High-sensitive cardiac Troponin T (hsTnT) is the most frequently used biomarker for the detection of cardiomyocyte injury. Severe aortic stenosis (AS) leads to an increased left ventricular load, with the potential of myocardial injury reflected by increased TnT levels. However, there is a lack of studies showing the prevalence and prognostic role of elevated hsTnT in patients with asymptomatic AS. To examine the association between the hsTnT levels and AS severity in asymptomatic AS patients. We hypothesized that patients with more severe AS will have elevated hsTnT levels and that hsTnT levels are associated with a higher risk for aortic valve events (AVE) and all-cause mortality (ACM). We performed a post-hoc analysis in 1739 asymptomatic patients with mild to moderate-severe AS, enrolled in the randomized, double-blinded SEAS-study (Simvastatin and Ezetimibe in Aortic Stenosis). All patients had available hsTnT blood samples measured at baseline (Year 0) and Year 1. We defined moderate to severe (mod-severe) AS as a transaortic maximal outflow velocity (Vmax)>3.5 m/s combined with aortic valve area (AVA)<1.0 cm2, otherwise non-severe AS. An hsTnT>14 ng/L was high according to assay (Roche, Elecsys Troponin T hs on cobas e 601). Linear multivariable regression model examined the association of hsTnT levels to clinical and echocardiographic variables. Cox multivariable regression model evaluated competing risks and hazard ratios (HR) of outcomes while adjusting for relevant variables, including a Framingham 10-years risk score of cardiovascular diseases. The competing risks were either ACM or AVE, i.e. the first of AVR, cardiovascular death and heart failure due to AS progression. At baseline, hsTnT was high in 26% (453/1739) patients; 25% (380/1529) in non-severe and 35% (73/210) in mod-severe AS. Relative TnT change over one year was 17% (mean 1.17, SD 1.01); 15% in non-severe vs. 32% in mod-severe AS, and neither associated to AS severity, hsTnT at baseline or lipid-lowering treatment. In multivariable linear regression analysis, there were significant correlations between hsTnT at baseline and age, male gender, creatinine, left ventricular mass index and BMI (all p<0.001, R-square=0.42), but not with AS severity. In multivariable Cox regression analyses, a high hsTnT at baseline was associated with AVE 1.61 [95% CI 1.29–1.99]. In contrast, hsTnT at baseline was not associated to all-cause mortality (see figure). In asymptomatic AS patients without severe AS, high-sensitive Troponin T is not associated with AS severity in cross-sectional analyses, and its levels do not change substantially during one year of follow-up. However, patients with hsTnT >14 ng/l had a sixty percent higher independent risk of subsequent aortic valve events. Multivariable Cox regression Type of funding source: Private company. Main funding source(s): Acknowledgements: Main sponsor (SEAS): MSD Singapore Company, LLC, partnership between Merck & Co. Inc. and Schering-Plough Corporation. Blood analysis sponsor: Roche

TASEF modelling of a water and a gasoline tank exposed to radiative heat flux from a pool fire

The analysis of nonstationary processes, taking place in exciton systems in consequence of the nonconservation of the number of elementary excitations, is presented and it is pointed out to a new possibility of light-energy capturing which exists in ecological systems due to the nonconservation of excitons. It is shown that, due to the nonconservation, the one-dimensional molecular chain is able to capture permanently the light energy of the order of 50 keV to 5 MeV. A part of the captured energy is expected to have a role in internal bioprocesses. It is also shown that the system is a seat where the processes of continuous creations and annihilations of pairs of excitons having opposite momenta take place with a probability of the order of 10−4 to 10−2. Further investigations would allow to identify biological phenomena caused by those processes.

In consequence of the nonconservation of excitons, the excitation number operator as well as the exciton pair creation and annihilation operators are expressed as functions of time and of the corresponding stationary operators. The nonstationary pair correlation processes and the nonstationary excitation density fluctuation processes are analysed using the nonstationary operators. It is found that the nonstationary pair correlations are characterized by a specific kind of dissipation that is linearly proportional with time. In contradistinction to stationary processes, the corresponding nonstationary ones, lead to elementary excitations having a double energy: E (nonstationary) = 2E (stationary). It is shown that in contrast to exciton density fluctuations, pair correlations have a tendency of localization related to a lattice point. It is also shown that the exciton non-statinoary pair correlations are in many respect similar to the density fluctuations that take place in the crystal due to a near slow neutron passage. Finally, a general method for the evaluation of the correlation function, applicable even in the case when the Green's function has a n-th order pole, is developed in the Appendix. Als Floge der Nichtkonservativitat der Exzitonen, werden sowohl der Exzitonenzahloperator als auch der Exzitonenpaar-Erzeugungs- und Vernichtungsoperator als Funktion der Zeit und der entsprechenden stationaren Operatoren ausgedruckt. Die nichtstationaren Paarkorrelationsprozesse und die nichtstationaren Anregungsdichte-Fluktuationsprozesse werden mit den nichtstationaren Operatoren analysiert. Es wird gefunden, das die nichtstationaren Paar-Korrelationen durch eine spezifische Dissipationsart charakterisiert sind, die linear proportional zur Zeit ist. Im Gegensatz zu stationaren Prozessen fuhren die entsprechenden nichtstationaren zu elementaren Anregungen mit doppelter Energie: E (nichtstationar) = 2E (stationar). Es wird gezeigt, das im Gegensatz zu den Exziton-Dichtefluktuationen die Paarkorrelationen eine Tendenz zur Lokalisierung bezuglich eines Gitterpunktes haben. Es wird ebenfalls gezeigt, das die nichtstationaren Exziton-Paar-Korrelationen in vieler Hinsicht den Dichtefluktuationen ahnlich sind, die im Kristall in der Nahe des Durchgangs langsamer Neutronen stattfinden. Schlieslich wird eine allgemeine Methode zur Berechnung der Korrelationsfunktion im Anhang entwickelt, die sogar fur den Fall, in dem die Greensche Funktion einen Pol n-ter Ordnung besitzt, anwendbar ist.