_{s}^{N}=0.113(45)(40), which translates into σ_{πN}=38(3)(3) MeV, σ_{sN}=105(41)(37) MeV, and y_{N}=0.20(8)(8) for the sigma terms and the related ratio, where the first errors are statistical and the second errors are systematic. Using isospin relations, we also compute the individual up and down quark contents of the proton and neutron (results in the main text).
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Affiliation(s)
- S Durr
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52428 Jülich, Germany
| | - Z Fodor
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52428 Jülich, Germany
| | - C Hoelbling
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - S D Katz
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- MTA-ELTE Lendület Lattice Gauge Theory Research Group, H-1117 Budapest, Hungary
| | - S Krieg
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52428 Jülich, Germany
| | - L Lellouch
- CNRS, Aix-Marseille U., Université de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
| | - T Lippert
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52428 Jülich, Germany
| | - T Metivet
- CNRS, Aix-Marseille U., Université de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
- CEA-Saclay, IRFU/SPhN, 91191 Gif-sur-Yvette, France
| | - A Portelli
- CNRS, Aix-Marseille U., Université de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
- Higgs Centre for Theoretical Physics, School of Physics and Astronomy, The University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K K Szabo
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
- Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52428 Jülich, Germany
| | - C Torrero
- CNRS, Aix-Marseille U., Université de Toulon, Centre de Physique Théorique, UMR 7332, F-13288 Marseille, France
| | - B C Toth
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - L Varnhorst
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
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Borsanyi S, Durr S, Fodor Z, Hoelbling C, Katz SD, Krieg S, Lellouch L, Lippert T, Portelli A, Szabo KK, Toth BC. Ab initio calculation of the neutron-proton mass difference. Science 2015; 347:1452-5. [DOI: 10.1126/science.1257050] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Borsanyi S, Fodor Z, Katz SD, Krieg S, Ratti C, Szabo KK. Freeze-out parameters from electric charge and baryon number fluctuations: is there consistency? Phys Rev Lett 2014; 113:052301. [PMID: 25126910 DOI: 10.1103/physrevlett.113.052301] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Indexed: 06/03/2023]
Abstract
Recent results for moments of multiplicity distributions of net protons and net-electric charge from the STAR Collaboration are compared to lattice QCD results for higher order fluctuations of baryon number and electric charge by the Wuppertal-Budapest Collaboration, with the purpose of extracting the freeze-out temperature and chemical potential. All lattice simulations are performed for a system of 2+1 dynamical quark flavors, at the physical mass for light and strange quarks; all results are continuum extrapolated. We show that it is possible to extract an upper value for the freeze-out temperature, as well as precise baryochemical potential values corresponding to the four highest collision energies of the experimental beam energy scan. Consistency between the freeze-out parameters obtained from baryon number and electric charge fluctuations is found. The freeze-out chemical potentials are now in agreement with the statistical hadronization model.
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Affiliation(s)
- S Borsanyi
- Department of Physics, Wuppertal University, Gauss Strasse 20, D-42119 Wuppertal, Germany
| | - Z Fodor
- Department of Physics, Wuppertal University, Gauss Strasse 20, D-42119 Wuppertal, Germany and Institute for Theoretical Physics, Eötvös University, Pázmány P. sétány 1/A, H-1117 Budapest, Hungary and Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - S D Katz
- Institute for Theoretical Physics, Eötvös University, Pázmány P. sétány 1/A, H-1117 Budapest, Hungary and MTA-ELTE "Lendület" Lattice Gauge Theory Research Group, Pázmány P. sétány 1/A, H-1117 Budapest, Hungary
| | - S Krieg
- Department of Physics, Wuppertal University, Gauss Strasse 20, D-42119 Wuppertal, Germany and Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - C Ratti
- Dipartimento di Fisica, Università di Torino and INFN, Sezione di Torino via Giuria 1, I-10125 Torino, Italy
| | - K K Szabo
- Department of Physics, Wuppertal University, Gauss Strasse 20, D-42119 Wuppertal, Germany and Jülich Supercomputing Centre, Forschungszentrum Jülich, D-52425 Jülich, Germany
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6
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Borsanyi S, Dürr S, Fodor Z, Frison J, Hoelbling C, Katz SD, Krieg S, Kurth T, Lellouch L, Lippert T, Portelli A, Ramos A, Sastre A, Szabo K. Isospin splittings in the light-baryon octet from lattice QCD and QED. Phys Rev Lett 2013; 111:252001. [PMID: 24483739 DOI: 10.1103/physrevlett.111.252001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Indexed: 06/03/2023]
Abstract
While electromagnetic and up-down quark mass difference effects on octet baryon masses are very small, they have important consequences. The stability of the hydrogen atom against beta decay is a prominent example. Here, we include these effects by adding them to valence quarks in a lattice QCD calculation based on Nf=2+1 simulations with five lattice spacings down to 0.054 fm, lattice sizes up to 6 fm, and average up-down quark masses all the way down to their physical value. This allows us to gain control over all systematic errors, except for the one associated with neglecting electromagnetism in the sea. We compute the octet baryon isomultiplet mass splittings, as well as the individual contributions from electromagnetism and the up-down quark mass difference. Our results for the total splittings are in good agreement with experiment.
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Affiliation(s)
- Sz Borsanyi
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - S Dürr
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Z Fodor
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany and Institute for Theoretical Physics, Eötvös University, Pázmány Peter sétany 1/A, H-1117 Budapest, Hungary
| | - J Frison
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - C Hoelbling
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - S D Katz
- Institute for Theoretical Physics, Eötvös University, Pázmány Peter sétany 1/A, H-1117 Budapest, Hungary and MTA-ELTE Lendület Lattice Gauge Theory Research Group, H-1117 Budapest, Hungary
| | - S Krieg
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany and IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Th Kurth
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
| | - L Lellouch
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - Th Lippert
- IAS/JSC, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - A Portelli
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France and School of Physics and Astronomy, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - A Ramos
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - A Sastre
- Aix-Marseille Université, CNRS, CPT, UMR 7332, 13288 Marseille, France and Université de Toulon, CNRS, CPT, UMR 7332, 83957 La Garde, France
| | - K Szabo
- Department of Physics, Wuppertal University, Gaussstrasse 20, D-42119 Wuppertal, Germany
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7
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Borsányi S, Fodor Z, Katz SD, Krieg S, Ratti C, Szabó KK. Freeze-out parameters: lattice meets experiment. Phys Rev Lett 2013; 111:062005. [PMID: 23971565 DOI: 10.1103/physrevlett.111.062005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Indexed: 06/02/2023]
Abstract
We present our results for ratios of higher order fluctuations of electric charge as functions of the temperature. These results are obtained in a system of 2+1 quark flavors at physical quark masses and continuum extrapolated. We compare them to preliminary data on higher order moments of the net electric charge distribution from the STAR collaboration. This allows us to determine the freeze-out temperature and chemical potential from first principles. We also show continuum-extrapolated results for ratios of higher order fluctuations of baryon number. These will allow us to test the consistency of the approach, by comparing them to the corresponding experimental data (once they become available) and thus, extracting the freeze-out parameters in an independent way.
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Affiliation(s)
- S Borsányi
- Department of Physics, Wuppertal University, Gaußstraße 20, D-42119 Wuppertal, Germany
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8
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Dürr S, Fodor Z, Frison J, Hoelbling C, Hoffmann R, Katz SD, Krieg S, Kurth T, Lellouch L, Lippert T, Szabo KK, Vulvert G. Ab Initio Determination of Light Hadron Masses. Science 2008; 322:1224-7. [DOI: 10.1126/science.1163233] [Citation(s) in RCA: 403] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- S. Dürr
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - Z. Fodor
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - J. Frison
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - C. Hoelbling
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - R. Hoffmann
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - S. D. Katz
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - S. Krieg
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - T. Kurth
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - L. Lellouch
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - T. Lippert
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - K. K. Szabo
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
| | - G. Vulvert
- John von Neumann–Institut für Computing, Deutsches Elektronen-Synchrotron Zeuthen, D-15738 Zeuthen and Forschungszentrum Jülich, D-52425 Jülich, Germany
- Bergische Universität Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany
- Institute for Theoretical Physics, Eötvös University, H-1117 Budapest, Hungary
- Centre de Physique Théorique (UMR 6207 du CNRS et des Universités d'Aix-Marseille I, d'Aix-Marseille II et du Sud Toulon-Var, affiliée à la FRUMAM), Case 907, Campus de Luminy, F-13288, Marseille Cedex 9, France
- Jülich Supercomputing Centre, FZ Jülich, D-52425 Jülich, Germany
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9
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Billups KL, Bank AJ, Padma-Nathan H, Katz SD, Williams RA. Erectile dysfunction as a harbinger for increased cardiometabolic risk. Int J Impot Res 2008; 20:236-42. [DOI: 10.1038/sj.ijir.3901634] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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10
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Aoki Y, Endrodi G, Fodor Z, Katz SD, Szabó KK. The order of the quantum chromodynamics transition predicted by the standard model of particle physics. Nature 2006; 443:675-8. [PMID: 17035999 DOI: 10.1038/nature05120] [Citation(s) in RCA: 1215] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 07/27/2006] [Indexed: 11/08/2022]
Abstract
Quantum chromodynamics (QCD) is the theory of the strong interaction, explaining (for example) the binding of three almost massless quarks into a much heavier proton or neutron--and thus most of the mass of the visible Universe. The standard model of particle physics predicts a QCD-related transition that is relevant for the evolution of the early Universe. At low temperatures, the dominant degrees of freedom are colourless bound states of hadrons (such as protons and pions). However, QCD is asymptotically free, meaning that at high energies or temperatures the interaction gets weaker and weaker, causing hadrons to break up. This behaviour underlies the predicted cosmological transition between the low-temperature hadronic phase and a high-temperature quark-gluon plasma phase (for simplicity, we use the word 'phase' to characterize regions with different dominant degrees of freedom). Despite enormous theoretical effort, the nature of this finite-temperature QCD transition (that is, first-order, second-order or analytic crossover) remains ambiguous. Here we determine the nature of the QCD transition using computationally demanding lattice calculations for physical quark masses. Susceptibilities are extrapolated to vanishing lattice spacing for three physical volumes, the smallest and largest of which differ by a factor of five. This ensures that a true transition should result in a dramatic increase of the susceptibilities. No such behaviour is observed: our finite-size scaling analysis shows that the finite-temperature QCD transition in the hot early Universe was not a real phase transition, but an analytic crossover (involving a rapid change, as opposed to a jump, as the temperature varied). As such, it will be difficult to find experimental evidence of this transition from astronomical observations.
