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Sample records for cardiac output values

  1. 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.

  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. Cardiac output monitoring

    Directory of Open Access Journals (Sweden)

    Mathews Lailu

    2008-01-01

    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  4. [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

  5. Methods in pharmacology: measurement of cardiac output

    OpenAIRE

    Geerts, Bart F; Aarts, Leon P; Jansen, Jos R.

    2011-01-01

    Many methods of cardiac output measurement have been developed, but the number of methods useful for human pharmacological studies is limited. The ‘holy grail’ for the measurement of cardiac output would be a method that is accurate, precise, operator independent, fast responding, non-invasive, continuous, easy to use, cheap and safe. This method does not exist today. In this review on cardiac output methods used in pharmacology, the Fick principle, indicator dilution techniques, arterial pul...

  6. 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.

  7. Comparison of cardiac output measurement techniques

    DEFF Research Database (Denmark)

    Espersen, K; Jensen, E W; Rosenborg, D; Thomsen, J K; Eliasen, Kirstin; Olsen, Niels Vidiendal; Kanstrup, I L

    1995-01-01

    Simultaneously measured cardiac output obtained by thermodilution (TD), transcutaneous suprasternal ultrasonic Doppler (DOP), CO2-rebreathing (CR) and the direct Fick method (FI) were compared in eleven healthy subjects in a supine position (SU), a sitting position (SI), and during sitting exercise...

  8. 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....

  9. 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...

  10. Automated non-invasive measurement of cardiac output: comparison of electrical bioimpedance and carbon dioxide rebreathing techniques.

    OpenAIRE

    Smith, S A; Russell, A.E.; West, M. J.; Chalmers, J

    1988-01-01

    Two commercial automated, non-invasive systems for estimation of cardiac output were evaluated. Values of cardiac output obtained by electrical bioimpedance cardiography (BoMed NCCOM3 machine) were compared with values derived from an indirect Fick technique that uses carbon dioxide rebreathing (Gould 9000 IV system) during 103 simultaneous measurements made at rest in 19 randomly selected subjects and on exercise in 11 subjects. Cardiac output values obtained with impedance cardiography were...

  11. Non-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance

    OpenAIRE

    Silke, Bernard

    1990-01-01

    Cardiac output measured by thermodilution in 25 patients within 24 hours of acute myocardial infarction was compared with cardiac output measured by Doppler echocardiography (24 patients) and electrical bioimpedance (25 patients). The mean (range) cardiac outputs measured by Doppler (4.03 (2.2-6.0) 1/min) and electrical bioimpedance (3.79 (1.1-6.2) 1/min) were similar to the mean thermodilution value (3.95 (2.1-6.2) 1/min). Both non-invasive techniques agreed closely with thermodilution in mo...

  12. Issues in methods and measurement of thermodilution cardiac output.

    Science.gov (United States)

    Sommers, M S; Woods, S L; Courtade, M A

    1993-01-01

    Criterion-related validity of the thermodilution cardiac output technique for cardiac output measurement has to have a high correlation (r = .91 to .98) with the direct Fick method, the gold standard of cardiac output measurement. Issues that can affect validity of the measurements include the position of the pulmonary artery catheter, the rate of injection of the indicator solution, the volume and temperature of the injectate, the timing of the injection of indicator solution during the respiratory cycle, the position of the subject, and the presence of concomitant infusions. Variation in measurement can be limited by considering the delivery system for the indicator solution, by recording time-temperature cardiac output curves, and by considering normal biologic variations. PMID:8337161

  13. Mini invasive hemodynamic monitoring: from arterial pressure to cardiac output

    OpenAIRE

    GIORGIO DELLA ROCCA; MAURIZIO CECCONI; MARIA GABRIELLA COSTA

    2008-01-01

    To evaluate the Cardiac Output (CO) the standard invasive pulmonary artery catheter (PAC) is considered today the gold standard. The major criticism to the PAC is that its level of invasiveness is not supported by an improvement in patient's outcome. The interest to lesser and lesser invasive techniques is high. Therefore, the alternative techniques have been recently developed.Cardiac Output can be monitored continuously by different devices that analyze the arterial waveform to track change...

  14. A Numerical Investigation of Heat Transfer Cardiac Output Measurements

    OpenAIRE

    Fotheringham, P.; A R Gourlay; McKee, S.; Andrews, S

    2005-01-01

    Measurement of cardiac output is often investigated using a technique based on hot-film anemometry. Here, we discuss a modification to hot-film anemometry, which involves a cylindrical heating element mounted flush on the surface of a typical Swan-Ganz catheter. In contrast to traditional thermodilution, the method discussed here has the potential to allow continuous monitoring of cardiac output.This paper demonstrates that there is a simple approximate relationship between the power input to...

  15. Modelflow underestimates cardiac output in heat-stressed individuals

    DEFF Research Database (Denmark)

    Shibasaki, Manabu; Wilson, Thad E; Bundgaard-Nielsen, Morten; Seifert, Thomas; Secher, Niels H; Crandall, Craig G

    2011-01-01

    Modelflow accurately tracks thermodilution-derived cardiac outputs during whole body heat stress. Acute changes of cardiac output were accomplished via lower-body negative pressure (LBNP) during normothermic and heat-stressed conditions. In nine healthy normotensive subjects, arterial pressure was measured...... similar with cardiac outputs measured by thermodilution (6.4 ± 0.8 l/min). The subsequent reduction in cardiac output during LBNP was also similar among these methods. Whole body heat stress elevated internal temperature from 36.6 ± 0.3 to 37.8 ± 0.4°C and increased cardiac output from 6.4 ± 0.8 to 10.......9 ± 2.0 l/min when evaluated with thermodilution (P <0.001). However, the increase in cardiac output estimated from the Modelflow method for both arterial cannulation (2.3 ± 1.1 l/min) and Finometer (1.5 ± 1.2 l/min) was attenuated compared with thermodilution (4.5 ± 1.4 l/min, both P <0.01). Finally...

  16. Determination of myocardial energetic output for cardiac rhythm pacing.

    Science.gov (United States)

    Herman, Dalibor; Prevorovská, Svetlana; Marsík, Frantisek

    2007-12-01

    This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dual-chamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters-the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not directly measurable, however, their values can be determined using the numerical model of the human cardiovascular system. The 24-segment hemodynamical model (pulsating type) of the human cardiovascular system was used for the numerical simulation of the changes of myocardial workload for cardiac rhythm pacing. The model was fitted by well-measurable parameters for each patient. The calculated parameters were compared using the two-tailed Student's test. The differences of SWI and MVO2 between the modes AAI and VVI and the modes DDD and VVI are statistically significant (P0.05). PMID:18080208

  17. Evaluation of heavy water for indicator dilution cardiac output measurement

    Energy Technology Data Exchange (ETDEWEB)

    Schreiner, M.S.; Leksell, L.G.; Neufeld, G.R. (Univ. of Pennsylvania School of Medicine, Philadelphia (USA))

    1989-10-01

    We evaluated deuterium oxide (D2O) as a tracer for cardiac output measurements. Cardiac output measurements made by thermodilution were compared with those made by indicator dilution with D2O and indocyanine green as tracers. Five triplicate measurements for each method were made at intervals of 30 minutes in each of 9 anesthetized, mechanically ventilated goats. Cardiac output ranged between 0.68 and 3.79 L/min. The 45 data points yielded a correlation coefficient of 0.948 for the comparison of D2O indicator dilution cardiac output measurements with thermodilution measurements and a linear regression slope of 1.046. D2O indicator dilution measurements were biased by -0.11 +/- 0.22 L/min compared with thermodilution measurements and had a standard deviation of +/- 0.12 L/min for triplicate measurements. Hematocrits ranging between 20 and 50 vol% had no effect on optical density for D2O. D2O is more stable than indocyanine green and approximately one-tenth the price (40 cents per injection compared with $4). The basic instrumentation cost of approximately $9,000 is an additional initial expense, but provides the ability to perform pulmonary extravascular water measurements with a double-indicator dilution technique. D2O has potential as a tracer for the clinical determination of indicator dilution cardiac output measurements and pulmonary extravascular water measurements.

  18. Determination of myocardial energetic output for cardiac rhythm pacing

    OpenAIRE

    Heřman, Dalibor; Převorovská, Světlana; Maršík, František

    2007-01-01

    This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dual-chamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters—the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not di...

  19. Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Hann Christopher E

    2010-11-01

    Full Text Available Abstract The application of positive end expiratory pressure (PEEP in mechanically ventilated (MV patients with acute respiratory distress syndrome (ARDS decreases cardiac output (CO. Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness. This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model. The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management.

  20. Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients.

    Science.gov (United States)

    Sundaresan, Ashwath; Chase, J Geoffrey; Hann, Christopher E; Shaw, Geoffrey M

    2010-01-01

    The application of positive end expiratory pressure (PEEP) in mechanically ventilated (MV) patients with acute respiratory distress syndrome (ARDS) decreases cardiac output (CO). Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness.This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model.The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management. PMID:21108836

  1. Relationship between cardiac output and effective renal plasma flow in patients with cardiac disease

    Energy Technology Data Exchange (ETDEWEB)

    McGriffin, D.; Tauxe, W.N.; Lewis, C.; Karp, R.; Mantle, J.

    1984-12-01

    The relationship between effective renal plasma flow (ERPF) and cardiac output was examined in 46 patients (22 with congestive heart failure and 24 following cardiac surgical procedures) by simultaneously measuring the global ERPF by the single-injection method and cardiac output by the thermodilution method. Of the patients in the heart-failure group, 21 also had pulmonary artery end diastolic pressure (PAEDP) recorded at the same time. ERPF and cardiac output were found to be related by the regression equations: cardiac output = 2.08 + 0.0065 ERPF (r, 080), with a SE of estimate of 0.81 l/min. ERPF and PAEDP were related by the regression equation: PAEDP = 42.02 - 0.0675 ERPF (r, 0.86), with a SE of estimate of 5.5 mm Hg. ERPF may be a useful noninvasive method of estimating cardiac output if it is known that no intrinsic kidney disease is present, and if the error of 0.81 l/min (1 SE of estimate) is within the range of clinical usefulness. The error is principally attributable to the determination of cardiac output by the thermodilution method.

  2. Pulse contour-derived cardiac output in hemodialysis patients

    DEFF Research Database (Denmark)

    Cordtz, Joakim; Ladefoged, Soeren D

    2010-01-01

    analysis, namely the Finometer monitor (FNM) for further use on patients dialyzing on a central vascular catheter. Fifty simultaneous cardiac output measurements were obtained during hemodialysis sessions in 25 patients. The internal variability of the FNM measurements was assessed by comparing 24 pairs of...

  3. Pulse contour-derived cardiac output in hemodialysis patients

    DEFF Research Database (Denmark)

    Cordtz, Joakim; Ladefoged, Soeren D

    2010-01-01

    Reliable methods for cardiac output determination are essential for studying the pathophysiology of intradialytic hypotension. Use of the current gold standard, the Transonic monitor, requires an arteriovenous fistula. We wished to verify the accuracy of a method based on finger pulse contour...

