Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation...Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.展开更多
Damage caused by the 2011 Tohoku Earthquake （Mw 9.0） to transmission and distribution pipelines in Sendai City is summarized. The locations of the pipeline repairs are discussed relative to earthquake intensity, geo...Damage caused by the 2011 Tohoku Earthquake （Mw 9.0） to transmission and distribution pipelines in Sendai City is summarized. The locations of the pipeline repairs are discussed relative to earthquake intensity, geomorphologic conditions and landform change in the developed areas of hilly land. Repair rate （repairs/km） is summarized according to pipe material and presence or absence of artificial landform change. The following findings were obtained： （1） More than 80% of the repairs took place in pipelines installed in higher lands such as hill and terrace areas consisting of hard soils; （2） Nearly all the pipe repairlocations in hill areas are where landform change was made through land development tor residential purposes over me past several decades; （3） The aforementioned repair rate was more than 3.6 times than that of other lowland areas where no landform change occurred. The heaviest concentrations of pipe repairs of vinyl chloride pipes and ductile iron pipes were observed within the boundary area between cutting and filling, having a thickness between -2.5 m and 2.5 m. Approximately 78% of the all pipe repairs occurred outside of areas where severe ground failures took place. A mechanism of pipe damage in the areas free of severe ground failure was discussed.展开更多
文摘Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.
文摘Damage caused by the 2011 Tohoku Earthquake （Mw 9.0） to transmission and distribution pipelines in Sendai City is summarized. The locations of the pipeline repairs are discussed relative to earthquake intensity, geomorphologic conditions and landform change in the developed areas of hilly land. Repair rate （repairs/km） is summarized according to pipe material and presence or absence of artificial landform change. The following findings were obtained： （1） More than 80% of the repairs took place in pipelines installed in higher lands such as hill and terrace areas consisting of hard soils; （2） Nearly all the pipe repairlocations in hill areas are where landform change was made through land development tor residential purposes over me past several decades; （3） The aforementioned repair rate was more than 3.6 times than that of other lowland areas where no landform change occurred. The heaviest concentrations of pipe repairs of vinyl chloride pipes and ductile iron pipes were observed within the boundary area between cutting and filling, having a thickness between -2.5 m and 2.5 m. Approximately 78% of the all pipe repairs occurred outside of areas where severe ground failures took place. A mechanism of pipe damage in the areas free of severe ground failure was discussed.