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Affiliation(s)
- Y Aoki
- Department of Physics, University of Wuppertal, D-42097 Wuppertal, Germany
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11
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Abstract
Intravenous iron is commonly used in conjunction with erythropoietic agents to treat anemia in patients with chronic kidney disease. Iron has been proposed to promote oxidative stress and endothelial dysfunction in vascular tissues. We studied the acute effects of intravenous iron sucrose on homocysteine-induced endothelial dysfunction in the brachial artery of normal human subjects. In all, 40 healthy subjects received intravenous iron sucrose 100 mg or placebo over 30 min immediately before ingestion of 100 mg/kg of oral methionine in a double-blind, randomized study. Flow- and nitroglycerin-mediated dilation in the brachial artery, serum markers of iron stores, and homocysteine and nitrotyrosine levels were measured before and after study drug administration. Intravenous iron significantly increased transferrin saturation and non-transferrin-bound iron (NTBI) when compared with placebo. Flow-mediated dilation significantly decreased from baseline 1 h after administration of iron sucrose when compared with placebo (from 6.66+/-0.47 to 1.93+/-0.35% after iron sucrose vs from 6.00+/-0.40 to 5.61+/-0.46% after placebo, P<0.001), but did not differ between groups at 4 h (1.10+/-0.39 vs 1.33+/-0.51%). Nitroglycerin-mediated vasodilation, and homocysteine and 3-nitrotyrosine levels did not differ after administration of iron sucrose and placebo. Intravenous administration of iron sucrose in the setting of transient hyperhomocysteinemia induced by methionine ingestion significantly increased transferrin saturation and plasma levels of NTBI and significantly attenuated flow-mediated dilation in the brachial artery when compared with placebo. This potential mechanistic link between intravenous iron and endothelial dysfunction warrants further study of cardiovascular effects of intravenous iron in anemic chronic kidney disease populations.
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Affiliation(s)
- H Zheng
- Department of Medicine, Yale University School of Medicine, New Haven, Conneticut, USA
| | - X Huang
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Q Zhang
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - SD Katz
- Department of Medicine, Yale University School of Medicine, New Haven, Conneticut, USA
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12
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Spierer DK, Goldsmith R, Baran DA, Hryniewicz K, Katz SD. Effects of Active vs. Passive Recovery on Work Performed During Serial Supramaximal Exercise Tests. Int J Sports Med 2004; 25:109-14. [PMID: 14986193 DOI: 10.1055/s-2004-819954] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The current investigation was undertaken to determine the effects of active versus passive recovery on work performance during repeated bouts of supramaximal exercise. Six healthy sedentary subjects and 9 moderately trained healthy hockey players performed serial 30-second Wingate anaerobic power tests (WAnT) on a bicycle ergometer interposed with 4 minutes of active recovery at a work rate corresponding to 28 % of VO(2)max or passive recovery at rest. Peak power, mean power, total work achieved, and fatigue index were calculated for the serial WAnT. Capillary blood lactate was determined at 5-minute intervals after the last WAnT during 30 minutes of active or passive recovery. Mean power was significantly greater during active recovery in sedentary subjects when compared with passive recovery (388 +/- 42 vs. 303 +/- 37 W, p < 0.05), but did not differ according to recovery mode in moderately trained hockey players (589 +/- 22 W active vs. 563 +/- 26 W passive, p = 0.14). Total work achieved significantly increased during active when compared with passive recovery in sedentary subjects (34 890 +/- 3768 vs. 27 260 +/- 3364 J, p < 0.02) and moderately trained hockey players (86 763 +/- 9151 vs. 75 357 +/- 8281 J, p < 0.05). Capillary blood lactate levels did not differ during active when compared with passive recovery in sedentary subjects but were significantly lower during active when compared with passive recovery in moderately trained hockey players. These data demonstrate that active recovery at a work rate corresponding to 28 % of VO(2)max increases total work achieved during repeated WAnT when compared with passive recovery in sedentary subjects and moderately trained hockey players.
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Affiliation(s)
- D K Spierer
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA.
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13
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Androne AS, Hryniewicz K, Goldsmith R, Arwady A, Katz SD. Acetylcholinesterase inhibition with pyridostigmine improves heart rate recovery after maximal exercise in patients with chronic heart failure. Heart 2003; 89:854-8. [PMID: 12860856 PMCID: PMC1767776 DOI: 10.1136/heart.89.8.854] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To characterise the effects of acetylcholinesterase inhibition with pyridostigmine on parasympathetic tone in patients with chronic heart failure (CHF). DESIGN Prospective randomised, double blind crossover trial. SETTING University hospital outpatient heart failure clinic. PATIENTS 20 ambulatory subjects with stable CHF (mean age 55 years, mean ejection fraction 24%). INTERVENTIONS Oral administration of a single dose of pyridostigmine 30 mg and matching placebo on separate days. MAIN OUTCOME MEASURES Heart rate recovery at one minute and three minutes after completion of maximal exercise. RESULTS Heart rate recovery at one minute after exercise was significantly greater after administration of pyridostigmine than after administration of placebo (mean (SEM) 27.4 (3.2) beats/min v 22.4 (2.4) beats/min, p < 0.01). Heart rate recovery at three minutes after exercise did not differ after administration of pyridostigmine and placebo (mean (SEM) 44.4 (3.9) beats/min v 41.8 (3.6) beats/min, NS). Peak heart rate, peak oxygen uptake, peak respiratory exchange ratio, plasma noradrenaline (norepinephrine) concentrations, and plasma brain natriuretic peptide concentrations did not differ after administration of pyridostigmine and placebo. CONCLUSIONS Acetylcholinesterase inhibition with pyridostigmine increased heart rate recovery at one minute but not at three minutes after exercise. A specific effect of pyridostigmine on heart rate one minute after exercise suggests that pyridostigmine augments parasympathetic tone in patients with CHF.
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Affiliation(s)
- A S Androne
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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14
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Abstract
Endothelial dysfunction is associated with impairment of aerobic capacity in patients with heart failure and may play a role in the progression of disease. Impaired endothelium-dependent vasodilation in patients with heart failure can be attributed to decreased bioavailability of nitric oxide and attenuated responses to nitric oxide in vascular smooth muscle. Impaired vasodilation in response to nitric oxide derived from vascular endothelium or organic nitrates in vascular smooth muscle may be related in part to increased degradation of the second messenger cyclic guanosine monophosphate by type 5 phosphodiesterase. Sildenafil, a specific type 5 phosphodiesterase inhibitor currently approved for the treatment of erectile dysfunction, has been shown to acutely enhance endothelium-dependent vasodilation in patients with heart failure. Further studies are warranted to characterize the safety and efficacy of type 5 phosphodiesterase inhibition in the treatment of chronic heart failure.
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MESH Headings
- 3',5'-Cyclic-GMP Phosphodiesterases
- Cyclic GMP/metabolism
- Cyclic Nucleotide Phosphodiesterases, Type 5
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Enzyme Activation/drug effects
- Enzyme Activation/physiology
- Guanylate Cyclase/drug effects
- Guanylate Cyclase/physiology
- Heart Failure/drug therapy
- Heart Failure/metabolism
- Heart Failure/physiopathology
- Humans
- Muscle, Smooth, Vascular/blood supply
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/physiopathology
- Nitric Oxide/antagonists & inhibitors
- Nitric Oxide/metabolism
- Nitric Oxide/therapeutic use
- Phosphoric Diester Hydrolases/drug effects
- Phosphoric Diester Hydrolases/physiology
- Vasodilation/drug effects
- Vasodilation/physiology
- Vasomotor System/drug effects
- Vasomotor System/metabolism
- Vasomotor System/physiopathology
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Affiliation(s)
- S D Katz
- Yale University School of Medicine, Heart Failure Center, Yale University, 135 College Street, Suite 201, New Haven, CT 06510, USA.
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15
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Fodor Z, Katz SD, Ringwald A. Determination of absolute neutrino masses from bursts of Z bosons in cosmic rays. Phys Rev Lett 2002; 88:171101. [PMID: 12005742 DOI: 10.1103/physrevlett.88.171101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2001] [Revised: 11/02/2001] [Indexed: 05/23/2023]
Abstract
Ultrahigh energy neutrinos (UHEnu) scatter on relic neutrinos (Rnu) producing Z bosons, which can decay hadronically producing protons (Z burst). We compare the predicted proton spectrum with the observed ultrahigh energy cosmic ray (UHECR) spectrum and determine the mass of the heaviest Rnu via a maximum likelihood analysis. Our prediction depends on the origin of the powerlike part of the UHECR spectrum: m(nu) = 2.75(+1.28)(-0.97) eV for Galactic halo and 0.26(+0.20)(-0.14) eV for extragalactic origin. The necessary UHEnu flux should be detected in the near future.