  4. Cardiac output and vasodilation in the vasovagal response

    DEFF Research Database (Denmark)

    Wieling, Wouter; Jardine, David L; de Lange, Frederik J;

    2016-01-01

    The simple faint is secondary to hypotension and bradycardia resulting in transient loss of consciousness. According to Ohm's law applied to the circulation, BP = SVR × CO, hypotension can result from a decrease in systemic vascular resistance (SVR), cardiac output (CO), or both. It is important...

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

    Directory of Open Access Journals (Sweden)

    Lavdaniti M.

    2008-01-01

    Full Text Available 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 presented in the international literature. The articles documentthat there are many methods of monitoring the hemodynamic status of patients, both invasive and non-invasive, themost popular of which is thermodilution. The invasive methods are the Fick method and thermodilution, whereasthe non-invasive methods are oeshophaegeal Doppler, transoesophageal echocardiography, lithium dilution, pulsecontour, partial CO2 rebreathing and thoracic electrical bioimpedance. All of them have their advantages and disadvantages,but thermodilution is the golden standard for critical patients, although it does entail many risks. The idealsystem for cardiac output monitoring would be non-invasive, easy to use, reliable and compatible in patients. A numberof research studies have been carried out in clinical care settings, by nurses as well as other health professionals, for thepurpose of finding a method of measurement that would have the least disadvantages. Nevertheless, the thermodilutiontechnique remains the most common approach in use today.

  6. Hidden value: how consumer learning boosts output

    OpenAIRE

    Leonard I. Nakamura

    2014-01-01

    Iphones. Ipads. Wikipedia. Google Maps. Yelp. TripAdvisor. New digital devices, applications, and services offer advice and information at every turn. The technology around us changes fast, so we are continually learning how best to use it. This increased pace of learning enhances the satisfaction we gain from what we buy and increases its value to us over time, even though it may cost the same — or less. However, this effect of consumer learning on value makes inflation and output growth mor...

  7. Cardiac Output Measurement in Patients with an Implanted Pacemaker

    Czech Academy of Sciences Publication Activity Database

    Vondra, Vlastimil; Halámek, Josef; Viščor, Ivo; Jurák, Pavel; Novák, M.

    Danvers : Institute of Electrical and Electronics Engineers, Inc., 2007, s. 916-918. ISBN 978-1-4244-0787-3. ISSN 1557-170X. [Annual International Conference of the IEEE Engineering in Medicine and Biology Society /29./. Lyon (FR), 23.08.2007-26.08.2007] R&D Projects: GA ČR GA102/06/0136 Institutional research plan: CEZ:AV0Z20650511 Keywords : cardiac output measurement * implanted pacemaker Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  8. Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients

    OpenAIRE

    Hann Christopher E; Chase J; Sundaresan Ashwath; Shaw Geoffrey M

    2010-01-01

    Abstract The application of positive end expiratory pressure (PEEP) in mechanically ventilated (MV) patients with acute respiratory distress syndrome (ARDS) decreases cardiac output (CO). Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness. This paper examines...

  9. Assessment of cardiac output changes using a modified FloTrac/Vigileo™ algorithm in cardiac surgery patients

    OpenAIRE

    Senn, Alban; Button, Danny; Zollinger, Andreas; Hofer, Christoph K

    2009-01-01

    Introduction The FloTrac/Vigileo™ (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration. Software modifications were performed in order to eliminate initially observed deficits. The aim of this study was to assess changes in cardiac output determined by the FloTrac/Vigileo™ system (FCO) with an initially released (FCOA) and a modified (FCOB) software version, as well as changes in cardiac output from the PiCCOplus™ system...

  10. 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.

  11. 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.)

  12. Lack of agreement between esophageal doppler cardiac output measurements and continuous pulse contour analysis during off-pump cardiac surgery

    Directory of Open Access Journals (Sweden)

    H. V. Groesdonk

    2010-03-01

    Full Text Available Objective: Transesophageal echo-Doppler cardiac output as well as arterial pulse contour analyses cardiac output are increasingly used for cardiac output monitoring. No data are available whether both techniques may be used interchangeably in patients undergoing cardiac surgery. Design: Prospective, observational study Setting: Operating rooms of a university affiliated hospital. Patients: 30 patients undergoing elective coronary artery bypass grafting surgery.Interventions: NoneMeasurements: 900 paired cardiac output measurements were obtained by pulse contour analysis following transpulmonary thermodilution equilibration by the PiCCO system (PiCCO, Pulsion, Munich, Germany and by the HemoSonic esophageal doppler monitor (HemoSonic 100; Arrow International, Reading, PA. Measurements were performed within the first hour after induction of anesthesia. Results: Bland-Altman analysis of the complete data set showed a mean difference (bias of - 0.12 l/min (95% CI -0.06 to -0.18 with limits of agreement + 1.8 l/min to -1.6 l/min (upper 95% CI 1.78 to 1.98; lower 95% CI -1.74 to -1.54, the percentage error was + 37% to -44.5%. Transesophageal echo-Doppler cardiac output closely correlated (r = 0.75, p < 0.0001 with pulse-contour analyses cardiac output. Conclusions: Several studies have shown the accuracy of calibrated pulse contour cardiac output measurements in patients undergoing cardiac surgery. Thus, the present data question the reliability of transesophageal echo-Doppler derived cardiac output measurements in this setting and may have implications for using transesophageal echo-Doppler during goal-directed hemodynamic optimization.

  13. Minimally invasive or noninvasive cardiac output measurement: an update.

    Science.gov (United States)

    Sangkum, Lisa; Liu, Geoffrey L; Yu, Ling; Yan, Hong; Kaye, Alan D; Liu, Henry

    2016-06-01

    Although cardiac output (CO) by pulmonary artery catheterization (PAC) has been an important guideline in clinical management for more than four decades, some studies have questioned the clinical efficacy of CO in certain patient populations. Further, the use of CO by PAC has been linked to numerous complications including dysrhythmia, infection, rupture of pulmonary artery, injury to adjacent arteries, embolization, pulmonary infarction, cardiac valvular damage, pericardial effusion, and intracardiac catheter knotting. The use of PAC has been steadily declining over the past two decades. Minimally invasive and noninvasive CO monitoring have been studied in the past two decades with some evidence of efficacy. Several different devices based on pulse contour analysis are available currently, including the uncalibrated FloTrac/Vigileo system and the calibrated PiCCO and LiDCO systems. The pressure-recording analytical method (PRAM) system requires only an arterial line and is commercially available as the MostCare system. Transesophageal echocardiography (TEE) can measure CO by non-Doppler- or Doppler-based methods. The partial CO2 rebreathing technique, another method to measure CO, is marketed by Novametrix Medical Systems as the NICO system. Thoracic electrical bioimpedance (TEB) and electric bioreactance (EB) are totally noninvasive CO monitoring. Nexfin HD and the newer ClearSight systems are examples of noninvasive CO monitoring devices currently being marketed by Edwards Lifesciences. The developing focus in CO monitoring devices appears to be shifting to tissue perfusion and microcirculatory flow and aimed more at markers that indicate the effectiveness of circulatory and microcirculatory resuscitations. PMID:26961819

  14. Non-invasive cardiac output monitoring in neonates using bioreactance: a comparison with echocardiography.

    LENUS (Irish Health Repository)

    Weisz, Dany E

    2012-01-01

    Non-invasive cardiac output monitoring is a potentially useful clinical tool in the neonatal setting. Our aim was to evaluate a new method of non-invasive continuous cardiac output (CO) measurement (NICOM™) based on the principle of bioreactance in neonates.

  15. Kredsløbsmonitorering af kritisk syge patienter med "pulse contour cardiac output"-systemet

    DEFF Research Database (Denmark)

    Afshari, Arash; Perner, Anders; Bonde, Jan

    2006-01-01

    The Pulse Contour Cardiac Output (PiCCO) monitoring system measures cardiac output with high precision and accuracy. The system may replace the pulmonary artery catheter in most critically ill patients because the rate of serious complications may be lower. Whether the use of dynamic or static fl...

  16. Kredsløbsmonitorering med lithium dilution cardiac output-systemet

    DEFF Research Database (Denmark)

    Christiansen, Christian; Hostrup, Anette; Tønnesen, Else;

    2008-01-01

    The lithium dilution cardiac output (LiDCO) system measures cardiac output beat-to-beat with high precision. The system is based on an arterial pulse power analysis which is calibrated every eight hours with a small non-pharmacological dose of lithium. The system is minimally invasive; it requires...

  17. Simultaneous cardiac output and regional myocardial perfusion determination with PET and nitrogen 13 ammonia

    DEFF Research Database (Denmark)

    Hove, Jens D; Kofoed, Klaus F; Wu, Hsiao M;

    2003-01-01

    The purpose of this study was to evaluate the possibility of measuring cardiac output during positron emission tomography (PET) examination of myocardial perfusion with nitrogen 13 ammonia.......The purpose of this study was to evaluate the possibility of measuring cardiac output during positron emission tomography (PET) examination of myocardial perfusion with nitrogen 13 ammonia....

  18. 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

  19. Reliability of first-pass radionuclide determination of cardiac output in the upright position at rest and during exercise

    Energy Technology Data Exchange (ETDEWEB)

    Kelbaek, H.; Gjoerup, T.; Hvid-Jacobsen, K.; Skagen, K.; Munck, O. (Herlev Hospital (Denmark). Dept. of Clinical Physiology and Nuclear Medicine); Godtfredsen, J. (Herlev Hospital (Denmark). Dept. of Cardiology); Heslet, L. (Herlev Hospital (Denmark). Dept. of Anesthesiology); Tjur, T.; Jensen, A.M. (Copenhagen Univ. (Denmark). Inst. for Mathematical Statistics)

    1992-11-01

    The reliability of non-invasive determination of cardiac output using first-pass radionuclide cardiography at rest and during exercise in the upright position was evaluated in 20 patients with coronary artery disease. Cardiac output values ranged from 2.97 to 5.99 l/min at rest and from 5.08 to 10.82 l/min during exercise. Cardiac output results obtained by the radionuclide method were compared with those derived from the thermodilution technique performed simultaneously. The mean difference between the two techniques was 0.02/l min at rest and -0.34 l/min during exercise; the limits of agreement (mean {+-}1.96 SD) were -1.29 to 1.33 l/min and -1.97 to 1.29 l/min, respectively, indicating an acceptable level of agreement. A high reproducibility of the radionuclide technique was found, with a mean difference between determinations by two observers of 0.03 l/min at rest and 0.21 l/min during exercise, the corresponding limits of agreement being -0.75 to 0.81 l/min and -0.79 to 1.21 l/min, respectively. With the aid of a variance component analysis of two determinations by each of four observers, 95% confidence intervals of {+-}10% at rest at {+-}12% during exercise were computed for the radionuclide cardiac output measurements. The observer variation was most pronounced for the part of the cardiac output determination related to measurement of left ventricular equilibrium activity during exercise. First-pass radionuclide cardiography is a reliable method for determination of cardiac output in cardiac patients at rest and during exercise in the upright position. (orig.).

