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Biomedical subjects

M A Conway

Publications and source records attributed to M A Conway.

32 records · Page 2Linked to original sources

Detection of low phosphocreatine to ATP ratio in failing hypertrophied human myocardium by 31P magnetic resonance spectroscopy.

Phosphorus-31 magnetic resonance spectroscopy can be used to study intracellular biochemistry non-invasively by measuring the relative proportions of high energy phosphates. Study of deteriorating cardiac metabolism might be useful in the management of hypertrophy and heart failure. 31P magnetic resonance spectroscopy was carried out in fourteen patients with aortic valve disease (six with aortic stenosis, eight with aortic incompetence). Six patients were receiving treatment for symptoms of heart failure. The phosphocreatine (PCr) to ATP ratio in these patients (1.1 [SD 0.32]) was significantly lower than that in thirteen controls (1.5 [0.2], p less than 0.001) or in the eight patients who did not have symptoms of heart failure (1.56 [0.15], p less than 0.0035). These findings indicate that heart failure in aortic valve disease is associated with low PCr, which could be due to loss of intracellular creatine. The measurement could eventually have a role in helping to determine the optimum timing for aortic valve replacement.

Adenosine Triphosphate↗

Cardiac metabolism during exercise in healthy volunteers measured by 31P magnetic resonance spectroscopy.

A technique was devised for individuals to exercise prone in a magnet during magnetic resonance spectroscopy of the heart and phosphorus-31 magnetic resonance spectra of the heart were obtained by the phase modulated rotating frame imaging technique in six healthy volunteers during steady state dynamic quadriceps exercise. During prone exercise heart rate, blood pressure, and total body oxygen consumption were measured at increasing loads and the results were compared with those during Bruce protocol treadmill exercise. During prone exercise with a 5 kg load the heart rate was similar and the systolic and diastolic blood pressures were higher than those during stage 1 of the Bruce protocol. The rate-pressure products were similar but the total body oxygen consumption was lower during prone exercise. There was no difference in the ratio of phosphocreatine to adenosine triphosphate during rest and exercise.Thus during exercise that produced a local cardiac stress equal to or greater than that during stage 1 of the Bruce protocol treadmill exercise, the energy requirements of the normal human myocardium were adequately supplied by oxidative phosphorylation.

Blood Pressure↗

Recurrent Listeria monocytogenes meningitis in a heart transplant recipient.

A case of recurrent Listeria monocytogenes meningitis is reported, the two episodes arising 4 months and 8 months after the patient had received a heart transplant. Both episodes immediately followed increased doses of corticosteroids for allograft rejection. The source of infection was not identified. Previous reports and possible explanations of recurrent L. monocytogenes infection are reviewed.

Heart Transplantation↗

Alterations of skeletal muscle metabolism in humans studied by phosphorus 31 magnetic resonance spectroscopy in congestive heart failure.

Muscle metabolism of the finger flexor muscle of the dominant arm was examined in patients with congestive heart failure and age-related controls. Phosphocreatine utilization and decrease in pH during exercise was significantly greater in patients than in controls. Recovery rates were slow in some of these patients. Measurements of forearm blood flow at rest or during exercise were not significantly reduced in patients compared with controls. The inorganic phosphate peak was split during exercise in some of the patients, suggesting the presence of more glycolytic fibers in their muscles. These observations suggest that metabolic abnormalities may be present in the skeletal muscles of patients with heart failure that are not due to reduced nutritive blood flow. This may, in part, explain the lack of correlation between measurements of cardiac function and exercise tolerance in these patients.

Adenosine Triphosphate↗

Neuropeptide Y and vasoactive intestinal polypeptide in cerebral arteries of the rat: relationships between innervation pattern and mechanical response.

Possible relationships between the density of peptide innervation and the contractile response of rat cerebral arteries to exogenously applied neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP) were examined. The effects of NPY on membrane potential and reactivity of cerebral arteries to exogenous norepinephrine also were studied. In normally innervated arteries there was no apparent correlation between degree of innervation and response to NPY. Marked, prolonged tachyphylaxis to NPY and VIP was observed following brief exposure to these peptides. Surgical removal of the superior cervical ganglia or the sphenopalatine ganglia greatly reduced and, in some cases, eliminated NPY- or VIP-immunoreactive perivascular nerves from cerebral arteries. However, responses of denervated middle cerebral arteries to exogenous NPY or VIP were not different from responses of innervated arteries. Doses of NPY that induced maximal contraction caused no change in membrane potential of the middle cerebral artery. NPY also did not alter the response of cerebral arteries to exogenous norepinephrine. Finally, electrical stimulation of normal or denervated arteries caused only minor constrictor or dilator responses. These results do not support a substantial role for peptidergic perivascular nerves in regulation of pial arterial contractility in the rat.

