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Biomedical subjects

J B Chambers

Publications and source records attributed to J B Chambers.

At least 19 recordsLinked to original sources

Maternal cardiac function in fetal growth-restricted and non-growth-restricted small-for-gestational age pregnancies.

OBJECTIVE: To compare maternal cardiac function in women with intrauterine growth restriction (IUGR) to those with small-for-gestational age (SGA) pregnancies (non-IUGR). METHODS: This was a cross-sectional study involving maternal echocardiography and uterine, umbilical and fetal middle cerebral artery Doppler assessment in 52 normotensive women at 20-36 weeks' gestation with SGA fetuses (26 IUGR and 26 non-IUGR). RESULTS: In the IUGR (compared to the non-IUGR) group, maternal cardiac output (CO) was lower (4.7 vs. 6.1 L/min, P<0.001) and total vascular resistance (TVR) was higher (1444 vs. 1088 dynes/s/cm5, P<0.001). The lower CO was due to a lower preload, demonstrated by a reduced stroke volume (59.9 vs. 73.6 mL, P<0.01) and smaller left atrial diameter (LAD) (31.5 vs. 34.1 mm, P=0.01). Mean arterial pressure and diastolic function were similar between the groups. Logistic regression and receiver-operating characteristics curve analysis for detection of IUGR demonstrated that a model using TVR, LAD, fetal middle cerebral artery pulsatility index and gestational age, had a sensitivity of 96.2% and a specificity of 84.6%. CONCLUSIONS: Maternal echocardiography can provide a very sensitive tool for identifying IUGR pregnancies.

Adult↗

A simple score for predicting coronary artery disease in patients with chest pain.

BACKGROUND: We have previously derived a chest pain score by comparing those with and without coronary artery disease on angiography, which was subsequently validated in patients attending coronary angiography. AIM: To test the predictive validity of the score prospectively in a more varied out-patient population, and to determine whether it had predictive validity in addition to exercise testing. DESIGN: Prospective clinical study. METHODS: The score was applied to 405 out-patients with chest pain who subsequently underwent coronary angiography. Framingham risk analysis and exercise testing were performed in 155. RESULTS: The score had a sensitivity of 91.4% and specificity of 28% for coronary artery disease, which was found in 31.8%, 51%, 63%, and 82% of those with scores of 0, 1, 2, and 3, respectively. Gender (p < 0.001), age (p < 0.001), and chest pain score (p = 0.009) independently predicted coronary artery disease on multivariate Poisson regression analysis. The chest pain score had additive predictive value with Framingham risk analysis and Duke's score. DISCUSSION: This simple chest pain score can predict coronary anatomy with similar sensitivity to exercise testing, and can be used in conjunction with exercise testing and other measures. Further validation of the chest pain score in the primary care setting will be useful.

Aged↗

Cardiovascular and metabolic responses to fasting and thermoneutrality in Ay mice.

Several lines of evidence support a role for reduced melanocortin signaling in the regulation of metabolic rate and cardiovascular function during negative energy balance. We tested the hypothesis that agouti yellow (B6.Cg-A(y)) mice would exhibit blunted physiologic responses to fasting and thermoneutrality. Male B6.Cg-A(y) mice (A(y); n=11, 34+/-2 g) and lean B6 littermates (B6; n=7, 26+/-2 g) were implanted with telemetry devices and housed in metabolic chambers (T(a)=23 degrees C) to determine the effects of a 24-h fasting and exposure to thermoneutrality (T(a)=30 degrees C) on mean arterial pressure (MAP), heart rate (HR), AP and HR variability (time and frequency domain), oxygen consumption (VO(2)), and locomotor activity. A(y) mice exhibited elevated baseline light-period MAP (A(y): 113+/-4; B6: 99+/-3 mm Hg) and VO(2) (A(y): 1.82+/-0.08 vs. B6: 1.45+/-0.13 ml/min) with no difference in HR (A(y): 530+/-12 vs. B6: 548+/-19 bpm). At 12-24 h after food removal, A(y) mice displayed normal fasting-induced bradycardia (A(y): -106+/-12; B6: -117+/-19 bpm) and reduction in VO(2) (A(y): -0.19+/-0.04 vs. B6: -0.28+/-0.05 ml/min), but with augmented hypotension (A(y): -9+/-2 vs. B6: -0.5+/-2 mm Hg) and blunted hyperactivity (A(y): 27+/-23 vs. B6: 122+/-42 m/11 h). Fasting was associated with increased HR variability in both time and frequency domain in B6 but not A(y) mice. Exposure to thermoneutrality produced comparable reductions in MAP, HR, and VO(2) in both strains. We conclude that inhibition of melanocortin signaling is not requisite for, but participates in, the metabolic and cardiovascular responses to negative energy balance.

