The aim of this study was to compare selected ankle and knee kinematic and kinetic parameters before and a fter a prolonged exhaustive treadmill run between two groups of non-rearfoot footstrike pattern (NRFP) runners with different training volumes. Twenty-eight habitual NRFP runners were assigned to two groups based on their weekly training volume (Highly-trained (HT)/Moderately-trained (MT)). Participants underwent the VO2max test, and the exhaustive treadmill ran with biomechanical analysis at the beginning and the end. The two-way RMANOVA was used to assess differences between the groups and the phase of the run. A paired t-test was used for post-hoc analysis in case of significant interaction effect. Kinetic results showed significant group effect for ankle plantarflexion moment and hip external rotation moment (end-phase: both greater in MT group). Kinematic results showed significant group×phase interaction for ankle dorsiflexion angle (end-phase: greater in MT group) at initial contact (IC), peak knee flexion angle (end-phase: greater in MT group), and peak ankle eversion angle during the stance phase (end-phase: greater in HT group). Additionally, a group effect was found for knee flexion angle at IC (end-phase: greater in HT group). This study suggests that HT healthy NRFP runners may have less potential for increased biomechanical risk of AT overload during an exhaustive run.

• MeSH
• Running * physiology   MeSH
• Biomechanical Phenomena MeSH
• Adult MeSH
• Ankle Joint * physiology   MeSH
• Kinetics MeSH
• Knee Joint * physiology   MeSH
• Knee * physiology   MeSH
• Physical Conditioning, Human * methods   MeSH
• Ankle * physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Oxygen Consumption MeSH
• Exercise Test MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Heart failure (HF) is a leading cause of morbidity and mortality, often driven by prolonged exposure to pathological stimuli such as pressure and volume overload. These factors contribute to excessive oxidative stress, adverse cardiac remodeling, and dysregulation of the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate (NO-sGC-cGMP) signaling pathway. Given the urgent need for effective treatments, this study investigated the potential of sGC stimulators to mitigate HF progression. We utilized male hypertensive Ren-2 transgenic (TGR) rats and a volume-overload HF model induced by an aortocaval fistula (ACF). Rats received the sGC stimulator BAY 41-8543 (3 mg/kg/day) for 30 weeks, while normotensive Hannover Sprague-Dawley rats served as controls. At the study endpoint (40 weeks of age), left ventricular tissue was analyzed using mass spectrometry, Western blotting, and histological assessment. TGR rats treated with sGC stimulators exhibited a significant increase in key antioxidant proteins (SOD1, CH10, ACSF2, NDUS1, DHE3, GSTM2, and PCCA), suggesting enhanced resistance to oxidative stress. However, sGC stimulator treatment also upregulated extracellular matrix remodeling markers (MMP-2, TGF-β, and SMAD2/3), which are typically associated with fibrosis. Despite this, Masson's trichrome staining revealed reduced collagen deposition in both TGR and TGR-ACF rats receiving sGC stimulators. Notably, all untreated TGR-ACF rats succumbed before the study endpoint, preventing direct assessment of sGC stimulator effects in advanced HF. These findings highlight the therapeutic potential of sGC stimulators in HF, particularly through their antioxidant effects. However, their concurrent influence on fibrosis warrants further investigation to optimize treatment strategies.

• MeSH
• Chronic Disease MeSH
• Fibrosis MeSH
• Cyclic GMP metabolism   MeSH
• Rats MeSH
• Disease Models, Animal MeSH
• Morpholines MeSH
• Oxidative Stress * drug effects   MeSH
• Rats, Sprague-Dawley * MeSH
• Rats, Transgenic MeSH
• Pyridines pharmacology   therapeutic use   MeSH
• Pyrimidines MeSH
• Ventricular Remodeling drug effects   MeSH
• Soluble Guanylyl Cyclase * metabolism   MeSH
• Signal Transduction drug effects   MeSH
• Heart Failure * drug therapy   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Male MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

