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Neonatal Screening for Critical Congenital Heart Defects

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ISBN: 9783039210480 9783039210497 Year: Pages: 98 DOI: 10.3390/books978-3-03921-049-7 Language: English
Publisher: MDPI - Multidisciplinary Digital Publishing Institute
Subject: Social Sciences --- Sociology
Added to DOAB on : 2019-06-26 08:44:06
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Critical congenital heart defects (CCHDs) are potentially life-threatening malformations that remain a significant cause of neonatal mortality and morbidity. Failure to diagnose these conditions shortly after birth may result in acute cardiovascular collapse and death. The identification of CCHDs by routine newborn clinical examination is routine in many countries, but consistently misses over a third of cases, and, although antenatal ultrasound screening can be very effective in early diagnosis, the provision and accuracy of ultrasound screening is highly variable. As most CCHDs present with mild cyanosis (hypoxaemia), which is frequently clinically undetectable, pulse oximetry is a rapid, simple, painless method of accurately identifying hypoxaemia, which has gained popularity as a screen for CCHD. This Special Issue of the International Journal of Neonatal Screening, devoted to ""Neonatal Screening for Critical Congenital Heart Defects (CCHDs)"", will consider the evidence for CCHD screening with pulse oximetry, the acceptability and cost-effectiveness of this intervention, the additional non-cardiac conditions which it may also identify, and international experiences of introducing CCHD screening across the globe.

The adrenergic system in cardiovascular physiology and pathophysiology

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889193981 Year: Pages: 85 DOI: 10.3389/978-2-88919-398-1 Language: English
Publisher: Frontiers Media SA
Subject: Physiology --- Science (General)
Added to DOAB on : 2015-12-10 11:59:06
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Cardiovascular diseases pose an enormous clinical challenge, remaining the most common cause of death in the world. ß-adrenoceptors play an important role on cardiac, vascular and/or endothelial function at a cellular level with relevant applications in several cardiovascular diseases, such as heart failure and hypertension. G protein– coupled receptors (GPCRs), including ß-adrenergic receptors, constitute the most ubiquitous superfamily of plasma membrane receptors and represent the single most important type of therapeutic drug target. Sympathetic nervous system hyperactivity, which characterizes several cardiovascular diseases, such as heart failure and hypertension, as well as physiological ageing, has been proved to exert in the long-term detrimental effects in a wide range of cardiovascular diseases. Acutely, sympathetic hyperactivity represents the response to an insult to the myocardium, aiming to compensate for decreased cardiac output. This process involves the activation of beta-adrenergic receptors by catecholamine with consequent heart rate and cardiac contractility increase. However, long-term exposure of the heart to elevated norepinephrine and epinephrine levels, originating from sympathetic nerve endings and chromaffin cells of the adrenal gland, results in further progressive deterioration in cardiac structure and function. At the molecular level, sustained sympathetic nervous system hyperactivity is responsible for several alterations including altered beta-adrenergic receptor signaling and function (down-regulation/ desensitization). Moreover, the detrimental effects of catecholamine affect also the function of different cell types including, but not limited to, endothelial cells, fibroblasts and smooth muscle cells. Thus, the success of beta-blocker therapy is due, at least in part, to the protection of the heart and the vasculature from the noxious effects of augmented catecholamine levels. The research topic aimed to support the progress towards understanding the role of sympathetic nervous system under physiological conditions, and the contribution of its hyperactivity in the pathogenesis and progression of cardiovascular diseases.