Agouti Signaling Protein↗

Diet-induced obesity and cardiovascular regulation in C57BL/6J mice.

1. In the present study, we determined the effect of diet-induced obesity on cardiovascular and metabolic regulation in mice at standard laboratory temperatures (ambient temperature (Ta) = 22 degrees C) and during exposure to thermoneutrality (Ta = 30 degrees C). 2. Male C57BL/6J (B6) mice fed a high-fat diet (HFF; n = 17) or chow (CHW; n = 14) for 15 weeks were surgically instrumented with telemetry devices, housed in metabolic chambers and assigned to either control or atenolol treatment (25 mg/kg per day in drinking water) to determine the effects of obesity on baseline cardiovascular function and on the responses to thermoneutrality and 24 h fasting. Mean arterial pressure (MAP), heart rate (HR), arterial pressure and HR variability (time and frequency domain), oxygen consumption (VO2) and locomotor activity were determined. 3. The HFF mice exhibited increased bodyweight (+10.6 +/- 4.1 g), moderate light period hypertension (+8.6 +/- 2.6 mmHg), no difference in HR and increased HR variability at standard laboratory temperature compared with CHW controls. Atenolol produced less of a decrease in HR in HFF mice (-42 +/- 10 b.p.m.) compared with CHW controls (-73 +/- 15 b.p.m.). Acute exposure to thermoneutrality (Ta = 30 degrees C) reduced HR similarly in both HFF and CHW mice (approximately 175 b.p.m.), but reduced MAP less in HFF than in CHW mice (-7.3 +/- 2.5 and -15.2 +/- 1.0 mmHg), respectively. Atenolol treatment had only minor effects on the HR response to thermonuetrality (-114 +/- 13 and -129 +/- 8 b.p.m. in HFF and CHW mice, respectively). The HFF mice displayed greater fasting-induced reductions in light period MAP than did CHW mice (-10.0 +/- 1.1 vs-3.1 +/- 3.5 mmHg, respectively), whereas HR was decreased equally in both groups. Fasting-induced increases in HR variability were attenuated in HFF mice. 4. We conclude that diet-induced obesity produced generally minor changes in cardiovascular regulation in B6 mice at baseline, some of which are distinct from the effects of diet-induced obesity in larger animal models. In contrast, acute variations in Ta or caloric availability produce pronounced alterations in cardiovascular function in either lean or obese mice, which are generally evident after atenolol and, thus, presumably not due exclusively to variation in cardiac sympathetic activity. Interestingly, the degree of obesity induced hypertension was augmented when mice were studied at thermonuetrality. The results suggest an important unrecognized role for vagal tone in the regulation of cardiovascular function in mice and support the need for considerable caution when using mouse models of obesity to examine regulation of cardiovascular function. We argue that mouse physiology studies should be performed in thermoneutral conditions.

Animals↗

A comparison of wall motion analysis and systolic left ventricular long axis function during dobutamine stress echocardiography.

