Effects of decreasing stimulation frequency on length-force characteristics were determined for rat medial gastrocnemius muscle. The peripheral nerve was stimulated supramaximally with a succession of twitch and frequencies of 100, 50, 40, 30, and 15 Hz. Active peak tetanic and twitch forces and active muscle geometry were analyzed. Optimal muscle length and active slack length shifted significantly (P < 0.05) to higher muscle length by a maximum of 2.8 and 3.2 mm, respectively. Further significant effects were found for distal fiber length and mean sarcomere length of distal fiber (increases) and for fiber angle and aponeurosis length (decreases). Neither muscle length range between active slack and optimal length nor aponeurosis angle was altered significantly. We concluded that decreasing stimulation frequency-dependent length-force characteristics are affected by a complex interaction of length-dependent calcium sensitivity, potentiation of the contractile system, distribution of sarcomere length, and interactions between force exerted and aponeurosis length. Length-dependent calcium sensitivity seems to be a major factor determining the magnitude of the shift of optimal muscle length.
In vivo strain measurements at 8 locations on the tibia of the goat were performed. Successive in vitro calibrations were used to determine the assumed linear relationship between the measured strain signals and the external loads (3 forces and 3 moments) at the tibia. For the reconstruction of the in vivo external loads from the strain data, a transformation matrix was created from the calibration experiments, using ‘singular-value decomposition’. The method is a reliable technique for measuring in vivo loads during functional gait and gives reproducible results.
Introduction: Patients with severe aortic stenosis and regurgitation who are inoperable or at high-risk for surgery can be treated with transcatheter aortic valve replacement (TAVR). The aim of this study was to provide a comprehensive overview of the literature of TAVR and reported clinical and performance outcomes. Areas covered: A total of 16 devices, described in 204 articles describing clinical and performance outcomes, were included. The most frequently observed outcome was 30-day mortality, ranging between 0-23%. Other commonly reported clinical outcomes were 30-day stroke, ranging between 0-14.3% and pacemaker implantation, ranging from 0-44.9%. The most common valve performance outcome was aortic valve regurgitation, however, mostly reported at 7 days follow-up. Next to a followup period of 30 days, numerous articles reported outcomes at 6 months and 1 year. The numbers of articles describing outcomes with a longer follow-up as well as including intermediate and low-risk patients were limited. Expert commentary: This literature review provided a clear overview of the reported clinical and performance outcomes of TAVR devices. Despite the frequently used VARC-2 definitions, we identified a huge variation across studies. Future studies using standardized definitions of study setups and outcomes are essential and might lead to better insights of TAVR.
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