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Affiliation(s)
- Z Fodor
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, D-22607, Hamburg, Germany
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16
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Katz SD, Parums DV. Sympathetic activation by sildenafil. Circulation 2001; 104:E119-20. [PMID: 11723034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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17
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Katz SD, Krum H. Acetylcholine-mediated vasodilation in the forearm circulation of patients with heart failure: indirect evidence for the role of endothelium-derived hyperpolarizing factor. Am J Cardiol 2001; 87:1089-92. [PMID: 11348607 DOI: 10.1016/s0002-9149(01)01466-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Vasomotor responses to intraarterial administration of acetylcholine are mediated by release of nitric oxide, prostaglandins, and an unidentified hyperpolarizing factor from vascular endothelial cells. The contribution of endothelium-derived hyperpolarizing factor (EDHF) to the vasodilatory response to acetylcholine in the skeletal muscle circulation of patients with congestive heart failure (CHF) has not been previously characterized. Accordingly, to specifically assess the role of EDHF, the regional vascular effects of sequential administration of acetylcholine and nitroglycerin in the brachial artery were determined in the forearm circulation with strain-gauge venous occlusion plethysmography in patients with CHF and in normal subjects during combined systemic inhibition of cyclooxygenase activity with indomethacin and regional inhibition of nitric oxide synthase activity with l-N(G)-monomethylarginine (l-NMMA). After administration of indomethacin, infusion of l-NMMA significantly decreased the forearm blood flow response to acetylcholine in normal subjects (5.4 +/- 1.2 to 3.5 +/- 0.6 ml/min/100 ml, p < 0.05) but not in patients with CHF (5.7 +/- 1.3 to 5.7 +/- 1.4 ml/min/100 ml). Infusion of l-NMMA did not change forearm blood flow responses to nitroglycerin in either group. The presence of a noncyclooxygenase, non-nitric-oxide relaxing factor indicates that EDHF, rather than nitric oxide, may be the predominant endothelium-derived substance mediating vasodilation in response to acetylcholine in patients with CHF.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Division of Circulatory Physiology, NewYork , NY 10032, USA.
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18
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Fodor Z, Katz SD. Grand unification signal from ultrahigh energy cosmic rays? Phys Rev Lett 2001; 86:3224-3227. [PMID: 11327937 DOI: 10.1103/physrevlett.86.3224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2000] [Revised: 01/31/2001] [Indexed: 05/23/2023]
Abstract
The spectrum of ultrahigh energy (above approximately 10(9) GeV) cosmic rays is consistent with the decay of grand unification scale particles. The predicted mass is m(X) = 10(b) GeV, where b = 14.6(+1.6)(-1.7).
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Affiliation(s)
- Z Fodor
- Institute for Theoretical Physics, Eötvös University, Pázmány 1, H-1117 Budapest, Hungary
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19
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Abstract
Natriuretic peptides are a family of endogenous peptide hormones with vasodilating, natriuretic, diuretic, and lusitropic properties. Administration of pharmacologic doses of exogenous natriuretic peptides may provide therapeutic benefit in patients with chronic heart failure. In controlled clinical trials, short-term administration of nesiritide (human brain natriuretic peptide) to patients with heart failure is associated with improved resting hemodynamics, modest increases in sodium excretion, evidence of suppression of neurohormonal activation, and improvements in symptoms of heart failure. Additional trials to determine the clinical efficacy and safety of nesiritide are warranted. (c)2001 by CHF, Inc.
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Affiliation(s)
- S D Katz
- New York Presbyterian Medical Center, Department of Medicine, Division of Circulatory Physiology, Columbia University College of Physicians and Surgeons, New York, NY 10032
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20
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Abstract
The effect of beta-adrenoceptor antagonists (beta-blockers) on neurohormonal activation in patients with congestive heart failure has been the subject of study in numerous small clinical trials. Short term therapy with beta-blockers is associated with a variable acute neurohormonal response which may be determined by the pharmacology of the agent under study and the baseline characteristics of the patient population. Long term therapy with beta-blockers devoid of intrinsic sympathomimetic activity (partial agonist activity) is associated with evidence of decreased plasma markers of activation of the sympathetic nervous system, the renin-angiotensin system, and endothelin-1. Beta1-selective and nonselective beta-blockers appear to be associated with evidence of decreased neurohormonal activation, with differential effects on beta-adrenoceptor density. Agents with partial agonist activity appear to differ from pure antagonists, with some studies reporting evidence of increased neurohormonal activation. The mechanisms by which beta-blockers reduce neurohormonal activation and the clinical relevance of changes in adrenergic function to their use in the treatment of heart failure require further investigation.
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Affiliation(s)
- D Baran
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA
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21
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Katz SD, Balidemaj K, Homma S, Wu H, Wang J, Maybaum S. Acute type 5 phosphodiesterase inhibition with sildenafil enhances flow-mediated vasodilation in patients with chronic heart failure. J Am Coll Cardiol 2000; 36:845-51. [PMID: 10987609 DOI: 10.1016/s0735-1097(00)00790-7] [Citation(s) in RCA: 222] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To determine the acute effects of type 5 phosphodiesterase inhibition with sildenafil on flow-mediated vasodilation in the brachial artery of patients with chronic heart failure. BACKGROUND Impaired endothelium-dependent, flow-mediated vasodilation in patients with heart failure is partly attributable to hyporesponsiveness of cyclic guanosine monophosphate (cGMP) mediated vasorelaxation effector mechanisms in vascular smooth muscle. The effect of inhibition of cGMP degradation with sildenafil, a specific type 5 cGMP phosphodiesterase inhibitor, on flow-mediated dilation in heart failure is unknown. METHODS Flow-mediated vasodilation after release of 1, 3 and 5 min of transient arterial occlusion was measured in the brachial artery with high resolution two-dimensional ultrasound imaging in 48 patients with chronic heart failure before and 1 h after randomized, double-blind assignment to a single oral dose of sildenafil 12.5, 25 or 50 mg or matching placebo. RESULTS In response to oral administration of a single dose of study drug, the change in flow-mediated vasodilation after release of 1, 3 and 5 min of arterial occlusion was significantly greater in patients receiving sildenafil 25 mg (3.3 +/- 1.9, 3.8 +/- 1.8 and 4.0 +/- 1.8%, respectively, p < 0.05) and patients receiving sildenafil 50 mg (3.7 +/- 1.3, 4.1 +/- 1.1, 3.9 +/- 1.3%, respectively, p < 0.05) than that of patients receiving placebo (0.7 +/- 1.1, 0.2 +/- 1.2, 0.6 +/- 0.8%, respectively). CONCLUSIONS Acute type 5 phosphodiesterase inhibition with sildenafil 25 and 50 mg increases endothelium-dependent, flow-mediated vasodilation in patients with chronic heart failure when compared with placebo.
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Affiliation(s)
- S D Katz
- Division of Circulatory Physiology, Columbia Presbyterian Medical Center, New York, New York 10032, USA.
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22
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Csikor F, Fodor Z, Hegedus P, Jakovac A, Katz SD, Piroth A. Electroweak phase transition in the minimal supersymmetric standard model: 4-dimensional lattice simulations. Phys Rev Lett 2000; 85:932-935. [PMID: 10991442 DOI: 10.1103/physrevlett.85.932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2000] [Indexed: 05/23/2023]
Abstract
Lattice results show no standard model (SM) electroweak phase transition (EWPT) for Higgs masses approximately 72 GeV, which is below the present experimental limit. Perturbation theory and 3-dimensional simulations indicate an EWPT in the minimal supersymmetric SM (MSSM) that is strong enough for baryogenesis up to m(h) approximately 105 GeV. In this Letter we present the results of our large scale 4-dimensional MSSM EWPT simulations. We carried out infinite volume and continuum limits and found a transition whose strength agrees well with perturbation theory, allowing MSSM electroweak baryogenesis at least up to m(h) = 103+/-4 GeV. We determined the properties of the bubble wall.
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Affiliation(s)
- F Csikor
- Institute for Theoretical Physics, Eotvos University, H-1117, Pazmany P. 1A, Budapest, Hungary
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23
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Katz SD, Maskin C, Jondeau G, Cocke T, Berkowitz R, LeJemtel T. Near-maximal fractional oxygen extraction by active skeletal muscle in patients with chronic heart failure. J Appl Physiol (1985) 2000; 88:2138-42. [PMID: 10846028 DOI: 10.1152/jappl.2000.88.6.2138] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Systemic oxygen uptake and deep femoral vein oxygen content were determined at peak exercise in 53 patients with chronic heart failure with impaired systolic function (mean left ventricular ejection fraction 0.18; n = 41) or preserved systolic function (mean left ventricular ejection fraction 0.70; n = 12) and in 6 age-matched sedentary normal subjects. At peak exercise, deep femoral vein oxygen content in heart failure patients with impaired systolic function and preserved systolic function were similar, both significantly lower than that of normal subjects (2.5 +/- 0.1, 2.9 +/- 0.2, and 5.0 +/- 0.1 ml/100 ml, respectively; P < 0.05). Deep femoral venous oxygen content was lower in patients with the greater impairment of aerobic capacity, regardless of the underlying systolic function (r = 0.72, P < 0.01). Fractional oxygen extraction in the skeletal muscle at peak exercise is enhanced in patients with chronic heart failure when compared with normal subjects, in proportion to the degree of aerobic impairment.