This state-of-the-art review aimed to synthesize evidence from various sex-stratified studies on aortic stenosis (AS), focusing on the difference in clinical presentation, anatomical characteristics, pathophysiology, and management of AS. In comparison to men, women with AS are present at later stages, are older, more symptomatic, frailer, and exhibit higher operative risk [Society of Thoracic Surgeons (STS) score]. Women tend to have smaller aortic valve (AV) areas and left ventricular (LV) outflow tract, leading to lower stroke volumes (SVs) than men and have a higher prevalence of paradoxical, low-flow, low-gradient AS. In women, chronic pressure overload due to AS results in concentric LV remodelling and hypertrophy, characterized by reduced LV cavities, higher filling pressures, lower wall stress, and more diastolic dysfunction. Conversely, men exhibit more dilated eccentric LV remodelling and hypertrophy. AVs in women are less calcified but more fibrotic. Moreover, women are often underdiagnosed, have severity underestimated, and experience delays or receive fewer referrals for AV replacement (AVR). However, women tend to benefit from transcatheter AVR (TAVR) with a long-term survival advantage over men, although the incidence of vascular complications and bleeding events in 30 days after TAVR is higher in women. Surgical AVR (SAVR) in women has high operative risk, is technically demanding and has poorer outcomes with increased mortality at 30 days compared to men. According to the STS score and EuroSCORE, the female sex itself is considered a risk factor for SAVR. Therefore, addressing sex-related disparities in AS and increasing awareness among physicians promises improved diagnosis and treatment, facilitating equitable care and the development of sex-specific personalized medicine.

• Publication type
• Journal Article MeSH
• Review MeSH

Chae, S, McDowell, KW, Baur, ML, Long, SA, Tufano, JJ, and Stone, MH. Accentuated eccentric loading and alternative set structures: A narrative review for potential synergies in resistance training. J Strength Cond Res 38(11): 1987-2000, 2024-As athletes become adapted to training over time, it becomes more difficult to develop their strength and power. In a conventional resistance training strategy, volume or load may be increased to provide novel stimuli to break through a plateau. However, physiological stress markers increase with increased volume or load, which is an innate shortcoming. In that case, practitioners strive to develop unconventional strategies that could increase training stimuli while adjusting fatigue. Two programming tactics, accentuated eccentric loading (AEL) using eccentric overload and alternative set structures (AS) using intraset rests, have been reported to increase training stimuli and alleviate fatigue, respectively. Importantly, when merging AEL and AS in various contexts, the 2 benefits could be accomplished together. Because AEL and AS cause different outcomes, it is important to deal with when and how they may be integrated into periodization. Moreover, prescribing eccentric overload and intraset rests requires logistical considerations that need to be addressed. This review discusses the scientific and practical aspects of AEL and AS to further optimize strength and power adaptations. This review discusses (a) scientific evidence as to which tactic is effective for a certain block, (b) potential practical applications, and (c) related discussions and future research directions.

• MeSH
• Muscle, Skeletal physiology   MeSH
• Humans MeSH
• Resistance Training * methods   MeSH
• Athletes MeSH
• Athletic Performance physiology   MeSH
• Muscle Strength * physiology   MeSH
• Muscle Fatigue physiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Embolie plodovou vodou je charakterizována náhlým kardiorespiračním kolapsem v peripartálním období. Představujeme bezprostřední management v situaci, kdy je stěžejní adekvátní rychlá reakce. Rozvoj diseminované intravaskulární koagulace potvrzuje, že diagnóza embolie plodovou vodou je vysoce pravděpodobná. Připomínáme podání kyseliny tranexamové a fibrinogenu, který je při hrazení krevních ztrát preferován před podáním plazmy s cílem snížit riziko ho selhání. Hlavními pilíři terapie jsou inotropika a plicní vazodilatancia. Přestože je podání koncentrátu C1 inhibitoru v literatuře navrhováno, reálně je jeho podání v kazuistikách popsáno výjimečně. ECMO podpora může být zvažována i u této diagnózy.

Amniotic fluid embolism is characterized by sudden cardiorespiratory collapse during labor or soon after delivery. We present immediate management when a rapid response is critical. The appearance of disseminated intravascular coagulation confirms high suspicion of the diagnosis plausibly. We remind administration of tranexamic acid and fibrinogen. Fibrinogen is preferred over plasma to minimize the risk of volume overload. Avoidance of fluid overload is an important management principle of pulmonary hypertension and right heart failure. Inotropes and pulmonary vasodilators are the mainstays of therapy. Although the therapeutic application of C1 esterase inhibitor concentrate is proposed in articles, the real application is reported sporadically. Extracorporeal membrane oxygenation can be considered.

