Hybrid ablation of persistent AF achieved stable sinus rhythm in a significant proportion of patients, as evidenced by continuous ECG monitoring, resulting in important LA and LV reverse remodeling after 12 months.

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Objectives: In women with severe preeclampsia the period immediately before and early postdelivery carries the greatest risk for cardiac decompensation due to acute changes in loading conditions. The authors aimed to evaluate dynamic changes in hemodynamic and echocardiographic-derived systolic and diastolic function parameters in preeclamptic women compared with healthy controls. Methods: Thirty women with severe preeclampsia and 30 healthy controls underwent transthoracic echocardiography 1 day before, 1 and 4 days postdelivery. Fluid responsiveness was assessed by passive leg raising. Results: Peak systolic myocardial velocities (s′) and global longitudinal strain (GLS) were significantly lower in preeclamptic group compared with controls only postdelivery (s′: 7.3 ± 0.8 vs. 8.3 ± 0.9 cm/s, P < 0.001; GLS: −21.4 ± 2.0 vs. −23.0 ± 1.4%, P = 0.027). In addition, significant decrease in s′ after delivery was observed only in preeclamptic group (P = 0.004). For diastolic parameters there were differences both before and postdelivery in E/e′ ratio (before: 8.4 ± 2.16 vs. 6.7 ± 1.89, P = 0.002; postdelivery: 8.3 ± 1.64 vs. 6.8 ± 1.27, P = 0.003) and mitral e′ velocity (before: 11.0 ± 2.39 vs. 12.6 ± 1.86, P = 0.004; postdelivery: 11.1 ± 2.28 vs. 14.0 ± 2.40 cm/s, P < 0.001). Significant increase in left ventricular stroke volume (P = 0.005) and transmitral E velocity (P = 0.003) was observed only in control group, reflecting response to volume load after delivery. Accordingly, only the minority of preeclamptic women were fluid responsive (11 vs. 43%, P = 0.014 between groups). Conclusion: Variations in cardiac parameters in healthy women seem to follow changes in loading conditions before and early after delivery. Different pattern in preeclamptic women, however, may be related to subtle myocardial dysfunction, that becomes uncovered with augmented volume load in early postpartum period.

Expression of acetylcholine receptor and of the asymmetric molecular forms of acetylcholinesterase (AChE) in the extrajunctional regions of rat muscles is suppressed during early postnatal development. In mature muscles, the extrajunctional synthesis of acetylcholine receptor, but not of the asymmetric molecular forms of AChE, becomes reactivated after denervation. The hypothesis that a denervated muscle needs reinnervation in order to revert transiently to an immature state characterized by high extrajunctional production of the asymmetric AChE forms, was examined in rat muscles recovering after nerve crush. Molecular forms of AChE were analysed by velocity sedimentation. Activity of the asymmetric A12 AChE form in the extrajunctional regions of the slow soleus (SOL) muscle increased during the first week after reinnervation to about 9 times its control level, remained high for about one week, and declined towards normal thereafter. If the nerve was crushed close to the muscle and reinnervation occurred very rapidly, the extrajunctional increase of the A12 AChE form still occurred but was less pronounced than after late reinnervation. In contrast, a transient paralysis of the SOL muscle due to acetylcholine receptor blockade by alpha-bungarotoxin, followed by spontaneous recovery of muscle activity after 3-5 days, did not revert AChE regulation into an immature state. Disuse of the SOL muscle caused by leg immobilization, which is known to change the tonic pattern of neural stimulation of the SOL muscle into a phasic one, did not prevent the reversion of AChE regulation during reinnervation. This indicates that neural stimulation pattern is not crucial for this reversion.(ABSTRACT TRUNCATED AT 250 WORDS)

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