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Affiliation(s)
- S D Katz
- Department of Medicine, Columbia University College of Physicians and Surgeons, Columbia Presbyterian Medical Center, New York 10032, USA
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24
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Wu HD, Katz SD, Beniaminovitz A, Khan T, DiTullio MR, Homma S. Assessment of endothelium-mediated vasodilation of the peripheral circulation by transcutaneous ultrasonography and venous occlusion plethysmography. Heart Vessels 2000; 14:143-8. [PMID: 10776807 DOI: 10.1007/bf02482298] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Transcutaneous ultrasonography is a non-invasive technique with the ability to measure the volumetric blood flow of the peripheral circulation. Peripheral blood flow can be determined by high-resolution imaging of vessel diameter coupled with Doppler assessment of flow velocity. This method, however, has not been validated in vivo. Accordingly, brachial artery flow in response to intraarterial infusion of vasodilators was assessed by ultrasonography in 16 healthy subjects and compared to values obtained simultaneously by venous occlusion plethysmography. Blood flow calculated from ultrasound-derived vessel diameter and flow velocity was found to highly correlate with plethysmographic flow, with r values ranging from 0.83 to 0.99. Using this ultrasound technique combined with plethysmography, the response of conduit and resistance vessels to endothelium-mediated vasodilation was characterized. Doppler velocity rose dramatically with endothelium-dependent acetylcholine (970%), but only modestly with endothelium-independent vasodilators, nitroglycerin (292%) and nitroprusside (340%). Despite eliciting the greatest overall forearm flow response, acetylcholine resulted in a smaller increase in conduit diameter (15.4%) than nitroglycerin (21.8%), and only a comparable change than nitroprusside (14.6%). Taken together, these results suggest that acetylcholine acts predominantly on resistance vessels, whereas nitrovasodilators affect mainly conduit vessels. In summary, transcutaneous ultrasonography can be used reliably to assess flow changes in the peripheral circulation. Combined with plethysmography, this technique is useful for determining the relative contribution of conduit and resistance vessels to peripheral flow, particularly in the assessment of endothelium-mediated vasodilation.
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Affiliation(s)
- H D Wu
- Division of Cardiology, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
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25
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O'Connor CM, Gattis WA, Gheorghiade M, Granger CB, Gilbert J, McKenney JM, Messineo FC, Burnett JC, Katz SD, Elkayam U, Kasper EK, Goldstein S, Cody RJ, Massie BM. A randomized trial of ecadotril versus placebo in patients with mild to moderate heart failure: the U.S. ecadotril pilot safety study. Am Heart J 1999; 138:1140-8. [PMID: 10577446 DOI: 10.1016/s0002-8703(99)70081-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine the short-term safety and tolerability of the addition of ecadotril to conventional therapy in patients with mild to moderate heart failure. METHODS Fifty ambulatory patients, 18 to 75 years of age, with mild to moderate heart failure, left ventricular ejection fraction </=35%, taking stable doses of angiotensin-converting enzyme inhibitor, diuretics, and optionally digoxin were enrolled in a randomized, double-blind, placebo-controlled dose-escalation study of ecadotril 50 to 400 mg twice daily versus conventional therapy alone. RESULTS No increases in deaths, serious adverse events, or dropouts from adverse events were observed for the ecadotril group compared with placebo. The serum measures of neurohormonal activation were highly variable. Changes in signs and symptoms of heart failure, New York Heart Association class, and patient self-assessment of symptoms were not observed with ecadotril therapy; however, the study was not designed to detect differences in these parameters. CONCLUSION In this small pilot study, ecadotril in doses of 50 to 400 mg twice daily was generally well-tolerated and without severe short-term adverse effects in patients with mild to moderate heart failure. Evaluation of the clinical efficacy and long-term safety of ecadotril and other neutral endopeptidase inhibitors in patients with heart failure requires further study.
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Affiliation(s)
- C M O'Connor
- Duke University Medical Center, Durham, NC 27710, USA
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26
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Katz SD, Radin M, Graves T, Hauck C, Block A, LeJemtel TH. Effect of aspirin and ifetroban on skeletal muscle blood flow in patients with congestive heart failure treated with Enalapril. Ifetroban Study Group. J Am Coll Cardiol 1999; 34:170-6. [PMID: 10400007 DOI: 10.1016/s0735-1097(99)00180-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the acute and chronic effects of cyclooxygenase inhibition with aspirin and thromboxane A2 receptor blockade with ifetroban on the chronic vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure. BACKGROUND Angiotensin-converting enzyme inhibition and antiplatelet therapy with aspirin independently reduce the risk for subsequent nonfatal coronary events in survivors of myocardial infarction. The safety of the combined administration of angiotensin-converting enzyme inhibitors and aspirin has been questioned due to their divergent effects on the vascular synthesis of vasodilating prostaglandins. METHODS Forearm blood flow (ml/min/100 ml) at rest and during rhythmic handgrip exercise and after transient arterial occlusion was determined by strain gauge plethysmography before and 4 h and six weeks after combined administration of enalapril with either aspirin, ifetroban or placebo in a multicenter, double-blind, randomized trial of 62 patients with mild to moderate heart failure. RESULTS Before randomization, forearm hemodynamics were similar in the three treatment groups except for increased resting forearm blood flow and decreased resting forearm vascular resistance in the aspirin group when compared with the placebo group. After combined administration of enalapril and study drug for 4 h and six weeks, changes from prerandomization values of mean arterial pressure, forearm blood flow and forearm vascular resistance at rest, during handgrip exercise and after transient arterial occlusion did not differ among the three treatment groups. CONCLUSIONS These findings demonstrate that the vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure are not critically dependent on prostaglandin pathways.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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Katz SD, Khan T, Zeballos GA, Mathew L, Potharlanka P, Knecht M, Whelan J. Decreased activity of the L-arginine-nitric oxide metabolic pathway in patients with congestive heart failure. Circulation 1999; 99:2113-7. [PMID: 10217650 DOI: 10.1161/01.cir.99.16.2113] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Impaired endothelium-dependent, nitric oxide (NO)-mediated vasodilation may contribute to increased vasomotor tone in patients with heart failure. Whether decreased endothelium-dependent, NO-mediated vasodilation in patients with heart failure is due to decreased synthesis or increased degradation of NO is unknown. METHODS AND RESULTS To specifically assess the synthetic activity of the L-arginine-NO metabolic pathway, urinary excretion of [15N]nitrates and [15N]urea was determined after a primed continuous intravenous infusion of L-[15N]arginine (40 micromol/kg) in 16 patients with congestive heart failure and 9 age-matched normal control subjects at rest and during submaximal treadmill exercise. After infusion of L-[15N]arginine, 24-hour urinary excretion of [15N]nitrates was decreased in patients with congestive heart failure at rest (2.2+/-0.5 versus 8.0+/-2.3 micromol/24 h) and during submaximal exercise (2.4+/-1.2 versus 11. 4+/-4.0 micromol/24 h) compared with control subjects (both P<0.01). After infusion of L-[15N]arginine, 24-hour urinary excretions of [15N]urea at rest in patients with congestive heart failure and control subjects were not different (1.1+/-0.3 versus 1.2+/-0.2 mmol/24 h, P>0.20). CONCLUSIONS A specific decrease in synthetic activity of the L-arginine-NO metabolic pathway contributes to decreased endothelium-dependent vasodilation in patients with congestive heart failure.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Division of Circulatory Physiology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Hamroff G, Katz SD, Mancini D, Blaufarb I, Bijou R, Patel R, Jondeau G, Olivari MT, Thomas S, Le Jemtel TH. Addition of angiotensin II receptor blockade to maximal angiotensin-converting enzyme inhibition improves exercise capacity in patients with severe congestive heart failure. Circulation 1999; 99:990-2. [PMID: 10051289 DOI: 10.1161/01.cir.99.8.990] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incomplete suppression of the renin-angiotensin system during long-term ACE inhibition may contribute to symptomatic deterioration in patients with severe congestive heart failure (CHF). Combined angiotensin II type I (AT1) receptor blockade and ACE inhibition more completely suppresses the activated renin-angiotensin system than either intervention alone in sodium-depleted normal individuals. Whether AT1 receptor blockade with losartan improves exercise capacity in patients with severe CHF already treated with ACE inhibitors is unknown. METHODS AND RESULTS Thirty-three patients with severe CHF despite treatment with maximally recommended or tolerated doses of ACE inhibitors were randomized 1:1 to receive 50 mg/d losartan or placebo for 6 months in addition to standard therapy in a multicenter, double-blind trial. Peak aerobic capacity (V(O2)) during symptom-limited treadmill exercise and NYHA functional class were determined at baseline and after 3 and 6 months of double-blind therapy. Peak V(O2) at baseline and after 3 and 6 months were 13.5+/-0.6, 15.1+/-1.0, and 15.7+/-1.1 mL. kg-1. min-1, respectively, in patients receiving losartan and 14.1+/-0.6, 14.3+/-0.9, and 13.6+/-1.1 mL. kg-1. min-1, respectively, in patients receiving placebo (P<0.02 for treatment group-by-time interaction). Functional class improved by at least one NYHA class in 9 of 16 patients receiving losartan and 1 of 17 patients receiving placebo. CONCLUSIONS Losartan enhances peak exercise capacity and alleviates symptoms in patients with CHF who are severely symptomatic despite treatment with maximally recommended or tolerated doses of ACE inhibitors.