• MeSH
• Disseminated Intravascular Coagulation etiology   MeSH
• Embolism, Amniotic Fluid * therapy   MeSH
• Fibrinogen MeSH
• Cardiopulmonary Resuscitation methods   MeSH
• Pregnancy Complications MeSH
• Tranexamic Acid pharmacology   therapeutic use   MeSH
• Humans MeSH
• Extracorporeal Membrane Oxygenation methods   MeSH
• Hypertension, Pulmonary etiology   physiopathology   MeSH
• Heart Failure etiology   MeSH
• Check Tag
• Humans MeSH

BACKGROUND: Heart failure (HF) is a frequent cause of morbidity and mortality of end-stage kidney disease (ESKD) patients on hemodialysis. It is not easy to distinguish HF from water overload. The traditional HF definition has low sensitivity and specificity in this population. Moreover, many patients on hemodialysis have exercise limitations unrelated to HF. Therefore, we postulated two new HF definitions ((1) Modified definition of the Acute Dialysis Quality Improvement working group; (2) Hemodynamic definition based on the calculation of the effective cardiac output). We hypothesize that the newer definitions will better identify patients with higher number of endpoints and with more advanced structural heart disease. METHODS: Cohort, observational, longitudinal study with recording predefined endpoints. Patients (n = 300) treated by hemodialysis in six collaborating centers will be examined centrally in a tertiary cardiovascular center every 6-12 months lifelong or till kidney transplantation by detailed expert echocardiography with the calculation of cardiac output, arteriovenous dialysis fistula flow volume calculation, bio-impedance, and basic laboratory analysis including NTproBNP. Effective cardiac output will be measured as the difference between measured total cardiac output and arteriovenous fistula flow volume and systemic vascular resistance will be also assessed non-invasively. In case of water overload during examination, dry weight adjustment will be recommended, and the patient invited for another examination within 6 weeks. A composite major endpoint will consist of (1) Cardiovascular death; (2) HF worsening/new diagnosis of; (3) Non-fatal myocardial infarction or stroke. The two newer HF definitions will be compared with the traditional one in terms of time to major endpoint analysis. DISCUSSION: This trial will differ from others by: (1) detailed repeated hemodynamic assessment including arteriovenous access flow and (2) by careful assessment of adequate hydration to avoid confusion between HF and water overload.

• MeSH
• Renal Insufficiency, Chronic * complications   MeSH
• Kidney Failure, Chronic * diagnosis   therapy   complications   MeSH
• Renal Dialysis adverse effects   MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Observational Studies as Topic MeSH
• Heart Failure * diagnosis   etiology   therapy   MeSH
• Water MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial Protocol MeSH
• Geographicals
• Czech Republic MeSH

Sodium is the main osmotically active ion in the extracellular fluid and its concentration goes hand in hand with fluid volume. Under physiological conditions, homeostasis of sodium and thus amount of fluid is regulated by neural and humoral interconnection of body tissues and organs. Both heart and kidneys are crucial in maintaining volume status. Proper kidney function is necessary to excrete regulated amount of water and solutes and adequate heart function is inevitable to sustain renal perfusion pressure, oxygen supply etc. As these organs are bidirectionally interconnected, injury of one leads to dysfunction of another. This condition is known as cardiorenal syndrome. It is divided into five subtypes regarding timeframe and pathophysiology of the onset. Hemodynamic effects include congestion, decreased cardiac output, but also production of natriuretic peptides. Renal congestion and hypoperfusion leads to kidney injury and maladaptive activation of renin-angiotensin-aldosterone system and sympathetic nervous system. In cardiorenal syndromes sodium and water excretion is impaired leading to volume overload and far-reaching negative consequences, including higher morbidity and mortality of these patients. Keywords: Cardiorenal syndrome, Renocardiac syndrome, Volume overload, Sodium retention.

• MeSH
• Homeostasis * physiology   MeSH
• Cardio-Renal Syndrome * metabolism   physiopathology   MeSH
• Kidney metabolism   physiopathology   MeSH
• Humans MeSH
• Sodium * metabolism   MeSH
• Water metabolism   MeSH
• Water-Electrolyte Imbalance metabolism   physiopathology   MeSH
• Water-Electrolyte Balance * physiology   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

While phosphodiesterase-5 inhibition (PED5i) may prevent hypertrophy and failure in pressure-overloaded heart in an experimental model, the impact of PDE5i on volume-overload (VO)-induced hypertrophy is unknown. It is also unclear whether the hypertrophied right ventricle (RV) and left ventricle (LV) differ in their responsiveness to long-term PDE5i and if this therapy affects renal function. The goal of this study was to elucidate the effect of PDE5i treatment in VO due to aorto-caval fistula (ACF) and to compare PDE5i treatment with standard heart failure (HF) therapy with angiotensin-converting enzyme inhibitor (ACEi). ACF/sham procedure was performed on male HanSD rats aged 8 weeks. ACF animals were randomized for PDE5i sildenafil, ACEi trandolapril, or placebo treatments. After 20 weeks, RV and LV function (echocardiography, pressure-volume analysis), myocardial gene expression, and renal function were studied. Separate rat cohorts served for survival analysis. ACF led to biventricular eccentric hypertrophy (LV: +68%, RV: +145%), increased stroke work (LV: 3.6-fold, RV: 6.7-fold), and reduced load-independent systolic function (PRSW, LV: -54%, RV: -51%). Both ACF ventricles exhibited upregulation of the genes of myocardial stress and glucose metabolism. ACEi but not PDE5i attenuated pulmonary congestion, LV remodeling, albuminuria, and improved survival (median survival in ACF/ACEi was 41 weeks vs. 35 weeks in ACF/placebo, p = .02). PDE5i increased cyclic guanosine monophosphate levels in the lungs, but not in the RV, LV, or kidney. PDE5i did not improve survival rate and cardiac and renal function in ACF rats, in contrast to ACEi. VO-induced HF is not responsive to PDE5i therapy.

