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- Hawkins, N. M., et al.
(author)
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Prevalence and prognostic impact of bundle branch block in patients with heart failure: Evidence from the CHARM programme
- 2007
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In: European journal of heart failure. - : Wiley. - 1388-9842. ; 9:5, s. 510-7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Bundle branch block (BBB) is a powerful independent predictor of cardiovascular mortality in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). The prognostic implications in HF with preserved systolic function (HF-PSF) are less well understood. METHODS: The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme randomised 7599 patients with symptomatic HF to receive candesartan or placebo. The primary outcome comprised cardiovascular death or HF hospitalisation. The relative risk conveyed by BBB relative to a normal electrocardiogram was examined. RESULTS: The prevalence of BBB was significantly lower in patients with preserved compared with reduced systolic function (CHARM-Preserved 14.4%, Alternative 29.6%, Added 30.5%), p<0.0001. Overall, the adjusted hazard ratio for the primary outcome was 1.48 (95% confidence interval 1.22-1.78), p<0.0001, reflecting increased risk in patients with reduced LVEF (1.72 [1.28-2.31], p=0.0003). The apparently more modest risk among patients with HF-PSF was significant in unadjusted (1.80 [1.37-2.37], p<0.0001) but not adjusted analysis (1.16 [0.88-1.54], p=0.2897). However, no formal statistical difference was observed between the two cohorts, and interpretation is limited by the unknown prevalence of left and right BBB morphologies in each. Comparing BBB presence with absence yielded qualitatively similar results. CONCLUSION: The simple clinical finding of BBB is a powerful independent predictor of worse clinical outcomes in patients with HF and reduced LVEF. It is less frequent, with a more modest predictive effect, in patients with preserved systolic function.
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- Hawkins, N. M., et al.
(author)
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Prevalence and prognostic implications of electrocardiographic left ventricular hypertrophy in heart failure: evidence from the CHARM programme
- 2007
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In: Heart. - : BMJ. - 1468-201X .- 1355-6037. ; 93:1, s. 59-64
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Journal article (peer-reviewed)abstract
- BACKGROUND: Electrocardiographic left ventricular hypertrophy (ECG LVH) is a powerful independent predictor of cardiovascular morbidity and mortality in hypertension. OBJECTIVE: To determine the contemporary prevalence and prognostic implications of ECG LVH in a broad spectrum of patients with heart failure with and without reduced left ventricular ejection fraction (LVEF). METHODS AND OUTCOME: The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme randomised 7599 patients with symptomatic heart failure to receive candesartan or placebo. The primary outcome comprised cardiovascular death or hospital admission for worsening heart failure. The relative risk (RR) conveyed by ECG LVH compared with a normal ECG was examined in a Cox model, adjusting for as many as 31 covariates of prognostic importance. RESULTS: The prevalence of ECG LVH was similar in all three CHARM trials (Alternative, 15.4%; Added, 17.1%; Preserved, 14.7%; Overall, 15.7%) despite a more frequent history of hypertension in CHARM-Preserved. ECG LVH was an independent predictor of worse prognosis in CHARM-Overall. RR for the primary outcome was 1.27 (95% confidence interval (CI) 1.04 to 1.55, p = 0.018). The risk of secondary end points was also increased: cardiovascular death, 1.50 (95% CI 1.13 to 1.99, p = 0.005); hospitalisation due to heart failure, 1.19 (95% CI 0.94 to 1.50, p = 0.148); and composite major cardiovascular events, 1.35 (95% CI 1.12 to 1.62, p = 0.002). CONCLUSION: ECG LVH is similarly prevalent in patients with symptomatic heart failure regardless of LVEF. The simple clinical finding of ECG LVH was an independent predictor of a worse clinical outcome in a broad spectrum of patients with heart failure receiving extensive contemporary treatment. Candesartan had similar benefits in patients with and without ECG LVH.
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- Coleman, Ross A., et al.