Animals↗

Effects of beta-adrenergic blockade on the ventilatory responses to hypoxic and hyperoxic exercise in man.

1. The ventilatory responses to step changes from rest to 100 W cycling exercise were studied in five healthy human subjects. Exercise was performed in hypoxia (end-tidal O2 pressure, PET,O2, 50-55 mmHg), a condition characterized by a marked enhancement of arterial chemoreceptor activity, and in hyperoxia (PET,O2 greater than 250 mmHg), a condition in which arterial chemoreceptor activity is largely suppressed. The subjects were studied at each O2 level after placebo and after an oral dose of 120 mg propranolol. 2. The magnitude of phase 1, the immediate, rapid ventilatory response at the onset of work, was unaffected by hypoxia and at both oxygen levels it was also unaffected by propranolol. 3. Phase 2, analysed from 20 to 120 s after the onset of exercise, was significantly affected by both O2 level and beta-blockade. The kinetics of the ventilatory changes in this phase were well described in all four conditions by a simple exponential function. The overall mean time constants after placebo were shorter in hypoxia (31.0 s) than in hyperoxia (40.2 s), and at each O2 level longer after propranolol, in hypoxia 61.3 s and in hyperoxia 106.0 s. 4. Continuous analysis of gas sampled at the mouth with a mass spectrometer showed constancy of end-tidal PCO2 throughout the step change in hypoxia both with and without beta-blockade. In contrast, in both hyperoxic conditions PET,CO2 rose, mainly in phase 2, to a value 5-6 mmHg higher than the starting value. 5. The steady-state ventilation was higher in hypoxia than in hyperoxia, and end-tidal CO2 pressure, PET,CO2, correspondingly lower. Neither ventilation nor PCO2 were, however, affected by propranolol in either condition. 6. It is concluded that the arterial chemoreceptors are important for both the rate of adaptation of ventilation to a new rate of metabolism during a step change of work rate, and for the matching of ventilation to CO2 flow which normally ensures isocapnia. The further slowing of the dynamics of the ventilatory response in hyperoxia as well as the preserved isocapnia in hypoxia after beta-blockade argue against any major role of beta-adrenergic mechanisms for these functions of the arterial chemoreceptors. The observed effects are considered to be secondary to the reduced cardiac output and an increased CO2 storage initially during exercise following beta-adrenergic blockade.

Humans↗

Haemodynamic determinants of elevated pulse wave velocity during acute isometric handgrip exercise.

BACKGROUND: Measurement of pulse wave velocity (PWV) provides a reliable index of vascular stiffness. Despite its widespread application, the physiological interrelationships between PWV, blood pressure (BP) and in particular, heart rate (HR), have yet to be fully elucidated. Furthermore, little is known about altered arterial compliance during acute exercise. AIM: To examine the effects of 3-min supine non-dominant isometric handgrip exercise (ISOMEX), performed at 30% of maximum voluntary contraction, on carotid-radial PWV, BP and HR in the dominant arm of 51 healthy subjects. RESULTS: During exercise, PWV correlated strongly with diastolic BP (r = 0.55, p < 0.01) and mean arterial pressure (r = 0.51, p < 0.01). PWV and HR failed to correlate at rest or during exercise. CONCLUSION: ISOMEX invoked an elevated PWV, which is predominantly related to BP or factors determining it, and not HR. The carotid-radial PWV stress test is a simple measurement that may have prognostic potential for use in large-scale population studies.

Adult↗

A positron emission tomography (PET) study of autobiographical memory retrieval.

Memory for the experiences of one's life, autobiographical memory (AM), is one of the most human types of memory, yet comparatively little is known of its neurobiology. A positron emission tomography (PET) study of AM retrieval revealed that the left frontal cortex was significantly active during retrieval (compared to memory control tasks), together with activation in the inferior temporal and occipital lobes in the left hemisphere. We propose that this left frontal lobe activation reflects the operation of control processes that modulate the construction of AMs in posterior neocortical networks.

Adult↗