AIMS: To compare long-axis function and wall motion analysis for the detection of significant coronary artery stenoses in patients with single and multivessel disease. METHODS AND RESULTS: We performed dobutamine stress echocardiography in 67 subjects, 14 with normal coronary anatomy, and 53 with significant coronary disease. A blunted increase in mean long-axis shortening of <0.25 cm was the best discriminator for coronary artery disease (sensitivity 85%, specificity 81%). Using this threshold, long axis function gave a sensitivity of 88% and specificity 89% for the detection of coronary artery disease in patients with normal resting wall motion while wall motion abnormality analysis had a sensitivity 73% and specificity 94%. Of 26 patients with a resting wall motion abnormality, 14 (54%) had multivessel disease. Long axis function detected multivessel disease in 12 of these (sensitivity 86%) compared with nine (sensitivity 64%) for wall motion analysis. CONCLUSION: Long axis function provides a promising, quantitative adjunct to wall motion analysis for the detection of coronary ischaemia using dobutamine stress echocardiography in patients with single and multivessel disease and with resting wall motion abnormalities.

Adult↗

Cardiovascular responses to caloric restriction and thermoneutrality in C57BL/6J mice.

We utilized variations in caloric availability and ambient temperature (T(a)) to examine interrelationships between energy expenditure and cardiovascular function in mice. Male C57BL/6J mice (n = 6) were implanted with telemetry devices and housed in metabolic chambers for measurement of mean arterial pressure (MAP), heart rate (HR), O(2) consumption (VO(2)), and locomotor activity. Fasting (T(a) = 23 degrees C), initiated at the onset of the dark phase, resulted in large and transient depressions in MAP, HR, VO(2), and locomotor activity that occurred during hours 6-17, which suggests torporlike episodes. Food restriction (14 days, 60% of baseline intake) at T(a) = 23 degrees C resulted in progressive reductions in MAP and HR across days that were coupled with an increasing occurrence of episodic torporlike reductions in HR (<300 beats/min) and VO(2) (<1.0 ml/min). Exposure to thermoneutrality (T(a) = 30 degrees C, n = 6) reduced baseline light-period MAP (-14 +/- 2 mmHg) and HR (-184 +/- 12 beats/min). Caloric restriction at thermoneutrality produced further reductions in MAP and HR, but indications of torporlike episodes were absent. The results reveal that mice exhibit robust cardiovascular responses to both acute and chronic negative energy balance. Furthermore, we conclude that T(a) is a very important consideration when assessing cardiovascular function in mice.

Animals↗

A chest pain score for stratifying the risk of coronary artery disease in patients having day case coronary angiography.

'Typical' or 'atypical' are universally used descriptions of chest pain, but they are limited by subjectivity. This study tested the ability of a semi-objective chest pain score to predict the likelihood of coronary disease. A chest pain questionnaire was given to 250 patients with stable chest pain attending coronary angiography. The answers to three questions were defined as 'typical' or 'atypical' and summed to give a 'typical' score between 0 and 3. Logit analysis was performed based on an age cut-off of 55 years and 'typical' score. There were 96 (38%) patients with normal coronary arteries and 154 (62%) with coronary disease. In patients aged under 55 years, the likelihood of coronary disease by 'typical' score was 11% (score 0), 30% (score 1), 40% (score 2), 53% (score 3). Similar figures for age 55 years were 39% (score 0), 45% (score 1), 77% (score 2), and 85% (score 3). There is a direct relationship between 'typical' chest pain score and the likelihood of coronary artery disease. This scoring system may be useful in the clinical characterization of patients for research, for guiding referral to a cardiologist or for aiding the decision to perform coronary angiography.

Adult↗

Clinical safety of SonoVue, a new contrast agent for ultrasound imaging, in healthy volunteers and in patients with chronic obstructive pulmonary disease.