Ca2+ Signaling and Heart Rhythm

Authors: --- --- ---
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889198740 Year: Pages: 133 DOI: 10.3389/978-2-88919-874-0 Language: English
Publisher: Frontiers Media SA
Subject: Physiology --- Science (General)
Added to DOAB on : 2016-01-19 14:05:46
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Ca2+ is a key second messenger in the intricate workings of the heart. In cardiac myocytes, Ca2+ signaling controls or modulates electrophysiological function, excitation-contraction coupling, contractile function, energy balance, cell death, and gene transcription. Thus, diverse Ca2+-dependent regulatory processes occur simultaneously within a cell. Yet, distinct signals can be resolved by local Ca2+ sensitive protein complexes and differential Ca2+ signal integration. In addition to its importance to normal cardiac function, such regulation is also crucial in disease conditions. Ca2+ is likely involved in ectopic cardiac rhythms in both atrial and ventricular tissues through generating triggered activity often appearing as delayed afterdepolarisations, particularly following cellular Ca overloading. Recent studies also implicate Ca2+ in Na+ channel expression and properties with consequences for conduction velocity and therefore arrhythmic substrate. At the cellular level, such regulation involves control of the activity of membrane ion channels and Ca2+ handling proteins. These in turn involve multiple extra- and intracellular signaling pathways. This e-book assembles review and original articles from experts in this field. It summarises major recent progress bearing on roles of Ca2+ in cardiac electrophysiological function encompassing both normal and abnormal cardiac function. These extend from physiological roles of Ca2+ signaling in pacemaker function, in particular generation of sino-atrial pacemaker potentials, to pathological roles of abnormal Ca2+ signaling in both atrial and ventricular arrhythmogenesis. It also seeks to bridge the gap between advances in basic science and development of new therapies.

Keywords

Ca2+ --- Heart --- Pak1 --- SA node --- voltage gated Ca2+ channels --- TRPC --- STIM1 --- Orai1 --- PP2A

Dysregulation of Autonomic Cardiac Control by Traumatic Stress and Anxiety

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889199150 Year: Pages: 118 DOI: 10.3389/978-2-88919-915-0 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Psychology
Added to DOAB on : 2016-01-19 14:05:46
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Current understanding of the interplay between sympathetic and parasympathetic influences on cardiac response to environmental stimuli and subsequent response selection (e.g. maintenance of resting homeostasis, mobilization of defensive response, task performance, tonic immobilization, and/or affiliation) will be explored. Reference will be made to how these processes conjoin with proposed polyvagal theory. Cardiac adjustments to environmental stimuli affect the internal physiological state of the organism as well as the quality of information processing that the individual can perform during the stimulus appraisal stage of the orienting response. Bradyrdia is adaptive in early stages of orientation to novel or potential threat, while greater HRV power serves to facilitate self-regulation, stimulus information processing and appraisal, and appropriate response selection. This issue is devoted to current research findings on how normal patterns of cardiac autonomic regulation of HRV are disrupted in PTSD, impairing sustained attention to the environment and increasing the rate of inappropriate responding to stimuli. Origins of our current state of understanding in the ‘intake-rejection’ hypothesis will be considered, and how the intake-rejection hypothesis has morphed into present-day Optimal Performance practice. Additionally, empirical data where available will be presented on how dysregulation of the normal pattern of cardiac autonomic regulation by PTSD impairs sustained attention to the environment, and increases the rate of inappropriate responding to stimuli through disinhibition, poor impulse control, emotional withdrawal, over-arousal, and attentional bias. Current research findings are sought that address in controlled, experimental and clinical trials the restorative effects of HRV biofeedback on HRV power, and how increases in HRV power relate to improved attention / immediate memory and self-regulation of affect using outcome measures of cognition, symptoms of PTSD and depression, stress perception, and level of adaptive function.