  20. Noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine.

    Science.gov (United States)

    Saugel, B; Cecconi, M; Wagner, J Y; Reuter, D A

    2015-04-01

    The determination of blood flow, i.e. cardiac output, is an integral part of haemodynamic monitoring. This is a review on noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine. We present the underlying principles and validation data of the following technologies: thoracic electrical bioimpedance, thoracic bioreactance, vascular unloading technique, pulse wave transit time, and radial artery applanation tonometry. According to clinical studies, these technologies are capable of providing cardiac output readings noninvasively and continuously. They, therefore, might prove to be innovative tools for the assessment of advanced haemodynamic variables at the bedside. However, for most technologies there are conflicting data regarding the measurement performance in comparison with reference methods for cardiac output assessment. In addition, each of the reviewed technology has its own limitations regarding applicability in the clinical setting. In validation studies comparing cardiac output measurements using these noninvasive technologies in comparison with a criterion standard method, it is crucial to correctly apply statistical methods for the assessment of a technology's accuracy, precision, and trending capability. Uniform definitions for 'clinically acceptable agreement' between innovative noninvasive cardiac output monitoring systems and criterion standard methods are currently missing. Further research must aim to further develop the different technologies for noninvasive continuous cardiac output determination with regard to signal recording, signal processing, and clinical applicability. PMID:25596280

  1. Against Journal Articles for Measuring Value in University Output

    Science.gov (United States)

    Mbali, C.

    2010-01-01

    The following lines of arguments against the metrics of journal articles is developed: (1) Textual output should no longer be main valued output; (2) Digitalization enables other ways of advancing knowledge; (3) Measures by journal article favours the disciplines of Natural Science and Engineering (NSE) and moulds other disciplines of Social…

  2. Value-Chain Networks and Entrepreneurial Output in Multinational Subsidiaries

    DEFF Research Database (Denmark)

    Dimitratos, Pavlos; Andersson, Ulf; Liouka, Ioanna

    2011-01-01

    on their entrepreneurial output. Entrepreneurial output can generate superior performance and positive externalities to the subsidiary. Based on a large-scale study of 268 multinational subsidiaries in the UK, we find that value-chain networks have a higher positive impact than multinational...

  3. Lack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution

    DEFF Research Database (Denmark)

    Møller-Sørensen, H; Hansen, K L; Ostergaard, M; Andersen, L W; Møller, Kirsten

    2012-01-01

    BACKGROUND: Minimally invasive monitoring systems of central haemodynamics are gaining increasing popularity. The present study investigated the precision of the endotracheal cardiac output monitor (ECOM) system and its agreement with pulmonary artery catheter thermodilution (PAC TD) for measuring...

  4. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    OpenAIRE

    Amann Matthias; Trabold Benedikt; Schweiger Stefan; Keyl Cornelius; Bele Sylvia; Prasser Christopher; Welnhofer Julia; Wiesenack Christoph

    2007-01-01

    Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC) measurement by the pulmonary artery catheter (PAC). However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP) device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA) only requires access to the radial or femoral artery using a s...

  5. 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...

  6. Determination of myocardial energetic output for cardiac rhythm pacing

    Czech Academy of Sciences Publication Activity Database

    Heřman, D.; Převorovská, Světlana; Maršík, František

    2007-01-01

    Roč. 7, č. 4 (2007), s. 156-161. ISSN 1567-8822 R&D Projects: GA ČR GA106/03/1073 Institutional research plan: CEZ:AV0Z20760514 Keywords : heart arrhythmia * cardiac pacing modes * numerical simulation Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  7. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    Directory of Open Access Journals (Sweden)

    Amann Matthias

    2007-11-01

    Full Text Available Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC measurement by the pulmonary artery catheter (PAC. However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years, who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min. The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (ΔCOPAC and percentage changes in COAP (ΔCOAP for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p PAC and ΔCOAP was 0.46 (p Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore, the used algorithm (V 1.03 failed to

  8. 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

  9. 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

  10. Temporary epicardial left ventricular and biventricular pacing improves cardiac output after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    García-Bengochea Jose B

    2012-10-01

    Full Text Available Abstract Background To evaluate, with different pacing modes, acute changes in left ventricular systolic function, obtained by continuous cardiac output thermodilution in various subsets of patients undergoing cardiopulmonary bypass surgery. Increments of mean arterial pressure and cardiac output were considered the end point. Methods Fifty cases electively submitted to cardiac surgery were analyzed. Isolated valve surgery 62%, coronary revascularization 30% and 8% mixed disease. Left ventricular ejection fraction was preserved in 50%,36% had moderate depression,(EF 36%-50% whereas 14% had severe depression (EF  Results Right atrium-right ventricular pacing, decreased significantly mean arterial pressure and cardiac output (2.3% in the overall population and in the subgroups studied. Right atrium-left ventricle, increased mean arterial pressure and cardiac output in 79% of patients and yielded cardiac output increments of 7.5% (0.40 l/m in the low ejection fraction subgroup and 7.3% (0.43 l/m in the left bundle branch block subset. In atrial fibrillation patients, left ventricular and biventricular pacing produced a significant increase in cardiac output 8.5% (0.39 l/min and 11.6% (0.53 l/min respectively. The dP/dt max increased significantly with both modes (p = 0.021,p = 0.028. Conclusion Right atrial-right ventricular pacing generated adverse hemodynamic effects. Right atrium-left ventricular pacing produced significant CO improvement particularly in cases with depressed ventricular function and left bundle branch block. The greatest increments were observed with left ventricular or biventricular pacing in atrial fibrillation with depressed ejection fraction.

  11. Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease.

    Science.gov (United States)

    Chandler, Heather K; Kirsch, Roxanne

    2016-01-01

    The purpose of this review is to discuss the management of the low cardiac output syndrome (LCOS) following surgery for congenital heart disease. The LCOS is a well-recognized, frequent post-operative complication with an accepted collection of hemodynamic and physiologic aberrations. Approximately 25% of children experience a decrease in cardiac index of less than 2 L/min/m2 within 6-18 hours after cardiac surgery. Post-operative strategies that may be used to manage patients as risk for or in a state of low cardiac output include the use of hemodynamic monitoring, enabling a timely and accurate assessment of cardiovascular function and tissue oxygenation; optimization of ventricular loading conditions; the judicious use of inotropic agents; an appreciation of and the utilization of positive pressure ventilation for circulatory support; and, in some circumstances, mechanical circulatory support. All interventions and strategies should culminate in improving the relationship between oxygen supply and demand, ensuring adequate tissue oxygenation. PMID:26585039

  12. Valve area and cardiac output in aortic stenosis: quantification by magnetic resonance velocity mapping

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Hildebrandt, P; Lindvig, K;

    1993-01-01

    Valve area and cardiac output were determined with magnetic resonance (MR) velocity mapping in 12 patients with aortic stenosis. Heart catheterization, Doppler echocardiography, and indicator dilution were performed for comparison. Left ventricle could be catheterized in only nine patients; in...... material, MR measured a mean area of 1.1 cm2 compared with 1.2 cm2 derived from Doppler echocardiography data, with a mean difference of 0.1 cm2 and [-0.5, +0.6] cm2 as limits of agreement. In 11 patients the cardiac output was quantified by MR to a mean of 4.9 L/min and by indicator dilution to 5.0 L......--the valvular area and the cardiac output--may be quantified, MR has potential to become a clinical tool in assessment of severity in aortic stenosis....

  13. Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans

    DEFF Research Database (Denmark)

    Calbet, J A L; Mortensen, Stefan; Munch, G D W;

    2016-01-01

    To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at...... rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of......: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans....

  14. Techniques of cardiac output measurement during liver transplantation: arterial pulse wave versus thermodilution

    DEFF Research Database (Denmark)

    Nissen, P.; Lieshout, J.J. van; Novovic, S.;

    2009-01-01

    In this study, we compared continuous cardiac output (CO) obtained from the femoral arterial pressure by simulation of an aortic input impedance model [model-simulated cardiac output (MCO)] to thermodilution cardiac output (TDCO) determined by bolus injection during liver transplantation. Both...... variables were measured in 39 adult patients (13 females) every 10th minute during liver transplant surgery. Paired measurements were compared during the 4 phases of surgery-dissection, anhepatic phase, early reperfusion (the first 15 minutes after reperfusion), and late reperfusion (15-60 minutes after......, and the mutual correlation coefficient was 0.812 (P < 0.001). This study indicates that during liver transplantation surgery, MCO reflects TDCO throughout the operation. Thus, for CO, this less invasive method appears to provide a reliable uninterrupted measurement during orthotopic liver...

  15. Cardiac output determined by echocardiography in patients with cirrhosis: comparison with the indicator dilution technique

    DEFF Research Database (Denmark)

    Andersen, Ulrik B; Møller, Søren; Bendtsen, Flemming; Henriksen, Jens H

    2003-01-01

    technique (CO(I)). METHODS: Twelve patients with cirrhosis were studied. CO(d) was measured as the spatial mean velocity of the left ventricular outflow tract, multiplied by the cross-sectional area and the heart rate. CO(I) was determined by the standard indicator dilution technique after injection of 125I......BACKGROUND/AIMS: Measurement of cardiac output in hyperkinetic patients with cirrhosis by Doppler echocardiography is increasingly reported, but has not been validated. We have compared simultaneous measurements of cardiac output by Doppler echocardiography (CO(d)) and by the indicator dilution...... with the Doppler technique. CONCLUSION: Doppler measurements of cardiac output in groups of patients with cirrhosis are accurate with respect to the group mean, but marked disagreements of over- and underestimation were seen in individual patients. The reproducibility of the Doppler technique is...

  16. Measurement of cardiac output by dynamic computed transmission tomography. Comparison with thermodilution method

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Yoshiaki; Yoshino, Futoshi; Ootani, Yukihiro; Kishimoto, Kinya; Takahashi, Ryuji

    1989-05-01

    The capacity of the new computed tomography (CT) instrument with excellent time resolution to measure cardiac output was explored. Dynamic scans of serial one-second images were performed at the middle section of left ventricle for 28 sec. We injected a bolus of 0.3 ml/kg angiografin for 2 sec or 0.4 ml/kg angiografin for 4 sec into the inferior vena cava. The regions of interest were set in the left ventricular cavity and thoracic aorta. Cardiac output was calculated by applying indicator dilution principles. The results were compared with those obtained by thermodilution. The CT results by using 2 sec 0.3 ml/kg angiografin correlated well (r=0.91, p<0.001) with those of thermodilution. This study indicates the utililty of dynamic CT for estimation of cardiac output. (author).

  17. Validation of a new spectrometer for noninvasive measurement of cardiac output

    International Nuclear Information System (INIS)

    Acetylene is a blood-soluble gas and for many years its uptake rate during rebreathing tests has been used to calculate the flow rate of blood through the lungs (normally equal to cardiac output) as well as the volume of lung tissue. A new, portable, noninvasive instrument for cardiac output determination using the acetylene uptake method is described. The analyzer relies on nondispersive IR absorption spectroscopy as its principle of operation and is configured for extractive (side-stream) sampling. The instrument affords exceptionally fast (30 ms, 10%-90%, 90%-10%, at 500 mL min-1 flow rates), interference-free, simultaneous measurement of acetylene, sulfur hexafluoride (an insoluble reference gas used in the cardiac output calculation), and carbon dioxide (to determine alveolar ventilation), with good (typically ±2% full-scale) signal-to-noise ratios. Comparison tests with a mass spectrometer using serially diluted calibration gas samples gave excellent (R2>0.99) correlation for all three gases, validating the IR system's linearity and accuracy. A similar level of agreement between the devices also was observed during human subject C2H2 uptake tests (at rest and under incremental levels of exercise), with the instruments sampling a common extracted gas stream. Cardiac output measurements by both instruments were statistically equivalent from rest to 90% of maximal oxygen consumption; the physiological validity of the measurements was confirmed by the expected linear relationship between cardiac output and oxygen consumption, with both the slope and intercept in the published range. These results indicate that the portable, low-cost, rugged prototype analyzer discussed here is suitable for measuring cardiac output noninvasively in a point-of-care setting

  18. 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.

