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Sample records for cardiac blood pool

  1. Gated cardiac blood pool studies in arrhythmias

    International Nuclear Information System (INIS)

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed

  2. Gated cardiac blood pool studies in arrhythmias

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    Itti, R.; Casset, D.; Philippe, L.; Cosnay, P.; Fauchier, J.P.

    1988-01-01

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed.

  3. The diagnostic value of cardiac blood pool imaging in cardiomyopathy

    International Nuclear Information System (INIS)

    Twenty-two normal controls and thirty-three patients with dilated and hypertrophic cardiomyopathy were examined by multigated cardiac imaging and phase analysis. The imaging traits of hypertrophic ones displayed thicken septal wall. The differences of synchronization of ventricular systolic function between hypertrophic ones and normal were statistically significant (P < 0.01). The imaging features of dilated cardiomyopathy showed that ventricular wall motion was seriously hypokinitic or akinitic and left ventricule enlarged abnormally. The function and synchronization of ventricular systole in dilated ones were worse than these in the hypertrophic (P < 0.01). These data suggest that the cardiac blood pool images can diagnose and differentiate the hypertrophic from dilated cardiomyopathy

  4. First clinical experiences with parametric SPECT of the gated cardiac blood pool

    International Nuclear Information System (INIS)

    SPECT of the gated cardiac blood pool as well as conventional 300LAO equilibrium radionuclide ventriculography was performed in a total of 12 patients (4 healthy subjects and 8 patients with CAD or cardiomyopathy). Seven out of 8 patients with myocardial pathology showed abnormalities of the anterior wall motion. In all of the respective cases SPECT and laevocardiography yielded concordant results while conventional radionuclide ventriculography was limited to the detection of septal and posterior wall motion abnormalities. Thus, SPECT of the cardiac blood pool is an anternative to ''first pass'' techniques which are limited to only few heart beats. (orig.)

  5. Combined respiratory and cardiac triggering improves blood pool contrast-enhanced pediatric cardiovascular MRI

    International Nuclear Information System (INIS)

    Contrast-enhanced cardiac MRA suffers from cardiac motion artifacts and often requires a breath-hold. This work develops and evaluates a blood pool contrast-enhanced combined respiratory- and ECG-triggered MRA method. An SPGR sequence was modified to enable combined cardiac and respiratory triggering on a 1.5-T scanner. Twenty-three consecutive children referred for pediatric heart disease receiving gadofosveset were recruited in HIPAA-compliant fashion with IRB approval and informed consent. Children underwent standard non-triggered contrast-enhanced MRA with or without suspended respiration. Additionally, a free-breathing-triggered MRA was acquired. Triggered and non-triggered studies were presented in blinded random order independently to two radiologists twice. Anatomical structure delineation was graded for each triggered and non-triggered acquisition and the visual quality on triggered MRA was compared directly to that on non-triggered MRA. Triggered images received higher scores from each radiologist for all anatomical structures on each of the two reading sessions (Wilcoxon rank sum test, P < 0.05). In direct comparison, triggered images were preferred over non-triggered images for delineating cardiac structures, with most comparisons reaching statistical significance (binomial test, P < 0.05). Combined cardiac and respiratory triggering, enabled by a blood pool contrast agent, improves delineation of most anatomical structures in pediatric cardiovascular MRA. (orig.)

  6. Combined respiratory and cardiac triggering improves blood pool contrast-enhanced pediatric cardiovascular MRI

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    Vasanawala, Shreyas S.; Newman, Beverley [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Chan, Frandics P. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Alley, Marcus T. [Stanford University School of Medicine, Lucas MRS Center, Department of Radiology, Stanford, CA (United States)

    2011-12-15

    Contrast-enhanced cardiac MRA suffers from cardiac motion artifacts and often requires a breath-hold. This work develops and evaluates a blood pool contrast-enhanced combined respiratory- and ECG-triggered MRA method. An SPGR sequence was modified to enable combined cardiac and respiratory triggering on a 1.5-T scanner. Twenty-three consecutive children referred for pediatric heart disease receiving gadofosveset were recruited in HIPAA-compliant fashion with IRB approval and informed consent. Children underwent standard non-triggered contrast-enhanced MRA with or without suspended respiration. Additionally, a free-breathing-triggered MRA was acquired. Triggered and non-triggered studies were presented in blinded random order independently to two radiologists twice. Anatomical structure delineation was graded for each triggered and non-triggered acquisition and the visual quality on triggered MRA was compared directly to that on non-triggered MRA. Triggered images received higher scores from each radiologist for all anatomical structures on each of the two reading sessions (Wilcoxon rank sum test, P < 0.05). In direct comparison, triggered images were preferred over non-triggered images for delineating cardiac structures, with most comparisons reaching statistical significance (binomial test, P < 0.05). Combined cardiac and respiratory triggering, enabled by a blood pool contrast agent, improves delineation of most anatomical structures in pediatric cardiovascular MRA. (orig.)

  7. Factor analysis of multigated cardiac blood pool scintigram for the measurement of left ventricular ejection fraction

    International Nuclear Information System (INIS)

    Left ventricular ejection fraction (EF) was measured by factor analysis (FA) of multigated cardiac blood pool scintigram in 38 consecutive patients, and compared with that measured by the variable ROI method (EFVROI) with automated left ventricular contour detection. FA was automatically performed without operator intervention with a success rate of 100%. The correlation of EF with EFVROI was significant in the group of 22 patients with normal wall motion (r=0.65, p<0.001), and the entire group of patients (r=0.70, p<0.001), but not significant (p=0.19) in the group of 16 patients with abnormal wall motion. In conclusion, left ventricular ejection fraction can be estimated by factor analysis of MUGA in patients with normal wall motion. (author)

  8. Evaluation of myocardiotoxicity with SPECT cardiac blood pool imaging for patients treated with adriamycin

    International Nuclear Information System (INIS)

    Evaluation of myocardiotoxicity on adriamycin (ADM) with SPECT cardiac blood pool imaging was presented. SPECT was done to monitor left ventricular function in 49 patients with Non-Hodgkin's Lymphoma and small cell carcinoma, they were treated with ADM of which the accumulation dose were over 300 mg/m2. The results showed that parameters of EF, PER and PFR before and after treatment with ADM were 57 +- 6%, 3.08 +- 0.63 EDV·s-1, 2.99 +- 0.23 EDV·s-1 and 50 +- 11%, 2.25 +- 0.66 EDV·s-1, 2.53 +- 0.35 EDV·s-1 respectively. The difference of these data are significant (P<0.05). The larger the accumulative dose of ADM, the more the parameters decrease, among them PFR is the most sensitive one. It was concluded that SPECT measurement of left ventricular function is a sensitive and useful method in monitoring ADM myocardiotoxicity

  9. Myocardial ischemia detected by isoproterenol stress cardiac blood-pool scintigraphy

    International Nuclear Information System (INIS)

    It is well known that left ventricular regional contraction abnormality (hypokinesis: hypo) occurs during myocardial ischemia. However, it is uncertain whether left ventricular asynchronous contraction (asynchrony) is an index of myocardial ischemia. To validate asynchrony as an index of myocardial ischemia, isoproterenol infusion stress (ISP) cardiac blood-pool scintigraphy (RI angiography) was performed in patients with ischemic heart disease. The subjects were classified into 2 groups: (1) 15 patients with coronary artery disease (CAD) and (2) 8 patients with 'normal' coronary arteries (NC). None had any electrical ventricular conduction disturbance. ISP was administered with increasing doses of 0.02, 0.04, 0.08 μg/kg/min at 3-min intervals, and it was terminated in the event of angina, significant ST changes or target heart rate. Symptom-limited ergometer exercise testing (EX) was also administered in 14 patients. Regional decrease in amplitude and phase delay identified by phase analysis was diagnosed as hypo and asynchrony, respectively. ISP myocardial scintigraphy was also performed in 15 patients. ISP and EX induced asynchrony in 14 (93%) and 13 patients (93%), respectively, while did hypo in 4 (27%) and 9 (64%), respectively. Ten (67%) of 15 patients had asynchrony without hypo in ISP; whereas only 4 (28%) of 14 patients did in EX. ISP-induced asynchrony occurred in one of 8 patients with NC. The locations of ISP-induced asynchrony and those of EX-induced asynchrony were concordant in 11 (79%) of 14 patients. Asynchrony on the ISP RI angiogram was observed at the same sites of redistribution on the ISP myocardial scintigram. We concluded that asynchrony itself is a sensitive and specific index of myocardial ischemia. (author)

  10. Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm

    International Nuclear Information System (INIS)

    Unlike the true left ventricular aneurysm, false aneurysms have recently been shown to be subject to late rupture. Rarely diagnosed before surgery or autopsy, the false aneurysm has never been identified by noninvasive techniques. We report the first such noninvasive diagnosis employing radioisotope gated cardiac blood pool imaging. Due to the unique and possibly life-threatening clinical course and potential for surgical cure of false left ventricular aneurysm, early noninvasive diagnosis by imaging techniques may be critical. The methods shown here are generally applicable, becoming widely available and may help in evaluation of false left ventricular aneurysm as a cause of sudden death

  11. Cardiac blood-pool scintigraphy in rats and hamsters: comparison of five radiopharmaceuticals and three pinhole collimator apertures

    International Nuclear Information System (INIS)

    Preclinical evaluation of cardiac drugs may require evaluation of cardiac function in intact animals. To optimize the quality of radionuclide measurements of ventricular function in small animals, a comparison was made of gated blood-pool scans recorded with five blood-pool radiopharmaceuticals (99mTc-labeled human polyclonal IgG, 99mTc-human serum albumin labeled by two methods, and red blood cells radiolabeled with 99mTc via in vivo and in vitro methods) in rats and three pinhole apertures in hamsters. The quality of the radiopharmaceuticals was evaluated by comparing count density ratios (LV/BACKGROUND and LV/LIVER) and ejection fractions recorded with each agent. The edge definition of the left ventricle and count rate performance of the 1-, 2-, and 3-mm apertures was evaluated in hamsters. In general, the images obtained with the radiolabeled cells were superior to those obtained with the labeled proteins and no significant differences between the protein preparations were detected. Left ventricular ejection fractions calculated with all five radiopharmaceuticals were not significantly different. The best quality images were obtained with the 1-mm pinhole collimator. Ejection fraction and acquisition time were inversely related to aperture size. A good compromise between resolution and sensitivity was obtained with the 2-mm pinhole collimator

  12. Multimodality evaluation of ventricular function: comparison of cardiac magnetic resonance imaging, echocardiography, and planar and SPECT blood pool imaging

    Science.gov (United States)

    Feiglin, David H.; Krol, Andrzej; Tillapaugh-Fay, Gwen M.; Szeverenyi, Nikolaus M.; Thomas, Frank D.

    2001-05-01

    Fifteen patients underwent resting echocardiography (EC), ECG gated cardiac MR ventriculography (MRV) and blood pool planar and SPECT ventriculography (SPV) sequentially on the same day. In addition, 36 patients had sequential ECG gated blood pool and SPV and 20 normal volunteers, age > 18 years, had sequential ECG gated cardiac MRI performed on both Siemens closed, 1.5T, and open, 0.2T, magnets. Echocardiography was performed using a HP 5500 system equipped with an S4 transducer in 2D mode. MRV at 0.2T and 1.5T used a circular polarized body coil. Nuclear Medicine studies used 25 mCi Tc- 99m labeled red blood cells. Gated planar and SPV were acquired on a dual head Siemens E-Cam system. We have found that MRV affords the most accurate measurement of ventricular function. SPV and MRV provide similar estimations of left ventricular function (LVEF). Further, SPV consistently provides higher LVEF, as compared to the planar data simultaneously acquired. Observed significant differences in intermodality measurements indicate that follow up studies in patients, especially in patients whose management is critically dependent on functional measurement changes, should be monitored by one modality only.

  13. Fourier analysis of multi-gated cardiac blood-pool data in patients with congenital heart diseases, (2)

    International Nuclear Information System (INIS)

    The clinical usefulness of Fourier analysis of multi-gated cardiac blood-pool data was evaluated in 18 subjects with normal cardiac functions and 14 patients with complex cardiac anomalies (ten with tetralogy of Fallot, two with tricuspid atresia (TA), one with double-outlet right ventricle (DORV), and one with Ebstein's anomaly (EA)). Using global ventricular time-activity curves, the phase and amplitude at fundamental frequency were calculated, and emptying patterns of the left and right ventricles (LV, RV) were evaluated by phase difference [D(phase)=RV phase minus LV phase] and amplitude ratio of RV to LV [R(amp)]. In patients with TOF, mean values of D (phase) and R(amp) were 25.3+-10.5 degrees and 13.5+-0.49 respectively and significantly larger than those of normal subjects (p<0.001). D (phase) became larger in inverse proportion to the ratio of pulmonary-to-systemic blood flow and there was an inverse linear correlation between these two variables (r=-0.830, p<0.01). On visual interpretation of functional images, the dynamic property of hypoplastic ventricles could be easily estimated in patients with TA or DORV. In a case with EA, the atrialized RV was shown clearly as a hypokinetic, atrial phase area. This method is valuable for pathophysiologic investigation of diseases with complex cardiac anomalies. (author)

  14. Blood Pool Segmentation Results in Superior Virtual Cardiac Models than Myocardial Segmentation for 3D Printing.

    Science.gov (United States)

    Farooqi, Kanwal M; Lengua, Carlos Gonzalez; Weinberg, Alan D; Nielsen, James C; Sanz, Javier

    2016-08-01

    The method of cardiac magnetic resonance (CMR) three-dimensional (3D) image acquisition and post-processing which should be used to create optimal virtual models for 3D printing has not been studied systematically. Patients (n = 19) who had undergone CMR including both 3D balanced steady-state free precession (bSSFP) imaging and contrast-enhanced magnetic resonance angiography (MRA) were retrospectively identified. Post-processing for the creation of virtual 3D models involved using both myocardial (MS) and blood pool (BP) segmentation, resulting in four groups: Group 1-bSSFP/MS, Group 2-bSSFP/BP, Group 3-MRA/MS and Group 4-MRA/BP. The models created were assessed by two raters for overall quality (1-poor; 2-good; 3-excellent) and ability to identify predefined vessels (1-5: superior vena cava, inferior vena cava, main pulmonary artery, ascending aorta and at least one pulmonary vein). A total of 76 virtual models were created from 19 patient CMR datasets. The mean overall quality scores for Raters 1/2 were 1.63 ± 0.50/1.26 ± 0.45 for Group 1, 2.12 ± 0.50/2.26 ± 0.73 for Group 2, 1.74 ± 0.56/1.53 ± 0.61 for Group 3 and 2.26 ± 0.65/2.68 ± 0.48 for Group 4. The numbers of identified vessels for Raters 1/2 were 4.11 ± 1.32/4.05 ± 1.31 for Group 1, 4.90 ± 0.46/4.95 ± 0.23 for Group 2, 4.32 ± 1.00/4.47 ± 0.84 for Group 3 and 4.74 ± 0.56/4.63 ± 0.49 for Group 4. Models created using BP segmentation (Groups 2 and 4) received significantly higher ratings than those created using MS for both overall quality and number of vessels visualized (p < 0.05), regardless of the acquisition technique. There were no significant differences between Groups 1 and 3. The ratings for Raters 1 and 2 had good correlation for overall quality (ICC = 0.63) and excellent correlation for the total number of vessels visualized (ICC = 0.77). The intra-rater reliability was good for Rater A (ICC = 0.65). Three models were successfully printed

  15. Gated cardiac blood pool studies in atrial fibrillation: Role of cycle length windowing

    International Nuclear Information System (INIS)

    Cycle length windowing is gaining increasing acceptance in gated blood pool imaging of patients with atrial fibrillation (AF). The goals of this study were: to assess differences of ejection fraction (EF) in AF with and without windowing and to determine how EF varied with cycle length in patients with AF. Twenty patients with AF were prospectively studied by gated blood pool imaging, with simultaneous collection in each patient of 5-7 studies with cycle length windows spanning the cycle length histogram. Each window accepted beats of only a narrow range of cycle lengths. EF was determined for each of the narrow cycle length windows as well as for the entire gated blood pool study without cycle length windowing. For every patient an average of the windowed EFs was compared with the non-windowed EF. EF values were similar (mean windowed: 46.6; non-windowed: 45.5; P=0.16), and there was a good correlation between the two techniques (r=0.97). The data were then examined for a relationship of EF with cycle length. The difference from average windowed EF (ΔEF) was calculated for each window and plotted vs. the cycle length of the center of each window. No predictable linear or nonlinear relationship of ΔEF with window position was observed. Lack of predictable variation of EF with cycle length is likely due to lack of a predictable amount of ventricular filling for a given cycle length, as the amount of diastolic filling in AF depends on the random cycle length of the preceding beat. In summary, windowing in AF does not provide a clinically significant difference in EF determination. If cycle length windowing is used, the exact location of the window is not critical. (orig.)

  16. Clinical evaluation of cardiac function in patients with acute left heart failure using multigated blood-pool method

    International Nuclear Information System (INIS)

    Inotropic and left ventricular volume indices were determined using multigated blood pool imaging to assess cardiac function in 15 patients with congestive heart failure (CHF). Twelve patients with old myocardial infarction (OMI) and 12 normal subjects (N) served as controls. In the OMI group without CHF, abnormal values in ejection fraction (EF) and peak ejection rate (PER) were observed in each four patients. End-systolic volume index (ESVI) and end-diastolic volume index (EDVI) were abnormally high in 3 patients and one patient, respectively. Inotropic indices may be more sensitive than volume indices in detecting OMI with no associated CHF. In detecting acute CHF, ESVI had the highest sensitivity (80%, 12/15), followed by EDVI (67%, 10/15). In both the CHF group and the OMI group, sensitivities of ESVI, EDVI, PER, and EF were 56%, 41%, 29%, and 26%, respectively. In assessing the clinical course of CHF, ESVI was a more sensitive index than EDVI and EF. It can be concluded that multigated blood-pool imaging is useful for assessing cardiac function in acute left heart failure. (Namekawa, K)

  17. Assessment of left ventricular function by gated cardiac blood-pool emission computed tomography using a rotating gamma camera

    International Nuclear Information System (INIS)

    To elucidate the usefulness of gated cardiac blood-pool single photon emission CT (SPECT) with Tc-99m for the evaluation of left ventricular (LV) global and regional functions, 18 patients with coronary artery disease were studied. Thirty-two gated projection images were obtained over 360-degree at 16 frames per cardiac cycle. As LV volume was calculated by integrating the numbers of voxels which constituted LV and multiplying by the volume of a single voxel (0.1143 ml), we performed phantom studies to determine the appropriate cut-off level to detect LV outline. These cut-off levels were affected by the background activity and organ volume itself. So we constructed Volume-Cut-Level-Curve at each background activity. In clinical studies, short axis images which constituted LV were selected and provisional LV volumes were calculated at the cut-off levels of 45, 50 and 55%. These volumes were plotted on the Volume-Cut-Level-Curve and the true cut-off levels were obtained to calculate LV end-diastolic or end-systolic volume (EDV, ESV). The cut-off levels were different at every patient and ED or ES. EDV, ESV and LV ejection fraction obtained by SPECT were correlatd well with those obtained by contrast ventriculography (LVG) (r=0.89, 0.94, 0.94 each, p<0.01). For the LV wall motion analysis, LVGs obtained at two projections were compared with SPECT or gated cardiac blood-pool planar imaging (Planar) in 5 segments. In addition to visual comparison, wall motion scores (WMS) based on the degree of wall motion abnormality were calculated in each segment. Correlation of WMS between LVG and SPECT (r=0.84) was significantly (p<0.01) superior to that between LVG and Planar (r=0.62). Especially in SPECT, wall motion analyses at septal and infero-posterior segments were superior to those in Planar. Although gated SPECT requires relatively long time to perform, it is a useful method to detect LV global and regional functions. (author)

  18. Factor analysis of multi-gated cardiac blood-pool data in patients with congenital heart disease

    International Nuclear Information System (INIS)

    The present study was undertaken to examine the usefulness of factor analysis in multi-gated cardiac blood-pool scintigraphic studies of 83 patients with various congenital heart diseases. In ventricular and atrial septal defects, two factors, including the first factor for ventricular components and the second factor for atrial and great vessel components, were extracted when Qp/Qs was comparatively small, being similar to normal subjects. In ventricular septal defect associated with higher Qp/Qs, however, the left and right ventricles were extracted as separate factors, thus providing three factors, including atrial and great vessel components. There was a significant positive correlation between Qp/Qs values and delayed ejection phase in both the left and right ventricular factors. In atrial septal defect associated with higher Qp/Qs, the right ventricle was divided into septal and free wall components, and the left ventricle was extracted as the same components as right ventricular septal component. In comparing two dynamic pattern curves of ventricular factors, there was no significant difference between delayed ejection phase and Qp/Qs values, although ejection phase tended to be prolonged in right ventricular free wall factors than both right ventricular septal and left ventricular factors. All patients with Ebstein's malformation had atrial factors in the inflow portion of the right ventricle, allowing clear distinction between the atrialized right ventricle and functional right ventricle. These results suggest that factor analysis may have a potential in analyzing multi-gated blood pool scintigraphic data in various congenital heart diseases. (N.K.)

  19. Usefulness of PFR/TPFR score to discriminate hypertrophic cardiomyopathy from hypertensive heart disease-using cardiac blood-pool imaging

    International Nuclear Information System (INIS)

    The purpose of the study was to see whether it is possible to discriminate hypertrophic cardiomyopathy from hypertensive heart disease (HHD) with cardiac blood-pool imaging. Subjects were 20 normals, 21 HHD patients and 19 hypertrophic cardiomyopathy (HCM) ones. Cardiac blood-pool imaging was carried out with 99mTc-labeled erythrocyte method to obtain ventricular volume curve and its differential curve for calculation of left ventricular ejection fraction (LVEF), 1/3LVEF, peak filling rate (PFR), time to peak filling rate (TPFR) and PFR/TPFR. LVEF and 1/3LVEF were found insignificant between the three groups. PFR was significantly lower in HCN group, TPFR was significantly prolonged in HCM and PFR/TPFR was significantly higher in HHD. PFR/TPFR was thus useful for discrimination. (K.H.)

  20. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

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    Gerretsen, S.C.; Versluis, B.; Bekkers, S.C.A.M. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Leiner, T. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands)], E-mail: leiner@rad.unimaas.nl

    2008-01-15

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 {+-} 3.1 vs. 3.0 T: 50.7 {+-} 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 {+-} 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 {+-} 0.3), and lowest for non-enhanced 3.0 T (1.7 {+-} 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T.

  1. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

    International Nuclear Information System (INIS)

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 ± 3.1 vs. 3.0 T: 50.7 ± 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 ± 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 ± 0.3), and lowest for non-enhanced 3.0 T (1.7 ± 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T

  2. Fourier analysis of multi-gated cardiac blood-pool data in patients with congenital heart diseases, (2). Assessment of diseases with complex cardiac anomalies, especially tetralogy of Fallot

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    Takeda, Kan; Maeda, Hisato; Yamaguchi, Nobuo; Nakamura, Kazuyoshi; Matsumura, Kaname; Nakagawa, Tsuyoshi; Sakurai, Minoru; Aoki, Kenzo

    1985-04-01

    The clinical usefulness of Fourier analysis of multi-gated cardiac blood-pool data was evaluated in 18 subjects with normal cardiac functions and 14 patients with complex cardiac anomalies (ten with tetralogy of Fallot, two with tricuspid atresia (TA), one with double-outlet right ventricle (DORV), and one with Ebstein's anomaly (EA)). Using global ventricular time-activity curves, the phase and amplitude at fundamental frequency were calculated, and emptying patterns of the left and right ventricles (LV, RV) were evaluated by phase difference (D(phase)=RV phase minus LV phase) and amplitude ratio of RV to LV (R(amp)). In patients with TOF, mean values of D (phase) and R(amp) were 25.3 +- 10.5 degrees and 13.5 +- 0.49 respectively and significantly larger than those of normal subjects. D (phase) became larger in inverse proportion to the ratio of pulmonary-to-systemic blood flow and there was an inverse linear correlation between these two variables. On visual interpretation of functional images, the dynamic property of hypoplastic ventricles could be easily estimated in patients with TA or DORV. In a case with EA, the atrialized RV was shown clearly as a hypokinetic, atrial phase area. This method is valuable for pathophysiologic investigation of diseases with complex cardiac anomalies. (author).

  3. Cardiac magnetic resonance angiography using blood-pool contrast agents. Comparison of citrate-coated very small superparamagnetic iron oxide particles with gadofosveset trisodium in pigs

    International Nuclear Information System (INIS)

    Purpose: To compare citrate-coated very small superparamagnetic iron oxide particles (VSOP) with gadofosveset trisodium as blood pool contrast agents for cardiac magnetic resonance angiography (CMRA) in pigs. Materials and Methods: Animal experiments were approved by the responsible authority. 10 CMRA-like examinations were performed at 1.5 T after administration of VSOP (0.06 mmol Fe/kg; 5 examinations) and gadofosveset trisodium (0.03 mmol Gd/kg; 5 examinations). The CMRA protocol included ECG-gated inversion-recovery-prepared T1-weighted gradient echo imaging (IR-GRE; one slice) and ECG-gated inversion recovery prepared steady state free precession imaging (IR SSFP; one slice) before and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, and 60 min after injection. At each time point, three different inversion times (TI; 200 msec, 300 msec, and 400 msec) were applied. Contrast-to-noise ratios (CNR) between blood and myocardium were calculated and compared using mixed linear models. Results: No significant differences of CNR were found between IR-GRE and IR SSFP. At 3 and 5 min after contrast agent administration, VSOP showed a significantly higher CNR than gadofosveset trisodium when TI of 200 msec and 300 msec were applied (TI of 200 msec at 3 min: 8.2 ± 0.7 vs. 5.4 ± 0.7; TI of 200 msec at 5 min: 7.9 ± 0.7 vs. 3.5 ± 0.8; TI of 300 msec at 3 min: 11.7 ± 0.7 vs. 8.8 ± 0.8; TI of 300 msec at 5 min: 11.4 ± 0.7 vs. 8.0 ± 0.8; p < 0.05). Moreover, significant differences in favor of VSOP were found for all time points from 10 to 40 min irrespective of TI (p < 0.05). Conclusion: VSOP has superior blood-pool properties compared to gadofosveset trisodium resulting in prolonged improvement of CNR on CMRA. (orig.)

  4. Cardiac magnetic resonance angiography using blood-pool contrast agents. Comparison of citrate-coated very small superparamagnetic iron oxide particles with gadofosveset trisodium in pigs

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    Schnorr, J.; Taupitz, M.; Schellenberger, E.A.; Warmuth, C.; Wagner, S.; Kaufels, N.; Wagner, M. [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie; Fahlenkamp, U.L. [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie; Universitaetsklinikum Bonn (Germany). Radiologische Klinik

    2012-02-15

    Purpose: To compare citrate-coated very small superparamagnetic iron oxide particles (VSOP) with gadofosveset trisodium as blood pool contrast agents for cardiac magnetic resonance angiography (CMRA) in pigs. Materials and Methods: Animal experiments were approved by the responsible authority. 10 CMRA-like examinations were performed at 1.5 T after administration of VSOP (0.06 mmol Fe/kg; 5 examinations) and gadofosveset trisodium (0.03 mmol Gd/kg; 5 examinations). The CMRA protocol included ECG-gated inversion-recovery-prepared T1-weighted gradient echo imaging (IR-GRE; one slice) and ECG-gated inversion recovery prepared steady state free precession imaging (IR SSFP; one slice) before and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, and 60 min after injection. At each time point, three different inversion times (TI; 200 msec, 300 msec, and 400 msec) were applied. Contrast-to-noise ratios (CNR) between blood and myocardium were calculated and compared using mixed linear models. Results: No significant differences of CNR were found between IR-GRE and IR SSFP. At 3 and 5 min after contrast agent administration, VSOP showed a significantly higher CNR than gadofosveset trisodium when TI of 200 msec and 300 msec were applied (TI of 200 msec at 3 min: 8.2 {+-} 0.7 vs. 5.4 {+-} 0.7; TI of 200 msec at 5 min: 7.9 {+-} 0.7 vs. 3.5 {+-} 0.8; TI of 300 msec at 3 min: 11.7 {+-} 0.7 vs. 8.8 {+-} 0.8; TI of 300 msec at 5 min: 11.4 {+-} 0.7 vs. 8.0 {+-} 0.8; p < 0.05). Moreover, significant differences in favor of VSOP were found for all time points from 10 to 40 min irrespective of TI (p < 0.05). Conclusion: VSOP has superior blood-pool properties compared to gadofosveset trisodium resulting in prolonged improvement of CNR on CMRA. (orig.)

  5. Clinical validation of the gated blood pool SPECT QBS processing software for evaluating cardiac function in patients with dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Full text: The study was carried out to evaluate the commercially available automated GBPS processing software for LVEF and RVEF measurement in patients with cardiomyopathy. Patients (total=41; 24 males; mean age-44 ± 14 years) referred to our department for assessment of cardiac function in patients having dilated cardiomyopathy were prospectively included in the study. In patients with DCM, First pass radionuclide ventriculography (FP-RNV) and planar multi-gated radionuclide angiography (MUGA) were performed at rest after in-vivo labeling of RBCs. LVEF was also calculated by Echo in these patients. LVEF and RVEF were calculated by MUGA and FP-RNV respectively. Immediately after obtaining the planar views, GBPS was performed with GE Infinia Hawkeye4 camera, detectors in L-mode configuration, with step and shoot mode acquisition - 60 steps over 180 deg, 20 s per step, 16 frames per cardiac cycle, 64 x 64 matrix. GBPS was processed using the fully automated QBS algorithm and LVEF, RVEF were calculated. Spearman's coefficient (r) of correlation was calculated for the different sets of values. The level of statistical significance was set at < 5%. Bland-Altman plots were inspected to visually assess the association between measurements from different methods. Results: Head on comparison of the mean values for patients: PLANAR QBPS ECHO LVEF (%) 31 ± 11 VS 34 ± 12; RVEF (%) 46 ± 14 VS 43 ± 17. In patients with DCM, LVEF values calculated from GBPS showed very good correlation with MUGA (r=0.91) and echocardiography (r=0.83; all p<0.0001). Bland-Altman plot showed overestimation for GBPS-LVEF values compared to MUGA. RVEF values calculated by FPRNV and QBS-SPECT also showed good correlation (r=0.87; p<0.0001). Bland-Altman plot for RVEF values showed a tendency for an overestimation of higher RVEF values with GBPS. Patients with DCM also tend to suffer from right ventricular cardiomyopathy. Isolated right sided cardiomyopathy is also a known entity. Since RVEF is

  6. Giant coronary artery aneurysm seen on blood-pool study.

    Science.gov (United States)

    Trujillo, Alexander; Soontrapa, Suthipong; Singh, Preeti; Sehli, Sharmila; Harris, Jennifer; Suarez, Jose A; Arvandi, Aliakbar; Paone, Ralph F; Meyerrose, Gary E

    2013-01-01

    An 81-year-old man was incidentally found to have a large pericardial cyst on a chest computed tomography. Before surgical removal, an echocardiogram demonstrated that the cyst was more likely a large (7.5 cm) right coronary arterial aneurysm. A cardiac blood-pool study demonstrated a blood-filled structure adjacent to the heart, roughly the same size as the combined size of both the right and left ventricles. Coronary angiography confirmed the presence of a large right coronary artery aneurysm. A coronary aneurysm should be considered when a blood-filled structure is seen adjacent to the heart on a multigated acquisition scan. PMID:23242065

  7. Right-sided cardiac function in healthy volunteers measured by first-pass radionuclide ventriculography and gated blood-pool SPECT: comparison with cine MRI

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette; Hesse, Birger;

    2005-01-01

    evaluation of right-sided cardiac function. The aim of our study was to compare the agreement between these methods when measuring right-sided cardiac function. METHODS: Twenty-four healthy volunteers were included. Mean age was 44 years (range: 25-60) and 29% were females. All participants had FP, GBPS and...... 6 ml m(-2) (95% CI: 0-11). CONCLUSIONS: (i) Normal values of RVEF differ between MRI, FP and GBPS with wide limits of agreement, accordingly it is difficult to evaluate changes over time if measured by different methods, (ii) RV volumes are in the same range when measured by MRI or GBPS but with...... wide limits of agreement, and (iii) if MRI is considered gold standard then FP is more accurate than GBPS for RVEF measurements....

  8. Effect of prone versus supine positioning on left ventricular ejection fraction (LVEF) and heart rate using ECG gated Tl-201 myocardial perfusion scans and gated cardiac blood pool scans

    International Nuclear Information System (INIS)

    There is limited data on the effect of posture on LVEF. The study aim was to determine any difference in LVEF using gated cardiac blood pool scanning (GCBPS) and Tl-201 gated myocardial perfusion scanning (MPS) in prone or supine positions. In 50 patients undergoing evaluation for varying heart conditions, automated LVEF, end diastolic volume (EDV), end systolic volume (ESV) measurements were obtained at rest during gated MPS on Discovery NM 530c (GE Healthcare). In another 50 patients, semi-automated LVEF measurements were obtained using GCBPS on dual-headed gamma cameras. Average heart rate (HR) was recorded. Differences between prone and supine LVEF, HR, EDV and ESV were compared using paired two-tailed t-tests (P < 0.05 considered significant). Pearson's correlation, difference plots, mean, standard deviation and 95% confidence interval of the differences were also derived to analyse LVEF results. Using GCPBS or MPS, no significant difference in LVEF or LV volumes (from gated MPS) was demonstrated between postures. Increased HR was noted in prone positioning. Posture did not affect measured LVEF or LV volumes. However HR was higher on prone imaging.

  9. Blood transfusion practices in cardiac anaesthesia

    Directory of Open Access Journals (Sweden)

    Hanumantha Rao Mangu

    2014-01-01

    Full Text Available The primary reasons for blood transfusion in cardiac surgery are to correct anaemia and to improve tissue oxygen delivery. However, there is a considerable debate regarding the actual transfusion trigger at which the benefits of transfusion overweight the risk. The association between extreme haemodilution, transfusion and adverse outcome after cardio pulmonary bypass (CPB is not clear and the current available literature is not sufficient to provide a strong recommendation regarding the safe haematocrit range during CPB. There is no quality evidence to support use of fresh red blood cell except during massive transfusion or exchange transfusion in neonate. Overall concern regarding the safety of allogeneic blood transfusion resulted in the search for autologous blood transfusion and perioperative blood salvage. The aim of this review is to provide cardiac surgery specific clinically useful guidelines pertaining to transfusion triggers, optimal haemodilution during CPB, autologous blood transfusion and role of perioperative blood salvage based on available evidence.

  10. Fourier analysis of a gated blood-pool study during atrial flutter

    International Nuclear Information System (INIS)

    First-harmonic Fourier analysis of a gated blood-pool study is based on the assumption that the cardiac chambers contract once per cardiac cycle. In atrial arrhythmias this condition may not exist for the atria. We recently studied a patient with atrial flutter and 2:1 artioventricular conduction. There were predictable alterations in the first-harmonic Fourier phase and amplitude images. The observed changes from first-harmonic Fourier analysis were: (a) very low atrial amplitude values, and (b) absence of identifiable atrial regions on the phase image

  11. Evaluation of the left cardiac function obtained by cardiac pool imaging

    International Nuclear Information System (INIS)

    In 13 patients with angina pectoris (AP) (mean age : 68.1 +- 11.3), 13 patients with myocardial infarction (MI) (mean age : 62.0 +- 15.7), 9 patients with hypertension (HT) (mean age: 72.6 +- 7.5) and other patients with cardiac diseases (Mis) (mean age: 60.9 +- 15.4), totalling 61, who had all been treated in the First Department of the Internal Medicine of the Nissei Hospital between April, 1982 and February, 1983, the left venticle ejection frequency was determined by cardiac pool method by the use of Simis 3, data processing system of Informatek Co. Of those patients, CAG and LVG were carried on in 14, and through the comparison with LVEF obtained by cardiac pool method, the results described below were obtained: 1) In 14 patients in whom LVG was carried on, comparison between contrast EF and EF by RI produced the correlation index r = 0.87, showing favorable agreement (P < 0.01). 2) EF by diseases show 46.1 +- 18.5 % in MI, 64.5 +- 14.0 % in AP, 70.6 +- 11.3 % in HT and 66.8 +- 18.4 % in Mis. MI group showed statistically significant (P < 0.01) low value in comparison with other 3 groups. 3) The patients were divided into a group in which ST depression was recognized and another group in which the same was not recognized, and LVEF of the two groups were compared. The former represented 57.6 +- 20.0 % while the latter 70.7 +- 12.6 %, showing statistically significant (P < 0.01) difference recognized between them. 4) As calculation of LVEF by the present method allows the evaluation of cardiac function non invasively (in combination), it is useful test method if carried on simultaneously with the observation of the wall motion. (author)

  12. Clinical assessment of cardiac performance in chronic lung diseases by using RI multi-gated cardiac pool scan and pulmonary artery catheterization

    International Nuclear Information System (INIS)

    To evaluate biventricular function at rest and hypoxic load in patients with chronic lung diseases, we examined radionuclide angiography in 6 normal controls, 19 patients with chronic obstructive lung diseases (COLD), 14 patients with restrictive lung diseases (RLD), using ECG-gated cardiac blood pool scans, and 7 patients (3 COLD, 4 RLD) were examined by the pulmonary artery catheter. After suitable background correction, left and right ventricular ejection fractions (LVEF and RVEF) were calulated by the formula : RVEF or LVEF = (end-diastole counts- end-systole counts)/end-diastole counts. Cardiac performance was measured at rest and after 20 minutes low oxygen (15 %) load. The results were as follows: 1) RVEF (%) at rest in the RLD group (46.6 ± 8.3 %) was less than that in the control group, and the COLD group (48.7 ± 8.7 %, 48.4 ± 12.4 %). 2) The responses to hypoxia in the COLD group and the RLD group showed absolute increases in RVEF of 8.7 ± 14.1 % and 7.4 ± 8.9 %, and also, mean pulmonary pressure (MPAP), cardiac index (CI) and pulmonary vascular resistance were increased significantly. These results suggest that in patients with chronic lung diseases, RV functions are after-hypoxic load-dependent and multiple cardiac pool image would be of value in the estimation of cardiac performance. (author)

  13. Pulmonary capillary wedge pressure, as inferred from lung areas in gated blood-pool scintigrams: concise communication

    International Nuclear Information System (INIS)

    To determine whether the apex-to-base distribution of pulmonary blood volume, as obtained from gated cardiac blood-pool scans, could be used as a noninvasive method to estimate mean pulmonary capillary wedge pressure (PCWP), gated blood-pool scans were analyzed in 77 patients who also had PCWP measurements at cardiac catheterization. Ten of these patients had gated cardiac blood-pool scans and PCWP measurements both at rest and during exercise. The apex-to-base distribution of pulmonary blood volume was determined from the end-systolic frame of the left anterior oblique view by placing equal-sized regions of interest over the apex and base of the right lung. The ratio of apex counts over base counts (A/B ratio) was considered abnormal if greater than unity. The mean A/B ratio was 1.15 +/- 0.27 (1 s.d.) for the 32 studies associated with an abnormal mean PCWP (greater than 12 mm Hg). The mean A/B ratio was 0.85 +/- 0.23 for the 55 studies associated with a normal mean PCWP (p less than 0.01 comparing normal group with abnormal). The sensitivity of the A/B ratio for a mean PCWP greater than 12 mm Hg was 81%R (26/32). The specificity of the A/B ratio for a mean PCWP greater than or equal to 12 mm Hg was 89% (49/55). Thus, noninvasive determination of the pulmonary apex-to-base ratio from gated cardiac blood-pool scans appears to differentiate subjects with normal and abnormal mean pulmonary capillary wedge pressures

  14. Noninvasive measurement of left ventricular pressure and max dP/dt using radionuclide multigated cardiac pool image

    International Nuclear Information System (INIS)

    Noninvasive measurements of left ventricular pressure and max dP/dt were performed using radionuclide multigated cardiac pool image (RMPI). The following differential equation was derived from the Bernoulli's theorum; dP/dt=ρ/S2.(dV/dt).(d2V/dt2) where dP/dt is the first derivative of the left ventricular pressure. ρ is the density of the blood, S is an area of the aortic valvular orifice, dV/dt and d2V/dt2 are the first and second derivatives of the cardiac volume measured by RMPI. The left ventricular pressure was calculated by the integrating of this equation in 6 patients. The max dP/dt was derived from Harada's equation; max dP/dt=ρ.C.max(du/dt) where ρ is the density of the blood, c is the pulse velocity of the aorta, and u is the velocity of the blood stream, therefore, du/dt is the acceleration of the blood stream. Value of du/dt was regarded as equivalent to d2V/dt2 obtained from the RMPI volume curves using the third Fourier's transform. Results were as follows; 1) The pressure curves determined from 6 subjects by the RMPI method were not exactly identical to those obtained directly by cardiac catheterization. The discrepancy is probably due to the interaction with reflexion waves. 2) Despite the above discrepancy, there was a significant correlation (r=0.57, Y=1.18X+146, p<0.05) between max dP/dt (X) measured from 16 subjects by cardiac catheterization and calculated max dP/dt (RI) (Y). It was concluded that the max dP/dt could be estimated noninvasively by RMPI method. (author)

  15. Relationship between cardiac function and resting cerebral blood flow

    DEFF Research Database (Denmark)

    Henriksen, Otto M; Jensen, Lars T; Krabbe, Katja;

    2014-01-01

    and cardiac output were measured in 31 healthy subjects 50-75 years old using magnetic resonance imaging techniques. Mean values of CBF, cardiac output and cardiac index were 43.6 ml per 100 g min(-1), 5.5 l min(-1) and 2.7 l min(-1) m(-2), respectively, in males, and 53.4 ml per 100 g min(-1), 4.3 l......Although both impaired cardiac function and reduced cerebral blood flow are associated with ageing, current knowledge of the influence of cardiac function on resting cerebral blood flow (CBF) is limited. The aim of this study was to investigate the potential effects of cardiac function on CBF. CBF...... min(-1) and 2.4 l min(-1) m(-2), respectively, in females. No effects of cardiac output or cardiac index on CBF or structural signs of brain ageing were observed. However, fractional brain flow defined as the ratio of total brain flow to cardiac output was inversely correlated with cardiac index (r(2...

  16. Ouabain induces cardiac remodeling in rats independent of blood pressure

    Institute of Scientific and Technical Information of China (English)

    Xing JIANG; Yan-ping REN; Zhuo-ren L(U)

    2007-01-01

    Aim: To investigate the ouabain's effects on cardiac remodeling in rats. Methods:Male Sprague-Dawley rats were treated with ouabain. Systolic blood pressure(SBP) was recorded weekly. After 4 and 6 weeks, echocardiography were performed,hemodynamic parameters were measured by invasive cardiac catheterization,changes in cardiac ultrastructure were analyzed using transmission electron microscopy, the collagen fraction of the left ventricle was assessed with Picrosirius red stain, and RT-PCR was applied to evaluate the mRNA level of myosin heavy chain-α and-β in the left ventricle. Results: Having been treated with ouabain for 4 weeks, there was no significant difference in the mean SBP of the two groups.However, left ventricular hypertrophy, myocardial ultrastructure deterioration,and extracellular matrix remodeling were induced by ouabain treatment; meanwhile,cardiac systolic and diastolic performance were both worsened. Moreover, the cardiac MHC-β mRNA was upregulated by ouabain treatment, whereas MHC-αmRNA was downregulated. After 4 weeks, the mean SBP in the ouabain group began to increase and was significantly higher than that in control group after 6 weeks (P<0.01); the rats' cardiac structure and function were worsened.Conclusion: These results suggested that ouabain induces alterations in cardiac structure and function, and the effects happened before the increase of blood pressure. The results indicated that ouabain induced cardiac remodeling in rats independent of blood pressure.

  17. Evaluation of left ventricular function in patients with atrial fibrillation by ECG gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    ECG gated blood pool scintigraphy (EGBP) is not always valid for the patients with atrial fibrillation (AF), since they have wide variability in cardiac cycle length (CL). To evaluate the left ventricular (LV) function during AF by EGBP, we devised a new processing algorithm to construct multiple gated images discriminated by preceding R-R interval (PRR) from the data acquired in list mode. 18 patients with AF were studied as to; 1) How affect the PRR on cardiac indices such as EF, TES, PER or TPER, 2) Comparison with conventional method getting all CL data, 3) LV filling curves derived by plotting EDV against PRR, 4) The slope and position of LV function curves (LVFC) derived by plotting SV against EDV. In most cases, EF, PER and TES were increased with longer PRR, and those by conventional method nearly corresponded to the average values obtained by our new method. Impairment of ventricular filling was demonstrated in the cases of mitral stenosis and constrictive pericarditis. LVFC of CHF group was situated at right and downward to controls, and left and upward shift was observed after treatment. The slope of LVFC was reduced in relation to the progression of NYHA's functional class. In conclusion, this new algorithm processing irregular CL enables LV filling and function curves to draw, which are useful in the evaluation of cardiac performance in the subjects with AF. (author)

  18. Limiting excessive postoperative blood transfusion after cardiac procedures. A review.

    OpenAIRE

    Ferraris, V A; Ferraris, S P

    1995-01-01

    Analysis of blood product use after cardiac operations reveals that a few patients ( 80%). The risk factors that predispose a minority of patients to excessive blood use include patient-related factors, transfusion practices, drug-related causes, and procedure-related factors. Multivariate studies suggest that patient age and red blood cell volume are independent patient-related variables that predict excessive blood product transfusion aft...

  19. The preparation and identification of 99mTc-DTPA-HSA instant kit for blood-pool imaging

    International Nuclear Information System (INIS)

    The procedures for the preparation of animal experiment and preliminary clinical application of 99mTc-DTPA-HSA instant kit are described. The data showed that the radiochemical purity of this preparation was 97%, and also was stable more than 3 hours in room temperature. A comparison of 99mTc-DePA-HSA and 99mTc-HSA was carried in rats. The disappearance of radioactivity from the blood solwer for 99mTc-DTPA-HSA (T1/2 269.7 min, 88.8% of injected dose remaining in the blood at 1 hour) that for 99mTc-HSA (T1/2 = 139.6 min, 78.5% of injected dose remaining in the blood at 1 hour). In rabbits the blood pool images of 99mTc-DTPA-HSA was much more clear than with 99mTc-HSA. Identification of radioactive metabolites excreted in rabbit's urine 1 hour after injection of 99mTc-DTPA-HSA or indicated that no decomposition of 99mTc-DTPA-HSA was found, while in of 99mTc-HSA degradation was obvious. The liver blood pool imaging and the gated cardiac blood pool imaging were performed using 99mTc-DTPA-HSA demonstrating satisfactory results in 10 cases and also no toxic effects were observed

  20. Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation

    DEFF Research Database (Denmark)

    Stokholm, K H; Breum, L; Astrup, A

    1991-01-01

    pressure (BP) declined. The fall in BP was caused by the reduction in cardiac output as the total peripheral resistance was unchanged. Finally, the decline in total blood volume was not significant. These findings together with a reduction in heart rate indicated that a reduced sympathetic tone via......Eight obese patients were studied before and after 2 weeks of treatment by a very-low-calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I-albumin) and radionuclide angiocardiography (first pass and...... equilibrium technique by [99Tcm]red blood cells). Cardiac output decreased concomitantly with the reduction in oxygen uptake as the calculated systemic arteriovenous difference of oxygen was unaltered. There were no significant decreases in left ventricular contractility indices, i.e. the ejection fraction...

  1. Cerebral blood flow in humans following resuscitation from cardiac arrest

    International Nuclear Information System (INIS)

    Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage

  2. Evaluation of left ventricular function in patients with atrial fibrillation by ECG gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    The assumption necessary to perform ECG gated blood pool scintigraphy (EGBPS) are seemingly not valid for patients with atrial fibrillation (af), since they have wide variability in cardiac cycle length. The data were acquired in frame mode within the limits of mean heart rate of fix the first diastolic volume, and were calculated by frame count normalization (FCN) method to correct total counts in each frame. EGBPS were performed twelve patients with af, who were operated against valvular disease. The data acquired within mean heart rate ±10 % in frame mode were divided to 32 frames, and calculated total frame counts. With FCN method total frame counts from at 22nd to 32nd frame were multiplied to be equal to the average of total frame counts. FCN method could correct total frame counts at the latter frames. And there was good correlation between left ventricular ejection fraction calculated from scintigraphy and that from contrast cineangiography. Thus EGBPS with FCN method may be allow estimation of cardiac function even in subjects with af. (author)

  3. Mechanical Blood Pumps for Cardiac Assistance

    OpenAIRE

    Akdis, M; Reul, H

    2005-01-01

    Cardiac assist devices are classified into the traditional engineering categories of displacement and rotary pumps. Clinical use and indications of the various pump categories are outlined and a detailed description of currently available systems is given. The first part deals with extracorporeal as well as implantable ventricular assist devices (VAD) of the displacement type and is followed by a section on current developments in the field of total artificial hearts (TAH). The second part co...

  4. Gated blood pool studies with a single probe - clinical validity

    International Nuclear Information System (INIS)

    The global volume alterations of the heart can be estimated non-invasively by means of the radiocardiographic function analysis developed by Hoffmann and Kleine. Since the failing heart with its functional disturbances demonstrates a pathological volume behaviour under physical exercise, it is possible to use these characteristics to differentiate between the intact heart and the failing heart by registration of the global volume alterations. The gated blood pool technique combined with the registration of the intraventricular pressure pulse by means of a Swan-Ganz flow-directed catheter enables demonstration of ventricular stroke work as a pressure-volume loop (work diagram). Its shape indicates whether the ventricle has to perform mainly pressure work or volume work. Myocardial failure is altering the basic conditions of the heart. The work diagram of the failing heart is significantly different from that of the intact human heart. It is shifted in its pressure-volume coordinates according to an increase of EDV and ESV and the rise of the filling pressure. Case demonstrations reveal the global volume behaviour of the heart under varying conditions: resting and physical exercise, drug influence on the intact and failing heart. (orig.)

  5. Mechanical Blood Pumps for Cardiac Assistance

    Directory of Open Access Journals (Sweden)

    M. Akdis

    2005-01-01

    Full Text Available Cardiac assist devices are classified into the traditional engineering categories of displacement and rotary pumps. Clinical use and indications of the various pump categories are outlined and a detailed description of currently available systems is given. The first part deals with extracorporeal as well as implantable ventricular assist devices (VAD of the displacement type and is followed by a section on current developments in the field of total artificial hearts (TAH. The second part covers the rotary pump category from cardiopulmonary bypass applications to implantable systems, including specific design aspects of radial, diagonal, and axial pumps.

  6. Gated blood pool imaging in the diagnosis and management of arrhythmia

    International Nuclear Information System (INIS)

    The usefulness of multigated cardiac blood pool imaging in evaluating left ventricular function and ventricular activation was studied in patients with cardiac arrhythmias. Subjects consisted of 12 patients with the Wolff-Parkinson-White (WPW) syndrome; 20 with ventricular premature contractions (VPC); 21 with various modes of artificial pacemakers; and two normal controls. 1. Phase analysis was useful in localizing the bypass tract in patients with the WPW syndrome. In four patients with the WPW syndrome and five with VVI pacing, the phase difference between the posterolateral wall of the left ventricle (LV) and the right ventricular apex correlated significantly with the activation time difference between these two regions as assessed by endocardial electrograms (r = 0.94, p < 0.001). 2. Images of VPC were obtained using the bad beat rejection program in an ADAC computer system. The origin of VPCs evaluated by phase image coincided with results of standard 12-lead electrograms. 3. The LV ejection fraction (LVEF) decreased significantly (p < 0.001) after the injection of lidocaine (-3.7 %) or disopyramide (-6.2 %). The percent reduction in LVEF was significantly greater with disopyramide than with lidocaine (-15.1 vs -11.2 %). There was a significant correlation between the percent reduction in LVEF and the disopyramide plasma concentrations (r = -0.62, p < 0.001). 4. The influence of the pacing mode and exercise on LV function was studied in 21 patients with artificial pacemakers. In the VDD and DDD modes, end-diastolic volume (EDV) and cardiac output (CO) decreased after converting to VVI mode. CO increased markedly to approximately 250 % of the control value in the VDD and DDD, and moderately in the VVI and AAI modes during ergometer exercise. (J.P.N.)

  7. Nanoparticle encapsulation in red blood cells enables blood-pool magnetic particle imaging hours after injection

    International Nuclear Information System (INIS)

    Magnetic particle imaging (MPI) is a new medical imaging approach that is based on the nonlinear magnetization response of super-paramagnetic iron oxide nanoparticles (SPIOs) injected into the blood stream. To date, real-time MPI of the bolus passage of an approved MRI SPIO contrast agent injected into the tail vein of living mice has been demonstrated. However, nanoparticles are rapidly removed from the blood stream by the mononuclear phagocyte system. Therefore, imaging applications for long-term monitoring require the repeated administration of bolus injections, which complicates quantitative comparisons due to the temporal variations in concentration. Encapsulation of SPIOs into red blood cells (RBCs) has been suggested to increase the blood circulation time of nanoparticles. This work presents first evidence that SPIO-loaded RBCs can be imaged in the blood pool of mice several hours after injection using MPI. This finding is supported by magnetic particle spectroscopy performed to quantify the iron concentration in blood samples extracted from the mice 3 and 24 h after injection of SPIO-loaded RBCs. Based on these results, new MPI applications can be envisioned, such as permanent 3D real-time visualization of the vessel tree during interventional procedures, bleeding monitoring after stroke, or long-term monitoring and treatment control of cardiovascular diseases. (paper)

  8. A method for measuring mean circumferential fiber shortening rate from gated blood pool scans

    International Nuclear Information System (INIS)

    Ejection fraction and ejection rate are easily obtained from gated cardiac images, but no method is available for calculating mean circumferential fiber shortening rate. We assumed that the cube root of left ventricular end-diastolic volume or counts is proportional to the minor axis of the left ventricle at end-diastole or end-systole. Mean circumferential fiber shortening rate is then equal to the [cube root of the end-diastolic volume (count) minus cube root of end-systolic volume (count)] divided by [cube root of end-diastolic volume (count) multiplied by the ejection time]. In 250 contrast ventriculograms, the standard mean circumferential fiber shortening rate (MCFSR) and that derived by the cube root method correlated well (r = 0.94). The mean value of MCFSR (0.85 +- 0.35) was greater than the cube root value (0.75 +- 0.35) (P < 0.001). The regression equation was y = 0.86x + 0.02. Similar correlations were obtained from gated radionuclide images using a semiautomated program (r = 0.93) in 24 subjects or completely automated program (r = 0.85) in 28 patients. The regression equation between MCFSR and that derived from the cube root of counts for the semiautomated program was y = 0.82x + 0.04 and for the automated program was y = 0.84x + 0.004. Similar correlations, slopes, and intercepts were seen using circumferential fractional shortening for angiographic data when correlated with both the semiautomated and automated gated blood pool scan programs. These data indicate that MCFSR and circumferential fractional shortening may be obtained from gated blood pool images using cube root estimates of end-diastolic and end-systolic radii with a high degree of correlation with the standard contrast ventriculographic technique. (orig.)

  9. Fast and reliable automated ventriculography for gated blood-pool studies

    International Nuclear Information System (INIS)

    A set of algorithms, requiring only one single operator-interaction and minimal running time, has been generated to analyze left-ventricular function from cardiac gated Tc-99m Blood-pool Nuclear Medicine scintigrams (CBPS). The process depends mainly on an optimal edge enhancement filter derived in the frequency domain and applied to the study via FFT. The bandpass filter is based on Prolate Spheroidal wave functions and was described by Shanmugam et al in 1979. It maximizes output in the vicinity of edges, and is adapted here to enhance the ventricular region of interest (ROI) yielding images with sharp edges and good signal-to-noise ratio (SNR). This procedure does not require previous background subtraction from initial images in order to adequately define left-ventricular contours. A filter format has been chosen which will allow successful performance of the technique over a wide range of CBPS. The filtered image is then scanned and, on the original frame edges around ROI are marked and counts within ROI are defined. It will automatically run for any allowed number or size of frames. Processing time averages less than one minute when employing an Array Processor for a set of 32 64x64 pixel frames. Nuclear Medicine image processing applications of such filter have not been reported to date. This process has been tested on variable rate, variable ejection fraction, known volume Vanderbilt cardiac phantom; with maximum deviation of 3.5% and estimated standard deviation (SD) of 1.7%. When compared to other processes currently available, this technique is clearly more reliable due to its accuracy, speed and simplicity. It has also been used to determine ventricular volumes from gated SPECT images, with a respectable SD of 2.8%

  10. Perioperative control of blood glucose level in cardiac surgery.

    OpenAIRE

    Minakata, Kenji; Sakata, Ryuzo

    2013-01-01

    It is well recognized that poor perioperative blood glucose (BG) control can increase the risk of infection, cardiovascular accidents, and even death in patients undergoing cardiac surgery. Since it has been reported that tight BG control (80-110 mg/dL) yields better outcomes in critically ill patients, it became a standard of care to control BG using intravenous insulin infusion in ICU. However, it has been debated in terms of the optimal target range whether a strict control with intensive ...

  11. Calculation of net renal uptake curves without use of a blood pool agent

    International Nuclear Information System (INIS)

    The usual method of generating net Hippuran renal uptake curves involves the administration of a blood pool agent. Two techniques are presented which permit the determination of net renal uptake curves from data intrinsic to the Hippuran study. This reduced the complexity of the procedure, as well as reducing its cost and decreasing the radiation exposure. The new procedures were tested in 9 patients and showed excellent correlation with the blood pool agent technique. (orig.)

  12. Perfusionist strategies for blood conservation in pediatric cardiac surgery.

    Science.gov (United States)

    Durandy, Yves

    2010-02-26

    There is increasing concern about the safety of homologous blood transfusion during cardiac surgery, and a restrictive transfusion practice is associated with improved outcome. Transfusion-free pediatric cardiac surgery is unrealistic for the vast majority of procedures in neonates or small infants; however, considerable progress has been made by using techniques that decrease the need for homologous blood products or even allow bloodless surgery in older infants and children. These techniques involve a decrease in prime volume by downsizing the bypass circuit with the help of vacuum-assisted venous drainage, microplegia, autologous blood predonation with or without infusion of recombinant (erythropoietin), cell salvaging, ultrafiltration and retrograde autologous priming. The three major techniques which are simple, safe, efficient, and cost-effective are: a prime volume as small as possible, cardioplegia with negligible hydric balance and circuit residual blood salvaged without any alteration. Furthermore, these three techniques can be used for all the patients, including emergencies and small babies. In every pediatric surgical unit, a strategy to decrease or avoid blood bank transfusion must be implemented. A strategy to minimize transfusion requirement requires a combined effort involving the entire surgical team with pre-, peri-, and postoperative planning and management. PMID:21160681

  13. Efficacy of the phase images in fourier analysis using gated cardiac POOL-SPECT for determining the indication for cardiac resynchronization therapy

    International Nuclear Information System (INIS)

    Although cardiac resynchronization therapy (CRT) improves quality of life and survival for patients with heart failure, exact methods to estimate the effect of cardiac asynchrony have not yet been defined. Initially, to examine whether the phase analysis images in the Fourier analysis using gated cardiac pool single photon emission computed tomography (POOL-SPECT) could be used to evaluate cardiac asynchrony, 19 consecutive patients with dilated cardiomyopathy were studied. Interventricular asynchrony was defined by whether the peak of the picture elements of the right ventricle in the phase histogram fitted that of the left ventricle and intraventricular asynchrony by whether the phase image was described homogenously or not. The patients with both inter- and intraventricular asynchrony had significant deterioration in both left ventricular ejection fraction (p<0.01) and New York Heart Association functional class (p<0.01). To evaluate the efficacy of these phase images for CRT setting, 7 patients were tested before and after CRT. During a 3.9±3.6 month follow-up period, all patients had an improvement in their condition, and the inter- and intraventricular asynchrony significantly improved after CRT. The degrees of the inter- and intraventricular asynchrony were related to the degree of cardiac depression pre CRT. These results have shown that the phase images from POOL-SPECT are useful for assessing the effect of CRT in patients with heart failure, which suggests that it may provide information about the indication for CRT. (author)

  14. Age of transfused blood is not associated with increased postoperative adverse outcome after cardiac surgery.

    LENUS (Irish Health Repository)

    McKenny, M

    2011-05-01

    This study investigated the hypothesis that storage age of transfused red blood cells (RBCs) is associated with adverse outcome after cardiac surgery, and examined association between volume of RBC transfusions and outcome after cardiac surgery.

  15. Diagnostic value of blood pool imaging for limbs viability after electrical injury

    International Nuclear Information System (INIS)

    This study was undertaken to evaluate the clinical usefulness of 99mTc labelled red blood cell imaging in the detection of limbs viability after electrical injury. 8 patients were studied. There are two steps in the imaging process: artery perfusion and blood pool imaging. In the case of severe injury, in which muscles were necrotic and vessels are obstructed, no radioactivities appeared in those areas. The imaging results were proved by plastic surgery. This study shows that 99mTc-RBC blood pool imaging is a reliable method for the detection of limbs' viability after electrical injury

  16. Magnetic resonance angiography with blood-pool contrast agents: future applications

    Energy Technology Data Exchange (ETDEWEB)

    Fink, C. [Univ. Hospitals, Grosshadern, Munich (Germany); Goyen, M. [Univ. Medical Center, Hamburg-Eppendorf, Hamburg (Germany); Lotz, J. [Hannover Medical School, Hannover (Germany)

    2007-03-15

    Blood pool agents remain in the intravascular space for a longer time period. Therefore the optimal imaging window for vascular structures is widened to about 30 minutes. Gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany) is the first blood-pool contrast agent approved in Europe for contrast-enhanced magnetic resonance angiography (MRA) of vessels in the abdomen, pelvis and lower extremity in adults. Other possible applications of blood-pool agents are now being considered, such as assessment of venous thromboembolism, coronary artery disease or sinus venous thrombosis. Perfusion MR imaging holds promise for detecting lung perfusion defects with higher spatial resolution and reduced scan time compared with radionuclide scintigraphy. In coronary artery disease, blood-pool agents enable a substantial increase in the quality of coronary artery imaging. Quantitative myocardial perfusion and myocardial viability seem to be possible, although modifications in protocols and sequence design are necessary for optimal results. Other novel applications of blood-pool agents include monitoring of inflammatory changes in systemic lupus erythematosus and evaluation of tumour invasion into lymph nodes and more reliable assessment of cerebral venous and sinus thrombosis. (orig.)