Carotid Body: A New Target for Rescuing Neural Control of Cardiorespiratory Balance in Disease

Authors: --- ---
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889199433 Year: Pages: 134 DOI: 10.3389/978-2-88919-943-3 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Physiology
Added to DOAB on : 2016-01-19 14:05:46
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The carotid body (CB) is in charge of adjusting ventilatory and cardiovascular function during changes in arterial blood gases. Regardless this essential function, the CB has been implicated in the sensing of other physiological signals such as changes in blood flow and glucose levels. More important, malfunction of the CB chemoreceptors has been associated with the progression and deterioration of several disease states such as hypertension, heart failure, renal failure, insulin resistance, diabetes and sleep apnea. Although the mechanisms involved in the alterations of the CB function in pathophysiology are currently under intense research, the development of therapeutic approaches to restore normal CB chemoreflex function remains unsolved. Recent studies showing the effect of CB denervation in pathophysiology have unveiled a key role of these arterial chemoreceptors in the development of autonomic imbalance and respiratory disturbances, and suggest that targeting the CB could represent a novel strategy to improve disease outcome. Unfortunately, classical pharmacotherapy intended to normalize CB function may be hard to establish since several cellular pathways are involved in the CB dysfunction. Augmented levels of angiotensin II, endothelin-1, cytokines and free radicals along with decreases in nitric oxide had all been related to the CB dysfunction. Moreover, changes in expression of angiotensin receptors, nitric oxide synthases and cytokines that take place within the CB tissue in pathological states also contribute to the enhanced CB chemoreflex drive. It has been shown in heart failure, hypertension and obstructive sleep apnea that the CB becomes tonically hyper-reactive. During the progression of the disease this CB chemosensory facilitation process induces central nervous system plasticity. The altered autonomic-respiratory control leads to increased cardiorespiratory distress and the deterioration of the condition. The focus of this e-book will be to cover the role of the CB in pathophysiology and to provide new evidence of the pathways involved in the maladaptive potentiation of the CB chemoreflex function. In memory of Professor Mashiko Shirahata and Professor Constancio Gonzalez.

The Adrenergic System in Cardiovascular Physiology and Pathophysiology, 2nd Edition

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889197316 Year: Pages: 78 DOI: 10.3389/978-2-88919-731-6 Language: English
Publisher: Frontiers Media SA
Subject: Physiology --- Science (General)
Added to DOAB on : 2016-04-07 11:22:02
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Cardiovascular diseases pose an enormous clinical challenge, remaining the most common cause of death in the world. ß-adrenoceptors play an important role on cardiac, vascular and/or endothelial function at a cellular level with relevant applications in several cardiovascular diseases, such as heart failure and hypertension. G protein– coupled receptors (GPCRs), including ß-adrenergic receptors, constitute the most ubiquitous superfamily of plasma membrane receptors and represent the single most important type of therapeutic drug target. Sympathetic nervous system hyperactivity, which characterizes several cardiovascular diseases, such as heart failure and hypertension, as well as physiological ageing, has been proved to exert in the long-term detrimental effects in a wide range of cardiovascular diseases. Acutely, sympathetic hyperactivity represents the response to an insult to the myocardium, aiming to compensate for decreased cardiac output. This process involves the activation of beta-adrenergic receptors by catecholamine with consequent heart rate and cardiac contractility increase. However, long-term exposure of the heart to elevated norepinephrine and epinephrine levels, originating from sympathetic nerve endings and chromaffin cells of the adrenal gland, results in further progressive deterioration in cardiac structure and function. At the molecular level, sustained sympathetic nervous system hyperactivity is responsible for several alterations including altered beta-adrenergic receptor signaling and function (down-regulation/ desensitization). Moreover, the detrimental effects of catecholamine affect also the function of different cell types including, but not limited to, endothelial cells, fibroblasts and smooth muscle cells. Thus, the success of beta-blocker therapy is due, at least in part, to the protection of the heart and the vasculature from the noxious effects of augmented catecholamine levels. The research topic aimed to support the progress towards understanding the role of sympathetic nervous system under physiological conditions, and the contribution of its hyperactivity in the pathogenesis and progression of cardiovascular diseases.