  19. Cardiac Output and Performance during a Marathon Race in Middle-Aged Recreational Runners

    OpenAIRE

    Billat, Véronique L.; Hélène Petot; Morgan Landrain; Renaud Meilland; Jean Pierre Koralsztein; Laurence Mille-Hamard

    2012-01-01

    Purpose. Despite the increasing popularity of marathon running, there are no data on the responses of stroke volume (SV) and cardiac output (CO) to exercise in this context. We sought to establish whether marathon performance is associated with the ability to sustain high fractional use of maximal SV and CO (i.e, cardiac endurance) and/or CO, per meter (i.e., cardiac cost). Methods. We measured the SV, heart rate (HR), CO, and running speed of 14 recreational runners in an incremental, maxima...

  20. High-output cardiac failure secondary to multiple vascular malformations in the liver: case report

    Energy Technology Data Exchange (ETDEWEB)

    Spaner, S.; Demeter, S. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Edmonton, Alberta (Canada); Lien, D. [Univ. of Alberta, Dept. of Pulmonary Medicine, Edmonton, Alberta (Canada); Shapiro, J. [Univ. of Alberta, Dept. of Surgery, Edmonton, Alberta (Canada); McCarthy, M.; Raymond, G. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Edmonton, Alberta (Canada)

    2001-08-01

    High-output cardiac failure is associated with several systemic illnesses, including hyperthyroidism, thiamine deficiency, severe anemia, multiple myeloma, Paget's disease of bone and Osler-Weber-Rendu syndrome. We present an unusual case of a woman with high-output cardiac failure as a result of multiple arteriovenous fistulas in the liver, most likely representing an unusual variant of Osler-Weber-Rendu syndrome (i.e., no other telangiectasias or a family history of vascular malformations was demonstrated). (author)

  1. Cardiac output determination during intravenous cardioangiography using X-ray fluorescence analysis

    Energy Technology Data Exchange (ETDEWEB)

    Boijsen, M.; Goss, F.; Jacobsson, L.; Lamm, C.; Schlossmann, D.; Bjoerneld, L.; Tylen, U.

    Cardiac output was determined with an indicator dilution technique during digital venous angiography of the left ventricle in 11 patients. The contrast medium injected into the right atrium was used as indicator. During and after the injection of contrast medium one blood sample per second was obtained through a catheter placed in the descending aorta. The samples were analyzed for iodine content with X-ray fluorescence analysis and cardiac output determined ad modum Stewart-Hamilton. Thermodilution was used as a reference method. The results indicate that the indicator dilution method with the use of contrast medium might be used for calibration of videodensitometric methods for blood flow measurements.

  2. 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

  3. A multiple-input multiple-output system for modeling the cardiac dynamics.

    Science.gov (United States)

    Monzon, Jorge E; Picaza, Carlos Alvarez; Pisarello, Maria I

    2011-01-01

    We describe the dynamics of the cardiovascular system by finding the input-output relationships in the state space of a functional cardiac model, based on state equations and observability criteria of control theory. The unit step response of the multiple-input multiple-output system model illustrates the damping effect of the arterial wall to the pulsatility of the heart. Our results show that hypertensive patients exhibit a lower inertia of the blood flow. PMID:22254491

  4. In vivo validation of cardiac output assessment in non-standard 3D echocardiographic images

    Science.gov (United States)

    Nillesen, M. M.; Lopata, R. G. P.; de Boode, W. P.; Gerrits, I. H.; Huisman, H. J.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.

    2009-04-01

    Automatic segmentation of the endocardial surface in three-dimensional (3D) echocardiographic images is an important tool to assess left ventricular (LV) geometry and cardiac output (CO). The presence of speckle noise as well as the nonisotropic characteristics of the myocardium impose strong demands on the segmentation algorithm. In the analysis of normal heart geometries of standardized (apical) views, it is advantageous to incorporate a priori knowledge about the shape and appearance of the heart. In contrast, when analyzing abnormal heart geometries, for example in children with congenital malformations, this a priori knowledge about the shape and anatomy of the LV might induce erroneous segmentation results. This study describes a fully automated segmentation method for the analysis of non-standard echocardiographic images, without making strong assumptions on the shape and appearance of the heart. The method was validated in vivo in a piglet model. Real-time 3D echocardiographic image sequences of five piglets were acquired in radiofrequency (rf) format. These ECG-gated full volume images were acquired intra-operatively in a non-standard view. Cardiac blood flow was measured simultaneously by an ultrasound transit time flow probe positioned around the common pulmonary artery. Three-dimensional adaptive filtering using the characteristics of speckle was performed on the demodulated rf data to reduce the influence of speckle noise and to optimize the distinction between blood and myocardium. A gradient-based 3D deformable simplex mesh was then used to segment the endocardial surface. A gradient and a speed force were included as external forces of the model. To balance data fitting and mesh regularity, one fixed set of weighting parameters of internal, gradient and speed forces was used for all data sets. End-diastolic and end-systolic volumes were computed from the segmented endocardial surface. The cardiac output derived from this automatic segmentation was

  5. In vivo validation of cardiac output assessment in non-standard 3D echocardiographic images

    Energy Technology Data Exchange (ETDEWEB)

    Nillesen, M M; Lopata, R G P; Gerrits, I H; Thijssen, J M; De Korte, C L [Clinical Physics Laboratory-833, Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); De Boode, W P [Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Huisman, H J [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kapusta, L [Pediatric Cardiology, Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)], E-mail: m.m.nillesen@cukz.umcn.nl

    2009-04-07

    Automatic segmentation of the endocardial surface in three-dimensional (3D) echocardiographic images is an important tool to assess left ventricular (LV) geometry and cardiac output (CO). The presence of speckle noise as well as the nonisotropic characteristics of the myocardium impose strong demands on the segmentation algorithm. In the analysis of normal heart geometries of standardized (apical) views, it is advantageous to incorporate a priori knowledge about the shape and appearance of the heart. In contrast, when analyzing abnormal heart geometries, for example in children with congenital malformations, this a priori knowledge about the shape and anatomy of the LV might induce erroneous segmentation results. This study describes a fully automated segmentation method for the analysis of non-standard echocardiographic images, without making strong assumptions on the shape and appearance of the heart. The method was validated in vivo in a piglet model. Real-time 3D echocardiographic image sequences of five piglets were acquired in radiofrequency (rf) format. These ECG-gated full volume images were acquired intra-operatively in a non-standard view. Cardiac blood flow was measured simultaneously by an ultrasound transit time flow probe positioned around the common pulmonary artery. Three-dimensional adaptive filtering using the characteristics of speckle was performed on the demodulated rf data to reduce the influence of speckle noise and to optimize the distinction between blood and myocardium. A gradient-based 3D deformable simplex mesh was then used to segment the endocardial surface. A gradient and a speed force were included as external forces of the model. To balance data fitting and mesh regularity, one fixed set of weighting parameters of internal, gradient and speed forces was used for all data sets. End-diastolic and end-systolic volumes were computed from the segmented endocardial surface. The cardiac output derived from this automatic segmentation was

  6. The ability of the Vigileo-FloTrac system to measure cardiac output and track cardiac output changes during one-lung ventilation.

    Science.gov (United States)

    Suehiro, Koichi; Tanaka, Katsuaki; Yamada, Tokuhiro; Matsuura, Tadashi; Mori, Takashi; Funao, Tomoharu; Nishikawa, Kiyonobu

    2015-06-01

    This study was aimed at comparing the cardiac output (CO) measured by the Vigileo™-FloTrac™ system with that estimated by the thermodilution pulmonary artery catheter (PAC) during one-lung ventilation (OLV) and determining the reliability of this system in tracking phenylephrine-induced CO changes during OLV. Sixteen patients scheduled for descending aorta replacement were enrolled. The study was performed 30 min after starting OLV under stable hemodynamic conditions. We recorded hemodynamic variables, CO measured by PAC thermodilution (ICO), CO measured by Vigileo™-FloTrac™ system (Version 3.02, Edwards Lifesciences, Irvine, CA, USA) (APCO), and systemic vascular resistance index (SVRI) before (T0) and after (T1) phenylephrine (100 μg) administration. We used Bland-Altman analysis to compare ICO and APCO. Polar plot and four-quadrant plot were used to assess the tracking ability of the Vigileo™-FloTrac™ system against ICO after administration of phenylephrine. Ninety hemodynamic interventions were performed. Bland-Altman analysis revealed that the mean bias between APCO and ICO was 0.05 L/min and the percentage error, 46.9 %. Four-quadrant plot analysis showed a concordance rate of 24.7 %, while polar plot analysis showed that the concordance rate was 13.3 %; the angular bias, -45.9°; radial limit of agreement, 85.3°. The bias between APCO and ICO was significantly correlated with the SVRI value (p < 0.001, r(2) = 0.822). The reliability of the Vigileo™-FloTrac™ system during OLV to estimate CO and track phenylephrine-induced CO changes was not acceptable. PMID:25212705

  7. Rowing increases stroke volume and cardiac output to a greater extent than cycling

    Czech Academy of Sciences Publication Activity Database

    Horn, P.; Ošťádal, P.; Ošťádal, Bohuslav

    2015-01-01

    Roč. 64, č. 2 (2015), s. 203-207. ISSN 0862-8408 Institutional support: RVO:67985823 Keywords : cardiac output * cycling * heart rate * stroke volume Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.293, year: 2014

  8. Phlebotomy eliminates the maximal cardiac output response to six weeks of exercise training

    DEFF Research Database (Denmark)

    Bonne, Thomas Christian; Doucende, Gregory; Flück, Daniela;

    2014-01-01

    With this study we tested the hypothesis that six weeks of endurance training increases maximal cardiac output (Qmax) relatively more by elevating blood volume (BV) than by inducing structural and functional changes within the heart. Nine healthy but untrained volunteers (VO2max 47 ± 5 ml.min(-1)...

  9. Effects of levosimendan for low cardiac output syndrome in critically ill patients

    DEFF Research Database (Denmark)

    Koster, Geert; Wetterslev, Jørn; Gluud, Christian;

    2015-01-01

    PURPOSE: To assess the benefits and harms of levosimendan for low cardiac output syndrome in critically ill patients. METHODS: We conducted a systematic review with meta-analyses and trial sequential analyses (TSA) of randomised clinical trials comparing levosimendan with any type of control. Two...

  10. A-V Delay Versus Cardiac Output Measured with Thorax Bioimpedance Monitor

    Czech Academy of Sciences Publication Activity Database

    Vondra, Vlastimil; Halámek, Josef; Viščor, Ivo; Jurák, Pavel; Novák, M.; Lipoldová, J.