  17. Evaluation of copper-labeled bifunctional chelate-albumin conjugates for blood pool imaging

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, C.J.; Rocque, P.A.; Welch, M.J. (Washington Univ., St. Louis, MO (United States). Edward Mallinckrodt Inst. of Radiology); Weinheimer, C.J. (Washington Univ., St. Louis, MO (United States). School of Medicine)

    1993-05-01

    [sup 62]Cu is a generator-produced positron-emitting radionuclide with a half-life amenable to blood-pool imaging with PET. Three bifunctional chelates [cyclic anhydride of diethylenetriamine-pentaacetic acid (cDTPAA), 6-bromoacetamidobenzyl-1,4,8,11-tetraazacyclotetradecane-N,N',N'', N''' tetraacetic acid (BAT), and p-carboxyethylphenylglyoxal-bis-([sup 4])N-methyl-thiosemicarbazone (CE-DTS)] were conjugated to HSA and labeled with [sup 67]Cu. Blood clearance and biodistribution of these three [sup 67]Cu-labeled conjugates were determined in rats. Of the three [sup 67]Cu-labeled bifunctional chelate-HSA conjugates, [sup 67]Cu-benzyl-TETA-HSA remained in the blood pool the longest, achieving stable blood levels at times longer than 24 h post-injection. The [sup 67]Cu radioactivity cleared the blood within 60 min post-injection of [sup 67]Cu-DTS-HSA, and within 10 min after administration of [sup 67]Cu-DTPA-HSA, indicating the dissociation of Cu[sup 2+] from these conjugates. Copper-labeled DTS-HSA achieved stable blood concentrations for at least 30 min post-injection and was therefore evaluated as a vascular imaging agent. DTS-HSA and benzy-TETA-HSA were labeled with [sup 62]Cu and administered to a dog for blood-pool imaging using PET. Because of the high labeling efficiency, DTS-HSA can be labeled with [sup 62]Cu without purification, making it more practical than [sup 62]Cu-benzyl-TETA-HSA as a blood-pool imaging agent. Generator-produced [sup 62]Cu-DTS-HSA should be a viable alternative blood pool agent to cyclotron-produced C[sup 15]O for PET facilities without cyclotrons. (author).

  18. Leucocyte filtration of salvaged blood during cardiac surgery : effect on red blood cell function in concentrated blood compared with diluted blood

    NARCIS (Netherlands)

    Gu, Y. John; de Vries, Adrianus J.; Hagenaars, J. Ans M.; van Oeveren, Willem

    2009-01-01

    Objective: Leucocyte filtration of salvaged blood has been suggested to prevent patients from receiving activated leucocytes during autotransfusion in cardiac surgery. This study examines whether leucocyte filtration of salvaged blood affects the red blood cell (RBC) function and whether there is a

  19. Radionuclide left ventricular absolute volume determination by ejection fraction measurement data and a left posterior oblique blood pool image

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Shinichiro (Saitama Medical School, Moroyama (Japan))

    1989-09-01

    A new method for the calculation of left ventricular volumes called the 'semi-geometric' method, was reported by Nichols et al in 1984. This method, however, still had certain limitations for practical use. This paper describes a modified semi-geometric method in which the left ventricular volume was obtained from conventional left ventricular ejection fraction measurement data collected from the modified left anterior oblique position with a caudal tilt of 10 degrees or more and a left posterior oblique blood pool image. The left ventricular end-diastolic volumes obtained by this method were compared with those calculated by combining the thermodilution cardiac output and the left ventricular ejection fraction. The correlation coefficient was r=0.93 (n=20). In the phantom experiment, the true volumes and those obtained by this method showed an excellent correlation (r=0.99). This method is considered accurate and practical. (author).

  20. Relaxivity of blood pool contrast agent depends on the host tissue as suggested by semianalytical simulations

    DEFF Research Database (Denmark)

    Jensen, Birgitte Fuglsang; Østergaard, Leif; Kiselev, Valerij G

    Concentration of MRI contrast agents (CA) is commonly determined indirectly using their relaxation effect. In quantitative perfusion studies, the change in the relaxation following a bolus passage is converted into concentrations assuming identical relaxivities for tissue and blood. Simulations...... presented in this study demonstrate that the relaxivity of blood pool CA depends significantly on both the host tissue and the pulse sequence, in agreement with previous experiments. In particular, the relaxation effect of Gd-based CA in brain tissues is several-fold larger than in bulk blood. The results...... can be applied to quantitation of perfusion, functional MRI and vessel size imaging...

  1. Visualization of hypertrophied papillary muscle mimicking left ventricular mass on gated blood pool and T1-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    A sixty-year old man with acute myocardial infarction was incidentally found to have a hypertrophied anterolateral papillary muscle (ALPPM) of the left ventricle on gated blood pool (GBP) and T1-201 myocardial perfusion images. Hypertrophy of the ALPPM was visualized as a movable defect in the lateral basal area on GBP imaging throughout the cardiac cycle and on the TI-201 study as a radionuclide accumulating structure, consistent with the defect in the GBP. A combination of these findings may suggest the presence of a hypertrophied papillary muscle of the left ventricle

  2. Analysis of Left Ventricular Functional Parameters in Normal Korean Subjects by ECG Gated Blood Pool Scan

    International Nuclear Information System (INIS)

    The demand for refinement in noninvasive and quantitative assessment of left ventricular (LU) function is increasing. To assess normal values of left ventricular functional parameters during both systole and diastole by scintigraphic method using computerized triple-head gamma camera and to evaluate correlations between these parameters. ECG gated blood pool scan with 99mTc-Human serum albumin was performed in 94 normal Korean subjects. Ejection fraction (EF), systolic parameters [peak emptying rate (PER), average emptying rate (AER), time to peak emptying rate (TPER)], and diastolic parameters [peak filling rate (PFR), average filling rate (AFR), time to peak filling rate (TPFR)] were obtained by analysis of LV time-activity curve, the correlation of these parameters to the age and sex, and the correlation between these parameters were evaluated. 1) Mean value of ejection fraction in study subjects was 59.6 ± 5.25% and showed no significant correlation to age (r=0.08) and sex but showed most pronounced correlation to PFR (r=0.46, p<0.001), PER (r=0.41, p<0.001), AFR (r=0.34, p<0.001) and AER (r=0.28, p<0.01). 2) Mean values of systolic parameters were as follows: PER=3.22 + 0.50 end-diastolic volume/sec, AER =2.22 + 0.45 end-diastolic volume/sec, TPER=103.5 + 29.30 msec. They showed no significant correlation to age and sex. 3) Mean values of diastolic parameters were as follows: PFR=2.71+0.51 end-diastolic volume/sec, AFR=1.830.44 end-diastolic volume/sec, TPFR=132.1 + 33.45 msec. They showed strong correlation to age (r=-0/70, -0.64, 0.37, p<0.001). Left ventricular functional parameters in normal Korean subjects were obtained reliably by computerized scintigraphic method and may be applied to the evaluation of cardiac function in diseased patients.

  3. Preparation and biodistribution of 99TcmN-DCHDTC as a new blood pool imaging agent

    International Nuclear Information System (INIS)

    99TcmN-DCHDTC (DCHDTC: dicyclohexyl dithiocarbamate) is prepared through a two-step ligand-exchange reaction by using SnCl2·2H2O as reduction agent and SDH (succinic dihydrazide) as a donor of nitride nitrogen atom (N3-). The radiochemical purity of the product is over 95% by TLC. 99TcmN-DCHDTC is stable over 6 h at room temperature. The IgP is 1.19. The electrophoresis results show the complex is neutral. The biodistribution results in mice indicate the complex has high blood uptake. The uptake ratios of blood/heart, blood/lung and blood/liver are 5.27, 1.31 and 1.07 at 30 min post-injection respectively. The results for the complex suggest that it will be potentially useful as a blood pool imaging agent

  4. Ventricular function during the acute rejection of heterotopic transplanted heart: Gated blood pool studies

    International Nuclear Information System (INIS)

    Twenty patients who had undergone a heterotopic heart transplant were studied prospectively to determine the relationship between rejection and ventricular dysfunction assessed from gated blood pool studies. A fully automated method for detecting ventricular edges was implemented; its success rate for the grafted left and right ventricles was 94% and 77%, respectively. The parameters, peak ejection and filling rates, were calculated pixel per pixel using a two-harmonic Fourier algorithm and then averaged over the ventricular region of interest. Peak filling and ejection rates were closely related with the severity of the rejection, while the left ventricular ejection fraction was not. Peak filling rates of both ventricles were the indices closely related to the presence of moderate rejection. Despite the low number of patients, these data suggested that gated blood pool derived indices of ventricular function are associated with ventricular dysfunction resulting from myocarditis rejection. Radionuclide ventriculography provides parametric data which are accurate and reliable for the diagnosis of rejection. (orig.)

  5. Influence of ectopic heart beats in gated ventricular blood-pool studies

    International Nuclear Information System (INIS)

    Direct data collection from ventricular blood-pool studies were stored in frame mode in a computer and by means of a modified tape recorder, the blood-pool image and ECG were recorded on tape. At the end of the study the tape data were replayed into the computer. The ECG signal was passed through a trigger circuit that detected the R wave which was sampled by the computer once every msec. Contractions outside of the desired range could be rejected along with the subsequent contraction. Of seven patients whose calculated ejection fractions were changed by more than 0.03, all had frequent (one in 20) ectopic contractions. The distorted ventricular volume curves were effectively restructured by the constraining procedure, changing the end-systolic volume and EF. Computer modeling showed a linear relationship between the percent of ectopic contractions and the underestimate of ejection fraction. One ectopic beat in ten led to a 5% underestimate of EF

  6. Dependency of blood pressure upon cardiac filling in patients with severe postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Stokholm, K H

    1994-01-01

    vasoconstriction. The reduction in cardiac output resulted from reductions in left ventricular end-diastolic volumes with unchanged left ventricular ejection fractions and only moderate increments in heart rate. The study was demonstrated that blood pressure is strongly dependent upon cardiac filling in severe......Autonomic denervation of the vascular bed results theoretically in a stronger dependency of blood pressure upon intravascular volume, and the study described aimed at an investigation of the relation between cardiac filling and arterial blood pressure in patients with severe postural hypotension....... Seven patients were studied during head-up tilt at three different tilt angles using intra-arterial blood pressure recordings and estimates of left ventricular volumes by radioisotope ventriculography. Blood pressure fell dramatically during head-up tilt due to reductions in cardiac output unopposed by...

  7. Uptitrating amlodipine significantly reduces blood pressure in diabetic patients with hypertension: a retrospective, pooled analysis

    OpenAIRE

    Jeffers BW; Bhambri R; Robbins J

    2014-01-01

    Barrett W Jeffers, Rahul Bhambri, Jeffery Robbins Pfizer Inc., New York, NY, USA Abstract: Diabetic patients with hypertension are approximately twice as likely to develop cardiovascular disease as non-diabetic patients with hypertension. Given that hypertension affects ~60% of patients with diabetes, effective blood pressure (BP) management is important in this high-risk population. This post-hoc analysis pooled data from six clinical studies to quantify additional BP efficacy achieved when...

  8. Assessment of myocardial perfusion abnormality and hibernating myocardium by gated blood pool and exercise-stress thallium tomographies after successful coronary angioplasty

    International Nuclear Information System (INIS)

    Cardiac function and myocardial perfusion were assessed by exercise-stress thallium SPECT and resting gated blood pool SPECT techniques before and after 47 successful coronary angioplasties. Thallium perfusion was analyzed visually and quantitatively in stress and resting studies. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) were calculated and regional wall motion was scored by amplitude and phase images in radionuclide planar and tomographic imagings. The thallium redistribution in delayed or resting SPECTs was more sensitive (87%) for detecting myocardial ischemia compared to symptoms (36%) and ECG changes (60%). An exercise capacity, LVEF, PFR, and the scores of perfusion and regional wall motion were improved significantly after coronary angioplasty. Stress thallium and gated blood pool SPECTs showed the improvements of myocardial perfusion in 159 (79%) of 201 segments and regional wall motion in 47 (51%) of 92 segments, respectively. These results suggest that the combined use of stress thallium SPECT, gated blood pool planar and SPECT techniques can contribute not only to the assessment of the efficacy of coronary angioplasty but also to detecting the mismatching of myocardial perfusion and contraction ('myocardial hibernation') in infarct-related myocardial lesions. (author)

  9. Prolonged in vivo circulation time by zwitterionic modification of magnetite nanoparticles for blood pool contrast agents.

    Science.gov (United States)

    Xiao, Wangchuan; Lin, Jiang; Li, Mingli; Ma, Yongjie; Chen, Yuxin; Zhang, Chunfu; Li, Dan; Gu, Hongchen

    2012-01-01

    Long circulation time is critical for blood pool contrast agents used in high-resolution magnetic resonance angiography. For iron oxide particle contrast agents, size and surface properties significantly influence their in vivo performance. We developed a novel long-circulating blood pool contrast agent by introducing zwitterionic structure onto the particle surface. Zwitterionic structure was fabricated by 3-(diethylamino)propylamine (DEAPA) grafted onto the surface of ployacrylic acid coated magnetite nanoparticles via EDC/NHS [N-(3-dimethylaminopropyl)-N'-ethylcarbo-diimide hydrochloride/N-hydroxysuccinimide] coupling chemistry. Zwitterionic particles demonstrated five times lower macrophage cell uptake than the original particles and low cell toxicity. Magnetic resonance angiography indicated that zwitterionic nanoparticles had much longer in vivo circulation time than the original particles and were an ideal candidate for blood pool contrast agent. We suppose that zwitterionic modification by DEAPA and EDC/NHS can be used generally for coating nanoparticles with carboxyl surface and to prolong their circulating time. PMID:22539402

  10. Alterations of the blood pool in the femoral head before and after renal transplantation

    International Nuclear Information System (INIS)

    The pathogenesis of idiopathic osteonecrosis of the femoral head (ION) is thought to be an ischemic event. The purpose of this study is to investigate alterations of the blood pool in the femoral head before and after renal transplantation. After renal transplantation, all patients received the same immunosuppressive therapy: corticosteroids, cyclosporin-A, and azathioprine. We performed 3-phase bone scintigraphy on 16 renal allograft recipients within 1 week before renal transplantation, and between week 4 and 9 after renal transplantation. Regions of interest (ROI) were assigned bilaterally in the femoral head, diaphysis, and soft tissue. The head-to-diaphysis ratios (HD ratios) were then calculated. Idiopathic osteonecrosis of the femoral head occurred in 2 femoral heads of 1 patient. The HD ratio before renal transplantation (mean HD±SD, 1.52±0.30) and the HD ratio after renal transplantation (1.28±0.30) were significantly different (P=0.000024). The HD ratios before and after renal transplantation were significantly different, indicating that the administration of steroids diminished the blood pool in the femoral head. A low HD ratio before renal transplantation revealed a poor blood pool in the femoral head, which may be a risk factor for ION. (author)

  11. 99mTc-MDP combined blood pool and bone phase radionuclide imaging in papain-injected carpal joints

    International Nuclear Information System (INIS)

    Scintigraphic changes, i.e., increased activity, were induced by 1% papain, dissolved in phosphate-buffered physiologic saline (pH 7.4), injected into one antebrachiocarpal joint in each of eight dogs. Scintigraphic evaluation was by the use of combined blood pool and bone phase scintigraphy of affected and normal carpi over a 28-day period. The qualitative and quantitative scintigraphic appearance in injected carpal joints were very similar in both blood pool and bone phases. The clinical use of combined blood pool and bone phase scintigraphy to diagnose early inflammatory joint changes appears limited

  12. Gallium-68-DOTA-albumin as a PET blood-pool marker: experimental evaluation in vivo

    International Nuclear Information System (INIS)

    Investigations into tumor angiogenesis and antiangiogenic treatment have renewed interest in tumor perfusion. To image tumor blood-pool by PET, suitable tracers are not generally available. In this experimental study, we characterized a 68Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) conjugate of rat serum albumin (68Ga-DOTA-RSA) in vivo using a generator-produced isotope. Biodistribution was determined in ACI rats after intravenous administration of 3-6 MBq of 68Ga-DOTA-RSA. Three ACI rats were imaged over 1 h by dynamic PET after intravenous administration of 15-25 MBq of 68Ga-DOTA-RSA while the blood-pool activity was recorded simultaneously in a closed extracorporeal loop (ECL) between the carotid artery and the jugular vein. Time-activity curves (TACs) were obtained from volume of interest (VOI) analysis and from the ECL data. Stability and metabolites in plasma and urine were analyzed by size exclusion HPLC (SE-HPLC) 1 h after intravenous injection of 67Ga-DOTA-RSA. Blood radioactivity decreased by 10% and 18% from 10 to 60 min p.i. by biodistribution and PET or ECL, respectively. Tissue sampling between 10 and 60 min p.i. showed slight increases in the uptake of spleen, myocardium, kidney and skeletal muscle while hepatic accretion remained unchanged. Total urinary excretion after 60 min amounted to 9% of the injected dose. HPLC demonstrated a single urinary metabolite corresponding in size to gallium-labeled DOTA. 68Ga-DOTA-RSA is a blood-pool tracer whose physical and biological half-life is well suited for PET. Our findings support clinical imaging using 68Ga-DOTA-labeled human serum albumin (HSA). The generator-produced label makes 68Ga-DOTA-labeled albumin continuously available even to centers lacking an in-house cyclotron

  13. Identification of cytoskeletal elements enclosing the ATP pools that fuel human red blood cell membrane cation pumps

    OpenAIRE

    Chu, Haiyan; Puchulu-Campanella, Estela; Galan, Jacob A.; Tao, W. Andy; Low, Philip S.; Hoffman, Joseph F.

    2012-01-01

    The type of metabolic compartmentalization that occurs in red blood cells differs from the types that exist in most eukaryotic cells, such as intracellular organelles. In red blood cells (ghosts), ATP is sequestered within the cytoskeletal–membrane complex. These pools of ATP are known to directly fuel both the Na+/K+ and Ca2+ pumps. ATP can be entrapped within these pools either by incubation with bulk ATP or by operation of the phosphoglycerate kinase and pyruvate kinase reactions to enzyma...

  14. Blood transfusion in cardiac surgery: Does the choice of anesthesia or type of surgery matter?

    OpenAIRE

    Nešković Vojislava; Milojević Predrag; Unić-Stojanović Dragana; Slavković Zoran

    2013-01-01

    Background/Aim. In spite of the evidence suggesting a significant morbidity associated with blood transfusions, the use of blood and blood products remain high in cardiac surgery. To successfully minimize the need for blood transfusion, a systematic approach is needed. The aim of this study was to investigate the influence of different anesthetic techniques, general vs combine epidural and general anesthesia, as well as different surgery strategies, on-pump vs off-pump, on postoperative...

  15. Evaluation of absolute left ventricular volume by gated equilibrium blood pool scintigraphy using count-based method. Clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Anno, Hirofumi; Takeuchi, Akira; Ejiri, Kazutaka

    1987-12-01

    In order to estimate the absolute left ventricular volume (LVV) and the cradiac output (CO), gated equilibrium blood pool scintigraphy was performed. CO by radionuclide (RN) method was compared with CO simultaneously measured by thermodilution method (TDM) using Swan-Ganz catheter in 22 patients with cardiac diseases. To improve these determinations by RN, LVV using the count-based method was corrected by each of four transmission factors (TF1 = 1, TF2 (water) = e/sup -0.15d/, TF3 = e/sup -0.13d/ and TF4 = 1 - (1 - e/sup -0.125d/)/sup 1.26/ d: depth). We compared CO by RN with by TDM. CO by RN was significantly correlated with TDM: TF1 (CO (RN) = 0.23 x CO (TDM) + 0.08, r = 0.628, p < 0.002), TF (CO (RN) = 1.10 x CO (TDM) - 0.47, r = 0.914, p < 0.001), TF3 (CO (RN) = 0.89 x CO (TDM) - 0.30, r = 0.912, p < 0.001), and TF4 (CO (RN) = 0.71 x CO (TDM) - 0.23, r = 0.911, p < 0.001), respectively. These results indicate that the linear sttenuation correction is necessary and sufficient for accurate measurement of LVV and CO by RN using count-based method in clinical use.

  16. Right ventricular emptying perfomance in congenital heart disease assessed by temporal Fourier analysis of gated blood-pool study

    International Nuclear Information System (INIS)

    The right ventricular (RV) emptying performance in patients with congenital heart diseases was investigated by temporal Fourier analysis of multigated cardiac blood-pool studies on a pixel-by-pixel basis. In 15 normal subjects, no significant differences were detected between the mean values of phase of left ventricle (LV) and RV. In patients with ventricular septal defect (VSD), cases with minimal interventricular left-to-right (L-to-R) shunt without pulmonary hypertension (PH) showed normal phase and amplitude images, and cases with moderate or large L-to-R shunt with hyperkinetic PH showed delay of RV phase compared to LV, however, in a case of Eisenmenger type VSD, as well as in patients with primary PH, RV phase lag was not detected. In patients with mild pulmonary stenosis with intact ventricular septum, phase and amplitude images were normal. A case with moderate pulmonary artery stenosis showed mild delay of RV phase. Distinct phase lag of RV was shown in patients with tetralogy of Fallot. Evaluation of RV emptying performance by temporal Fourier analysis is highly valuable for pathophysiologic investigation of congenital heart disease

  17. Assessment of left ventricular function by gated myocardial perfusion and gated blood-pool SPECT. Can we use the same reference database?

    International Nuclear Information System (INIS)

    The purpose of this study was to compare left ventricular (LV) volume and ejection fraction (LVEF) measurements obtained with electrocardiographic gated single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (GS-MPI) with those obtained with gated SPECT cardiac blood-pool imaging (GS-pool). Fifteen patients underwent GS-MPI with technetium-99m tetrofosmin and GS-pool with technetium-99m-erythrocyte, within a mean interval of 8±3 days. Eight patients had suspected dilated cardiomyopathy and seven patients had angiographically significant coronary artery disease. End-diastolic volume (EDV), end-systolic volume (ESV) and LVEF measurements were estimated from GS-MPI images by means of Cedars-Sinai automatic quantitative program and from GS-pool images by the threshold technique. Mean differences between GS-MPI and GS-pool in EDV, ESV and LVEF measurements were -2.8±10.5 ml [95% confidence interval (CI): -8.6±3.0 ml], 2.6±7.3 ml (CI: -1.4-6.6 ml) and -2.3±5.1% (CI: -5.1-0.6%), respectively. No significant difference in the mean differences from 0 was found for EDV, ESV or LVEF measurements. Bland-Altman plots revealed no trend over the measured LV volumes and LVEF. For all parameters, regression lines approximated lines of identity. The excellent agreement between GS-MPI and GS-pool measurements suggests that, for estimation of LV volumes and LVEF, these two techniques may be used interchangeably and measurements by one method can serve as a reference for the other. (author)

  18. Diagnosis of osteomyelitis in children by combined blood pool and bone imaging

    International Nuclear Information System (INIS)

    Differentiation of osteomyelitis from cellulitis or septic arthritis can be difficult. The radiological examination often does not have the characteristic features. Seventy of 71 children with osteomyelitis had focal areas of increased radioactivity demonstrated by /sup 99m/Tc methylene diphosphonate bone scans at the site of the infection. The addition of blood pool images aids in the interpretation of the study as they permit evaluation of the effect of hyperemia. The 13 children with cellulitis had diffuse increase in radioactivity involving both the bones and soft tissues. Bone imaging as the initial screening procedure for osteomyelitis is recommended. (auth)

  19. Dynamic circular buffering: a technique for equilibrium gated blood pool imaging.

    Science.gov (United States)

    Vaquero, J J; Rahms, H; Green, M V; Del Pozo, F

    1996-03-01

    We have devised a software technique called "dynamic circular buffering" (DCB) with which we create a gated blood pool image sequence of the heart in real time using the best features of LIST and FRAME mode methods of acquisition/processing. The routine is based on the concept of independent "agents" acting on the timing and position data continuously written into the DCB. This approach allows efficient asynchronous operation on PC-type machines and enhanced capability on systems capable of true multiprocessing and multithreading. PMID:8904285

  20. REGIONAL CARDIAC BLOOD FLOW WITH AIR PARTICLE EXPOSURE

    Science.gov (United States)

    This proposal offers the unique application of novel techniques to improve understanding of the mechanisms whereby ambient particulate exerts deleterious influences on the heart and circulation. Enhanced ischemia has broad implications for cardiac morbidity and mor...

  1. Ventricular emptying performance in patients with tetralogy of Fallot; Assessment with Fourier analysis of gated blood-pool data

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Kan; Maeda, Hisato; Nakagawa, Tsuyoshi; Ito, Tsunao; Yamaguchi, Nobuo; Matsuda, Akira (Mie Univ., Tsu (Japan). School of Medicine)

    1989-12-01

    Comparison of emptying patterns between left and right ventricles (LV, RV) was performed with Fourier analysis of gated blood-pool data in patients with tetralogy of Fallot (TF). Using global time-activity curves, the phase and amplitude at the first-harmonic component of Fourier series were calculated and emptying patterns of both ventricles were evaluated by phase difference {l brace}D(phase)=RV phase minus LV phase{r brace} and RV/LV amplitude ratio {l brace}R(amp){r brace}. In 20 patients with normal cardiac function, D(phase) was minimal (mean 2.0{plus minus}6.6 degrees) and R(amp) was less than 1.0 (mean 0.60{plus minus}0.19). In 11 patients with TF, D(phase) was significantly larger than normal, with a mean value of 24.3{plus minus}10.0 degrees (p<0.01) and became greater in a reversed proportion to the ratio of the pulmonary-to-systemic blood flow (p<0.01). In all but one cases with TF, R(amp) was greater than 1.0 with a mean value of 1.4{plus minus}0.4, significantly larger than normal (p<0.001). Furthermore, using time-activity curves approximated by terms up to the 3rd-harmonic component, the temporal difference in emptying patterns between both ventricles was investigated. In TF cases, the time from end-diastole to minimum count (T2) was significantly larger in RV than in LV (p<0.001). The elongated T2 interval of RV seemed to play an important role in producing RV phase lag. Thus, this non-invasive method is valuable for pathophysiologic investigation of patients with TF and can be of help in estimating the severity of their disease. (author).

  2. Influence of circulating antigen on blood pool activity of a radioiodinated monoclonal antibody

    International Nuclear Information System (INIS)

    Athymic mice with and without circulating CA 125 antigen were injected with 0.1-100 μg of 131I-labeled OC 125 F(ab')2 antibody fragment. Both the blood clearance of 131I activity and the change in serum CA 125 were monitored over 24 h. Influence of CA 125 on blood pool activity could be avoided only at the 100 μg dose. In patient studies, circulating CA 125 levels decreased for the first 2 h after injection of OC 125 F(ab')2 but generally returned to preinjection levels shortly thereafter. In vitro binding studies using the sera from patients injected with 131I-labeled OC 125 F(ab')2 suggest that circulating CA 125 could interfere with the tumor uptake of the labeled antibody. (author)

  3. Evaluation of factor analysis and other functional images in exercise gated blood-pool study

    International Nuclear Information System (INIS)

    Factor analysis, a new method of functional imaging, has been applied to cardiovascular nuclear medicine. Because of the difficulty of its interpretation, it has not been popular as a method for detecting abnormal wall motion. The purpose of this study was to evaluate the usefulness of factor analysis in exercise gated blood-pool study in patients with ischemic heart disease. In our factor analysis, left ventricular region of interest (LVROI) was extracted to exclude the surrounding radioactivities. The new method was compared with the conventional factor analysis using whole region (whole ROI method), and the other functional images, i.e. stroke volume, ejection fraction and phase images. At first we tried 3-factor analysis of the LVROI method, which resulted in many uninterpretable factors. Whereas in 2-factor analysis no uninterpretable factors were extracted. In comparison with cine-mode display, the LVROI method with 2-factor analysis showed the best sensitivity (85%) and specificity (100%). In exercise gated blood-pool study, it became easier to detect abnormal wall motion by comparing the factor image at exercise with resting image. In conclusion, the 2-factor analysis using the LVROI method greatly improved the limitation of conventional factor analysis, and will be useful in detecting wall motion abnormality in patients with ischemic heart disase. (author)

  4. Modern Perforator Flap Imaging with High-Resolution Blood Pool MR Angiography.

    Science.gov (United States)

    Kagen, Alexander C; Hossain, Rydhwana; Dayan, Erez; Maddula, Soumya; Samson, William; Dayan, Joseph; Smith, Mark L

    2015-01-01

    Advances in microsurgical techniques have improved autologous reconstructions by providing new donor site options while decreasing donor site morbidity. Various preoperative imaging modalities have been studied to assess the relevant vascular anatomic structures, with magnetic resonance (MR) angiography traditionally lagging behind computed tomography (CT) with respect to spatial resolution. Blood pool MR angiography with gadofosveset trisodium, a gadolinium-based contrast agent with extended intravascular retention, has allowed longer multiplanar acquisitions with resultant voxel sizes similar to or smaller than those of CT and with improved signal-to-noise ratio and soft-tissue contrast while maintaining the ability to depict flow with time-resolved imaging. The resultant vascular detail enables precise evaluation of the relevant vascular anatomic structures, including the vessel course, size, and branching pattern, as well as the venous arborization pattern. In addition, any architectural distortion, vessel alteration, or injury from prior surgery can be depicted. The reporting radiologist should be aware of pertinent and incidental findings relevant to the planned surgery and the patient's disease so that he or she can assist the microsurgeon in flap design as a member of the multidisciplinary team. Given the lack of ionizing radiation exposure in patients who often have an elevated body mass index, high-spatial-resolution blood pool MR angiography has become the imaging reference standard for the preoperative assessment of perforator flap vascular and soft-tissue morphology in our practice. PMID:25884098

  5. Technical requirements, biophysical considerations and protocol optimization with magnetic resonance angiography using blood-pool agents

    International Nuclear Information System (INIS)

    In order to maximize the potential benefits of contrast-enhanced magnetic resonance angiography, careful attention must be paid to the choice of hardware, data acquisition and processing, and to the choice of contrast agent. Typically, contrast-enhanced magnetic resonance angiography uses parallel-imaging techniques, which shorten the acquisition time, enhance spatial resolution and reduce artefacts. The timing of data acquisition is crucial for maximal enhancement of the arteries: for optimal arterial depiction, the centre of k-space should be acquired at the time of peak concentration of contrast agent in the arterial bed being investigated, and a number of k-space acquisition techniques are available to achieve this. SENSE or GRAPPA techniques can be used to facilitate parallel-imaging reconstruction of either the image data or k-space data, respectively. Gadolinium contrast agents shorten the proton relaxation times (most importantly T1) of blood, thereby increasing the signal-to-noise ratio and enhancing differentiation between blood vessels and other tissues. The blood-pool (intravascular) contrast agent gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany) is reversibly protein-bound in human plasma. This results in a marked increase in relaxivity, and hence a strong T1 shortening effect compared with other gadolinium-based contrast agents. Furthermore, the blood retention time of gadofosveset trisodium is substantially prolonged compared with conventional contrast agents. As a result, gadofosveset trisodium permits both first-pass and steady-state imaging. (orig.)

  6. Synthesis of fluorine-18 radio-labeled serum albumins for PET blood pool imaging

    International Nuclear Information System (INIS)

    We sought to develop a practical, reproducible and clinically translatable method of radiolabeling serum albumins with fluorine-18 for use as a PET blood pool imaging agent in animals and man. Fluorine-18 radiolabeled fluoronicotinic acid-2,3,5,6-tetrafluorophenyl ester, [18F]F-Py-TFP was prepared first by the reaction of its quaternary ammonium triflate precursor with [18F]tetrabutylammonium fluoride ([18F]TBAF) according to a previously published method for peptides, with minor modifications. The incubation of [18F]F-Py-TFP with rat serum albumin (RSA) in phosphate buffer (pH 9) for 15 min at 37–40 °C produced fluorine-18-radiolabeled RSA and the product was purified using a mini-PD MiniTrap G-25 column. The overall radiochemical yield of the reaction was 18–35% (n = 30, uncorrected) in a 90-min synthesis. This procedure, repeated with human serum albumin (HSA), yielded similar results. Fluorine-18-radiolabeled RSA demonstrated prolonged blood retention (biological half-life of 4.8 hours) in healthy awake rats. The distribution of major organ radioactivity remained relatively unchanged during the 4 hour observation periods either by direct tissue counting or by dynamic PET whole-body imaging except for a gradual accumulation of labeled metabolic products in the bladder. This manual method for synthesizing radiolabeled serum albumins uses fluorine-18, a widely available PET radionuclide, and natural protein available in both pure and recombinant forms which could be scaled up for widespread clinical applications. These preclinical biodistribution and PET imaging results indicate that [18F]RSA is an effective blood pool imaging agent in rats and might, as [18F]HSA, prove similarly useful as a clinical imaging agent

  7. Inclusion body myositis, muscle blood vessel and cardiac amyloidosis, and transthyretin Val122Ile allele.

    Science.gov (United States)

    Askanas, V; Engel, W K; Alvarez, R B; Frangione, B; Ghiso, J; Vidal, R

    2000-04-01

    Typical of sporadic inclusion body myositis muscle biopsies are vacuolated muscle fibers containing intracellular amyloid deposits and accumulations of "Alzheimer-characteristic" proteins. There is no muscle blood vessel or cardiac amyloidosis. We report on a 70-year-old African-American man homozygous for the transthyretin Val122Ile allele who has both sporadic inclusion body myositis and cardiac amyloidosis. His unique pathological features included transthyretin immunoreactivity in prominent muscle blood vessel amyloid and congophilic amyloid deposits within vacuolated muscle fibers. PMID:10762172

  8. Femoral Blood Flow and Cardiac Output During Blood Flow Restricted Leg Press Exercise

    Science.gov (United States)

    Everett, M. E.; Hackney, K.; Ploutz-Snyder, L.

    2011-01-01

    Low load blood flow restricted resistance exercise (LBFR) causes muscle hypertrophy that may be stimulated by the local ischemic environment created by the cuff pressure. However, local blood flow (BF) during such exercise is not well understood. PURPOSE: To characterize femoral artery BF and cardiac output (CO) during leg press exercise (LP) performed at a high load (HL) and low load (LL) with different levels of cuff pressure. METHODS: Eleven subjects (men/women 4/7, age 31.4+/-12.8 y, weight 68.9+/-13.2 kg, mean+/-SD) performed 3 sets of supine left LP to fatigue with 90 s of rest in 4 conditions: HL (%1-RM/cuff pressure: 80%/0); LL (20%/0); LBFR(sub DBP) (20%/1.3 x diastolic blood pressure, BP); LBFR(sub SBP) (20%/1.3 x supine systolic BP). The cuff remained inflated throughout the LBFR exercise sessions. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using Doppler ultrasound at rest and immediately after each set of exercise. Heart rate (HR) was monitored using a 3-lead ECG. BF was calculated as VTI x vessel cross-sectional area. CO was calculated as HR x SV. The data obtained after each set of exercise were averaged and used for analyses. Multi-level modeling was used to determine the effect of exercise condition on dependent variables. Statistical significance was set a priori at p LL (9.92+/-0.82 cm3) > LBFR(sub dBP)(6.47+/-0.79 cm3) > LBFR(sub SBP) (3.51+/-0.59 cm3). Blunted exercise induced increases occurred in HR, SV, and CO after LBFR compared to HL and LL. HR increased 45% after HL and LL and 28% after LBFR (p<0.05), but SV increased (p<0.05) only after HL. Consequently, the increase (p<0.05) in CO was greater in HL and LL (approximately 3 L/min) than in LBFR (approximately 1 L/min). CONCLUSION: BF during LBFR(sub SBP) was 1/3 of that observed in LL, which supports the hypothesis that local ischemia stimulates the LBFR hypertrophic response. As the cuff did not compress the artery, the ischemia may have occurred

  9. Hemodynamic and ADH responses to central blood volume shifts in cardiac-denervated humans

    Science.gov (United States)

    Convertino, V. A.; Thompson, C. A.; Benjamin, B. A.; Keil, L. C.; Savin, W. M.; Gordon, E. P.; Haskell, W. L.; Schroeder, J. S.; Sandler, H.

    1990-01-01

    Hemodynamic responses and antidiuretic hormone (ADH) were measured during body position changes designed to induce blood volume shifts in ten cardiac transplant recipients to assess the contribution of cardiac and vascular volume receptors in the control of ADH secretion. Each subject underwent 15 min of a control period in the seated posture, then assumed a lying posture for 30 min at 6 deg head down tilt (HDT) followed by 20 min of seated recovery. Venous blood samples and cardiac dimensions (echocardiography) were taken at 0 and 15 min before HDT, 5, 15, and 30 min of HDT, and 5, 15, and 30 min of seated recovery. Blood samples were analyzed for hematocrit, plasma osmolality, plasma renin activity (PRA), and ADH. Resting plasma volume (PV) was measured by Evans blue dye and percent changes in PV during posture changes were calculated from changes in hematocrit. Heart rate (HR) and blood pressure (BP) were recorded every 2 min. Results indicate that cardiac volume receptors are not the only mechanism for the control of ADH release during acute blood volume shifts in man.

  10. Stable xenon CT measurement of cerebral blood flow in cardiac transplantation candidates: Correlation with cognitive function

    International Nuclear Information System (INIS)

    Thirteen consecutive unselected patients with NYHA class 4 cardiac failure referred for cardiac transplantation underwent neurologic examination and cerebral blood flow measurement (rCBF) using the stable xenon enhanced CT method on a GE9800 system. Eleven men and two women were studied (mean age = 43.8 +- 6.1). On neurological examination, six of the patients demonstrated normal mental function; the remaining seven patients demonstrated memory, language, or learning impairment. There was no difference in mean cardiac output between the groups (4.9 L/min +- 1.68 vs. 4.2L/min +- 1.57). rCBF was significantly reduced in the impaired group. Cognitive impairment in patients with cardiac failure can be correlated with cerebral ischemia. Stable xenon CT measurement of rCBF in transplant candidates may help identify patients requiring more rapid transplantation to prevent permanent cerebral injury

  11. Ex-vivo response to blood products and haemostatic agents after paediatric cardiac surgery

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Andreasen, Jo B; Christiansen, Kirsten; Ravn, Hanne B

    2013-01-01

    . The aims of the present study were to investigate changes in coagulation profiles after paediatric cardiac surgery and the effect after ex-vivo addition of blood products and haemostatic agents. Coagulation profiles were evaluated by thromboelastometry (ROTEM) in 54 children before and immediately...

  12. Dye-dilution cardiac output without blood withdrawal in the conscious rabbit

    International Nuclear Information System (INIS)

    Cardiac output can be measured in the conscious rabbit without blood withdrawal by use of a modified dye-dilution method. Blood flows continuously from the central ear artery through a Silastic catheter that passes through a modified cuvette lumen and back into an ear vein. Blood flow through this shunt was 1.5 ml/min. This modified technique was evaluated by comparison with a simultaneously performed cardiac output measurement using radioactive microspheres and by making consecutive dye-dilution measurements at short time intervals. A correlation coefficient of 0.96 was obtained when comparing dye-dilution and microsphere cardiac outputs. The difference between 11 paired measurements was 7.09 +- 5.24% (mean +- SD). Consecutive outputs measured within 3 min of each other by the flow-through technique had a correlation coefficient of 0.99 and a difference between the first and second determinations of 3.52 +- 2.38%. The method permits dye-dilution cardiac output measurement in the conscious rabbit while avoiding the potential error caused by blood withdrawal from small animals

  13. Identification of common blood gene signatures for the diagnosis of renal and cardiac acute allograft rejection.

    Directory of Open Access Journals (Sweden)

    Li Li

    Full Text Available To test, whether 10 genes, diagnostic of renal allograft rejection in blood, are able to diagnose and predict cardiac allograft rejection, we analyzed 250 blood samples from heart transplant recipients with and without acute rejection (AR and with cytomegalovirus (CMV infection by QPCR. A QPCR-based logistic regression model was built on 5 of these 10 genes (AR threshold composite score >37%  = AR and tested for AR prediction in an independent set of 109 samples, where it correctly diagnosed AR with 89% accuracy, with no misclassifications for AR ISHLT grade 1b. CMV infection did not confound the AR score. The genes correctly diagnosed AR in a blood sample within 6 months prior to biopsy diagnosis with 80% sensitivity and untreated grade 1b AR episodes had persistently elevated scores until 6 months after biopsy diagnosis. The gene score was also correlated with presence or absence of cardiac allograft vasculopathy (CAV irrespective of rejection grade. In conclusion, there is a common transcriptional axis of immunological trafficking in peripheral blood in both renal and cardiac organ transplant rejection, across a diverse recipient age range. A common gene signature, initially identified in the setting of renal transplant rejection, can be utilized serially after cardiac transplantation, to diagnose and predict biopsy confirmed acute heart transplant rejection.

  14. Assessment of left ventricular function in patients with atrial fibrillation by left ventricular filling and function curves determined by ECG gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    Accurate cardiac function in patients with atrial fibrillation (Af) is difficult to assess, since a wide fluctuation of cardiac cycle makes the ventricular hemodynamics variable. Although ECG gated blood pool scintigraphy (EGBPS) is useful to evaluate left ventricular (LV) function, a conventional EGBPS might have a problem in applying to Af. Therefore, a new processing algorithm was devised to make multiple gated images discriminated by preceding R-R intervals (PRR), and LV filling and function curves were obtained in 62 patients with Af to evaluate LV function. LV filling curve, obtained by plotting end-diastolic volume (EDV) againt PRR, demonstrated that the blood filling was impaired in mitral stenosis and constrictive pericarditis, but recovered after mitral commissurotomy. LV function curve, by plotting stroke volume (SV) againt EDV, was quantitatively analysed by the indices such as Slope and Position. Both indices reduced significantly in heart failure. When compared among underlying diseases individually, the indices decreased in the following order; lone Af, hyperthyroidism, senile Af, hypertension, mitral valve disease, ischemic heart disease, dilated cardiomyopathy and aortic regurgitation. After the treatment with digitalis and/or diuretics, left and upward shift of function curve was observed. The rise in heart rate by atropine infusion made Slope and Position unchanged, and which implied that function curve was little influenced by heart rate per se. The rise in systolic blood pressure by angiotensin-II infusion caused shifts in function curve to rightward and downward. Downward shift, mostly seen in patients with gentler slope in control state, may imply afterload mismatch due to a decrease in preload reserve. (J.P.N.)

  15. Regional blood flow distribution in dog during induced hypotension and low cardiac output. Spontaneous breathing versus artificial ventilation.

    OpenAIRE

    Viires, N; Sillye, G; Aubier, M.; Rassidakis, A; Roussos, C

    1983-01-01

    Respiratory muscle blood flow and organ blood flow was studied in two groups of dogs with radioactively labeled microspheres to assess the influence of the working respiratory muscles on the regional distribution of blood flow when arterial pressure and cardiac output were lowered by pericardial tamponade. In one group (n = 6), the dogs were paralyzed and mechanically ventilated (Mv), while in the other (n = 6), they were left to breathe spontaneously (Sb). Cardiac output fell to 30% of contr...

  16. Nitroglycerin reduces augmentation index and central blood pressure independent of effects on cardiac preload

    Institute of Scientific and Technical Information of China (English)

    Mike; Saddon; Karen; McNeil; Philip; Chowienczyk

    2009-01-01

    Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest,during LBNP (10,20 and 30 mmHg,each for 15 min) and after NTG (10,30 and 100 μg/min,each dose for 15 min) in ten healthy volunteers. Cardiac pre-load,stroke volume and cardiac output w...

  17. Whole-body magnetic resonance angiography with blood-pool agents

    International Nuclear Information System (INIS)

    Although often asymptomatic, peripheral arterial disease (PAD) is associated with significant morbidity in a large proportion of patients. Atherosclerosis is the underlying pathology in many instances, involving the whole arterial tree. Whole-body magnetic resonance angiography (MRA) permits rapid, non-invasive and accurate evaluation of the entire vascular system and can be used for both diagnostic purposes and monitoring of vascular involvement in diseases such as diabetes, Marfan's syndrome and Takayasu arteritis. MRA has been used successfully in the identification of high-grade stenosis in PAD, abnormalities of the ileocaval veins and carotid plaque imaging. Carotid disease is significantly correlated with severe coronary artery disease and renal artery atherosclerosis. Symptomatic lesions in one vascular bed are often related to additional asymptomatic atherosclerotic lesions in other vascular regions. MRA may be advantageous over computed tomographic angiography because it can be performed with contrast media virtually devoid of serious toxicity and without utilization of ionizing radiation. Display of the entire arterial vasculature can be achieved in < 90 s, with excellent sensitivity and specificity. Recent technological advances, such as parallel imaging and the implementation of dedicated matrix coils, have further increased image quality, and in combination with the blood-pool contrast agents, such as gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany), extended imaging time, higher spatial resolution and larger anatomical coverage can be achieved. (orig.)

  18. Whole-body magnetic resonance angiography with blood-pool agents

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, H. [Inst. for Clinical Radiology, Univ. Hospital Munich, Munich (Germany); Morana, G. [Radiological Dept., Hospital Ca' Foncello, Treviso (Italy)

    2007-03-15

    Although often asymptomatic, peripheral arterial disease (PAD) is associated with significant morbidity in a large proportion of patients. Atherosclerosis is the underlying pathology in many instances, involving the whole arterial tree. Whole-body magnetic resonance angiography (MRA) permits rapid, non-invasive and accurate evaluation of the entire vascular system and can be used for both diagnostic purposes and monitoring of vascular involvement in diseases such as diabetes, Marfan's syndrome and Takayasu arteritis. MRA has been used successfully in the identification of high-grade stenosis in PAD, abnormalities of the ileocaval veins and carotid plaque imaging. Carotid disease is significantly correlated with severe coronary artery disease and renal artery atherosclerosis. Symptomatic lesions in one vascular bed are often related to additional asymptomatic atherosclerotic lesions in other vascular regions. MRA may be advantageous over computed tomographic angiography because it can be performed with contrast media virtually devoid of serious toxicity and without utilization of ionizing radiation. Display of the entire arterial vasculature can be achieved in < 90 s, with excellent sensitivity and specificity. Recent technological advances, such as parallel imaging and the implementation of dedicated matrix coils, have further increased image quality, and in combination with the blood-pool contrast agents, such as gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany), extended imaging time, higher spatial resolution and larger anatomical coverage can be achieved. (orig.)

  19. Comprehensive kinetics of triiodothyronine production, distribution, and metabolism in blood and tissue pools of the rat using optimized blood-sampling protocols.

    Science.gov (United States)

    DiStefano, J J; Jang, M; Malone, T K; Broutman, M

    1982-01-01

    We have determined estimates for 24 physiological parameters of production, interpool transport, distribution, and metabolism of T3 in the major T3 pools of the unanesthetized male Sprague-Dawley rat, from blood-borne data and a comprehensive model and analysis of this system. Most of these indices have previously been unavailable. Whereas only 3% (2 ng/100 g BW) of the total body T3 pool (74 ng/100 g BW) is in plasma, the composite of slowly equilibrating (slow) tissue pools (e.g. muscle, skin, and brain) appears to contain most of the T3, 76% (57 ng/100 g BW) of the total. The composite of rapidly equilibrating (fast) tissue pools (e.g. liver and kidney) contains the remaining 19% (16 ng/100 g BW). The total body T3 production rate is 0.12 ng/100 g BW . min, and we estimate that about half of this emanates directly from T4 in the slow pools, whereas the remainder is derived from both thyroidal secretion and T4 to T3 conversion in the fast pools. Our results also indicate that T3 molecules spend an average of only 0.5 min in transit each time through plasma, whereas the single pass mean transit times in fast and slow tissue pools (the times available for hormone action) are 10 times and 200 times greater. In contrast, the mean residence time for T3 in the entire system is greater than 12 h despite the extremely rapid early disappearance of injected T3 from plasma. To obtain the required accuracy, we used a novel optimization approach for choosing blood-sampling schedules (1, 4, 44, 202, and 600 min), a remarkably small number of sample times, and each was adjustable by about +/- 20% without effect on optimized parameter accuracies. PMID:7053984

  20. Cardiac Morphology and Function, and Blood Gas Transport in Aquaporin-1 Knockout Mice

    Science.gov (United States)

    Al-Samir, Samer; Wang, Yong; Meissner, Joachim D.; Gros, Gerolf; Endeward, Volker

    2016-01-01

    We have studied cardiac and respiratory functions of aquaporin-1-deficient mice by the Pressure-Volume-loop technique and by blood gas analysis. In addition, the morphological properties of the animals' hearts were analyzed. In anesthesia under maximal dobutamine stimulation, the mice exhibit a moderately elevated heart rate of < 600 min−1 and an O2 consumption of ~0.6 ml/min/g, which is about twice the basal rate. In this state, which is similar to the resting state of the conscious animal, all cardiac functions including stroke volume and cardiac output exhibited resting values and were identical between deficient and wildtype animals. Likewise, pulmonary and peripheral exchange of O2 and CO2 were normal. In contrast, several morphological parameters of the heart tissue of deficient mice were altered: (1) left ventricular wall thickness was reduced by 12%, (2) left ventricular mass, normalized to tibia length, was reduced by 10–20%, (3) cardiac muscle fiber cross sectional area was decreased by 17%, and (4) capillary density was diminished by 10%. As the P-V-loop technique yielded normal end-diastolic and end-systolic left ventricular volumes, the deficient hearts are characterized by thin ventricular walls in combination with normal intraventricular volumes. The aquaporin-1-deficient heart thus seems to be at a disadvantage compared to the wild-type heart by a reduced left-ventricular wall thickness and an increased diffusion distance between blood capillaries and muscle mitochondria. While under the present quasi-resting conditions these morphological alterations have no consequences for cardiac function, we expect that the deficient hearts will show a reduced maximal cardiac output. PMID:27252655

  1. Greater Volume of Acute Normovolemic Hemodilution May Aid in Reducing Blood Transfusions After Cardiac Surgery

    Science.gov (United States)

    Goldberg, Joshua; Paugh, Paugh; Dickinson, Timothy A.; Fuller, John; Paone, Gaetano; Theurer, Patty F.; Shann, Kenneth G.; Sundt, Thoralf M.; Prager, Richard L.; Likosky, Donald S.

    2016-01-01

    Background Perioperative red blood cell transfusions (RBC) are associated with increased morbidity and mortality after cardiac surgery. Acute normovolemic hemodilution (ANH) is recommended to reduce perioperative transfusions; however, supporting data are limited and conflicting. We describe the relationship between ANH and RBC transfusions after cardiac surgery using a multi-center registry. Methods We analyzed 13,534 patients undergoing cardiac surgery between 2010 and 2014 at any of the 26 hospitals participating in a prospective cardiovascular perfusion database. The volume of ANH (no ANH, HCT, and center. Results ANH was used in 17% of the patients. ANH was associated with a reduction in RBC transfusions (RRadj 0.74, p <0.001). Patients having ≥800mL of ANH had the most profound reduction in RBC transfusions (RRadj 0.57, p<0.001). Platelet and plasma transfusions were also significantly lower with ANH. The ANH population had superior postoperative morbidity and mortality compared to the no ANH population. Conclusions There is a significant association between ANH and reduced perioperative RBC transfusion in cardiac surgery. Transfusion reduction is most profound with larger volumes of ANH. Our findings suggest the volume of ANH, rather than just its use, may be an important feature of a center’s blood conservation strategy. PMID:26206721

  2. Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis

    DEFF Research Database (Denmark)

    Schytz, Philip Andreas; Mace, Maria Lerche; Soja, Anne Merete Boas;

    2015-01-01

    reducing EBFR on BP exists and data are conflicting. The aim of this study was to evaluate the effect and the potential mechanism(s) involved by investigating the impact of changes in EBFR on BP, pulse rate (PR) and cardiac output (CO) in HD patients with arteriovenous-fistulas (AV-fistulas). METHODS: We...

  3. Aspects of the continuous clinical measurement of arterial blood pressure and cardiac output

    International Nuclear Information System (INIS)

    In this paper the authors try to classify circulatory measurements as to certain characteristics such as ''activeness'', ''invasivenesss'', etc. Next they turn to defining some fundamental measurements in the blood circulation and focus attention on the continuous measurement of systemic arterial pressure and flow to finally emphasize the inaccuracy of clinical cardiac output methods. The conclusion is that clinical circulatory measurement methods have accuracies at least an order of magnitude worse than common physical methods used in electrical or mechanical engineering. (Auth.)

  4. Determination of cardiac output, tissue blood flow, volume and lipid content in Sprague-Dawley rats

    International Nuclear Information System (INIS)

    One critical aspect of physiologically-based pharmacokinetic (PBPK) model development is the choice of values for organ blood flows, cardiac output and tissue volumes for input into models. These values vary depending upon the strain, size, age, and sex of animal for which a PBPK model is being developed. Tissue blood flows, cardiac output, tissue volume, and lipid content were determined in male S-D rats, (350-375 g, N=8). A radiolabel microsphere method utilizing Scandium (46Sc), Tin (113Sn),and Gadolinium (153Gd) was used to determine blood flow. Each rat received 3 radiolabeled injections. After the third injection, animals were sacrificed, and radioactivity in each tissue was determined in a 3-channel gamma counter. Tissues sampled include brain, heart, kidneys, liver, lungs, spleen, pancreas, adrenals, stomach, intestines, colon, testis, bone and skeletal muscle. Cardiac output was 142 ml/min. Blood flow values for eliminating organs were 0.49 (liver), 16.52 (kidney), and 1.77 (lung) ml/min/g tissue. Tissues which had significantly increased blood flow during the dark cycle included femur, abdonimal fat, triceps brachii and abdominal muscles, stomach, spleen and lung. Dissectable fat, organ volume, and organ lipid content were determined in a separate group of rats (N= 8). Volume and lipid content were determined for the same tissues as blood flow. Body fat was 7.35% of bw and extractable lipid content of eliminating organs was 42.3 (liver), 43.4 (kidney), and 35.9 (lung) mg/g tissue. Precise measurements should improve the accuracy of PBPK model predictions, and therfore help in reducing uncertainites in risk assessment of volatile organics and other pollutnats

  5. Determination of regurgitation fraction by EEG-triggered gated blood pool scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kress, P.; Geffers, H.; Stauch, M.; Nechwatal, W.; Sigel, H.; Bitter, F.; Adam, W.E.

    1981-02-04

    The determination of regurgitation fraction by EEG-triggered gated blood pool scintigraphy is based on the different stroke volumes of left and right ventricles in patients with aortic and/or mitral valve incompetence. The count rate difference between enddiastole and endsystole over each ventricle (..delta..C) is equivalent to the stroke volume. After calculating the ratio of the count rate differences between the left and right ventricles (A = ..delta..Csub(l)/..delta..Csub(r)), regurgitation fraction is expressed in the formula 1-1/A. In a group of 66 patients without valvular regurgitation or shunt, we found (A) to be between 0.89 and 1.97 (mean value 1.43 with a standard deviation of +- 0.27). The deviation of the mean value of (A) from 1 may be due to significant overlapping of right ventricle and right atrium in the left anterior oblique (LAO) 30/sup 0/ position, leading to an underestimation of right ventricular enddiastolic-endsystolic count rate difference. In 23 our of 24 patients with aortic or mitral valve incompetence (A) exceeded the upper limit. In 13 cases with aortic/and/or mitral valve regurgitation (A) was compared with the ratio of the stroke volume of left and right ventricles with the stroke volume of the left ventricle determined angiographically and the stroke volume of the right ventricle determined by thermodilution. The specifity of the described method for detecting valvular regurgitation is high, while the sensitivity is relatively low. The principal advantages of this method are non-invasiveness, good practicability, and the fact that important additional information about the functional state of the heart is gained.

  6. Transfusion of blood during cardiac surgery is associated with higher long-term mortality in low-risk patients

    DEFF Research Database (Denmark)

    Jakobsen, Carl-Johan; Ryhammer, Pia Katarina; Jensen, Mariann Tang; Andreasen, Jan Jesper; Mortensen, Poul Erik

    2012-01-01

    Numerous reports have emphasized the need for reduction in transfusions of allogeneic red blood cells (RBC) due to increased morbidity and mortality. Nevertheless, transfusion rates are still high in several cardiac surgery institutions. Reports on long-term survival after cardiac surgery and RBC...... transfusion are few....

  7. A Case of Hepatic Hemangioma Detected by Blood Pool with {sup 99m}Tc Human Serum Albumin

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hwi Joong; Moon, Hee Bum; Kwon, In Soon; Choi, Kang Won; Kim, Chung Yong; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-03-15

    A case of hepatic hemangioma is presented in which blood pool imaging by {sup 99m}Tc-HSA provided a definite diagnostic clue. Cavernous hemangiomas are the most common benign tumor of the liver. But the majority of them are asymptomatic and are found incidentally at laparotomy or autopsy. Selective hepatic arteriography has been the most helpful technique for the preoperative diagnosis. Recently radioisotope scan and ultrasonogram proved to be a new, definite and non- invasive diagnostic procedure.

  8. A case of hepatic hamangioma detected by blood pool scan with sup(99m)Tc human serum albumin

    International Nuclear Information System (INIS)

    A case of hepatic hemangioma is presented in which blood pool imaging by sup(99m)Tc-HSA provided a definite diagnostic clue. Cavernous hemangiomas are the most common benign tumor of the liver. But the majority of them are asymptomatic and are found incidentally at laparotomy or autopsy. Selective hepatic arteriography has been the most helpful technique for the preoperative diagnosis. Recently radioisotope scan and ultrasonogram proved to be a new, definite and non-invasive diagnostic procedure. (author)

  9. A Case of Hepatic Hemangioma Detected by Blood Pool with 99mTc Human Serum Albumin

    International Nuclear Information System (INIS)

    A case of hepatic hemangioma is presented in which blood pool imaging by 99mTc-HSA provided a definite diagnostic clue. Cavernous hemangiomas are the most common benign tumor of the liver. But the majority of them are asymptomatic and are found incidentally at laparotomy or autopsy. Selective hepatic arteriography has been the most helpful technique for the preoperative diagnosis. Recently radioisotope scan and ultrasonogram proved to be a new, definite and non- invasive diagnostic procedure.

  10. Potential synergy between lipid-lowering and blood-pressure-lowering in the Anglo-Scandinavian Cardiac Outcomes Trial

    DEFF Research Database (Denmark)

    Sever, Peter; Dahlöf, Björn; Poulter, Neil; Wedel, Hans; Beevers, Gareth; Caulfield, Mark; Collins, Rory; Kjeldsen, Sverre; Kristinsson, Arni; McInnes, Gordon; Mehlsen, Jesper; Nieminem, Markku; O'Brien, Eoin; Ostergren, Jan

    2006-01-01

    A prespecified objective of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) was to assess whether any synergistic effects were apparent between the lipid-lowering and blood-pressure-lowering regimens in preventing cardiovascular events.......A prespecified objective of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) was to assess whether any synergistic effects were apparent between the lipid-lowering and blood-pressure-lowering regimens in preventing cardiovascular events....

  11. Uptitrating amlodipine significantly reduces blood pressure in diabetic patients with hypertension: a retrospective, pooled analysis

    Directory of Open Access Journals (Sweden)

    Jeffers BW

    2014-11-01

    Full Text Available Barrett W Jeffers, Rahul Bhambri, Jeffery Robbins Pfizer Inc., New York, NY, USA Abstract: Diabetic patients with hypertension are approximately twice as likely to develop cardiovascular disease as non-diabetic patients with hypertension. Given that hypertension affects ~60% of patients with diabetes, effective blood pressure (BP management is important in this high-risk population. This post-hoc analysis pooled data from six clinical studies to quantify additional BP efficacy achieved when titrating hypertensive diabetic patients from amlodipine 5 mg to 10 mg. Approximately half of the diabetic patients were male (44/98; 44.9% with a mean (standard deviation [SD] age of 60.6 (9.6 years and a baseline mean (standard error [SE] systolic blood pressure/diastolic blood pressure (SBP/DBP of 150.8 (1.30/87.5 (0.94 mmHg while on amlodipine 5 mg (159.1 [1.40]/92.6 [0.94] mmHg prior to treatment. In comparison, 350/610 (57.4% non-diabetic patients were male with a mean (SD age of 58.7 (11.1 years and baseline mean (SE SBP/DBP of 150.3 (0.62/90.9 (0.41 mmHg while on amlodipine 5 mg (160.0 [0.67]/96.2 [0.45] mmHg prior to treatment. Increasing amlodipine from 5 mg to 10 mg lowered sitting SBP by -12.5 mmHg (95% confidence interval (CI: -15.5, -9.5; P<0.0001 and DBP by -6.0 mmHg (-7.4, -4.6; P<0.0001 in diabetic patients; and SBP by -12.4 mmHg (-13.5, -11.3; P<0.0001 and DBP by -7.3 mmHg (-8.0, -6.7; P<0.0001 in non-diabetic patients. In total, 12.0% (95% CI: 6.4, 20.0 of diabetic patients achieved their BP goal versus 46.4% (42.4, 50.4 of non-diabetic patients after titration to amlodipine 10 mg. Overall, 22.0% of diabetic patients experienced 31 adverse events (AEs and 28.9% of non-diabetic patients experienced 282 AEs. Serious AEs were reported by one (1.0% diabetic and five (0.8% non-diabetic patients. In this analysis, increasing amlodipine from 5 mg to 10 mg produced a clinically significant reduction in the BP of diabetic hypertensive patients

  12. Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Camila Takao Lopes

    2015-12-01

    Full Text Available Abstract OBJECTIVE To identify predictors of red blood cell transfusion (RBCT after cardiac surgery. METHOD A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. RESULTS The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3/mm3, lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. CONCLUSION Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

  13. The effect of halothane on the distribution of cardiac output and organ blood flows in the hemorrhagic, hypotensive dog

    International Nuclear Information System (INIS)

    Halothane was given to dogs which had been bled to an arterial mean blood pressure of 60 mmHg, and the circulatory effects were studied with the aid of the radioactive microsphere technique. The cardiac output and coronary blood flow were well maintained, whereas the arterial mean blood pressure was slightly, and the stroke volume markedly increased, indicating an improved heart function. The blood flows to the brain, lungs, liver and kidneys were well preserved throughout the anesthesia. The effect of retransfusing the withdrawn blood was also studied, and it resulted in an increased cardiac output, arterial mean blood pressure and increased blood flows to the heart, lungs, spleen, bowel and liver. (author)

  14. Blood transfusion in cardiac surgery: Does the choice of anesthesia or type of surgery matter?

    Directory of Open Access Journals (Sweden)

    Nešković Vojislava

    2013-01-01

    Full Text Available Background/Aim. In spite of the evidence suggesting a significant morbidity associated with blood transfusions, the use of blood and blood products remain high in cardiac surgery. To successfully minimize the need for blood transfusion, a systematic approach is needed. The aim of this study was to investigate the influence of different anesthetic techniques, general vs combine epidural and general anesthesia, as well as different surgery strategies, on-pump vs off-pump, on postoperative bleeding complications and the need for blood transfusions during perioperative period. Methods. Eighty-two consecutive patients scheduled for coronary artery bypass surgery were randomized according to surgical and anesthetic techniques into 4 different groups: group 1 (patients operated on off-pump, under general anesthesia; group 2 (patients operated on off-pump, with combined general and high thoracic epidural anesthesia; group 3 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, under general anesthesia, and group 4 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, with combined general and high thoracic epidural anesthesia. Indications for transfusion were based on clinical judgment, but a restrictive policy was encouraged. Bleeding was considered significant if it required transfusion of blood or blood products, or reopening of the chest. The quantity of transfused blood or blood products was specifically noted. Results. None of the patients was transfused blood or blood products during the surgery, and as many as 70/81 (86.4% patients were not transfused at all during hospital stay. No difference in postoperative bleeding or blood transfusion was noted in relation to the type of surgery and anesthetic technique applied. If red blood cells were transfused, postoperative bleeding was the most influential parameter for making clinical

  15. [Single-donor (apheresis) platelets and pooled whole-blood-derived platelets--significance and assessment of both blood products].

    Science.gov (United States)

    Hitzler, Walter E

    2014-01-01

    The transfusion efficacy of ATK, which contain fully functional platelets, is beyond all doubt. The equivalence of ATK and PTK has been subject of many studies. Some of those studies show the superiority of ATK's, while others do not, but there have been no studies that demonstrated a superiority of PTK's. The superiority of platelets stored in plasma and in third generation additive solution was demonstrated in clinical studies; therefore, it cannot be said that all the platelet concentrates on the German market are equivalent in efficacy. Of decisive importance, above all, is the risk of transfusion-transmitted infections with known pathogens, or those not yet discovered. This risk is different for ATK compared to PTK. Taking this difference in risk and the difference in donor exposure of transfused patients into account, it can definitely be said that ATK and PTK are not equivalent. In 2012, the Robert-Koch-Institute (RKI) published a mathematical risk model for different platelet concentrates and assessed the risk of transmitting known pathogens such as HIV, HCV, and HBV. The risk was higher for PTK compared to ATK. The relative risks for PTK derived from 4BCs were 2.2 (95%--CI: 2.1-2.4) for HIV, 2.7 (95%--CI: 2.5-3.0) for HCV, and 2.2 (95%--CI: 2.8-3.7) for HBV. At the present time, these are the relative risks of transfusion-transmitted infections with the traditional pathogens for PTK compared to ATK. In addition to the RKI assessed risks, there is the theoretical risk of a new, unknown agent, transmitted through blood exposure. The magnitude of this risk is hardly predictable for PTK. The experience gathered so far, especially in the last three decades, with the emergence of HIV, prions, and West Nil virus, shows that the biological nature of a next transfusion-transmissible infectious agent cannot be predictable. This agent, if we think at a conventional sexually transmissible agent with nucleic acid and long latent period, would spread first in areas with

  16. Half a decade of mini-pool nucleic acid testing: Cost-effective way for improving blood safety in India

    Directory of Open Access Journals (Sweden)

    Shivaram Chandrashekar

    2014-01-01

    Full Text Available Background and Objectives: It is well established that Nucleic acid testing (NAT reduces window phase of transfusion transmissible infections (TTI and helps improve blood safety. NAT testing can be done individually or in pools. The objectives of this study were to determine the utility, feasibility and cost effectiveness of an in-house minipool-NAT(MP-NAT. Materials and Methods: Blood donors were screened by history, tested by ELISA and sero-negative samples were subjected to an in-house NAT by using reverse transcriptase-polymerase chain reaction (RT-PCR. Testing was done in mini-pools of size eight (8. Positive pools were repeated with individual samples. Results: During the study period of Oct 2005-Sept 2010 (5 years all blood donors (n=53729 were screened by ELISA. Of which 469 (0.87% were positive for HIV-1, HBV or HCV. Sero-negative samples (n=53260 were screened by in-house MP-NAT. HIV-NAT yield was 1/53260 (n=1 and HBV NAT yield (n=2 was 1/26630. Conclusion: NAT yield was lower than other India studies possibly due to the lower sero-reactivity amongst our donors. Nevertheless it intercepted 9 lives including the components prepared. The in-house assay met our objective of improving blood safety at nominal cost and showed that it is feasible to set up small molecular biology units in medium-large sized blood banks and deliver blood within 24-48 hours. The utility of NAT (NAT yield will vary based on the donor population, the type of serological test used, the nature of kit employed and the sensitivity of NAT test used. The limitations of our in-house MP-NAT consisted of stringent sample preparation requirements, with labor and time involved. The benefits of our MP-NAT were that it acted as a second level of check for ELISA tests, was relatively inexpensive compared to ID-NAT and did not need sophisticated equipment.

  17. Clinical Assessment of Intraventricular Blood Transport in Patients Undergoing Cardiac Resynchronization Therapy

    Science.gov (United States)

    Rossini, Lorenzo; Martinez-Legazpi, P.; Benito, Y.; Perez Del Villar, C.; Gonzalez-Mansilla, A.; Barrio, A.; Yotti, R.; Kahn, A. M.; Shadden, S. C.; Fernandez-Aviles, F.; Bermejo, J.; Del Alamo, J. C.

    2015-11-01

    In the healthy heart, left ventricular (LV) filling generates flow patterns which have been proposed to optimize blood transport by coupling diastole and systole phases. We present a novel image-based method to assess how flow patterns influence LV blood transport in patients undergoing cardiac resynchronization therapy (CRT). Solving the advection equation with time-varying inflow boundary conditions allows to track the transport of blood entering the LV in the different filling waves, as well as the transport barriers which couple filling and ejection. The velocity fields were obtained using echocardiographic color Doppler velocimetry, which provides two-dimensional time-resolved flow maps in the apical long axis three-chamber view of the LV. We analyze flow transport in a group of patients with CRT devices as well as in healthy volunteers. In the patients under CRT, the device programming was varied to analyze flow transport under different values of the atrioventricular (AV) conduction delay and to model tachycardia. This analysis illustrates how CRT influences the transit of blood inside the LV, contributes to conserving kinetic energy and favors the generation of hemodynamic forces that accelerate blood in the direction of the LV outflow tract.

  18. Fat contamination of pericardial suction blood in cardiac surgery : clinical and experimental studies in perspectives of transfusion logistics

    OpenAIRE

    Appelblad, Micael

    2006-01-01

    Introduction: During cardiac surgery aided by cardiopulmonary bypass (CPB) the autotransfusion of pericardial suction blood (PSB) is regarded mandatory to limit allogeneic blood exposure. PSB is however proposed as a source of lipid microemboli and to contribute to brain damage. This thesis addresses the logistics of allogeneic blood transfusion during coronary artery bypass grafting (CABG), the embolic potential of reinfused PSB, and means to reduce PSB fat contamination, investigated both c...

  19. Pulmonary diffusing capacity, capillary blood volume, and cardiac output during sustained microgravity

    Science.gov (United States)

    Prisk, G. K.; Guy, Harold J. B.; Elliott, Ann R.; Deutschman, Robert A., III; West, John B.

    1993-01-01

    We measured pulmonary diffusing capacity (DL), diffusing capacity per unit lung volume, pulmonary capillary blood volume (Vc), membrane diffusing capacity (Dm), pulmonary capillary blood flow or cardiac output (Qc), and cardiac stroke volume (SV) in four subjects exposed to nine days of microgravity. DL in microgravity was elevated compared with preflight standing values and was higher than preflight supine because of the elevation of both Vc and Dm. The elevation in Vc was comparable to that measured supine in 1 G, but the increase in Dm was in sharp contrast to the supine value. We postulate that, in 0 G, pulmonary capillary blood is evenly distributed throughout the lung, providing for uniform capillary filling, leading to an increase in the surface area available for diffusion. By contrast, in the supine 1-G state, the capillaries are less evenly filled, and although a similar increase in blood volume is observed, the corresponding increase in surface area does not occur. DL and its subdivisions showed no adaptive changes from the first measurement 24 h after the start of 0 G to eight days later. Similarly, there were no trends in the postflight data, suggesting that the principal mechanism of these changes was gravitational. The increase in Dm suggests that subclinical pulmonary edema did not result from exposure to 0 G. Qc was modestly increased inflight and decreased postflight compared with preflight standing. Compared with preflight standing, SV was increased 46 percent inflight and decreased 14 percent in the 1st week postflight. There were temporal changes in Qc and SV during 0 G, with the highest values recorded at the first measurement, 24 h into the flight. The lowest values of Qc and SV occurred on the day of return.

  20. Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model

    OpenAIRE

    Wagner Henrik; Madsen Hardig Bjarne; Steen Stig; Sjoberg Trygve; Harnek Jan; Olivecrona Goran K

    2011-01-01

    Abstract Background Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the cor...

  1. Telomere length in white blood cell DNA and lung cancer: a pooled analysis of three prospective cohorts.

    Science.gov (United States)

    Seow, Wei Jie; Cawthon, Richard M; Purdue, Mark P; Hu, Wei; Gao, Yu-Tang; Huang, Wen-Yi; Weinstein, Stephanie J; Ji, Bu-Tian; Virtamo, Jarmo; Hosgood, H Dean; Bassig, Bryan A; Shu, Xiao-Ou; Cai, Qiuyin; Xiang, Yong-Bing; Min, Shen; Chow, Wong-Ho; Berndt, Sonja I; Kim, Christopher; Lim, Unhee; Albanes, Demetrius; Caporaso, Neil E; Chanock, Stephen; Zheng, Wei; Rothman, Nathaniel; Lan, Qing

    2014-08-01

    We investigated the relationship between telomere length and lung cancer in a pooled analysis from three prospective cohort studies: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, conducted among men and women in the United States, and previously published data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial conducted among male smokers in Finland, and the Shanghai Women's Health Study (SWHS), which is comprised primarily of never-smokers. The pooled population included 847 cases and 847 controls matched by study, age, and sex. Leukocyte telomere length was measured by a monochrome multiplex qPCR assay. We used conditional logistic regression models to calculate ORs and their 95% confidence intervals (CI) for the association between telomere length and lung cancer risk, adjusted for age and pack-years of smoking. Longer telomere length was associated with increased lung cancer risk in the pooled analysis [OR (95% CI) by quartile: 1.00; 1.24 (0.90-1.71); 1.27 (0.91-1.78); and 1.86 (1.33-2.62); P trend = 0.000022]. Findings were consistent across the three cohorts and strongest for subjects with very long telomere length, i.e., lung cancer risks for telomere length [OR (95% CI)] in the upper half of the fourth quartile were 2.41 (1.28-4.52), 2.16 (1.11-4.23), and 3.02(1.39-6.58) for the PLCO trial, the ATBC trial, and the SWHS, respectively. In addition, the association persisted among cases diagnosed more than 6 years after blood collection and was particularly evident for female adenocarcinoma cases. Telomere length in white blood cell DNA may be a biomarker of future increased risk of lung cancer in diverse populations. PMID:24853549

  2. Gated blood pool tomography (GSPECT) in patients with arrhythmogenic right ventricular dysplasia (ARVD)

    International Nuclear Information System (INIS)

    ARVD is suspected in young patients presenting severe ventricular arrhythmias, often without any other cardiac symptoms. The diagnosis is based on well established angiographic criteria, and the aim of the present study was to assess the usefulness of GSPECT as a screening method. 14 patients with proven ARVD (7 males and 7 females, mean age = 35) have been investigated using GSPECT (32 projections + 16 frames for each one). Patients showed significantly increased RVEDV (102 +- 29ml/m/sup 2/, p<0.01) and markedly decreased RVEF (0.30 +- 0.08, p<0.001). In all 14 cases functional images revealed regional RV kinetic alterations. Fourier phase mapping showed RV abnormalities in 12 cases. GSPECT provides precise and complete biventricular informations for the diagnosis of ARVD and for the demonstration of a possible LV extension

  3. Gated blood pool tomography (GSPECT) in patients with arrhythmogenic right ventricular dysplasia (ARVD)

    Energy Technology Data Exchange (ETDEWEB)

    Itti, R.; Casset, D.; Cosnay, P.; Fauchier, J.P.

    1985-05-01

    ARVD is suspected in young patients presenting severe ventricular arrhythmias, often without any other cardiac symptoms. The diagnosis is based on well established angiographic criteria, and the aim of the present study was to assess the usefulness of GSPECT as a screening method. 14 patients with proven ARVD (7 males and 7 females, mean age = 35) have been investigated using GSPECT (32 projections + 16 frames for each one). Patients showed significantly increased RVEDV (102 +- 29ml/m/sup 2/, p<0.01) and markedly decreased RVEF (0.30 +- 0.08, p<0.001). In all 14 cases functional images revealed regional RV kinetic alterations. Fourier phase mapping showed RV abnormalities in 12 cases. GSPECT provides precise and complete biventricular informations for the diagnosis of ARVD and for the demonstration of a possible LV extension.

  4. Quantification of 16 QT-prolonging Drugs and Metabolites in Human Postmortem Blood and Cardiac Tissue Using UPLC–MS-MS

    DEFF Research Database (Denmark)

    Mikkelsen, Christian Reuss; Jornil, Jakob; Vukelic Andersen, Ljubica; Banner, Jytte; Hasselstrøm, Jørgen Bo

    2016-01-01

    quantification of 16 QT-prolonging drugs (QTD) and metabolites in postmortem whole blood and postmortem cardiac tissue. Samples were prepared by protein precipitation and quantified using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Deuterated internal standards were used...... blood and cardiac tissue. To the best of the authors’ knowledge, this article presents the first fully validated method for quantification of QTD in cardiac tissue....

  5. Reference values for total blood volume and cardiac output in humans

    Energy Technology Data Exchange (ETDEWEB)

    Williams, L.R. [Indiana Univ., South Bend, IN (United States). Division of Liberal Arts and Sciences

    1994-09-01

    Much research has been devoted to measurement of total blood volume (TBV) and cardiac output (CO) in humans but not enough effort has been devoted to collection and reduction of results for the purpose of deriving typical or {open_quotes}reference{close_quotes} values. Identification of normal values for TBV and CO is needed not only for clinical evaluations but also for the development of biokinetic models for ultra-short-lived radionuclides used in nuclear medicine (Leggett and Williams 1989). The purpose of this report is to offer reference values for TBV and CO, along with estimates of the associated uncertainties that arise from intra- and inter-subject variation, errors in measurement techniques, and other sources. Reference values are derived for basal supine CO and TBV in reference adult humans, and differences associated with age, sex, body size, body position, exercise, and other circumstances are discussed.

  6. Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung: a case control study

    OpenAIRE

    Tuinman, Pieter R; Vlaar, Alexander P; Cornet, Alexander D.; Hofstra, Jorrit J.; Levi, Marcel; Meijers, Joost CM; Beishuizen, Albertus; Schultz, Marcus J; Groeneveld, AB Johan; Juffermans, Nicole P.

    2011-01-01

    Introduction Blood transfusion is associated with increased morbidity and mortality in cardiac surgery patients, but cause-and-effect relations remain unknown. We hypothesized that blood transfusion is associated with changes in pulmonary and systemic inflammation and coagulation occurring in patients who do not meet the clinical diagnosis of transfusion-related acute lung injury (TRALI). Methods We performed a case control study in a mixed medical-surgical intensive care unit of a university...

  7. Ultrastable polyethyleneimine-stabilized gold nanoparticles modified with polyethylene glycol for blood pool, lymph node and tumor CT imaging

    Science.gov (United States)

    Zhang, Yongxing; Wen, Shihui; Zhao, Lingzhou; Li, Du; Liu, Changcun; Jiang, Wenbin; Gao, Xiang; Gu, Wentao; Ma, Nan; Zhao, Jinhua; Shi, Xiangyang; Zhao, Qinghua

    2016-03-01

    Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG monomethyl ether via PEI amine-enabled conjugation chemistry, followed by acetylation of the remaining PEI surface amines. The formed PEGylated Au PSNPs were characterized via different methods. We show that the PEGylated Au PSNPs with an Au core size of 5.1 nm have a relatively long half-decay time (7.8 h), and display a better X-ray attenuation property than conventionally used iodine-based CT contrast agents (e.g., Omnipaque), and are hemocompatible and cytocompatible in a given concentration range. These properties of the Au PSNPs afford their uses as a contrast agent for effective CT imaging of the blood pool and major organs of rats, lymph node of rabbits, and the xenografted tumor model of mice. Importantly, the PEGylated Au PSNPs could be excreted out of the body with time and also showed excellent in vivo stability. These findings suggest that the formed PEGylated Au PSNPs may be used as a promising contrast agent for CT imaging of different biological systems.Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG

  8. Routine measurements of left and right ventricular output by gated blood pool emission tomography in comparison with thermodilution measurements: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Mariano-Goulart, D.; Boudousq, V.; Comte, F.; Eberle, M.C.; Zanca, M.; Kotzki, P.O.; Rossi, M. [Dept. of Nuclear Medicine, Montpellier University Hospital (France); Piot, C.; Raczka, F.; Davy, J.M. [Dept. of Cardiology B, Montpellier University Hospital (France)

    2001-04-01

    The aim of this preliminary study was to evaluate the accuracy of left and right ventricular output computed from a semi-automatic processing of tomographic radionuclide ventriculography data (TRVG) in comparison with the conventional thermodilution method. Twenty patients with various heart diseases were prospectively included in the study. Thermodilution and TRVG acquisitions were carried out on the same day for all patients. Analysis of gated blood pool slices was performed using a watershed-based segmentation algorithm. Right and left ventricular output measured by TRVG correlated well with the measurements obtained with thermodilution (r=0.94 and 0.91 with SEE=0.38 and 0.46 l/min, respectively, P<0.001). The limits of agreement for TRVG and thermodilution measurements were -0.78-1.20 l/min for the left ventricle and -0.34-1.16 l/min for the right ventricle. No significant difference was found between the results of TRVG and thermodilution with respect to left ventricular output (P=0.09). A small but significant difference was found between right ventricular output measured by TRVG and both left ventricular output measured by TRVG (mean difference=0.17 l/min, P=0.04) and thermodilution-derived cardiac output (mean difference=0.41 l/min, P=0.0001). It is concluded that the watershed-based semi-automatic segmentation of TRVG slices provides non-invasive measurements of right and left ventricular output and stroke volumes at equilibrium, in routine clinical settings. Further studies are necessary to check whether the accuracy of these measurements is good enough to permit correct assessment of intracardiac shunts. (orig.)

  9. First pass and gated blood pool in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Twenty patients with chronic obstructive lung disease were studied. The spirometry demonstrated predominantly reduction of vital capacity with signs of pulmonary hyperinflation. Obstruction of the proximal and distal airways was also noted. Total pulmonary resistance and static lung compliance were increased in the majority of these patients. Hypoxemia was present in the entire group, with no carbon dioxide retention. Various degrees of pulmonary artery dilatation were detected on the radioisotopic examination, suggesting pulmonary hypertension, confirmed by the increased mean pulmonary transit time. Regional disturbance of myocardial motility of the right ventricle was observed in 90% of the patients, being severe in 15%. The end-systolic volume was increased in 95% of the patients and the end-diastolic in 55%. These changes represent an initial functional disturbance, which does not allow to draw conclusions about reduction of the cardiac output or the ejection fraction. Left ventricular motility was normal in 85% of the patients, reduced in 15% and severely reduced in only one patient. Left ventricular volume was discrete or moderately increased in six patients (20%). The ejection fraction was decreased in one patient (5%). The increased ejection fraction observed in three patients is likely a consequence of a rise in the ejected volume by a normal myocardium. The aorta was elongated in 75% of the patients. Taking into consideration the patients' age, it could be concluded that aortosclerosis with structural changes of its caliber is the cause of the elongation. (author)

  10. A Giant Hepatic Hemangioma Complicated by Kasabach-Merritt Syndrome: Findings of Tc-99m RBC Scintigraphy and SPECT Including a Total Body Blood Pool Imaging Study

    International Nuclear Information System (INIS)

    Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study

  11. A Giant Hepatic Hemangioma Complicated by Kasabach-Merritt Syndrome: Findings of Tc-99m RBC Scintigraphy and SPECT Including a Total Body Blood Pool Imaging Study

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae; Kim, Dong Wook; Yim, Chang Yeol [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2009-02-15

    Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study.

  12. Recent Stem Cell Advances: Cord Blood and Induced Pluripotent Stem Cell for Cardiac Regeneration- a Review.

    Science.gov (United States)

    Medhekar, Sheetal Kashinath; Shende, Vikas Suresh; Chincholkar, Anjali Baburao

    2016-05-30

    Stem cells are primitive self renewing undifferentiated cell that can be differentiated into various types of specialized cells like nerve cell, skin cells, muscle cells, intestinal tissue, and blood cells. Stem cells live in bone marrow where they divide to make new blood cells and produces peripheral stem cells in circulation. Under proper environment and in presence of signaling molecules stem cells begin to develop into specialized tissues and organs. These unique characteristics make them very promising entities for regeneration of damaged tissue. Day by day increase in incidence of heart diseases including left ventricular dysfunction, ischemic heart disease (IHD), congestive heart failure (CHF) are the major cause of morbidity and mortality. However infracted tissue cannot regenerate into healthy tissue. Heart transplantation is only the treatment for such patient. Due to limitation of availability of donor for organ transplantation, a focus is made for alternative and effective therapy to treat such condition. In this review we have discussed the new advances in stem cells such as use of cord stem cells and iPSC technology in cardiac repair. Future approach of CB cells was found to be used in tissue repair which is specifically observed for improvement of left ventricular function and myocardial infarction. Here we have also focused on how iPSC technology is used for regeneration of cardiomyocytes and intiating neovascularization in myocardial infarction and also for study of pathophysiology of various degenerative diseases and genetic disease in research field. PMID:27426082

  13. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe

    DEFF Research Database (Denmark)

    Brøndum, E.; Hasenkam, John Michael; Secher, Niels H.; Bertelsen, Mads Frost; Grøndahl, C.; Petersen, K.K.; Buhl, Rikke; Aalkjaer, C.; Baandrup, U.; Nygaard, H.; Smerup, Morten Holdgaard; Stegmann, F.; Sloth, E.; Østergaard, K.H.; Nissen, P.; Runge, M.; Pitsillides, K.; Wang, T.

    2009-01-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in...... the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was...... 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow...

  14. Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model

    Directory of Open Access Journals (Sweden)

    Wagner Henrik

    2011-12-01

    Full Text Available Abstract Background Mechanical chest compressions (CCs have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow, but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the coronary perfusion pressure (CPP. In this study our aim was to correlate average peak coronary flow velocity (APV to CPP during mechanical CCs. Methods In a closed chest porcine model, cardiac arrest was established through electrically induced ventricular fibrillation (VF in eleven pigs. After one minute, mechanical chest compressions were initiated and then maintained for 10 minutes upon which the pigs were defibrillated. Measurements of coronary blood flow in the left anterior descending artery were made at baseline and during VF with a catheter based Doppler flow fire measuring APV. Furthermore measurements of central (thoracic venous and arterial pressures were also made in order to calculate the theoretical CPP. Results Average peak coronary flow velocity was significantly higher compared to baseline during mechanical chests compressions and this was observed during the entire period of mechanical chest compressions (12 - 39% above baseline. The APV slowly declined during the 10 min period of mechanical chest compressions, but was still higher than baseline at the end of mechanical chest compressions. CPP was simultaneously maintained at > 20 mmHg during the 10 minute episode of cardiac arrest. Conclusion Our study showed good correlation between CPP and APV which was highly significant, during cardiac arrest with on-going mechanical CCs in a closed chest porcine model. In addition APV was even higher during mechanical CCs compared to baseline. Mechanical

  15. Radionuclide angiography and blood pool imaging to assess skin ulcer healing prognosis in patients with peripheral vascular disease

    International Nuclear Information System (INIS)

    Several non-invasive diagnostic techniques including segmental limb blood pressures, skin fluoresence, and photo plethysmography, have been evaluated as predictors of skin ulcer healing in patients with peripheral vascular disease, but none are widely used. Using 20mCi of Tc-99m phosphate compounds, four phase bone scans were obtained, including (1) radionuclide angiogram (2) blood pool image (3) 2 hour and 4-6 hour static images and (4) 24 hour static delayed images. The first two phases were used to assess vacularity to the region of distal extremity ulceration; the last two phases evaluated presence or absence of osteomyelitis. Studies were performed in 30 patients with non-healing ulcers of the lower extremities. Perfusion to the regions of ulceration on images was graded as normal, increased, or reduced with respect to the opposite (presumed normal) limb or some other normal reference area. Hypervascular response was interpreted as good prognosis for healing unless osteomyelitis was present. Clinicians followed patients for 14 days to assess limb healing with optimum care. If there was no improvement, angiography and/or surgery (reconstructive surgery, sympathectomy, or amputation) was done. Results showed: sensitivity for predicting ulcer healing was 94%, specificity 89%. Patients who failed to heal their ulcers showed reduced perfusion, no hypervascular response, or osteomyelitis. Microcirculatory adequacy for ulcer healing appear predictable by this technique

  16. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    Energy Technology Data Exchange (ETDEWEB)

    Lalonde, Michel, E-mail: mlalonde15@rogers.com; Wassenaar, Richard [Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Wells, R. Glenn; Birnie, David; Ruddy, Terrence D. [Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7 (Canada)

    2014-07-15

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  17. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    International Nuclear Information System (INIS)

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  18. Clinical application of respiratory navigator echo triggered black blood contrast cardiac MRI

    International Nuclear Information System (INIS)

    Objective: To investigate the application of respiratory navigator echo triggered black blood contrast FSE in cardiac MRI. Methods: The respiratory navigator echo trigger technique combining with black blood FSE (NAV-FSE) was tested on 11 volunteers and 5 patients in free breathing, using breath-hold FSE (BH-FSE) with the same imaging protocals as control. The imaging efficiency and the image sharpness were compared between NAV-FSE and BH-FSE and t-test was used for the statistics. Results: All NAV-FSE acquisitions were completed in sixteen subjects while 4 BH-FSE acquisitions failed because of poor breath holding. The efficiencies of NAV-FSE were (42.95 ± 11.50)%, (56.14 ± 11.40)% and (55.25 ± 14.70)% when echo train length (ETL) were 24, 16 and 8, respectively. When ETL were 16 and 24, the sharpness of NAV-FSE (0.43 ± 0.02 vs 0.36 ± 0.02) and BH-FSE (0.36 ± 0.03 vs 0.35 ± 0.02) were statistically different (t =4.26, 5.53, respectively; P <0.05). NAV-FSE could have a shorter ETL setting without consideration of breath holding. Conclusion: The navigator echo trigger technique could be compatible with black blood contrast FSE to image the heart without the restriction of breath holding and it allows to optimize the parameters to improve the image quality. (authors)

  19. Pre-operative blood donation versus acute normovolemic hemodilution in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Mohammad Rezvan Nobahar

    2014-01-01

    Full Text Available Introduction: Acute normovolemic hemodilution (ANH and preoperative autologous blood donation (PABD have questionable efficacy, viral and bacterial infection risks, intermittent blood shortages as homeostasis problem, electrolyte and hemodynamic disturbances. Materials and Methods: In this cross sectional survey, we studied 70 patients undergoing open heart coronary artery bypass grafts [CABG] and different valvular replacement 1 ml surgery (35 in ANH, 35 in PABD in Shaheed Modares - Hospital. We measured electrolytes and homeostatic factors to evaluate the influence of two transfusion methods on homeostatic function and hemodynamic balance. Results: We compared 70 patients (38 male [54.3%] and 32 female [45.7%] with mean age 54.8 years undergoing open heart surgery (CABG and valvular. In ANH group, significant decrease was detected in Na (28.5% K (2.5%, prothrombin time (PT (88.57%, partial thromboplastin time (PTT (94.28%, creatine phosphokinase (CPK (11.4%, lactic dehydrogenase (LDH (11.43%, albumin (Alb (17.14%, globulin (91.43% and total protein (80%. Mean initial and post-operative hemoglobin was 14.12 ± 1.06 versus 11.97 ± 0.98, hematocrit 42.22 ± 3.45 versus 35.40 ± 2.88, systolic blood pressure 124.1 ± 14.4 versus 110.88 ± 15.6 (reduction 22.86% diastolic blood pressure 76.02 ± 10 versus 69.26 ± 11 (reduction 3% and pulse rate was 75.45 ± 10 versus 84.45 ± 12 (12% in this case difference between two groups was strongly significant (P = 0.001. In PABD group, significant decrease was detected in Na (20%, K (2.5%, PT (91.43% PTT (80%, CPK (8.57%, LDH (5.72%, Alb (57.15%, globulin (71.43% and total-protein (62.85%, the value of hemodynamic changes were in normal range. Conclusion: Though autologous blood transfusion (ANH and PABD was preferable to allogeneic transfusion in cardiac surgical patients; but PABD offers more advantages in homeostasis, hemodynamic stability and electrolyte balance.

  20. Evaluation of Blood Pressure and Heart Rate in Patients with Hypertension Who Received Tapentadol Extended Release for Chronic Pain: A Post Hoc, Pooled Data Analysis

    OpenAIRE

    Biondi, David M.; Xiang, Jim; Etropolski, Mila; Moskovitz, Bruce

    2014-01-01

    Background and Objectives Hypertension is one of the most common co-existing conditions in patients with chronic pain, and the potential effects of an analgesic on heart rate and blood pressure are of particular concern for patients with hypertension. The purpose of this analysis was to evaluate changes in blood pressure and heart rate with tapentadol extended release (ER) treatment in patients with hypertension. Methods We performed a post hoc analysis of data pooled from three randomized, p...

  1. Are There Benefits to a Fresh Whole Blood vs. Packed Red Blood Cell Cardiopulmonary Bypass Prime on Outcomes in Neonatal and Pediatric Cardiac Surgery?

    Science.gov (United States)

    Valleley, Melinda S.; Buckley, Klayton W.; Hayes, Kylie M.; Fortuna, Randall R.; Geiss, Dale M.; Holt, David W.

    2007-01-01

    Abstract: Techniques for pediatric cardiac surgery requiring cardiopulmonary bypass (CPB) have significantly improved over the years. The use of fresh whole blood (FWB) and pre-bypass ultrafiltration (PBUF) has been suggested as means for improving perioperative and postoperative outcomes. It is the intent of this study to show that fresh whole blood along with PBUF will result in balanced CPB prime that can offer a reduction in blood product exposures and blood loss along with improving several measured postoperative outcomes. After institutional review board approval, a retrospective review was conducted on 100 patients to analyze the benefits of FWB and PBUF on outcomes in neonatal and pediatric cardiac surgery. Data analysis included preoperative and CPB data, perioperative inotrope and blood product exposure, and postoperative blood loss and blood product exposure measured for up to a 12-hour period in the intensive care unit (ICU). The three groups compared were FWB prime vs. packed red blood cell (PRBC) prime, <5 kg FWB prime vs. <5 kg PRBC prime, and 5+ kg FWB prime and 5+ kg PRBC prime. Cumulative blood product exposures for the FWB prime group found 62% received one blood exposure for the operative and postoperative period (p < .0001). The majority of patients who received a PRBC prime (64%) received three or more cumulative exposures (p < .0003). The <5 kg FWB group also received significantly less cumulative blood exposure, with 64% receiving just one exposure. Comparatively, 85% of the <5 kg PRBC patients received three or more blood product exposures perioperatively and postoperatively (p < .0001). Perioperative inotrope and postoperative blood loss did not differ among the groups. Outcomes for intraoperative death, intraoperative extubation, delayed sternal closure, and mediastinal reexploration were also not statistically different. The results of this study found that FWB leads to significantly less blood exposure, specifically in the <5-kg

  2. Blood brain barrier is impermeable to solutes and permeable to water after experimental pediatric cardiac arrest.

    Science.gov (United States)

    Tress, Erika E; Clark, Robert S B; Foley, Lesley M; Alexander, Henry; Hickey, Robert W; Drabek, Tomas; Kochanek, Patrick M; Manole, Mioara D

    2014-08-22

    Pediatric asphyxial cardiac arrest (CA) results in unfavorable neurological outcome in most survivors. Development of neuroprotective therapies is contingent upon understanding the permeability of intravenously delivered medications through the blood brain barrier (BBB). In a model of pediatric CA we sought to characterize BBB permeability to small and large molecular weight substances. Additionally, we measured the percent brain water after CA. Asphyxia of 9 min was induced in 16-18 day-old rats. The rats were resuscitated and the BBB permeability to small (sodium fluorescein and gadoteridol) and large (immunoglobulin G, IgG) molecules was assessed at 1, 4, and 24 h after asphyxial CA or sham surgery. Percent brain water was measured post-CA and in shams using wet-to-dry brain weight. Fluorescence, gadoteridol uptake, or IgG staining at 1, 4h and over the entire 24 h post-CA did not differ from shams, suggesting absence of BBB permeability to these solutes. Cerebral water content was increased at 3h post-CA vs. sham. In conclusion, after 9 min of asphyxial CA there is no BBB permeability over 24h to conventional small or large molecule tracers despite the fact that cerebral water content is increased early post-CA indicating the development of brain edema. Evaluation of novel therapies targeting neuronal death after pediatric CA should include their capacity to cross the BBB. PMID:24937271

  3. Inadequate Blood Pressure Control in Hypertensive Patients Referred for Cardiac Stress Test.

    Science.gov (United States)

    Mousa, Tarek M; Akinseye, Oluwaseun A; Kerwin, Todd C

    2015-09-01

    The current study examined the degree of blood pressure (BP) control and incidence of myocardial ischemia in hypertensive patients (n=2039) referred for cardiac stress test. Patients were categorized into well-controlled (controlled (140-160/90-100 mm Hg), and very poorly controlled (>160/100 mm Hg) groups according to their resting BP. The mean age[±standard error of the mean] of the patients was 68±13 years, and 885 (43.4%) were men. The prevalence of well-controlled hypertension (HTN) was 47.2%, poorly controlled HTN was 29.5%, and very poorly controlled HTN was 23.3%. Evidence of ischemia was seen in 19.8% and 19.3% of the well-controlled and poorly controlled groups, respectively. The very poorly controlled group had the lowest incidence of ischemia (14.3%) (Pcontrolled BP. Quality of care might be improved by optimally controlling BP in patients with angina symptoms prior to ordering diagnostic testing associated with radiation exposure and cost. PMID:26011137

  4. A blood pool contrast aided T1 functional MRI in patients with brain tumors - a preliminary study

    International Nuclear Information System (INIS)

    The aim of our study was to determine the possibility of using a new functional technique: a T1-dependent sequence with administration of blood pool contrast agent (BPCA), in patients with brain tumors before and after surgical treatment. We also aimed to compare our results with those obtained using the fMRI technique, based on Blood Oxygenation Level-Dependent (BOLD) contrast. For each of our 14 oncologic patients (four before and ten after neurosurgical intervention), we obtained: a T1-3D GRE sequence (TR = 2.6 ms/TE = 1.1 ms/FA = 10 ) after intravenous administration of BPCA (0.03 mmol/kg), as well as a T2*EPI sequence (TR = 3 s/TE = 50 ms/FA = 90 ). Movement and/or tactile block type paradigms were carried out during both functional runs. SPM5 software was used for analysis. For both functional techniques, maximum activations were localized in the same areas. There were no significant differences observed in the t values calculated for activations located in the primary motor cortex between groups of pre- and post-intervention patients (in the same functional technique). The mean values for T2* EPI examinations were 10.84 and 9.36, respectively. The mean t values for the T1 technique were lower, especially for the post-intervention patients (5.83 and 3.9, respectively). The T1 technique can be used to detect functional areas in patients with brain tumors, pre-, and post-surgical intervention. This technique enables the evaluation of cortical centers that suffer from susceptibility artifacts when using the T2* BOLD technique. Activations found using both techniques have the same localization, with lower values for the T1 technique. (orig.)

  5. Evaluation of cardiac blood blow, metabolism and sympathetic nerve function in patients with cardiac failure using PET and SPECT. Prognostic diagnosis based on the analysis of aggravating factors of the disease

    International Nuclear Information System (INIS)

    Focusing on the failure of energy metabolism, which is assumed to be attributed to the cardiac muscle disorder of a patient with cardiac failure, the characteristics and diagnostic significance of the metabolic disorders of cadiac muscles were investigated in those patients. The diagnostic efficacy of β-methyl iodophenyl pentadecanoic acid (BMIPP) which is a imaging agent for lipid metabolism in the cardiac muscle was assessed in the clinical states of cardiac failure due to pulmonary hypertension. Even if there was a considerable increase in the mean pulmonary arterial pressure (mPAP), the initial accumulation of BMIPP linearly increased, similarly to the increase in the accumulation of MIBI, a blood flow agent. The initial accumulation of BMIPP was thought to reflect a thicken cardiac muscle and/or increased blood flow. Also, its washing-out rate was suggested to be usable as an clinical indicator to estimate the loading of ventricular pressure. (M.N.)

  6. Evaluation of cardiac blood blow, metabolism and sympathetic nerve function in patients with cardiac failure using PET and SPECT. Prognostic diagnosis based on the analysis of aggravating factors of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Shimozu, Junko; Yasumura, Yoshio; Nagatani, Kenzo; Miyatake, Kunio [National Cardiovascular Center, Suita, Osaka (Japan)

    1998-02-01

    Focusing on the failure of energy metabolism, which is assumed to be attributed to the cardiac muscle disorder of a patient with cardiac failure, the characteristics and diagnostic significance of the metabolic disorders of cadiac muscles were investigated in those patients. The diagnostic efficacy of {beta}-methyl iodophenyl pentadecanoic acid (BMIPP) which is a imaging agent for lipid metabolism in the cardiac muscle was assessed in the clinical states of cardiac failure due to pulmonary hypertension. Even if there was a considerable increase in the mean pulmonary arterial pressure (mPAP), the initial accumulation of BMIPP linearly increased, similarly to the increase in the accumulation of MIBI, a blood flow agent. The initial accumulation of BMIPP was thought to reflect a thicken cardiac muscle and/or increased blood flow. Also, its washing-out rate was suggested to be usable as an clinical indicator to estimate the loading of ventricular pressure. (M.N.)

  7. Evaluation of left ventricular function in patients with ischemic heart disease by isoproterenol infusion stress blood pool scintigraphy

    International Nuclear Information System (INIS)

    Findings of isoproterenol infusion stress blood pool scintigraphy with Tc-99m-O4 (ISP-SG) were compared with those of exercise stress scintigraphy (EX-SG) in 10 patients with coronary artery disease (CAD), 9 with vasospastic angina (VA), and 7 normal controls (NC). EX-SG showed an increased left ventricular enddiastolic volume (EDV) and an unchanged left ventricular ejection fraction (EF) in CAD and VA patients. By contraries, EDV was unchanged and EF was increased in NC. ISP-SG showed the same results as those by EX-SG in CAD patients; it showed an unchanged EDV, a decreased left ventricular endsystolic volume, and an increased EF in both VA patients and NC. Both types of SG showed regional wall motion abnormality (RWMA) in CAD patients; however, ISP-SG showed normal wall motion in all VA patients, although RWMA was seen on EX-SG in some of them. The results indicate that ISP-SG may be helpful in the evaluation of left ventricular function when the execution of EX-SG is impossible, and in the diagnosis of ischemic heart disease complicated by coronary spasm. (Namekawa, K.)

  8. The clinical value of early 99Tcm-RBC blood pool imaging in patients with replanted fingers

    International Nuclear Information System (INIS)

    Objective: To study the clinical value of early (99Tcm-RBC blood pool imaging (BPI) in patients with replanted fingers (RF). Methods: Five times of BPI were performed on each of the 30 patients with RF, at 4-8, 8-12, 24, 36 and 48 h after the replantation surgery, and that was one time before and 4 times after the hyperbaric oxygen (HBO) treatment on the patients. The radioactivity uptake of replanted finger/normal finger ratio (T/NT) was analyzed using region of interest analysis. The vascular crisis and prognosis were predicted. 0, I and II groups were classified according to their radionuclide distribution. The change of T/NT was comparatively studied. The vascular crisis and prognosis were predicted. Results: The replanted finger T/NT (0.624 +- 0.310) after 4 times of HBO treatment was significantly higher than before the treatment (0.413 +- 0.274, t = 2.79, P 2 = 28.8, 20.0, P 2 = 11.7, 18.0, P < 0.01), respectively. Conclusions: BPI could play an important role on dynamic evaluating the early therapeutic surveillance, predicting the vascular crisis and prognosis, and selecting the next treatment programme in the patients with RF

  9. Are there two functionally distinguished Neu5Gc pools with respect to rouleau formation on the bovine red blood cell?

    Science.gov (United States)

    Musielak, Malgorzata

    2004-01-01

    Bovine red blood cells (RBCs) do not exhibit any aggregation tendency in autologous plasma and, therefore, all bovine rouleaux obtained in vitro are regarded as artificial. The present study reports the bovine RBC rouleau formation by either bovine or human fibrinogen and Ca2+ ions. The phenomenon was induced through two-step cell incubation: in 0.9% NaCl and 1% bovine albumin at 37 degrees C for 30 min followed by 20 hrs incubation at 30 degrees C in the fresh solution supplemented with 10 mM glucose. Its mechanism is unknown. During the incubation the number of N-glycolylneuraminic acid molecules per cell decreased from 48.1 to 44.9 amoles, which accounted for 7%. The treatment of RBCs with V. cholerae sialidase under the same conditions resulted in a 94% drop in the Neu5Gc quantity and did not induce the rouleau formation in the same fibrinogen preparation. The preliminary results rise a question whether the bulk of sialic acid is required in the aggregation of bovine erythrocytes under static conditions. Only a minor pool of Neu5Gc seems to be responsible for suppression of the phenomenon. PMID:15258381

  10. Effects of heme oxygenase-1 upregulation on blood pressure and cardiac function in an animal model of hypertensive myocardial infarction.

    Science.gov (United States)

    Chen, Tian-Meng; Li, Jian; Liu, Lin; Fan, Li; Li, Xiao-Ying; Wang, Yu-Tang; Abraham, Nader G; Cao, Jian

    2013-01-01

    In this study, we evaluate the effect of HO-1 upregulation on blood pressure and cardiac function in the new model of infarct spontaneous hypertensive rats (ISHR). Male spontaneous hypertensive rats (SHR) at 13 weeks (n = 40) and age-matched male Wistar (WT) rats (n = 20) were divided into six groups: WT (sham + normal saline (NS)), WT (sham + Co(III) Protoporphyrin IX Chloride (CoPP)), SHR (myocardial infarction (MI) + NS), SHR (MI + CoPP), SHR (MI + CoPP + Tin Mesoporphyrin IX Dichloride (SnMP)), SHR (sham + NS); CoPP 4.5 mg/kg, SnMP 15 mg/kg, for six weeks, one/week, i.p., n = 10/group. At the sixth week, echocardiography (UCG) and hemodynamics were performed. Then, blood samples and heart tissue were collected. Copp treatment in the SHR (MI + CoPP) group lowered blood pressure, decreased infarcted area, restored cardiac function (left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), +dp/dt(max), (-dp/dt(max))/left ventricular systolic pressure (LVSP)), inhibited cardiac hypertrophy and ventricular enlargement (downregulating left ventricular end-systolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and heart weight/body weight (HW/BW)), lowered serum CRP, IL-6 and Glu levels and increased serum TB, NO and PGI2 levels. Western blot and immunohistochemistry showed that HO-1 expression was elevated in the SHR (MI + CoPP) group, while co-administration with SnMP suppressed the benefit functions mentioned above. In conclusion, HO-1 upregulation can lower blood pressure and improve post-infarct cardiac function in the ISHR model. These functions may be involved in the inhibition of inflammation and the ventricular remodeling process and in the amelioration of glucose metabolism and endothelial dysfunction. PMID:23358254

  11. Effects of Heme Oxygenase-1 Upregulation on Blood Pressure and Cardiac Function in an Animal Model of Hypertensive Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Lin Liu

    2013-01-01

    Full Text Available In this study, we evaluate the effect of HO-1 upregulation on blood pressure and cardiac function in the new model of infarct spontaneous hypertensive rats (ISHR. Male spontaneous hypertensive rats (SHR at 13 weeks (n = 40 and age-matched male Wistar (WT rats (n = 20 were divided into six groups: WT (sham + normal saline (NS, WT (sham + Co(III Protoporphyrin IX Chloride (CoPP, SHR (myocardial infarction (MI + NS, SHR (MI + CoPP, SHR (MI + CoPP + Tin Mesoporphyrin IX Dichloride (SnMP, SHR (sham + NS; CoPP 4.5 mg/kg, SnMP 15 mg/kg, for six weeks, one/week, i.p., n = 10/group. At the sixth week, echocardiography (UCG and hemodynamics were performed. Then, blood samples and heart tissue were collected. Copp treatment in the SHR (MI + CoPP group lowered blood pressure, decreased infarcted area, restored cardiac function (left ventricular ejection fraction (LVEF, left ventricular fraction shortening (LVFS, +dp/dtmax, (−dp/dtmax/left ventricular systolic pressure (LVSP, inhibited cardiac hypertrophy and ventricular enlargement (downregulating left ventricular end-systolic diameter (LVEDD, left ventricular end-systolic diameter (LVESD and heart weight/body weight (HW/BW, lowered serum CRP, IL-6 and Glu levels and increased serum TB, NO and PGI2 levels. Western blot and immunohistochemistry showed that HO-1 expression was elevated in the SHR (MI + CoPP group, while co-administration with SnMP suppressed the benefit functions mentioned above. In conclusion, HO-1 upregulation can lower blood pressure and improve post-infarct cardiac function in the ISHR model. These functions may be involved in the inhibition of inflammation and the ventricular remodeling process and in the amelioration of glucose metabolism and endothelial dysfunction.

  12. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    OpenAIRE

    Akram Sardari; Mostafa Nejatian; Mehrdad Sheikhvatan

    2010-01-01

    Background: Systolic blood pressure recovery (rSBP) is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD). This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR) in a population-based sample of patients undergoing coronary artery bypass grafting (CABG).Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent sta...

  13. Impact of High-Normal Blood Pressure Measured in Emergency Room on Adverse Cardiac Events in Acute Myocardial Infarction

    OpenAIRE

    Yoon, Nam Sik; Jeong, Myung Ho; Ahn, Youngkeun; Kim, Jong Hyun; Chae, Shung Chull; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Donghoon; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Chung, Wook Sung; Jang, Yang Soo

    2012-01-01

    Background and Objectives Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized. Subjects and Methods We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients. Results Among 14871 patients, 159 (61±12.3 years, 122 males) satisfied the study indication. Six-month and ...

  14. Comparison of gated blood pool SPECT and spiral multidetector computed tomography in the assessment of right ventricular functional parameters. Validation with first-pass radionuclide angiography

    International Nuclear Information System (INIS)

    The aim of this study was to compare gated blood pool single photon emission computed tomography (SPECT) (GBPS) and multidetector row computed tomography (MDCT) for the determination of right ventricular ejection fraction (RVEF) and right ventricular volumes (RVV) and to compare first-pass radionuclide angiography (FP-RNA) as the gold standard. Twenty consecutive patients (11 men, 9 women) referred for MDCT for the evaluation of the presence of coronary artery disease underwent FP-RNA and GBPS. The mean right ventricular end-diastolic volume (EDV) calculated with GBPS revealed a statistically significant lower value than that of MDCT. The mean right ventricular end-systolic volume (ESV) calculated with GBPS was also lower than that of MDCT. A comparison of right ventricular EDV from GBPS and MDCT yielded a correlation coefficient of 0.5972. Right ventricular ESV between GBPS and MDCT showed a correlation coefficient of 0.5650. The mean RVEFs calculated with FP-RNA (39.8%±4.0%), GBPS (43.7%±6.9%), and MDCT (40.4%±7.7%) showed no statistical differences (Kruskal-Wallis statistics 4.538, P=0.1034). A comparison of RVEFs from FP-RNA and GBPS yielded a correlation coefficient of 0.7251; RVEFs between FP-RNA and MDCT showed a correlation coefficient of 0.6166 and between GBPS and MDCT showed a correlation coefficient of 0.6367. The RVEF, EDV, and ESV calculated by GBPS had good correlation with those obtained with MDCT. In addition, there were no statistical differences of RVEF calculated from FP-RNA, GBPS, and MDCT. However, with regard to RVV, EDV and ESV from GBPS revealed statistically significantly lower values than those of MDCT. Although reasonable correlations among these modalities were obtained, the agreement among these three modalities was not good enough for interchangeable use in the clinical setting. Also, these results should be confirmed in patients with cardiac diseases in future larger population-based studies. (author)

  15. Interactions between breathing rate and low-frequency fluctuations in blood pressure and cardiac intervals.

    Science.gov (United States)

    Horsman, H M; Peebles, K C; Tzeng, Y C

    2015-10-01

    Evidence derived from spontaneous measures of cardiovagal baroreflex sensitivity (BRS) suggests that slow breathing at 6 breaths/min augments BRS. However, increases in BRS associated with slow breathing may simply reflect the frequency-dependent nature of the baroreflex rather than the modulation of baroreflex function by changes in breathing rate per se. To test this hypothesis we employed a crossover study design (n = 14) wherein breathing rate and systolic arterial blood pressure (SAP) oscillation induced via the application of oscillating lower body negative pressure (OLBNP) were independently varied at fixed frequencies. Breathing rate was controlled at 6 or 10 breaths/min with the aid of a metronome, and SAP oscillations were driven at 0.06 Hz and 0.1 Hz using OLBNP. The magnitudes of SAP and R-R interval (cardiac period) oscillations were quantified using power spectral analysis, and the transfer function gain between SAP and R-R interval was used to estimate BRS. Linear mixed-effects models were used to examine the main effects and interactions between breathing rate and OLBNP frequency. There was no statistical interaction between breathing and OLBNP frequency (P = 0.59), indicating that the effect of breathing rate on BRS did not differ according to OLBNP frequency (and vice versa). Additionally, there was no main effect for breathing rate (P = 0.28). However, we observed a significant main effect for OLBNP frequency (P = 0.01) consistent with the frequency-dependent nature of baroreflex. These findings suggest that increases in spectral indices of BRS reflect the frequency dependence of the baroreflex and are not due to slow breathing per se. PMID:26205543

  16. Comparison of blood pool and extracellular gadolinium chelate for functional MR evaluation of vascular thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ruth P., E-mail: ruthplim74@gmail.com [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Austin Health, Department of Radiology, Heidelberg, Victoria 3084 (Australia); The University of Melbourne, School of Medicine, Parkville, Victoria 3010 (Australia); Bruno, Mary, E-mail: mary.bruno@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Rosenkrantz, Andrew B., E-mail: Andrew.rosenkrantz@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Kim, Danny C., E-mail: danny.kim@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Mulholland, Thomas, E-mail: Thomas.mulholland@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Kwon, Jane, E-mail: jane.kwon@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Palfrey, Amy P., E-mail: amy.pastva10@stjohns.edu [St John' s University, Department of Psychology, 8000 Utopia Parkway, Jamaica-Queens, NY 11439 (United States); Ogedegbe, Olugbenga, E-mail: Olugbenga.Ogedegbe@nyumc.org [New York University School of Medicine, Clinical and Translational Science Institute, 227 E30th St, 8th Floor, New York, NY 10016 (United States)

    2014-07-15

    Objective: To compare performance of single-injection blood pool agent (gadofosveset trisodium, BPA) against dual-injection extracellular contrast (gadopentetate dimeglumine, ECA) for MRA/MRV in assessment of suspected vascular TOS. Materials and methods: Thirty-one patients referred for vascular TOS evaluation were assessed with BPA (n = 18) or ECA (n = 13) MRA/MRV in arm abduction and adduction. Images were retrospectively assessed for: image quality (1 = non-diagnostic, 5 = excellent), vessel contrast (1 = same signal as muscle, 4 = much brighter than muscle) and vascular pathology by two independent readers, with a separate experienced reader providing reference assessment of vascular pathology. Results: Median image quality was diagnostic or better (score ≥3) for ECA and BPA at all time points, with BPA image quality superior at abduction late (BPA 4.5, ECA 4, p = 0.042) and ECA image quality superior at adduction-early (BPA 4.5; ECA 4.0, p = 0.018). High qualitative vessel contrast (mean score ≥3) was observed at all time points with both BPA and ECA, with superior BPA vessel contrast at abduction-late (BPA 3.97 ± 0.12; ECA 3.73 ± 0.26, p = 0.007) and ECA at adduction-early (BPA 3.42 ± 0.52; ECA 3.96 ± 0.14, p < 0.001). Readers readily identified arterial and venous pathology with BPA, similar to ECA examinations. Conclusion: Single-injection BPA MRA/MRV for TOS evaluation demonstrated diagnostic image quality and high vessel contrast, similar to dual-injection ECA imaging, enabling identification of fixed and functional arterial and venous pathology.

  17. Comparison of blood pool and extracellular gadolinium chelate for functional MR evaluation of vascular thoracic outlet syndrome

    International Nuclear Information System (INIS)

    Objective: To compare performance of single-injection blood pool agent (gadofosveset trisodium, BPA) against dual-injection extracellular contrast (gadopentetate dimeglumine, ECA) for MRA/MRV in assessment of suspected vascular TOS. Materials and methods: Thirty-one patients referred for vascular TOS evaluation were assessed with BPA (n = 18) or ECA (n = 13) MRA/MRV in arm abduction and adduction. Images were retrospectively assessed for: image quality (1 = non-diagnostic, 5 = excellent), vessel contrast (1 = same signal as muscle, 4 = much brighter than muscle) and vascular pathology by two independent readers, with a separate experienced reader providing reference assessment of vascular pathology. Results: Median image quality was diagnostic or better (score ≥3) for ECA and BPA at all time points, with BPA image quality superior at abduction late (BPA 4.5, ECA 4, p = 0.042) and ECA image quality superior at adduction-early (BPA 4.5; ECA 4.0, p = 0.018). High qualitative vessel contrast (mean score ≥3) was observed at all time points with both BPA and ECA, with superior BPA vessel contrast at abduction-late (BPA 3.97 ± 0.12; ECA 3.73 ± 0.26, p = 0.007) and ECA at adduction-early (BPA 3.42 ± 0.52; ECA 3.96 ± 0.14, p < 0.001). Readers readily identified arterial and venous pathology with BPA, similar to ECA examinations. Conclusion: Single-injection BPA MRA/MRV for TOS evaluation demonstrated diagnostic image quality and high vessel contrast, similar to dual-injection ECA imaging, enabling identification of fixed and functional arterial and venous pathology

  18. Blood Pool Contrast-enhanced Magnetic Resonance Angiography with Correlation to Digital Subtraction Angiography: A Pictorial Review

    Directory of Open Access Journals (Sweden)

    Martha-Grace Knuttinen

    2014-01-01

    Full Text Available Magnetic resonance angiography (MRA provides noninvasive visualization of the vascular supply of soft tissue masses and vascular pathology, without harmful radiation. This is important for planning an endovascular intervention, and helps to evaluate the efficiency and effectiveness of the treatment. MRA with conventional extracellular contrast agents relies on accurate contrast bolus timing, limiting the imaging window to first-pass arterial phase. The recently introduced blood pool contrast agent (BPCA, gadofosveset trisodium, reversibly binds to human serum albumin, resulting in increased T1 relaxivity and prolonged intravascular retention time, permitting both first-pass and steady-state phase high-resolution imaging. In our practice, high-quality MRA serves as a detailed "roadmap" for the needed endovascular intervention. Cases of aortoiliac occlusive disease, inferior vena cava thrombus, pelvic congestion syndrome, and lower extremity arteriovenous malformation are discussed in this article. MRA was acquired at 1.5 T with an 8-channel phased array coil after intravenous administration of gadofosveset (0.03 mmol/kg body weight, at the first-pass phase. In the steady-state, serial T1-weighted 3D spoiled gradient echo images were obtained with high resolution. All patients underwent digital subtraction angiography (DSA and endovascular treatment. MRA and DSA findings of vascular anatomy and pathology are discussed and correlated. BPCA-enhanced MRA provides high-quality first-pass and steady-state vascular imaging. This could increase the diagnostic accuracy and create a detailed map for pre-intervention planning. Understanding the pharmacokinetics of BPCA and being familiar with the indications and technique of MRA are important for diagnosis and endovascular intervention.

  19. Short-term effects of oral dronedarone administration on cardiac function, blood pressure and electrocardiogram in conscious telemetry dogs.

    Science.gov (United States)

    Saengklub, Nakkawee; Youngblood, Brad; Del Rio, Carlos; Sawangkoon, Suwanakiet; Hamlin, Robert L; Kijtawornrat, Anusak

    2016-07-01

    Dronedarone is a multichannel blocking antiarrhythmic drug that has been used for management of atrial fibrillation in humans, but the data in veterinary medicine are inadequate. The objective of this study was to determine the short-term effects of oral dronedarone on cardiac inotropy and lusitropy, blood pressure and electrocardiogram (ECG) in healthy dogs. A total of 6 beagle dogs were instrumented with telemetry units and sono-micrometry crystals to obtain left ventricular pressure-volume relationship, mean blood pressure (MBP) and ECG. Dogs were given orally dronedarone (20 mg/kg, twice per day) for 7 days. All parameters were obtained hourly at 4-8 hr after the first dose and at 12-, 96- (day 4) and 168-hr (day 7) after dosing. The results showed that dronedarone had no effect on inotropy and lusitropy, while it significantly lengthened PQ interval (P<0.001) and lowered MBP (P<0.05). Dronedarone also tended to reduce cardiac output (P=0.237) and heart rate (P=0.057). These results suggested that short-term effects of oral dronedarone administration at a dose of 20 mg/kg, twice per day, produced negative dromotropy with minimal effect on cardiac function in conscious dogs. PMID:26922916

  20. Are antifibrinolytic drugs equivalent in reducing blood loss and transfusion in cardiac surgery? A meta-analysis of randomized head-to-head trials

    Directory of Open Access Journals (Sweden)

    Stokes Barrie J

    2005-07-01

    Full Text Available Abstract Background Aprotinin has been shown to be effective in reducing peri-operative blood loss and the need for re-operation due to continued bleeding in cardiac surgery. The lysine analogues tranexamic acid (TXA and epsilon aminocaproic acid (EACA are cheaper, but it is not known if they are as effective as aprotinin. Methods Studies were identified by searching electronic databases and bibliographies of published articles. Data from head-to-head trials were pooled using a conventional (Cochrane meta-analytic approach and a Bayesian approach which estimated the posterior probability of TXA and EACA being equivalent to aprotinin; we used as a non-inferiority boundary a 20% increase in the rates of transfusion or re-operation because of bleeding. Results Peri-operative blood loss was significantly greater with TXA and EACA than with aprotinin: weighted mean differences were 106 mls (95% CI 37 to 227 mls and 185 mls (95% CI 134 to 235 mls respectively. The pooled relative risks (RR of receiving an allogeneic red blood cell (RBC transfusion with TXA and EACA, compared with aprotinin, were 1.08 (95% CI 0.88 to 1.32 and 1.14 (95% CI 0.84 to 1.55 respectively. The equivalent Bayesian posterior mean relative risks were 1.15 (95% Bayesian Credible Interval [BCI] 0.90 to 1.68 and 1.21 (95% BCI 0.79 to 1.82 respectively. For transfusion, using a 20% non-inferiority boundary, the posterior probabilities of TXA and EACA being non-inferior to aprotinin were 0.82 and 0.76 respectively. For re-operation the Cochrane RR for TXA vs. aprotinin was 0.98 (95% CI 0.51 to 1.88, compared with a posterior mean Bayesian RR of 0.63 (95% BCI 0.16 to 1.46. The posterior probability of TXA being non-inferior to aprotinin was 0.92, but this was sensitive to the inclusion of one small trial. Conclusion The available data are conflicting regarding the equivalence of lysine analogues and aprotinin in reducing peri-operative bleeding, transfusion and the need for re

  1. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    OpenAIRE

    Johannes Salamon; Martin Hofmann; Caroline Jung; Michael Gerhard Kaul; Franziska Werner; Kolja Them; Rudolph Reimer; Peter Nielsen; Annika Vom Scheidt; Gerhard Adam; Tobias Knopp; Harald Ittrich

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superp...

  2. Influence of a hyperlipidic diet on the composition of the non-membrane lipid pool of red blood cells of male and female rats.

    OpenAIRE

    Remesar, Xavier; Antelo, Arantxa; Llivina, Clàudia; Albà, Emma; Berdié, Lourdes; Agnelli, Silvia; Arriarán, Sofía; Fernández-López, José Antonio; Alemany, Marià

    2015-01-01

    Background and objectives. Red blood cells (RBC) are continuously exposed to oxidative agents, affecting their membrane lipid function. However, the amount of lipid in RBCs is higher than the lipids of the cell membrane, and includes triacylglycerols, which are no membrane components. We assumed that the extra lipids originated from lipoproteins attached to the cell surface, and we intended to analyse whether the size and composition of this lipid pool were affected by sex or diet. Experiment...

  3. Monitoring and evaluation of lymphatic filariasis interventions: an improved PCR-based pool screening method for high throughput Wuchereria bancrofti detection using dried blood spots

    OpenAIRE

    Plichart, Catherine; Lemoine, Aurore

    2013-01-01

    Background Effective diagnostic tools are necessary to monitor and evaluate interruption of Lymphatic Filariasis (LF) transmission. Accurate detection of Wuchereria bancrofti (Wb) microfilaria (mf) is essential to measure the impact of community treatment programmes. PCR-based assays are specific, highly sensitive tools allowing the detection of Wuchereria bancrofti DNA in human blood samples. However, current protocols describing the pool screening approach, use samples of less than 60 μl of...

  4. Using high resolution cardiac CT data to model and visualize patient-specific interactions between trabeculae and blood flow.

    Science.gov (United States)

    Kulp, Scott; Gao, Mingchen; Zhang, Shaoting; Qian, Zhen; Voros, Szilard; Metaxas, Dimitris; Axel, Leon

    2011-01-01

    In this paper, we present a method to simulate and visualize blood flow through the human heart, using the reconstructed 4D motion of the endocardial surface of the left ventricle as boundary conditions. The reconstruction captures the motion of the full 3D surfaces of the complex features, such as the papillary muscles and the ventricular trabeculae. We use visualizations of the flow field to view the interactions between the blood and the trabeculae in far more detail than has been achieved previously, which promises to give a better understanding of cardiac flow. Finally, we use our simulation results to compare the blood flow within one healthy heart and two diseased hearts. PMID:22003651

  5. Pulmonary Hemorrhage: Imaging with a New Magnetic Resonance Blood Pool Agent in Conjunction with Breathheld Three-Dimensional Magnetic Resonance Angiography

    International Nuclear Information System (INIS)

    Purpose: To describe the three-dimensional magnetic resonance angiography (3D MRA) imaging appearance of the pulmonary arteries following administration of a superparamagnetic iron oxide blood pool agent to human volunteers, and to demonstrate in an animal model (pigs) how this technique can be used to detect pulmonary parenchymal hemorrhage. Methods: Two volunteers were examined following the intravenous administration of a superparamagnetic iron oxide blood pool agent (NC100150 Injection, Nycomed Amersham Imaging, Wayne, PA, USA). T1-weighted 3D gradient recalled echo (GRE) image sets (TR/TE 5.1/1.4 msec, flip angle 30 deg.) were acquired breathheld over 24 sec. To assess the detectability of pulmonary bleeding with intravascular MR contrast, pulmonary parenchymal injuries were created in two animals under general anesthesia, and fast T1-weighted 3D GRE image sets collected before and after the injury. Results: Administration of the intravascular contrast in the two volunteers resulted in selective enhancement of the pulmonary vasculature permitting complete visualization and excellent delineation of central, segmental, and subsegmental arteries. Following iatrogenic injury in the two animals, pulmonary hemorrhage was readily detected on the 3D image sets. Conclusion: The data presented illustrate that ultrafast 3D GRE MR imaging in conjunction with an intravenously administered intravascular blood pool agent can be used to perform high-quality pulmonary MRA as well as to detect pulmonary hemorrhage

  6. Study on improvement of detectability of abnormal wall motion of the left ventricle by factor analysis of the gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    The author developed a new zooming method for rectangular left ventricular region of interest (LVROI) in which the left ventricle (LV) was selected and set at the left edge of the rectangular ROI, allowing image magnification in factor analysis of gated blood pool study. When factor analysis of gated blood pool study was performed using the rectangular LVROI method in 10 normal subjects, three factors were extracted, such as an atrial factor, LV factor, and factor with slight hypokinetic time activity curve at the base of LV. In 18 patients with angina pectoris, the detectability of left ventricular wall motion abnormality (LVWMA) was 83 % with the rectangular LVROI method as compared with 50 % with the whole heart LVROI method and 64 % with regional ejection fraction imaging. For 14 patients with angiographically proven significant stenosis, the detectability of LVWMA was significantly higher with the rectangular LVROI (86 %) than two other methods (40 % and 64 %). Factor analysis was of limited value in detecting LVWMA in cases of diffuse hypokinesis demonstrated by echocardiography and regional ejection fraction imaging. In the factor analysis of gated blood pool study, the rectangular IVROI was found useful for the detection of LVWMA in ischemic heart disease. (Namekawa, K.)

  7. Reduced peripheral arterial blood flow with preserved cardiac output during submaximal bicycle exercise in elderly heart failure

    Directory of Open Access Journals (Sweden)

    Leng Xiaoyan

    2009-11-01

    Full Text Available Abstract Background Older heart failure (HF patients exhibit exercise intolerance during activities of daily living. We hypothesized that reduced lower extremity blood flow (LBF due to reduced forward cardiac output would contribute to submaximal exercise intolerance in older HF patients. Methods and Results Twelve HF patients both with preserved and reduced left ventricular ejection fraction (LVEF (aged 68 ± 10 years without large (aorta or medium sized (iliac or femoral artery vessel atherosclerosis, and 13 age and gender matched healthy volunteers underwent a sophisticated battery of assessments including a peak exercise oxygen consumption (peak VO2, b physical function, c cardiovascular magnetic resonance (CMR submaximal exercise measures of aortic and femoral arterial blood flow, and d determination of thigh muscle area. Peak VO2 was reduced in HF subjects (14 ± 3 ml/kg/min compared to healthy elderly subjects (20 ± 6 ml/kg/min (p = 0.01. Four-meter walk speed was 1.35 ± 0.24 m/sec in healthy elderly verses 0.98 ± 0.15 m/sec in HF subjects (p p ≤ 0.03. Conclusion During CMR submaximal bike exercise in the elderly with heart failure, mechanisms other than low cardiac output are responsible for reduced lower extremity blood flow.

  8. Computational Modeling of Open-Irrigated Electrodes for Radiofrequency Cardiac Ablation Including Blood Motion-Saline Flow Interaction

    Science.gov (United States)

    González-Suárez, Ana; Berjano, Enrique; Guerra, Jose M.; Gerardo-Giorda, Luca

    2016-01-01

    Radiofrequency catheter ablation (RFCA) is a routine treatment for cardiac arrhythmias. During RFCA, the electrode-tissue interface temperature should be kept below 80°C to avoid thrombus formation. Open-irrigated electrodes facilitate power delivery while keeping low temperatures around the catheter. No computational model of an open-irrigated electrode in endocardial RFCA accounting for both the saline irrigation flow and the blood motion in the cardiac chamber has been proposed yet. We present the first computational model including both effects at once. The model has been validated against existing experimental results. Computational results showed that the surface lesion width and blood temperature are affected by both the electrode design and the irrigation flow rate. Smaller surface lesion widths and blood temperatures are obtained with higher irrigation flow rate, while the lesion depth is not affected by changing the irrigation flow rate. Larger lesions are obtained with increasing power and the electrode-tissue contact. Also, larger lesions are obtained when electrode is placed horizontally. Overall, the computational findings are in close agreement with previous experimental results providing an excellent tool for future catheter research. PMID:26938638

  9. Intima-media thickness evaluation by B-mode ultrasound: Correlation with blood pressure levels and cardiac structures

    Directory of Open Access Journals (Sweden)

    F.L. Plavnik

    2000-01-01

    Full Text Available The aim of this study was to analyze the thickness of the intima-media complex (IMC using a noninvasive method. The carotid and femoral common arteries were evaluated by noninvasive B-mode ultrasound in 63 normotensive and in 52 hypertensive subjects and the thickness of the IMC was tested for correlation with blood pressure, cardiac structures and several clinical and biological parameters. The IMC was thicker in hypertensive than in normotensive subjects (0.67 ± 0.13 and 0.62 ± 0.16 vs 0.54 ± 0.09 and 0.52 ± 0.11 mm, respectively, P<0.0001. In normotensive patients, the simple linear regression showed significant correlations between IMC and age, body mass index and 24-h systolic blood pressure for both the carotid and femoral arteries. In hypertensives the carotid IMC was correlated with age and 24-h systolic blood pressure while femoral IMC was correlated only with 24-h diastolic blood pressure. Forward stepwise regression showed that age, body mass index and 24-h systolic blood pressure influenced the carotid IMC relationship (r2 = 0.39 in normotensives. On the other hand, the femoral IMC relationship was influenced by 24-h systolic blood pressure and age (r2 = 0.40. In hypertensives, age and 24-h systolic blood pressure were the most important determinants of carotid IMC (r2 = 0.37, while femoral IMC was influenced only by 24-h diastolic blood pressure (r2 = 0.10. There was an association between carotid IMC and echocardiographic findings in normotensives, while in hypertensives only the left posterior wall and interventricular septum were associated with femoral IMC. We conclude that age and blood pressure influence the intima-media thickness, while echocardiographic changes are associated with the IMC.

  10. Exercise-related change in airway blood flow in humans: Relationship to changes in cardiac output and ventilation

    OpenAIRE

    Morris, Norman R; Ceridon, Maile L.; Beck, Kenneth C.; Strom, Nicholas A.; Schneider, Donald A; Mendes, Eliana S; Wanner, Adam; Johnson, Bruce D.

    2008-01-01

    This study examined the relationship between airway blood flow (Q̇aw), ventilation (V̇E) and cardiac output (Q̇tot) during exercise in healthy humans (n = 12, mean age 34 ± 11 yr). Q̇aw was estimated from the uptake of the soluble gas dimethyl ether while V̇E and Q̇tot were measured using open circuit spirometry. Measurements were made prior to and during exercise at 34 ± 5W (Load 1) and 68 ± 10 W (Load 2) and following the cessation of exercise (recovery). Q̇aw increased in a stepwise fashio...

  11. Evaluation of adjusted central venous blood gases versus arterial blood gases of patients in post-operative paediatric cardiac surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Naveen G Singh

    2015-01-01

    Full Text Available Background and Aims: Central venous catheters are in situ in most of the intensive care unit (ICU patients, which may be an alternative for determining acid-base status and can reduce complications from prolonged arterial cannulation. The aim of this study was to examine the reliability between adjusted central venous blood gas (aVBG and arterial blood gas (ABG samples for pH, partial pressure of carbon-di-oxide (pCO2, bicarbonate (HCO3−, base excess (BE and lactates in paediatric cardiac surgical ICU. Methods: We applied blood gas adjustment rule, that is aVBG pH = venous blood gas (VBG pH +0.05, aVBG CO2 = VBG pCO2 - 5 mm Hg from the prior studies. In this study, we validated this relationship with simultaneous arterial and central venous blood obtained from 30 patients with four blood sample pairs each in paediatric cardiac surgical ICU patients. Results: There was a strong correlation (R i.e., Pearson's correlation between ABG and aVBG for pH = 0.9544, pCO2 = 0.8738, lactate = 0.9741, HCO3− = 0.9650 and BE = 0.9778. Intraclass correlation co-efficients (ICCs for agreement improved after applying the adjustment rule to venous pH (0.7505 to 0.9454 and pCO2 (0.4354 to 0.741. Bland Altman showed bias (and limits of agreement for pH: 0.008 (−0.04 to + 0.057, pCO2: −3.52 (–9.68 to +2.65, lactate: −0.10 (−0.51 to +0.30, HCO3−: −2.3 (–5.11 to +0.50 and BE: −0.80 (−3.09 to +1.49. Conclusion: ABG and aVBG samples showed strong correlation, acceptable mean differences and improved agreement (high ICC after adjusting the VBG. Hence, it can be promising to use trend values of VBG instead of ABG in conjunction with a correction factor under stable haemodynamic conditions.

  12. Evaluation of the cardiac performance in patients with coronary arterty disease by the pulmonary blood volume change in exercise testing

    International Nuclear Information System (INIS)

    Evaluation of the cardiac performance was studied by the change of the pulmonary blood volume (PBV) during the exercise testing in 17 normal subjects (group N), 18 patients with angina pectoris (group A) and 25 with both old myocardial infarction and angina pectoris (group M). The exercise testing was performed by bicycle ergometer in supine position. Blood pressure, heart rate, cardiac output measured by dye dilution method, left ventricular ejection fraction (EF) by multi-gate method, pulmonary artery pressure by Swan-Ganz catheter and PBV was measured during exercise. PBV was estimated by the radioactivity of the systemically administered Tc-99m labeled RBC in the lung field. ROI was adjusted over the right upper and lower lung field. And also the effect of the nitroglycerin was examined. In the result, (1) EF at the peak exercise increased in group N but decreased in Groups A and M. (2) Increased pulmonary artery diastolic pressure at the peak exercise (PAd at exercise) was remarkably higher in groups A and M than group M. (3) PBV was unchanged in group N; however, increased 9.6% in group A and 10.9% in group M. (4) Increased rate of PBV revealed good correlation with ΔEF (r=-0.68, p<0.01) and PAd at exercise (r=0.83, p<0.01), and was considered as the pulmonary congestion due to left ventricular dysfunction. (5) After the sublingual administration of nitroglycerin, the increased PAd and PBV at the peak exercise was suppressed. Particularly, it was remarkable in group A. Thus it was concluded that the noninvasive measurement of PBV during exercise could suggest the extent of the pulmonary congestion and was very useful for evaluation of the cardiac performance in coronary artery disease. (author)

  13. Proposta do uso de pool de sangue total como controle interno de qualidade em hematologia Proposal for the use of a pool of whole blood as internal quality control in hematology

    Directory of Open Access Journals (Sweden)

    Carina Daniele Schons

    2010-06-01

    Full Text Available INTRODUÇÃO: A confiabilidade dos resultados do laboratório é garantida pela realização do controle de qualidade, que tem como funções básicas análise, pesquisa e prevenção da ocorrência de erros laboratoriais por meio de programas que abrangem tanto o controle interno quanto o externo. OBJETIVO: Propor a padronização de utilização de pool de sangue total como controle interno de qualidade no setor de hematologia. MÉTODO: Foram selecionadas amostras de sangue total, colhidas com ácido etilenodiaminotetracético (EDTA, de mesmos grupo sanguíneo e fator Rh, livres de interferentes, como hemólise, lipemia e icterícia. De um total de 30 ml de sangue total, obtiveram-se três alíquotas de 10 ml cada, às quais foram adicionados, respectivamente, 0 ml (sem adição, 1 ml e 5 ml de glicerol (conservante. As amostras foram avaliadas em contador automático ADVIA® 60. Após determinação dos valores de média e DP, todas as amostras foram avaliadas por um período de 45 dias úteis para confecção do gráfico de Levey-Jennings e verificação da estabilidade da amostra. RESULTADO E CONCLUSÃO: Podemos verificar que o pool de sangue total, preparado de acordo com a metodologia proposta, não apresenta estabilidade necessária para sua utilização, como controle interno alternativo no setor de hematologia.INTRODUCTION: The reliability of laboratory results is ensured by the implementation of quality control, which has basic functions, such as analysis, research and prevention of laboratory errors through programs that encompass both internal and external control. OBJECTIVE: To propose a standard method to use pooled whole blood as internal quality control in the Hematology division. METHOD: The selected whole blood samples were collected with EDTA, belonged to the same blood group and Rh factor and did not present interfering factors, such as hemolysis, lipemia and icterus. From a total of 30 ml of whole blood it was obtained 3

  14. Synthesis, relaxation properties and in vivo assessment of a carborane-GdDOTA-monoamide conjugate as an MRI blood pool contrast agent.

    Science.gov (United States)

    Goswami, Lalit N; Cai, Quanyu; Ma, Lixin; Jalisatgi, Satish S; Hawthorne, M Frederick

    2015-09-01

    The synthesis, relaxivity measurements and in vivo assessment of a carborane-GdDOTA-monoamide (CB-GdDOTA-MA) amphiphilic conjugate as a blood pool contrast agent (BPCA) is reported. This BPCA exhibited excellent binding (87.4%) with human serum albumin (HSA) and showed a higher relaxivity value (r1 = 6.8 mM(-1) s(-1), 7 T) as compared to the clinically used BPCA, MS-325 (r1 = 5.1 mM(-1) s(-1), 9.4 T) in PBS. The blood pool contrast enhancement (CE) capability of CB-GdDOTA-MA was evaluated by performing MR angiography (MRA) in CF1 mice (n = 4) at a Gd dose of 0.1 mmol per kg body weight. The significant CE of blood vessels persisted for about 3-4 min post-injection (p.i.) and quickly diminishes over time. The significant CE of the bladder for up to 3 h p.i. indicated that the renal system is the primary clearance pathway for CB-GdDOTA-MA. However, the CE of liver tissues and intestine (up to 24 h p.i.) is suggestive of a significant hepatic uptake of the CB-GdDOTA-MA. PMID:26204958

  15. The effects of residual pump blood on patient plasma free haemoglobin levels post cardiac surgery.

    Science.gov (United States)

    H, Schotola; Aj, Wetz; Af, Popov; I, Bergmann; Bc, Danner; Fa, Schöndube; M, Bauer; A, Bräuer

    2016-09-01

    At the end of cardiopulmonary bypass, there are invariably several hundred millilitres of residual pump blood in the reservoir, which can either be re-transfused or discarded. The objective of this prospective observational study was to investigate the quality of the residual pump blood, focusing on plasma free haemoglobin (pfHb) and blood cell counts. Fifty-one consecutive patients were included in the study. Forty-nine units of residual pump blood and 58 units of transfused red blood cell (RBC) concentrates were analysed. The mean preoperative pfHb of the patients was 0.057 ± 0.062 g/l, which increased gradually to 0.55 ± 0.36 g/l on arrival in the intensive care unit postoperatively. On the first postoperative day, the mean pfHb had returned to within the normal range. Our data showed that haemoglobin, haematocrit, and erythrocyte counts of residual pump blood were approximately 40% of the values in standardised RBC concentrates. Plasma free haemoglobin was significantly higher in residual pump blood compared to RBC concentrates, and nearly twice as high as the pfHb in patient blood samples taken contemporaneously. Our findings indicate that residual pump blood pfHb levels are markedly higher compared to patients' blood and RBC concentrates, but that its administration does not significantly increase patients' pfHb levels. PMID:27608341

  16. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach.

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

    Full Text Available In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI / magnetic resonance imaging (MRI road map approach and an MPI-guided approach using a blood pool tracer.A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4 was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography.Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide.4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions.

  17. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    Science.gov (United States)

    Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Results Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. Conclusions 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions. PMID:27249022

  18. Correction of counting rate drop at the end of blood pool ROI curves on the bases of the total visual field curve

    International Nuclear Information System (INIS)

    A correction method based on the constant total counting rate in the final diastolic phase is described. The method should be applied in cases without time standardisation. If Fourier techniques are used for curve smoothing and for the calculation of phase and amplitude images, also users who do not have list mode, hybrid mode or frame mode with direct correction will be able to apply the method of gated blood pool scanning. In fact, time correction at a later stage may even have some advantages. (orig.)

  19. Clinical Utilities of Peripheral Blood Gene Expression Profiling in the Management of Cardiac Transplant Patients

    OpenAIRE

    Fang, Kenneth C.

    2007-01-01

    Cardiac allografts induce host immune responses that lead to endomyocardial tissue injury and progressive graft dysfunction. Inflammatory cell infiltration and myocyte damage characterize acute cellular rejection (ACR) that presents episodically in either a subclinical or symptom-associated manner. Sampling of the endomyocardium by transvenous biopsy enables pathologic grading using light microscopic criteria to distinguish severity based on the focality or diffuseness of inflammation and ass...

  20. Case series: CT scan in cardiac arrest and imminent cardiogenic shock

    International Nuclear Information System (INIS)

    Imaging a patient having a cardiac arrest on the examination table is not a common occurrence. Altered hemodynamics resulting from pump failure causes stasis of blood in the dependent organs of the body, which is manifested on imaging by dependent contrast pooling and layering. Often a patient with imminent cardiogenic shock also shows a similar dependent contrast pooling and layering, which is a marker of the worsening clinical condition. We report the contrast-enhanced CT scan features in four cases, two of whom had cardiac arrest during imaging, while the other two developed cardiogenic shock soon after the examination. Dependent contrast pooling and layering were found in all of them, with faint or no opacification of the left cardiac chambers. Contrast pooling was noted in the dependent lumbar veins, hepatic veins, hepatic parenchyma, and the right renal vein, as well as in the dependent part of the IVC and the right heart chambers

  1. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  2. Evaluation of right and left ventricular function by quantitative blood-pool SPECT (QBS): comparison with conventional methods and quantitative gated SPECT (QGS).

    Science.gov (United States)

    Odagiri, Keiichi; Wakabayashi, Yasushi; Tawarahara, Kei; Kurata, Chinori; Urushida, Tsuyoshi; Katoh, Hideki; Satoh, Hiroshi; Hayashi, Hideharu

    2006-10-01

    Though quantitative ECG-gated blood-pool SPECT (QBS) has become a popular tool in research settings, more verification is necessary for its utilization in clinical medicine. To evaluate the reliability of the measurements of left and right ventricular functions with QBS, we performed QBS, as well as first-pass pool (FPP) and ECG-gated blood-pool (GBP) studies on planar images in 41 patients and 8 healthy volunteers. Quantitative ECG-gated myocardial perfusion SPECT (QGS) was also performed in 30 of 49 subjects. First, we assessed the reproducibility of the measurements of left and right ventricular ejection fraction (LVEF, RVEF) and left and right ventricular end-diastolic volume (LVEDV, RVEDV) with QBS. Second, LVEF and RVEF obtained from QBS were compared with those from FPP and GBP, respectively. Third, LVEF and LVEDV obtained from QBS were compared with those from QGS, respectively. The intra- and inter-observer reproducibilities were excellent for LVEF, LVEDV, RVEF and RVEDV measured with QBS (r = 0.88 to 0.96, p < 0.01), while the biases in the measurements of RVEF and RVEDV were relatively large. LVEF obtained from QBS correlated significantly with those from FPP and GBP, while RVEF from QBS did not. LVEF and LVEDV obtained from QBS were significantly correlated with those from QGS, but the regression lines were not close to the lines of identity. In conclusion, the measurements of LVEF and LVEDV with QBS have good reproducibility and are useful clinically, while those of RVEF and RVEDV are less useful compared with LVEF and LVEDV. The algorithm of QBS for the measurements of RVEF and RVEDV remains to be improved. PMID:17134018

  3. Influence of a hyperlipidic diet on the composition of the non-membrane lipid pool of red blood cells of male and female rats.

    Science.gov (United States)

    Remesar, Xavier; Antelo, Arantxa; Llivina, Clàudia; Albà, Emma; Berdié, Lourdes; Agnelli, Silvia; Arriarán, Sofía; Fernández-López, José Antonio; Alemany, Marià

    2015-01-01

    Background and objectives. Red blood cells (RBC) are continuously exposed to oxidative agents, affecting their membrane lipid function. However, the amount of lipid in RBCs is higher than the lipids of the cell membrane, and includes triacylglycerols, which are no membrane components. We assumed that the extra lipids originated from lipoproteins attached to the cell surface, and we intended to analyse whether the size and composition of this lipid pool were affected by sex or diet. Experimental design. Adult male and female Wistar rats were fed control or cafeteria diets. Packed blood cells and plasma lipids were extracted and analysed for fatty acids by methylation and GC-MS, taking care of not extracting membrane lipids. Results. The absence of ω3-PUFA in RBC extracts (but not in plasma) suggest that the lipids extracted were essentially those in the postulated lipid surface pool and not those in cell membrane. In cells' extracts, there was a marked depletion of PUFA (and, in general, of insaturation). Fatty acid patterns were similar for all groups studied, with limited effects of sex and no effects of diet in RBC (but not in plasma) fatty acids. Presence of trans fatty acids was small but higher in RBC lipids, and could not be justified by dietary sources. Conclusions. The presence of a small layer of lipid on the RBC surface may limit oxidative damage to the cell outer structures, and help explain its role in the transport of lipophilic compounds. However, there may be other, so far uncovered, additional functions for this lipid pool. PMID:26213652

  4. Evaluation of right and left ventricular function by quantitative blood-pool SPECT (QBS). Comparison with conventional methods and quantitative gated SPECT (QGS)

    International Nuclear Information System (INIS)

    Though quantitative ECG-gated blood-pool SPECT (QBS) has become a popular tool in research settings, more verification is necessary for its utilization in clinical medicine. To evaluate the reliability of the measurements of left and right ventricular functions with QBS, we performed QBS, as well as first-pass pool (FPP) and ECG-gated blood-pool (GBP) studies on planar images in 41 patients and 8 healthy volunteers. Quantitative ECG-gated myocardial perfusion SPECT (QGS) was also performed in 30 of 49 subjects. First, we assessed the reproducibility of the measurements of left and right ventricular ejection fraction (LVEF, RVEF) and left and right ventricular end-diastolic volume (LVEDV, RVEDV) with QBS. Second, LVEF and RVEF obtained from QBS were compared with those from FPP and GBP, respectively. Third, LVEF and LVEDV obtained from QBS were compared with those from QGS, respectively. The intra- and inter-observer reproducibilities were excellent for LVEF, LVEDV, RVEF and RVEDV measured with QBS (r=0.88 to 0.96, p<0.01), while the biases in the measurements of RVEF and RVEDV were relatively large. LVEF obtained from QBS correlated significantly with those from FPP and GBP, while RVEF from QBS did not. LVEF and LVEDV obtained from QBS were significantly correlated with those from QGS, but the regression lines were not close to the lines of identity. In conclusion, the measurements of LVEF and LVEDV with QBS have good reproducibility and are useful clinically, while those of RVEF and RVEDV are less useful compared with LVEF and LVEDV. The algorithm of QBS for the measurements of RVEF and RVEDV remains to be improved. (author)

  5. Blood pressure and cardiac autonomic modulation at rest, during exercise and recovery time in the young overweight

    Directory of Open Access Journals (Sweden)

    Jaqueline Alves de Araújo

    2016-03-01

    Full Text Available Abstract This study aimed to assess the blood pressure (BP, cardiac autonomic modulation at rest, in physical exercise and in the recovery in untrained eutrophic (E and overweight (O youth. The body mass index (BMI, waist circumference (WC, systolic BP-SBP (E: 109.80 ± 10.05; O: 121.85 ± 6.98 mmHg and diastolic BP - DBP (E: 65.90 ± 7.28; O: 73.14 ± 12.22 mmHg were higher in overweight and the heart rate recovery (%HRR was lower as compared with E volunteers. The BMI was associated with SBP (r= 0.54, DBP (r= 0.65, load on the heart rate variability threshold - HRVT (r= -0.46, %HRR 2' (r= -0.48 and %HRR 5' (r= -0.48, and WC was associated with SBP (r= 0.54, DBP (r= 0.64 and HRR 2' (r= -0.49. The %HRR was associated to SBP, DBP and HRVT. In summary, the anthropometric variables, BP and cardiac autonomic modulation in the recovery are altered in overweight youth.

  6. Cardiac and blood pressure responses to mental stress in reactive hypertensives.

    Science.gov (United States)

    Pannarale, G; Isea, J E; Coats, A J; Conway, J; Sleight, P

    1991-01-01

    To study the haemodynamic response to a standardized mental stress, we measured ascending aorta velocity using Doppler ultrasonography in 20 reactive ("white-coat") hypertensives and 20 age and sex matched normal controls (NC) familiar with the hospital setting. Reactive hypertensives (RH) had 3 office diastolic BP recordings between 90-110 mmHg and ambulatory BP less than 140/90 mmHg. The cardiac response to mental arithmetic was greater in RH than NC (minute distance, RH: +36.7 +/- 40.2% vs NC: +10.3 +/- 19%, p less than 0.05; peak velocity, RH: +8.4 +/- 16.5% vs NC: -1.4 +/- 11.9%, p less than 0.05), and there was a different peripheral resistance response (RH: -12.2 +/- 24.2% vs NC: +6.5 +/- 22%, p less than 0.05). We suggest that subjects with reactive hypertension have a strong cardiac response to mental stress and this could be a characteristic of this condition. PMID:2022068

  7. Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI

    International Nuclear Information System (INIS)

    To investigate the feasibility of MRI for non-invasive assessment of the coronary sinus (CS) and the number and course of its major tributaries in heart failure patients. Fourteen non-ischaemic heart failure patients scheduled for cardiac resynchronisation therapy (CRT) underwent additional whole-heart coronary venography. MRI was performed 1 day before device implantation. The visibility, location and dimensions of the CS and its major tributaries were assessed and the number of potential implantation sites identified. The MRI results were validated by X-ray venography conventionally acquired during the device implantation procedure. The right atrium (RA), CS and mid-cardiac vein (MCV) could be visualised in all patients. 36% of the identified candidate branches were located posterolaterally, 48% laterally and 16% anterolaterally. The average diameter of the CS was quantified as 9.8 mm, the posterior interventricular vein (PIV) 4.6 mm, posterolateral segments 3.3 mm, lateral 2.9 mm and anterolateral 2.9 mm. Concordance with X-ray in terms of number and location of candidate branches was given in most cases. Contrast-enhanced MRI venography appears feasible for non-invasive pre-interventional assessment of the course of the CS and its major tributaries. (orig.)

  8. Hemoglobin Targets and Blood Transfusions in Hemodialysis Patients without Symptomatic Cardiac Disease Receiving Erythropoietin Therapy

    OpenAIRE

    Foley, Robert N.; Curtis, Bryan M.; Parfrey, Patrick S.

    2008-01-01

    Background and objectives: Optimal hemoglobin targets for chronic kidney disease patients receiving erythropoiesis-stimulating agents remain controversial. The effects of different hemoglobin targets on blood transfusion requirements have not been well characterized, despite their relevance to clinical decision-making.

  9. Coupling Between Blood Pressure And Heart Rate as Markers of Sudden Cardiac Death

    Czech Academy of Sciences Publication Activity Database

    Halámek, Josef; Jurák, Pavel; Kára, T.; Nykodým, J.; Eisenberger, M.; Souček, M.

    Brno : Brno University of Technology, 2004, s. 352-354. ISBN 80-214-2633-0. ISSN 1211-412X. [Biosignal 2004 /17./. Brno (CZ), 23.06.2004-25.06.2004] R&D Projects: GA ČR GA102/02/1339 Keywords : heart rate * systolic blood pressure * cardioverterdefibrilator Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  10. Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval.

    Science.gov (United States)

    Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  11. Cerebral blood flow during cardiopulmonary bypass in pediatric cardiac surgery: the role of transcranial Doppler – a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Sanders Stephen P

    2006-12-01

    Full Text Available Abstract Background Transcranial Doppler Ultrasound (TCD is a sensitive, real time tool for monitoring cerebral blood flow velocity (CBFV. This technique is fast, accurate, reproducible and noninvasive. In the setting of congenital heart surgery, TCD finds application in the evaluation of cerebral blood flow variations during cardiopulmonary bypass (CPB. Methodology We performed a search on human studies published on the MEDLINE using the keyword "trans cranial Doppler" crossed with "pediatric cardiac surgery" AND "cardio pulmonary by pass", OR deep hypothermic cardiac arrest", OR "neurological monitoring". Discussion Current scientific evidence suggests a good correlation between changes in cbral blood flow and mean cerebral artery (MCA blood flow velocity. The introduction of Doppler technology has allowed an accurate monitorization of cerebral blood flow (CBF during circulatory arrest and low-flow CPB. TCD has also been utilized in detecting cerebral emboli, improper cannulation or cross clamping of aortic arch vessels. Limitations of TCD routine utilization are represented by the need of a learning curve and some experience by the operators, as well as the need of implementing CBF informations with, for example, data on brain tissue oxygen delivery and consumption. Conclusion In this light, TCD plays an essential role in multimodal neurological monitorization during CPB (Near Infrared Spectroscopy, TCD, processed electro encephalography that, according to recent studies, can help to significantly improve neurological outcome after cardiac surgery in neonates and pediatric patients.

  12. Quantitative evaluation of MR perfusion imaging using blood pool contrast agent in subjects without pulmonary diseases and in patients with pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Hansch, Andreas; Hinneburg, Uta [University Hospital Jena, Institute of Diagnostic and Interventional Radiology II, Jena (Germany); University Hospital Jena, Institute of Diagnostic and Interventional Radiology II, Gera (Germany); Kohlmann, Peter; Laue, Hendrik [Fraunhofer MEVIS - Institute for Medical Image Computing, Bremen (Germany); Boettcher, Joachim [SRH Klinikum Gera, Institute of Diagnostic and Interventional Radiology, Gera (Germany); Malich, Ansgar [Suedharzkrankenhaus Nordhausen, Institute of Diagnostic and Interventional Radiology, Nordhausen (Germany); Wolf, Gunter [University Hospital Jena, Department of Internal Medicine III, Jena (Germany); Pfeil, Alexander [University Hospital Jena, Institute of Diagnostic and Interventional Radiology II, Jena (Germany); University Hospital Jena, Institute of Diagnostic and Interventional Radiology II, Gera (Germany); University Hospital Jena, Department of Internal Medicine III, Jena (Germany)

    2012-08-15

    To assess the feasibility of time-resolved parallel three-dimensional magnetic resonance imaging (MRI) for quantitative analysis of pulmonary perfusion using a blood pool contrast agent. Quantitative perfusion analysis was performed using novel software to assess pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) in a quantitative manner. The evaluation of lung perfusion in the normal subjects showed an increase of PBF, PBV ventrally to dorsally (gravitational direction), and the highest values at the upper lobe, with a decrease to the middle and lower lobe (isogravitational direction). MTT showed no relevant changes in either the gravitational or isogravitational directions. In comparison with normally perfused lung areas (in diseased patients), the pulmonary embolism (PE) regions showed a significantly lower mean PBF (20 {+-} 0.6 ml/100 ml/min, normal region 94 {+-} 1 ml/100 ml/min; P < 0.001), mean PBV (2 {+-} 0.1 ml/100 ml, normal region 9.8 {+-} 0.1 ml/100 ml; P < 0.001) and mean MTT (3.8 {+-} 0.1 s; normal region 6.3 {+-} 0.1; P < 0.001). Our results demonstrate the feasibility of using time-resolved dynamic contrast-enhanced MRI to determine normal range and regional variation of pulmonary perfusion and perfusion deficits in patients with PE. (orig.)

  13. Quantitative evaluation of MR perfusion imaging using blood pool contrast agent in subjects without pulmonary diseases and in patients with pulmonary embolism

    International Nuclear Information System (INIS)

    To assess the feasibility of time-resolved parallel three-dimensional magnetic resonance imaging (MRI) for quantitative analysis of pulmonary perfusion using a blood pool contrast agent. Quantitative perfusion analysis was performed using novel software to assess pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) in a quantitative manner. The evaluation of lung perfusion in the normal subjects showed an increase of PBF, PBV ventrally to dorsally (gravitational direction), and the highest values at the upper lobe, with a decrease to the middle and lower lobe (isogravitational direction). MTT showed no relevant changes in either the gravitational or isogravitational directions. In comparison with normally perfused lung areas (in diseased patients), the pulmonary embolism (PE) regions showed a significantly lower mean PBF (20 ± 0.6 ml/100 ml/min, normal region 94 ± 1 ml/100 ml/min; P < 0.001), mean PBV (2 ± 0.1 ml/100 ml, normal region 9.8 ± 0.1 ml/100 ml; P < 0.001) and mean MTT (3.8 ± 0.1 s; normal region 6.3 ± 0.1; P < 0.001). Our results demonstrate the feasibility of using time-resolved dynamic contrast-enhanced MRI to determine normal range and regional variation of pulmonary perfusion and perfusion deficits in patients with PE. (orig.)

  14. Blood transfusion is associated with increased resource utilisation, morbidity and mortality in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Scott Bharathi

    2008-01-01

    Full Text Available The purpose of the present investigation was to examine the impact of blood transfusion on resource utilisation, morbidity and mortality in patients undergoing coronary artery bypass graft (CABG surgery at a major university hospital. The resources we examined are time to extubation, intensive care unit length of stay (ICULOS and postoperative length of stay (PLOS. We further examined the impact of number of units of packed red blood cells (PRBCs transfused during PLOS. This is a retrospective observational study and includes 1746 consecutive male and female patients undergoing primary CABG (on- and off-pump at our institution. Of these, 1067 patients received blood transfusions, while 677 did not. The data regarding the demography, blood transfusion, resource utilisation, morbidity and mortality were collected from the records of patients undergoing CABG over a period of three years. The mean time to extubation following surgery was 8.0 h for the transfused group and 4.3 h for the nontransfused group ( P ≤ 0.001. The mean ICULOS for the transfused group was 1.6 d and 1.2 d for the nontransfused group ( P < 0.001. The PLOS was 7.2 d for the transfused group and 4.3 d for no-transfused cohorts ( P ≤ 0.001. In all patients and in patients with no preoperative morbidity, partial correlation coefficients were used to examine the effects of transfusion on mortality, time to extubation, ICULOS and PLOS. Linear regression model was used to assess the effect of number of PRBC units transfused on PLOS. We noted that PLOS increased with the number of PRBCs units transfused. Transfusion is significantly correlated with the increased time to extubation, ICULOS, PLOS and mortality. The transfused patients had significantly more postoperative complications than their nontransfused counterparts ( P ≤ 0.001. The 30-day hospital mortality was 3.1% for the transfused group with no deaths in the nontransfused group ( P ≤ 0.001. We conclude that the CABG

  15. Preliminary evaluation of treatment efficacy of umbilical cord blood-derived mesenchymal stem cell-differentiated cardiac pro-genitor cells in a myocardial injury mouse model

    Directory of Open Access Journals (Sweden)

    Truc Le-Buu Pham

    2015-12-01

    Full Text Available Recently, stem cell therapy has been investigated as a strategy to prevent or reverse damage to heart tissue. Although the results of cell transplantation in animal models and patients with myocardial ischemia are promising, the selection of the appropriate cell type remains an issue that requires consideration. In this study, we aimed to evaluate the effect of cardiac progenitor cell transplantation in a mouse model of myocardial ischemia. The cardiac progenitor cells used for transplantation were differentiated from umbilical cord blood mesenchymal stem cells. Animal models injected with phosphate-buffered saline (PBS and healthy mice were used as controls. Cell grafting was assessed by changes in blood pressure and histological evaluation. After 14 days of transplantation, the results demonstrated that the blood pressure of transplanted mice was stable, similar to healthy mice, whereas it fluctuated in PBS-injected mice. Histological analysis showed that heart tissue had regenerated in transplanted mice, but remained damaged in PBS-injected mice. Furthermore, trichrome staining revealed that the transplanted mice did not generate significant amount of scar tissue compared with PBS-injected control mice. In addition, the cardiac progenitor cells managed to survive and integrate with local cells in cell-injected heart tissue 14 days after transplantation. Most importantly, the transplanted cells did not exhibit tumorigenesis. In conclusion, cardiac progenitor cell transplantation produced a positive effect in a mouse model of myocardial ischemia. [Biomed Res Ther 2015; 2(12.000: 435-445

  16. Validation of Perfusion Quantification with 3D Gradient Echo Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using a Blood Pool Contrast Agent in Skeletal Swine Muscle.

    Directory of Open Access Journals (Sweden)

    Stefan Hindel

    Full Text Available The purpose of our study was to validate perfusion quantification in a low-perfused tissue by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI with shared k-space sampling using a blood pool contrast agent. Perfusion measurements were performed in a total of seven female pigs. An ultrasonic Doppler probe was attached to the right femoral artery to determine total flow in the hind leg musculature. The femoral artery was catheterized for continuous local administration of adenosine to increase blood flow up to four times the baseline level. Three different stable perfusion levels were induced. The MR protocol included a 3D gradient-echo sequence with a temporal resolution of approximately 1.5 seconds. Before each dynamic sequence, static MR images were acquired with flip angles of 5°, 10°, 20°, and 30°. Both static and dynamic images were used to generate relaxation rate and baseline magnetization maps with a flip angle method. 0.1 mL/kg body weight of blood pool contrast medium was injected via a central venous catheter at a flow rate of 5 mL/s. The right hind leg was segmented in 3D into medial, cranial, lateral, and pelvic thigh muscles, lower leg, bones, skin, and fat. The arterial input function (AIF was measured in the aorta. Perfusion of the different anatomic regions was calculated using a one- and a two-compartment model with delay- and dispersion-corrected AIFs. The F-test for model comparison was used to decide whether to use the results of the one- or two-compartment model fit. Total flow was calculated by integrating volume-weighted perfusion values over the whole measured region. The resulting values of delay, dispersion, blood volume, mean transit time, and flow were all in physiologically and physically reasonable ranges. In 107 of 160 ROIs, the blood signal was separated, using a two-compartment model, into a capillary and an arteriolar signal contribution, decided by the F-test. Overall flow in hind leg muscles

  17. Cation exchange separation of 61Cu2+ from natCo targets and preparation of 61Cu-DOTA-HSA as a blood pool agent

    International Nuclear Information System (INIS)

    An improved method for isolation of 61Cu2+ from a natCo target using cation exchange was developed. 61Cu2+ was eluted from a cation exchange resin column by 0.2 M HCl with 90% acetone, while Co2+ remained on the column. The whole separation process was completed within 50 min at more than 72% yield. The Co2+ impurity level in 61Cu2+ solution was reduced to less than 0.1 ppm. Highly pure 61Cu2+ solution was then applied to prepare 61Cu-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-human serum albumin (HSA) which showed good blood pool imaging properties

  18. Critical appraisal and pooled analysis of telmisartan alone or in combination with hydrochlorothiazide for achieving blood pressure goals

    OpenAIRE

    Morimoto,

    2010-01-01

    Satoshi Morimoto, Nobuyuki Takahashi, Tatsuyori Morita, Kazunori Someya, Nagaoki Toyoda, Toshiji IwasakaSecond Department of Internal Medicine, Kansai Medical University 2-3-1, Shinmachi, Hirakata, Osaka 573-1191, JapanAbstract: Rigid control of blood pressure (BP) is essential to prevent cardiovascular disease. However, only about 40% of hypertensive patients undergoing pharmacological intervention with a single agent achieve their BP goals in contemporary clinical practice. Combined therapy...

  19. The Agreement Between Blood Pool - Delayed Bone Scintigraphy and Tc-99m Human Immunoglobulin G (HIG Scintigraphy in the Determination of the Presence and Severity of Inflammatory Arthritis

    Directory of Open Access Journals (Sweden)

    Gulizar Kacar

    2011-08-01

    Full Text Available Objective: In this study, it was aimed to investigate the agreement between early phase of bone scintigraphy – human immunoglobulin scintigraphy (EPBS-HIG and late phase bone scintigraphy – HIG (LPBS-HIG in the determination of the presence and also the severity of inflammatory arthritis. Material and Methods: Twenty-eight patients (23 female, 5 male; between 19 to 80 years of age with inflammatory arthritis were included in the study. Tc-99m HIG and blood pool/late phase bone scintigraphies were performed in all patients. In scintigraphic examinations, the joints were scored with the degree of accumulation of the radiopharmaceutical by the semiquantitative analysis (0=Background activity, 1=Faint uptake, 2=Moderate uptake, 3=Marked uptake which is called as visually active joint score as severity index of the disease. To estimate the agreement between EPBS – HIG and LPBS - HIG in the determination of the presence and severity of inflammatory arthritis, 2x2 kappa coefficients were calculated. Results: Our results showed good agreement between EPBS - HIG for the presence of inflammation (kappa: 0.72 but not for the severity of the disease (kappa: 0.29, poor agreement between LPBS - HIG for both the presence (kappa: 0.51 and severity (kappa: 0.01 of inflammatory arthritis. Conclusion: The blood pool scintigraphy could be used in the investigation of the presence of inflammatory arthritis because the good agreement with HIG and the lower cost but not for the severity of the disease. (MIRT 2011;20:45-51

  20. Improved red blood cell survival after cardiac operations with administration of urea during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    The plasma hemoglobin and red blood cell survival (half-life of 51Cr) was studied in 48 patients undergoing single valve replacement or coronary artery bypass graft. Urea or placebo was administered during cardiopulmonary bypass in a prospective, randomized, double-blind manner to test the potential effect on mechanical hemolysis. The mean plasma hemoglobin level at the end of extracorporeal circulation was significantly lower in the urea-treated groups (coronary artery bypass 342 mg/L; valve replacement 364 mg/L) than in the control groups (coronary artery bypass 635 mg/L, valve replacement 518 mg/L. The half-life of 51Cr was significantly longer in the urea-treated patients (coronary artery bypass 18 days; valve replacement 16 days) than in the control groups (coronary artery bypass 12.4 days; valve replacement 12.7 days) but still below the normal reference value (29 +/- 4 days). The plasma hemoglobin returned to near normal values (50 mg/L) the day after operation (day 1) and remained low with no differences between control and urea-treated groups. The total blood hemoglobin was followed for 2 weeks after operation and showed significantly less anemia in the urea-treated group. The lowest mean blood hemoglobin level was noted between days 5 and 9-114 (coronary artery bypass) and 107 (valve replacement) gm/L in the urea-treated patients compared to 92.3 gm/L in the control subjects. The reduction in the severity of the anemia led to less transfusion in the urea-treated patients (approximately 0.5 unit/patient) than in the control subjects (approximately 1 unit/patient) between days 3 and 14

  1. Functional Flow Patterns and Static Blood Pooling in Tumors Revealed by Combined Contrast-Enhanced Ultrasound and Photoacoustic Imaging.

    Science.gov (United States)

    Bar-Zion, Avinoam; Yin, Melissa; Adam, Dan; Foster, F Stuart

    2016-08-01

    Alterations in tumor perfusion and microenvironment have been shown to be associated with aggressive cancer phenotypes, raising the need for noninvasive methods of tracking these changes. Dynamic contrast-enhanced ultrasound (DCEUS) and photoacoustic (PA) imaging serve as promising candidates-one has the ability to measure tissue perfusion, whereas the other can be used to monitor tissue oxygenation and hemoglobin concentration. In this study, we investigated the relationship between the different functional parameters measured with DCEUS and PA imaging, using two morphologically different hind-limb tumor models and drug-induced alterations in an orthotopic breast tumor model. Imaging results showed some correlation between perfusion and oxygen saturation maps and the ability to sensitively monitor antivascular treatment. In addition, DCEUS measurements revealed different vascular densities in the core of specific tumors compared with their rims. Noncorrelated perfusion and hemoglobin concentration measurements facilitated discrimination between blood lakes and necrotic areas. Taken together, our results illustrate the utility of a combined contrast-enhanced ultrasound method with photoacoustic imaging to visualize blood flow patterns in tumors. Cancer Res; 76(15); 4320-31. ©2016 AACR. PMID:27325651

  2. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  3. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    International Nuclear Information System (INIS)

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

  4. Effects of nimodipine on cerebral blood flow and cerebrospinal fluid pressure after cardiac arrest: correlation with neurologic outcome.

    Science.gov (United States)

    Forsman, M; Aarseth, H P; Nordby, H K; Skulberg, A; Steen, P A

    1989-04-01

    Fifty-one patients were included in a blind randomized study to evaluate whether the Ca-blocker nimodipine could influence cerebral blood flow (CBF) or cerebrospinal fluid pressure (CSFP) during the cerebral hypoperfusion period that follows resuscitation from cardiac arrest and to determine whether changes in CBF correlate with neurologic outcome. CBF measured 1 to 4 hours after arrest with the use of 133Xe intravenous was significantly greater with nimodipine than with placebo (27 +/- 3 versus 13 +/- 1 ml.100 g-1.min-1 at 3 hours), but with no significant difference at 24 hours. There was no clinical evidence of seriously increased CSFP in any patient in either group the first 48 hours. Mean arterial pressure was significantly lower (86 +/- 4 versus 101 +/- 4 mm Hg at 3 hours), and antiarrhythmic drugs were used significantly less frequently in the nimodipine group than in the placebo group. Twelve patients in each group eventually regained consciousness. There was no significant difference in neurologic status between the two groups at any point, and no positive correlation between CBF in the hypoperfusion period and neurologic outcome. PMID:2929976

  5. Preclinical Evaluation of the Immunomodulatory Properties of Cardiac Adipose Tissue Progenitor Cells Using Umbilical Cord Blood Mesenchymal Stem Cells: A Direct Comparative Study

    Directory of Open Access Journals (Sweden)

    Isaac Perea-Gil

    2015-01-01

    Full Text Available Cell-based strategies to regenerate injured myocardial tissue have emerged over the past decade, but the optimum cell type is still under scrutiny. In this context, human adult epicardial fat surrounding the heart has been characterized as a reservoir of mesenchymal-like progenitor cells (cardiac ATDPCs with potential clinical benefits. However, additional data on the possibility that these cells could trigger a deleterious immune response following implantation are needed. Thus, in the presented study, we took advantage of the well-established low immunogenicity of umbilical cord blood-derived mesenchymal stem cells (UCBMSCs to comparatively assess the immunomodulatory properties of cardiac ATDPCs in an in vitro allostimulatory assay using allogeneic mature monocyte-derived dendritic cells (MDDCs. Similar to UCBMSCs, increasing amounts of seeded cardiac ATDPCs suppressed the alloproliferation of T cells in a dose-dependent manner. Secretion of proinflammatory cytokines (IL6, TNFα, and IFNγ was also specifically modulated by the different numbers of cardiac ATDPCs cocultured. In summary, we show that cardiac ATDPCs abrogate T cell alloproliferation upon stimulation with allogeneic mature MDDCs, suggesting that they could further regulate a possible harmful immune response in vivo. Additionally, UCBMSCs can be considered as valuable tools to preclinically predict the immunogenicity of prospective regenerative cells.

  6. REDUCCIÓN DE TRANSFUSIONES ALOGÉNICAS EN CIRUGÍA CARDÍACA EMPLEANDO UN PROGRAMA DE AHORRO DE SANGRE / The reduction of allogeneic blood transfusions in cardiac surgery using a blood saving program

    Directory of Open Access Journals (Sweden)

    Altinay Padrón Bulit

    2009-09-01

    Full Text Available Antecedents and objectives: Cardiac surgery has been a process which traditionally requires large amounts of homologous blood transfusions. Due to the negative effects on perioperativemorbimortality, and its cost, some alternatives have been developed in order to reduce or avoid giving a transfusion to the patients. The aim of this study is to put into practice and assess theeffectiveness of a strategy for reducing the use of allogeneic transfusions in the cardiac surgery perioperative at the Ernesto Che Guevara Cardiology Hospital. Method: 151 patients, who were operated on with or without extracorporeal circulation, and who were inserted in a blood saving program that included acute intentional normovolemic hemodilution with autotransfusion during theyear 2008, were studied in order to assess the effectiveness of such strategies. Results: It was possible to avoid the transfusions with allogeneic components in 55 percent of the patients (56.0 percent from the group intervened with extracorporeal circulation (ECC, and 52.64 percent of the patients operated on without ECC and the patients who received the transfusions needed a smaller amount of allogeneic blood components, as well as fewer units administered through the transfusion. Conclusions: The strategies for saving blood were effective in order to reduce the homologous transfusions in the cardiac surgery perioperative.

  7. Lactotripeptides effect on office and 24-h ambulatory blood pressure, blood pressure stress response, pulse wave velocity and cardiac output in patients with high-normal blood pressure or first-degree hypertension: a randomized double-blind clinical trial.

    Science.gov (United States)

    Cicero, Arrigo F G; Rosticci, Martina; Gerocarni, Beatrice; Bacchelli, Stefano; Veronesi, Maddalena; Strocchi, Enrico; Borghi, Claudio

    2011-09-01

    Contrasting data partially support a certain antihypertensive efficacy of lactotripeptides (LTPs) derived from enzymatic treatment of casein hydrolysate. Our aim was to evaluate this effect on a large number of hemodynamic parameters. We conducted a prospective double-blind randomized clinical trial, which included 52 patients affected by high-normal blood pressure (BP) or first-degree hypertension. We investigated the effect of a 6-week treatment with the LTPs isoleucine-proline-proline and valine-proline-proline at 3 mg per day, assumed to be functional food, on office BP, 24-h ambulatory BP monitoring (ABPM) values, stress-induced BP increase and cardiac output-related parameters. In the LTP-treated subjects, we observed a significant reduction in office systolic BP (SBP; -5±8 mm Hg, P=0.013) and a significant improvement in pulse wave velocity (PWV; -0.66±0.81 m s(-1), P=0.001; an instrumental biomarker of vascular rigidity). No effect on 24-h ABPM parameters and BP reaction to stress was observed from treatment with the combined LTPs. LTPs, but not placebo, were associated with a mild but significant change in the stroke volume (SV), SV index (markers of cardiac flow), the acceleration index (ACI) and velocity index (VI) (markers of cardiac contractility). No effect was observed on parameters related to fluid dynamics or vascular resistance. LTPs positively influenced the office SBP, PWV, SV, SV index, ACI and VI in patients with high-normal BP or first-degree hypertension. PMID:21753776

  8. ECG-gated thallium-201 myocardial SPECT in patients with old myocardial infarction compared with ECG-gated blood pool SPECT

    International Nuclear Information System (INIS)

    We evaluated one of the merits of ECG-gated thallium-201 single photon emission computed tomography (g-Tl SPECT), i.e., the ability to appreciate left ventricular (LV) wall motion. LV wall motion assessed by g-Tl SPECT and by ECG-gated Blood Pool SPECT (g-BP SPECT) was classified into three grades and compared segment by segment. Tl-201 uptake by g-Tl SPECT was also classified into three grades and compared with those of wall motion in g-BP SPECT. Fifty patients with prior myocardial infarction were injected intravenously at rest with 111 to 185 MBq (3 to 5 mCi) of Tl-201. The left ventricular regions were divided into anterior, septal, inferior and lateral segments (50 patients x 4 segments = 200 segments in total). The grades of wall motion and Tl-201 uptake detected by g-Tl SPECT correlated well with those of wall motion in g-BP SPECT (94.5% and 85%, respectively). With g-Tl SPECT it was possible to evaluate left ventricular wall motion, providing clear perfusion images. (author)

  9. Magnetic resonance characterization of tumor microvessels in experimental breast tumors using a slow clearance blood pool contrast agent (carboxymethyldextran-A2-Gd-DOTA) with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Preda, Anda [University of California San Francisco, Department of Radiology, Center for Pharmaceutical and Molecular Imaging, San Francisco, CA (United States); Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Novikov, Viktor; Moeglich, Martina; Turetschek, Karl; Shames, David M.; Roberts, Timothy P.L.; Brasch, Robert C. [University of California San Francisco, Department of Radiology, Center for Pharmaceutical and Molecular Imaging, San Francisco, CA (United States); Floyd, Eugenia; Carter, Wayne O. [Pfizer Central Research, Groton, CT (United States); Corot, Claire [Guerbet Laboratories, Aulnay sous Bois (France)

    2005-11-01

    Carboxymethyldextran (CMD)-A2-Gd-DOTA, a slow clearance blood pool contrast agent with a molecular weight of 52.1 kDa, designed to have intravascular residence for more than 1 h, was evaluated for its potential to characterize and differentiate the microvessels of malignant and benign breast tumors. Precontrast single-slice inversion-recovery snapshot FLASH and dynamic contrast-enhanced MRI using an axial T1-weighted three-dimensional spoiled gradient recalled sequence was performed in 30 Sprague-Dawley rats with chemically induced breast tumors. Endothelial transfer coefficient and fractional plasma volume of the breast tumors were estimated from MRI data acquired with CMD-A2-Gd-DOTA enhancement injected at a dose of 0.1 mmol Gd/kg body weight using a two-compartment bidirectional model of the tumor tissue. The correlation between MRI microvessel characteristics and histopathological tumor grade was determined using the Scarff-Bloom-Richardson method. Using CMD-A2-Gd-DOTA, no significant correlations were found between the MR-estimated endothelial transfer coefficient or plasma volumes with histological tumor grade. Analysis of CMD-A2-Gd-DOTA-enhanced MR kinetic data failed to demonstrate feasibility for the differentiation of benign from malignant tumors or for image-based tumor grading. (orig.)

  10. Magnetic resonance characterization of tumor microvessels in experimental breast tumors using a slow clearance blood pool contrast agent (carboxymethyldextran-A2-Gd-DOTA) with histopathological correlation

    International Nuclear Information System (INIS)

    Carboxymethyldextran (CMD)-A2-Gd-DOTA, a slow clearance blood pool contrast agent with a molecular weight of 52.1 kDa, designed to have intravascular residence for more than 1 h, was evaluated for its potential to characterize and differentiate the microvessels of malignant and benign breast tumors. Precontrast single-slice inversion-recovery snapshot FLASH and dynamic contrast-enhanced MRI using an axial T1-weighted three-dimensional spoiled gradient recalled sequence was performed in 30 Sprague-Dawley rats with chemically induced breast tumors. Endothelial transfer coefficient and fractional plasma volume of the breast tumors were estimated from MRI data acquired with CMD-A2-Gd-DOTA enhancement injected at a dose of 0.1 mmol Gd/kg body weight using a two-compartment bidirectional model of the tumor tissue. The correlation between MRI microvessel characteristics and histopathological tumor grade was determined using the Scarff-Bloom-Richardson method. Using CMD-A2-Gd-DOTA, no significant correlations were found between the MR-estimated endothelial transfer coefficient or plasma volumes with histological tumor grade. Analysis of CMD-A2-Gd-DOTA-enhanced MR kinetic data failed to demonstrate feasibility for the differentiation of benign from malignant tumors or for image-based tumor grading. (orig.)

  11. Features of cerebral blood flow, cardiac arrhythmias and conduction disturbances in patients with essential hypertension stage II associated with occlusive and stenotic lesions of brachiocephalic arteries

    Directory of Open Access Journals (Sweden)

    Vizir V.A.

    2015-09-01

    Full Text Available Arterial hypertension is the most common disease of the cardiovascular system in industrially advanced countries. With the aim to determine the characteristics of cerebral blood flow, disorders of cardiac rhythm and conduction in patients with stage 2 hypertension associated with stenotic and occlusive lesions of brachiocephalic arteries, cerebral blood flow indicators were studied in 87 patients using duplex scanning of extracranial arteries and Holter ECG monitoring. It was established that linear blood flow velocity was considerably decreased in the basins of the internal and common carotid artery; cerebral blood flow asymmetry was present in the course of the internal carotid artery. Evidence-based differences in structure of arrhythmias were revealed by single and paired ventricular extrasystoles, as well as episodes of unstable ventricular tachycardia. All this indicates the progressive decrease of elasticity and tonicity of vessel walls, intensified rigidity and sinuosity of carotid arteries, more severe disorders of cardiac rhythm and conduction in case of simultaneous hypertension and atherosclerotic lesion of brachiocephalic arteries.

  12. Intra-operative intravenous fluid restriction reduces perioperative red blood cell transfusion in elective cardiac surgery, especially in transfusion-prone patients: a prospective, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Georgopoulou Stavroula

    2010-02-01

    Full Text Available Abstract Background Cardiac surgery is a major consumer of blood products, and hemodilution increases transfusion requirements during cardiac surgery under CPB. As intraoperative parenteral fluids contribute to hemodilution, we evaluated the hypothesis that intraoperative fluid restriction reduces packed red-cell (PRC use, especially in transfusion-prone adults undergoing elective cardiac surgery. Methods 192 patients were randomly assigned to restrictive (group A, 100 pts, or liberal (group B, 92 pts intraoperative intravenous fluid administration. All operations were conducted by the same team (same surgeon and perfusionist. After anesthesia induction, intravenous fluids were turned off in Group A (fluid restriction patients, who only received fluids if directed by protocol. In contrast, intravenous fluid administration was unrestricted in group B. Transfusion decisions were made by the attending anesthesiologist, based on identical transfusion guidelines for both groups. Results 137 of 192 patients received 289 PRC units in total. Age, sex, weight, height, BMI, BSA, LVEF, CPB duration and surgery duration did not differ between groups. Fluid balance was less positive in Group A. Fewer group A patients (62/100 required transfusion compared to group B (75/92, p Conclusions Our data suggest that fluid restriction reduces intraoperative PRC transfusions without significantly increasing postoperative transfusions in cardiac surgery; this effect is more pronounced in transfusion-prone patients. Trial registration NCT00600704, at the United States National Institutes of Health.

  13. Right ventricular volume determination by continuous [sup 81m]Kr infusion and [sup 99m]Tc blood pool imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Shinichiro; Yamashita, Saburo; Suzuki, Tetsuo; Muramatsu, Toshihiro; Ide, Masao; Suzuki, Shigeo; Dohi, Yutaka; Nishimura, Katsuyuki; Miyamae, Tatsuya (Saitama Medical School, Moroyama (Japan))

    1992-10-01

    Our newly developed radionuclide method for the calculation of right ventricular (RV) volume was examined. Using a semi-geometric count-based method, volume can be measured by the following equation: Cv=Cm/(L/d). V=(Ct/Cv)xd[sup 3]=(Ct/Cm)xLxd[sup 2]. (V=volume, Cv=voxel count, Cm=the maximum count of a container, Ct=the total count of the container, L=maximum length of the image of the container, L=maximum length of the image of the container obtained from a direction perpendicular to the direction where the count data were collected, and d=pixel size). A phantom study was performed by setting a cylindrical container in a system which circulated 5 liters of water per minute. [sup 81m]Kr solution was infused continuously into the container, and images of the container were collected for one minute. Cm and Ct were obtained, and because the container was cylindrical, the maximum width of the image of the container was measured as L. The volume of the container was calculated using the above equation. This theorem was applied to RV images obtained in the 30 degree right anterior oblique position by continuous infusion of the [sup 81m]Kr solution. Multiple gated acquisition was performed and RV end-diastolic maximum counts and total counts were obtained. The RV maximum width was measured as L on the end-diastolic cardiac pool image with [sup 99m]Tc-D-HSA collected in the 40 degree left anterior oblique position. The values obtained from these two images were substituted in the above equation and the RV end-diastolic volume (RV-EDV) was calculated. The RV ejection fraction (RV-EF) was obtained from the [sup 81m]Kr image. The RV stroke volume (SV) was calculated from multiplying the RV-EDV by the RV-EF. This value was compared to the SV with thermodilution. The correlation of these two values was r=0.90. This new method for calculating RV volume was thus considered useful. (author).

  14. Observation of blood B-type natriuretic peptide level changes in different periods and different cardiac pacing modes

    Institute of Scientific and Technical Information of China (English)

    WANG Ru-xing; LI Xiao-rong; JIANG Wen-ping; LIU Zhi-hua; YANG Xiang-jun; XIAO Chun-hui; SHAO Li-zheng; ZHU Jian-qiu

    2005-01-01

    @@ In recent years, the indications of cardiac pacing have extended continuously with the rapid development of pacing technique. Pacemaker treatment has not only limited in arrhythmias of bradycardia and the number of pacemaker treatment has increased year by year.

  15. Vernal Pools

    Data.gov (United States)

    California Department of Resources — This is a polygon layer representing existing vernal pool complexes in California's Central Valley, as identified and mapped by Dr. Robert F. Holland. The purpose...

  16. Antimyosin imaging in cardiac transplant rejection

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.L.; Cannon, P.J. (Department of Medicine, College of Physicians and Surgeons, Columbia University, New York (United States))

    1991-09-01

    Fab fragments of antibodies specific for cardiac myosin have been labeled with indium-111 and injected intravenously into animals and into patients with heart transplants. The antibodies, developed by Khaw, Haber, and co-workers, localize in cardiac myocytes that have been damaged irreversibly by ischemia, myocarditis, or the rejection process. After clearance of the labeled antibody from the cardiac blood pool, planar imaging or single photon emission computed tomography is performed. Scintigrams reveal the uptake of the labeled antimyosin in areas of myocardium undergoing transplant rejection. In animal studies, the degree of antimyosin uptake appears to correlate significantly with the degree of rejection assessed at necropsy. In patients, the correlation between scans and pathologic findings from endomyocardial biopsy is not as good, possibly because of sampling error in the endomyocardial biopsy technique. The scan results at 1 year correlate with either late complications (positive) or benign course (negative). Current limitations of the method include slow blood clearance, long half-life of indium-111, and hepatic uptake. Overcoming these limitations represents a direction for current research. It is possible that from these efforts a noninvasive approach to the diagnosis and evaluation of cardiac transplantation may evolve that will decrease the number of endomyocardial biopsies required to evaluate rejection. This would be particularly useful in infants and children. 31 references.

  17. Antimyosin imaging in cardiac transplant rejection

    International Nuclear Information System (INIS)

    Fab fragments of antibodies specific for cardiac myosin have been labeled with indium-111 and injected intravenously into animals and into patients with heart transplants. The antibodies, developed by Khaw, Haber, and co-workers, localize in cardiac myocytes that have been damaged irreversibly by ischemia, myocarditis, or the rejection process. After clearance of the labeled antibody from the cardiac blood pool, planar imaging or single photon emission computed tomography is performed. Scintigrams reveal the uptake of the labeled antimyosin in areas of myocardium undergoing transplant rejection. In animal studies, the degree of antimyosin uptake appears to correlate significantly with the degree of rejection assessed at necropsy. In patients, the correlation between scans and pathologic findings from endomyocardial biopsy is not as good, possibly because of sampling error in the endomyocardial biopsy technique. The scan results at 1 year correlate with either late complications (positive) or benign course (negative). Current limitations of the method include slow blood clearance, long half-life of indium-111, and hepatic uptake. Overcoming these limitations represents a direction for current research. It is possible that from these efforts a noninvasive approach to the diagnosis and evaluation of cardiac transplantation may evolve that will decrease the number of endomyocardial biopsies required to evaluate rejection. This would be particularly useful in infants and children. 31 references

  18. Comparative value of ECG-gated blood pool SPET and ECG-gated myocardial perfusion SPET in the assessment of global systolic left ventricular function

    International Nuclear Information System (INIS)

    Both electrocardiographically (ECG) gated blood pool SPET (GBPS) and ECG-gated myocardial perfusion SPET (GSPET) are currently used for the measurement of global systolic left ventricular (LV) function. In this study, we aimed to compare the value of GSPET and GBPS for this purpose. The population included 65 patients who underwent rest thallium-201 GSPET imaging at 15 min after 201Tl injection followed by planar (planarRNA) and GBPS equilibrium radionuclide angiography immediately after 4-h redistribution myocardial perfusion SPET imaging. Thirty-five patients also underwent LV conventional contrast angiography (X-rays). LV ejection fraction (EF) and LV volume [end-diastolic (EDV) and end-systolic (ESV) volumes] were calculated with GBPS and GSPET and compared with the gold standard methods (planarRNA LVEF and X-ray based calculation of LV volume). For both LVEF and LV volume, the inter-observer variability was lower with GBPS than with GSPET. GBPS LVEF was higher than planarRNA (PRNA LVEF showed a slightly better correlation with GBPS LVEF than with GSPET LVEF: r=0.87 and r=0.83 respectively. GSPET LV volume was lower than that obtained using X-rays and GBPS (PRNA LVEF, signal to noise ratio, LV volume calculated using X-rays, summed rest score and acquisition scan distance (i.e. the radius of rotation). The accuracy of GBPS for the measurement of LVEF and LV volume was correlated only with the signal level, the signal to noise ratio and the acquisition scan distance. Both GSPET and GBPS provide reliable estimation of global systolic LV function. The better reliability of GBPS and in particular its lower sensitivity to different variables as compared with GSPET favours its use when precise assessment of global systolic LV function is clinically indicated. (orig.)

  19. High-resolution blood-pool-contrast-enhanced MR angiography in glioblastoma: tumor-associated neovascularization as a biomarker for patient survival. A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Puig, Josep; Blasco, Gerard; Remollo, Sebastian; Hernandez, David; Pedraza, Salvador [Hospital Universitari Dr Josep Trueta, Research Unit of Diagnostic Imaging Institute (IDI), Department of Radiology [Girona Biomedical Research Institute] IDIBGI, Girona (Spain); Daunis-i-Estadella, Josep; Mateu, Gloria [University of Girona, Department of Computer Science, Applied Mathematics and Statistics, Girona (Spain); Alberich-Bayarri, Angel [La Fe Polytechnics and University Hospital, Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, Valencia (Spain); Essig, Marco [University of Manitoba, Department of Radiology, Winnipeg (Canada); Jain, Rajan [NYU School of Medicine, Division of Neuroradiology, Department of Radiology, New York, NY (United States); Puigdemont, Montserrat [Hospital Universitari Dr Josep Trueta, Catalan Institute of Oncology (ICO), Hospital Cancer Registry, Girona (Spain); Sanchez-Gonzalez, Javier [Philips Healthcare Iberica, Madrid (Spain); Wintermark, Max [Stanford University, Department of Radiology, Neuroradiology Division, Palo Alto, CA (United States)

    2016-01-15

    The objective of the study was to determine whether tumor-associated neovascularization on high-resolution gadofosveset-enhanced magnetic resonance angiography (MRA) is a useful biomarker for predicting survival in patients with newly diagnosed glioblastomas. Before treatment, 35 patients (25 men; mean age, 64 ± 14 years) with glioblastoma underwent MRI including first-pass dynamic susceptibility contrast (DSC) perfusion and post-contrast T1WI sequences with gadobutrol (0.1 mmol/kg) and, 48 h later, high-resolution MRA with gadofosveset (0.03 mmol/kg). Volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter were obtained, and DSC perfusion and DWI parameters were evaluated. Prognostic factors were assessed by Kaplan-Meier survival and Cox proportional hazards model. Eighteen (51.42 %) glioblastomas were hypervascular on high-resolution MRA. Hypervascular glioblastomas were associated with higher CEL volume and lower Karnofsky score. Median survival rates for patients with hypovascular and hypervascular glioblastomas treated with surgery, radiotherapy, and chemotherapy were 15 and 9.75 months, respectively (P < 0.001). Tumor-associated neovascularization was the best predictor of survival at 5.25 months (AUC = 0.794, 81.2 % sensitivity, 77.8 % specificity, 76.5 % positive predictive value, 82.4 % negative predictive value) and yielded the highest hazard ratio (P < 0.001). Tumor-associated neovascularization detected on high-resolution blood-pool-contrast-enhanced MRA of newly diagnosed glioblastoma seems to be a useful biomarker that correlates with worse survival. (orig.)

  20. The comparison of ordered subset expectation maximization and filtered back projection technique for RBC blood pool SPECT in detection of liver hemangioma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo; Kim, Hee Joung; Bong, Jung Kyun; Lee, Jong Doo [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2000-07-01

    Odered subset expectation maximization (OSEM) is a new iterative reconstruction technique for tomographic images that can reduce the reconstruction time comparing with conventional iteration method. We adopted this method of RBC blood pool SPECT and tried to validate the usefulness of OSEM in detection of liver hemangioma comparing with filtered back projection (FBP). A 64 projection SPECT study was acquired over 360 .deg. C by dual-head cameras after the injection of 750MBq of {sup 99m}Tc-RBC. OSEM was performed with various condition of subset (1,2,4,8,16 and 32) and iteration number (1,2,4,8 and 16) to obtain the best set for lesion detection. OSEM underwent in 17 lesions of 15 patients with liver hemangioma and compared with FBP images. Two nuclear medicine physicians reviewed these results independently. Best set for images was 4 iteration and 16 subset. In general, OSEM revealed more homogeneous images than FBP. Eighty-eight percent (15/17) of OSEM images were superior or equal to FBP for anatomic resolution. According to the blind review of images 70.5% (12/17) of OSEM was better in contrast (4/17), anatomic detail (4/17) and both (2/17). Two small lesions were detected by OSEM only and another 2 small lesions were failed to depict in both methods. Remaining 3 lesions revealed no difference in image quality. OSEM can provide better image quality as well as better results in detection of liver hemangioma than conventional FBP technique.

  1. High-resolution blood-pool-contrast-enhanced MR angiography in glioblastoma: tumor-associated neovascularization as a biomarker for patient survival. A preliminary study

    International Nuclear Information System (INIS)

    The objective of the study was to determine whether tumor-associated neovascularization on high-resolution gadofosveset-enhanced magnetic resonance angiography (MRA) is a useful biomarker for predicting survival in patients with newly diagnosed glioblastomas. Before treatment, 35 patients (25 men; mean age, 64 ± 14 years) with glioblastoma underwent MRI including first-pass dynamic susceptibility contrast (DSC) perfusion and post-contrast T1WI sequences with gadobutrol (0.1 mmol/kg) and, 48 h later, high-resolution MRA with gadofosveset (0.03 mmol/kg). Volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter were obtained, and DSC perfusion and DWI parameters were evaluated. Prognostic factors were assessed by Kaplan-Meier survival and Cox proportional hazards model. Eighteen (51.42 %) glioblastomas were hypervascular on high-resolution MRA. Hypervascular glioblastomas were associated with higher CEL volume and lower Karnofsky score. Median survival rates for patients with hypovascular and hypervascular glioblastomas treated with surgery, radiotherapy, and chemotherapy were 15 and 9.75 months, respectively (P < 0.001). Tumor-associated neovascularization was the best predictor of survival at 5.25 months (AUC = 0.794, 81.2 % sensitivity, 77.8 % specificity, 76.5 % positive predictive value, 82.4 % negative predictive value) and yielded the highest hazard ratio (P < 0.001). Tumor-associated neovascularization detected on high-resolution blood-pool-contrast-enhanced MRA of newly diagnosed glioblastoma seems to be a useful biomarker that correlates with worse survival. (orig.)

  2. Beat-to-beat evaluation of left ventricular ejection in cardiac arrhythmias

    International Nuclear Information System (INIS)

    Conventional multi-gated cardiac blood pool studies suffer from two kinds of superimpositions: the spatial overlapping of various heart chambers and the temporal superimposition of a large number of cardiac cycles. The first problem can be partially solved by first pass techniques or by emission tomography. For the second one, which is specially critical arrhythmias, the single probe device (''nuclear stethoscope'') represents an original solution. Patients with normal cardiac rythm and patients presenting various kinds of cardiac rythm alterations were examined using a commercial ''nuclear stethoscope''. Some characteristic results achieved in these cases, were presented. For blood pool labeling, 20 mCi of 99mTc albumin was injected. The single probe detector was then positioned over the left ventricular area. The beat-to-beat left ventricular activity curve was then recorded for several minutes on paper in the same time as the E.C.G. signal. In cases with irregular cardiac rythm, the multigated techniques yield an average value of left ventricular ejection. Due to the relatively constant duration of systole, the superimposition of cycles may be valid during contration: differences mainly appear during diastole. But, as it could be demonstrated using the ''nuclear stethoscope'', individual cycles can show a large variability of ejection and average ejection fraction is only a very partial aspect of the real cardiac function

  3. Detraining differentially preserved beneficial effects of exercise on hypertension: effects on blood pressure, cardiac function, brain inflammatory cytokines and oxidative stress.

    Directory of Open Access Journals (Sweden)

    Deepmala Agarwal

    Full Text Available AIMS: This study sought to investigate the effects of physical detraining on blood pressure (BP and cardiac morphology and function in hypertension, and on pro- and anti-inflammatory cytokines (PICs and AIC and oxidative stress within the brain of hypertensive rats. METHODS AND RESULTS: Hypertension was induced in male Sprague-Dawley rats by delivering AngiotensinII for 42 days using implanted osmotic minipumps. Rats were randomized into sedentary, trained, and detrained groups. Trained rats underwent moderate-intensity exercise (ExT for 42 days, whereas, detrained groups underwent 28 days of exercise followed by 14 days of detraining. BP and cardiac function were evaluated by radio-telemetry and echocardiography, respectively. At the end, the paraventricular nucleus (PVN was analyzed by Real-time RT-PCR and Western blot. ExT in AngII-infused rats caused delayed progression of hypertension, reduced cardiac hypertrophy, and improved diastolic function. These results were associated with significantly reduced PICs, increased AIC (interleukin (IL-10, and attenuated oxidative stress in the PVN. Detraining did not abolish the exercise-induced attenuation in MAP in hypertensive rats; however, detraining failed to completely preserve exercise-mediated improvement in cardiac hypertrophy and function. Additionally, detraining did not reverse exercise-induced improvement in PICs in the PVN of hypertensive rats; however, the improvements in IL-10 were abolished. CONCLUSION: These results indicate that although 2 weeks of detraining is not long enough to completely abolish the beneficial effects of regular exercise, continuing cessation of exercise may lead to detrimental effects.

  4. Specificity of the diffuse pattern of cardiac uptake in myocardial infarction imaging with technetium-99m stannous pyrophosphate

    International Nuclear Information System (INIS)

    To analyze the specificity of the diffuse pattern of cardiac uptake with technetium-99m stannous pyrophosphate (TcPYP), we evaluated the bone scans of 1,383 noncardiac patients and the myocardial scintigrams of 120 cardiac patients. Seventy (14.4 percent) of 483 bone scans performed on a scintillation camera revealed diffuse TcPYP cardiac uptake. Among the total 603 camera bone scans and myocardial scintigrams, the incidence of diffuse cardiac uptake was 16 percent among patients with clinical coronary disease but 13 percent among those patients without clinical symptoms. Discrete myocardial uptake was seen in 25 of 26 patients with transmural infarction. Femoral vasculature was more frequently visualized (84 percent vs 3 percent, P < 0.001) and left mastectomy occurred more often (30 percent vs 1 percent, P < 0.001) among patients with diffuse cardiac uptake than among patients with negative images, indicating possible blood pool imaging. The diffuse pattern of cardiac uptake appeared nonspecific and may be due to unintentional cardiac blood pool imaging

  5. Decreased Bioenergetic Health Index in monocytes isolated from the pericardial fluid and blood of post-operative cardiac surgery patients

    OpenAIRE

    Kramer, Philip A.; Chacko, Balu K.; George, David J.; Zhi, Degui; Wei, Chih-Cheng; Dell'Italia, Louis J.; Melby, Spencer J.; George, James F.; Darley-Usmar, Victor M.

    2015-01-01

    Translational bioenergetics requires the measurement of mitochondrial function in clinically relevant samples and the integration of the data in a form that can be applied to personalized medicine. In the present study, we show the application of the measurement of the Bioenergetic Health Index (BHI) to cardiac surgery patients.

  6. Pulmonary perfusion with oxygenated blood or custodiol HTK solution during cardiac surgery for postoperative pulmonary function in COPD patients

    DEFF Research Database (Denmark)

    Buggeskov, Katrine B; Wetterslev, Jørn; Secher, Niels H;

    2013-01-01

    Five to thirty percent of patients undergoing cardiac surgery present with chronic obstructive pulmonary disease (COPD) and have a 2- to 10-fold higher 30-day mortality risk. Cardiopulmonary bypass (CPB) creates a whole body systemic inflammatory response syndrome (SIRS) that could impair pulmona...

  7. Pooling Resources

    Institute of Scientific and Technical Information of China (English)

    DING WENLEI

    2010-01-01

    @@ While the 1997 Asian financial crisis gave birth to the Chiang Mai Initiative,a foreign currency reserve pool to address short-term liquidity difficulties in the region,the 2008global financial crisis promoted Asian political leaders,bankers and scholars to seek closer regional financial cooperation based on the initiative's framework.

  8. Pool scrubbing

    International Nuclear Information System (INIS)

    The Source Term Project in the Third Frame Work Programme of the European Union Was conducted under and important joined effort on pool scrubbing research. CIEMAT was the Task Manager of the project and several other organizations participated in it: JRC-Ispra, NNC Limited, RUB-NES and UPM. The project was divided into several tasks. A peer review of the models in the pool scrubbing codes SPARC90 and BUSCA-AUG92 was made, considering the different aspects in the hydrodynamic phenomenology, particle retention and fission product vapor abortions. Several dominant risk accident sequences were analyzed with MAAP, SPARC90 and BUSCA-AUG92 codes, and the predictions were compared. A churn-turbulent model was developed for the hydrodynamic behaviour of the pool. Finally, an experimental programme in the PECA facility of CIEMAT was conducted in order to study the decontamination factor under jet injection regime, and the experimental observations were compared with the SPARC and BUSCA codes. (Author)

  9. Sudden Cardiac Arrest

    Science.gov (United States)

    ... scan, or MUGA, which shows how well your heart is pumping blood. Magnetic resonance imaging (MRI) which gives doctors detailed pictures of your heart. How is SCA treated? Sudden cardiac arrest should ...

  10. Detection of rejection of canine orthotopic cardiac allografts with indium-111 lymphocytes and gamma scintigraphy

    International Nuclear Information System (INIS)

    Previous studies have demonstrated the feasibility of detecting canine heterotopic cardiac allograft rejection scintigraphically after administration of 111In lymphocytes. To determine whether the approach is capable of detecting rejection in orthotopic cardiac transplants in which labeled lymphocytes circulating in the blood pool may reduce sensitivity, the present study was performed in which canine orthotopic cardiac transplants were evaluated in vivo. Immunosuppression was maintained with cyclosporine A (10-20 mg/kg/day) and prednisone (1 mg/kg/day) for 2 wk after transplantation. Subsequently, therapy was tapered. Five successful allografts were evaluated scintigraphically every 3 days after administration of 100-350 microCi 111In autologous lymphocytes. Correction for labeled lymphocytes circulating in the blood pool, but not actively sequestered in the allografts was accomplished by administering 3-6 mCi 99mTc autologous erythrocytes and employing a previously validated blood-pool activity correction technique. Cardiac infiltration of labeled lymphocytes was quantified as percent indium excess (%IE), scintigraphically detectable 111In in the transplant compared with that in blood, and results were compared with those of concomitantly performed endomyocardial biopsy. Scintigraphic %IE for hearts not undergoing rejection manifest histologically was 0.7 +/- 0.4. Percent IE for rejecting hearts was 6.8 +/- 4.0 (p less than 0.05). Scintigraphy detected each episode of rejection detected by biopsy. Scintigraphic criteria for rejection (%IE greater than 2 s.d. above normal) were not manifest in any study in which biopsies did not show rejection. Since scintigraphic results with 111In-labeled lymphocytes were concordant with biopsy results in orthotopic cardiac transplants, noninvasive detection of graft rejection in patients should be attainable with the approach developed

  11. Cardiac function in offspring of women with diabetes using fetal ECG, umbilical cord blood pro-BNP, and neonatal interventricular septal thickness

    DEFF Research Database (Denmark)

    Halse, Karen; Lindegaard, Marie Louise Skakkebæk; Amer-Wahlin, Isis;

    2013-01-01

    Objective: Increased pro-brain natriuretic peptide (BNP) concentrations in newborns of diabetic women are associated with fetal stress, and fetal ECG changes often occur in labor in diabetic women. These findings could reflect a degree of fetal cardiomyopathy. We aimed to explore possible relations...... between serological and morphological markers of cardiac dysfunction and abnormal changes on fetal ECGs during labor and delivery in pregnancies complicated by diabetes. Materials and methods: Pregnant women with diabetes (30 type 1, nine type 2, and 60 gestational diabetes) and their newborn offspring...... were included prospectively. Umbilical cord blood pro-BNP concentrations were measured immediately after delivery (n=68) and echocardiography was performed in the newborns (n=75). Fetal ECG in combination with cardiotocography, that is STAN technology was also performed during labor. Results: The...

  12. Determinants of exercise peak arterial blood pressure, circulatory power, and exercise cardiac power in a population based sample of Finnish male and female aged 30 to 47 years: the Cardiovascular Risk in Young Finns Study

    OpenAIRE

    Hulkkonen, Janne; Aatola, Heikki; Pälve, Kristiina; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma SA; Raitakari, Olli T.; Kähönen, Mika

    2014-01-01

    Background Novel parameters derived from peak maximal oxygen uptake (VO2) and exercise arterial blood pressure, such as peak circulatory power (CP) and exercise cardiac power (ECP), can be used in the risk assessment of cardiovascular disease and stroke. However, the determinants of these factors are poorly characterized in the general population. Methods We assessed peak arterial blood pressure, CP and ECP with standardized cardiopulmonary exercise test (CPET) on 281 female and 257 male part...

  13. Dogs infected with the blood trypomastigote form of Trypanosoma cruzi display an increase expression of cytokines and chemokines plus an intense cardiac parasitism during acute infection.

    Science.gov (United States)

    de Souza, Sheler Martins; Vieira, Paula Melo de Abreu; Roatt, Bruno Mendes; Reis, Levi Eduardo Soares; da Silva Fonseca, Kátia; Nogueira, Nívia Carolina; Reis, Alexandre Barbosa; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    2014-03-01

    The recent increase in immigration of people from areas endemic for Chagas disease (Trypanosoma cruzi) to the United States and Europe has raised concerns about the transmission via blood transfusion and organ transplants in these countries. Infection by these pathways occurs through blood trypomastigotes (BT), and these forms of T. cruzi are completely distinct of metacyclic trypomastigotes (MT), released by triatomine vector, in relation to parasite-host interaction. Thus, research comparing infection with these different infective forms is important for explaining the potential impacts on the disease course. Here, we investigated tissue parasitism and relative mRNA expression of cytokines, chemokines, and chemokine receptors in the heart during acute infection by MT or BT forms in dogs. BT-infected dogs presented a higher cardiac parasitism, increased relative mRNA expression of pro-inflammatory and immunomodulatory cytokines and of the chemokines CCL3/MIP-1α, CCL5/RANTES, and the chemokine receptor CCR5 during the acute phase of infection, as compared to MT-infected dogs. These results suggest that infection with BT forms may lead to an increased immune response, as revealed by the cytokines ratio, but this kind of immune response was not able to control the cardiac parasitism. Infection with the MT form presented an increase in the relative mRNA expression of IL-12p40 as compared to that of IL-10 or TGF-β1. Correlation analysis showed increased relative mRNA expression of IFN-γ as well as IL-10, which may be an immunomodulatory response, as well as an increase in the correlation of CCL5/RANTES and its CCR5 receptor. Our findings revealed a difference between inoculum sources of T. cruzi, as vectorial or transfusional routes of T. cruzi infection may trigger distinct parasite-host interactions during the acute phase, which may influence immunopathological aspects of Chagas disease. PMID:24317279

  14. Simultaneous evaluation of myocardial blood flow, cardiac function and lung water content using [15O]H2O and positron emission tomography

    International Nuclear Information System (INIS)

    This study sought to evaluate an imaging approach using [15O]H2O and positron emission tomography (PET) for simultaneous assessment of myocardial perfusion, cardiac function and lung water content as a potential indicator of pulmonary oedema. Twenty-six subjects divided into two groups (group I, 13 patients with idiopathic dilated cardiomyopathy; group II, 13 healthy volunteers) underwent dynamic PET scanning after intravenous infusion of ∼995 MBq [15O]H2O. In both groups, echocardiograms were performed after the PET studies. From the dynamic [15O]H2O data, lung water content (LWC) at equilibrium, myocardial blood flow (MBF), cardiac output (CO), stroke volume (SV) and stroke volume indexes (SVI) using the indicator dilution principle were determined. LWC was 18% (p = 0.038) higher in patients than in controls. Global MBF did not differ significantly between the groups, but regional MBF values were significantly lower (p 0.1) of -0.02 ± 0.82 vs -0.05 ± 0.54 l/min (CO), -1.44 ± 14.31 vs 1.70 ± 10.56 ml/beat (SV) and 0.47 ± 6.21 vs 0.30 ± 5.02 ml/beat/m2 (SVI). The 95% limits of agreement were -1.62 to 1.59 vs -1.11 to 1.01 l/min (CO), -26.61 to 29.49 vs -22.39 to 18.99 ml/beat (SV) and -11.69 to 12.88 vs -9.53 to 10.14 ml/beat/m2 (SVI). Right ventricular CO was increased by 33% (p = 0.014) in the patient group as compared with normal controls. Our results demonstrate that additional analysis of cardiac function and lung water content are feasible from the dynamic cardiac [15O]H2O PET studies acquired for myocardial perfusion. The parameters appear to work as expected. Further studies are warranted to elucidate the clinical value of these new parameters. (orig.)

  15. End-expiration respiratory gating for a high-resolution stationary cardiac SPECT system

    Science.gov (United States)

    Chan, Chung; Harris, Mark; Le, Max; Biondi, James; Grobshtein, Yariv; Liu, Yi-Hwa; Sinusas, Albert J.; Liu, Chi

    2014-10-01

    Respiratory and cardiac motions can degrade myocardial perfusion SPECT (MPS) image quality and reduce defect detection and quantitative accuracy. In this study, we developed a dual respiratory and cardiac gating system for a high-resolution fully stationary cardiac SPECT scanner in order to improve the image quality and defect detection. Respiratory motion was monitored using a compressive sensor pillow connected to a dual respiratory-cardiac gating box, which sends cardiac triggers only during end-expiration phases to the single cardiac trigger input on the SPECT scanners. The listmode data were rebinned retrospectively into end-expiration frames for respiratory motion reduction or eight cardiac gates only during end-expiration phases to compensate for both respiratory and cardiac motions. The proposed method was first validated on a motion phantom in the presence and absence of multiple perfusion defects, and then applied on 11 patient studies with and without perfusion defects. In the normal phantom studies, the end-expiration gated SPECT (EXG-SPECT) reduced respiratory motion blur and increased myocardium to blood pool contrast by 51.2% as compared to the ungated images. The proposed method also yielded an average of 11.2% increase in myocardium to defect contrast as compared to the ungated images in the phantom studies with perfusion defects. In the patient studies, EXG-SPECT significantly improved the myocardium to blood pool contrast (p < 0.005) by 24% on average as compared to the ungated images, and led to improved perfusion uniformity across segments on polar maps for normal patients. For a patient with defect, EXG-SPECT improved the defect contrast and definition. The dual respiratory-cardiac gating further reduced the blurring effect, increased the myocardium to blood pool contrast significantly by 36% (p < 0.05) compared to EXG-SPECT, and further improved defect characteristics and visualization of fine structures at the expense of increased noise on

  16. End-expiration respiratory gating for a high-resolution stationary cardiac SPECT system

    International Nuclear Information System (INIS)

    Respiratory and cardiac motions can degrade myocardial perfusion SPECT (MPS) image quality and reduce defect detection and quantitative accuracy. In this study, we developed a dual respiratory and cardiac gating system for a high-resolution fully stationary cardiac SPECT scanner in order to improve the image quality and defect detection. Respiratory motion was monitored using a compressive sensor pillow connected to a dual respiratory–cardiac gating box, which sends cardiac triggers only during end-expiration phases to the single cardiac trigger input on the SPECT scanners. The listmode data were rebinned retrospectively into end-expiration frames for respiratory motion reduction or eight cardiac gates only during end-expiration phases to compensate for both respiratory and cardiac motions. The proposed method was first validated on a motion phantom in the presence and absence of multiple perfusion defects, and then applied on 11 patient studies with and without perfusion defects. In the normal phantom studies, the end-expiration gated SPECT (EXG-SPECT) reduced respiratory motion blur and increased myocardium to blood pool contrast by 51.2% as compared to the ungated images. The proposed method also yielded an average of 11.2% increase in myocardium to defect contrast as compared to the ungated images in the phantom studies with perfusion defects. In the patient studies, EXG-SPECT significantly improved the myocardium to blood pool contrast (p < 0.005) by 24% on average as compared to the ungated images, and led to improved perfusion uniformity across segments on polar maps for normal patients. For a patient with defect, EXG-SPECT improved the defect contrast and definition. The dual respiratory–cardiac gating further reduced the blurring effect, increased the myocardium to blood pool contrast significantly by 36% (p < 0.05) compared to EXG-SPECT, and further improved defect characteristics and visualization of fine structures at the expense of increased

  17. Cardiac failure due to arteriovenous fistula with brachiocephalic stenosis: a gated heart case study

    International Nuclear Information System (INIS)

    Full text: There are numerous causes of cardiac failure of which the commonest in our community include ischaemic cardiomyopathy, post-viral cardiomyopathy, alcohol-induced cardiomyopathy and drug-induced cardiomyopathy. All these entities cause low output cardiac failure however high output cardiac failure is also well recognised. This includes heart failure related to such conditions as hyperthyroidism, anaemia, pregnancy, beri-beri, and Paget's disease. A rare cause of high output cardiac failure is an arteriovenous fistula. We present an unusual case of a patient with end-stage renal failure on haemodialysis who developed extensive dilatation of their left arm arteriovenous fistula secondary to bachiocephalic vein stenosis. The labelled red blood cell gated heart blood pool study demonstrated decreased left ventricular function and extensive pooling of blood within the tortuous dilated left arm vessels. A follow-up study post-ligation of the arteriovenous fistula showed improvement of the left ventricular ejection fraction. The associated contrast venography findings are also demonstrated. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  18. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  19. TU-A-12A-09: Absolute Blood Flow Measurement in a Cardiac Phantom Using Low Dose CT

    Energy Technology Data Exchange (ETDEWEB)

    Ziemer, B; Hubbard, L; Lipinski, J; Molloi, S [University of California, Irvine, CA (United States)

    2014-06-15

    Purpose: To investigate a first pass analysis technique to measure absolute flow from low dose CT images in a cardiac phantom. This technique can be combined with a myocardial mass assignment to yield absolute perfusion using only two volume scans and reduce the radiation dose to the patient. Methods: A four-chamber cardiac phantom and perfusion chamber were constructed from poly-acrylic and connected with tubing to approximate anatomical features. The system was connected to a pulsatile pump, input/output reservoirs and power contrast injector. Flow was varied in the range of 1-2.67 mL/s with the pump operating at 60 beats/min. The system was imaged once a second for 14 seconds with a 320-row scanner (Toshiba Medical Systems) using a contrast-enhanced, prospective-gated cardiac perfusion protocol. Flow was calculated by the following steps: subsequent images of the perfusion volume were subtracted to find the contrast entering the volume; this was normalized by an upstream, known volume region to convert Hounsfield (HU) values to concentration; this was divided by the subtracted images time difference. The technique requires a relatively stable input contrast concentration and no contrast can leave the perfusion volume before the flow measurement is completed. Results: The flow calculated from the images showed an excellent correlation with the known rates. The data was fit to a linear function with slope 1.03, intercept 0.02 and an R{sup 2} value of 0.99. The average root mean square (RMS) error was 0.15 mL/s and the average standard deviation was 0.14 mL/s. The flow rate was stable within 7.7% across the full scan and served to validate model assumptions. Conclusion: Accurate, absolute flow rates were measured from CT images using a conservation of mass model. Measurements can be made using two volume scans which can substantially reduce the radiation dose compared with current dynamic perfusion techniques.

  20. TU-A-12A-09: Absolute Blood Flow Measurement in a Cardiac Phantom Using Low Dose CT

    International Nuclear Information System (INIS)

    Purpose: To investigate a first pass analysis technique to measure absolute flow from low dose CT images in a cardiac phantom. This technique can be combined with a myocardial mass assignment to yield absolute perfusion using only two volume scans and reduce the radiation dose to the patient. Methods: A four-chamber cardiac phantom and perfusion chamber were constructed from poly-acrylic and connected with tubing to approximate anatomical features. The system was connected to a pulsatile pump, input/output reservoirs and power contrast injector. Flow was varied in the range of 1-2.67 mL/s with the pump operating at 60 beats/min. The system was imaged once a second for 14 seconds with a 320-row scanner (Toshiba Medical Systems) using a contrast-enhanced, prospective-gated cardiac perfusion protocol. Flow was calculated by the following steps: subsequent images of the perfusion volume were subtracted to find the contrast entering the volume; this was normalized by an upstream, known volume region to convert Hounsfield (HU) values to concentration; this was divided by the subtracted images time difference. The technique requires a relatively stable input contrast concentration and no contrast can leave the perfusion volume before the flow measurement is completed. Results: The flow calculated from the images showed an excellent correlation with the known rates. The data was fit to a linear function with slope 1.03, intercept 0.02 and an R2 value of 0.99. The average root mean square (RMS) error was 0.15 mL/s and the average standard deviation was 0.14 mL/s. The flow rate was stable within 7.7% across the full scan and served to validate model assumptions. Conclusion: Accurate, absolute flow rates were measured from CT images using a conservation of mass model. Measurements can be made using two volume scans which can substantially reduce the radiation dose compared with current dynamic perfusion techniques

  1. RT-PCR em pools de soros sangüíneos para o diagnóstico da infecção aguda e de animais persistentemente infectados pelo vírus da diarréia viral bovina RT-PCR in pools of bovine blood serum to detect acute infection and persistently infected animals with bovine viral diarrhea virus

    Directory of Open Access Journals (Sweden)

    D. Pilz

    2007-02-01

    Full Text Available Utilizou-se a técnica da RT-PCR para a detecção da região 5' UTR do genoma do vírus da diarréia viral bovina (BVDV em pools de soros sangüíneos provenientes de um rebanho, constituído por 226 animais, que apresentava distúrbios da reprodução. A partir das amostras individuais de soro e de acordo com a categoria dos animais e o número de animais por categoria foram formados 10 pools (A a J de soros. A primeira avaliação revelou a amplificação de um produto com 290pb nas reações referentes aos grupos D (35 vacas e H (25 bezerros lactentes que, após o desmembramento em amostras individuais, resultou na identificação de 11 vacas lactantes e 12 bezerros em amamentação positivos. Para a identificação de animais persistentemente infectados (PI entre os 23 positivos na primeira avaliação, realizou-se a segunda colheita de soros sangüíneos, três meses após. A RT-PCR das amostras individuais de soro revelou resultado positivo em cinco bezerros. Em dois, foi possível isolar o BVDV em cultivo de células MDBK. A especificidade das reações da RT-PCR foi confirmada pelo seqüenciamento dos produtos amplificados a partir do soro de uma vaca com infecção aguda, de um bezerro PI e das duas amostras do BVDV isoladas em cultivo celular. A utilização da RT-PCR em pools de soros sangüíneos demonstrou ser uma estratégia rápida de diagnóstico etiológico e de baixo custo tanto para a detecção de infecção aguda quanto de animais PI.The 5' untranslated region of the bovine viral diarrhea virus (BVDV genome was detected by RT-PCR assay in pools of blood sera samples collected from a cattle herd (n=226 animals with reproductive failures. Based on the classes of animal and the number of animals per class, the individual blood serum samples were distributed in 10 sera pools (A to J. During the first evaluation a 290bp amplicon was amplified in reactions from groups D (35 cows and H (25 sucking calves. The individual analysis

  2. Cardiac Glycosides Inhibit LPS-induced Activation of Pro-inflammatory Cytokines in Whole Blood through an NF-kappa-B-dependent Mechanism

    Directory of Open Access Journals (Sweden)

    Shah VO*

    2011-03-01

    Full Text Available Summary: The process of hemodialysis (HD produces a pro-inflammatory state that can lead to an increased risk for cardiovascular disease. In part, this is the result of activation of the pro-inflammatory transcription factor NF-B in response to uremia as well as in response to HD itself, which not only involves exposure of blood leukocytes to abnormal surfaces but also potentially to any bacterial contamination associated with HD. Previously, we used lipopolysaccharide (LPS to activate isolated peripheral blood mononuclear cells (PBMC, as a model of HD-induced stress, and demonstrated that specific natural products that are known to inhibit the activation of NF-B exhibited a broad anti-inflammatory activity. These natural products, however, were not effective when whole blood was used. In the present study, a natural product library (TimTec NPL480 was screened, using whole blood, for the abilities of these natural products to protect against LPS-induced expression and secretion of the pro-inflammatory cytokines TNF, IL-1 and IL-6. We report here that the cardiac glycosides strophanthidin, ouabain, proscillaridin A, digoxin, digitoxin and lanatoside C are effective natural products that limit the development of a pro-inflammatory state by preventing the activation of these pro-inflammatory signals. These active natural products also inhibited the stress-induced activation of NF-B in a reporter assay, suggesting that inhibition of NF-kappa-B is at least partly the mechanism by which these natural products protect whole blood leukocytes from activation by LPS. Industrial relevance: Media for hemodialysis is used millions of times annually for patients with end stage renal disease, each use representing a potential pro-inflammatory insult. It would be useful to have a drug that could be added to the media which would protect blood leukocytes from any pro-inflammatory activation that may accompany the dialysis procedure. A natural

  3. Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure

    International Nuclear Information System (INIS)

    The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 (Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume (RVEDV) was calculated as RVEDV = CO/(EF x HR) (CO = cardiac output; HR = heart rate). Systolic work (W sub(S)), diastolic work (W sub(D)) and net work (W sub(N)) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: 1. RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. 2. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. 3. Right ventricular end-diastolic volume index (RVEDVI) showed a converse relation with RVEF. 4. Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p<0.05). 5. RV W sub(S), RV W sub(D) and RV W sub(N) showed no difference among each groups in the control state, and significantly decreased after NG. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting

  4. Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure

    Energy Technology Data Exchange (ETDEWEB)

    Yasue, Takao; Watanabe, Sachiro; Sugishita, Nobuyoshi; Tanaka, Tsutomu; Yokoyama, Hideo (Prefectural Gifu Hospital (Japan))

    1983-09-01

    The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 (Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume (RVEDV) was calculated as RVEDV = CO/(EF x HR) (CO = cardiac output; HR = heart rate). Systolic work (W sub(S)), diastolic work (W sub(D)) and net work (W sub(N)) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: 1. RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. 2. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. 3. Right ventricular end-diastolic volume index (RVEDVI) showed a converse relation with RVEF. 4. Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p<0.05). 5. RV W sub(S), RV W sub(D) and RV W sub(N) showed no difference among each groups in the control state, and significantly decreased after NG. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting.

  5. Effects of transfer from the operating room to the intensive care unit after cardiac surgery on hemodynamics and blood gases

    International Nuclear Information System (INIS)

    Objective was to evaluate the effect of transferring open-heart surgery patients from the operating room to the intensive care unit on hemodynamic parameters and blood gases. The study was conducted as a prospective, observational study at the German Hospital, Istanbul, Turkey in 2007. Hemodynamic, blood gas values and oxygen saturation measured by pulse oximetry SpO2 values were recorded in 37 patients who undergone open-heart surgery. Data were evaluated by descriptive statistical methods, Friedman's test and correlation analysis. Thirty-seven patients were included in this study. The low systolic and diastolic arterial blood pressure values prior to transfer, while patients were still under the effect of anesthesia, increased during the transfer and to one and 30 minutes after completion of transfer and return to normal values p<0.05. The SpO2 value measured at 30 minutes after completion of transfer was higher than the first value p<0.05. The pH p<0.001 and arterial partial pressure of oxygen p<0.001 values at the beginning of the transfer had significantly increased at the end of transfer and arterial partial pressure of carbon dioxide values had significantly decreased p<0.001. The transfer of open-heart surgery patients was observed to safe. (author)

  6. In vivo MRI measurement of fetal blood oxygen saturation in cardiac ventricles of fetal sheep: a feasibility study.

    Science.gov (United States)

    Wedegärtner, Ulrike; Kooijman, Hendrik; Yamamura, Jin; Frisch, Michael; Weber, Christoph; Buchert, Ralph; Huff, Anna; Hecher, Kurt; Adam, Gerhard

    2010-07-01

    The purpose of this study was to assess the feasibility to determine fetal blood oxygen saturation (sO(2)) with T(2)-weighted MR sequences using a fetal sheep model. T(2) measurements were performed on a 1.5-T scanner using a T(2) preparation pulse in combination with a three-dimensional balanced steady-state free precession sequence repeated at different echo times. Eight sheep fetuses were examined during a control, hypoxic, and recovery phase to perform T(2)-weighted scans of the fetal blood in the heart. Signal intensities in the left and right ventricle were measured to calculate the MR blood sO(2). During each phase, fetal carotid artery sO(2) was directly measured and correlated with MR sO(2). A Bland-Altman plot was performed. Fetal carotid artery sO(2) was 69% sO(2) during control, 16% sO(2) during hypoxemia, and 67% sO(2) during recovery. Mean values of the MR sO(2) were 49% sO(2) and 40% sO(2) for control, 6% sO(2) and 3% sO(2) for hypoxemia, and 51% sO(2) and 43% sO(2) for recovery in left ventricle and right ventricle, respectively. Mean values of fetal carotid artery sO(2) and MR sO(2) were highly correlated (left ventricle: r = 0.87, right ventricle: r = 0.89). According to the Bland-Altman plot, MR sO(2) was lower compared to fetal carotid artery sO(2) (left ventricle: 15%, right ventricle: 20%). Based on our preliminary results, it seems to be possible to assess fetal sO(2) with MR oximetry. PMID:20572133

  7. Cardiac catheterization and angiography. Third edition

    International Nuclear Information System (INIS)

    This book discusses the papers on cardiac catheterization and angiography. The topics covered are: historical perspective and present practice of cardiac catheterization; angiography principles and utilization of radiologic and cineangiographic equipment; complications, incidence and prevention of side effects of cardiac catheterization; techniques; blood flow measurement of heart; pressure measurement; diagnostic techniques of angiography; special catheter techniques; coronary angiography, temporary and permanent pacemakers, potential role of lasers in the cardiac catheterization and evaluation of cardiac function

  8. Hawaii ESI: POOLS (Anchialine Pool Points)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for anchialine pools in Hawaii. Anchialine pools are small, relatively shallow coastal ponds that occur...

  9. Blood gases and oxygen saturation response to active cycle of breathing techniques in COPD patients during phase I of cardiac rehabilitation

    International Nuclear Information System (INIS)

    Objective: To determine the effectiveness of active cycle of breathing techniques (ACBTs) on arterial blood gases (ABG), oxygen saturation and other vitals including chest expansion, heart rate, and respiratory rate in COPD patients during phase I of cardiac rehabilitation program after open heart surgery. Methodology: In this experimental study, sample size chosen was 100 patients, randomly divided into experimental (n=50) and control (n=50) groups. Pre-test values of ABG, oxygen saturation, chest expansion, respiratory rate, and heart rate of the participants were taken. Then, conventional physical therapy including spirometry was performed 2 hourly by the control group whereas the experimental group performed ACBTs along with spirometry twice a day for a period of one week. Participants were re-assessed after one week treatment. Results: There was highly significant difference (p<0.01) in pre-test and post-test values of PCO/sub 2/ and oxygen saturation in experimental group as compared to control group. The results of bicarbonate values, base excess and heart rate were statistically significant (p<0.01) in control group and there was no significant difference (p>0.05) in experimental group. The values of pH, chest expansion and respiratory rate were highly significant (p<0.01) in both control as well as experimental group. Conclusion: ACBT was more effective to decrease post CABG complication as compared to conventional chest physical therapy. Some parameters like bicarbonate values, base excess and heart rate did not show improvement with ACBT. (author)

  10. Selenoprotein P and apolipoprotein E receptor-2 interact at the blood-brain barrier and also within the brain to maintain an essential selenium pool that protects against neurodegeneration

    Science.gov (United States)

    Burk, Raymond F.; Hill, Kristina E.; Motley, Amy K.; Winfrey, Virginia P.; Kurokawa, Suguru; Mitchell, Stuart L.; Zhang, Wanqi

    2014-01-01

    Selenoprotein P (Sepp1) and its receptor, apolipoprotein E receptor 2 (apoER2), account for brain retaining selenium better than other tissues. The primary sources of Sepp1 in plasma and brain are hepatocytes and astrocytes, respectively. ApoER2 is expressed in varying amounts by tissues; within the brain it is expressed primarily by neurons. Knockout of Sepp1 or apoER2 lowers brain selenium from ∼120 to ∼50 ng/g and leads to severe neurodegeneration and death in mild selenium deficiency. Interactions of Sepp1 and apoER2 that protect against this injury have not been characterized. We studied Sepp1, apoER2, and brain selenium in knockout mice. Immunocytochemistry showed that apoER2 mediates Sepp1 uptake at the blood-brain barrier. When Sepp1−/− or apoER2−/− mice developed severe neurodegeneration caused by mild selenium deficiency, brain selenium was ∼35 ng/g. In extreme selenium deficiency, however, brain selenium of ∼12 ng/g was tolerated when both Sepp1 and apoER2 were intact in the brain. These findings indicate that tandem Sepp1-apoER2 interactions supply selenium for maintenance of brain neurons. One interaction is at the blood-brain barrier, and the other is within the brain. We postulate that Sepp1 inside the blood-brain barrier is taken up by neurons via apoER2, concentrating brain selenium in them.—Burk, R. F., Hill, K. E., Motley, A. K., Winfrey, V. P., Kurokawa, S., Mitchell, S. L., Zhang, W. Selenoprotein P and apolipoprotein E receptor-2 interact at the blood-brain barrier and also within the brain to maintain an essential selenium pool that protects against neurodegeneration. PMID:24760755

  11. Effects of dobutamine stress on cardiac contraction synchronism in a canine model

    International Nuclear Information System (INIS)

    In cardiac resynchronization therapy, many devices need to be optimized to take into account the magnitude and characteristics of patients’ ventricular mechanical dyssynchrony. The optimization process is mostly performed at rest; however, mechanical resynchronization might be more important under stress, while patients need to improve their cardiac efficiency. The objective of this study was to observe if levels of cardiac stress could modify the ventricular contraction synchronism. Cardiac stress was induced with dobutamine infusion in eight healthy canine subjects. Hemodynamic and ventricular synchronism assessments were performed by left ventricular pressure measurements and radionuclide tomographic-gated blood pools. Cardiac output increased from 2.8 ± 1.0 at rest to 5.7 ± 2.2 L min−1 at 20 µg kg−1 min−1, while the ventricular performance (dP/dtmax) increased from 1588 ± 374 to 8004 ± 710 mmHg s−1. At baseline, the interventricular delay (in degrees) was −6.3 ± 2.6°, the left ventricle contraction preceding the right. The delay significantly increased to −21.6 ± 3.1° with dobutamine stress (p < 0.0001). On assessment of the left intraventricular synchrony, septal-to-lateral delay was −6.9 ± 5.1° at baseline which revealed a preceded contraction of the left lateral wall from the septum. Cardiac stress produced a significant modulation (p = 0.01), with an inversion of the contraction pattern, the septum contraction preceding the lateral wall contraction by 15.5 ± 5.6° at maximum dobutamine infusion; a significant linear trend (p < 0.001) was found between cardiac stress levels and septal-to-lateral delays. Cardiac activity levels modified the ventricular synchronism supporting the fact that optimizations of cardiac resynchronization devices could be improved by taking cardiac stress into account. (paper)

  12. Evaluation of 99mTc-albumin distribution ratio in cardiac chambers and lungs

    International Nuclear Information System (INIS)

    In order to assess blood volume of the cardiac chambers and lungs, distribution ratio of 99mTc-albumin (HSA) was obtained from radionuclide angiocardiogram and non-gated or gated equilibrium cardiac pool scintigram, using a scintillation camera coupled to a minicomputer. The radioactivity of 99mTc of the entire cardiac blood pool including the large vessels (T), the right ventricle including the right atrium (RV) and the left ventricle (LV) was calculated from the 30deg anterior oblique cardiac pool scintigram. That of the both lungs (Lu) was calculated from the anterior cardiac pool scintigram. The radioactivity of total injected dose of HSA (H) was estimated from the initial transit of the tracer obtained by the radionuclide angiocardiogram. Then, distribution ratio of HSA of the each region of interest was expressed as RV/H, LV/H, T/H and Lu/H. RV/H, LV/H and T/H were 3.4±0.6%, 3.1±0.5% and 10.4±2.0% in controls, 6.0±0.8%, 2.6±0.8% and 14.2±2.4% in cor pulmonale, and 7.9±1.7%, 7.7±3.5% and 20.7±4.3% in heart diseases with left heart failure, respectively. Lu/H was 4.9±1.4% in controls, 4.4±1.1% in cor pulmonale and 6.6±1.9% in heart diseases without left heart failure. LV/H was correlated with left ventricular end-diastolic volume by contrast ventriculography. LV/H and RV/H were related with functional classification of NYHA. In conclusion, these parameters may be utilized as indices of the volume of blood pool of the heart chambers and lungs, and this method seems to be clinically applicable for the evaluation of pathophysiology in heart diseases. (author)

  13. Sympathetic Activation Does Not Affect the Cardiac and Respiratory Contribution to the Relationship between Blood Pressure and Pial Artery Pulsation Oscillations in Healthy Subjects.

    Directory of Open Access Journals (Sweden)

    Pawel J Winklewski

    Full Text Available Using a novel method called near-infrared transillumination backscattering sounding (NIR-T/BSS that allows for the non-invasive measurement of pial artery pulsation (cc-TQ and subarachnoid width (sas-TQ in humans, we assessed the influence of sympathetic activation on the cardiac and respiratory contribution to blood pressure (BP cc-TQ oscillations in healthy subjects.The pial artery and subarachnoid width response to handgrip (HGT and cold test (CT were studied in 20 healthy subjects. The cc-TQ and sas-TQ were measured using NIR-T/BSS; cerebral blood flow velocity (CBFV was measured using Doppler ultrasound of the left internal carotid artery; heart rate (HR and beat-to-beat mean BP were recorded using a continuous finger-pulse photoplethysmography; respiratory rate (RR, minute ventilation (MV, end-tidal CO2 (EtCO2 and end-tidal O2 (EtO2 were measured using a metabolic and spirometry module of the medical monitoring system. Wavelet transform analysis was used to assess the relationship between BP and cc-TQ oscillations.HGT evoked an increase in BP (+15.9%; P<0.001, HR (14.7; P<0.001, SaO2 (+0.5; P<0.001 EtO2 (+2.1; P<0.05 RR (+9.2%; P = 0.05 and MV (+15.5%; P<0.001, while sas-TQ was diminished (-8.12%; P<0.001, and a clear trend toward cc-TQ decline was observed (-11.0%; NS. CBFV (+2.9%; NS and EtCO2 (-0.7; NS did not change during HGT. CT evoked an increase in BP (+7.4%; P<0.001, sas-TQ (+3.5%; P<0.05 and SaO2(+0.3%; P<0.05. HR (+2.3%; NS, CBFV (+2.0%; NS, EtO2 (-0.7%; NS and EtCO2 (+0.9%; NS remained unchanged. A trend toward decreased cc-TQ was observed (-5.1%; NS. The sas-TQ response was biphasic with elevation during the first 40 seconds (+8.8% vs. baseline; P<0.001 and subsequent decline (+4.1% vs. baseline; P<0.05. No change with respect to wavelet coherence and wavelet phase coherence was found between the BP and cc-TQ oscillations.Short sympathetic activation does not affect the cardiac and respiratory contribution to the relationship

  14. Human umbilical cord blood mononuclear cells activate the survival protein Akt in cardiac myocytes and endothelial cells that limits apoptosis and necrosis during hypoxia.

    Science.gov (United States)

    Henning, Robert J; Dennis, Steve; Sawmiller, Darrell; Hunter, Lorynn; Sanberg, Paul; Miller, Leslie

    2012-06-01

    We have previously reported that human umbilical cord blood mononuclear cells (HUCBC), which contain hematopoietic, mesenchymal, and endothelial stem cells, can significantly reduce acute myocardial infarction size. To determine the mechanism whereby HUCBC increase myocyte and vascular endothelial cell survival, we treated cardiac myocytes and coronary artery endothelial cells in separate experiments with HUCBC plus culture media or culture media alone and subjected the cells to 24 h of hypoxia or normoxia. We then determined in myocytes and endothelial cells activation of the cell survival protein Akt by Western blots. We also determined in these cells apoptosis by annexin V staining and necrosis by propidium iodide staining. Thereafter, we inhibited with API, a specific and sensitive Akt inhibitor, Akt activation in myocytes and endothelial cells cultured with HUCBC during hypoxia and determined cell apoptosis and necrosis. In cells cultured without HUCBC, hypoxia only slightly activated Akt. Moreover, hypoxia increased myocyte apoptosis by ≥ 226% and necrosis by 58% in comparison with myocytes in normoxia. Hypoxic treatment of endothelial cells without HUCBC increased apoptosis by 94% and necrosis by 59%. In contrast, hypoxia did not significantly affect HUCBC. Moreover, in myocyte + HUCBC cultures in hypoxia, HUCBC induced a ≥ 135% increase in myocyte phospho-Akt. Akt activation decreased myocyte apoptosis by 76% and necrosis by 35%. In endothelial cells, HUCBC increased phospho-Akt by 116%. HUCBC also decreased endothelial cell apoptosis by 58% and necrosis by 42%. Inhibition of Akt with API in myocytes and endothelial cells cultured with HUCBC during hypoxia nearly totally prevented the HUCBC-induced decrease in apoptosis and necrosis. We conclude that HUCBC can significantly decrease hypoxia-induced myocyte and endothelial cell apoptosis and necrosis by activating Akt in these cells and in this manner HUCBC can limit myocardial ischemia and injury. PMID

  15. Blood pressure and fasting lipid changes after 24 weeks’ treatment with vildagliptin: a pooled analysis in >2,000 previously drug-naïve patients with type 2 diabetes mellitus

    Science.gov (United States)

    Evans, Marc; Schweizer, Anja; Foley, James E

    2016-01-01

    Introduction We have previously shown modest weight loss with vildagliptin treatment. Since body weight balance is associated with changes in blood pressure (BP) and fasting lipids, we have assessed these parameters following vildagliptin treatment. Methods Data were pooled from all double-blind, randomized, controlled, vildagliptin mono-therapy trials on previously drug-naïve patients with type 2 diabetes mellitus who received vildagliptin 50 mg once daily (qd) or twice daily (bid; n=2,108) and wherein BP and fasting lipid data were obtained. Results Data from patients receiving vildagliptin 50 mg qd or bid showed reductions from baseline to week 24 in systolic BP (from 132.5±0.32 to 129.8±0.34 mmHg; P<0.0001), diastolic BP (from 81.2±0.18 to 79.6±0.19 mmHg; P<0.0001), fasting triglycerides (from 2.00±0.02 to 1.80±0.02 mmol/L; P<0.0001), very low density lipoprotein cholesterol (from 0.90±0.01 to 0.83±0.01 mmol/L; P<0.0001), and low density lipoprotein cholesterol (from 3.17±0.02 to 3.04±0.02 mmol/L; P<0.0001), whereas high density lipoprotein cholesterol increased (from 1.19±0.01 to 1.22±0.01 mmol/L; P<0.001). Weight decreased by 0.48±0.08 kg (P<0.001). Conclusion This large pooled analysis demonstrated that vildagliptin shows a significant reduction in BP and a favorable fasting lipid profile that are associated with modest weight loss. PMID:27574437

  16. Swimming pool cleaner poisoning

    Science.gov (United States)

    Swimming pool cleaner poisoning occurs when someone swallows this type of cleaner, touches it, or breathes in ... The harmful substances in swimming pool cleaner are: Bromine ... copper Chlorine Soda ash Sodium bicarbonate Various mild acids

  17. Swimming pool granuloma

    Science.gov (United States)

    A swimming pool granuloma is a long-term (chronic) skin infection. It is caused by the bacteria Mycobacterium marinum . ... A swimming pool granuloma occurs when water containing Mycobacterium marinum bacteria enters a break in the skin. Signs of ...

  18. Sonographic shift of hypervascular liver tumor on blood pool harmonic images with definity: Time-related changes of contrast-enhanced appearance in rabbit VX2 tumor under extra-low acoustic power

    International Nuclear Information System (INIS)

    We elucidated the features of the time-related contrast-enhanced ultrasound appearance of hypervascular liver tumor using Definity, which has no accumulation activity in the liver. Ten rabbits with VX2 tumors broadcast into the liver were used. Changes in contrast-enhanced sonograms were evaluated by real-time observation (FR 15 Hz) of harmonic imaging under extra-low MI (MI 0.065) with Definity, and their intensity changes were analyzed. Hepatic angiography (4/10) and histopathological examination (10/10) were performed to investigate the tumor vascularity. VX2 tumors were hypervascular on angiogram (4/10) and histology (10/10). They showed time-related sonographic appearance changes from hyperechoic to hypoechoic, which were confirmed by quantitative intensity analysis. Hypervascular VX2 tumors showed characteristic time-related shift on contrast-enhanced sonograms in real-time and extra-low MI harmonic images with Definity. These findings may be useful for the ultrasound diagnosis of human hypervascular liver tumor like hepatocellular carcinoma with blood-pool contrast agent

  19. The science of pooling

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, E.

    1995-10-01

    The pooling of data from radon studies is described. Pooling refers to the analysis of original data from several studies, not meta-analysis in which summary measures from published data are analyzed. A main objective for pooling is to reduce uncertainty and to obtain more precise estimates of risk than would be available from any single study.

  20. Correlação entre gasometria atrial direita e índice cardíaco no pós-operatório de cirurgia cardíaca Correlation between right atrial venous blood gasometry and cardiac index in cardiac surgery postoperative period

    Directory of Open Access Journals (Sweden)

    João Jackson Duarte

    2010-06-01

    Full Text Available OBJETIVO: Determinar a confiabilidade em se correlacionar o índice cardíaco com os dados fornecidos pela gasometria do sangue venoso atrial direito em pacientes submetidos à cirurgia cardíaca, durante o período pós-operatório. MÉTODOS: A partir das amostras de sangue arterial e venoso do átrio direito, colhidas no pós-operatório de cirurgia cardíaca, foram determinados os parâmetros de oxigênio do sangue venoso do átrio direito. Estes parâmetros foram então comparados com o índice cardíaco determinado pela termodiluição. RESULTADOS: Houve boa correlação entre a saturação de oxigênio do sangue venoso do átrio direito (SvO2, diferença artério-venosa do conteúdo de oxigênio do sangue colhido no átrio direito e o índice cardíaco aferido pela termodiluição, com boa sensibilidade e especificidade e alto valor preditivo positivo e negativo. A pressão do sangue do átrio direito (PvO2 apresentou baixa sensibilidade na estimativa de baixo débito cardíaco. CONCLUSÃO: No pós-operatório de cirurgia cardíaca, a SvO2e a diferença artério-venosa do conteúdo de oxigênio (C(avO2 apresentaram-se como parâmetros confiáveis correlacionados a baixo débito cardíaco. A PvO2 foi pouco sensível no diagnóstico de baixo débito no pós-operatório de cirurgia cardíaca.OBJECTIVE: To determine, even during postoperative period, the confiability of the cardiac index correlate with the data data given by a central atrial venous blood gasometry in patients who underwent cardiac surgery. METHODS: From the sample of arterial and venous blood of right atrium gathered in postoperative of cardiac surgery, it was determinated the hemoglobin concentration and the gasometric study through what was observed of the venous oxygen saturation (SvO2 and the partial pressure of oxygen from venous blood gathered in right atrium (PvO2, add to the calculation of artery-venous difference of the oxygen content - radial artery / right atrium (C

  1. Blood pressure and fasting lipid changes after 24 weeks’ treatment with vildagliptin: a pooled analysis in >2,000 previously drug-naïve patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Evans M

    2016-08-01

    Full Text Available Marc Evans,1 Anja Schweizer,2 James E Foley3 1Diabetes Resource Centre, Llandough Hospital, Cardiff, UK; 2Medical Affairs Cardio Metabolic, Novartis Pharma AG, Basel, Switzerland; 3Medical Affairs Cardio-Metabolic, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA Introduction: We have previously shown modest weight loss with vildagliptin treatment. Since body weight balance is associated with changes in blood pressure (BP and fasting lipids, we have assessed these parameters following vildagliptin treatment. Methods: Data were pooled from all double-blind, randomized, controlled, vildagliptin monotherapy trials on previously drug-naïve patients with type 2 diabetes mellitus who received vildagliptin 50 mg once daily (qd or twice daily (bid; n=2,108 and wherein BP and fasting lipid data were obtained. Results: Data from patients receiving vildagliptin 50 mg qd or bid showed reductions from baseline to week 24 in systolic BP (from 132.5±0.32 to 129.8±0.34 mmHg; P<0.0001, diastolic BP (from 81.2±0.18 to 79.6±0.19 mmHg; P<0.0001, fasting triglycerides (from 2.00±0.02 to 1.80±0.02 mmol/L; P<0.0001, very low density lipoprotein cholesterol (from 0.90±0.01 to 0.83±0.01 mmol/L; P<0.0001, and low density lipoprotein cholesterol (from 3.17±0.02 to 3.04±0.02 mmol/L; P<0.0001, whereas high density lipoprotein cholesterol increased (from 1.19±0.01 to 1.22±0.01 mmol/L; P<0.001. Weight decreased by 0.48±0.08 kg (P<0.001. Conclusion: This large pooled analysis demonstrated that vildagliptin shows a significant reduction in BP and a favorable fasting lipid profile that are associated with modest weight loss. Keywords: TG, HDL, LDL, body weight DPP-4 inhibitor, GLP-1 

  2. Oncogenic osteomalacia diagnosed by blood pool scintigraphy

    International Nuclear Information System (INIS)

    Oncogenic osteomalacia is a rare metabolic bone disease characterized by phosphaturia and hypophosphatemia. Certain tumors secrete a phosphaturic factor, which results in this metabolic abnormality; this factor called as phosphatonin, is in fact a fibroblast growth factor 23 (FGF-23) involved closely in phosphate homeostasis and skeletogenesis. Complete excision of these tumors facilitates reversal of the problem. We have reported here the case of a patient who was crippled with this disease and on thorough investigation revealed an oncogenic osteomalacia with tumor focus in the right tibia. The tumor was identified as a mesenchymal tumor, i.e., hemangiopericytoma. Tumor excision alleviated patient symptoms with rapid symptomatic and biochemical improvement

  3. Endothelin A receptor antagonist, atrasentan, attenuates renal and cardiac dysfunction in Dahl salt-hypertensive rats in a blood pressure independent manner.

    Directory of Open Access Journals (Sweden)

    Mohammed A Samad

    Full Text Available Proteinuria is a hallmark of chronic kidney disease (CKD and cardiovascular disease (CVD, and a good predictor of clinical outcome. Selective endothelin A (ETA receptor antagonist used with renin-angiotensin system (RAS inhibitors prevents development of proteinuria in CKD. However, whether the improvement in proteinuria would have beneficial effects on CVD, independent of RAS inhibition, is not well understood. In this study, we investigated whether atrasentan, an ETA receptor antagonist, has renal and cardiovascular effects independent of RAS inhibition. Male Dahl salt sensitive (DSS rats, at six weeks of age, received water with or without different doses of atrasentan and/or enalapril under high salt (HS diet or normal diet (ND for 6 weeks. At the end of 12th week, atrasentan at a moderate dose significantly attenuated proteinuria and serum creatinine without reducing mean arterial pressure (MAP, thereby preventing cardiac hypertrophy and improving cardiac function. ACE inhibitor enalapril at a dose that did not significantly lowered BP, attenuated cardiac hypertrophy while moderately improving cardiac function without reducing proteinuria and serum creatinine level. Nonetheless, combined therapy of atrasentan and enalapril that does not altering BP exerted additional cardioprotective effect. Based on these findings, we conclude that BP independent monotherapy of ETA receptor antagonist attenuates the progression of CKD and significantly mitigates CVD independent of RAS inhibition.

  4. Endothelin A receptor antagonist, atrasentan, attenuates renal and cardiac dysfunction in Dahl salt-hypertensive rats in a blood pressure independent manner.

    Science.gov (United States)

    Samad, Mohammed A; Kim, Ui Kyoung; Kang, Joshua J; Ke, Qingen; Kang, Peter M

    2015-01-01

    Proteinuria is a hallmark of chronic kidney disease (CKD) and cardiovascular disease (CVD), and a good predictor of clinical outcome. Selective endothelin A (ETA) receptor antagonist used with renin-angiotensin system (RAS) inhibitors prevents development of proteinuria in CKD. However, whether the improvement in proteinuria would have beneficial effects on CVD, independent of RAS inhibition, is not well understood. In this study, we investigated whether atrasentan, an ETA receptor antagonist, has renal and cardiovascular effects independent of RAS inhibition. Male Dahl salt sensitive (DSS) rats, at six weeks of age, received water with or without different doses of atrasentan and/or enalapril under high salt (HS) diet or normal diet (ND) for 6 weeks. At the end of 12th week, atrasentan at a moderate dose significantly attenuated proteinuria and serum creatinine without reducing mean arterial pressure (MAP), thereby preventing cardiac hypertrophy and improving cardiac function. ACE inhibitor enalapril at a dose that did not significantly lowered BP, attenuated cardiac hypertrophy while moderately improving cardiac function without reducing proteinuria and serum creatinine level. Nonetheless, combined therapy of atrasentan and enalapril that does not altering BP exerted additional cardioprotective effect. Based on these findings, we conclude that BP independent monotherapy of ETA receptor antagonist attenuates the progression of CKD and significantly mitigates CVD independent of RAS inhibition. PMID:25775254

  5. Changes in cardiac specific microRNA-208a level in peripheral blood in ST segment elevation acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    姚怡

    2013-01-01

    Objective To observe serum cardiac specific microRNA-208a(miR-208a) levels in ST segment elevation acute myocardial infarction(STEAMI) patients,and to explore the role of serum miR-208a levels in the diagnosis of STEAMI. Methods The serum miR-208a concentrations were assessed within 12 hours after STEAMI,while

  6. The resource pooling principle

    OpenAIRE

    Wischik, Damon; Handley, Mark; Bagnulo, Marcelo

    2008-01-01

    Since the ARPAnet, network designers have built localized mechanisms for statistical multiplexing, load balancing, and failure resilience, often without understanding the broader implications. These mechanisms are all types of resource pooling, whichmeans making a collection of resources behave like a single pooled resource. We believe that the natural evolution of the Internet is that it should achieve resource pooling by harnessing the responsiveness of multipath-capable end systems. We arg...

  7. Cold pool dissipation

    Science.gov (United States)

    Grant, Leah D.; Heever, Susan C.

    2016-02-01

    The mechanisms by which sensible heat fluxes (SHFs) alter cold pool characteristics and dissipation rates are investigated in this study using idealized two-dimensional numerical simulations and an environment representative of daytime, dry, continental conditions. Simulations are performed with no SHFs, SHFs calculated using a bulk formula, and constant SHFs for model resolutions with horizontal (vertical) grid spacings ranging from 50 m (25 m) to 400 m (200 m). In the highest resolution simulations, turbulent entrainment of environmental air into the cold pool is an important mechanism for dissipation in the absence of SHFs. Including SHFs enhances cold pool dissipation rates, but the processes responsible for the enhanced dissipation differ depending on the SHF formulation. The bulk SHFs increase the near-surface cold pool temperatures, but their effects on the overall cold pool characteristics are small, while the constant SHFs influence the near-surface environmental stability and the turbulent entrainment rates into the cold pool. The changes to the entrainment rates are found to be the most significant of the SHF effects on cold pool dissipation. SHFs may also influence the timing of cold pool-induced convective initiation by altering the environmental stability and the cold pool intensity. As the model resolution is coarsened, cold pool dissipation is found to be less sensitive to SHFs. Furthermore, the coarser resolution simulations not only poorly but sometimes wrongly represent the SHF impacts on the cold pools. Recommendations are made regarding simulating the interaction of cold pools with convection and the land surface in cloud-resolving models.

  8. 无创和有创血压监测在心源性休克患者中的应用比较%A comparative study on invasive and non-invasive blood pressure monitoring for cardiac shock

    Institute of Scientific and Technical Information of China (English)

    洪丽萍

    2011-01-01

    目的 探讨心源性休克患者在休克纠正前后无创血压(NBP)和有创血压(IBP)监测数值之间的差别.方法 选择26例心源性休克患者,根据监测方法不同分为A组(NBP组)与B组(IBP组),同步记录肱动脉NBP与桡动脉IBP的收缩压(SBP)与舒张压(DBP)水平.结果 当NBP监测SBP<90mmHg,A组监测SBP 、DBP值均显著高于B组(均P<0.05).休克纠正后SBP90~110mmHg,A组监测SBP值显著高于B组(P<0.05),而DBP显著低于B组(P<0.05);SBP≥110mmHg,A组监测SBP 、DBP值均显著低于B组(均P<0.05).结论 NBP和IBP监测数值存在一定程度的差别.休克纠正前及纠正后初期,无创血压监测可能高于实际血压水平;休克纠正后当SBP≥110mmHg,可以用无创血压监测代替有创血压监测.%Objective To explore the difference between invasive and non-invasive blood pressure monitoring before and after correction of cardiac shock. Methods A total of 26 subjects were selected in the study,which were divided into A(NBP group) and B(IBP group) groups according to the different monitoring methods. The levels of SBP and DBP were simultaneously recorded. Results The values of SBP and DBP in group A were significantly higher than those in group B when SBP was less than 90mmHg (allP<0.05). Compared with group B, when SBP was measured in a range from 90 to 110mmHg after correction of cardiac shock, the value of SBP in group A was significantly increased (P<0.05), but it was adverse about the value of DBP (P<0.05). When SBP was more than 110mmHg, the values of SBP and DBP in group A were significantly higher than those in group B (all P<0.05). Conclusion The values were different between invasive and non-invasive blood pressure monitoring before and after correction of cardiac shock. The value of non-invasive blood pressure monitoring may be higher than that of invasive blood pressure monitoring before and the initial stage of post-correction of cardiac shock, but after correction of

  9. Aspartate aminotransferase (AST) blood test

    Science.gov (United States)

    ... Saunders; 2016:chap 73. Read More Acute kidney failure Acute pancreatitis Alanine transaminase (ALT) blood test ALP - blood test Burns Cardiac catheterization Enzyme Heart attack Hemolytic anemia Hepatic Liver cancer - hepatocellular carcinoma Liver disease Mononucleosis Muscular ...

  10. Evaluation of cardiac function in SLE using radionuclide ventriculography

    International Nuclear Information System (INIS)

    Purpose: To evaluate the left ventricular function of systemic lupus erythematosus (SLE) patients by equilibrium radionuclide ventriculography. Methods: 20 normal controls and 30 SLE patients were studied by gated cardiac blood pool imaging and gated myocardial imaging and the left ventricular systolic and diastolic parameters were analysed. Results: The LVEF, SH, PER and PFR of 30 SLE patients were 0.52 +- 0.11, 60.89 +- 12.12 degree, 3.08 +- 0.48 EDV/s and 2.88 +- 0.47EDV/s. While those parameters of 20 normal controls were 0.68 +- 0.02, 53.25 +- 5.26 degree, 3.66 +- 0.51 EDV/s and 3.34 +- 0.88 EDV/s, respectively. The parameters of systolic and diastolic function were significantly lower in patients than those in controls (t 4.50, 3.11, 5.80 and 4.60, P<0.01). Conclusions: The cardiac function of SLE patients was lower (poorer) as compared with that of normal population. Radionuclide ventriculography is useful to evaluating cardiac function in SLE patients and thereby helps with the diagnosis of the myocardial damage in the disease and guides the treatment of it

  11. Comparative radionuclide and thermodilution determinations of cardiac output and stroke volume in the baboon (Papio ursinus)

    Energy Technology Data Exchange (ETDEWEB)

    Dormehl, I.C.; Bosman, H.; Hugo, N.; Maree, M.; van Vuuren, C.; van Zandwyk, C.; van Aswegen, A.; Paterson, L.

    1987-01-01

    Thermodilution cardiac output determinations and multigated equilibrium blood-pool scintigraphy were performed in ten healthy chacma baboons (Papio ursinus). The correlation was moderately good between both the radionuclide and thermodilution stroke volume (r = 0.58, SEE = 3 ml; SVth = 0.78SVr + 15.6 ml) as well as the cardiac output (r = 0.72, SEE = 0.2 liter/min; COth = 0.56 Cor + 2.1 liter/min). The attenuation depth dr as determined by radionuclide techniques was found to correlate well with the radiologically determined values dx (r = 0.8, SEE = 0.4 cm; dx = 0.87dr + 0.72 cm) which validated the depth values used in the calculations.

  12. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  13. PDA: Pooled DNA analyzer

    Directory of Open Access Journals (Sweden)

    Lin Chin-Yu

    2006-04-01

    Full Text Available Abstract Background Association mapping using abundant single nucleotide polymorphisms is a powerful tool for identifying disease susceptibility genes for complex traits and exploring possible genetic diversity. Genotyping large numbers of SNPs individually is performed routinely but is cost prohibitive for large-scale genetic studies. DNA pooling is a reliable and cost-saving alternative genotyping method. However, no software has been developed for complete pooled-DNA analyses, including data standardization, allele frequency estimation, and single/multipoint DNA pooling association tests. This motivated the development of the software, 'PDA' (Pooled DNA Analyzer, to analyze pooled DNA data. Results We develop the software, PDA, for the analysis of pooled-DNA data. PDA is originally implemented with the MATLAB® language, but it can also be executed on a Windows system without installing the MATLAB®. PDA provides estimates of the coefficient of preferential amplification and allele frequency. PDA considers an extended single-point association test, which can compare allele frequencies between two DNA pools constructed under different experimental conditions. Moreover, PDA also provides novel chromosome-wide multipoint association tests based on p-value combinations and a sliding-window concept. This new multipoint testing procedure overcomes a computational bottleneck of conventional haplotype-oriented multipoint methods in DNA pooling analyses and can handle data sets having a large pool size and/or large numbers of polymorphic markers. All of the PDA functions are illustrated in the four bona fide examples. Conclusion PDA is simple to operate and does not require that users have a strong statistical background. The software is available at http://www.ibms.sinica.edu.tw/%7Ecsjfann/first%20flow/pda.htm.

  14. Cardiac rehabilitation

    Science.gov (United States)

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  15. Cardiac Rehabilitation

    Science.gov (United States)

    Cardiac rehabilitation (rehab) is a medically supervised program to help people who have A heart attack Angioplasty or coronary artery bypass grafting for coronary heart disease A heart valve repair or replacement A ...

  16. Cardiac sarcoidosis

    OpenAIRE

    Costello BT; Nadel J.; Taylor AJ

    2016-01-01

    Benedict T Costello,1,2 James Nadel,3 Andrew J Taylor,1,21Department of Cardiovascular Medicine, The Alfred Hospital, 2Baker IDI Heart and Diabetes Research Institute, Melbourne, VIC, 3School of Medicine, University of Notre Dame, Sydney, NSW, Australia Abstract: Cardiac sarcoidosis is a rare but life-threatening condition, requiring a high degree of clinical suspicion and low threshold for investigation to make the diagnosis. The cardiac manifestations include heart failure, conducting syst...

  17. Influence of a history of arterial hypertension and pretreatment blood pressure on the effect of angiotensin converting enzyme inhibition after acute myocardial infarction. Trandolapril Cardiac Evaluation Study

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    inhibition after AMI complicated by left ventricular dysfunction may be of particular importance in patients with a history of arterial hypertension or a relatively high pretreatment blood pressure. However, further investigations are necessary to establish the clinical impact of these results.......OBJECTIVE: To evaluate the influence of a history of arterial hypertension and the level of pretreatment blood pressure on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril on mortality and morbidity in patients with acute myocardial infarction (AMI) and left...... broad spectrum of potential confounders. Also, benefit from ACE inhibition increased with increasing blood pressure at the time of randomization. Significant interactions between benefit from ACE inhibition and hypertension history, and systolic and diastolic blood pressure were found. CONCLUSION: ACE...

  18. Vitamin D Pooling Project

    Science.gov (United States)

    The Vitamin D Pooling Project of Rarer Cancers brought together investigators from 10 cohorts to conduct a large prospective epidemiologic study of the association between vitamin D status and seven rarer cancers.

  19. Swimming Pool Safety

    Science.gov (United States)

    ... Spread the Word Shop AAP Find a Pediatrician Safety & Prevention Immunizations All Around At Home At Play ... Español Text Size Email Print Share Swimming Pool Safety Page Content ​What is the best way to ...

  20. Pools for the Handicapped.

    Science.gov (United States)

    American School and University, 1979

    1979-01-01

    Three institutions in Ohio now stress hydrotherapy and water recreation as important parts of individual educational programs for the handicapped. Specially designed and adapted pools provide freedom of movement and ego building as well as physical education and recreation. (Author)

  1. Cardiac Computed Tomography (Multidetector CT, or MDCT)

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Cardiac Computed Tomography (Multidetector CT, or MDCT) Updated:Sep 3,2015 What is Computerized Tomography (CT)? CT is a noninvasive test that uses ...

  2. Invasive versus noninvasive techniques in the evaluation of cardiac function and diagnosis of heart disease

    International Nuclear Information System (INIS)

    The expanding discipline of modern noninvasive cardiovascular medicine now comprises the new techniques of echography, Doppler ultrasound, radionuclide scintigraphy, ambulatory electrocardiography and computer analysis; as well as improvements in phonocardiography, pulse recordings, systolic time intervals, cardiokymography, electrographic mapping, vector-cardiography, exercise testing, radioisotope tracers and plethysmography. Among these noninvasive procedures, echocardiography and radioscintigraphy have proved to be the most useful in the determination of cardiac function and diagnosis. Thus M-mode and two-dimensional echocardiography, and nuclear myocardial perfusion and cardiac blood pool scintigraphy have undergone rapid advancements to become indispensable and widely available modalities for clinical management and investigational use. Since echocardiography and nuclear cardiology comprise the most important atraumic means in the accurate evaluation of cardiovascular performance, the authors focus on the value and application of these two recently devised practical imaging methodologies, compared to the invasive assessment of disorders and function of the heart. To accomplish these objectives, cardiac catheterization is described firstly, and then echocardiography and nuclear cardiology respectively are delineated relative to cardiac catheterization. Finally the special advantages and future horizons pertaining to the noninvasive approaches of ultrasound and radioscintigraphy techniques in cardiovascular evaluation are discussed. (Auth.)

  3. Anatomical-based partial volume correction for low-dose dedicated cardiac SPECT/CT

    Science.gov (United States)

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-09-01

    Due to the limited spatial resolution, partial volume effect has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods include perturbation geometry transfer matrix (pGTM), pGTM followed by multi-target correction (MTC), pGTM with known concentration in blood pool, the former followed by MTC and our newly proposed methods, which perform the MTC method iteratively, where the mean values in all regions are estimated and updated by the MTC-corrected images each time in the iterative process. The NCAT phantom was simulated for cardiovascular imaging with 99mTc-tetrofosmin, a myocardial perfusion agent, and 99mTc-red blood cell (RBC), a pure intravascular imaging agent. Images were acquired at six different count levels to investigate the performance of PVC methods in both high and low count levels for low-dose applications. We performed two large animal in vivo cardiac imaging experiments following injection of 99mTc-RBC for evaluation of intramyocardial blood volume (IMBV). The simulation results showed our proposed iterative methods provide superior performance than other existing PVC methods in terms of image quality, quantitative accuracy, and reproducibility (standard deviation), particularly for low-count data. The iterative approaches are robust for both 99mTc-tetrofosmin perfusion imaging and 99mTc-RBC imaging of IMBV and blood pool activity even at low count levels. The animal study results indicated the effectiveness of PVC to correct the overestimation of IMBV due to blood pool contamination. In conclusion, the iterative PVC methods can achieve more accurate quantification, particularly for low

  4. Cardiac MRI. T2-mapping versus T2-weighted dark-blood TSE imaging for myocardial edema visualization in acute myocardial infarction

    International Nuclear Information System (INIS)

    Purpose: To assess the diagnostic accuracy of T2 mapping for the detection of myocardial edema in acute myocardial infarction (AMI), and to compare this diagnostic accuracy with that of the current standard for myocardial edema imaging, which is T2w dark-blood TSE imaging. Materials and Methods: 29 patients with AMI were examined at 1.5 T. For the visualization of myocardial edema, T2 maps, calculated from three T2w SSFP images, and T2w dark-blood TSE images were acquired in standard short- and long-axis views. Cine SSFP images were acquired for the analysis of left ventricular (LV) function and late gadolinium enhancement images (LGE) for the visualization of myocardial necrosis. The T2 maps as well as the T2w dark-blood TSE images were evaluated twice independently from the cine SSFP and LGE images. The presence or absence of myocardial edema was rated visually for each LV segment. As the standard of reference, the infarct zone was defined based on the cine SSFP and the LGE images. Results: In this segment-based analysis, T2 mapping showed a sensitivity of 82 % and a specificity of 94 % for the detection of edema in the infarct zone. T2w dark-blood TSE imaging revealed a sensitivity of 50 % and a specificity of 98 %. T2 mapping showed a higher intra-rater agreement compared to T2w dark-blood TSE imaging (κ: 0.87 vs. 0.76). Conclusions: T2 mapping allows for the visualization of myocardial edema in AMI with a high sensitivity and specificity, and features better diagnostic accuracy in terms of a higher sensitivity compared to T2w dark-blood TSE imaging. (orig.)

  5. Cardiac MRI. T2-mapping versus T2-weighted dark-blood TSE imaging for myocardial edema visualization in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nassenstein, K.; Nensa, F.; Schlosser, T.; Umutlu, L.; Lauenstein, T. [University Hospital Essen (Germany). Dept. of Diagnostic and Interventional Radiology and Neuroradiology; Bruder, O. [Elisabeth Hospital, Essen (Germany). Dept. of Cardiology and Angiology; Maderwald, S.; Ladd, M.E. [Duisburg-Essen Univ., Essen (Germany). Erwin L. Hahn Institute for Magnetic Resonance Imaging

    2014-02-15

    Purpose: To assess the diagnostic accuracy of T2 mapping for the detection of myocardial edema in acute myocardial infarction (AMI), and to compare this diagnostic accuracy with that of the current standard for myocardial edema imaging, which is T2w dark-blood TSE imaging. Materials and Methods: 29 patients with AMI were examined at 1.5 T. For the visualization of myocardial edema, T2 maps, calculated from three T2w SSFP images, and T2w dark-blood TSE images were acquired in standard short- and long-axis views. Cine SSFP images were acquired for the analysis of left ventricular (LV) function and late gadolinium enhancement images (LGE) for the visualization of myocardial necrosis. The T2 maps as well as the T2w dark-blood TSE images were evaluated twice independently from the cine SSFP and LGE images. The presence or absence of myocardial edema was rated visually for each LV segment. As the standard of reference, the infarct zone was defined based on the cine SSFP and the LGE images. Results: In this segment-based analysis, T2 mapping showed a sensitivity of 82 % and a specificity of 94 % for the detection of edema in the infarct zone. T2w dark-blood TSE imaging revealed a sensitivity of 50 % and a specificity of 98 %. T2 mapping showed a higher intra-rater agreement compared to T2w dark-blood TSE imaging ({kappa}: 0.87 vs. 0.76). Conclusions: T2 mapping allows for the visualization of myocardial edema in AMI with a high sensitivity and specificity, and features better diagnostic accuracy in terms of a higher sensitivity compared to T2w dark-blood TSE imaging. (orig.)

  6. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  7. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  8. 芬太尼复合麻醉对心脏手术病人脑血流动力学的影响%Effect of Fentanyl Anaesthesia on Cerebral Blood Flow Kinetics of Patients Undergoing Cardiac Operation

    Institute of Scientific and Technical Information of China (English)

    李玉成; 胡啸玲

    2001-01-01

    目的应用经颅多谱勒(TCD)研究芬太尼复合麻醉对心脏手术病人脑血流动力学的影响。方法24例择期心脏手术病人,采用TCD监测右侧大脑中动脉血流速率(V-MCA),同时监测血压、呼末二氧化碳分压(PetCO2)和脉搏氧饱和度(SpO2),搏动指数(PI)。分别于麻醉前后记录。维持PetCO2和SpO2正常范围。结果与麻醉前比,麻醉后脑血流速率下降31%~35%(P<0.01),PI增加22%(P<0.01)。MPA下降10%。结论芬太尼复合麻醉可降低脑血流速率,减少脑血流量。%ObjectiveTo study the effect of fentanyl anesthesia on cerebral blood flow kinetics by transcranial Doppler sonography(TCD) in adult patients undergoing cardiac operation.Methods Blood flow velocity of middle cerebral artery (V-MCA) in twenty-four adult patients undergoing cardiac valve replacement were measured by TCD and recorded before(baseline)and after anesthesia. Mean artery pressure (MAP),pulse oximetry(SpO2) and pressure of end-tidal carbon dioxide(Pet CO2)were monitored at the same time. SpO2 and Pet CO2 were maintained in a normal range (96%~100% and 35-45 mm Hg) respectively.ResultsAfter anesthesia, the peak V-MCA(Vm-MCA)decreased 31%~35%(P<0.01), MPA decreased 10% and the pulsatility index(PI)of middle cerebral artery increased 22%(P<0.01) as compared with their baselines.ConclusionThe results suggest that fentanyl anesthesia can decrease V-MCA and cerebral blood flow volume.

  9. Cardiac sarcoidosis

    Science.gov (United States)

    Smedema, J.P.; Zondervan, P.E.; van Hagen, P.; ten Cate, F.J.; Bresser, P.; Doubell, A.F.; Pattynama, P.; Hoogsteden, H.C.; Balk, A.H.M.M.

    2002-01-01

    Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology. Symptomatic cardiac involvement occurs in approximately 5% of patients. The prevalence of sarcoidosis in the Netherlands is unknown, but estimated to be approximately 20 per 100,000 population (3200 patients). We report on five patients who presented with different manifestations of cardiac sarcoidosis, and give a brief review on the current management of this condition. Magnetic Resonance Imaging (MRI) can be of great help in diagnosing this condition as well as in the follow-up of the response to therapy. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:25696121

  10. Cardiac Hypertrophy: A Review on Pathogenesis and Treatment

    OpenAIRE

    Ankur Rohilla; Praveen Kumar; Seema Rohilla; Ashok Kushnoor

    2012-01-01

    Cardiac hypertrophy has been considered as an important risk factor for cardiac morbidity and mortality whose prevalence has increased during the last few decades. Cardiac hypertrophy, a disease associated with the myocardium, is characterized by thickening of ventricle wall of heart and consequent reduction in the contracting ability of heart to pump the blood. Cardiac hypertrophy has been divided into two types, i.e. physiological and pathological hypertrophy. The exercise-induced increase ...

  11. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  12. The Future of Pooling.

    Science.gov (United States)

    Young, Peter C.; Fone, Martin

    1997-01-01

    Discusses seven propositions underlying the strategies that insurance pools can, will, and must pursue: (1) risk management versus risk financing; (2) elimination of windfall advantages; (3) the maintenance of market-dominant status; (4) cost leadership; (5) client focus; (6) innovation and diversification; and (7) leadership challenges. A sidebar…

  13. Liquid sodium pool fires

    International Nuclear Information System (INIS)

    Experimental sodium pool combustion results have led to a definition of the combustion kinetics, and have revealed the hazards of sodium-concrete contact reactions and the possible ignition of organic matter (paint) by hydration of sodium peroxide aerosols. Analysis of these test results shows that the controlling mechanism is sodium evaporation diffusion. (author)

  14. Physiological and pathological cardiac hypertrophy.

    Science.gov (United States)

    Shimizu, Ippei; Minamino, Tohru

    2016-08-01

    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. PMID:27262674

  15. Physiological and structural differences in spatially distinct subpopulations of cardiac mitochondria: influence of cardiac pathologies

    OpenAIRE

    Hollander, John M.; Thapa, Dharendra; Shepherd, Danielle L.

    2014-01-01

    Cardiac tissue contains discrete pools of mitochondria that are characterized by their subcellular spatial arrangement. Subsarcolemmal mitochondria (SSM) exist below the cell membrane, interfibrillar mitochondria (IFM) reside in rows between the myofibrils, and perinuclear mitochondria are situated at the nuclear poles. Microstructural imaging of heart tissue coupled with the development of differential isolation techniques designed to sequentially separate spatially distinct mitochondrial su...

  16. Cardiac rhabdomyosarcoma

    OpenAIRE

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan

    2001-01-01

    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  17. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  18. Backfitting swimming pool reactors

    International Nuclear Information System (INIS)

    Calculations based on measurements in a critical assembly, and experiments to disclose fuel element surface temperatures in case of accidents like stopping of primary coolant flow during full power operation, have shown that the power of the swimming pool type research reactor FRG-2 (15 MW, operating since 1967) might be raised to 21 MW within the present rules of science and technology, without major alterations of the pool buildings and the cooling systems. A backfitting program is carried through to adjust the reactor control systems of FRG-2 and FRG-1 (5 MW, housed in the same reactor hall) to the present safety rules and recommendations, to ensure FRG-2 operation at 21 MW for the next decade. (author)

  19. Changes in arterial blood pressure induced by passive leg raising predict hypotension during the induction of sedation in critically ill patients without severe cardiac dysfunction

    Institute of Scientific and Technical Information of China (English)

    YU Tao; PAN Chun; GUO Feng-mei; YANG Yi; QIU Hai-bo

    2013-01-01

    Background Hypotension due to the induction of sedation with dexmedetomidine infusion may be harmful in critically ill patients.Changes in pulse pressure induced by the passive leg raising test (PLR-△PP) as marker of fluid responsiveness,assessed prior to sedation,may predict hemodynamic changes.The present study was to investigate the power of the PLR test in critically ill patients in predicting hypotension induced by the induction of dexmedetomidine sedation.Methods Fluid responsiveness was estimated by a passive leg raising (PLR) test before dexmedetomidine sedation.Patients were assigned to either the "Nonresponders" or "Responders" group according to their hemodynamic responses to the PLR test ("Nonresponders",PLR-△PP <10.3%; "Responders",PLR-△PP >10.3%).Sedation was performed with a dexmedetomidine infusion (0.5 μg/kg over a 10-minute loading period,then 0.2-0.7 μg-kg-1.h-1)and titrated to maintain the target Richmond agitation sedation scale (RASS) score in the range of-2 to-1 and the bispectral index value in the range of 60 to 75.Radial artery pulse pressure,heart rate (HR),and central venous pressure (CVP) were measured at each phase of the study procedure.Hemodynamic fluctuations during the use of dexmedetomidine sedation were recorded and compared between the two groups.Results Fifty patients had a median (25%-75% interquartile range) of 71 (61-78) years old were studied.At baseline,39 of the 50 patients were "Nonresponders" and 11 were "Responders".Following dexmedetomidine sedation,patients classified as "Responders" had a significantly greater systolic blood pressure decrease during the induction of dexmedetomidine sedation than the "Nonresponders" ((-26.3 ± 6.8)% vs.(-11.8 ± 8.5)%,P <0.001).In addition,the "Responders" group required significantly more fluid boluses (8 vs.3; P <0.001) and vasopressors (2 vs.0; P <0.05)than the "Nonresponders" group to restore blood pressure.Finally,PLR-△PP was positively correlated

  20. CERN Electronics Pool presentations

    CERN Multimedia

    2011-01-01

    The CERN Electronics Pool has organised a series of presentations in collaboration with oscilloscope manufacturers. The last one will take place according to the schedule below.   Time will be available at the end of the presentation to discuss your personal needs. The Agilent presentation had to be postponed and will be organised later. -     Lecroy: Thursday, 24 November 2011, in 530-R-030, 14:00 to 16:30.

  1. Swimming Pools and Molluscum Contagiosum

    Science.gov (United States)

    ... Travelers' Health: Smallpox & Other Orthopoxvirus-Associated Infections Poxvirus Swimming Pools Recommend on Facebook Tweet Share Compartir The ... often ask if molluscum virus can spread in swimming pools. There is also concern that it can ...

  2. Effect of Blood Glucose Level on Cardiac Function in Pregnant Women with Gestational Diabetes Mellitus%血糖水平对妊娠糖尿病孕妇心脏功能的影响

    Institute of Scientific and Technical Information of China (English)

    谢书华

    2016-01-01

    目的:分析血糖水平对妊娠糖尿病孕妇心脏功能影响。方法选择2014年9月至2015年10月诊断妊娠糖尿病孕妇120例,依据患者妊娠期血糖控制水平分为优控组67例,差控组53例。另取同期正常妊娠孕产妇40例作为对照组。分别于确诊时与临产前,采用免疫放射比浊法检测血清C反应蛋白、酶联免疫吸附法检测血清白细胞介素-6水平变化。采用心脏超声检测心脏二维超声结构变化,采用心脏血流多普勒、组织多谱勒分析心脏舒张功能指数E/A,E/Ea比值变化。免疫荧光比浊法检测血浆钠尿肽(BNP,pg/mL)水平。比较3组孕妇指标差异。结果确诊时,3组孕妇年龄、体质量指数、血脂水平、血清C反应蛋白(CRP,mg/L)、白细胞介素-6(IL-6,ng/mL)、BNP(pg/mL)水平无统计学意义(P>0.05)。临产前,对照组、优控组、差控组孕妇血清CRP、IL-6水平逐渐升高,3组比较差异有统计学意义(P<0.05),其中,优控组与对照组差异无统计学意义(P>0.05)。对照组、优控组、差控组孕妇二维超声结构左心房直径、左心室舒张期内径、室间隔厚度、左心室后壁厚度、左室射血分数差异无统计学意义(P>0.05)。E/A比值逐渐下降,E/Ea比值以及血清BNP水平逐渐升高,3组间比较差异有统计学意义(P<0.05)。其中,优控组与对照组比较差异无统计学意义(P>0.05)。结论妊娠期孕产妇血糖增加可以激发机体微炎性反应,导致孕产妇临产前心脏舒张功能下降,可能增加孕产妇围生期并发症发生率。%ObjectiveTo analyze the effect of blood glucose level on cardiac function in pregnant women with gestational diabetes mellitus.MethodsThe 120 cases of pregnant women with gestational diabetes were selected from September 2014 to October 2015.According to the level of blood glucose, the patients were divided into sixty

  3. Large molten pool heat transfer

    International Nuclear Information System (INIS)

    This workshop on large molten pool heat transfer is composed of 5 sessions which titles are: feasibility of in-vessel core debris cooling; experiments on molten pool heat transfer; calculational efforts on molten pool convection; heat transfer to the surrounding water, experimental techniques; future experiments and ex-vessel studies (RASPLAV, TOLBIAC, BALI, SULTAN, CORVIS, VULCANO, CORINE programs)

  4. Imaging cardiac amyloidosis: a pilot study using 18F-florbetapir positron emission tomography

    International Nuclear Information System (INIS)

    Cardiac amyloidosis, a restrictive heart disease with high mortality and morbidity, is underdiagnosed due to limited targeted diagnostic imaging. The primary aim of this study was to evaluate the utility of 18F-florbetapir for imaging cardiac amyloidosis. We performed a pilot study of cardiac 18F-florbetapir PET in 14 subjects: 5 control subjects without amyloidosis and 9 subjects with documented cardiac amyloidosis. Standardized uptake values (SUV) of 18F-florbetapir in the left ventricular (LV) myocardium, blood pool, liver, and vertebral bone were determined. A 18F-florbetapir retention index (RI) was computed. Mean LV myocardial SUVs, target-to-background ratio (TBR, myocardial/blood pool SUV ratio) and myocardial-to-liver SUV ratio between 0 and 30 min were calculated. Left and right ventricular myocardial uptake of 18F-florbetapir were noted in all the amyloid subjects and in none of the control subjects. The RI, TBR, LV myocardial SUV and LV myocardial to liver SUV ratio were all significantly higher in the amyloidosis subjects than in the control subjects (RI median 0.043 min-1, IQR 0.034 - 0.051 min-1, vs. 0.023 min-1, IQR 0.015 - 0.025 min-1, P = 0.002; TBR 1.84, 1.64 - 2.50, vs. 1.26, IQR 0.91 - 1.36, P = 0.001; LV myocardial SUV 3.84, IQR 1.87 - 5.65, vs. 1.35, IQR 1.17 - 2.28, P = 0.029; ratio of LV myocardial to liver SUV 0.67, IQR 0.44 - 1.64, vs. 0.18, IQR 0.15 - 0.35, P = 0.004). The myocardial RI, TBR and myocardial to liver SUV ratio also distinguished the control subjects from subjects with transthyretin and those with light chain amyloid. 18F-Florbetapir PET may be a promising technique to image light chain and transthyretin cardiac amyloidosis. Its role in diagnosing amyloid in other organ systems and in assessing response to therapy needs to be further studied. (orig.)

  5. Joint multi-object registration and segmentation of left and right cardiac ventricles in 4D cine MRI

    Science.gov (United States)

    Ehrhardt, Jan; Kepp, Timo; Schmidt-Richberg, Alexander; Handels, Heinz

    2014-03-01

    The diagnosis of cardiac function based on cine MRI requires the segmentation of cardiac structures in the images, but the problem of automatic cardiac segmentation is still open, due to the imaging characteristics of cardiac MR images and the anatomical variability of the heart. In this paper, we present a variational framework for joint segmentation and registration of multiple structures of the heart. To enable the simultaneous segmentation and registration of multiple objects, a shape prior term is introduced into a region competition approach for multi-object level set segmentation. The proposed algorithm is applied for simultaneous segmentation of the myocardium as well as the left and right ventricular blood pool in short axis cine MRI images. Two experiments are performed: first, intra-patient 4D segmentation with a given initial segmentation for one time-point in a 4D sequence, and second, a multi-atlas segmentation strategy is applied to unseen patient data. Evaluation of segmentation accuracy is done by overlap coefficients and surface distances. An evaluation based on clinical 4D cine MRI images of 25 patients shows the benefit of the combined approach compared to sole registration and sole segmentation.

  6. Cardiac conduction system

    Science.gov (United States)

    The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals ... to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle ...

  7. Cardiac factors in orthostatic hypotension

    Science.gov (United States)

    Löllgen, H.; Dirschedl, P.; Koppenhagen, K.; Klein, K. E.

    Cardiac function is determined by preload, afterload, heart rate and contractility. During orthostatic stress, the footward blood shift is compensated for by an increase of afterload. LBNP is widely used to analyze effects of volume displacement during orthostatic stress. Comparisons of invasive ( right heart catheterization) and non-invasive approach (echocardiography) yielded similar changes. Preload and afterload change with graded LBNP, heart rate increases, and stroke volume and cardiac output decrease. Thus, the working point on the left ventricular function curve is shifted to the left and downward, similar to hypovolemia. However, position on the Frank-Starling curve, the unchanged ejection fraction, and the constant Vcf indicate a normal contractile state during LBNP. A decrease of arterial oxygen partial pressure during LBNP shwos impaired ventilation/perfusion ratio. Finally, LBNP induced cardiac and hemodynamic changes can be effectively countermeasured by dihydroergotamine, a potent venoconstrictor. Comparison of floating catheter data with that of echocardiography resulted in close correlation for cardiac output and stroke volume. In addition, cardiac dimensions changed in a similar way during LBNP. From our findings, echocardiography as a non-invasive procedure can reliably used in LBNP and orthostatic stress tests. Some informations can be obtained on borderline values indicating collaps or orthostatic syncope. Early fainters can be differentiated from late fainters by stroke volume changes.

  8. Cardiac thrombi in different clinical scenarios

    Directory of Open Access Journals (Sweden)

    Fahad Alkindi

    2013-01-01

    Full Text Available Intracardiac thrombi are commonly found in patients with ischemic stroke. The echocardiographic identification of thrombi is important in decision-making since it represents an indication to long-term anticoagulation, in order to reduce the risk of new stroke. Intracardiac thrombi can develop during the time course of several cardiac pathologies that favor blood stasis and/or predispose to the aggregation of thrombotic material. Examples of cardiac pathologies that favor the formation of thrombus are illustrated and discussed.

  9. Nanomaterials for Cardiac Myocyte Tissue Engineering

    OpenAIRE

    Rodolfo Amezcua; Ajay Shirolkar; Carolyn Fraze; David A. Stout

    2016-01-01

    Since their synthesizing introduction to the research community, nanomaterials have infiltrated almost every corner of science and engineering. Over the last decade, one such field has begun to look at using nanomaterials for beneficial applications in tissue engineering, specifically, cardiac tissue engineering. During a myocardial infarction, part of the cardiac muscle, or myocardium, is deprived of blood. Therefore, the lack of oxygen destroys cardiomyocytes, leaving dead tissue and possib...

  10. The new pooled cohort equations risk calculator

    DEFF Research Database (Denmark)

    Preiss, David; Kristensen, Søren L

    2015-01-01

    total cardiovascular risk score. During development of joint guidelines released in 2013 by the American College of Cardiology (ACC) and American Heart Association (AHA), the decision was taken to develop a new risk score. This resulted in the ACC/AHA Pooled Cohort Equations Risk Calculator. This risk...... calculator, based on major National Heart, Lung, and Blood Institute-funded cohort studies, is designed to predict 10-year risk of 'hard' atherosclerotic cardiovascular disease (ASCVD) events, namely, nonfatal myocardial infarction, fatal coronary heart disease, nonfatal, or fatal stroke. Considerable...... disease and any measure of social deprivation. An early criticism of the Pooled Cohort Equations Risk Calculator has been its alleged overestimation of ASCVD risk which, if confirmed in the general population, is likely to result in statin therapy being prescribed to many individuals at lower risk than...

  11. The Productive Ligurian Pool

    CERN Document Server

    Casella, E; Couvelard, X; Caldeira, R M A

    2011-01-01

    In contrast with the behavior of the eddies in the open-ocean, the sub-mesoscale eddies generated in the constricted Ligurian Basin (NW Mediterranean), are unproductive but their combined effect, arranged in a rim-like fashion, contributes to the containment of a Productive Ligurian Pool (PLP). Data de- rived from MODIS satellite sensor showed persistent higher chlorophyll con- centrations in the centre of the basin, concurrent with high EKE values in its surroundings, derived from AVISO altimetry merged products. This sug- gested that this 'productive pool' is maintained by the intense (sub)mesoscale eddy activity in the rim. Numerical realistic experiments, using a Regional Ocean Model System, forced by MERCATOR and by a high-resolution COSMO- l7 atmospheric model, also showed that most of the sub-mesoscale eddies, during 2009 and 2010, are concentrated in the rim surrounding the basin, contributing to the formation of a basin-scale cyclonic gyre. We hypothesized that the interaction between eddies in the r...

  12. COLPEX - Cold Pool Experiment

    Science.gov (United States)

    Wells, H.; Price, J.; Horlacher, V.; Sheridan, P. F.; Vosper, S. B.; Brown, A. R.; Mobbs, S. D.; Ross, A. N.

    2009-04-01

    Planning has started towards designing a new field campaign aimed at studying the behaviour of the boundary layer over complex terrain. Of specific interest is the formation of cold-pools in valleys during stable night-time conditions. The field campaign will run continuously until the end of the winter in 2009/10. The experiment will make use of a wide variety of ground-based sensors including turbulence towers, automatic weather stations, Doppler lidar, radiation sensors and soil temperature probes. We also hope to deploy an instrumented car and a tethered balloon facility for limited periods. Data from the field campaign will be used for a number of purposes. Firstly, to increase our understanding of how the valley cold pools form and why, for instance, some valleys offer a more favourable environment for their formation than others. Secondly, to investigate the formation and dissipation of fog in complex terrain. Thirdly, the data set will also be used to help validate and develop the Met Office Unified Model at high resolution. An area for the experiment has been identified in the Shropshire/Powis area of the UK where a network of valleys and low hills exist with a typical valley width of ~1.5km and hill top to valley floor heights of 75-200m. 0m.

  13. Evaluation of cardiac function by equilibrium gated radionuclide ventriculography in DCM patients treated with rhGH

    International Nuclear Information System (INIS)

    Objective: To evaluate the cardiac function using equilibrium gated radionuclide ventriculography in dilated cardiomyopathy (DCM) patients treated with recombinant human growth hormone (rhGH). Methods: Fifty-six DCM patients were randomized into two groups: rhGH group (n=28), treated with rhGH 4.5 U qod im plus routine heart failure treatment; control group (n=28), treated with routine heart failure treatment only. Cardiac function was assessed by dimensional echocardiography (2D-echo) and equilibrium gated radionuclide ventriculography before and 3 months after the treatment. Results: 1) The end systolic inner diameter (mm) of left ventricle measured by 2D-echo decreased from 59.8 +- 7.2 to 53.6 +- 8.4 (P<0.01). The left ventricle ejection fraction (LVEF) significantly increased from (28.32+-6.95)% to (38.30+-5.91)% (P<0.01). Systolic early time (PER) increased from (2.11+-0.91) EDV/s to (2.96+-0.60) EDV/s (P<0.05) after the treatment in 7 patients with only left ventricle dilatation. 2) LVEF increased from (23.6+-9.65)% to (35.65+-9.21)% (P<0.01). PeR of left ventricle increased from (0.94+-0.65) EDV/s to (1.76+-0.82) EDV/s (P<0.01). The right ventricle ejection fraction (RVEF) increased from (22.40+-7.50)% to (33.65+-5.11)% (P<0.01). PER of right ventricle increased from (0.89 +- 0.46) EDV/s to (1.37+-0.51) EDV/s (P<0.05) in 21 patients with both left and right ventricle dilatation by equilibrium gated cardiac blood pool imaging. Conclusions: The study shows that equilibrium gated cardiac blood pool imaging is an objective and useful method for evaluating cardiac function in DCM patients treated with rhGH for 3 months; and rhGH can significantly improve cardiac function, increase both LVEF and RVEF in DCM patients

  14. [Ethical issues raised by organ donation after cardiac death.

    OpenAIRE

    Tortosa, Jean-Christophe; Rodríguez-Arias Vailhen, David; Moutel, Grégoire

    2010-01-01

    International audience France, Spain and US are three leader countries in activity of organ procurement and transplantation. Donation after cardiac death is one of the strategies they have been implemented in order to face organ shortage. Donation after cardiac death is internationally considered to be an encouraging source of organs for transplantation both because of its capacity to significantly increase the donor pool and because of the quality of the organs obtained from non-heart-bea...

  15. Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deux, Jean-Francois [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, CNRS EAC 4396, Centre de Recherches Chirurgicales, Henri Mondor Hospital, Creteil (France); Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Mihalache, Cristian-Ionut; Legou, Francois; Luciani, Alain; Kobeiter, Hicham; Rahmouni, Alain [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); Damy, Thibaud [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiology Department, Henri Mondor Hospital, Creteil (France); Mayer, Julie [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Rappeneau, Stephane [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Plante-Bordeneuve, Violaine [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Department of Neurophysiology of Neurology, Henri Mondor Hospital, Creteil (France)

    2015-08-15

    To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT). Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNR{sub myoc}), blood pool SNR (SNR{sub blood}), contrast-to-noise ratio between blood pool and myocardium (CNR{sub blood-myoc}) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated. Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNR{sub myoc} of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNR{sub blood-myoc} was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (-0.56 ± 0.21). Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA. (orig.)

  16. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  17. Using a human cardiovascular-respiratory model to characterize cardiac tamponade and pulsus paradoxus

    Directory of Open Access Journals (Sweden)

    Ma Tony S

    2009-08-01

    pericardium is a result of competition for fixed filling space. We find that simulating active septal contraction is important in modeling ventricular interaction. The model predicts increased arterio-venous CO2 due to hypoperfusion, and we explore implications of respiratory pattern in tamponade. Conclusion Our modeling study of cardiac tamponade dissects the roles played by septal motion, atrioventricular and right-left ventricular interactions, pulmonary blood pooling, and the depth of respiration. The study fully describes the physiological basis of pulsus paradoxus. Our detailed analysis provides biophysically-based insights helpful for future experimental and clinical study of cardiac tamponade and related pericardial diseases.

  18. The boom in power pools

    International Nuclear Information System (INIS)

    In connection with the liberalization of the power market there is euphoria in all parts of the world concerning the establishment of power pools. Power pools are to afford the transparency necessary when competition is fiercer, and have benefits for both buyers and vendors. But the technical community expects only a few to have great chances of survival. In Europe, for instance, only one leading power pool is expected to survive in the long term. It will set the power rate index for all players in the market. The other pools might establish themselves in regional niche markets. (orig.)

  19. Strategic inputs into patent pools

    OpenAIRE

    Baron, Justus; Delcamp, Henry

    2010-01-01

    This article explores what factors determine the decision of a patent pool to accept new inputs. We propose a dynamic analysis of 1337 U.S. patent inputs into 7 important pools. This analysis highlights a trade-off between firm and patent characteristics as the determinants of inclusion of patents into pools. For instance we prove that firms already member of the pool or holding large patent portfolios are able to include lower quality patents. These findings can be explained both by bargaini...

  20. Cardiac iron across different transfusion-dependent diseases

    OpenAIRE

    Wood, John C.

    2008-01-01

    Iron overload occurs in patients who require regular blood transfusions to correct genetic and acquired anaemias, such as β-thalassaemia major, sickle cell disease, and myelodysplastic syndromes. Although iron overload causes damage in many organs, accumulation of cardiac iron is a leading cause of death in transfused patients with β-thalassaemia major. The symptoms of cardiac iron overload will occur long after the first cardiac iron accumulation, at a point when treatment is more complex th...

  1. Cardiac Target Organ Damage in Hypertension: Insights from Epidemiology

    OpenAIRE

    Lawler, Patrick R.; Hiremath, Pranoti; Cheng, Susan

    2014-01-01

    Hypertension is an important risk factor implicated in the development of multiple common cardiac conditions, including coronary atherosclerosis, heart failure, and atrial fibrillation. Epidemiologic studies have provided insight into the shared pathogenesis of hypertension and subclinical as well as clinically evident cardiac diseases. The mechanistic common ground between chronic blood pressure elevation and cardiac disease likely begins early in life. Understanding these connections will a...

  2. Hypertensive cardiac hypertrophy—is genetic variance the missing link?

    OpenAIRE

    Nunez, Derek J. R.; PIERS CLIFFORD, C.; Al-Mahdawi, Sahar; DUTKA, DAVID

    1996-01-01

    1Hypertensive cardiac hypertrophy is a major independent predictor of adverse cardiovascular events. In man the cardiac response to increased afterload is very variable, even when ambulatory blood pressure monitoring is used. Analysis of breeding experiments using normotensive and hypertensive rat strains, human twin studies and other data indicate that genetic factors play a significant role in regulating cardiac mass; in other words, a large component of total variability is accounted for b...

  3. Invasive and non-invasive methods for cardiac output measurement

    OpenAIRE

    Lavdaniti M.

    2008-01-01

    The hemodynamic status monitoring of high-risk surgical patients and critically ill patients inIntensive Care Units is one of the main objectives of their therapeutic management. Cardiac output is one of the mostimportant parameters for cardiac function monitoring, providing an estimate of whole body perfusion oxygen deliveryand allowing for an understanding of the causes of high blood pressure. The purpose of the present review is thedescription of cardiac output measurement methods as prese...

  4. The role of cell savers and filters in cardiac surgery

    NARCIS (Netherlands)

    Vermeijden, Jan Wytze

    2015-01-01

    This thesis investigates the different possibilities of blood sparing strategies in routine cardiac on pump surgery. Reducing allogeneic blood transfusions can improve patient outcome. The main focus of the thesis is on methods of improving shed and cardiotomy blood by filtration with the use of leu

  5. [Cardiac output monitoring by impedance cardiography in cardiac surgery].

    Science.gov (United States)

    Shimizu, H; Seki, S; Mizuguchi, A; Tsuchida, H; Watanabe, H; Namiki, A

    1990-04-01

    The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients. PMID:2362347

  6. Model 1: Blood

    International Nuclear Information System (INIS)

    Because most radiopharmaceuticals are introduced into the body via the vascular system and may remain in the circulation for prolonged periods of time, it is useful to have a model of the blood as an aid in the estimation of radiation dose. It is extremely difficult to devise a precise blood model; the geometry is complex and distribution of blood may vary with position, physiological state and disease process. Estimates of blood volume distribution vary among investigators. Furthermore, the regional hematocrit varies throughout the body, thus affecting distribution of the labeled material according to whether it is attached to cellular elements or in the plasma. The size of the blood pool volumes range from the heart to the capillaries. Variable amounts of non-penetrating radiation contributions to organs depend on the volume of blood in the various sized vessels and the energy of the electrons which may penetrate into tissue from the blood vessel. The present model represents an advance in that it takes into account to some extent the distribution of significant blood pools in the body. Further refinement of the macro-geometry is possible with data which can now be obtained from modern radionuclide imaging equipment. A more difficult problem is definging the micro-geometry relative to the distribution of blood in capillaries and sinusoids, and their relationship to one another

  7. Quantification of myocardial blood flow using dynamic N-13 ammonia PET and factor analysis

    International Nuclear Information System (INIS)

    We evaluate the feasibility of extracting pure left ventricular blood pool and myocardial time activity curves (TACs) and of generating factor images from human dynamic N-13 ammonia PET using factor analysis. The myocardial blood flow (MBF) estimates obtained with factor analysis were compared with those obtained with the user drawn region-of-interest (ROI) method. Stress and rest N-13 ammonia cardiac PET imaging was acquired for 23 min in 5 patients with coronary artery disease using GE Advance tomography. Factor analysis generated physiological TACs and factor images using the normalized TACs from each dixel. Four steps were involved in this algorithm: (a) data preprocessing; (b) principal component analysis; (c) oblique rotation with positivity constraints; (d) factor image computation. Area under curves and MBF estimated using the two compartment N-13 ammonia model were used to validate the accuracy of the factor analysis generated physiological TACs. The MBF values obtained by factor analysis were linearly correlated with MBF obtained by the ROI method (slope = 0.84, r=0.91. Left ventricular blood pool TACs obtained by the two methods agreed well (Area under curve ratio: 1.02 (0∼1 min), 0.98 (0∼2 min), 0.86 (1∼2 min). The results of this study demonstrates that MBF can be measured accurately and noninvasively with dynamic N-13 ammonia PET imaging and factor analysis. This method is simple and accurate, and can measure MBF without blood sampling, ROI definition or spillover correction

  8. BIOMATERIALS FOR ROTARY BLOOD PUMPS

    NARCIS (Netherlands)

    VANOEVEREN, W

    1995-01-01

    Rotary blood pumps are used for cardiac assist and cardiopulmonary support since mechanical blood damage is less than with conventional roller pumps. The high shear rate in the rotary pump and the reduced anticoagulation of the patient during prolonged pumping enforces high demands on the biocompati

  9. Heart Attack or Sudden Cardiac Arrest: How Are They Different?

    Science.gov (United States)

    ... for Heart360 Cardiovascular Conditions • Conditions Home • Arrhythmia and Atrial Fibrillation • Cardiac Arrest • Cardiac Rehab • Cardiomyopathy • Cardiovascular Conditions of Childhood • Cholesterol • Congenital Heart Defects • Diabetes • Heart Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  10. External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

    LENUS (Irish Health Repository)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient\\'s cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  11. Double-oblique cine cardiac MR imaging

    International Nuclear Information System (INIS)

    A study has been performed analyzing the contrast between the blood pool and myocardium on double oblique long- and short-axis cine MR images using gradient echo fast imaging with steady precession and fast low-angle shot sequences. Inflow of unsaturated spins dominates the contrast behavior of short-axis images. With long-axis imaging, suboptimal contrast is seen in peak systole and early diastole due to partial saturation of spins in the imaging section and anatomic considerations at small ventricular volumes. The effects of echo time, flip angle, motion compensation, and spatial presaturation on the contrast between the blood pool and myocardium are discussed

  12. Continuous intravenous infusion of ATP in humans yields large expansions of erythrocyte ATP pools but extracellular ATP pools are elevated only at the start followed by rapid declines

    OpenAIRE

    Rapaport, Eliezer; Salikhova, Anna; Abraham, Edward H.

    2015-01-01

    The pharmacokinetics of adenosine 5′-triphosphate (ATP) was investigated in a clinical trial that included 15 patients with advanced malignancies (solid tumors). ATP was administered by continuous intravenous infusions of 8 h once weekly for 8 weeks. Three values of blood ATP levels were determined. These were total blood (erythrocyte) and blood plasma (extracellular) ATP pools along with the initial rate of release of ATP into the blood plasma. We found that values related to erythrocyte ATP...

  13. Autologous Transfusion in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2003-11-01

    Full Text Available Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The aim of this study was to evaluate the effect of autologous transfusion on patients' hematocryte value, intra and postoperative blood loss, hospitalization time, the development of infective complications and other factors. Materials and Methods: Between June 2001 to April 2002, 208 patients were underwent cardiac surgery in cardiac surgery ward in Imam Khomeini Medical Center. One or more blood units donate from 104 Patients before cardiopulmonary bypass and heparin injection, and transfused to them after CPB and Protamin injection (autologous Group, group 1. 104 patients underwent cardiac surgery routinely (control group, group 2."nResults: Mean of age was 55.9±8.6 in group 1 and 56.6±9.3 in group 2 (P=NS. 73 male and 31 females were in group 1 and 79 males and 25 females were in group 2 (P=NS. Smoking, familial history, hyperlipidemia, diabetes mellitus, renal failure, hypertension, stroke, and history of myocardial infarction was similar in two groups."nSeverity of angina, urgency operation, number vessels disease, duration of cardiopulmonary bypass, duration of aortic cross clamp time, use of internal thoracic artery graft, and number of grafts was similar in both groups. Mean of bleeding post operation was 548 cc in group 1 and 803 cc in-group 2 (P=0.003. Bleeding that need to operation was 1.8% in group 1 and 8.6% in group 2 (P=0.002. Wound infection, mediastinitis, renal failure, ventilatory prolonged, stroke, need to Intra-aortic Balloon Pump (IABP, intraoperative bleeding, and hospital stay was similar in both groups. Mean of extubationt time was 10.2 hours in group 1 and 14.8 hours in group 2 (P=0.001."nConclusion: Preoperative and intra-operative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive

  14. Role of Circulating Fibrocytes in Cardiac Fibrosis

    Science.gov (United States)

    Lin, Rong-Jie; Su, Zi-Zhuo; Liang, Shu-Min; Chen, Yu-Yang; Shu, Xiao-Rong; Nie, Ru-Qiong; Wang, Jing-Feng; Xie, Shuang-Lun

    2016-01-01

    Objective: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis. Data Sources: This review is based on the data from 1994 to present obtained from PubMed. The search terms were “circulating fibrocytes” and “cardiac fibrosis”. Study Selection: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected. Results: Circulating fibrocytes, which are derived from hematopoietic stem cells, represent a subset of peripheral blood mononuclear cells exhibiting mixed morphological and molecular characteristics of hematopoietic and mesenchymal cells (CD34+/CD45+/collagen I+). They can produce extracellular matrix and many cytokines. It is shown that circulating fibrocytes participate in many fibrotic diseases, including cardiac fibrosis. Evidence accumulated in recent years shows that aging individuals and patients with hypertension, heart failure, coronary heart disease, and atrial fibrillation have more circulating fibrocytes in peripheral blood and/or heart tissue, and this elevation of circulating fibrocytes is correlated with the degree of fibrosis in the hearts. Conclusions: Circulating fibrocytes are effector cells in cardiac fibrosis. PMID:26831236

  15. Lipid Micro Emboli in Cardiac Surgery

    OpenAIRE

    Eyjolfsson, Atli

    2011-01-01

    This thesis is based on five studies. It includes the characterization of lipid micro emboli in shed mediastinal blood during cardiac surgery. The reuse of blood directly by cardiotomy suction is a common practice in order to reduce the need of blood transfusions. In shed mediastinal blood we showed that there is an abundance of lipid particles in the size range of 10-60μm. These lipid particles are also recirculated by the cardiotomy suction, through filters and the plastic tubing in the car...