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Affiliation(s)
- G Hamroff
- Departments of Medicine, Divisions of Cardiology, The Albert Einstein College of Medicine, Bronx, NY, USA
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Abstract
Valgus instability of the elbow joint is a clinical diagnosis. However, many authors describe valgus stress radiographs as an aid in making this diagnosis. We studied valgus stress radiographs of 20 men (40 elbows) and 20 women (40 elbows), none with a history of elbow trauma or instability. The medial ulnohumeral distance was measured with no stress, valgus stress by gravity, and an applied valgus stress of 25 N (approximately 5 pounds). Measurements were made with the elbow positioned in extension and in 30 degrees of flexion. The increase in medial ulnohumeral gapping with either gravity or 5 pounds of stress was statistically significant at both extension and 30 degrees of flexion compared with the unstressed condition. The difference in ulnohumeral gapping between gravity stress and 5 pounds of valgus stress in extension and in 30 degrees of flexion was also significant. We found no differences with regard to hand dominance or sex. We conclude that uninjured elbows have significant medial ulnohumeral gapping on valgus stress radiography. Although this is an important tool in diagnosing valgus instability of the elbow, it may yield a false-positive assessment of valgus instability. Valgus stress radiographs comparing contralateral elbows may reduce the false-positive rate since there appears to be no significant difference in medial ulnohumeral gapping between the two elbows.
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Affiliation(s)
- G A Lee
- Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA
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Abstract
Congestive heart failure (CHF) is a common cardiovascular disorder that is characterised, in part, by a decreased cardiac output reserve. Accordingly, there is ongoing interest in the role of positive inotropic agents (e.g. adrenergic agonists and phosphodiesterase type III inhibitors, which mediate their cardiovascular effects via a cyclic adenosine monophosphate-dependent mechanism) in the treatment of CHF. However, enthusiasm for positive inotropic therapy in CHF has been dampened by the results of clinical trials, which have shown that these drugs are associated with an increased risk of mortality. Calcium sensitising agents are a heterogeneous group of positive inotropic agents that mediate their cardiovascular actions (at least in part) by increasing the sensitivity of the contractile elements to calcium. Increased sensitivity to calcium may be related to changes in calcium binding to troponin C, or to direct effects on the actin-myosin complex. In addition, the inhibition of phosphodiesterase type III may contribute to the positive inotropic action of calcium sensitising agents. Five agents with calcium sensitising properties (pimobendan, levosimendan, MCI-154, EMD-53998 and CGP-48506) have been studied as possible therapies for CHF. All of these agents have demonstrated a positive inotropic action in isolated cardiac tissue and in animal models of CHF. In clinical trials, pimobendan, the most extensively studied of these drugs, was well tolerated and was associated with improved exercise tolerance during the first 6 months of therapy; however, it was also associated with a nonsignificant trend towards increased mortality. Because many of the calcium sensitising agents also inhibit phosphodiesterase type III activity, the long term safety of these agents is uncertain. Large-scale survival trials are required to determine the long term safety and efficacy of these agents before their role in the treatment of CHF can be defined.
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Affiliation(s)
- L Mathew
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
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Abstract
Forearm blood flow (ml/min/100 ml) was determined with strain-gauge venous occlusion plethysmography at rest and in response to handgrip exercise in 7 patients with congestive heart failure and in 9 normal subjects before and after regional administration of endothelin-1 in the brachial artery. Administration of endothelin-1 significantly decreased forearm blood flow at rest and during exercise in normal subjects but did not change it at rest or during exercise in patients with congestive heart failure.
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Affiliation(s)
- H Krum
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA
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Hamroff G, Blaufarb I, Mancini D, Katz SD, Bijou R, Jondeau G, Olivari MT, Thomas S, LeJemtel TH. Angiotensin II-receptor blockade further reduces afterload safely in patients maximally treated with angiotensin-converting enzyme inhibitors for heart failure. J Cardiovasc Pharmacol 1997; 30:533-6. [PMID: 9335416 DOI: 10.1097/00005344-199710000-00020] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Combined therapy with an angiotensin-II type I receptor (AT1) antagonist and an angiotensin-converting enzyme (ACE) inhibitor results in more complete suppression of the renin-angiotensin system. Accordingly, the blood-pressure response and safety of combining AT1-receptor blockade with losartan for ACE inhibition were evaluated in patients with congestive heart failure who were already treated with maximally recommended or tolerated doses of an ACE inhibitor. Forty-three patients with symptomatic congestive heart failure were evaluated biweekly for 1 month before addition of losartan and weekly during administration of losartan at a daily dose of 25 mg for the first week and 50 mg for the second week. Systolic blood pressure, which remained unchanged before addition of losartan, decreased from 122 +/- 18 mm Hg to 112 +/- 17 and 107 +/- 17 mm Hg (p < 0.001) after 1 week of 25 mg and 1 week of 50 mg losartan, respectively. Diastolic blood pressure also significantly decreased. The decreases in blood pressure were well tolerated by all patients, even by those in whom symptomatic hypotension developed during uptitration of ACE inhibition. Serum potassium and sodium and parameters of renal function remained unchanged. Combining AT1-receptor blockade with losartan to maximally recommended or tolerated ACE inhibition appears safe and leads to further vasodilatation in symptomatic patients with congestive heart failure.
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Affiliation(s)
- G Hamroff
- Division of Cardiology, the Albert Einstein College of Medicine, Bronx, New York 10461, U.S.A
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Abstract
The pathogenesis of heart failure is determined by the ventricular and vascular responses to myocellular injury. Experimental and clinical studies suggest that the vascular endothelium may play an important role in modulating progression of ventricular and vascular remodeling in heart failure. Endothelial cell dysfunction has been described in the coronary and skeletal muscle circulations of patients with heart failure and appears to be characterized by decreased endothelial synthesis of nitric oxide and increased production of endothelin-1. The pathogenesis of endothelial dysfunction in heart failure is unknown, but may be related to increased oxidative stress, abnormal regional flow conditions, and cytokine and neurohormonal activation. The specific role of endothelial dysfunction in the pathogenesis of heart failure remains to be determined. If endothelial dysfunction does contribute to progression of disease in early heart failure, specific therapies to enhance endothelial dysfunction may improve long-term morbidity and mortality.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Division of Circulatory Physiology, New York, NY 10032, USA
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Katz SD, Yuen J, Bijou R, LeJemtel TH. Training improves endothelium-dependent vasodilation in resistance vessels of patients with heart failure. J Appl Physiol (1985) 1997; 82:1488-92. [PMID: 9134897 DOI: 10.1152/jappl.1997.82.5.1488] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The effects of physical training on endothelium-dependent vasodilation in skeletal muscle resistance vessels were investigated in patients with heart failure. Forearm blood flows (ml.min-1.100 ml-1) in response to brachial arterial administration of acetylcholine (5 x 10(-5) and 5 x 10(-4) M at 1 ml/min) and nitroglycerin (5 x 10(-6) and 5 x 10(-5) M at 1 ml/min) were determined by strain-gauge venous occlusion plethysmography before and after 8 wk of daily handgrip exercise in 12 patients with chronic heart failure. After 8 wk of daily handgrip exercise, the vasodilatory responses to acetylcholine significantly increased from pretraining values, i.e., 16.6 +/- 2.0 vs. 8.6 +/- 1.3 ml.min-1.100 ml-1 (P < 0.05) and 27.5 +/- 1.5 vs. 14.6 +/- 1.7 ml.min-1.100 ml-1 (P < 0.05), respectively, whereas the vasodilatory responses to nitroglycerin did not change. Handgrip exercise training appears to specifically enhance endothelium-dependent vasodilation in the forearm skeletal muscle circulation of patients with heart failure.
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Affiliation(s)
- S D Katz
- Department of Medicine, Albert Einstein College of Medicine, Bronx 10461, USA
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Khan T, Levin HR, Oz MC, Katz SD. Delayed reversal of impaired metabolic vasodilation in patients with end-stage heart failure during long-term circulatory support with a left ventricular assist device. J Heart Lung Transplant 1997; 16:449-53. [PMID: 9154956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Whether increased cardiac output during chronic circulatory support with a left ventricular assist device (LVAD) is associated with improved metabolic vasodilation in the peripheral circulation of patients with congestive heart failure is unknown. METHODS Forearm blood flow, determined by venous occlusion plethysmography, mean arterial pressure, and cardiac output were measured at rest and after 5 minutes of arterial occlusion (a maximal metabolic vasodilatory stimulus) in 14 patients with severe heart failure before LVAD implantation, and in the early (<4 weeks) and late (8 to 12 weeks) postoperative recovery phases after LVAD implantation. Nine normal subjects served as controls. Vascular conductance was calculated as the ratio of forearm blood flow and mean arterial pressure. RESULTS Mean arterial pressure and cardiac output increased to normal values in the early and late recovery phases after LVAD implantation. Resting forearm blood flow and vascular conductance were similar to normal subjects in the early and late recovery phases after LVAD implantation. Peak forearm blood flow and vascular conductance were significantly less than control subjects in the early preoperative recovery phase (p < 0.05) but were similar to control subjects in the late postoperative recovery phase after LVAD implantation. CONCLUSIONS In spite of early normalization of cardiac output, mean arterial pressure, and resting forearm blood flow during chronic circulatory support with the LVAD, peak forearm blood flow, and peak vascular conductance did not increase to values similar to those observed in normal subjects until the late postoperative recovery period. The delayed effect of the LVAD on metabolic vasodilation may be related to flow-dependent changes in the peripheral vasculature of patients with heart failure.