(author)
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A continental scale evaluation of the role of limpet grazing on rocky shores
- 2006
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In: OECOLOGIA. - : Springer Science and Business Media LLC. - 0029-8549 .- 1432-1939. ; 147:3, s. 556-564
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Journal article (peer-reviewed)abstract
- It is critical for our knowledge of biodiversity and ecosystem processes to understand how individual species contribute to ecosystem processes and how these contributions vary in space and time. We used a manipulative field experiment in five locations over 17 degrees of latitude [from southern Portugal to the Isle of Man (British Isles)] to determine the relative response of rocky intertidal algal assemblages released from control by the grazing of limpets. Response ratios showed that when limpets were removed there was a trend of effects from north to south. In the north, grazing had a strong effect on algal assemblages, but removing grazers reduced spatial variability in assemblages. In the south, the effect of limpet grazing was far weaker and removal of grazers had a much reduced impact on spatial variability. Here we show a clear trophic control of an ecosystem in that grazing by limpets not only determines macroalgal abundance overall but also modifies ecosystem stability via variability in cover of algae.
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- Moschella, P. S., et al.
(author)
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Low-crested coastal defence structures as artificial habitats for marine life: Using ecological criteria in design
- 2005
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In: Coastal Engineering. - : Elsevier BV. - 0378-3839. ; 52:10-11, s. 1053-1071
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Journal article (peer-reviewed)abstract
- Coastal defence structures to protect sedimentary coastlines from erosion and flooding are increasingly common throughout Europe. They will become more widespread over the next 10-30 years in response to rising and stormier seas and accelerating economic development of the coastal zone. Building coastal defences results in the loss and fragmentation of sedimentary habitats and their replacement by artificial rocky habitats that become colonised by algae and marine animals. The engineering design and construction of these structures have received considerable attention. However, the ecological consequences of coastal defences have been less extensively investigated. Furthermore, due to their rapid proliferation, there is a growing need to understand the role of these man-made habitats in the coastal ecosystems in order to implement impact minimisation and/or mitigation measures. As part of the DELOS project, targeted studies were carried out throughout Europe to assess the ecological similarity of low-crested coastal defence structures (LCS) to natural rocky shores and to investigate the influence of LCS design features on the colonising marine epibiota. LCSs can be considered as a relatively poor surrogate of natural rocky shores. Epibiotic communities were qualitatively similar to those on natural rocky shores as both habitats are regulated by the same physical and biological factors. However, there were quantitative differences in the diversity and abundance of epibiota on artificial structures. Typically, epibiotic assemblages were less diverse than rocky shore communities. Also, LCSs offered less structurally complex habitats for colonisation and in some locations experienced higher disturbance than natural shores. We propose several criteria that can be integrated into the design and construction of LCSs to minimise ecological impacts and allow targeted management of diversity and natural living resources. (c) 2005 Elsevier B.V. All rights reserved.
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- Airoldi, L., et al.
(author)
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An ecological perspective on the deployment and design of low-crested and other hard coastal defence structures
- 2005
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In: Coastal Engineering. - : Elsevier BV. - 0378-3839. ; 52:10-11, s. 1073-1087
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Journal article (peer-reviewed)abstract
- Coastal areas play a crucial role in the economical, social and political development of most countries; they support diverse and productive coastal ecosystems that provide valuable goods and services. Globally flooding and coastal erosion represent serious threats along many coastlines, and will become more serious as a consequence of human-induced changes and accelerated sea-level rise. Over the past century, hard coastal defence structures have become ubiquitous features of coastal landscapes as a response to these threats. The proliferation of defence works can affect over half of the shoreline in some regions and results in dramatic changes to the coastal environment. Surprisingly little attention has been paid to the ecological consequences of coastal defence. Results from the DELOS (Environmental Design of Low Crested Coastal Defence Structures, EVK3-CT-2000-00041) project indicate that the construction of coastal defence structures will affect coastal ecosystems. The consequences can be seen on a local scale, as disruption of surrounding soft-bottom environments and introduction of new artificial hard-bottom habitats, with consequent changes to the native assemblages of the areas. Proliferation of coastal defence structures can also have critical impacts on regional species diversity, removing isolating barriers, favouring the spread of non-native species and increasing habitat heterogeneity. Knowledge of the environmental context in which coastal defence structures are placed is fundamental to an effective management of these structures as, while there are some general consequences of such construction, many effects are site specific. Advice is provided to meet specific management goals, which include mitigating specific impacts on the environment, such as minimising changes to surrounding sediments, spread of exotic species or growth of nuisance species, and/or enhancing specific natural resources, for example enhancing fish recruitment or promoting diverse assemblages for eco-tourism. The DELOS project points out that the downstream effects of defence structures on coastal processes and regional-scale impacts on biodiversity necessitate planning and management at a regional (large coastline) scale. To effectively understand and manage coastal defences, environmental management goals must be clearly stated and incorporated into the planning, construction, and monitoring stages. (c) 2005 Elsevier B.V. All rights reserved.