RATIONALE AND OBJECTIVES: To evaluate the safety profile of SonoVue, a new echo-contrast agent based on stabilized sulfur hexafluoride (SF6) microbubbles, in healthy volunteers and in patients with chronic obstructive pulmonary disease (COPD). METHODS: Safety and tolerability of SonoVue were evaluated in 66 healthy volunteers during two placebo-controlled phase I studies (a single intravenous ascending-dose study in 36 volunteers given SonoVue doses of 0.003 to 0.12 mL/kg and a multiple-dose study in 30 subjects given cumulative doses of 0.15 to 0.6 mL/kg) and in 12 patients with COPD of various degrees of clinical severity, who were given SonoVue at a dosage of 4 mL (corresponding to 0.057 mL/kg in a 70-kg patient). Adverse events were monitored up to 48 to 72 hours after administration. All volunteers underwent extensive safety assessments (monitoring of vital signs, electrocardiogram, blood oxygen saturation, laboratory assessments, and Mini-Mental test) up to 24 to 72 hours after administration. In addition, patients with COPD underwent specific lung function tests, such as forced expiratory volume, forced vital capacity, and forced midexpiratory flow. RESULTS: No serious adverse events occurred throughout the study. All nonserious adverse events were minor, mild, and rapidly self-resolving. No difference in the incidence of adverse events was observed among the various dosages of SonoVue and between SonoVue and placebo. There were no clinically significant changes in any of the safety assessments. No statistically significant differences between SonoVue and placebo were observed in mean forced expiratory volume, forced vital capacity, or forced midexpiratory flow levels. No substantial changes from baseline in blood oxygen saturation were observed for either study agent at any postinjection time point. CONCLUSIONS: SonoVue showed a good safety profile both in healthy subjects and in patients with COPD.

Adult↗

Cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in obese Zucker rats.

The primary purpose of the study was to test the hypothesis that reduced leptin signaling is necessary to elicit the cardiovascular and metabolic responses to fasting. Lean (Fa/?; normal leptin receptor; n = 7) and obese (fa/fa; mutated leptin receptor; n = 8) Zucker rats were instrumented with telemetry transmitters and housed in metabolic chambers at 23 degrees C (12:12-h light-dark cycle) for continuous (24 h) measurement of metabolic and cardiovascular variables. Before fasting, mean arterial pressure (MAP) was higher (MAP: obese = 103 +/- 3; lean = 94 +/- 1 mmHg), whereas oxygen consumption (VO(2): obese = 16.5 +/- 0.3; lean = 18.6 +/- 0.2 ml. min(-1). kg(-0.75)) was lower in obese Zucker rats compared with their lean controls. Two days of fasting had no effect on MAP in either lean or obese Zucker rats, whereas VO(2) (obese = -3.1 +/- 0.3; lean = -2.9 +/- 0.1 ml. min(-1). kg(-0.75)) and heart rate (HR: obese = -56 +/- 4; lean = -42 +/- 4 beats/min) were decreased markedly in both groups. Fasting increased HR variability both in lean (+1.8 +/- 0.4 ms) and obese (+2.6 +/- 0.3 ms) Zucker rats. After a 6-day period of ad libitum refeeding, when all parameters had returned to near baseline levels, the cardiovascular and metabolic responses to 2 days of thermoneutrality (ambient temperature 29 degrees C) were determined. Thermoneutrality reduced VO(2) (obese = -2.4 +/- 0.2; lean = -3.3 +/- 0.2 ml. min(-1). kg(-0.75)), HR (obese = -46 +/- 5; lean = -55 +/- 4 beats/min), and MAP (obese = -13 +/- 6; lean = -10 +/- 1 mmHg) similarly in lean and obese Zucker rats. The results indicate that the cardiovascular and metabolic responses to fasting and thermoneutrality are conserved in Zucker rats and suggest that intact leptin signaling may not be requisite for the metabolic and cardiovascular responses to reduced energy intake.

Animals↗

Central leptin infusion attenuates the cardiovascular and metabolic effects of fasting in rats.