• MeSH
• Angiotensin-Converting Enzyme Inhibitors * pharmacology   MeSH
• Phosphodiesterase 5 Inhibitors * pharmacology   MeSH
• Cardiomegaly drug therapy   MeSH
• Rats MeSH
• Ventricular Remodeling * MeSH
• Heart Failure * drug therapy   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Male MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Albumín je najvýznamnejším proteínom plazmy. Hypoalbuminémia u kriticky chorých novorodencov vzniká v dôsledku zníženej syntézy, zvýšených strát alebo redistribúcie albumínu. Intravenózna liečba exogénnym albumínom sa u novorodencov ordinuje v prípadoch hyperbilirubinémie, hypovolémie, hypoalbuminémie alebo v stavoch spojených so stratami bielkovín. Mnohokrát je jej podanie nevhodné a môže viesť k nežiaducim účinkom ako napríklad k objemovému preťaženiu, neurologickému alebo renálnemu poškodeniu. V súčasnosti sa podanie albumínu neodporúča v liečbe hyperbilirubinémie, objemovej resuscitácie v pôrodnej sále ani v rutinnej liečbe hypoalbuminémie u nedonosených novorodencov.

Use of albumin in newborns Albumin is the most important plasma protein. Hypoalbuminemia in critically ill newborn infants occurs due to reduced synthesis, increased losses or redistribution of albumin. Intravenous treatment with exogenous albumin is administered in newborns in cases of hyperbilirubinemia, hypovolemia, hypoalbuminemia or in protein-losing states. However, its administration is often inappropriate and can be associated with possible harms such as fluid overload, neurological injury, or renal injury. Currently, albumin administration is not recommended in the treatment of neonatal hyperbilirubinemia, volume resuscitation in the delivery room, or in the routine treatment of hypoalbuminemia in preterm infants.

• MeSH
• Albumins * physiology   therapeutic use   MeSH
• Hyperbilirubinemia etiology   MeSH
• Hypoalbuminemia etiology   therapy   MeSH
• Hypovolemia therapy   MeSH
• Infusions, Intravenous MeSH
• Humans MeSH
• Infant, Premature MeSH
• Infant, Newborn blood   MeSH
• Resuscitation methods   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn blood   MeSH

Valvular heart disease leads to ventricular pressure and/or volume overload. Pressure overload leads to fibrosis, which might regress with its resolution, but the limits and details of this reverse remodeling are not known. To gain more insight into the extent and nature of cardiac fibrosis in valve disease, we analyzed needle biopsies taken from the interventricular septum of patients undergoing surgery for valve replacement focusing on the expression and distribution of major extracellular matrix protein involved in this process. Proteomic analysis performed using mass spectrometry revealed an excellent correlation between the expression of collagen type I and III, but there was little correlation with the immunohistochemical staining performed on sister sections, which included antibodies against collagen I, III, fibronectin, sarcomeric actin, and histochemistry for wheat germ agglutinin. Surprisingly, the immunofluorescence intensity did not correlate significantly with the gold standard for fibrosis quantification, which was performed using Picrosirius Red (PSR) staining, unless multiplexed on the same tissue section. There was also little correlation between the immunohistochemical markers and pressure gradient severity. It appears that at least in humans, the immunohistochemical pattern of fibrosis is not clearly correlated with standard Picrosirius Red staining on sister sections or quantitative proteomic data, possibly due to tissue heterogeneity at microscale, comorbidities, or other patient-specific factors. For precise correlation of different types of staining, multiplexing on the same section is the best approach.

• MeSH
• Aortic Valve Insufficiency metabolism   pathology   surgery   MeSH
• Aortic Valve Stenosis * metabolism   pathology   surgery   MeSH
• Extracellular Matrix Proteins * metabolism   analysis   MeSH
• Fibrosis * metabolism   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Ventricular Septum pathology   metabolism   MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH