Waqas Nawaz

and 9 more

Purpose: This study was to assess the feasibility and cardio-protective effects of biocompatible silicon built restraint device (ASD) in rat’s heart failure (HF) model. Background: Ventricle restraint therapy (VRT) is a well-established and promising approach for management of advanced-stage dilated HF. Previous VRT devices offer a subjective level of restraint to the dilated heart muscles. However, the impact of the restraint nature, mesh tubular design and biocompatibility of VRT devices is not well investigated. Method: The performance and compliance of ASD were determined in vitro by adopting a pneumatic drive and ball burst test. SD rats were grouped into four (n=24); control, HF, ASD+HF and CSD+HF groups, respectively. HF was induced by left anterior descending artery ligation in all groups except the control group. ASD and CSD devices were implanted in the heart of ASD+HF and CSD+HF groups respectively. Results: The functional and expansion ability of ASD was observed to be safer and suitable to attenuate ventricular remodeling. ASD treated rats showed normal heart rhythm which was validated by a smooth -ST and asymmetrical T-wave. Hemodynamic parameters, and systolic and diastolic functions improved in the ASD+HF group and reduction in ventricular wall stress indicated reverse remodeling. Furthermore BNP values were reduced in ASD+HF group which confirmed ASD feasibility and reverse remodeling at a molecular level. ASD+HF group also showed no fibrosis thus proposing that ASD has its significant curative effects on the heart muscles. Conclusion: ASD was found to be a promising restraint therapy than the previously standard restraint therapies.

Danieli Salinas

and 4 more

Objectives: Universal implementation of cystic fibrosis (CF) newborn screening (NBS) has led to the diagnostic dilemma of infants with CF screen positive, inconclusive diagnosis (CFSPID), for which there is limited guidance regarding prognosis and standardized care. Rates of reclassification from CFSPID to CF vary and risk factors for reclassification are unknown. We investigated whether clinical characteristics are associated with risk of reclassification from CFSPID to a CF diagnosis. Methods: Children with a positive CF NBS were recruited from two sites in California. Retrospective, longitudinal, and cross-sectional data were collected. A subset of subjects had nasal epithelial cells collected for CFTR functional assessment. Multivariate logistic regression was used to assess the risk of CFSPID-to-CF reclassification. Results: A total of 112 children completed the study (CF=53, CFSPID=59). Phenotypic characteristics between groups showed differences in pancreatic insufficiency prevalence, immunoreactive trypsinogen (IRT) levels, and Pseudomonas aeruginosa (PSA) colonization. Spirometry measures were not different between groups. Nasal epithelial cells from 10 subjects showed 7-30% of wild type (WT)-CFTR function in those who reclassified and 27-67% of WT-CFTR function in those who retained the CFSPID designation. Modeling revealed that increasing sweat chloride concentration (sw[Cl -]) and PSA colonization were independent risk factors for reclassification to CF. Conclusion: Increasing sw[Cl -] and history of PSA colonization are associated with risk of reclassification from CFSPID to CF in a population with high IRT and two CFTR variants. Close follow-up to monitor phenotypic changes remains critical in this population. The role of CFTR functional assays in this population requires further exploration.