  16. Model of large pool fires

    International Nuclear Information System (INIS)

    A two zone entrainment model of pool fires is proposed to depict the fluid flow and flame properties of the fire. Consisting of combustion and plume zones, it provides a consistent scheme for developing non-dimensional scaling parameters for correlating and extrapolating pool fire visible flame length, flame tilt, surface emissive power, and fuel evaporation rate. The model is extended to include grey gas thermal radiation from soot particles in the flame zone, accounting for emission and absorption in both optically thin and thick regions. A model of convective heat transfer from the combustion zone to the liquid fuel pool, and from a water substrate to cryogenic fuel pools spreading on water, provides evaporation rates for both adiabatic and non-adiabatic fires. The model is tested against field measurements of large scale pool fires, principally of LNG, and is generally in agreement with experimental values of all variables

  17. Potassium evaluation in blood of Brazilian athletes using NAA

    International Nuclear Information System (INIS)

    Full text: According to nutrition sources an athlete needs per day at least one gram of potassium for keeping the correct mineral balance in the organism. Its deficiency or even instantaneous low concentration in blood can diminish the athlete performance originating nervous irritability, muscular weakness, and mental disorientation and in more several causes cardiac arrhythmias. In this study the K levels in blood were determined in athletes submitted to constant load exercise at treadmill at LABEX (Laboratorio de Bioquimica do Exercicio - UNICAMP, Brazil) using Neutron Activation Analyses (NAA). The blood samples were collected from male athletes, age 18 to 26 years, before and after the physical training. Immediately after the collection an amount of 10 micro liters of whole blood was transferred to the filter paper and dried for a few minutes using an infrared lamp. To determine the concentration of potassium each sample was irradiated in the nuclear reactor (IEA-R1, 2-4MW, pool type) at IPEN and was gamma counted using an HPGe Spectrometer of High Energy Resolution. The concentrations of the selected element, 1525keV related to the potassium activated 42K, were calculated using in -house software. The potassium levels were evaluated before and after the physical exercise and the data were compared with the normal range. (author)

  18. Autotransfusão de coleta pré-operatória em cirurgia cardíaca Pré-operative blood sampling for autotransfusion during cardiac surgery

    Directory of Open Access Journals (Sweden)

    Fábio B Jatene

    1988-04-01

    nenhum dos grupos em relação ao grupo controle.Autotransfusion (AT is an alternative to reduce the incidence of complications following homologous blood transfusion. The utilization of autogenous blood is feasible in elective surgical procedures (Pre-AT. A prospective comparative study was carried out in order to establish the ideal parameters for pre-AT, concerning volume, time interval prior to surgery and benefits to the patient, among others. Ninety-six consecutive patients candidates for myocardial revascularization, were analized in the present study. These patients did not present hypoproteinemia, anemia, infections or more than 70 years of age; cardiac reoperations were discarded. Four groups (G were considered: GI - control group, without pre-AT (41 patients; GII - collection of 500 to 600 ml, comprizing the groups; GII-A - until 7 days before surgery (35 patients; GII-B - from 8 to 15 days before surgery (14 patients; GIII - collection of 1000 ml more than 30 days before operation, with reinfusion and a new collection after 15 days (6 patients. Mean age and hemotocrit were comparable in the different groups. In a few patients postoperative AT was utilized. The results indicated that homologous blood transfusion were necessary in 63% of GI, 26% of GII-A, 43% of GII-B and 67% of GIII patients. The mean amount of autogenous blood reinfused was 534 ml/patient in GII-A, 539 ml/patient in GII-B, and 908 ml/patient in GIII. The postoperative hematocrit at discharge from the hospital was comparable in the four groups. There were no deaths. A smaller number of patients in GII-A received homologous blood (p = 0,008 and there was no statistically significant difference in the groups II-A, II-B and III concerning the volume of homologous blood received. There was no higher incidence of complications, specially bleeding, in the different groups when compared with the control group.

  19. Blood Clots

    Science.gov (United States)

    ... Index A-Z Blood Clots Blood clots are semi-solid masses of blood that can be stationary (thrombosis) ... treated? What are blood clots? Blood clots are semi-solid masses of blood. Normally, blood flows freely through ...

  20. Cardiac perception and cardiac control. A review.

    Science.gov (United States)

    Carroll, D

    1977-12-01

    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  1. Cardiac Rehabilitation: Improving Function and Reducing Risk.

    Science.gov (United States)

    Servey, Jessica T; Stephens, Mark

    2016-07-01

    Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions aimed at lowering blood pressure and improving lipid and diabetes mellitus control, with tobacco cessation, behavioral counseling, and graded physical activity. The physical activity component typically involves 36 sessions over 12 weeks, during which patients participate in supervised exercise under cardiac monitoring. There are also intensive programs that include up to 72 sessions lasting up to 18 weeks, although these programs are not widely available. Additional components of cardiac rehabilitation include counseling on nutrition, screening for and managing depression, and assuring up-to-date immunizations. Cardiac rehabilitation is covered by Medicare and recommended for patients following myocardial infarction, bypass surgery, and stent placement, and for patients with heart failure, stable angina, and several other conditions. Despite proven benefits in mortality rates, depression, functional capacity, and medication adherence, rates of referral for cardiac rehabilitation are suboptimal. Groups less likely to be referred are older adults, women, patients who do not speak English, and persons living in areas where cardiac rehabilitation is not locally available. Additionally, primary care physicians refer patients less often than cardiologists and cardiothoracic surgeons. PMID:27386722

  2. Kidneys from donors after cardiac death provide survival benefit.

    NARCIS (Netherlands)

    Snoeijs, M.G.; Schaubel, D.E.; Hene, R.; Hoitsma, A.J.; Idu, M.M.; Ijzermans, J.N.M.; Ploeg, R.J.; Ringers, J.; Christiaans, M.H.; Buurman, W.A.; Heurn, L.W.E. van

    2010-01-01

    The continuing shortage of kidneys for transplantation requires major efforts to expand the donor pool. Donation after cardiac death (DCD) increases the number of available kidneys, but it is unknown whether patients who receive a DCD kidney live longer than patients who remain on dialysis and wait

  3. Kidneys from donors after cardiac death provide survival benefit

    NARCIS (Netherlands)

    M.G. Snoeijs (Maarten); D.E. Schaubel (Douglas); R. Hené (Ronald); A.J. Hoitsma (Andries); M.M. Idu (Mirza); J.N.M. IJzermans (Jan); R.J. Ploeg (Rutger); J. Ringers; M.H. Christiaans (Maarten); W.A. Buurman; L.W.E. van Heurn (Ernest)

    2010-01-01

    textabstractThe continuing shortage of kidneys for transplantation requires major efforts to expand the donor pool. Donation after cardiac death (DCD) increases the number of available kidneys, but it is unknown whether patients who receive a DCD kidney live longer than patients who remain on dialys

  4. Pooling techniques for bioassay screening

    International Nuclear Information System (INIS)

    Pooling techniques commonly are used to increase the throughput of samples used for screening purposes. While advantages of such techniques are increased analytical efficiency and cost savings, the sensitivity of measurements decreases because it is inversely proportional to the number of samples m the pools. Consequently, uncertainties in estimates of dose and risk which are based on the results of pooled samples increase as the number of samples in the pools increases m all applications. However, sensitivities may not be seriously degraded, for example, in urinanalysis, if the samples in the pools are of known time duration, or if the fraction of some attribute of the grab urine samples to that m a 24-hour composite is known (e.g., mass, specific gravity, creatinine, or volume, per 24-h interval). This paper presents square and cube pooling schemes that greatly increase throughput and can considerably reduce analytical costs (on a sample basis). The benefit-cost ratios for 5x5 square and 5x5x5 cube pooling schemes are 2.5 and 8.3, respectively. Three-dimensional and higher arrayed pooling schemes would result in even greater economies; however, significant improvements in analytical sensitivity are required to achieve these advantages. These are various other considerations for designing a pooling scheme, where the number of dimensions and of samples in the optimum array are influenced by: 1) the minimal detectable amount (MDA) of the analytical processes, 2) the screening dose-rate requirements, 3) the maximum masses or volumes of the composite samples that can be analyzed, 4) the information already available from results of composite analysis, and 5) the ability of an analytical system to guard against both false negative and false positive results. Many of these are beyond the scope of this paper but are being evaluated. (author)

  5. Fibrinogen Concentrate Therapy in Complex Cardiac Surgery

    NARCIS (Netherlands)

    Bilecen, Suleyman; Peelen, Linda M.; Kalkman, Cor J.; Spanjersberg, Alexander J.; Moons, Karel G. M.; Nierich, Arno P.

    2013-01-01

    Objectives: Fibrinogen concentrate increasingly is used to treat coagulopathic bleeding in cardiac surgery although its effectiveness and safety have not been shown. The authors conducted a cohort study to quantify the effects of fibrinogen concentrate on postoperative blood loss and transfusion and

  6. Exosomes in cardiac injury and repair

    NARCIS (Netherlands)

    Vrijsen, K.R.

    2013-01-01

    Stem cell therapy has been proposed as a strategy to regenerate the damaged myocardium after myocardial infarction. The differentiation capacity of many different stem cells to cardiomyocytes and blood vessels and their effect on cardiac function has been studied. Despite low retention and engraftme

  7. Methods and apparatus for determining cardiac output

    Science.gov (United States)

    Cohen, Richard J. (Inventor); Mukkamala, Ramakrishna (Inventor); Sherman, Derin A. (Inventor)

    2010-01-01

    The present invention provides methods and apparatus for determining a dynamical property of the systemic or pulmonary arterial tree using long time scale information, i.e., information obtained from measurements over time scales greater than a single cardiac cycle. In one aspect, the invention provides a method and apparatus for monitoring cardiac output (CO) from a single blood pressure signal measurement obtained at any site in the systemic or pulmonary arterial tree or from any related measurement including, for example, fingertip photoplethysmography.According to the method the time constant of the arterial tree, defined to be the product of the total peripheral resistance (TPR) and the nearly constant arterial compliance, is determined by analyzing the long time scale variations (greater than a single cardiac cycle) in any of these blood pressure signals. Then, according to Ohm's law, a value proportional to CO may be determined from the ratio of the blood pressure signal to the estimated time constant. The proportional CO values derived from this method may be calibrated to absolute CO, if desired, with a single, absolute measure of CO (e.g., thermodilution). The present invention may be applied to invasive radial arterial blood pressure or pulmonary arterial blood pressure signals which are routinely measured in intensive care units and surgical suites or to noninvasively measured peripheral arterial blood pressure signals or related noninvasively measured signals in order to facilitate the clinical monitoring of CO as well as TPR.

  8. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  9. Cardiac Target Organ Damage in Hypertension: Insights from Epidemiology

    Science.gov (United States)

    Lawler, Patrick R.; Hiremath, Pranoti; Cheng, Susan

    2014-01-01

    Hypertension is an important risk factor implicated in the development of multiple common cardiac conditions, including coronary atherosclerosis, heart failure, and atrial fibrillation. Epidemiologic studies have provided insight into the shared pathogenesis of hypertension and subclinical as well as clinically evident cardiac diseases. The mechanistic common ground between chronic blood pressure elevation and cardiac disease likely begins early in life. Understanding these connections will aid ongoing efforts to identify individuals at risk, develop targeted therapeutics, and improve overall outcomes for individuals with elevated blood pressure in the population at large. PMID:24801135

  10. Peripheral vasodilatation determines cardiac output in exercising humans

    DEFF Research Database (Denmark)

    Bada, A A; Svendsen, J H; Secher, N H; Saltin, B; Mortensen, S P

    In dogs, manipulation of heart rate has no effect on the exercise-induced increase in cardiac output. Whether these findings apply to humans remain uncertain, because of the large differences in cardiovascular anatomy and regulation. To investigate the role of heart rate and peripheral...... arterial ATP infusion at rest. Exercise and ATP infusion increased cardiac output, leg blood flow and vascular conductance (P <0.05), whereas cerebral perfusion remained unchanged. During atrial pacing increasing heart rate by up to 54 beats min(−1), cardiac output did not change in any of the three...... demonstrate that the elevated cardiac output during steady-state exercise is regulated by the increase in skeletal muscle blood flow and venous return to the heart, whereas the increase in heart rate appears to be secondary to the regulation of cardiac output....

  11. Dynamic cardiac phantoms for use in computer software quality control

    International Nuclear Information System (INIS)

    A pilot study was initiated to obtain and implement a similar set of clinical dynamic cardiac studies (software phantoms) on different computer systems for the purpose of quality control of analysis software. Normal and abnormal gated blood pool studies were collected and transferred between six computer systems using serial transmission. Major impediments in attempting to analyse the transferred data files were incomplete or missing data records required for the calculations. Only the left ventricular ejection fraction (LVEF) parameter could be analysed on all six computers. The LVEF results obtained for 10 software phantoms using the commercial software were similar in some phantoms but widely divergent in others. Development of software phantoms still requires improvement in data transfer between computers in order to ensure a complete file content in the transferred study, and a solution for the differences in acquisition protocols. In the meantime users can start to obtain their own set of standard studies illustrative of various clinical disorders, and share these with other users with the same computer type and analysis software. (author). 4 refs, 1 tab

  12. ENERGY STAR Certified Pool Pumps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Pool Pumps that are effective as of February...

  13. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  14. Grundfoss: Chlorination of Swimming Pools

    DEFF Research Database (Denmark)

    Hjorth, Poul G.; Hogan, John; Andreassen, Viggo

    1998-01-01

    Grundfos asked for a model, describing the problem of mixing chemicals, being dosed into water systems, to be developed. The application of the model should be dedicated to dosing aqueous solution of chlorine into swimming pools.......Grundfos asked for a model, describing the problem of mixing chemicals, being dosed into water systems, to be developed. The application of the model should be dedicated to dosing aqueous solution of chlorine into swimming pools....

  15. Pool impacts of Leidenfrost drop

    Science.gov (United States)

    Darbois Texier, Baptiste; Maquet, Laurent; Dorbolo, Stephane; Dehandschoewercker, Eline; Pan, Zhao; Truscott, Tadd

    2015-11-01

    This work concerns the impact of a droplet made of a volatile liquid (typically HFE) on a pool of an other liquid (typically silicone oil) which temperature is above the boiling point of the drop. Depending on the properties of the two liquids and the impacting conditions, four different regimes are observed. For low impacting speeds, the droplet bounces on the surface of the bath and finally levitates above it in a Leidenfrost state. Such a regime occurs as soon as the pool temperature exceeds the boiling point of the drop. This observation means that there is no threshold in temperature for a Leidenfrost effect on a liquid surface contrary to the case of a solid substrate. For intermediate impacting velocities, the pinch-off of the surface of the pool entraps the drop in the liquid bulk. The entrapped drop is separated from the pool by a layer of its own vapour in a similar way of antibulles. For increasing impacting speeds, the vapour layer between the drop and the pool does not hold during the pinch-off event. The contact of the drop with the hot liquid provokes a sudden and intense evaporation. At very large impacting speeds, the drop rapidely contacts the pool, spreads and finally induces a hemi-spherical cavity. In the end, these four different regimes are summarized in a Froud-Weber diagram which boundaries are discussed.

  16. Sublingual Microcirculation is Impaired in Post-cardiac Arrest Patients

    DEFF Research Database (Denmark)

    G. Omar, Yasser; Massey, Michael; Wiuff Andersen, Lars; A. Giberson, Tyler; Berg, Katherine; N. Cocchi, Michael; I. Shapiro, Nathan; W. Donnino, Michael

    2013-01-01

    markers in the post-cardiac arrest state. METHODS: We prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using the...... microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients. RESULTS: We evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual...... microcirculatory blood flow was significantly impaired in post-cardiac arrest patients at 6h (MFI 2.6 [IQR: 2-2.9]) and 24h (2.7 [IQR: 2.3-2.9]) compared to controls (3.0 [IQR: 2.9-3.0]; p<0.01 and 0.02, respectively). After adjustment for initial APACHE II score, post-cardiac arrest patients had significantly...

  17. Cardiac imaging systems and methods employing computerized tomographic scanning

    International Nuclear Information System (INIS)

    A novel method for obtaining cardiac images with X-rays is described. The problem of blurring of the image due to motion of the heart and its associated blood vessels is overcome by monitoring the cardiac cycle to produce a repeating pulse signal indicative of the same selectable phase; a pacemaker may be used to stabilize the cardiac period. Conventional CT scanning may then be performed and only the information recorded in coincidence with certain phases of the cardiac cycle is compounded to produce cardiac images which are free from blurring. Alternatively, the X-ray tube may be gated on and off by the pulse derived from the cardiac cycle in order to reduce X-ray dosage. (U.K.)

  18. Cardiac troponin: an emerging cardiac biomarker in animal health

    Directory of Open Access Journals (Sweden)

    Vishal V. Undhad

    Full Text Available Analysis of cardiac troponin I (cTn I and T (cTnT are considered the “gold standard” for the non-invasive diagnosis of myocardial injury in human and animals. It has replaced traditionally used cardiac biomarkers such as myoglobin, lactate dehydrogenase (LDH, creatine kinase (CK and CK-MB due to its high sensitivity and specificity for the detection of myocardial injury. Cardiac troponins are proteins that control the calcium-mediated interaction between actin and myosin, allowing contraction at the sarcomere level. Concentration of the cTn can be correlated microscopic lesion and loss of immunolabeling in myocardium damage. Troponin concentration remains elevated in blood for 1-2wks so that wide window is available for diagnosis of myocardial damage. The cTn test has >95% specificity and sensitivity and test is less time consuming (10 to 15 minutes and less costly (INR 200 to INR 500. [Vet. World 2012; 5(8.000: 508-511

  19. Comparison of cardiac output of the left and right side of the heart by ultrafast computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Wolfkiel, C.J.; Ferguson, J.L.; Law, W.R.; Chomka, E.V.; Brundage, B.H.

    1986-03-05

    Ultrafast computed tomography (CT) evaluation of cardiac output (CO) can be determined using indicator dilution theory. The concentration of an iodinated contrast agent injected into a vein of a subject can be measured as a function of time by serial EKG, gated CT imaging. The contrast density of the blood pool measured by CT defines the indicator concentration. CT CO is proportional to the area under a time density curve from a region of the blood pool. Proper subject position and scanning timing allows CT to measure CO in the pulmonary (PA) artery and the aorta (AO) with the same contrast bolus. Three anesthetized dogs were multiply scanned following simultaneous injections of contrast and radioactive tracer microspheres. Microsphere CO was determined by reference withdrawal method. Multiple thermodilution CO measurements were made just prior and after each CT CO procedure. 24 comparisons were made of thermodilution, microsphere and CT CO measured in the PA (right sided CO (RSCO)) and the AO (left sided CO (LSCO)). CT CO was calculated as the ratio of the volume of contrast injected to the time density curve area corrected for the relation of contrast density to CT number. RSCO agreed very closely to LSCO (r = .99, p < .001; y = 1.0x +/- .32). RSCO correlated to thermodilution (r = .96, p < .001; y = 1.2x +/- 1.3) and microsphere CO (r = .93, p < .001; y = .69x +/- 1.3). These data show that CT CO measurements can be made in the PA and AO with equal accuracy.

  20. Laser speckle analysis synchronised with cardiac cycle

    Science.gov (United States)

    Zakharov, Pavel; Scheffold, Frank; Weber, Bruno

    2015-07-01

    We present an improved Laser speckle imaging approach to investigate the cerebral blood flow response following function stimulation of a single vibrissa. By synchronising speckle analysis with the cardiac cycle we are able to obtain robust averaging of the correlation signals while at the same time removing the contributions due to the pulsation of blood flow and associated tissue adaptation. With our inter-pulse correlation analysis we can follow second-scale dynamics of the cortical vascular system in response to functional brain activation. We find evidence for two temporally separated processes in the blood flow pattern following stimulation we tentatively attribute to vasodilation and vasoconstriction phases, respectively.

  1. Automatic blood pressure measuring system (M091)

    Science.gov (United States)

    1977-01-01

    The Leg Volume Measuring System is used to measure leg calf girth changes that occur during exposure to lower body negative pressure as a result of pooling of blood and other fluids in the lower extremities.

  2. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.;

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from the...... right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported a...... progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0.001] and...

  3. HYDROLOGY AND LANDSCAPE CONNECTIVITY OF VERNAL POOLS

    Science.gov (United States)

    Vernal pools are shaped by hydrologic processes which influence many aspects of pool function. The hydrologic budget of a pool can be summarized by a water balance equation that relates changes in the amount of water in the pool to precipitation, ground- and surface-water flows, ...

  4. 21 CFR 1250.89 - Swimming pools.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Swimming pools. 1250.89 Section 1250.89 Food and... SANITATION Sanitation Facilities and Conditions on Vessels § 1250.89 Swimming pools. (a) Fill and draw swimming pools shall not be installed or used. (b) Swimming pools of the recirculation type shall...

  5. Cardiac Hypertrophy: A Review on Pathogenesis and Treatment

    Directory of Open Access Journals (Sweden)

    Ankur Rohilla

    2012-07-01

    Full Text Available Cardiac hypertrophy has been considered as an important risk factor for cardiac morbidity and mortality whose prevalence has increased during the last few decades. Cardiac hypertrophy, a disease associated with the myocardium, is characterized by thickening of ventricle wall of heart and consequent reduction in the contracting ability of heart to pump the blood. Cardiac hypertrophy has been divided into two types, i.e. physiological and pathological hypertrophy. The exercise-induced increase in the ability of pumping blood leads to thickening of ventricle wall, referred to as physiological hypertrophy. On the other hand, reduced ability of pumping blood as a result of hypertension and volume overload on heart denotes pathological hypertrophy. Numerous mediators have been found to be involved in the pathogenesis of cardiac hypertrophy that include mitogen-activated protein kinase (MAPK, protein kinase C (PKC insulin-like growth factor-I (IGF-I, phosphatidylinositol 3-kinase (PI3K-AKT/PKB, calcinurin-nuclear factor of activated T cells (NFAT and mammalian target of rapamycin (mTOR. The prevention strategy for cardiac hypertrophy involve thiazide diuretics, angiotensin-converting enzyme (ACE inhibitors, angiotensin (Ang II receptor blockers, beta blockers and calcium channel blockers. The present review article highlights the signaling mechanisms involved and the approaches required in the treatment of cardiac hypertrophy.

  6. Incretin attenuates diabetes-induced damage in rat cardiac tissue.

    Science.gov (United States)

    AbdElmonem Elbassuoni, Eman

    2014-09-01

    Glucagon-like peptide-1 (GLP-1), as a member of the incretin family, has a role in glucose homeostasis, its receptors distributed throughout the body, including the heart. The aim was to investigate cardiac lesions following diabetes induction, and the potential effect of GLP-1 on this type of lesions and the molecular mechanism driving this activity. Adult male rats were classified into: normal, diabetic, 4-week high-dose exenatide-treated diabetic rats, 4-week low-dose exenatide-treated diabetic rats, and 1-week exenatide-treated diabetic rats. The following parameters were measured: in blood: glucose, insulin, lactate dehydrogenase (LDH), total creatine kinase (CK), creatine kinase MB isoenzyme (CK-MB), and CK-MB relative index; in cardiac tissue: lipid peroxide (LPO) and some antioxidant enzymes. The untreated diabetic group displayed significant increases in blood level of glucose, LDH, and CK-MB, and cardiac tissue LPO, and a significant decrease in cardiac tissue antioxidant enzymes. GLP-1 supplementation in diabetic rats definitely decreased the hyperglycemia and abolished the detrimental effects of diabetes on the cardiac tissue. The effect of GLP-1 on blood glucose and on the heart also appeared after a short supplementation period (1 week). It can be concluded that GLP-1 has beneficial effects on diabetes-induced oxidative cardiac tissue damage, most probably via its antioxidant effect directly acting on cardiac tissue and independent of its hypoglycemic effect. PMID:25011640

  7. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  8. Monitoring pool-tail fines

    Science.gov (United States)

    Bunte, K.; Potyondy, J. P.; Abt, S. R.; Swingle, K. W.

    2010-12-01

    Fine sediment deposited in pool-tail areas of mountain streams is often measured to monitor changes in the supply of fines (e.g., by dam removal, bank erosion, or watershed effects including fires and road building) or to assess the status and trend of aquatic ecosystems. Grid counts, pebble counts, and volumetric bedmaterial samples are typically used to quantify pool-tail fines. Grid-count results exhibit a high degree of variability not only among streams and among operators, but also among crews performing a nearly identical procedure (Roper et al. 2010). Variability is even larger when diverse methods are employed, each of which quantifies fines in a different way: grid counts visually count surface fines on small patches within the pool-tail area, pebble counts pick up and tally surface particles along (riffle) transects, and volumetric samples sieve out fines from small-scale bulk samples; and even when delimited to pool-tail areas, individual methods focus on different sampling locales. Two main questions were analyzed: 1) Do pool-tail fines exhibit patterns of spatial variability and are some grid count schemes more likely to provide accurate results than others. 2) How and why does the percentage of fines vary among grid counts, pebble counts, and volumetric samples. In a field study, grids were placed at 7 locales in two rows across the wetted width of 10 pool tails in a 14-m wide 3rd order coarse gravel-bed mountain stream with banks, sometimes interrupted by a secondary peak of fines within the central half of the wetted width. Among the five sampling schemes tested, grid counts covering the wetted width with 7 locales produced the highest accuracy and the least variability among the pools of the reach. Pebble counts between the two waterlines indicated 2-3 times more fines than grid counts, likely because grid counts did not extend exactly up to the waterline. However, when confined to the central 50% of the wetted width, grid counts indicated 1.2 and

  9. Patent Pools: Intellectual Property Rights and Competition

    OpenAIRE

    Rodriguez, Victor

    2010-01-01

    Patent pools do not correct all problems associated with patent thickets. In this respect, patent pools might not stop the outsider problem from striking pools. Moreover, patent pools can be expensive to negotiate, can exclude patent holders with smaller numbers of patents or enable a group of major players to form a cartel that excludes new competitors. For all the above reasons, patent pools are subject to regulatory clearance because they could result in a monopoly. The aim of this article...

  10. Influence of metabolic dysfunction on cardiac mechanics in decompensated hypertrophy and heart failure.

    Science.gov (United States)

    Tewari, Shivendra G; Bugenhagen, Scott M; Vinnakota, Kalyan C; Rice, J Jeremy; Janssen, Paul M L; Beard, Daniel A

    2016-05-01

    Alterations in energetic state of the myocardium are associated with decompensated heart failure in humans and in animal models. However, the functional consequences of the observed changes in energetic state on mechanical function are not known. The primary aim of the study was to quantify mechanical/energetic coupling in the heart and to determine if energetic dysfunction can contribute to mechanical failure. A secondary aim was to apply a quantitative systems pharmacology analysis to investigate the effects of drugs that target cross-bridge cycling kinetics in heart failure-associated energetic dysfunction. Herein, a model of metabolite- and calcium-dependent myocardial mechanics was developed from calcium concentration and tension time courses in rat cardiac muscle obtained at different lengths and stimulation frequencies. The muscle dynamics model accounting for the effect of metabolites was integrated into a model of the cardiac ventricles to simulate pressure-volume dynamics in the heart. This cardiac model was integrated into a simple model of the circulation to investigate the effects of metabolic state on whole-body function. Simulations predict that reductions in metabolite pools observed in canine models of heart failure can cause systolic dysfunction, blood volume expansion, venous congestion, and ventricular dilation. Simulations also predict that myosin-activating drugs may partially counteract the effects of energetic state on cross-bridge mechanics in heart failure while increasing myocardial oxygen consumption. Our model analysis demonstrates how metabolic changes observed in heart failure are alone sufficient to cause systolic dysfunction and whole-body heart failure symptoms. PMID:27085901

  11. Preoperative cardiac risk management

    OpenAIRE

    Vidaković Radosav; Poldermans Don; Nešković Aleksandar N.

    2011-01-01

    Approximately 100 million people undergo noncardiac surgery annually worldwide. It is estimated that around 3% of patients undergoing noncardiac surgery experience a major adverse cardiac event. Although cardiac events, like myocardial infarction, are major cause of perioperative morbidity or mortality, its true incidence is difficult to assess. The risk of perioperative cardiac complications depends mainly on two conditions: 1) identified risk factors, and 2) the type of the surgical p...

  12. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Krutika Gajjar

    2012-06-01

    Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.

  13. Design, evaluation and application of an eight channel transmit/receive coil array for cardiac MRI at 7.0 T

    International Nuclear Information System (INIS)

    The objective of this work is to design, examine and apply an eight channel transmit/receive coil array tailored for cardiac magnetic resonance imaging at 7.0 T that provides image quality suitable for clinical use, patient comfort, and ease of use. The cardiac coil array was designed to consist of a planar posterior section and a modestly curved anterior section. For radio frequency (RF) safety validation, numerical computations of the electromagnetic field (EMF) and the specific absorption rate (SAR) distribution were conducted. In vivo cardiac imaging was performed using a 2D CINE FLASH technique. For signal-to-noise ratio (SNR) assessment reconstructed images were scaled in SNR units. The parallel imaging capabilities of the coil were examined using GRAPPA and SENSE reconstruction with reduction factors of up to R = 4. The assessment of the RF characteristics yielded a maximum noise correlation of 0.33. The baseline SNR advantage at 7.0 T was put to use to acquire 2D CINE images of the heart with a spatial resolution of 1 mm × 1 mm × 4 mm. The coil array supports 1D acceleration factors of up to R = 3 without impairing image quality significantly. For un-accelerated 2D CINE FLASH acquisitions the results revealed an SNR of approximately 140 for the left ventricular blood pool. Blood/myocardium contrast was found to be approximately 90 for un-accelerated 2D CINE FLASH acquisitions. The proposed 8 channel cardiac transceiver surface coil has the capability to acquire high contrast, high spatial and temporal resolution in vivo images of the heart at 7.0 T

  14. Design, evaluation and application of an eight channel transmit/receive coil array for cardiac MRI at 7.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Gräßl, Andreas, E-mail: Andreas.Graessl@mdc-berlin.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); Winter, Lukas, E-mail: Lukas.Winter@mdc-berlin.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); Thalhammer, Christof, E-mail: Christof.Thalhammer@mdc-berlin.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); Renz, Wolfgang, E-mail: Wolfgang.Renz@mdc-berlin.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); Siemens Healthcare, 91052 Erlangen (Germany); Kellman, Peter, E-mail: kellmanp@mail.nih.gov [Laboratory of Cardiac Energetics, National Institutes of Health/NHLBI, Bethesda, MD (United States); Martin, Conrad, E-mail: Conrad.Martin@mdc-berlin.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); Knobelsdorff-Brenkenhoff, Florian von, E-mail: florian.von-knobelsdorff@charite.de [Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Robert-Roessle-Strasse 10, 13125 Berlin (Germany); HELIOS Klinikum Berlin-Buch, Department of Cardiology and Nephrology, 13125 Berlin (Germany); Experimental and Clinical Research Center (ECRC), Charité – University Medicine Campus Berlin Buch, 13125 Berlin (Germany); Tkachenko, Valeriy, E-mail: v.o.tkachenko@googlemail.com [Experimental and Clinical Research Center (ECRC), Charité – University Medicine Campus Berlin Buch, 13125 Berlin (Germany); and others

    2013-05-15

    The objective of this work is to design, examine and apply an eight channel transmit/receive coil array tailored for cardiac magnetic resonance imaging at 7.0 T that provides image quality suitable for clinical use, patient comfort, and ease of use. The cardiac coil array was designed to consist of a planar posterior section and a modestly curved anterior section. For radio frequency (RF) safety validation, numerical computations of the electromagnetic field (EMF) and the specific absorption rate (SAR) distribution were conducted. In vivo cardiac imaging was performed using a 2D CINE FLASH technique. For signal-to-noise ratio (SNR) assessment reconstructed images were scaled in SNR units. The parallel imaging capabilities of the coil were examined using GRAPPA and SENSE reconstruction with reduction factors of up to R = 4. The assessment of the RF characteristics yielded a maximum noise correlation of 0.33. The baseline SNR advantage at 7.0 T was put to use to acquire 2D CINE images of the heart with a spatial resolution of 1 mm × 1 mm × 4 mm. The coil array supports 1D acceleration factors of up to R = 3 without impairing image quality significantly. For un-accelerated 2D CINE FLASH acquisitions the results revealed an SNR of approximately 140 for the left ventricular blood pool. Blood/myocardium contrast was found to be approximately 90 for un-accelerated 2D CINE FLASH acquisitions. The proposed 8 channel cardiac transceiver surface coil has the capability to acquire high contrast, high spatial and temporal resolution in vivo images of the heart at 7.0 T.

  15. The nucleate pool boiling dilemma

    International Nuclear Information System (INIS)

    It is shown that the scatter of experimental data is due to the history and machining finish of the heated surface. All experimental pool boiling data published to date, which does not specify precisely the characteristics of the heated surface cannot be expected to provide reliable design information. (U.K.)

  16. EP BICYCLE POOL - VIGNETTES 2002

    CERN Multimedia

    EP-SMI Help Desk

    2002-01-01

    The vignettes (insurance certificates) for 2002 become obligatory from 1 June. If you have a bicycle from the EP Pool, please bring it to the EP-SMI Help Desk (Building 124) on any working day up to 31 May between 8h.30 - 12h.00 or 13h.30 - 17h.30. EP-SMI Help Desk

  17. Comparison of different protocols for the bovine viral diarrhea virus detection by RT-PCR in pools of whole blood and blood serum artificially contaminated/ Comparação de diferentes protocolos para a detecção do vírus da diarréia viral bovina por RT-PCR em grupos de sangue total e de soro sangüíneo, artificialmente contaminados

    Directory of Open Access Journals (Sweden)

    Amauri A. Alfieri

    2005-06-01

    Full Text Available The RT-PCR technique was optimized and evaluated to detect the 5’ untranslated region of bovine viral diarrhea virus (BVDV from clinical samples that consisted of blood serum and whole blood artificially contaminated with the NADL strain of BVDV. To optimization of technique, the following conditions were evaluated: i two pairs of primers, 103 / 372 (WEINSTOCK et al., 2001 and 324 / 326 (VILCEK et al., 1994, ii four methods of nucleic acid extraction (phenol/chloroform/isoamyl alcohol; silica/guanidine isothiocyanate; a combination of the two previous methods; and TRIzol™ and iii different concentrations and compositions of reagents and time/temperature of the reactions. Between the alternatives tested that resulted in the amplification of the 290 bp product that was easily visualized in ethidium bromide stained 2% agarose gel was that presented the following conditions: i primers 103 and 372; ii initial volume and clinical sample: 50 mL of blood serum; iii extraction of nucleic acid: silica/guanidine isothiocyanate method; iv reverse transcription: 9 mL extracted nucleic acid, 1xPCR buffer (20 mM Tris-HCl pH 8.4 and 50 mM KCl, 1.5 mM MgCl2; 60 units of reverse transcriptase enzyme M-MLV, RNA denaturation at 97°C / 4 min, and reverse transcription at 42°C / 30 min; v PCR: primers 103 / 372 with anneling temperature at 59°C. The utilization of RT-PCR within these optimized conditions allowed the amplification of the BVDV NADL strain (103,56 TCID50 from pools of artificially contaminated blood serum until the dilution 1:160.A técnica da RT-PCR foi otimizada e avaliada para a detecção da região 5’ terminal não-traduzida do genoma do vírus da diarréia viral bovina (BVDV em amostras clínicas de bovinos, constituídas por soro sangüíneo e sangue total, artificialmente contaminadas com a estirpe NADL do BVDV. Para a otimização da técnica foram avaliados: i dois pares de primers, 103 / 372 (WEINSTOCK et al., 2001 e 324 / 326

  18. Role of Nuclear Medicine in the cardiac resinchronization therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Simone Cristina Soares, E-mail: simonecordis@yahoo.com.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Giorgi, Maria Clementina Pinto; D' Orio, Silvana Angelina; Meneghetti, Jose Claudio [Instituto do Coracao (InCor/FM/USP), Sao Paulo, SP (Brazil)

    2011-10-15

    Cardiac resynchronization therapy (CRT) emerged as one of the most promising approaches in the treatment of cardiac dyssynchrony in heart failure patients' refractory to medical treatment. However, despite very promising clinical and functional results, individual response analyses show that a significant number of patients do not respond to treatment. The role of nuclear medicine and molecular imaging in the selection of CRT candidates by the assessment of cardiac dyssynchrony, myocardial viability, myocardial perfusion and blood flow and sympathetic cardiac activity has been discussed in this review. The potential utilization of this tool to improve the comprehension of detrimental effects of dyssynchrony on cardiac function and the evaluation and monitoring of the response to CRT were also considered. Other molecular targets that characterize glucose and fatty acid metabolism, apoptosis, angiotensin converting enzyme activity and angiogenesis that can be evaluated with this technique were described. (author)

  19. Role of Nuclear Medicine in the cardiac resinchronization therapy

    International Nuclear Information System (INIS)

    Cardiac resynchronization therapy (CRT) emerged as one of the most promising approaches in the treatment of cardiac dyssynchrony in heart failure patients' refractory to medical treatment. However, despite very promising clinical and functional results, individual response analyses show that a significant number of patients do not respond to treatment. The role of nuclear medicine and molecular imaging in the selection of CRT candidates by the assessment of cardiac dyssynchrony, myocardial viability, myocardial perfusion and blood flow and sympathetic cardiac activity has been discussed in this review. The potential utilization of this tool to improve the comprehension of detrimental effects of dyssynchrony on cardiac function and the evaluation and monitoring of the response to CRT were also considered. Other molecular targets that characterize glucose and fatty acid metabolism, apoptosis, angiotensin converting enzyme activity and angiogenesis that can be evaluated with this technique were described. (author)

  20. MRI and pathologic correlation of cardiac myxomas

    International Nuclear Information System (INIS)

    Objective: To investigate the MRI features of cardiac myxoma by correlated with its pathological findings. Methods: MRI features of 22 cases of pathologically confirmed cardiac myxomas were retrospectively reviewed. Results: Of 22 cases, 21 are solitary, 12 located in left atrium, 6 located in right atrium, 2 located in left ventricle and 1 located in fight ventricle. The other one occupied multiple chambers. MRI: 19 are heterogeneous and 3 are homogeneous. Cine-MRI: 18 attach to the endocardium with a pedunculated stalk and 4 are sessile and with a broad attachment. Thirteen cases had secondary valve insufficience or stenosis. Nine have compromised cardiac function. Nineteen cases demonstrated mild to moderate heterogeneous enhancement after Gd-DTPA administration and 3 case showed no enhancement. Four cases had gadolinium first-pass perfusion study and showed a slow and continuous increasing time-intensity, lower than normal myocardium. The pedicles and wall showed delay enhancement. Pathologic findings: 21 are oval and lobular configuration, 1 is grape-like. Ten cases had fresh hemorrhage and 5 had chronic hemorrhage. Fourteen had necrosis, 2 had cystic change and 4 had calcification. Blood vessels or inflammatory cells could be detected in 19 cases. Conclusions: MRI can evaluate the size, location, morphology, especially the vascularity, histologic features and cardiac function of cardiac myxomas. (authors)

  1. Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos Intrathoracic blood volume versus pulmonary artery occlusion pressure as estimators of cardiac preload in critically ill patients

    Directory of Open Access Journals (Sweden)

    Vinko Tomicic F

    2005-06-01

    Full Text Available Background:Monitoring of cardiac preload by determination of pulmonary artery occlusion pressure (PAOP has been traditionally used to guide fluid therapy to optimize cardiac output (CO. Since factors such as intrathoracic pressure and ventricular compliance may modify PAOP, volumetric estimators of preload have been developed. The PiCCO system is able to measure CO and intrathoracic blood volume (ITBV by transpulmonary thermodilution. Aim: To compare a volumetric (ITBV versus a pressure (PAOP determination to accurately estimate cardiac preload in severely ill patients. Patients and Methods: From June 2001 to October 2003, 22 mechanically ventilated patients with hemodynamic instability underwent hemodynamic monitoring with pulmonary artery catheter (PAC and PiCCO system. ITBV index (ITBVI, PAOP and CI were measured simultaneously by both methods. One hundred thirty eight deltas (D were obtained from the difference of ITBVI, PAOP, CI-PAC and CI-PiCCO between 6-12 am and 6-12 pm. Linear regression analysis of DITBVI versus Ð CI-PiCCO and Ð PAOP versus DCI-PAC were made. Results: Mean age of patients was 60.8 ± 19.4 years. APACHE II was 23.9 ± 7. Fifteen patients met criteria for acute respiratory distress syndrome (ARDS. Delta ITBVI significantly correlated with DCI-PiCCO (r=0.54; 95% confidence interval = 0.41-0.65; p <0.01. There was no correlation between DPAOP and DCI-PAC. Conclusion: ITBVI correlated better with CI than PAOP, and therefore it seems to be a more accurate estimator of preload in unstable, mechanically ventilated patients

  2. Blunt cardiac rupture.

    Science.gov (United States)

    Martin, T D; Flynn, T C; Rowlands, B J; Ward, R E; Fischer, R P

    1984-04-01

    Blunt injury to the heart ranges from contusion to disruption. This report comprises 14 patients seen during a 6-year period with cardiac rupture secondary to blunt trauma. Eight patients were injured in automobile accidents, two patients were injured in auto-pedestrian accidents, two were kicked in the chest by ungulates, and two sustained falls. Cardiac tamponade was suspected in ten patients. Five patients presented with prehospital cardiac arrest or arrested shortly after arrival. All underwent emergency department thoracotomy without survival. Two patients expired in the operating room during attempted cardiac repair; both had significant extracardiac injury. Seven patients survived, three had right atrial injuries, three had right ventricular injuries, and one had a left atrial injury. Cardiopulmonary bypass was not required for repair of the surviving patients. There were no significant complications from the cardiac repair. The history of significant force dispersed over a relatively small area of the precordium as in a kicking injury from an animal or steering wheel impact should alert the physician to possible cardiac rupture. Cardiac rupture should be considered in patients who present with signs of cardiac tamponade or persistent thoracic bleeding after blunt trauma. PMID:6708151

  3. Expression profiling reveals differences in metabolic gene expression between exercise-induced cardiac effects and maladaptive cardiac hypertrophy

    DEFF Research Database (Denmark)

    Strøm, Claes C; Aplin, Mark; Ploug, Thorkil;

    2005-01-01

    gene expression in response to exercise. Rats exercised for seven weeks on a treadmill were characterized by invasive blood pressure measurements and echocardiography. RNA was isolated from the left ventricle and analysed on DNA microarrays containing 8740 genes. Selected genes were analysed by......While cardiac hypertrophy elicited by pathological stimuli eventually leads to cardiac dysfunction, exercise-induced hypertrophy does not. This suggests that a beneficial hypertrophic phenotype exists. In search of an underlying molecular substrate we used microarray technology to identify cardiac...... quantitative PCR. The exercise program resulted in cardiac hypertrophy without impaired cardiac function. Principal component analysis identified an exercise-induced change in gene expression that was distinct from the program observed in maladaptive hypertrophy. Statistical analysis identified 267 upregulated...

  4. Using a Combined Platform of Swarm Intelligence Algorithms and GIS to Provide Land Suitability Maps for Locating Cardiac Rehabilitation Defibrillators

    OpenAIRE

    KAFFASH-CHARANDABI, Neda; SADEGHI-NIARAKI, Abolghasem; Park, Dong-Kyun

    2015-01-01

    Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identi-fied and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and...

  5. Evidence for angiotensin II type 2 receptor–mediated cardiac myocyte enlargement during in vivo pressure overload

    OpenAIRE

    Senbonmatsu, Takaaki; Ichihara, Sahoko; Price, Edward; Gaffney, F.Andrew; Inagami, Tadashi

    2000-01-01

    The pathophysiological roles of the angiotensin II type 2 receptor (AT2) in cardiac hypertrophy remain unclear. By the targeted deletion of mouse AT2 we were able to prevent the left ventricular hypertrophy resulting from pressure overload, while cardiac contractile functions remained normal. This implies that AT2 is a mediator of cardiac hypertrophy in response to increased blood pressure. The effects of AT2 deletion were independent of activation of embryonic genes for cardiac hypertrophy. ...

  6. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  7. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  8. Learning rules from multisource data for cardiac monitoring

    CERN Document Server

    Cordier, Marie-Odile; Quiniou, René

    2009-01-01

    This paper formalises the concept of learning symbolic rules from multisource data in a cardiac monitoring context. Our sources, electrocardiograms and arterial blood pressure measures, describe cardiac behaviours from different viewpoints. To learn interpretable rules, we use an Inductive Logic Programming (ILP) method. We develop an original strategy to cope with the dimensionality issues caused by using this ILP technique on a rich multisource language. The results show that our method greatly improves the feasibility and the efficiency of the process while staying accurate. They also confirm the benefits of using multiple sources to improve the diagnosis of cardiac arrhythmias.

  9. Penetrating cardiac injury by a metallic fragment

    International Nuclear Information System (INIS)

    An adult male had a penetrating injury of the chest resulting in cardiac tamponade. The injury resulted as a consequence of a detached iron piece from an iron bar in a steel mill. Emergency sternotomy and percardiotomy revealed blood in the pericardial cavity and full thickness penetration of the right ventricle. The defect was repaired following the removal of the iron fragment. Postoperative recovery was uneventful. (author)

  10. A Consensual Linear Opinion Pool

    CERN Document Server

    Carvalho, Arthur

    2012-01-01

    We propose a pooling method to aggregate expert opinions. Intuitively, it works as if the experts were continuously updating their opinions in order to accommodate the expertise of others. Each updated opinion takes the form of a linear opinion pool, where the weight that an expert assigns to a peer's opinion is inversely related to the distance between their opinions. In other words, experts are assumed to prefer opinions that are close to their own opinions. We prove that such an updating process leads to consensus, i.e., the experts all converge towards the same opinion. Further, we show that if experts are rewarded using the quadratic scoring rule, then the above mentioned assumption follows naturally. We empirically demonstrate the efficacy of our method using real-world data.

  11. Agglutinins and cardiac surgery: a web based survey of cardiac anaesthetic practice; questions raised and possible solutions

    OpenAIRE

    Shah, S.; Gilliland, H; Benson, G

    2014-01-01

    Introduction Cardiac surgery involves cardiopulmonary bypass during which the core temperature is generally lowered to hypothermic levels. Patients presenting for cardiac surgery are sometimes reported to have cold or warm autoantibodies at the time of blood screening. It is known that cold agglutinins may cause potentially life-threatening haemolysis, intracoronary haemagglutination leading to inadequate cardioplegia distribution, thrombosis, embolism, ischaemia or infarction. The risk (if a...

  12. Blood pressure

    Science.gov (United States)

    ... the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart contracts, which ... as it relaxes, which is called diastole. Normal blood pressure is considered to be a systolic blood pressure ...

  13. Blood transfusions

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000431.htm Blood transfusions To use the sharing features on this ... several sources of blood which are described below. Blood From the Public (Volunteer Blood Donation) The most ...

  14. Blood Basics

    Science.gov (United States)

    ... Patient Group Links Advocacy Toolkit Home For Patients Blood Basics Blood is a specialized body fluid. It ... about 9 pints. Jump To: The Components of Blood and Their Importance Many people have undergone blood ...

  15. Blood Thinners

    Science.gov (United States)

    If you have some kinds of heart or blood vessel disease, or if you have poor blood flow to your brain, your doctor may recommend that you take a blood thinner. Blood thinners reduce the risk of heart ...

  16. Blood culture

    Science.gov (United States)

    Culture - blood ... A blood sample is needed . The site where blood will be drawn is first cleaned with an antiseptic such ... organism from the skin getting into (contaminating) the blood sample and causing a false-positive result (see ...

  17. Metabolic and cardiac changes in high cholesterol-fructose-fed rats

    DEFF Research Database (Denmark)

    Axelsen, Lene N; Pedersen, Henrik D; Petersen, Jørgen S;

    2010-01-01

    ) levels in serum compared to control fed rats and they had more than a twofold increase in liver weight. However, in contrast to what has previously been reported, HCF diet had no effect on body weight, blood pressure, fasting blood glucose, fasting plasma insulin, glucose tolerance, or cardiac function......-Dawley rats received a HCF diet for 16 to 17weeks. Body weight was measured weekly and mean arterial blood pressure, fasting blood glucose, fasting plasma insulin, glucose tolerance, and blood lipid levels were measured following 15weeks of feeding. One to 2weeks later, while still on the HCF diet, cardiac......Introduction: High cholesterol-fructose (HCF) fed rats have previously been described as an animal model of impaired cardiac insulin signaling and decreased contractile performance. In this study, we evaluated the metabolic and cardiac effects of a HCF diet in rats. Methods: Male Sprague...

  18. Successful Lung Transplant From Donor After Cardiac Death: A Potential Solution to Shortage of Thoracic Organs

    OpenAIRE

    McKellar, Stephen H.; Durham, Lucian A.; Scott, John P.; Cassivi, Stephen D.

    2010-01-01

    Lung transplant is an effective treatment for patients with end-stage lung disease but is limited because of the shortage of acceptable donor organs. Organ donation after cardiac death is one possible solution to the organ shortage because it could expand the pool of potential donors beyond brain-dead and living donors. We report the preliminary experience of Mayo Clinic with donation after cardiac death, lung procurement, and transplant.

  19. Essential vernal pool habitat action plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Vernal pool ecosystem conservation and recovery requires the recovery team to develop methods to determine the distribution of vernal pool types throughout the...

  20. Left ventricular dysfunction and blood glycohemoglobin levels in young diabetics

    International Nuclear Information System (INIS)

    Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart diesease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection/cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels. (orig.)

  1. Cardiac calcified amorphous tumor: A systematic review of the literature

    OpenAIRE

    Quentin de Hemptinne; Didier de Cannière; Jean-Luc Vandenbossche; Philippe Unger

    2015-01-01

    Background: Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic intracavitary cardiac mass. Several case reports have been published but large series are lacking. Objective: To determine clinical features, current management and outcomes of this rare disease. Design: A systematic review of all articles reporting cases of CAT in order to perform a pooled analysis of its clinical features, management and outcomes. Data sources: An electronic search of all English arti...

  2. Validation of the pooled cohort risk score in an Asian population – a retrospective cohort study

    OpenAIRE

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2014-01-01

    Background The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in the contemporary cohorts and limited studies to examine the use of the risk score limit the applicability of the equation in an Asian population. This study examines the validity of the pooled cohort ...

  3. [Cardiac evaluation before non-cardiac surgery].

    Science.gov (United States)

    Menzenbach, Jan; Boehm, Olaf

    2016-07-01

    Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices. Application of diagnostic means, should be used adjusted to this risk estimation. Cardiac biomarkers are useful to discover risk of complications or mortality, that cannot be assessed by clinical signs. After preoperative optimization and perioperative cardiac protection, the observation of the postoperative period remains, to prohibit complications or even death. In consideration of limited resources of intensive care department, postoperative ward rounds beyond intensive care units are considered to be an appropriate instrument to avoid or recognize complications early to reduce postoperative mortality. PMID:27479258

  4. 7 CFR 1033.7 - Pool plant.

    Science.gov (United States)

    2010-01-01

    ... its route distribution in this marketing area for 3 consecutive months or if the plant is required to... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1033.7 Section 1033.7 Agriculture... Handling Definitions § 1033.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants...

  5. 7 CFR 1030.7 - Pool plant.

    Science.gov (United States)

    2010-01-01

    ... its route distribution in this marketing area for 3 consecutive months or if the plant is required to... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1030.7 Section 1030.7 Agriculture... Handling Definitions § 1030.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants...

  6. 7 CFR 1131.7 - Pool plant.

    Science.gov (United States)

    2010-01-01

    ... its route distribution in this marketing area for 3 consecutive months or if the plant is required to... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1131.7 Section 1131.7 Agriculture... Handling Definitions § 1131.7 Pool plant. Pool Plant means a plant or unit of plants specified...

  7. 7 CFR 1032.7 - Pool plant.

    Science.gov (United States)

    2010-01-01

    ... a majority of its route distribution in this marketing area for 3 consecutive months or if the plant... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1032.7 Section 1032.7 Agriculture... Handling Definitions § 1032.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants...

  8. Allogeneic leukocytes in cardiac surgery: Good or bad?

    Directory of Open Access Journals (Sweden)

    Anneke Brand

    2011-09-01

    Full Text Available Worldwide, cardiac surgery is a common procedure requiring a large quantity of allogeneic blood products, which are associated with postoperative complications. Leukocytes present in blood products may play a role in these complications, which are referred to as transfusion-related immunomodulation (TRIM. Several randomized controlled trials (RCTs in different settings investigated the effects of allogeneic leukocytes in red blood cells (RBCs. Cardiac surgery studies reported a reduction in postoperative infections and mortality in patients that received leukocyte-reduced RBCs compared with leukocyte-containing RBCs; this was mainly due to more deaths due to infections and multiple organ dysfunction syndrome (MODS in the group that received leukocyte-containing RBCs. Patients with postoperative complications had higher concentrations of inflammatory mediators. These findings suggest that leukocyte-containing transfusion during cardiac surgery induces a second insult to the systemic inflammatory response. In the present review we discuss the possible role of blood transfusions in cardiac surgery. Especially, we focus on the possible role of allogeneic leukocytes associated with postoperative complications after cardiac surgery.

  9. Hemodynamics driven cardiac valve morphogenesis.

    Science.gov (United States)

    Steed, Emily; Boselli, Francesco; Vermot, Julien

    2016-07-01

    Mechanical forces are instrumental to cardiovascular development and physiology. The heart beats approximately 2.6 billion times in a human lifetime and heart valves ensure that these contractions result in an efficient, unidirectional flow of the blood. Composed of endocardial cells (EdCs) and extracellular matrix (ECM), cardiac valves are among the most mechanically challenged structures of the body both during and after their development. Understanding how hemodynamic forces modulate cardiovascular function and morphogenesis is key to unraveling the relationship between normal and pathological cardiovascular development and physiology. Most valve diseases have their origins in embryogenesis, either as signs of abnormal developmental processes or the aberrant re-expression of fetal gene programs normally quiescent in adulthood. Here we review recent discoveries in the mechanobiology of cardiac valve development and introduce the latest technologies being developed in the zebrafish, including live cell imaging and optical technologies, as well as modeling approaches that are currently transforming this field. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. PMID:26608609

  10. Cardiac metabolism and arrhythmias

    OpenAIRE

    Barth, Andreas S.; Tomaselli, Gordon F.

    2009-01-01

    Sudden cardiac death remains a leading cause of mortality in the Western world, accounting for up to 20% of all deaths in the U.S.1, 2 The major causes of sudden cardiac death in adults age 35 and older are coronary artery disease (70–80%) and dilated cardiomyopathy (10–15%).3 At the molecular level, a wide variety of mechanisms contribute to arrhythmias that cause sudden cardiac death, ranging from genetic predisposition (rare mutations and common polymorphisms in ion channels and structural...

  11. [Cardiac Rehabilitation 2015].

    Science.gov (United States)

    Hoffmann, Andreas

    2015-11-25

    The goals of cardiac rehabilitation are (re-)conditioning and secondary prevention in patients with heart disease or an elevated cardiovascular risk profile. Rehabilitation is based on motivation through education, on adapted physical activity, instruction of relaxation techniques, psychological support and optimized medication. It is performed preferably in groups either in outpatient or inpatient settings. The Swiss working group on cardiac rehabilitation provides a network of institutions with regular quality auditing. Positive effects of rehabilitation programs on mortality and morbidity have been established by numerous studies. Although a majority of patients after cardiac surgery are being referred to rehabilitation, these services are notoriously underused after catheter procedures. PMID:26602848

  12. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed for...... uncertain and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  13. POOL development status and production experience

    CERN Document Server

    Chytracek, R; Frank, M; Girone, M; Govi, G; Moscicki, J T; Papadopoulos, I; Schmücker, H; Karr, K; Malon, D; Vaniachine, A; Tanenbaum, W; Xie, Z; Barrass, T; Cioffi, C; IT

    2005-01-01

    The pool of persistent objects for LHC (POOL) project, part of the large Hadron collider (LHC) computing grid (LCG), is now entering its third year of active development. POOL provides the baseline persistency framework for three LHC experiments. It is based on a strict component model, insulating experiment software from a variety of storage technologies. This paper gives a brief overview of the POOL architecture, its main design principles and the experience gained with integration into LHC experiment frameworks. It also presents recent developments in the POOL works areas of relational database abstraction and object storage into relational database management systems (RDBMS) systems.

  14. Cardiac oxygen supply is compromised during the night in hypertensive patients

    OpenAIRE

    Westerhof, B E; Lieshout, van, J.J.; Parati, G.; Montfrans, van, G.A.; Guelen, I.; Spaan, J.A.E.; Westerhof, N.; Karemaker, J. M.; W J W Bos

    2011-01-01

    The enhanced heart rate and blood pressure soon after awaking increases cardiac oxygen demand, and has been associated with the high incidence of acute myocardial infarction in the morning. The behavior of cardiac oxygen supply is unknown. We hypothesized that oxygen supply decreases in the morning and to that purpose investigated cardiac oxygen demand and oxygen supply at night and after awaking. We compared hypertensive to normotensive subjects and furthermore assessed whether pressures mea...

  15. Molecular Basis of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2014-01-01

    Full Text Available Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

  16. The cardiac patient during Ramadan and Hajj.

    Science.gov (United States)

    Chamsi-Pasha, Hassan; Ahmed, Waqar H; Al-Shaibi, Khaled F

    2014-10-01

    The holy month of Ramadan is one of the five pillars of Islam. During this month, fasting Muslims refrain from eating, drinking, smoking, and sex from dawn until sunset. Although the Quran exempts sick people from the duty of fasting, it is not uncommon for many heart disease patients to fast during Ramadan. Despite the fact that more than a billion Muslims worldwide fast during Ramadan, there is no clear consensus on its effects on cardiac disease. Some studies have shown that the effects of fasting on stable patients with cardiac disease are minimal and the majority of patients with stable cardiac illness can endure Ramadan fasting with no clinical deterioration. Fasting during Ramadan does not seem to increase hospitalizations for congestive heart failure. However, patients with decompensated heart failure or those requiring large doses of diuretics are strongly advised not to fast, particularly when Ramadan falls in summer. Patients with controlled hypertension can safely fast. However, patients with resistant hypertension should be advised not to fast until their blood pressure is reasonably controlled. Patients with recent myocardial infarction, unstable angina, recent cardiac intervention or cardiac surgery should avoid fasting. Physician advice should be individualized and patients are encouraged to seek medical advice before fasting in order to adjust their medications, if required. The performance of the Hajj pilgrimage is another pillar of Islam and is obligatory once in the lifetime for all adult Muslims who are in good health and can afford to undertake the journey. Hajj is a physically, mentally, emotionally, and spiritually demanding experience. Medical checkups one or two months before leaving for Hajj is warranted, especially for those with chronic illnesses such as cardiovascular disease. Patients with heart failure, uncontrolled hypertension, serious arrhythmias, unstable angina, recent myocardial infarction, or cardiac surgery should be

  17. The decrease of cardiac chamber volumes and output during positive-pressure ventilation

    DEFF Research Database (Denmark)

    Kristensen, Kasper Kyhl; Ahtarovski, Kiril Aleksov; Iversen, Kasper;

    2013-01-01

    effect of PPV on the central circulation by studying cardiac chamber volumes with cardiac magnetic resonance imaging (CMR). We hypothesized that PPV lowers cardiac output (CO) mainly via the Frank-Starling relationship. In 18 healthy volunteers, cardiac chamber volumes and flow in aorta and the pulmonary......Positive-pressure ventilation (PPV) is widely used for treatment of acute cardiorespiratory failure, occasionally at the expense of compromised cardiac function and arterial blood pressure. The explanation why has largely rested on interpretation of intracardiac pressure changes. We evaluated the...... artery were measured by CMR during PPV levels of 0, 10, and 20 cmH2O applied via a respirator and a face mask. All cardiac chamber volumes decreased in proportion to the level of PPV. Following 20-cmH2O PPV, the total diastolic and systolic cardiac volumes (±SE) decreased from 605 (±29) ml to 446 (±29...

  18. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available Automatic Implantable Cardiac Defibrillator February 19, 2009 Halifax Health Medical Center, Daytona Beach, FL Welcome to Halifax Health Daytona Beach, Florida. Over the next hour you' ...

  19. Sudden Cardiac Arrest

    Science.gov (United States)

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  20. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Aranđelović Aleksandra Č.

    2004-01-01

    Full Text Available Sudden cardiac death in an athlete is rare and tragic event. An athlete's death draws high public attention given that athletes are considered the healthiest category of society. The vast majority of sudden cardiac death in young athletes is due to congenital cardiac malformations such as hypertrophie cardiomyopathy and various coronary artery anomalies. In athletes over age 35, the usual cause of sudden cardiac death is coronary artery disease. With each tragic death of a young athlete, there is a question why this tragedy has not been prevented. The American College of Sports Medicine and the American Heart Association recommend that a pre-participation exam should include a complete cardiovascular history and physical examination.

  1. Cardiac Risk Assessment

    Science.gov (United States)

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  2. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  3. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  4. Safety in cardiac surgery

    OpenAIRE

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for Cardio-Thoracic Surgery (NVT) database. The safety of care is usually measured using patient outcomes. If outcomes are not available, the process and structure of care may be used. Outcomes should be adjusted ...

  5. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  6. Ranolazine in Cardiac Arrhythmia.

    Science.gov (United States)

    Saad, Marwan; Mahmoud, Ahmed; Elgendy, Islam Y; Richard Conti, C

    2016-03-01

    Ranolazine utilization in the management of refractory angina has been established by multiple randomized clinical studies. However, there is growing evidence showing an evolving role in the field of cardiac arrhythmias. Multiple experimental and clinical studies have evaluated the role of ranolazine in prevention and management of atrial fibrillation, with ongoing studies on its role in ventricular arrhythmias. In this review, we will discuss the pharmacological, experimental, and clinical evidence behind ranolazine use in the management of various cardiac arrhythmias. PMID:26459200

  7. Cardiac tumours in infancy

    OpenAIRE

    Yadava, O.P.

    2012-01-01

    Cardiac tumours in infancy are rare and are mostly benign with rhabdomyomas, fibromas and teratomas accounting for the majority. The presentation depends on size and location of the mass as they tend to cause cavity obstruction or arrhythmias. Most rhabdomyomas tend to regress spontaneously but fibromas and teratomas generally require surgical intervention for severe haemodynamic or arrhythmic complications. Other relatively rare cardiac tumours too are discussed along with an Indian perspect...

  8. Cardiac Image Registration

    Directory of Open Access Journals (Sweden)

    2008-09-01

    Full Text Available Long procedure time and somewhat suboptimal results hinder the widespread use of catheter ablation of complex arrhythmias such as atrial fibrillation (AF. Due to lack of contrast differentiation between the area of interest and surrounding structures in a moving organ like heart, there is a lack of proper intraprocedural guidance using current imaging techniques for ablation. Cardiac image registration is currently under investigation and is in clinical use for AF ablation. Cardiac image registration, which involves integration of two images in the context of left atrium (LA, is intermodal, with the acquired image and the real-time reference image residing in different image spaces, and involves optimization, where one image space is transformed into the other. Unlike rigid body registration, cardiac image registration is unique and challenging due to cardiac motion during the cardiac cycle and due to respiration. This review addresses the basic principles of the emerging technique of registration and the inherent limitations as they relate to cardiac imaging and registration.