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Affiliation(s)
- T Khan
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
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Demopoulos L, Yeh M, Gentilucci M, Testa M, Bijou R, Katz SD, Mancini D, Jones M, LeJemtel TH. Nonselective beta-adrenergic blockade with carvedilol does not hinder the benefits of exercise training in patients with congestive heart failure. Circulation 1997; 95:1764-7. [PMID: 9107160 DOI: 10.1161/01.cir.95.7.1764] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown. METHODS AND RESULTS We studied 23 patients with CHF who were treated with carvedilol or propranolol in addition to ACE inhibitors, furosemide, and digoxin. Of the patients treated with carvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL.kg-1.min-1) was serially measured in trained and sedentary patients. Peak reactive hyperemia (mL.min-1.100 mL-1) was determined in the calf and forearm immediately before and after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9 +/- 1.4 to 16.0 +/- 1.6 (P < .001) and 12.4 +/- 1.0 to 15.7 +/- 0.9 (P < .001) mL.kg-1.min-1, respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly in the calves but not the forearms of trained patients. CONCLUSIONS Long-term, nonselective beta-adrenergic blockade with carvedilol or propranolol does not prevent patients with CHF from deriving systemic and regional benefits from physical training.
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Affiliation(s)
- L Demopoulos
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Marcus LS, Hart D, Packer M, Yushak M, Medina N, Danziger RS, Heitjan DF, Katz SD. Hemodynamic and renal excretory effects of human brain natriuretic peptide infusion in patients with congestive heart failure. A double-blind, placebo-controlled, randomized crossover trial. Circulation 1996; 94:3184-9. [PMID: 8989127 DOI: 10.1161/01.cir.94.12.3184] [Citation(s) in RCA: 224] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The pharmacological effects of infusion of human brain natriuretic peptide (hBNP) in patients with severe congestive heart failure have not been characterized previously. METHODS AND RESULTS Twenty patients with severe congestive heart failure were randomized in a double-blind, placebo-controlled, crossover trial to receive incremental 90-minute infusions of hBNP (0.003, 0.01, 0.03, and 0.1 microgram/kg per minute) or placebo on 2 consecutive days. At the highest completed dose of the hBNP, mean pulmonary artery pressure decreased from 38.3 +/- 1.6 to 25.9 +/- 1.7 mm Hg; mean pulmonary capillary wedge pressure decreased from 25.1 +/- 1.1 to 13.2 +/- 1.3 mm Hg; mean right atrial pressure decreased from 10.9 +/- 1 to 4.8 +/- 1.0 mm Hg; mean arterial pressure decreased from 85.2 +/- 2.0 to 74.9 +/- 1.7 mm Hg; and cardiac index increased from 2.0 +/- 0.1 to 2.5 +/- 0.1 L/min per square meter (all P < .01 versus placebo). Urine volume and urine sodium excretion increased significantly during hBNP infusion when compared with placebo infusion (90 +/- 38 versus 67 +/- 27 mL/h and 2.6 +/- 2.4 versus 1.4 +/- 1.2 mEq/h, respectively, both P < .05 versus placebo), whereas creatinine clearance and urinary potassium excretion did not change. CONCLUSIONS Infusion of incremental doses of hBNP is associated with favorable hemodynamic and natriuretic effects in patients with severe congestive heart failure.
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Affiliation(s)
- L S Marcus
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Katz SD, Krum H, Khan T, Knecht M. Exercise-induced vasodilation in forearm circulation of normal subjects and patients with congestive heart failure: role of endothelium-derived nitric oxide. J Am Coll Cardiol 1996; 28:585-90. [PMID: 8772743 DOI: 10.1016/0735-1097(96)00204-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study was undertaken to investigate the role of endothelium-derived nitric oxide in the regulation of forearm blood flow during exercise in normal subjects and patients with congestive heart failure. BACKGROUND Nitric oxide-mediated vasodilation in response to muscarinic stimulation is impaired in the peripheral circulation of patients with congestive heart failure. Whether nitric oxide-mediated vasodilation during exercise is also impaired in patients with congestive heart failure is unknown. METHODS Forearm blood flows (ml/min per 100 ml) were determined during rhythmic hand grip exercise at 15%, 30% and 45% of maximal voluntary contraction by venous occlusion plethysmography before and after regional inhibition of nitric oxide synthesis with administration of L-NG-monomethylarginine (L-NMMA) in the brachial artery of 17 patients with congestive heart failure (mean age 49 years, mean left ventricular ejection fraction 0.22) and 10 age-matched normal subjects. RESULTS Before administration of L-NMMA in the brachial artery, forearm blood flows in patients with congestive heart failure during rhythmic hand grip exercise at 15%, 30% and 45% of maximal voluntary contraction were slightly but not significantly lower than that of normal subjects ([mean +/- SE] 6.8 +/- 1.0, 8.5 +/- 1.0 and 12.9 +/- 1.7 ml/min per 100 ml, respectively, in patients with congestive heart failure vs. 6.6 +/- 1.2, 11.6 +/- 1.9 and 16.2 +/- 1.9 ml/min per 100 ml, respectively, in normal subjects, p = NS). After administration of L-NMMA in the brachial artery, forearm blood flows in normal subjects significantly decreased by 10% to 21% during hand grip exercise but did not change during exercise in patients with congestive heart failure. CONCLUSIONS Regional inhibition of nitric oxide synthase with administration of L-NMMA in the brachial artery significantly decreased forearm blood flows during rhythmic hand grip exercise in normal subjects but not in patients with congestive heart failure. These findings suggest that nitric oxide-mediated vasodilation during submaximal exercise is impaired in the forearm circulation of patients with congestive heart failure.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
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Krum H, Sackner-Bernstein JD, Goldsmith RL, Kukin ML, Schwartz B, Penn J, Medina N, Yushak M, Horn E, Katz SD. Double-blind, placebo-controlled study of the long-term efficacy of carvedilol in patients with severe chronic heart failure. Circulation 1995; 92:1499-506. [PMID: 7664433 DOI: 10.1161/01.cir.92.6.1499] [Citation(s) in RCA: 295] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Clinical trials have shown that beta-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate heart failure, but the utility and safety of these drugs in patients with advanced disease have not been evaluated. METHODS AND RESULTS We enrolled 56 patients with severe chronic heart failure into a double-blind, placebo-controlled study of the vasodilating beta-blocker carvedilol. All patients had advanced heart failure, as evidenced by a mean left ventricular ejection fraction of 0.16 +/- 0.01 and a mean maximal oxygen consumption of 13.6 +/- 0.6 mL.kg-1.min-1 despite digitalis, diuretics, and an angiotensin-converting enzyme inhibitor (if tolerated). After a 3-week, open-label, up-titration period, 49 of the 56 patients were assigned (in a double-blind fashion using a 2:1 randomization) to receive either carvedilol (25 mg BID, n = 33) or matching placebo (n = 16) for 14 weeks, while background therapy remained constant. Hemodynamic and functional variables were measured at the start and end of the study. Compared with the placebo group, patients in the carvedilol group showed improved cardiac performance, as reflected by an increase in left ventricular ejection fraction (P = .005) and stroke volume index (P = .010) and a decrease in pulmonary wedge pressure, mean right atrial pressure, and systemic vascular resistance (P = .003, .002, and .017, respectively). In addition, compared with placebo, patients treated with carvedilol benefited clinically, as shown by an improvement in symptom scores (P = .002), functional class (P = .013), and submaximal exercise tolerance (P = .006). The combined risk of death, worsening heart failure, and life-threatening ventricular tachyarrhythmia was lower in the carvedilol group than in the placebo group (P = .028), but carvedilol-treated patients had more dizziness and advanced heart block. CONCLUSIONS Carvedilol produces clinical and hemodynamic improvement in patients who have severe heart failure despite treatment with angiotensin-converting enzyme inhibitors.
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Affiliation(s)
- H Krum
- Division of Circulatory Physiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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Solomon S, Katz SD, Stevenson-Smith W, Yellin EL, LeJemtel TH. Determination of vascular impedance in the peripheral circulation by transcutaneous pulsed Doppler ultrasound. Chest 1995; 108:515-21. [PMID: 7634892 DOI: 10.1378/chest.108.2.515] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Instantaneous blood flow velocity characteristics and vascular impedance spectra derived noninvasively by pulsed Doppler ultrasound and invasively by electromagnetic flow probe were compared in the canine common femoral artery to validate the pulsed Doppler technique for determination of vascular impedance in the peripheral circulation. Although Doppler ultrasonography is routinely performed to evaluate blood flow velocity patterns in the human peripheral circulation; the validity of this technique to derive peripheral vascular impedance has yet to be investigated. Simultaneous measurements of blood flow velocity were determined by both noninvasive pulsed Doppler ultrasound and surgically implanted electromagnetic flow probe in the common femoral artery of eight dogs and compared in both time and frequency domains. Vascular impedance spectra derived from measurements of blood flow velocity determined by Doppler ultrasound and electromagnetic flow probe and simultaneous measurement of arterial pressure by a micromanometer-tipped catheter were obtained at baseline and after intra-arterial injection of acetylcholine in five additional dogs. During the first 10 to 20% of the cardiac cycle, Doppler ultrasound blood flow velocity was transiently greater than the simultaneously recorded electromagnetic blood flow velocity. During the remainder of the cardiac cycle, the two blood flow velocity waveforms were nearly superimposable. The frequency spectra of the blood flow velocity waveforms derived from Doppler ultrasound and electromagnetic flow probes were similar for harmonies less than 10 Hz. Vascular impedance spectra derived from measurements of blood flow velocity determined by Doppler ultrasound and electromagnetic flow probe with simultaneous measurement of arterial pressure by a micromanometer-tipped catheter were similar at baseline and after regional administration of acetylcholine. Mean vascular resistance (impedance at 0 Hz), characteristic impedance, and the first minima of the impedance modulus derived from Doppler ultrasound and electromagnetic flow probe blood flow velocity measurements were closely correlated at baseline and after dilation with acetylcholine (r > or = 0.89, p < 0.05 for all correlations). Doppler ultrasonography is a convenient and accurate technique for determination of vascular impedance in the peripheral circulation.