    2008-01-01

    Roč. 6, č. 1 (2008), s. 73. ISSN 1556-7451. [World Congress on Heart Disease /14./. 26.07.2008-29.07.2008, Toronto] Institutional research plan: CEZ:AV0Z20650511 Keywords : atrio-ventricular delay * resynchronization therapy * impedance cardiography * cardiac output Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  11. 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...

  12. Effect of region of interest selection on first-pass radionuclide cardiac output determination

    International Nuclear Information System (INIS)

    In principle, region of interest (ROI) selection should not affect the measurement of cardiac output by the first-pass technique with a radioactive intravascular indicator. Clinical application of the method requires that this theoretical hypothesis be tested. Sixty-eight left anterior oblique first-pass studies were acquired with a scintillation camera and computer using red blood cells labeled in vitro with /sup 99m/Tc. Calculated mean cardiac output varied in the following order with respect to ROI: lung greater than right heart greater than left ventricle greater than whole heart (both ventricles) greater than aorta. Similar variations were observed in patients both with and without valvular regurgitation. Regions of interest over left ventricle or whole heart yielded the best correlations with cardiac output by thermodilution (r = 0.96, 0.95, respectively, n = 28) as well as the smallest interobserver variations (r = 0.994, 0.995, respectively, n = 33). First-pass studies with [/sup 99m/Tc]red blood cells labeled in vitro can yield accurate, reproducible determinations of cardiac output provided that the effect of ROI selection is recognized and that regions are properly selected

  13. Assessment of cardiac output with transpulmonary thermodilution during exercise in humans

    DEFF Research Database (Denmark)

    Calbet, José A L; Boushel, Robert

    2015-01-01

    The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q̇) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q̇ and preload indexes of global end-diastolic volume...

  14. Effect of region of interest selection on first-pass radionuclide cardiac output determination

    Energy Technology Data Exchange (ETDEWEB)

    Glass, E.C.; Rahimian, J.; Hines, H.H.

    1986-08-01

    In principle, region of interest (ROI) selection should not affect the measurement of cardiac output by the first-pass technique with a radioactive intravascular indicator. Clinical application of the method requires that this theoretical hypothesis be tested. Sixty-eight left anterior oblique first-pass studies were acquired with a scintillation camera and computer using red blood cells labeled in vitro with /sup 99m/Tc. Calculated mean cardiac output varied in the following order with respect to ROI: lung greater than right heart greater than left ventricle greater than whole heart (both ventricles) greater than aorta. Similar variations were observed in patients both with and without valvular regurgitation. Regions of interest over left ventricle or whole heart yielded the best correlations with cardiac output by thermodilution (r = 0.96, 0.95, respectively, n = 28) as well as the smallest interobserver variations (r = 0.994, 0.995, respectively, n = 33). First-pass studies with (/sup 99m/Tc)red blood cells labeled in vitro can yield accurate, reproducible determinations of cardiac output provided that the effect of ROI selection is recognized and that regions are properly selected.

  15. A model to calculate cardiac output in hemodialysis patients by thermodilution

    Directory of Open Access Journals (Sweden)

    Alayoud Ahmed

    2012-06-01

    Full Text Available Abstract The Blood Temperature Monitor module (BTM is used to measure recirculation by thermodilution in dialysis. Numerous studies have confirmed its interest in the measuring of the vascular access flow. In this letter we describe a model to calculate cardiac output in dialysis by the BTM.

  16. Non-invasive measurements of cardiac output in atrial fibrillation: Inert gas rebreathing and impedance cardiography

    DEFF Research Database (Denmark)

    Osbak, Philip S; Henriksen, Jens Henrik Sahl; Kofoed, Klaus F;

    2011-01-01

    Abstract Background. Atrial fibrillation (AF) is associated with significant morbidity and mortality. To test the effect of interventions, knowledge of cardiac output (CO) is important. However, the irregular heart rate might cause some methods for determination of CO to have inherent weaknesses...

  17. Investigations concerning the application of the cross-correlation method in cardiac output measurements

    Directory of Open Access Journals (Sweden)

    Gawlikowski Maciej

    2012-05-01

    Full Text Available Abstract Background In spite of numerous non-invasive examinations the “gold clinical standard” of cardiac output measurements is the invasive pulmonary artery catheterization by means of the Swan-Ganz catheter and the application of the thermodilution method to estimate the blood flow. The results obtained by means of thermodilution are sensitive to many physical and biological disturbances. The unreliability of this method amounts to 20-45% and depends on the given variant of the method. Therefore some other method, more accurate and resistant to disturbances, was looked for. This paper presents a new approach to cardiac output measurements, based on cross-correlation signal analysis. The goal of investigations was to verify experimentally the application of the cross-correlation method of cardiac output measurements. Results In 99.2% of the examined cases the extreme of the cross-correlation function was easy to be estimated by numerical algorithms. In 0,8% of the remaining cases (with a plateau region adjacent to the maximum point numerical detection of the extreme was inaccurate. The typical unreliability of the investigated method amounted o 5.1% (9.8% in the worst case. Investigations performed on a physical model revealed that the unreliability of cardiac output measurements by means of the cross-correlation method is 3–5 times better than in the case of thermodilution. Conclusions The performed investigations and theoretical analysis have shown, that the cross-correlation method may be applied in cardiac output measurements. This kind of measurements seems to be more accurate and disturbance-resistant than clinically applied thermodilution.

  18. The thick left ventricular wall of the giraffe heart normalises wall tension, but limits stroke volume and cardiac output

    DEFF Research Database (Denmark)

    Smerup, Morten Holdgaard; Damkjær, Mads; Brøndum, Emil; Baandrup, Ulrik T.; Kristiansen, Steen Buus; Nygaard, Hans; Aalkjær, Christian; Sauer, Cathrine; Buchanan, Rasmus; Bertelsen, Mads Frost; Østergaard, Kristine Hovkjær; Grøndahl, Carsten; Candy, Geoffrey; Hasenkam, J Michael; Secher, Niels H; Bie, Peter; Wang, Tobias

    2015-01-01

    pressures to calculate left ventricular wall stress. Cardiac output was also determined by inert gas rebreathing to provide an additional and independent estimate of stroke volume. Echocardiography and inert gas-rebreathing yielded similar cardiac outputs of 16.1±2.5 and 16.4±1.4 l min(-1), respectively...

  19. Non-invasive cardiac output trending during exercise recovery on a bathroom-scale-based ballistocardiograph

    International Nuclear Information System (INIS)

    Cardiac ejection of blood into the aorta generates a reaction force on the body that can be measured externally via the ballistocardiogram (BCG). In this study, a commercial bathroom scale was modified to measure the BCGs of nine healthy subjects recovering from treadmill exercise. During the recovery, Doppler echocardiogram signals were obtained simultaneously from the left ventricular outflow tract of the heart. The percentage changes in root-mean-square (RMS) power of the BCG were strongly correlated with the percentage changes in cardiac output measured by Doppler echocardiography (R2 = 0.85, n = 275 data points). The correlation coefficients for individually analyzed data ranged from 0.79 to 0.96. Using Bland–Altman methods for assessing agreement, the mean bias was found to be −0.5% (±24%) in estimating the percentage changes in cardiac output. In contrast to other non-invasive methods for trending cardiac output, the unobtrusive procedure presented here uses inexpensive equipment and could be performed without the aid of a medical professional

  20. Initial Observations of the Effects of Calcium Chloride Infusions in Pediatric Patients with Low Cardiac Output.

    Science.gov (United States)

    Averin, Konstantin; Villa, Chet; Krawczeski, Catherine D; Pratt, Jesse; King, Eileen; Jefferies, John L; Nelson, David P; Cooper, David S; Ryan, Thomas D; Sawyer, Jaclyn; Towbin, Jeffrey A; Lorts, Angela

    2016-03-01

    Myocardial contractility and relaxation are highly dependent on calcium homeostasis. Immature myocardium, as in pediatric patients, is thought to be more dependent on extracellular calcium for optimal function. For this reason, intravenous calcium chloride infusions may improve myocardial function in the pediatric patient. The objectives of this study were to report the hemodynamic changes seen after administration of continuous calcium chloride to critically ill children. We retrospectively identified pediatric patients (newborn to 17 years old) with hemodynamic instability admitted to the cardiac ICU between May 2011 and May 2012 who received a continuous infusion of calcium chloride. The primary outcome was improvement in cardiac output, assessed by arterial-mixed venous oxygen saturation (A-V) difference. Sixty-eight patients, mean age 0.87 ± 2.67 years, received a total of 116 calcium infusions. Calcium chloride infusions resulted in significant improvements in primary and secondary measures of cardiac output at 2 and 6 h. Six hours after calcium initiation, A-V oxygen saturation difference decreased by 7.4 % (32.6 ± 2.1 to 25.2 ± 2.0 %, p HR (149.1 vs 145.6 bpm p = 0.07). Urine output increased 0.66 ml/kg/h in the 8-h period after calcium initiation when compared to pre-initiation (p = 0.003). Neonates had the strongest evidence of effectiveness with other age groups trending toward significance. Calcium chloride infusions improve markers of cardiac output in a heterogenous group of pediatric patients in a cardiac ICU. Neonates appear to derive the most benefit from utilization of these infusions. PMID:26687150

  1. Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO

    Directory of Open Access Journals (Sweden)

    Sophia Horster

    2012-01-01

    Full Text Available USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring. The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (=70. Seventy paired left-sided CO measurements (transaortic access = COUS-A were obtained. The mean COUS-A were 6.55 l/min (±2.19 versus COPiCCO 6.5 l/min (±2.18. The correlation coefficient was =0.89. Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO. It seems to be appropriate in situations where CO measurements are most pertinent to patient management.

  2. Input Output Kernel Regression : Supervised and Semi-Supervised Structured Output Prediction with Operator-Valued Kernels

    OpenAIRE

    Brouard, Céline; d'Alché-Buc, Florence; Szafranski, Marie

    2015-01-01

    In this paper, we introduce a novel approach, called Input Output Kernel Regression (IOKR), for learning mappings between structured inputs and structured outputs. The approach belongs to the family of Output Kernel Regression methods devoted to regression in feature space endowed with some output kernel. In order to take into account structure in input data and benefit from kernels in the input space as well, we use the Reproducing Kernel Hilbert Space theory for vector-valued functions. We ...

  3. Estimating changes in cardiac output using an implanted hemodynamic monitor in heart failure patients

    DEFF Research Database (Denmark)

    Ståhlberg, Marcus; Damgaard, Morten; Ersgård, David;

    2010-01-01

    OBJECTIVES: The aim of this study was to evaluate an algorithm that estimates changes in cardiac output (CO) from right ventricular (RV) pressure waveforms derived from an implantable hemodynamic monitor (IHM) in heart failure patients. DESIGN: Twelve heart failure patients (NYHA II-III, EF 32......%) with an implantable hemodynamic monitor (Chronicle) were included in this study. Changes in cardiac output were provoked by body position change at rest (left lateral supine, horizontal supine, sitting, and standing) and a steady state bicycle exercise at 20 watts. Estimated CO derived from the IHM (CO(IHM......)) was compared to CO measured with inert gas rebreathing (CO(RB)), echocardiography (CO(ECHO)) and impedance cardiography (CO(ICG)). CO(RB) was considered the reference method. RESULTS: The median intra-patient correlation coefficient comparing CO(RB) and CO(IHM) was 0.83 (range: 0.63-0.98). Comparing...