  9. Cardiac Image Registration

    Directory of Open Access Journals (Sweden)

    Jasbir Sra

    2008-09-01

    Full Text Available Long procedure time and somewhat suboptimal results hinder the widespread use of catheter ablation of complex arrhythmias such as atrial fibrillation (AF. Due to lack of contrast differentiation between the area of interest and surrounding structures in a moving organ like heart, there is a lack of proper intraprocedural guidance using current imaging techniques for ablation. Cardiac image registration is currently under investigation and is in clinical use for AF ablation. Cardiac image registration, which involves integration of two images in the context of the left atrium (LA, is intermodal, with the acquired image and the real-time reference image residing in different image spaces, and involves optimization, where one image space is transformed into the other. Unlike rigid body registration, cardiac image registration is unique and challenging due to cardiac motion during the cardiac cycle and due to respiration. This review addresses the basic principles of the emerging technique of registration and the inherent limitations as they relate to cardiac imaging and registration.

  10. Postoperative cardiac arrest due to cardiac surgery complications

    International Nuclear Information System (INIS)

    To examine the role of anesthetists in the management of cardiac arrest occurring in association with cardiac anesthesia. In this retrospective study we studied the potential performances for each of the relevant incidents among 712 patients undergoing cardiac operations at Golestan and Naft Hospitals Ahwaz between November 2006 and July 2008. Out of total 712 patients undergoing cardiac surgery, cardiac arrest occurred in 28 cases (3.9%) due to different postoperative complications. This included massive bleeding (50% of cardiac arrest cases, 1.9% of patients); pulseless supra ventricular tachycardia (28.5% of cardiac arrest cases, 1.1% of patients); Heart Failure (7% of cardiac arrest cases, 0.2% of patients); Aorta Arc Rapture (3.5% of cardiac arrest cases, 0.1% of patients); Tamponade due to pericardial effusion (3.5% of cardiac arrest cases, 0.1% of total patients); Right Atrium Rupture (3.5% of cardiac arrest cases, 0.1% of patients) were detected after cardiac surgery. Out of 28 cases 7 deaths occurred (25% of cardiac arrest cases, 0.1% of patients). The most prevalent reason for cardiac arrest during post operative phase was massive bleeding (50%) followed by pulseless supra ventricular tachycardia (28.5%). Six patients had some morbidity and the remaining 15 patients recovered. There are often multiple contributing factors to a cardiac arrest under cardiac anesthesia, as much a complete systematic assessment of the patient, equipment, and drugs should be completed. We also found that the diagnosis and management of cardiac arrest in association with cardiac anesthesia differs considerably from that encountered elsewhere. (author)

  11. Neurohumoral indicators of efficacy radiofrequency cardiac denervation

    Science.gov (United States)

    Evtushenko, A. V.; Evtushenko, V. V.; Saushkina, Yu. V.; Lishmanov, Yu. B.; Pokushalov, E. A.; Sergeevichev, D. S.; Gusakova, A. M.; Suslova, T. E.; Dymbrylova, O. N.; Bykov, A. N.; Syryamkin, V. I.; Kistenev, Yu. V.; Anfinogenova, Ya. D.; Smyshlyaev, K. A.; Lotkov, A. I.; Kurlov, I. O.

    2015-11-01

    In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using 123I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

  12. Neurohumoral indicators of efficacy radiofrequency cardiac denervation

    Energy Technology Data Exchange (ETDEWEB)

    Evtushenko, A. V., E-mail: ave@cardio-tomsk.ru; Evtushenko, V. V. [National Research Tomsk State University, Tomsk (Russian Federation); Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Saushkina, Yu. V.; Gusakova, A. M.; Suslova, T. E.; Dymbrylova, O. N.; Smyshlyaev, K. A.; Kurlov, I. O. [Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Lishmanov, Yu. B.; Anfinogenova, Ya. D. [National Research Tomsk Polytechnic University, Tomsk (Russian Federation); Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Sergeevichev, D. S. [Academician E.N. Meshalkin State Research Institute of Circulation Pathology, Novosibirsk (Russian Federation); Bykov, A. N.; Syryamkin, V. I.; Kistenev, Yu. V. [National Research Tomsk State University, Tomsk (Russian Federation); Lotkov, A. I. [Institute of Strength Physics and Materials Science of the Siberian Branch of the RAS, Tomsk (Russian Federation); Pokushalov, E. A.

    2015-11-17

    In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using {sup 123}I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

  13. Anti-rat soluble IL-6 receptor antibody down-regulates cardiac IL-6 and improves cardiac function following trauma-hemorrhage.

    Science.gov (United States)

    Yang, Shaolong; Hu, Shunhua; Choudhry, Mashkoor A; Rue, Loring W; Bland, Kirby I; Chaudry, Irshad H

    2007-03-01

    Although anti-IL-6-mAb down-regulates cardiac IL-6 and attenuates IL-6-mediated cardiac dysfunction following trauma-hemorrhage, it is not known whether blockade of IL-6 receptor will down-regulate cardiac IL-6 and improve cardiac function under those conditions. Six groups of male adult rats (275-325 g) were used: sham/trauma-hemorrhage+vehicle, sham/trauma-hemorrhage+IgG, sham/trauma-hemorrhage+anti-rat sIL-6R. Rats underwent trauma-hemorrhage (removal of 60% of the circulating blood volume and fluid resuscitation after 90 min). Vehicle (V), normal goat IgG or anti-rat sIL-6R (16.7 microg/kg BW) was administered intra-peritoneally in the middle of resuscitation. Two hours later, cardiac function was measured by ICG dilution technique; blood samples collected, cardiomyocytes isolated, and cardiomyocyte nuclei were then extracted. Cardiac IL-6, IL-6R, gp130, IkappaB-alpha/P-IkappaB-alpha, NF-kappaB, and ICAM-1 expressions were measured by immunoblotting. Plasma IL-6 and cardiomyocyte NF-kappaB DNA-binding activity were determined by ELISA. In additional animals, heart harvested and cardiac MPO activity and CINC-1 and -3 were also measured. In another group of rats, cardiac function was measure by microspheres at 24 h following trauma-hemorrhage. Cardiac function was depressed and cardiac IL-6, P-IkappaB-alpha, NF-kappaB and its DNA-binding activity, ICAM-1, MPO activity, and CINC-1 and -3 were markedly increased after trauma-hemorrhage. Moreover, cardiac dysfunction was evident even 24 h after trauma-hemorrhage. Administration of sIL-6R following trauma-hemorrhage: (1) improved cardiac output at 2 h and 24 h (p<0.05); (2) down-regulated both cardiac IL-6 and IL-6R (p<0.05); and (3) attenuated cardiac P-IkappaB-alpha, NF-kappaB, NF-kappaB DNA-binding activity, ICAM-1, CINC-1, -3, and MPO activity (p<0.05). IgG did not significantly influence the above parameters. Thus, IL-6-mediated up-regulation of cardiac NF-kappaB, ICAM-1, CINC-1, -3, and MPO activity likely

  14. Application of Drag-Reducing Polymer Solutions as Test Fluids for In Vitro Evaluation of Potential Blood Damage in Blood Pumps

    OpenAIRE

    Daly, Amanda R.; Sobajima, Hideo; Olia, Salim E.; Takatani, Setsuo; Kameneva, Marina V.

    2010-01-01

    In vitro evaluation of the potential of a circulatory-assist device to damage blood cells has generally been performed using blood from various species. Problems with this approach include the variability of blood sensitivity to mechanical stress in different species, preparation of blood including the adjustment of hematocrit to a standard value, changes in the mechanical properties of blood that occur during storage, and necessity to pool blood samples to obtain an adequate amount of blood ...

  15. Blood Types

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Blood Types KidsHealth > For Teens > Blood Types Print A A ... or straight hair instead of curly. ...Make Eight Blood Types The different markers that can be found in ...

  16. Blood Types

    Science.gov (United States)

    ... confidence to respond in emergency situations with the skills that can help to save a life. Learn more » Red Cross Information Donating Blood Learn About Blood Hosting a Blood Drive For Hospitals Engage with Us About Us Media ...

  17. Intraperitoneal Injection of Multiplacentas Pooled Cells Treatment on a Mouse Model with Aplastic Anemia

    Science.gov (United States)

    Li, Jun; Chen, Hong; Lv, Yan-Bo; Wang, Qiang; Xie, Zheng-Jun; Ma, Li-Hua; He, Jie; Xue, Wei; Yu, Shan; Guo, Jun; Wang, Ting-Hua; Wu, Tian-Xi; Pan, Xing-Hua

    2016-01-01

    Coinfusion of hematopoietic and mesenchymal stem cells is more effective than hematopoietic stem cell transplantation alone. It is necessary to explore a safe and routine mixed stem cell intraperitoneal transplantation method. Multiplacentas pooled cells were intraperitoneally injected into a radiation- and immunity-induced mouse aplastic anemia model with single time. Then, mouse survival time, peripheral blood hemoglobin count, bone marrow architecture, and donor cell engraftment were assessed. The recipient mouse exhibited donor cell engraftment in both bone marrow and peripheral blood. Survival time and peripheral blood hemoglobin count increased in placenta pooled cells treated mice, compared with model-only controls (P = 0.048 and P = 0.000, resp.). However, placentas pooled cells failed to cause a significant decrease in bone marrow pimelosis area (P = 0.357). Intraperitoneally transplanted multiplacentas pooled cells can survive and engraft into a host body through blood circulation, which can increase the life span of an aplastic anemia model mice, and delay but not abrogate the development of aplastic anemia. Furthermore, they appear to play a role in increasing peripheral blood hemoglobin level response for increasing the life span of aplastic anemia model mice. PMID:26997957

  18. Giant blood cyst tumor in the left ventricular outflow tract

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chong; HU Jian; NI Yi-ming; JIANG Zhi-nong; XU He-yun

    2007-01-01

    @@ Blood cyst is a rare primary cardiac tumor usually affecting the cardiac valves. Associated with severe occlusion-related complications, it is generally removed surgically. With a brief review of the literature, we present a case of pedunculated tumor in the left ventricular outflow tract identified by echocardiography.

  19. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled

    DEFF Research Database (Denmark)

    Dahlöf, Björn; Sever, Peter S; Poulter, Neil R;

    2005-01-01

    The apparent shortfall in prevention of coronary heart disease (CHD) noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics an...... and beta blockers. Our aim, therefore, was to compare the effect on non-fatal myocardial infarction and fatal CHD of combinations of atenolol with a thiazide versus amlodipine with perindopril....

  20. Immunoelectrophoresis - blood

    Science.gov (United States)

    IEP - serum; Immunoglobulin electrophoresis - blood; Gamma globulin electrophoresis; Serum immunoglobulin electrophoresis ... A blood sample is needed. For information on how this is done, see: Venipuncture

  1. Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest.

    Science.gov (United States)

    Rittenberger, Jon C; Friess, Stuart; Polderman, Kees H

    2015-12-01

    Cardiac arrest is the most common cause of death in North America. Neurocritical care interventions, including targeted temperature management (TTM), have significantly improved neurological outcomes in patients successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an emergency neurological life support protocol. Patients remaining comatose following resuscitation from cardiac arrest should be considered for TTM. This protocol will review induction, maintenance, and re-warming phases of TTM, along with management of TTM side effects. Aggressive shivering suppression is necessary with this treatment to ensure the maintenance of a target temperature. Ancillary testing, including electrocardiography, computed tomography and/or magnetic resonance imaging of the brain, continuous electroencephalography monitoring, and correction of electrolyte, blood gas, and hematocrit changes, are also necessary to optimize outcomes. PMID:26438463

  2. Abnormal cardiac autonomic regulation in mice lacking ASIC3.

    Science.gov (United States)

    Cheng, Ching-Feng; Kuo, Terry B J; Chen, Wei-Nan; Lin, Chao-Chieh; Chen, Chih-Cheng

    2014-01-01

    Integration of sympathetic and parasympathetic outflow is essential in maintaining normal cardiac autonomic function. Recent studies demonstrate that acid-sensing ion channel 3 (ASIC3) is a sensitive acid sensor for cardiac ischemia and prolonged mild acidification can open ASIC3 and evoke a sustained inward current that fires action potentials in cardiac sensory neurons. However, the physiological role of ASIC3 in cardiac autonomic regulation is not known. In this study, we elucidate the role of ASIC3 in cardiac autonomic function using Asic3(-/-) mice. Asic3(-/-) mice showed normal baseline heart rate and lower blood pressure as compared with their wild-type littermates. Heart rate variability analyses revealed imbalanced autonomic regulation, with decreased sympathetic function. Furthermore, Asic3(-/-) mice demonstrated a blunted response to isoproterenol-induced cardiac tachycardia and prolonged duration to recover to baseline heart rate. Moreover, quantitative RT-PCR analysis of gene expression in sensory ganglia and heart revealed that no gene compensation for muscarinic acetylcholines receptors and beta-adrenalin receptors were found in Asic3(-/-) mice. In summary, we unraveled an important role of ASIC3 in regulating cardiac autonomic function, whereby loss of ASIC3 alters the normal physiological response to ischemic stimuli, which reveals new implications for therapy in autonomic nervous system-related cardiovascular diseases. PMID:24804235

  3. Abnormal Cardiac Autonomic Regulation in Mice Lacking ASIC3

    Directory of Open Access Journals (Sweden)

    Ching-Feng Cheng

    2014-01-01

    Full Text Available Integration of sympathetic and parasympathetic outflow is essential in maintaining normal cardiac autonomic function. Recent studies demonstrate that acid-sensing ion channel 3 (ASIC3 is a sensitive acid sensor for cardiac ischemia and prolonged mild acidification can open ASIC3 and evoke a sustained inward current that fires action potentials in cardiac sensory neurons. However, the physiological role of ASIC3 in cardiac autonomic regulation is not known. In this study, we elucidate the role of ASIC3 in cardiac autonomic function using Asic3−/− mice. Asic3−/− mice showed normal baseline heart rate and lower blood pressure as compared with their wild-type littermates. Heart rate variability analyses revealed imbalanced autonomic regulation, with decreased sympathetic function. Furthermore, Asic3−/− mice demonstrated a blunted response to isoproterenol-induced cardiac tachycardia and prolonged duration to recover to baseline heart rate. Moreover, quantitative RT-PCR analysis of gene expression in sensory ganglia and heart revealed that no gene compensation for muscarinic acetylcholines receptors and beta-adrenalin receptors were found in Asic3−/− mice. In summary, we unraveled an important role of ASIC3 in regulating cardiac autonomic function, whereby loss of ASIC3 alters the normal physiological response to ischemic stimuli, which reveals new implications for therapy in autonomic nervous system-related cardiovascular diseases.

  4. Leptin as a mediator between obesity and cardiac dysfunction

    Directory of Open Access Journals (Sweden)

    Joanna Karbowska

    2012-05-01

    Full Text Available  Obesity is now recognised as one of the most important risk factors for heart disease. Obese individuals have high circulating levels of leptin, a hormone secreted by adipose tissue and in­volved in energy homeostasis. Growing evidence suggests that leptin may contribute to the development of cardiac dysfunction. In a large prospective study leptin has been shown to be an independent risk factor for coronary heart disease. An independent positive association has also been found between plasma leptin levels and heart rate in hypertensive patients and heart transplant recipients. In animal studies chronic leptin infusion increased heart rate and blood pressure. It has also been demonstrated that circulating leptin levels are elevated in patients with heart failure. The level of plasma leptin was associated with increased myocardial wall thickness and correlated with left ventricular mass, suggesting a role for this hormone in mediating left ventricular hypertrophy in humans. Moreover, leptin directly induced hypertrophy and hyperplasia in human and rodent cardiomyocytes, accompanied by cardiac extracellular matrix remodelling. Leptin may also influence energy substrate utilisation in cardiac tissue.These findings suggest that leptin acting directly or through the sympathetic nervous system may have adverse effects on cardiac structure and function, and that chronic hyperleptinaemia may greatly increase the risk of cardiac disorders. Additional studies are needed to define the role of leptin in cardiac physiology and pathophysiology, nevertheless the reduction in plasma leptin levels with caloric restriction and weight loss may prevent cardiac dysfunction in obese patients.

  5. Livermore pool-type reactor

    International Nuclear Information System (INIS)

    The Livermore Pool-Type Reactor (LPTR) has served a dual purpose since 1958--as an instrument for fundamental research and as a tool for measurement and calibration. Our early efforts centered on neutron-diffraction, fission, and capture gamma-ray studies. During the 1960's it was used for extensive calibration work associated with radiochemical and physical measurements on nuclear-explosive tests. Since 1970 the principal applications have been for trace-element measurements and radiation-damage studies. Today's research program is dominated by radiochemical studies of the shorter-lived fission products and by research on the mechanisms of radiation damage. Trace-element measurement for the National Uranium Resource Evaluation (NURE) program is the major measurement application today

  6. A simplified analytical model for pool swell

    International Nuclear Information System (INIS)

    Vapour suppression pool is being used in the containment of PHWR's to limit the pressure and temperature build-up in the containment following a LOCA. The discharge of high pressure water due to LOCA flashes into steam in the drywell, causes a rapid pressure build-up and forces an air-steam mixture into the suppression pool via the vent system. The containment and the pool internal structures need to withstand the hydrodynamic loading due to jet impingement and general motion of the pool water during the water clearing phase from the vents, the loads associated with pool swell in the subsequent air-clearing phase and those due to chugging - the oscillatory condensation of steam - apart from the general thermodynamic loading due to the mass and energy releases from the LOCA. This paper presents a simplified analytical model for pool swell assuming that the bubble is spherical in shape and it migrates vertically. (orig./HP)

  7. Employee reactions to talent pool membership

    OpenAIRE

    Swailes, Stephen; Blackburn, Michelle

    2016-01-01

    Purpose: Despite a large literature on talent management there is very little research on the comparative attitudes of employees in talent pools with those not in talent pools. This is an important omission as employee reactions should influence how effective talent programmes are and how they can be designed and evaluated. Consequently, this paper explores the work-related attitudes of employees who are members and non-members of talent pools. Design: Matched samples of employees worki...

  8. Multi-bank loan pool contracts

    OpenAIRE

    Gintschel, Andreas; Hackethal, Andreas

    2004-01-01

    We show that multi-bank loan pools improve the risk-return profile of banks? loan business. Banks write simple contracts on the proceeds from pooled loan portfolios, taking into account the free-rider problems in joint loan production. Thus, banks benefit greatly from diversifying credit risk while limiting the efficiency loss due to adverse incentives. We present calibration results that the formation of loan pools reduce the volatility in default rates, proxying for credit risk, of particip...

  9. Perspectives on the value of biomarkers in acute cardiac care and implications for strategic management.

    Science.gov (United States)

    Kossaify, Antoine; Garcia, Annie; Succar, Sami; Ibrahim, Antoine; Moussallem, Nicolas; Kossaify, Mikhael; Grollier, Gilles

    2013-01-01

    Biomarkers in acute cardiac care are gaining increasing interest given their clinical benefits. This study is a review of the major conditions in acute cardiac care, with a focus on biomarkers for diagnostic and prognostic assessment. Through a PubMed search, 110 relevant articles were selected. The most commonly used cardiac biomarkers (cardiac troponin, natriuretic peptides, and C-reactive protein) are presented first, followed by a description of variable acute cardiac conditions with their relevant biomarkers. In addition to the conventional use of natriuretic peptides, cardiac troponin, and C-reactive protein, other biomarkers are outlined in variable critical conditions that may be related to acute cardiac illness. These include ST2 and chromogranin A in acute dyspnea and acute heart failure, matrix metalloproteinase in acute chest pain, heart-type fatty acid binding protein in acute coronary syndrome, CD40 ligand and interleukin-6 in acute myocardial infarction, blood ammonia and lactate in cardiac arrest, as well as tumor necrosis factor-alpha in atrial fibrillation. Endothelial dysfunction, oxidative stress and inflammation are involved in the physiopathology of most cardiac diseases, whether acute or chronic. In summary, natriuretic peptides, cardiac troponin, C-reactive protein are currently the most relevant biomarkers in acute cardiac care. Point-of-care testing and multi-markers use are essential for prompt diagnostic approach and tailored strategic management. PMID:24046510

  10. [The third wave of cardiac surgery].

    Science.gov (United States)

    Riera-Kinkel, Carlos

    2016-01-01

    A review of the history of cardiac surgery around the world is made divided into three stages, the first since the beginning of humanity until 300 years BC; the second moment shows how comes the platform that would give the anatomical and functional bases of the cardiovascular system. This historic moment includes: 1. the description and analysis of the function of blood and its components; 2. the description of the normal and abnormal Anatomy of the human heart and its vessels; 3. the anatomic and functional correlation: Foundation of the deductive thinking, and 4. the anatomic and functional integration with the clinic. Finally, the third wave, which is living today, is the stage of the technological explosion that begins with procedures as thoracoscopic surgery with the concept of reducing surgical trauma through minimum approach surgery. Also the use of robotics to solve some of the alterations in the CC, another is hybrid procedures and finally the use of fetal cardiac surgery. PMID:27428342

  11. Current operating practices of nuclear insurance pools

    International Nuclear Information System (INIS)

    This paper discusses the nuclear pooling system and co-operation between the pools, present practice and capacity, with a breakdown of the limits for third party liability and material damage. The author also describes the relationship between the pools and the nuclear operators (the policyholders), and concludes that the nuclear pools have been successful in serving the interests of their member companies, their policyholders and the governments as they have provided a stable insurance market by making available capacity in amounts that had never before been assembled and placed at risk in a single location. 2 tabs

  12. Guide for decontaminating swimming pool at schools

    International Nuclear Information System (INIS)

    Because of TEPCO Fukushima Dai-ichi Nuclear Power Plant accident due to the Great East Japan Earthquake, a huge amount of radioactive materials was widely dispersed and precipitated into the environment. Swimming pools in Fukushima prefectures were contaminated with the radioactives. We JAEA carried out several demonstration tests to decontaminate the radioactives and discharge the pool water safely. We concluded the results obtained from the tests as 'Guide for decontaminating Swimming Pool at School' and released it quickly. Following this, we also released the guide in English. This manuscript, as an experimental report of the swimming pool water decontamination, is consisted from the guide in Japanese and English prepared. (author)

  13. Intraoperative Cardiac Ultrasound Examination Using Vector Flow Imaging

    DEFF Research Database (Denmark)

    Hansen, Kristoffer Lindskov; Pedersen, Mads Møller; Møller-Sørensen, Hasse; Kjaergaard, Jesper; Nilsson, Jens Christian; Lund, Jens Teglgaard; Jensen, Jørgen Arendt; Bachmann, Michael Bachmann

    2013-01-01

    proposed. The vector flow method implemented on a Commercial scanner provided real-time, angle-independent estimates of cardiac blood flow. Epicardiac and epiaortic, intraoperative US examinations were performed on three patients with stenosed coronary arteries scheduled for bypass surgery. Repeating...

  14. Viral metagenomics and blood safety.

    Science.gov (United States)

    Sauvage, V; Eloit, M

    2016-02-01

    The characterization of the human blood-associated viral community (also called blood virome) is essential for epidemiological surveillance and to anticipate new potential threats for blood transfusion safety. Currently, the risk of blood-borne agent transmission of well-known viruses (HBV, HCV, HIV and HTLV) can be considered as under control in high-resource countries. However, other viruses unknown or unsuspected may be transmitted to recipients by blood-derived products. This is particularly relevant considering that a significant proportion of transfused patients are immunocompromised and more frequently subjected to fatal outcomes. Several measures to prevent transfusion transmission of unknown viruses have been implemented including the exclusion of at-risk donors, leukocyte reduction of donor blood, and physicochemical treatment of the different blood components. However, up to now there is no universal method for pathogen inactivation, which would be applicable for all types of blood components and, equally effective for all viral families. In addition, among available inactivation procedures of viral genomes, some of them are recognized to be less effective on non-enveloped viruses, and inadequate to inactivate higher viral titers in plasma pools or derivatives. Given this, there is the need to implement new methodologies for the discovery of unknown viruses that may affect blood transfusion. Viral metagenomics combined with High Throughput Sequencing appears as a promising approach for the identification and global surveillance of new and/or unexpected viruses that could impair blood transfusion safety. PMID:26778104

  15. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  16. A blood circulation model for reference man

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, R.W.; Eckerman, K.F. [Oak Ridge National Lab., TN (United States). Health Sciences Research Div.; Williams, L.R. [Indiana Univ., South Bend, IN (United States). Div. of Liberal Arts and Sciences

    1999-01-01

    This paper describes a dynamic blood circulation model that predicts the movement and gradual dispersal of a bolus of material in the circulation after its intravascular injection into an adult human. The main purpose of the model is to improve the dosimetry of internally deposited radionuclides that decay in the circulation to a significant extent. The total blood volume is partitioned into the blood contents of 24 separate organs or tissues, right heart chambers, left heart chambers, pulmonary circulation, arterial outflow to the systemic tissues (aorta and large arteries), and venous return from the systemic tissues (large veins). As a compromise between physical reality and computational simplicity, the circulation of blood is viewed as a system of first-order transfers between blood pools, with the delay time depending on the mean transit time across the pool. The model allows consideration of incomplete, tissue-dependent extraction of material during passage through the circulation and return of material from tissues to plasma.

  17. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  18. Validation of noninvasive pulse contour cardiac output using finger arterial pressure in cardiac surgery patients requiring fluid therapy

    NARCIS (Netherlands)

    Hofhuizen, C.M.; Lansdorp, B.; Hoeven, J.G. van der; Scheffer, G.J.; Lemson, J.

    2014-01-01

    INTRODUCTION: Nexfin (Edwards Lifesciences, Irvine, CA) allows for noninvasive continuous monitoring of blood pressure (ABPNI) and cardiac output (CONI) by measuring finger arterial pressure (FAP). To evaluate the accuracy of FAP in measuring ABPNI and CONI as well as the adequacy of detecting chang

  19. Validation of noninvasive pulse contour cardiac output using finger arterial pressure in cardiac surgery patients requiring fluid therapy

    NARCIS (Netherlands)

    Hofhuizen, Charlotte; Lansdorp, Benno; Hoeven, van der Johannes G.; Scheffer, Gert-Jan; Lemson, Joris

    2014-01-01

    Introduction Nexfin (Edwards Lifesciences, Irvine, CA) allows for noninvasive continuous monitoring of blood pressure (ABPNI) and cardiac output (CONI) by measuring finger arterial pressure (FAP). To evaluate the accuracy of FAP in measuring ABPNI and CONI as well as the adequacy of detecting change

  20. Finite Element Model to Study One Dimensional Calcium Dyanmics in Cardiac Myocytes

    Science.gov (United States)

    Pathak, Kunal B.; Adlakha, Neeru

    2015-12-01

    The multi physical process involving calcium ions regulate expansion and contraction of cardiac myocytes. This mechanism of expansion and contraction of cardiac myocytes is responsible for contraction and expansion of heart for pumping of blood into arteries and receiving blood into heart from vein. Thus calcium dynamics in cardiac myocytes is responsible for the activities of the myocytes cells and functioning of the heart. The specific spatiotemporal calcium ion dynamics is required to trigger, sustain and terminate activity of the cell. In this paper an attempt has been done to propose a model to study calcium dynamics in cardiac myocytes for a one-dimensional unsteady state case. The model incorporates the process like diffusion, reaction involving source and excess buffers. Appropriate boundary conditions and initial conditions have been framed. The finite element method has been employed to obtain the solution. The numerical results have been used to study the effect of buffers and source influx on calcium dynamics in cardiac myocytes.

  1. Radiography in cardiology [cardiac disorders, cardiac insufficiency

    International Nuclear Information System (INIS)

    The diagnostic procedure in cardiology nearly always requires an X-ray examination of the thorax. This examination is very informative when it is correctly performed and interpreted. The radiographs need to be read precisely and comprehensively: this includes the evaluation of the silhouette of the heart (size, form and position) as well as the examination of extra-cardiac thoracic structures allowing among other things to search for signs of cardiac insufficiency. The conclusion of the X-ray examination can be drawn after having brought together information concerning the case history, the clinical examination and the study of the radiographs. The radiologist finds himself in one of three situations: (1) the information provided by the X-ray pictures is characteristic of a disease and permits a diagnosis, (2) the X-ray pictures indicate a group of hypotheses; further complementary tests could be useful and (3) the X-ray pictures provide ambiguous even contradictory information; it is necessary to complete the radiological examination by other techniques such as an ultrasonographic study of the heart

  2. Fourier and factorial analysis: An objective and comparative evaluation on a cardiac phantom

    International Nuclear Information System (INIS)

    Orthogonal and oblique factor analysis represent an alternative to Fourier analysis in the evaluation of cardiac dynamic behaviour in gated blood pool studies. In order to estimate their respective places, orthogonal factor analysis (OFA), factor analysis of dynamic structures (FADS) and Fourier analysis (FA) are tested on a dynamic and periodical phantom with well known and reproducible kinetics. The phantom data are acquired under standard conditions by varying the counting rates and the temporal frequency sampling. To compare the results of the three methods with maximal objectivity, the relative contribution of each component is calculated. With standard acquisition conditions, FA and OFA give very close results. Only a minor advantage in evaluation of small phase differences is observed with OFA. FADS solutions are effectively related to the dynamic behaviour of the phantom, but their interpretation is more complicated and the quality of the oblique factors is reduced as the number of calculated factors increases. The influence of the counting statistics on FA, OFA and FADS is very similar. However, in cases of undersampling, robustness is demonstrated with the factorial technics. (orig.)

  3. Granulocyte-Colony Stimulating Factor Mobilizing Autologous Peripheral Blood Stem Cells Transplantation to Form Cardiac Myoid Cells and Angiogenesis%G-CSF动员后外周血干细胞移植的成心肌和血管作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    刘文华; 陈永胜; 姜雪松; 于凯江; 李海波

    2007-01-01

    目的 研究粒细胞集落刺激因子(G-CSF)动员后自体外周血干细胞(PBSCs)移植的成心肌和血管的作用.方法 60只日本大耳白兔随机分成移植组、动员剂组和对照组,每组20只,均采用结扎冠状动脉前降支的方法建立心肌梗死(MI)模型,移植组连续给予G-CSF 7 d,在模型建立后1周,将分离外周血所得的干细胞用BrdU标记,制成细胞悬液经心外膜注射到心梗区及周边,对照组只给予等量的生理盐水注射.组织学分析检测植入细胞的存活及分化情况,并测定毛细血管密度.结果 移植组在梗死区可发现BrdU阳性心肌样细胞,且表达Actin阳性.HE染色显示移植组梗死区细胞排列有序,可见大量的新生毛细血管,而对照组梗死区结构紊乱,毛细血管密度较移植组明显降低(P<0.01).Masson染色对照组胶原纤维明显多于移植组和动员剂组.结论 G-CSF动员后植入自体外周血单个核细胞可在梗死区内及周边区存活并分化成心肌样细胞,同时明显促进了毛细血管的生成.%Objective To study autologous peripheral blood stem cells (PBSCs) transplantation for cardiac myoid cells formation and angionesis after recombinant human granulocyte-colony stimulating factor (rhG-CSF) mobilizing. Methods The 60 white Japanese big-ear rabbits were divided into 3 groups, i.e. transplantation (T) mobiliztor (M) and control (C) groups, each group with 20 rabbits. Myocardial infarction (MI) model was developed by ligating the anterior descending coronary artery. G-CSFs were given continually for 7 d in T and M groups since 1 h after MI model development. Cell suspension which derived from the peripheral blood and labeled with BrdU which prepared 1 week ago were injected into infarction regions and borders, while in C groups only the same doses saline was injected. The survival and differentiation of the implanted cells were detected with histological analyses and capillary densities. Results Brd

  4. Sufficient blood, safe blood: can we have both?

    Directory of Open Access Journals (Sweden)

    Bönig Halvard

    2012-03-01

    Full Text Available Abstract The decision in September 2011 in the UK to accept blood donations from non-practicing men who have sex with men (MSM has received significant public attention. Will this rule change substantially boost the number of blood donations or will it make our blood less safe? Clearly, most European countries have a blood procurement problem. Fewer young people are donating, while the population is aging and more invasive therapies are requiring more blood. Yet if that was the reason for allowing non-practicing MSM to donate, clearly re-admission of some other, much larger populations that are currently deferred from donation should likewise be considered. As far as risks for blood safety are concerned, evidence has been provided that the current quality of infectious disease marker testing significantly mitigates against, although does not completely eradicate, risks associated with admission of donors with a high risk of carrying certain blood-transmissible agents. However, it could be argued that more effective recruitment of the non-donor pool, which is substantially larger than the group of currently ineligible donors, would be a better strategy. Recruitment of this group will benefit the availability of blood without jeopardizing the current excellent safety profile of blood.

  5. Serum myoglobin after cardiac catheterisation.

    OpenAIRE

    McComb, J. M.; McMaster, E A

    1982-01-01

    Study of 80 consecutive patients undergoing elective diagnostic cardiac catheterisation showed that after the procedure 25 (31%) developed myoglobinaemia. This was attributed to complications of the catheterisation in two. The remaining 23 had received premedication by intramuscular injection. In patients without intramuscular injections myoglobinaemia did not occur after uncomplicated cardiac catheterisation. The study did not support the proposition that cardiac catheterisation results in m...

  6. Sulfur cycling in two Dutch moorland pools.

    NARCIS (Netherlands)

    Marnette, E.C.L.

    1993-01-01

    Due to atmospheric acid deposition, the chemistry of many moorland pools has changed, resulting in changes in their fauna and flora. Most moorland pools are sensitive to acid loading because underlying and surrounding soils are low in chemical buffering capacity. Biological processes in the sediment

  7. Ripples in a superconducting tidal pool

    International Nuclear Information System (INIS)

    The behaviour of electrons in a metal is often compared to that of water in a pool. An empty pool is like a material that has all of its electrons removed. As electrons are 'poured' into the metal, they first occupy the lowest energies available - the bottom of the pool - and eventually fill up to the Fermi energy, the top of the pool. At this point we no longer discuss electrons but quasiparticles. These are electrons that have modified properties due to their interactions within the material. Waves in a pool can be excited, and their properties will depend on the depth of the water. Similarly in a metal, quasiparticles behave like waves that have a material-dependent dispersion relation between their energy and their wavevector, which specifies their direction and wavelength. This simple analogy also hints at an indirect method of measuring the dispersion relation of a metal, and hence the myriad of properties that depend on it. (U.K.)

  8. Report on fuel pool water loss tests

    Energy Technology Data Exchange (ETDEWEB)

    Zalenski, R.F. [West Valley Nuclear Services Co., West Valley, NY (United States)

    1995-12-31

    To resolve potential concerns on the integrity of the fuel storage pool at the West Valley Demonstration Project (WVDP), a highly accurate testing technique was developed to quantify water losses from the pool. The fuel pool is an unlined, single wall, reinforced concrete structure containing approximately 818,000 gallons of water. Since an initial test indicated that water losses could possibly be attributed solely to evaporation, a cover was suspended and sealed over the pool to block evaporation losses. High accuracy water level and temperature instrumentation was procured and installed. The conclusions of this report indicate that unaccounted-for water losses from the pool are insignificant and there is no detectable leakage within the range of test accuracy.

  9. Artificial blood

    Directory of Open Access Journals (Sweden)

    Sarkar Suman

    2008-01-01

    Full Text Available Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  10. Motivating Factors and Potential Deterrents to Blood Donation in High School Aged Blood Donors

    OpenAIRE

    Rachel Finck; Alyssa Ziman; Matthew Hoffman; Michelle Phan-Tang; Shan Yuan

    2016-01-01

    Background. To ensure an adequate supply of blood, collection centers must design campaigns that successfully recruit and maintain an active donor pool. Understanding factors that motivate and deter individuals from donating may help centers develop targeted recruitment campaigns. These factors among high school aged blood donors have not yet been fully investigated. Study Design and Methods. A voluntary, anonymous survey was administered to student donors at high school mobile blood drives. ...

  11. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  12. Primary cardiac tumors

    International Nuclear Information System (INIS)

    Cardiac tumors happen to be among the less known pathologies without clear treatment standards. Even one decade ago most of the cardiac tumor diagnosis were made post mortem, and only reports of isolated cases could be found in the literature, showing the lack of interest in the investigation of these pathologies by cardiology and cardiovascular surgery specialists. With the development of echocardiography and of cardiovascular surgery, more cases of primary and metastatic cardiac tumors have been diagnosed. Many cases have been treated by palliative or curative surgical interventions, thus increasing the reports in the world literature and the experience in this field, and pointing out the real incidence of these pathologies, not being as bizarre as it had been considered. a revision of the literature will be made, in which the frequency and the suggested interventions will be reported, as well as the cases of cardiac pathology in two cardiovascular centers of the country known by the author. The echocardiographic, pathologic and histological characteristics of the representative cases will be presented, without a greater evidence level, due to the problem's incidence and the few cases reported by these centers

  13. Cardiac MRI tagging

    International Nuclear Information System (INIS)

    Cardiac MRI tagging is an original technique based upon the perturbation of the magnetization of determined regions of the myocardium (tags). The motion of the tags accurately reflects the deformation of the underlying tissue. Data analysis requires special techniques to reconstruct the 3D motion of the heart, and to evaluate the myocardial strain, locally and throughout the whole heart. (authors)

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... Over the next hour you'll see the implantation of an automated implantable cardiac defibrillator. The surgery ... evening we're going to be discussing the implantation of a defibrillator. It’s a battery-powered implantable ...

  15. Cardiac effects of vasopressin.

    Science.gov (United States)

    Pelletier, Jean-Sébastien; Dicken, Bryan; Bigam, David; Cheung, Po-Yin

    2014-07-01

    Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits. PMID:24621650

  16. Cardiac pacemaker power sources

    International Nuclear Information System (INIS)

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  17. Targeting pleiotropic signaling pathways to control adult cardiac stem cell fate and function

    Directory of Open Access Journals (Sweden)

    GiancarloForte

    2014-07-01

    Full Text Available The identification of different pools of cardiac progenitor cells resident in the adult mammalian heart opened a new era in heart regeneration as a means to restore the loss of functional cardiac tissue and overcome the limited availability of donor organs. Indeed, resident stem cells are believed to participate to tissue homeostasis and renewal in healthy and damaged myocardium although their actual contribution to these processes remain unclear. The poor outcome in terms of cardiac regeneration following tissue damage point out at the need for a deeper understanding of the molecular mechanisms controlling CPC behavior and fate determination before new therapeutic strategies can be developed. The regulation of cardiac resident stem cell fate and function is likely to result from the interplay between pleiotropic signaling pathways as well as tissue- and cell-specific regulators. Such a modular interaction – which has already been described in the nucleus of a number of different cells where transcriptional complexes form to activate specific gene programs - would account for the unique responses of cardiac progenitors to general and tissue-specific stimuli.The study of the molecular determinants involved in cardiac stem/progenitor cell regulatory mechanisms may shed light on the processes of cardiac homeostasis in health and disease and thus provide clues on the actual feasibility of cardiac cell therapy through tissue-specific progenitors.

  18. Pool scrubbing models for iodine components

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, K. [Battelle Ingenieurtechnik GmbH, Eschborn (Germany)

    1996-12-01

    Pool scrubbing is an important mechanism to retain radioactive fission products from being carried into the containment atmosphere or into the secondary piping system. A number of models and computer codes has been developed to predict the retention of aerosols and fission product vapours that are released from the core and injected into water pools of BWR and PWR type reactors during severe accidents. Important codes in this field are BUSCA, SPARC and SUPRA. The present paper summarizes the models for scrubbing of gaseous Iodine components in these codes, discusses the experimental validation, and gives an assessment of the state of knowledge reached and the open questions which persist. The retention of gaseous Iodine components is modelled by the various codes in a very heterogeneous manner. Differences show up in the chemical species considered, the treatment of mass transfer boundary layers on the gaseous and liquid sides, the gas-liquid interface geometry, calculation of equilibrium concentrations and numerical procedures. Especially important is the determination of the pool water pH value. This value is affected by basic aerosols deposited in the water, e.g. Cesium and Rubidium compounds. A consistent model requires a mass balance of these compounds in the pool, thus effectively coupling the pool scrubbing phenomena of aerosols and gaseous Iodine species. Since the water pool conditions are also affected by drainage flow of condensate water from different regions in the containment, and desorption of dissolved gases on the pool surface is determined by the gas concentrations above the pool, some basic limitations of specialized pool scrubbing codes are given. The paper draws conclusions about the necessity of coupling between containment thermal-hydraulics and pool scrubbing models, and proposes ways of further simulation model development in order to improve source term predictions. (author) 2 tabs., refs.

  19. Pool scrubbing models for iodine components

    International Nuclear Information System (INIS)

    Pool scrubbing is an important mechanism to retain radioactive fission products from being carried into the containment atmosphere or into the secondary piping system. A number of models and computer codes has been developed to predict the retention of aerosols and fission product vapours that are released from the core and injected into water pools of BWR and PWR type reactors during severe accidents. Important codes in this field are BUSCA, SPARC and SUPRA. The present paper summarizes the models for scrubbing of gaseous Iodine components in these codes, discusses the experimental validation, and gives an assessment of the state of knowledge reached and the open questions which persist. The retention of gaseous Iodine components is modelled by the various codes in a very heterogeneous manner. Differences show up in the chemical species considered, the treatment of mass transfer boundary layers on the gaseous and liquid sides, the gas-liquid interface geometry, calculation of equilibrium concentrations and numerical procedures. Especially important is the determination of the pool water pH value. This value is affected by basic aerosols deposited in the water, e.g. Cesium and Rubidium compounds. A consistent model requires a mass balance of these compounds in the pool, thus effectively coupling the pool scrubbing phenomena of aerosols and gaseous Iodine species. Since the water pool conditions are also affected by drainage flow of condensate water from different regions in the containment, and desorption of dissolved gases on the pool surface is determined by the gas concentrations above the pool, some basic limitations of specialized pool scrubbing codes are given. The paper draws conclusions about the necessity of coupling between containment thermal-hydraulics and pool scrubbing models, and proposes ways of further simulation model development in order to improve source term predictions. (author) 2 tabs., refs

  20. Value of black blood T2* cardiovascular magnetic resonance

    OpenAIRE

    Carpenter John Paul; Smith Gillian C; He Taigang; Alam Mohammed H; Firmin David N; Pennell Dudley J

    2011-01-01

    Abstract Purpose To assess whether black blood T2* cardiovascular magnetic resonance is superior to conventional white blood imaging of cardiac iron in patients with thalassaemia major (TM). Materials and methods We performed both conventional white blood and black blood T2* CMR sequences in 100 TM patients to determine intra and inter-observer variability and presence of artefacts. In 23 patients, 2 separate studies of both techniques were performed to assess interstudy reproducibility. Resu...

  1. Postmortem blood ferritin concentrations in sudden infant death syndrome.

    OpenAIRE

    Worwood, M.; Raha-Chowdhury, R.; Fagan, D G; Moore, C.A.

    1995-01-01

    AIMS--To confirm the observation of extremely high concentrations of ferritin in postmortem serum samples in sudden infant death syndrome (SIDS); to examine the factors influencing blood ferritin concentrations postmortem; to determine whether or not these high blood ferritin concentrations are characteristic of SIDS. METHODS--Postmortem samples of cardiac blood were obtained from 58 full term infants who died of SIDS and 14 full-term infants who died of a variety of other causes. Whole blood...

  2. Operation and maintenance techniques of pool and pool water purification system in IMEF

    International Nuclear Information System (INIS)

    IMEF pool is used pass way between pool and hot cell in order to inlet and outlet of fuel pin in cask. All operation is performed conforming with naked eyes. Therefore floating matter is filtered so as to easy under water handling. Also radioactivity in pool water is controlled according to the nuclear law, radioactivity ration maintained less than 15mR/hr on pool side. Perfect operation and maintenance can be achieved well trained operator. Result obtained from the perfection can give more influence over restrain, spreading contamination of radioactivity materials. This report describes operation and maintenance technique of pool water purification system in IMEF. (Author). 7 refs., 13 figs

  3. [Cardiac amyloidosis. General review].

    Science.gov (United States)

    Laraki, R

    1994-04-01

    Cardiac amyloidosis, most often of AL type, is a non-exceptional disease as it represents 5 to 10% of non-ischemic cardiomyopathies. It realizes typically a restrictive cardiomyopathy. Nevertheless the wide diversity of possible presentation makes it a "big shammer" which must be evoked in front of every unexplained cardiopathy after the age of forty. If some associated manifestations can rapidly suggest the diagnosis, as a peripheric neuropathy especially a carpal tunnel syndrome or palpebral ecchymosis, cardiac involvement can also evolve in an apparently isolated way. The most suggestive paraclinic elements for the diagnosis are, in one hand, the increased myocardial echogenicity with a "granular sparkling" appearance seen throughout all walls of the left ventricle and, in the other hand, the association of a thickened left ventricle and a low voltage (electrocardiogram could also show pseudo-infarct Q waves). In front of such aspects, the proof of amyloidosis is brought by an extra-cardiac biopsy or by scintigraphy with labelled serum amyloid P component, so that the indications of endomyocardial biopsy are very limited today. The identification of the amyloid nature of a cardiopathy has an direct therapeutic implication: it contra-indicates the use of digitalis, calcium channel blockers and beta-blockers. The treatment of AL amyloidosis (chemotherapy with alkylant agents) remains very unsatisfactory especially in the cardiac involvement which is the most frequent cause of death (in AL amyloidosis). Last, cardiac amyloidosis is a bad indication for transplantation which results are burden by rapid progression of deposits especially in the gastro-intestinal tract and the nervous system. PMID:8059146

  4. Cardiac surgery outcomes.

    Science.gov (United States)

    Halpin, Linda S; Barnett, Scott D; Beachy, Jim

    2003-01-01

    Accrediting organizations and payers are demanding valid and reliable data that demonstrate the value of services. Federal agencies, healthcare industry groups, and healthcare watchdog groups are increasing the demand for public access to outcomes data. A new and growing outcomes dynamic is the information requested by prospective patients in an increasingly consumer-oriented business. Patients demand outcomes, and resources are developing to meet these demands. Physicians are increasingly confronted with requests for information about their mortality and morbidity rates, malpractice suits, and disciplinary actions received. For example, in Virginia, prospective patients have access to data provided by the nonprofit group Virginia Health Information. After numerous resolutions by the Virginia Senate since 1999, the prospective Virginia medical consumer now has access to several annual publications: Virginia Hospitals: A Consumer's Guide, 1999 Annual Report and Strategic Plan Update, and the 1999 Industry Report: Virginia Hospitals and Nursing Facilities. Consumers have access to cardiac outcomes data stratified by hospital, gender, and cardiac service line (cardiac surgery, noninvasive cardiology, and invasive cardiology). This is particularly relevant to IHI because Virginia Health Information specifically targets cardiac care. IHI has a sizable investment in cardiovascular outcomes and has found outcomes measurement and research are key to providing quality care. IHI's goal is to move from an outcomes management model to a disease management model. The hope is to incorporate all aspects of the patient's continuum of care, from preoperative and diagnostic services through cardiac interventions to postoperative rehabilitation. Furthermore, every step along the way will be supported with functional status and quality of life assessments. Although these goals are ambitious and expensive, the return on investment is high. PMID:14618772

  5. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...

  6. Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis.

    Science.gov (United States)

    Muehlenbachs, Atis; Bollweg, Brigid C; Schulz, Thadeus J; Forrester, Joseph D; DeLeon Carnes, Marlene; Molins, Claudia; Ray, Gregory S; Cummings, Peter M; Ritter, Jana M; Blau, Dianna M; Andrew, Thomas A; Prial, Margaret; Ng, Dianna L; Prahlow, Joseph A; Sanders, Jeanine H; Shieh, Wun Ju; Paddock, Christopher D; Schriefer, Martin E; Mead, Paul; Zaki, Sherif R

    2016-05-01

    Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients. These sudden cardiac deaths associated with Lyme carditis occurred from late summer to fall, ages ranged from young adult to late 40s, and four patients were men. Autopsy tissue samples were evaluated by light microscopy, Warthin-Starry stain, immunohistochemistry, and PCR for B. burgdorferi, and immunohistochemistry for complement components C4d and C9, CD3, CD79a, and decorin. Post-mortem blood was tested by serology. Interstitial lymphocytic pancarditis in a relatively characteristic road map distribution was present in all cases. Cardiomyocyte necrosis was minimal, T cells outnumbered B cells, plasma cells were prominent, and mild fibrosis was present. Spirochetes in the cardiac interstitium associated with collagen fibers and co-localized with decorin. Rare spirochetes were seen in the leptomeninges of two cases by immunohistochemistry. Spirochetes were not seen in other organs examined, and joint tissue was not available for evaluation. Although rare, sudden cardiac death caused by Lyme disease might be an under-recognized entity and is characterized by pancarditis and marked tropism of spirochetes for cardiac tissues. PMID:26968341

  7. The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation

    OpenAIRE

    Ahn, Chi Bum; Kang, Yang Jun; Kim, Myoung Gon; Yang, Sung; Lim, Choon Hak; Son, Ho Sung; Kim, Ji Sung; Lee, So Young; Son, Kuk Hui; Sun, Kyung

    2016-01-01

    Background Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was perfo...

  8. Pentoxifylline Attenuates Cardiac Remodeling Induced by Tobacco Smoke Exposure

    Directory of Open Access Journals (Sweden)

    Marcos Minicucci

    2016-01-01

    Full Text Available Abstract Background: Tobacco smoke exposure is an important risk factor for cardiac remodeling. Under this condition, inflammation, oxidative stress, energy metabolism abnormalities, apoptosis, and hypertrophy are present. Pentoxifylline has anti‑inflammatory, anti-apoptotic, anti-thrombotic and anti-proliferative properties. Objective: The present study tested the hypothesis that pentoxifylline would attenuate cardiac remodeling induced by smoking. Methods: Wistar rats were distributed in four groups: Control (C, Pentoxifylline (PX, Tobacco Smoke (TS, and PX-TS. After two months, echocardiography, invasive blood pressure measurement, biochemical, and histological studies were performed. The groups were compared by two-way ANOVA with a significance level of 5%. Results: TS increased left atrium diameter and area, which was attenuated by PX. In the isolated heart study, TS lowered the positive derivate (+dp/dt, and this was attenuated by PX. The antioxidants enzyme superoxide dismutase and glutathione peroxidase were decreased in the TS group; PX recovered these activities. TS increased lactate dehydrogenase (LDH and decreased 3-hydroxyacyl Coenzyme A dehydrogenases (OH-DHA and citrate synthase (CS. PX attenuated LDH, 3-OH-DHA and CS alterations in TS-PX group. TS increased IL-10, ICAM-1, and caspase-3. PX did not influence these variables. Conclusion: TS induced cardiac remodeling, associated with increased inflammation, oxidative stress, apoptosis, and changed energy metabolism. PX attenuated cardiac remodeling by reducing oxidative stress and improving cardiac bioenergetics, but did not act upon cardiac cytokines and apoptosis.

  9. Genetic and physiologic dissection of the vertebrate cardiac conduction system.

    Directory of Open Access Journals (Sweden)

    Neil C Chi

    2008-05-01

    Full Text Available Vertebrate hearts depend on highly specialized cardiomyocytes that form the cardiac conduction system (CCS to coordinate chamber contraction and drive blood efficiently and unidirectionally throughout the organism. Defects in this specialized wiring system can lead to syncope and sudden cardiac death. Thus, a greater understanding of cardiac conduction development may help to prevent these devastating clinical outcomes. Utilizing a cardiac-specific fluorescent calcium indicator zebrafish transgenic line, Tg(cmlc2:gCaMP(s878, that allows for in vivo optical mapping analysis in intact animals, we identified and analyzed four distinct stages of cardiac conduction development that correspond to cellular and anatomical changes of the developing heart. Additionally, we observed that epigenetic factors, such as hemodynamic flow and contraction, regulate the fast conduction network of this specialized electrical system. To identify novel regulators of the CCS, we designed and performed a new, physiology-based, forward genetic screen and identified for the first time, to our knowledge, 17 conduction-specific mutations. Positional cloning of hobgoblin(s634 revealed that tcf2, a homeobox transcription factor gene involved in mature onset diabetes of the young and familial glomerulocystic kidney disease, also regulates conduction between the atrium and the ventricle. The combination of the Tg(cmlc2:gCaMP(s878 line/in vivo optical mapping technique and characterization of cardiac conduction mutants provides a novel multidisciplinary approach to further understand the molecular determinants of the vertebrate CCS.

  10. Automated detection of cardiac phase from intracoronary ultrasound image sequences.

    Science.gov (United States)

    Sun, Zheng; Dong, Yi; Li, Mengchan

    2015-01-01

    Intracoronary ultrasound (ICUS) is a widely used interventional imaging modality in clinical diagnosis and treatment of cardiac vessel diseases. Due to cyclic cardiac motion and pulsatile blood flow within the lumen, there exist changes of coronary arterial dimensions and relative motion between the imaging catheter and the lumen during continuous pullback of the catheter. The action subsequently causes cyclic changes to the image intensity of the acquired image sequence. Information on cardiac phases is implied in a non-gated ICUS image sequence. A 1-D phase signal reflecting cardiac cycles was extracted according to cyclical changes in local gray-levels in ICUS images. The local extrema of the signal were then detected to retrieve cardiac phases and to retrospectively gate the image sequence. Results of clinically acquired in vivo image data showed that the average inter-frame dissimilarity of lower than 0.1 was achievable with our technique. In terms of computational efficiency and complexity, the proposed method was shown to be competitive when compared with the current methods. The average frame processing time was lower than 30 ms. We effectively reduced the effect of image noises, useless textures, and non-vessel region on the phase signal detection by discarding signal components caused by non-cardiac factors. PMID:26406038

  11. Blood smear

    Science.gov (United States)

    ... osmotic fragility ) Deficiency of an enzyme called lecithin cholesterol acyl transferase Abnormalities of hemoglobin , the protein in ... sickle and Pappenheimer Red blood cells, target cells Formed elements of blood References Bain BJ. The peripheral ...

  12. Experimental investigation of passive pool mixing

    International Nuclear Information System (INIS)

    After the initial blow-down phase of a hypothetical design basis accident or severe accident in the General Electric Simplified Boiling Water Reactor (SBWR), heat is added to the suppression pool by gas-vapor flow through the isolation condenser (IC) and passive containment cooler (PCC) vent lines. The exit of the vent lines is fairly shallow (on the order of 0.75 meters) in order to enhance IC/PCC operation. The surface temperature of a pool increases when heat is injected. The magnitude of increase depends on the amount of the pool involved in heat absorption and thermal gradients in the absorbing region. Thermal stratification occurs because a rising plume carries the energy of the vented gas-vapor to the pool surface and, as a result, only the region of the pool above the injection point is involved in heat absorption. This experimental investigation demonstrated the feasibility of using the IC/PCC vent flow to drive pool mixing. A passive mixer was designed and constructed on the basis of buoyancy and momentum utilization. The mixer was sized to represent one in a system of several mixers which could be implemented in the SBWR. The experimental results show that the potential exists to involve a significant amount of the suppression pool in heat absorption using a passive mixer

  13. Understanding STAT3 signaling in cardiac ischemia.

    Science.gov (United States)

    O'Sullivan, K E; Breen, E P; Gallagher, H C; Buggy, D J; Hurley, J P

    2016-05-01

    Cardiovascular disease is the leading cause of death worldwide. It remains one of the greatest challenges to global health and will continue to dominate mortality trends in the future. Acute myocardial infarction results in 7.4 million deaths globally per annum. Current management strategies are centered on restoration of coronary blood flow via percutaneous coronary intervention, coronary artery bypass grafting and administration of anti-platelet agents. Such myocardial reperfusion accounts for 40-50 % of the final infarct size in most cases. Signaling transducer and activator of transcription 3 (STAT3) has been shown to have cardioprotective effects via canonical and non-canonical activation and modulation of mitochondrial and transcriptional responses. A significant body of in vitro and in vivo evidence suggests that activation of the STAT3 signal transduction pathway results in a cardio protective response to ischemia and attempts have been made to modulate this with therapeutic effect. Not only is STAT3 important for cardiomyocyte function, but it also modulates the cardiac microenvironment and communicates with cardiac fibroblasts. To this end, we here review the current evidence supporting the manipulation of STAT3 for therapeutic benefit in cardiac ischemia and identify areas for future research. PMID:27017613

  14. The correlation of ECHO findings of right cardiac pathologies with BNP, uric acid, and CRP in OSAS

    OpenAIRE

    ARAZ*, Ömer; UÇAR, Elif YILMAZEL; DEĞİRMENCİ, Hüsnü; PULUR, Didem

    2014-01-01

    Right cardiac pathologies develop in patients with obstructive sleep apnea syndrome (OSAS) and in most patients there are no symptoms in the early stages of right cardiac disorders. We aimed to evaluate a possible relationship between B-type natriuretic peptide (BNP), blood uric acid, C-reactive protein (CRP), and the right cardiac pathologies in patients with OSAS, and the role of these parameters in the management of patients with OSAS. Materials and methods: A total of 98 subjects, 31 (31...

  15. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  16. SAFETY AND MANAGEMENT OF SWIMING POOLS

    Directory of Open Access Journals (Sweden)

    Cemal GÜNDOĞDU

    2008-04-01

    Full Text Available In this study,it was investigated the situation related to the safety and management of swimming pools belongs to municipality This study was planned to determine the present situation related to the safety and management of open,half-olympic and closed swimming pools which are especially used for sports activities,to find out the deficiencies in practise and to overcome these.Our study included totally 80 open,closed,olympic, half-olympic public swimming pools(the pools that belongs to municipality,private administration and university,the colleges connected to the ministry of education, Military schools and police college.In our research,search,natural observation and meeting methods were used.In accordance with this aim the checklist questions,which were prepared for health and safety controls in swimming pools, were tested on the people by face-to-face meeting method. While the statistical evaluation of the available results were being done,frequency and percentage dispersion obtained from checklist was found.It was found that the 52 % of the training and lifeguard choise of the pools in Turkey,64 % of the emergency action equipment,71 % of the signs and signboards for the safety of the pool,75 % of the pool edge and its surroundings are not suitable for the standards and that these threaten the swimmers health importantly.Consequently,we are in the opinion that the pool staff should receive the periodical training about the first aid and using emergency situation equipment.And it is necessary that the Ministry Responsible for sports,Ministry of Interior,Ministry of Health,Ministry of Tourism be cooperate with water sports federations and the related civil society organizationsKey Words: .

  17. Cardiac autoimmunity in HIV related heart muscle disease

    OpenAIRE

    Currie, P; Goldman, J; Caforio, A; Jacob, A.; Baig, M.; Brettle, R; Haven, A; Boon, N.; McKenna, W

    1998-01-01

    Objective—To assess the frequency of circulating cardiac specific autoantibodies in HIV positive patients with and without echocardiographic evidence of left ventricular dysfunction.
Subjects—74 HIV positive patients including 28 with echocardiographic evidence of heart muscle disease, 52 HIV negative people at low risk of HIV infection, and 14 HIV negative drug users who had all undergone non-invasive cardiac assessment were studied along with a group of 200 healthy blood donors.
Results—Car...

  18. Glycemic control in cardiac surgery: Rationale and current evidence

    Directory of Open Access Journals (Sweden)

    G Girish

    2014-01-01

    Full Text Available Studies in cardiac surgical patients have shown an association of hyperglycemia with increased incidences of sepsis, mediastinitis, prolonged mechanical ventilation, cardiac arrhythmias and longer intensive care and hospital stay. There is considerable controversy regarding appropriate glycemic management in these patients and in the definition of hyperglycemia and hypoglycemia or the blood sugar levels at which therapy should be initiated. There is also dilemma regarding the usage of "tight glycemic control" with studies showing conflicting evidences. Part of the controversy can be explained by the differing designs of these studies and the variable definitions of hyperglycemia and hypoglycemia.

  19. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Sørensen, T I; Stadeager, C; Ring-Larsen, H

    1989-01-01

    The pathogenesis of ascites formation in cirrhosis is uncertain. It is still under debate whether the effective blood volume is reduced (underfilling theory) or whether the intravascular compartment is expanded (overflow theory). This problem has not yet been solved because of insufficient tools...... for measuring the central blood volume. We have developed a method that enables us to determine directly the central blood volume, i.e., the blood volume in the heart cavities, lungs, and central arterial tree. In 60 patients with cirrhosis and 16 control subjects the central blood volume was assessed...... according to the kinetic theory as the product of cardiac output and mean transit time of the central vascular bed. Central blood volume was significantly smaller in patients with cirrhosis than in controls (mean 21 vs. 27 ml/kg estimated ideal body weight, p less than 0.001; 25% vs. 33% of the total blood...

  20. Airways disorders and the swimming pool.

    Science.gov (United States)

    Bougault, Valérie; Boulet, Louis-Philippe

    2013-08-01

    Concerns have been expressed about the possible detrimental effects of chlorine derivatives in indoor swimming pool environments. Indeed, a controversy has arisen regarding the possibility that chlorine commonly used worldwide as a disinfectant favors the development of asthma and allergic diseases. The effects of swimming in indoor chlorinated pools on the airways in recreational and elite swimmers are presented. Recent studies on the influence of swimming on airway inflammation and remodeling in competitive swimmers, and the phenotypic characteristics of asthma in this population are reviewed. Preventative measures that could potentially reduce the untoward effects of pool environment on airways of swimmers are discussed. PMID:23830132