Function of Renal Sympathetic Nerves

Authors: --- ---
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889452958 Year: Pages: 96 DOI: 10.3389/978-2-88945-295-8 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Physiology
Added to DOAB on : 2018-02-27 16:16:44
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Sympathetic overactivity is associated with the development of hypertension. Renal denervation (RDN) prevents or delays hypertension in a variety of animal models, which laid the groundwork for the introduction of RDN as a clinical therapy in humans. In 2007, a novel, minimally invasive RDN ablation catheter was first trialled in hypertensive patients, with a 93% success rate of lowering blood pressure for at least three years post-RDN. However, a large scale, sham-controlled clinical trial (Symplicity HTN -3) failed to show reductions in BP greater than sham. The aim of this research topic was to evaluate the efficacy and safety of RDN, to explore the contribution of both afferent and efferent renal nerve activity to hypertension and non-hypertension disorders, and to stimulate future research to better understand the function of the renal nerves and the effects of RDN by highlighting gaps in knowledge.

Can't Get You Out of My Head: Brain-Body Interactions in Perseverative Cognition

Authors: --- --- --- --- et al.
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889454143 Year: Pages: 111 DOI: 10.3389/978-2-88945-414-3 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Neurology
Added to DOAB on : 2018-11-16 17:17:57
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Perseverative cognition is defined as the repetitive or sustained activation of cognitive representations of past stressful events or feared events in the future and even at non-clinical levels it causes a “fight-or-flight” action tendency, followed by a cascade of biological events, starting in the brain and ending as peripheral stress responses. In the past decade, such persistent physiological activation has proven to impact individuals’ health, potentially leading to somatic disease. As such, perseverative cognition has recently been proposed as the missing piece in the relationships between stress, psychopathology, and risk for health. Perseverative cognition is indeed a hallmark of conditions such as anxiety and mood disorders that are at increased -though still unexplained- cardiovascular risk. Although the pivotal role of ruminative and worrisome thoughts in determining the onset and maintenance of psychopathological disorders has been acknowledged for a long time, its effects on the body via reciprocal influences between mental processes and the body's physiology have been neglected. Moreover, perseverative cognition is definitely not restricted to psychopathology, it is extremely common and likely even omnipresent, pervading daily life. The objective of the Research Topic is to provide an interdisciplinary examination of cutting-edge neuroscientific research on brain-body signatures of perseverative cognition in both healthy and psychopathological individuals. Despite the evident role of the brain in repetitive thinking and the assumption that our mind is embodied, bran-body pathways from perseverative cognition to health risk have remained largely unexplored.

Neuro-Development and Psychological Issues in Congenital Heart Defects

Authors: ---
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889454280 Year: Pages: 87 DOI: 10.3389/978-2-88945-428-0 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General) --- Pediatrics
Added to DOAB on : 2018-11-16 17:17:57
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The advances in the peri-operative management of congenital heart defects have substantially improved the survival of infants over the last few decades, reaching >95% survival in the reports of the international congenital data-base from the European Association of Cardio-Thoracic Surgery and form the Society of Thoracic Surgery (North-America).Nevertheless, the surviving children often experience neurodevelopmental deficits and behavioral, emotional and social issues. These problems often have a profound impact on the quality of life of the growing population of these children at risk and their families.

Recent Advances in Doppler Signal Processing and Modelling Techniques for Fetal Monitoring

Authors: --- ---
Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889455362 Year: Pages: 99 DOI: 10.3389/978-2-88945-536-2 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Physiology
Added to DOAB on : 2019-01-23 14:53:42
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The guest editors of this eBook have accepted 10 very high-quality submissions for inclusion in a special issue of Frontiers in Physiology. The key difference between this eBook and contemporary fetal physiology related literature is that this Research Topic summarizes additional insights into the physiological link between physiologically understandable mathematical indices of fetal signals and the developing cardiovascular functions in fetal health and compromises. This book should be of considerable help to researchers, professionals in fetal monitoring device industries, academics, and graduate students from a wide range of disciplines. The text provides a comprehensive account of recent research in this emerging field and we anticipate that the concepts presented here will generate further research in this field.

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