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Affiliation(s)
- S Solomon
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Abstract
The vascular endothelium releases vasoactive substances that appear to play an important role in the normal regulation of peripheral vasomotor tone. Nitric oxide, endothelins, prostaglandins, and other endothelium-derived vasodilating and vasoconstricting factors are released by the vascular endothelium in response to a diverse array of hormonal, pharmacologic, chemical, and physical stimuli. Shear stress, produced by pulsatile blood flow at the endothelial cell luminal surface, alters endothelial production of several endothelium-derived vasoactive substances, which may contribute to regional regulation of skeletal muscle blood flow during exercise. Abnormal vascular endothelium function has been shown in both experimental and clinical heart failure. Preliminary data suggest that abnormalities of endothelial function may contribute to increased peripheral vasomotor tone during exercise in patients with congestive heart failure.
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Affiliation(s)
- S D Katz
- Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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Katz SD. Left ventricular thrombus and the incidence of thromboembolism in patients with congestive heart failure: can clinical factors identify patients at increased risk? J Cardiovasc Risk 1995; 2:97-102. [PMID: 7606657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Left ventricular thrombus is highly prevalent in patients with congestive heart failure, but the increase of thromboembolic events is low. Reliable clinical indicators of increased thromboembolic risk are not yet available. Clinical decisions to treat patients who have congestive heart failure with oral anticoagulants must be made on an individual basis.
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Affiliation(s)
- S D Katz
- Division of Circulatory Phisiology, Columbia Presbyterial Medical Center, New York, NY 10032, USA
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Katz SD, Rao R, Berman JW, Schwarz M, Demopoulos L, Bijou R, LeJemtel TH. Pathophysiological correlates of increased serum tumor necrosis factor in patients with congestive heart failure. Relation to nitric oxide-dependent vasodilation in the forearm circulation. Circulation 1994; 90:12-6. [PMID: 8025986 DOI: 10.1161/01.cir.90.1.12] [Citation(s) in RCA: 146] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Tumor necrosis factor-alpha (TNF alpha), which we and others have shown to be elevated in patients with severe congestive heart failure (CHF), is involved in the regulation of nitric oxide metabolism. Whether increased concentrations of TNF alpha affect nitric oxide-mediated vasodilation in patients with CHF has not been studied previously. METHODS AND RESULTS Serum concentrations of TNF alpha, interleukin-1 (IL-1), interleukin-2 (IL-2), and interleukin-6 (IL-6) were determined in venous blood (pg/mL) from 17 patients with stable New York Heart Association classes II and III CHF (mean age, 58 +/- 11 years; mean left ventricular ejection fraction, 19.5 +/- 7.3) and 17 age-matched normal subjects with enzyme-linked immunosorbent assays (detection limit of assays, 20 pg/mL). Forearm blood flows were determined with plethysmography (mL/min per 100 mL) in 17 patients and 7 normal subjects in response to brachial artery administration of graded concentrations of acetylcholine (10(-6) mol/L and 10(-5) mol/L) and nitroglycerin (10(-7) mol/L and 10(-6) mol/L). Serum concentrations of TNF alpha were above the detection limits of the assay in 10 of 17 patients with CHF (mean serum concentration, 39.4 +/- 3.8 pg/mL). Forearm blood flow responses to acetylcholine and nitroglycerin were significantly greater in these 10 patients than in the 7 patients without detectable serum TNF alpha and were closely correlated with TNF alpha serum concentrations (r > or = .81, P < .01 and r > or = .65, P < .05 respectively). In 1 of 17 normal subjects, the serum concentration of TNF alpha was just above the detection limit of the assay. Serum concentrations of IL-2 were above the detection limit of the assay in 14 of 17 patients with CHF (mean serum concentration, 112 +/- 19 pg/mL). IL-2 was not detected in the serum of normal subjects. Serum concentrations of IL-1 and IL-6 were below the detection limit of the assays in all patients and normal subjects assayed. CONCLUSIONS Increased TNF alpha concentrations are closely correlated with forearm blood flow responses to regional administration of acetylcholine and nitroglycerin. The significant correlation between serum concentrations of TNF alpha and forearm blood flow responses to acetylcholine and nitroglycerin suggests that both the inducible and the constitutive forms of nitric oxide synthase are involved in the regulation of peripheral vasomotor tone in patients with CHF.
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Affiliation(s)
- S D Katz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461
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Schwarz M, Katz SD, Demopoulos L, Hirsch H, Yuen JL, Jondeau G, LeJemtel TH. Enhancement of endothelium-dependent vasodilation by low-dose nitroglycerin in patients with congestive heart failure. Circulation 1994; 89:1609-14. [PMID: 8149528 DOI: 10.1161/01.cir.89.4.1609] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Since organic nitroesters and endothelium-derived nitric oxide mediate vasodilation through a final common pathway, that is, by activation of soluble guanylate cyclase in vascular smooth muscle, nitroglycerin (NTG) could specifically enhance the endothelium-dependent vasodilatory response to acetylcholine (Ach) in patients with congestive heart failure (CHF) and endothelial cell dysfunction. Accordingly, the net effects of an intra-arterial infusion of NTG (10(-9) mol/L) on endothelium-dependent and endothelium-independent vasodilation were assessed in the forearm circulation of patients with CHF. METHODS AND RESULTS The forearm blood flow responses to intra-arterial administration of graded concentrations of Ach (10(-7) to 10(-5) mol/L) were determined by venous occlusion plethysmography (mL/min per 100 mL) in 18 patients with CHF and 5 age-matched normal subjects before and during intra-arterial infusion of NTG (10(-9) mol/L) for 20 minutes. In eight patients, the duration of the infusion of NTG (n = 5) or vehicle control solution (n = 3) was extended to 12 hours with measurement of the forearm blood flow responses to Ach at 20 minutes, 4 hours, and 12 hours. In five additional patients, forearm blood flow response to intra-arterial administration of two doses of phentolamine (0.05 and 0.5 mg) were determined before and during a 20-minute NTG infusion. Regional administration of NTG 10(-9) mol/L did not change resting forearm blood flow in either normal subjects or patients with CHF. Before administration of NTG 10(-9) mol/L, intra-arterial infusions of Ach 10(-7), 10(-5) and 10(-5) mol/L increased forearm blood flow to 14.7 +/- 6.2, 20.2 +/- 4.7, and 38.4 +/- 7.9 mL/min per 100 mL in normal subjects and to 4.1 +/- 0.8, 5.0 +/- 1.1, and 10.6 +/- 2.3 mL/min per 100 mL in patients with CHF. After administration of NTG 10(-9) mol/L for 20 minutes, the vasodilatory response to Ach significantly increased to 5.6 +/- 1.0, 6.9 +/- 1.6, and 17.7 +/- 3.4 mL/min per 100 mL in patients with CHF but did not change in normal subjects. The enhanced forearm blood flow responses to administration of Ach observed after 20 minutes of NTG administration in patients with CHF were sustained throughout a 12-hour NTG infusion. In contrast, regional administration of NTG did not change the vasodilatory responses to phentolamine. CONCLUSIONS NTG, when administered intra-arterially for 20 minutes at a dose that does not affect resting forearm blood flow, specifically increased the vasodilatory response to intra-arterial administration of Ach in patients with CHF but not in normal subjects. The vasodilatory response to Ach was consistently enhanced by low-dose NTG throughout a 12-hour period. The vasodilating effects of organic nitroesters on the peripheral vasculature of patients with CHF may result in part from an interaction with the vascular endothelium.
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Affiliation(s)
- M Schwarz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461
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Katz SD, Bleiberg B, Wexler J, Bhargava K, Steinberg JJ, LeJemtel TH. Lactate turnover at rest and during submaximal exercise in patients with heart failure. J Appl Physiol (1985) 1993; 75:1974-9. [PMID: 8307848 DOI: 10.1152/jappl.1993.75.5.1974] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Systemic and lower limb skeletal muscle lactate metabolism was studied in 10 men with congestive heart failure by use of a primed continuous intravenous infusion of L-(+)-[U-14C]lactate. Arterial and deep femoral venous blood samples were obtained at rest and during 30 min of submaximal exercise. Systemic lactate metabolic turnover rate (Rd) was determined using Steele's isotopic steady-state equation (Rd = isotopic infusion rate/arterial specific activity). Plasma lactate concentrations in the artery and deep femoral vein did not change significantly from resting values during exercise (1.11 +/- 0.13 vs. 1.26 +/- 0.12 and 1.27 +/- 0.12 vs. 1.30 +/- 0.12 mM, respectively), whereas Rd increased from 22.5 +/- 1.8 to 41.6 +/- 4.8 mumol.kg-1.min-1 (P < 0.005). Rd did not significantly correlate with arterial lactate concentration during rest or exercise. Because of simultaneous uptake and release of lactate in skeletal muscle, arterial and deep femoral venous lactate concentrations are not closely related to either systemic or lower limb skeletal muscle lactate metabolism in patients with congestive heart failure.