The role of reduced leptin signaling in the regulation of cardiovascular responses to negative energy balance is not known. We tested the hypothesis that central infusion of leptin would attenuate the cardiovascular and metabolic responses to fasting. Male Sprague-Dawley rats, instrumented with telemetry devices and intracerebroventricular cannulas, were housed in metabolic chambers for continuous (24 hours) measurement of dark-phase (active) and light-phase (inactive) mean arterial pressure, heart rate, oxygen consumption, and respiratory quotient. Rats received central infusions of either saline (0.5 microL/h) or leptin (42 ng/h) for 6 days through osmotic pumps and were either fed ad libitum or were fasted for 48 hours followed by refeeding for 4 days. In ad lib animals, continuous intracerebroventricular leptin infusion significantly reduced caloric intake, body weight, and respiratory quotient compared with saline controls while having no effect on mean arterial pressure or heart rate. Fasting reduced mean arterial pressure, heart rate, oxygen consumption, and respiratory quotient in rats receiving saline infusions. Fasting-induced reductions in mean arterial pressure were specific to the active phase and were not attenuated by central leptin infusion. In contrast, intracerebroventricular leptin, at a dose that had no cardiovascular effects in ad lib control animals, completely prevented fasting-induced decreases in light-phase heart rate and oxygen consumption and blunted fasting-induced reductions in dark-phase heart rate and oxygen consumption. The results are consistent with the hypothesis that reductions in central leptin signaling contribute to the integrated cardiovascular and metabolic responses to acute caloric deprivation.

Animals↗

Concurrent reductions in blood pressure and metabolic rate during fasting in the unrestrained SHR.

Fasting produces multiple cardiovascular, metabolic, and behavioral responses. To examine the interrelationship between these responses, male spontaneously hypertensive rats (SHR; n = 8) implanted with cardiovascular telemetry devices were housed in metabolic chambers at 23 degrees C for 22-h daily measurements of physiological variables. The experimental apparatus was designed so that ingestive behavior was detected by photobeams and locomotion was detected by a load sensor. Cardiovascular and metabolic status were determined as both a function of the circadian cycle (12-h dark and 10-h light), as well as during periods of inactivity (no ingestion and minimal locomotion) within the dark and light phases. Data were obtained during baseline, 48-h of caloric deprivation, and 6 days of refeeding. Fasting produced significant reductions in mean arterial pressure (dark: -9.2+/-1.3 from 143.7+/-3.7 mm Hg; light: -8.6+/-1.8 from 140.1+/-3.7 mm Hg), heart rate (dark: -43.4+/-5.2 from 330.0+/-5.2 beats/min; light: -27.4+/-5.2 from 294.0+/-5.2 beats/min), and oxygen consumption (dark: -5.0+/-0.6 from 20.6+/-0.3 ml x min(-1) x kg (0.75); light: -2.7+/-0.2 from 14.9 +/-0.2 ml x min(-1) x kg(0.75)). Analysis of inactive periods during both light and dark phases revealed that these reductions were not dependent on behavioral effects. We conclude that fasting produces concurrent and interrelated reductions in cardiovascular and metabolic function in the SHR. The merging of cardiovascular telemetry, indirect calorimetry, and behavioral monitoring provides a powerful approach for investigation of the integrative physiological responses to energetic challenges.

Animals↗

Cardiovascular and metabolic responses of hypertensive and normotensive rats to one week of cold exposure.

Challenges to energy homeostasis, such as cold exposure, can have consequences for both metabolic and cardiovascular functioning. We hypothesized that 1-wk cold exposure (4 degrees C) would produce concurrent increases in metabolic rate (VO(2); indirect calorimetry), heart rate (HR), and mean arterial blood pressure (MAP) measured by telemetry. In the initial hours of change in ambient temperature (T(a)), both spontaneously hypertensive rats (SHRs) and normotensive Sprague-Dawley rats showed rapid increases (in cold) or decreases (in rewarming) of VO(2), HR, and MAP, although the initial changes in MAP and HR were more exaggerated in SHRs. Throughout cold exposure, HR, VO(2), food intake, and locomotor activity remained elevated but MAP decreased in both strains, particularly in the SHR. During rewarming, all measures normalized quickly in both strains except MAP, which fell below baseline (hypotension) for the first few days. The results indicate that variations of T(a) produce rapid changes in a suite of cardiovascular and behavioral responses that have many similarities in hypertensive and normotensive strains of rats. The findings are consistent with the general concept that the cardiovascular responses to cold exposure in rats are closely related to and perhaps a secondary consequence of the mechanisms responsible for increasing heat production.

Acclimatization↗