  4. Pulmonary artery pressure responses to increased cardiac output in chickens with raised metabolic rate

    OpenAIRE

    West, John B.; Fu, Zhenxing; Gu, Yusu; Wagner, Harrieth E.; Carr, J. Austin; Peterson, Kirk L.

    2010-01-01

    Previous work has shown remarkable differences in the pressure-flow relations of the pulmonary circulation between birds and mammals. For example several studies suggest that the avian pulmonary blood vessels behave like rigid tubes, very different from the situation in mammalian lung. We therefore speculated that birds would develop high pulmonary artery pressures when the cardiac output was substantially increased during heavy exercise, for example during flight. However because of the tech...

  5. Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

    OpenAIRE

    Tareq Goussous; Alex Haynes; Katherine Najarian; Marcos Daccarett; Shukri David

    2009-01-01

    High-output cardiac failure secondary to hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia (HHT). Here we report a 43-year-old woman who presented at 29 weeks gestation of her second pregnancy with complications of right-sided heart failure and preterm labor. After delivery via cesarean section, the patient was found to have intrahepatic arteriovenous malformations through non-invasive imaging. Subsequently, a family history of vascular malformations and epis...

  6. Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters

    OpenAIRE

    Kiefer, Nicholas; Hofer, Christoph K; Marx, Gernot; Geisen, Martin; Giraud, Raphaël; Siegenthaler, Nils; Hoeft, Andreas; Bendjelid, Karim; Rex, Steffen

    2012-01-01

    ABSTRACT: INTRODUCTION: Transpulmonary thermodilution is used to measure cardiac output (CO), global end-diastolic volume (GEDV) and extravascular lung water (EVLW). A system has been introduced (VolumeView/EV1000™ system, Edwards Lifesciences, Irvine CA, USA) that employs a novel algorithm for the mathematical analysis of the thermodilution curve. Our aim was to evaluate the agreement of this method with the established PiCCO™ method (Pulsion Medical Systems SE, Munich, Germany, clinicaltria...

  7. The Unpredictable Effect of Changing Cardiac Output on Hypoxemia after Acute Pulmonary Thromboembolism

    OpenAIRE

    Tsang, John Y.C.; Wayne J E Lamm; Blazej Neradilek; Polissar, Nayak L.; Michael P. Hlastala

    2008-01-01

    Previous studies reported that the degree of hypoxemia following acute pulmonary thromboembolism (APTE) was highly variable and that its mechanism was mainly due to the creation of many high and low ventilation/perfusion (V/Q) units, as a result of the heterogeneous regional blood flow (Q) caused by embolic obstruction. We studied the effect of changing cardiac output (Qt) on gas exchange after APTE in 5 embolized piglets (23 ± 3 Kg), using Dobutamine intermittently at approximately 20 µg/kg/...

  8. 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.)

  9. Multisite Tissue Oxygenation Monitoring Indicates Organ-Specific Flow Distribution and Oxygen Delivery Related to Low Cardiac Output in Preterm Infants With Clinical Sepsis

    NARCIS (Netherlands)

    van der Laan, Michelle E; Roofthooft, Marc; Fries, Marian W A; Schat, Trijntje E; Bos, Arend F; Berger, Rolf M F; Kooi, Elisabeth M W

    2016-01-01

    OBJECTIVES: Cardiac output may be compromised in preterm infants with sepsis. Whether low cardiac output is associated with low tissue oxygen supply in these patients is unclear. The aim of the current study was to assess the association between cardiac output, assessed by echocardiography, and tiss

  10. The correlation between the first heart sound and cardiac output as measured by using digital esophageal stethoscope under anaesthesia

    OpenAIRE

    Duck Shin, Young; Hoon Yim, Kyoung; Hi Park, Sang; Wook Jeon, Yong; Ho Bae, Jin; Soo Lee, Tae; Hwan Kim, Myoung; Jin Choi, Young

    2014-01-01

    Objective: The use of an esophageal stethoscope is a basic heart sounds monitoring procedure performed in patients under general anesthesia. As the size of the first heart sound can express the left ventricle function, its correlation with cardiac output should be investigated. The aim of this study was to investigate the effects of cardiac output (CO) on the first heart sound (S1) amplitude. Methods : Six male beagles were chosen. The S1 was obtained with the newly developed esophageal steth...

  11. Lack of agreement between bioimpedance and continuous thermodilution measurement of cardiac output in intensive care unit patients

    OpenAIRE

    Barry, Ben N; Mallick, Abhiram; Bodenham, Andrew R; Vucevic, Michael

    1997-01-01

    Background: Bolus thermodilution is the standard bedside method of cardiac output measurement in the intensive care unit (ICU). The Baxter Vigilance monitor uses a modified thermodilution pulmonary artery catheter with a thermal filament to give a continuous read-out of cardiac output. This has been shown to correlate very well with both the 'gold standard' dye dilution method and the bolus thermodilution method. Bioimpedance cardiography using the Bomed NCCOM 3 offers a noninvasive means of ...

  12. 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...

  13. A prospective study to evaluate the accuracy of pulse power analysis to monitor cardiac output in critically ill patients

    OpenAIRE

    Grounds R Michael; Fawcett Jayne; Cecconi Maurizio; Rhodes Andrew

    2008-01-01

    Abstract Background Intermittent measurement of cardiac output may be performed using a lithium dilution technique (LiDCO). This can then be used to calibrate a pulse power algorithm of the arterial waveform which provides a continuous estimate of this variable. The purpose of this study was to examine the duration of accuracy of the pulse power algorithm in critically ill patients with respect to time when compared to measurements of cardiac output by an independent technique. Methods Pulse ...

  14. Measurement of cardiac output during exercise by open-circuit acetylene uptake.

    Science.gov (United States)

    Barker, R C; Hopkins, S R; Kellogg, N; Olfert, I M; Brutsaert, T D; Gavin, T P; Entin, P L; Rice, A J; Wagner, P D

    1999-10-01

    Noninvasive measurement of cardiac output (QT) is problematic during heavy exercise. We report a new approach that avoids unpleasant rebreathing and resultant changes in alveolar PO(2) or PCO(2) by measuring short-term acetylene (C(2)H(2)) uptake by an open-circuit technique, with application of mass balance for the calculation of QT. The method assumes that alveolar and arterial C(2)H(2) pressures are the same, and we account for C(2)H(2) recirculation by extrapolating end-tidal C(2)H(2) back to breath 1 of the maneuver. We correct for incomplete gas mixing by using He in the inspired mixture. The maneuver involves switching the subject to air containing trace amounts of C(2)H(2) and He; ventilation and pressures of He, C(2)H(2), and CO(2) are measured continuously (the latter by mass spectrometer) for 20-25 breaths. Data from three subjects for whom multiple Fick O(2) measurements of QT were available showed that measurement of QT by the Fick method and by the C(2)H(2) technique was statistically similar from rest to 90% of maximal O(2) consumption (VO(2 max)). Data from 12 active women and 12 elite male athletes at rest and 90% of VO(2 max) fell on a single linear relationship, with O(2) consumption (VO(2)) predicting QT values of 9.13, 15.9, 22.6, and 29.4 l/min at VO(2) of 1, 2, 3, and 4 l/min. Mixed venous PO(2) predicted from C(2)H(2)-determined QT, measured VO(2), and arterial O(2) concentration was approximately 20-25 Torr at 90% of VO(2 max) during air breathing and 10-15 Torr during 13% O(2) breathing. This modification of previous gas uptake methods, to avoid rebreathing, produces reasonable data from rest to heavy exercise in normal subjects. PMID:10517785

  15. The prognostic value of cardiac ultrasonography in patients with cardiac arrest

    Directory of Open Access Journals (Sweden)

    Ehsan Bolvardi

    2016-04-01

    Full Text Available Introduction: Echocardiography or cardiac imaging is proposed as a gold standard method for identifying high risk patients for cardiac arrest. In this systematic review, we studied the prognostic value of cardiac sonography in patients with cardiac arrest. Methods: PubMed was searched for the relevant articles. Case reports were not included. Inclusion criteria were all the studies applied transthorasic echocardiography in patients with cardiac arrest arrived at emergency department that studied the efficacy of this modality on patients survived to emergency discharge and returned to spontaneous circulation.Result: Overall, 870 articles were obtained through initial search and only nine articles were included after the evaluation of the title, abstract, and the full text. Echocardiography has high sensitivity and specificity in predicting the return of spontaneous circulation.Conclusion: Cardiac sonography is a fairly effective (not definitive modality in predicting death in patients with lack of cardiac activity during resuscitation. Echocardiography should not be the sole basis for the decision to cease resuscitative efforts.

  16. Continuous versus bolus cardiac output monitoring during or thotopic liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Fang-Ping Bao; Jian Wu

    2008-01-01

    BACKGROUND: Cardiac output monitoring is important for critical patients. This study aimed to determine the delayed response of continuous cardiac output (CCO) thermodilution measurement, whether CCO and bolus cardiac output (BCO) thermodilution agree sufifciently to be used interchangeably, and whether CCO monitoring is reliable for patients undergoing liver transplantation. METHODS:Thirteen patients undergoing liver transplan-tation without veno-venous bypass were studied (37-66 years old, weight 46-75 kg). Continuous and bolus thermodilution measurements were performed at predeifned time points using an "Opti-Q" SvO2/CCO monitor (Abbott Laboratories, North Chicago, IL, USA). Bias and 95% limits of agreement were calculated according to Bland and Altman analysis. The limits of agreement by which two methods are judged to be interchangeable were deifned in advance as ±(13%× BCOmean) L/min. The repeatability and relative error of CCO, and the differences between CCO and the mean of the two measurements were calculated. RESULTS:Cardiac output measurements yielded 196 data pairs with ranges of 1.9 to 17.9 L/min for CCO and 2.1 to 18.3 L/min for BCO. The response time of CCO was delayed in the early phases after caval clamping and after reperfusion. At most of the measurement points, bias and 95%limits of agreement were-0.18±1.91 L/min. 95%limits of agreement did not fall within the predetermined limits of agreement of ±1.14 L/min. The repeatability coefifcient of CCO was 0.36 L/min and the relative error was 4.6±4.7%. The mean difference between CCO and the average of the two methods was-0.09 L/min (0.49 L/min). CONCLUSIONS:In patients undergoing liver transplan-tation, the delayed response of CCO limits its application during the early phases after caval clamping and after reperfusion of the graft. The two methods are not interchangeable even in hemodynamic stability. Continuous thermodilution monitoring, however, is reliable or acceptable for clinical purposes.