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- Forest, F., et al.
(author)
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The role of biotic and abiotic factors in evolution of ant dispersal in the milkwort family (Polygalaceae)
- 2007
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In: Evolution. - : Wiley. - 0014-3820 .- 1558-5646. ; 61:7, s. 1675-1694
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Journal article (peer-reviewed)abstract
- A phylogenetic approach was taken to investigate the evolutionary history of seed appendages in the plant family Polygalaceae (Fabales) and determine which factors might be associated with evolution of elaiosomes through comparisons to abiotic (climate) and biotic (ant species number and abundance) timelines. Molecular datasets from three plastid regions representing 160 species were used to reconstruct a phylogenetic tree of the order Fabales, focusing on Polygalaceae. Bayesian dating methods were used to estimate the age of the appearance of ant-dispersed elaiosomes in Polygalaceae, shown by likelihood optimizations to have a single origin in the family. Topology-based tests indicated a diversification rate shift associated with appearance of caruncular elaiosomes. We show that evolution of the caruncular elaiosome type currently associated with ant dispersal occurred 54.0-50.5 million year ago. This is long after an estimated increase in ant lineages in the Late Cretaceous based on molecular studies, but broadly concomitant with increasing global temperatures culminating in the Late Paleocene-Early Eocene thermal maxima. These results suggest that although most major ant clades were present when elaiosomes appeared, the environmental significance of elaiosomes may have been an important factor in success of elaiosome-bearing lineages. Ecological abundance of ants is perhaps more important than lineage numbers in determining significance of ant dispersal. Thus, our observation that elaiosomes predate increased ecological abundance of ants inferred from amber deposits could be indicative of an initial abiotic environmental function.
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- Jonsson, Per R., 1957, et al.
(author)
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Interactions between wave action and grazing control the distribution of intertidal macroalgae
- 2006
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In: Ecology. - 0012-9658 .- 1939-9170. ; 87:5, s. 1169-1178
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Journal article (peer-reviewed)abstract
- Canopy-forming macroalgae are key species on temperate rocky shores. However, there is a lack of understanding of how the relative balance of physical and biological factors controls the establishment and persistence of intertidal macroalgae. Here we present an integrated study of the relative importance of wave-induced forces and grazing for the recruitment and Survival of the canopy-forming intertidal macroalgae Fucus vesiculosus and F. spiralis. A set of overtopped breakwaters provided a nearly unconfounded gradient in wave exposure between seaward and landward sides. A biomechanical analysis was performed based on empirical measurements of maximum drag forces in breaking waves, a model of long-term maximum wave height, and the breaking stress of Fucus spp. The estimated maximum flow speed (7-8 m/s) on the seaward side of the breakwaters was predicted to completely dislodge or prune Fucus spp. larger than similar to 10 cm, while dislodgment was highly unlikely on the landward side for all sizes. Experimental transplantation of Fucus spp. supported the biomechanical analysis but also suggested that mechanical abrasion may further limit survival in wave-exposed locations. Experimental removal of the limpet Patella vulgata, which was the principal grazer at this site, resulted in recruitment of Fucus spp. on the seaward side. We present a model of limpet grazing that indicates that limpet densities > 5-20 individuals/m(2) provide a proximate mechanism preventing establishment of Fucus spp., whereas wave action > 2 m/s reduces persistence through dislodgment and battering. In a conceptual model we further propose that recruitment and survival of juvenile Fucus spp. are controlled indirectly by wave exposure through higher limpet densities at exposed locations. This model predicts that climate change, and in particular an increased frequency of storm events in the northeast Atlantic, will restrict fucoids to more sheltered locations.
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