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Affiliation(s)
- S D Katz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461
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Jondeau G, Katz SD, Toussaint JF, Dubourg O, Monrad ES, Bourdarias JP, LeJemtel TH. Regional specificity of peak hyperemic response in patients with congestive heart failure: correlation with peak aerobic capacity. J Am Coll Cardiol 1993; 22:1399-402. [PMID: 8227797 DOI: 10.1016/0735-1097(93)90549-g] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aim of this study was to compare peak reactive hyperemic blood flows in the forearm and calf of patients with congestive heart failure and in age- and gender-matched normal subjects. In addition, we attempted to correlate peak oxygen consumption with forearm and calf peak reactive hyperemic flows in the patients with heart failure. BACKGROUND Disparate results have been reported regarding forearm peak reactive hyperemia in patients with congestive heart failure. Because training significantly increases peak reactive hyperemic flow in normal subjects, we hypothesized that in patients with congestive heart failure who curtail walking because of exertional symptoms, calf peak reactive hyperemic flow would be preferentially attenuated and that impairment of calf vasculature may correlate with peak oxygen consumption. METHODS Forearm and calf blood flows were measured by venous occlusive plethysmography at rest and after 5 min of arterial occlusion in 46 patients with congestive heart failure and 7 age- and gender-matched normal subjects. Peak oxygen consumption was measured during graded exercise on a bicycle ergometer. RESULTS Calf peak reactive hyperemic flow was lower in patients with congestive heart failure than in normal subjects (22 +/- 1 vs. 32.5 +/- 3.5 ml/min per 100 ml, p < 0.001), whereas forearm peak reactive hyperemic flows were similar in the two groups. Calf peak reactive hyperemic flow was linearly related to peak oxygen consumption (r = 0.58, p < 0.0001), but forearm peak reactive hyperemic flow was not. Forearm and calf peak reactive hyperemic flows were not related at rest or after 5 min of arterial occlusion in the patients with heart failure. CONCLUSIONS Calf peak reactive hyperemic flow is reduced in patients with congestive heart failure, whereas forearm peak reactive hyperemic flow is identical to that of age- and gender-matched normal subjects. Calf peak reactive hyperemic flow is linearly related to peak oxygen consumption in patients with congestive heart failure, but forearm peak reactive hyperemic flow is not.
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Affiliation(s)
- G Jondeau
- Service de Cardiologie, Hôpital Ambroise Paré, Boulogne, France
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Katz SD, Schwarz M, Yuen J, LeJemtel TH. Impaired acetylcholine-mediated vasodilation in patients with congestive heart failure. Role of endothelium-derived vasodilating and vasoconstricting factors. Circulation 1993; 88:55-61. [PMID: 8391403 DOI: 10.1161/01.cir.88.1.55] [Citation(s) in RCA: 164] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The vasodilatory response to intra-arterial administration of acetylcholine is reduced in patients with congestive heart failure compared with that of normal subjects. The reduced response to acetylcholine may be related to decreased endothelial release of nitric oxide, interaction with peripheral alpha-adrenergic transmission, or production of cyclooxygenase-dependent vasoconstricting substances. The extent to which each of these mechanisms contributes to the reduced vasodilatory response to acetylcholine in patients with congestive heart failure is not known. METHODS AND RESULTS Thirty-one patients with congestive heart failure (New York Heart Association functional class II-III) and five age-matched normal subjects were studied. Regional vascular responses in the forearm to infusions of acetylcholine, an endothelium-dependent vasodilator (10(-7) to 10(-5) mol/L) and nitroglycerin, an endothelium-independent vasodilator (10(-6) mol/L) in the brachial artery were determined with venous occlusion plethysmography before and after regional alpha-adrenergic blockade with intra-arterial phentolamine (25 micrograms/min) and systemic cyclooxygenase with oral indomethacin (50 mg). Administration of phentolamine significantly increased resting baseline forearm blood flow in 11 patients with congestive heart failure (2.9 +/- 0.4 to 5.4 +/- 0.8 mL.min-1.100 mL-1) and normal subjects (4.6 +/- 0.3 to 11.3 +/- 2.1 mL.min-1.100 mL-1). Before administration of phentolamine, intra-arterial infusions of acetylcholine 10(-7), 10(-6), and 10(-5) mol/L increased forearm blood flow to 4.0 +/- 1.0, 6.0 +/- 1.7, and 16.1 +/- 4.0 mL.min-1.100 mL-1, respectively, in patients with congestive heart failure and to 14.7 +/- 6.2, 20.2 +/- 4.7, and 38.7 +/- 7.9 mL.min-1.100 mL-1, respectively, in normal subjects. After administration of phentolamine, the vasodilatory responses to intra-arterial infusions of acetylcholine and nitroglycerin did not change in either patients or normal subjects. Administration of indomethacin did not alter resting forearm blood flow in 15 patients with congestive heart failure (2.7 +/- 0.4 to 2.7 +/- 0.4 mL.min-1.100 mL-1) or normal subjects (4.6 +/- 0.3 to 5.4 +/- 0.8 mL.min-1.100 mL-1). Administration of indomethacin significantly increased the vasodilatory response to infusion of acetylcholine by an average of 39% in patients with congestive heart failure but did not change the vasodilatory response to acetylcholine in normal subjects. In patients with congestive heart failure, baseline forearm blood flow and the vasodilatory responses to intra-arterial infusions of acetylcholine and nitroglycerin were significantly less than those of normal subjects both before and after administration of phentolamine and indomethacin. CONCLUSIONS The reduced vasodilatory response to intra-arterial infusion of acetylcholine in patients with congestive heart failure probably results from several coexistent abnormalities in peripheral vascular function, including abnormal production of cyclooxygenase-dependent vasoconstricting factor, impaired endothelial release of nitric oxide, and decreased vascular smooth muscle responsiveness to cyclic GMP-mediated vasodilation.
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Affiliation(s)
- S D Katz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461
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Abstract
The current study was undertaken to determine prospectively the risk of cerebral thromboembolism and the prognostic significance of left ventricular thrombus in ambulatory patients with chronic congestive heart failure. A total of 264 ambulatory patients (mean age 62 years, mean left ventricular ejection fraction 27%) were followed prospectively for 24 +/- 9 months to determine the incidence of nonhemorrhagic stroke, transient ischemic attack, and mortality. Two-dimensional echocardiographic studies, performed for clinical indications other than previous systemic thromboembolism in 109 patients, were analyzed to relate the presence of left ventricular thrombus to subsequent outcome. Nine cerebral thromboembolic events occurred in 264 patients during the two-year mean follow-up period, yielding a rate of 1.7 thromboembolic events per 100 patient-years of follow-up. Known risk factors for stroke (hypertension, diabetes mellitus, and/or atrial fibrillation) were present in all nine patients with cerebral thromboembolic events. The 109 patients with echocardiographic studies had more severe heart failure than patients without echocardiographic studies (functional class 2.6 vs 2.1, p < 0.01), greater risk of a thromboembolic event (2.4 vs 1.4 events/100 patient-years of follow-up, p < 0.01), and higher mortality (21.3 vs 5.5 deaths/100 patient-years, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S D Katz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y
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van Hoeven KH, Kitsis RN, Katz SD, Factor SM. Peripartum versus idiopathic dilated cardiomyopathy in young women--a comparison of clinical, pathologic and prognostic features. Int J Cardiol 1993; 40:57-65. [PMID: 8349367 DOI: 10.1016/0167-5273(93)90231-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Clinicopathologic features of 13 women with peripartum cardiomyopathy were compared to 13 women aged 19 through 38 with idiopathic dilated cardiomyopathy. No presenting clinical or pathologic variable distinguished either group. However, the clinical course differed between the groups. Eleven of 13 patients with idiopathic dilated cardiomyopathy had a poor clinical outcome, defined as persistent heart failure or death. Patients in this group succumbed one year or more after disease onset. Five of 13 patients with peripartum cardiomyopathy had poor outcome, with death occurring 9 months or less after disease onset. The clinical course of peripartum cardiomyopathy appears distinct from that of idiopathic dilated cardiomyopathy in young women.
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Affiliation(s)
- K H van Hoeven
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY
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Hale PM, McAllister JP, Katz SD, Wright LC, Lovely TJ, Miller DW, Wolfson BJ, Salotto AG, Shroff DV. Improvement of cortical morphology in infantile hydrocephalic animals after ventriculoperitoneal shunt placement. Neurosurgery 1992; 31:1085-96; discussion 1096. [PMID: 1470319 DOI: 10.1227/00006123-199212000-00015] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
As a sequel to our previous descriptions of the pathological changes induced by hydrocephalus in the infantile cerebral cortex, the study presented here has evaluated the effects of surgical decompression on cortical cytology and cytoarchitecture. Hydrocephalus was induced in 14 kittens by the intracisternal injection of kaolin at 4 to 11 days of age. Nine of these hydrocephalic animals received low-pressure ventriculoperitoneal shunts at 9 to 15 days after kaolin injection; these animals were monitored preoperatively and postoperatively by ultrasound and were killed at various postshunt intervals up to 30 days. Five normal or saline-injected animals served as age-matched controls. At the time of shunt placement, the ventricular index confirmed that all recipient animals had attained moderate or severe degrees of ventriculomegaly. Within 3 days after shunt placement, the size of the lateral ventricles had decreased to control levels and was accompanied by rapid and dramatic improvements in behavior and skull ossification. When the animals were killed, gross inspection revealed that about half of the animals exhibited mild to moderate ventriculomegaly, with cortical mantles 50 to 80% their normal thickness. Tissue from frontal (primary motor), parietal (association), and occipital (primary visual) cortical areas was processed for light microscopic analysis. Pyknotic or dark shrunken neurons, which are found typically in hydrocephalic brains, were observed only occasionally in the cortex of shunted animals. Gliosis and mild edema were prevalent, however, in the periventricular white matter. The laminae of the cerebral cortex could be identified in all shunted animals. In those animals with mild residual ventriculomegaly, the entire cortical mantle was somewhat compressed, as evidenced by an increased packing density of neurons. Furthermore, the somata of some neurons were disoriented. Overall, these results indicate that most of the morphological characteristics of the cerebral cortex are preserved after surgical decompression and suggest that ventriculoperitoneal shunts may prevent neuronal damage and/or promote neuronal repair.
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Affiliation(s)
- P M Hale
- Department of Anatomy, Temple University School of Medicine, Philadelphia, Pennsylvania
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