  17. Changes in Heart Rate in Patients with a Pacemaker do not Affect Cardiac Output

    Czech Academy of Sciences Publication Activity Database

    Vondra, Vlastimil; Soukup, L.; Jurák, Pavel; Halámek, Josef; Viščor, Ivo; Lipoldová, J.; Leinveber, Pavel

    Piscataway : IEEE, 2012, s. 511. ISBN 978-1-4244-4119-8. [EMBC 2012. Annual International Conference of the IEEE Engineering in Medicine and Biology Society /34./. San Diego (US), 28.08.2012-01.09.2012] R&D Projects: GA MŠk ME09050; GA MŠk ED0017/01/01; GA ČR GAP102/12/2034 Institutional support: RVO:68081731 Keywords : Pacemaker * Changes in Heart Rate * Cardiac Output Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  18. Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

    Directory of Open Access Journals (Sweden)

    Tareq Goussous

    2009-01-01

    Full Text Available High-output cardiac failure secondary to hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia (HHT. Here we report a 43-year-old woman who presented at 29 weeks gestation of her second pregnancy with complications of right-sided heart failure and preterm labor. After delivery via cesarean section, the patient was found to have intrahepatic arteriovenous malformations through non-invasive imaging. Subsequently, a family history of vascular malformations and epistaxis was elucidated and a diagnosis of HHT was made. This case is presented, along with a review of the literature and discussion of hepatic involvement in HHT with particular focus on the pregnant patient.

  19. Comparison between continuous non-invasive estimated cardiac output by pulse wave transit time and thermodilution method

    Directory of Open Access Journals (Sweden)

    Ashish C Sinha

    2014-01-01

    Full Text Available Aims and Objectives: Cardiac output (CO measurement is essential for many therapeutic decisions in anesthesia and critical care. Most available non-invasive CO measuring methods have an invasive component. We investigate "pulse wave transit time" (estimated continuous cardiac output [esCCO] a method of CO measurement that has no invasive component to its use. Materials and Methods: After institutional ethical committee approval, 14 adult (21-85 years patients undergoing surgery and requiring pulmonary artery catheter (PAC for measuring CO, were included. Postoperatively CO readings were taken simultaneously with thermodilution (TD via PAC and esCCO, whenever a change in CO was expected due to therapeutic interventions. Both monitoring methods were continued until patients′ discharge from the Intensive Care Unit and observer recording values using TD method was blinded to values measured by esCCO system. Results: Three hundred and one readings were obtained simultaneously from both methods. Correlation and concordance between the two methods was derived using Bland-Altman analysis. Measured values showed significant correlation between esCCO and TD ( r = 0.6, P < 0.001, 95% confidence limits of 0.51-0.68. Mean and (standard deviation for bias and precision were 0.13 (2.27 L/min and 6.56 (2.19 L/min, respectively. The 95% confidence interval for bias was - 4.32 to 4.58 L/min and for precision 2.27 to10.85 L/min. Conclusions: Although, esCCO is the only true non-invasive continuous CO monitor available and even though its values change proportionately to TD method (gold standard with the present degree of error its utility for clinical/therapeutic decision-making is questionable.

  20. Non-Invasive Determination of Cardiac Output in Pre-Capillary Pulmonary Hypertension.

    Directory of Open Access Journals (Sweden)

    Frédéric Lador

    Full Text Available Cardiac output (CO is a major diagnostic and prognostic factor in pre-capillary pulmonary hypertension (PH. Reference methods for CO determination, like thermodilution (TD, require invasive procedures and allow only steady-state measurements. The Modelflow (MF method is an appealing technique for this purpose as it allows non-invasive and beat-by-beat determination of CO.We aimed to compare CO values obtained simultaneously from non-invasive pulse wave analysis by MF (COMF and by TD (COTD to determine its precision and accuracy in pre-capillary PH. The study was performed on 50 patients with pulmonary arterial hypertension (PAH or chronic thrombo-embolic PH (CTEPH. CO was determined at rest in all patients (n = 50 and during nitric oxide vasoreactivity test, fluid challenge or exercise (n = 48.Baseline COMF and COTD were 6.18 ± 1.95 and 5.46 ± 1.95 L·min-1, respectively. Accuracy and precision were 0.72 and 1.04 L·min-1, respectively. Limits of agreement (LoA ranged from -1.32 to 2.76 L·min-1. Percentage error (PE was ±35.7%. Overall sensitivity and specificity of COMF for directional change were 95.2% and 82.4%, (n = 48 and 93.3% and 100% for directional changes during exercise (n = 16, respectively. After application of a correction factor (1.17 ± 0.25, neither proportional nor fixed bias was found for subsequent CO determination (n = 48. Accuracy was -0.03 L·min-1 and precision 0.61 L·min-1. LoA ranged from -1.23 to 1.17 L·min-1 and PE was ±19.8%.After correction against a reference method, MF is precise and accurate enough to determine absolute values and beat-by-beat relative changes of CO in pre-capillary PH.

  1. Estimation of cardiac output by first-pass transit of radiotracers

    International Nuclear Information System (INIS)

    To evaluate cardiac function with various tracers to be used for radionuclide scintigraphy, we examined the validity of a simplified method to measure cardiac output (CO) by modifying the equation of Stewart-Hamilton in the radionuclide study. After a bolus injection of I-123 or Tc-99m tracer, the total injection dose and count in the pulmonary artery during the first transit of the tracer were measured to calculate the CO Index. The CO Index was obtained from the integral of the first transit of radiotracers in the pulmonary artery divided by the total injected count. CO was estimated from the regression formula which was obtained by comparing the CO Index with CO measured by the Doppler echocardiographic method. There were close correlations between the CO Index and CO measured by Doppler echocardiography both in the study with I-123 (n=13, r=0.85, p0.634 for I-123 and CO=3.18 x (CO Index)0.518 for Tc-99m). CO measured by this method is useful for the assessment of cardiac function with various tracers in routine clinical studies, and this simple method may be utilized for assessment of organ blood flow on the basis of the microsphere model. (author)

  2. Cardiac output and vasodilation in the vasovagal response: An analysis of the classic papers.

    Science.gov (United States)

    Wieling, Wouter; Jardine, David L; de Lange, Frederik J; Brignole, Michele; Nielsen, Henning B; Stewart, Julian; Sutton, Richard

    2016-03-01

    The simple faint is secondary to hypotension and bradycardia resulting in transient loss of consciousness. According to Ohm's law applied to the circulation, BP = SVR × CO, hypotension can result from a decrease in systemic vascular resistance (SVR), cardiac output (CO), or both. It is important to understand that when blood pressure (BP) is falling, SVR and CO do not change reciprocally as they do in the steady state. In 1932, Lewis, assuming that decreased SVR alone accounted for hypotension, defined "the vasovagal response" along pathophysiologic lines to denote the association of vasodilation with vagal-induced bradycardia in simple faint. Studies performed by Barcroft and Sharpey-Schafer between 1940 and 1950 used volume-based plethysmography to demonstrate major forearm vasodilation during extreme hypotension and concluded that the main mechanism for hypotension was vasodilation. Plethysmographic measurements were intermittent and not frequent enough to capture rapid changes in blood flow during progressive hypotension. However, later investigations by Weissler, Murray, and Stevens performed between 1950 and 1970 used invasive beat-to-beat BP measurements and more frequent measurements of CO using the Fick principle. They demonstrated that CO significantly fell before syncope, and little vasodilation occurred until very late in the vasovagal reaction Thus, since the 1970s, decreasing cardiac output rather than vasodilation has been regarded as the principal mechanism for the hypotension of vasovagal syncope. PMID:26598322

  3. Increasing cardiac output and decreasing oxygenation sequence in pump twins of acardiac twin pregnancies

    International Nuclear Information System (INIS)

    An acardiac twin pregnancy is a rare but serious complication of monochorionic twinning and consists of an acardiac twin and a pump twin. The acardiac twin is a severely malformed fetus that lacks most organs, particularly a heart, but grows during pregnancy because it is perfused by the developmentally normal pump twin via a set of arterioarterial and venovenous placental anastomoses. Pump twins die intrauterine or neonatally in about 50% of the cases. Because the effects of an acardiac mass on the pump twin's development are incompletely known, methods for outcome prognosis are currently not available. We sought to derive simple relations for the pump twin's excess cardiac output and decreased oxygenation and to use available clinical cases for a preliminary test of the model. As a method, we used a theoretical flow model to represent the fetoplacental circulation of an acardiac twin pregnancy and estimated blood deoxygenation and reoxygenation following perfusion of the two bodies and placentas, respectively. The results show the pump twin's excess cardiac output and decrease of venous oxygen saturation to depend on the ratio of pump twin to acardiac twin umbilical blood flow, whose ratio can be measured by ultrasonography. The clinical cases show a decreasing umbilical flow ratio with gestation. In conclusion, prospective serial study is necessary to test whether measurement of umbilical flow ratios allows monitoring the pump twin's pathophysiologic development, possibly resulting in a guideline for prognosis of pump twin survival. (note)

  4. Increasing cardiac output and decreasing oxygenation sequence in pump twins of acardiac twin pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); VanBavel, Ed [Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Vandenbussche, Frank P H A [Department of Obstetrics, Leiden University Medical Center, Leiden (Netherlands); Nikkels, Peter G J [Department of Pathology, University Medical Center, Utrecht (Netherlands)

    2005-02-07

    An acardiac twin pregnancy is a rare but serious complication of monochorionic twinning and consists of an acardiac twin and a pump twin. The acardiac twin is a severely malformed fetus that lacks most organs, particularly a heart, but grows during pregnancy because it is perfused by the developmentally normal pump twin via a set of arterioarterial and venovenous placental anastomoses. Pump twins die intrauterine or neonatally in about 50% of the cases. Because the effects of an acardiac mass on the pump twin's development are incompletely known, methods for outcome prognosis are currently not available. We sought to derive simple relations for the pump twin's excess cardiac output and decreased oxygenation and to use available clinical cases for a preliminary test of the model. As a method, we used a theoretical flow model to represent the fetoplacental circulation of an acardiac twin pregnancy and estimated blood deoxygenation and reoxygenation following perfusion of the two bodies and placentas, respectively. The results show the pump twin's excess cardiac output and decrease of venous oxygen saturation to depend on the ratio of pump twin to acardiac twin umbilical blood flow, whose ratio can be measured by ultrasonography. The clinical cases show a decreasing umbilical flow ratio with gestation. In conclusion, prospective serial study is necessary to test whether measurement of umbilical flow ratios allows monitoring the pump twin's pathophysiologic development, possibly resulting in a guideline for prognosis of pump twin survival. (note)

  5. Combining multiple thresholding binarization values to improve OCR output

    Science.gov (United States)

    Lund, William B.; Kennard, Douglas J.; Ringger, Eric K.

    2013-01-01

    For noisy, historical documents, a high optical character recognition (OCR) word error rate (WER) can render the OCR text unusable. Since image binarization is often the method used to identify foreground pixels, a body of research seeks to improve image-wide binarization directly. Instead of relying on any one imperfect binarization technique, our method incorporates information from multiple simple thresholding binarizations of the same image to improve text output. Using a new corpus of 19th century newspaper grayscale images for which the text transcription is known, we observe WERs of 13.8% and higher using current binarization techniques and a state-of-the-art OCR engine. Our novel approach combines the OCR outputs from multiple thresholded images by aligning the text output and producing a lattice of word alternatives from which a lattice word error rate (LWER) is calculated. Our results show a LWER of 7.6% when aligning two threshold images and a LWER of 6.8% when aligning five. From the word lattice we commit to one hypothesis by applying the methods of Lund et al. (2011) achieving an improvement over the original OCR output and a 8.41% WER result on this data set.

  6. Cardiac Output and Stroke Volume at Anaerobic Threshold During Walking Exercise in Healthy Aged Subjects

    OpenAIRE

    Haga, Shukoh; Esaki, Kazuki; Toshinai, Kouji; Kinugasa, Takeshi; Takemasa, Toru; Ueya, Etsuo; Hamaoka, Takaumi; Katsumura, Toshihito; Kizaki, Takako; Ohno, Hideki

    2003-01-01

    HAGA, S., ESAKI, K., TOSHINAI, K., KINUGASA, T., TAKEMASA, T., UEYA, E., HAMAOKA, T., KATSUMURA, T., KIZAKI, t. and OHNO, H., Cardiac Output and Stroke Volume at Anaerobic Threshold During Walking Exercise in Healthy Aged Subjects. Abv. Exerc. Sports Physiol., Vol.9, No.1 pp.37-43, 2003. There have been few previous studies of cardiac outout for cardiovascular function at anaerobic threshold (AT) during walking exercise in healthy elderly subjects. The present study was performed to investiga...

  7. Is pulmonary gas exchange during exercise in hypoxia impaired with the increase of cardiac output?

    DEFF Research Database (Denmark)

    Calbet, J.A.; Robach, P.; Lundby, C.;

    2008-01-01

    diffusion with increases in exercise intensity. We have consistently observed that during steady-state, submaximal (100-120 W) exercise on the cycle ergometer in hypoxia the lung can accommodate an increase in cardiac output of approximately 2 L x min(-1) without any significant effect on pulmonary gas......During exercise in humans, the alveolar-arterial O(2) tension difference ((A-a)DO(2)) increases with exercise intensity and is an important factor determining the absolute level of oxygen binding to hemoglobin and therefore the level of systemic oxygen transport. During exercise in hypoxia, the (A......-a)DO(2) is accentuated. Using the multiple inert gas elimination technique it has been shown that during exercise in acute hypoxia the contribution of ventilation-perfusion inequality to (A-a)DO(2) is rather small and in the absence of pulmonary edema intrapulmonary shunts can be ruled out. This implies...

  8. Sildenafil improves cardiac output and exercise performance during acute hypoxia, but not normoxia.

    Science.gov (United States)

    Hsu, Andrew R; Barnholt, Kimberly E; Grundmann, Nicolas K; Lin, Joseph H; McCallum, Stewart W; Friedlander, Anne L

    2006-06-01

    Sildenafil causes pulmonary vasodilation, thus potentially reducing impairments of hypoxia-induced pulmonary hypertension on exercise performance at altitude. The purpose of this study was to determine the effects of sildenafil during normoxic and hypoxic exercise. We hypothesized that 1) sildenafil would have no significant effects on normoxic exercise, and 2) sildenafil would improve cardiac output, arterial oxygen saturation (SaO2), and performance during hypoxic exercise. Ten trained men performed one practice and three experimental trials at sea level (SL) and simulated high altitude (HA) of 3,874 m. Each cycling test consisted of a set-work-rate portion (55% work capacity: 1 h SL, 30 min HA) followed immediately by a time trial (10 km SL, 6 km HA). Double-blinded capsules (placebo, 50, or 100 mg) were taken 1 h before exercise in a randomly counterbalanced order. For HA, subjects also began breathing hypoxic gas (12.8% oxygen) 1 h before exercise. At SL, sildenafil had no effects on any cardiovascular or performance measures. At HA, sildenafil increased stroke volume (measured by impedance cardiography), cardiac output, and SaO2 during set-work-rate exercise. Sildenafil lowered 6-km time-trial time by 15% (P<0.05). SaO2 was also higher during the time trial (P<0.05) in response to sildenafil, despite higher work rates. Post hoc analyses revealed two subject groups, sildenafil responders and nonresponders, who improved time-trial performance by 39% (P<0.05) and 1.0%, respectively. No dose-response effects were observed. During cycling exercise in acute hypoxia, sildenafil can greatly improve cardiovascular function, SaO2, and performance for certain individuals. PMID:16455814

  9. Management of perioperative low cardiac output state without extracorporeal life support: What is feasible?

    Directory of Open Access Journals (Sweden)

    Kumar Girish

    2010-01-01

    Full Text Available A transient and reversible reduction in cardiac output-low cardiac output state (LCOS often occurs following surgery for congenital heart disease. Inappropriately managed LCOS is a risk factor for increased morbidity and death. LCOS may occasionally be progressive and refractory needing a period of "myocardial rest" with extracorporeal life support (ECLS. ECLS is currently considered a routine tool available for rapid deployment in most industrialized countries. Accumulated experience and refinements in technology have led to improving survivals - discharge survivals of 35%−50%, with almost 100% survival in select groups on elective left ventricular assist device. Thus, there is an increasing trend to initiate ECLS "early or electively in the operating room" in high-risk patients. India has a huge potential need for ECLS given the large number of infants presenting late with preexisting ventricular dysfunction or in circulatory collapse. ECLS is an expensive and resource consuming treatment modality and is not a viable therapeutic option in our country. The purpose of this paper is to reiterate an anticipatory, proactive approach to LCOS: (1 methods for early detection of evolving LCOS and (2 timely initiation of individualized therapy. This paper also explores what is feasible with the refinement of "simple, conventional, inexpensive strategies" for the management of LCOS. Therapy for LCOS should be multimodal based on the type of circulation and physiology. Our approach to LCOS includes: (1 intraoperative strategies, (2 aggressive afterload reduction, (3 lusitropy, (4 exclusion of structural defects, (5 harnessing cardiopulmonary interactions, and (6 addressing metabolic and endocrine abnormalities. We have achieved a discharge survival rate of greater than 97% with these simple methods.

  10. A prospective study to evaluate the accuracy of pulse power analysis to monitor cardiac output in critically ill patients

    Directory of Open Access Journals (Sweden)

    Grounds R Michael

    2008-02-01

    Full Text Available Abstract Background Intermittent measurement of cardiac output may be performed using a lithium dilution technique (LiDCO. This can then be used to calibrate a pulse power algorithm of the arterial waveform which provides a continuous estimate of this variable. The purpose of this study was to examine the duration of accuracy of the pulse power algorithm in critically ill patients with respect to time when compared to measurements of cardiac output by an independent technique. Methods Pulse power analysis was performed on critically ill patients using a proprietary commercial monitor (PulseCO. All measurements were made using an in-dwelling radial artery line and according to manufacturers instructions. Intermittent measurements of cardiac output were made with LiDCO in order to validate the pulse power measurements. These were made at baseline and then following 1, 2, 4 and 8 hours. The LiDCO measurement was considered the reference for comparison in this study. The two methods of measuring cardiac output were then compared by linear regression and a Bland Altman analysis. An error rate for the limits of agreement (LOA between the two techniques of less than 30% was defined as being acceptable for this study. Results 14 critically ill medical and surgical patients were enrolled over a three month period. At baseline patients showed a wide range of cardiac output (median 7.5 L/min, IQR 5.1 -9.0 L/min. The bias and limits of agreement between the two techniques was deemed acceptable for the first four hours of the study with percentage errors being 29%, 22%, and 285 respectively. The percentage error at eight hours following calibration increased to 36%. The ability of the PulseCo to detect changes in cardiac output was assessed with a similar analysis. The PulseCO tracked the changes in cardiac output with adequate accuracy for the first four hours with percentage errors being 20%, 24% and 25%. However at eight hours the error had increased to

  11. Value of cardiac catheterization and cineangiography in infantile lobar emphysema

    Energy Technology Data Exchange (ETDEWEB)

    Roguin, N.; Peleg, H.; Naveh, Y.; Riss, E.

    1980-01-01

    Lobar emphysema is an uncommon cause of respiratory distress in infancy. Congenital heart disease is seen in about 20% of the patients with infantile (congenital) lobar emphysema. We described six infants with lobar emphysema. In three of them a congenital heart disease was demonstrated by cardiac catheterization and cineangiography; two had a tetralogy of Fallot with right aortic arch and the third infant a ventricular septal defect. The pulmonary angiography showed stretching of the arteries with very poor filling of the peripheral arteries and a characteristic smaller pulmonary vein in the affected lobe. In all the six patients the pulmonary artery pressure was normal. All the patients underwent lobectomy with good results. We feel that a preoperative cardiac catheterization and cineangiography is of value in this very sick group of infants.

  12. Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ståhlberg, Marcus; Damgaard, Morten; Norsk, Peter; Gabrielsen, Anders; Sahlén, Anders; Linde, Cecilia; Braunschweig, Frieder

    2009-01-01

    prolonged by 40 ms in 27 CRT patients and 9 controls without heart failure. Cardiac output (CO) was measured by inert gas rebreathing (Innocor) as the average over different body positions (left-lateral, supine, sitting, standing, and exercise). In eight CRT patients with an implantable haemodynamic monitor...

  13. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G

    2012-02-03

    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  14. Effect of heat stress on cardiac output and systemic vascular conductance during simulated hemorrhage to presyncope in young men

    DEFF Research Database (Denmark)

    Ganio, Matthew S; Overgaard, Morten; Seifert, Thomas; Secher, Niels H; Johansson, Pär I; Meyer, Martin; Crandall, Craig G

    2012-01-01

    During moderate actual or simulated hemorrhage, as cardiac output decreases, reductions in systemic vascular conductance (SVC) maintain mean arterial pressure (MAP). Heat stress, however, compromises the control of MAP during simulated hemorrhage, and it remains unknown whether this response is due...

  15. Estimation of cardiac output by first-pass data with technetium-99m-labeled myocardial perfusion imaging agent

    International Nuclear Information System (INIS)

    Technetium-99m-tetrofosmin, a myocardial perfusion imaging agent was used for estimation of cardiac output by means of first-pass radionuclide angiography performed in the anterior projection. Region of interests (ROIs) were assigned over right ventricle, left ventricle and whole chest, and time activity curves (TACs) were obtained. Cardiac output indices (COIs) were calculated by the following equation; COI=p3/2·Qc/∫0tA(s)ds, where p=number of pixels of the ventricular ROI, Qc=the peak count rate of the TAC obtained from the whole chest's ROI and ∫0tA(s)ds=the area under ventricular TAC. The COI(y) determined by ROI over the left ventricle yield the best correlation with the cardiac output by conventional radionuclide method (x) (y=0.0381x+6.22, r=0.828, n=48, p<0.001). In conclusion, cardiac output can be easily measured with first pass data using myocardial perfusion imaging agent. (author)

  16. Management of perioperative low cardiac output state without extracorporeal life support: What is feasible?

    International Nuclear Information System (INIS)

    A transient and reversible reduction in cardiac output–low cardiac output state (LCOS) often occurs following surgery for congenital heart disease. Inappropriately managed LCOS is a risk factor for increased morbidity and death. LCOS may occasionally be progressive and refractory needing a period of “myocardial rest” with extracorporeal life support (ECLS). ECLS is currently considered a routine tool available for rapid deployment in most industrialized countries. Accumulated experience and refinements in technology have led to improving survivals – discharge survivals of 35%–50%, with almost 100% survival in select groups on elective left ventricular assist device. Thus, there is an increasing trend to initiate ECLS “early or electively in the operating room” in high-risk patients. India has a huge potential need for ECLS given the large number of infants presenting late with preexisting ventricular dysfunction or in circulatory collapse. ECLS is an expensive and resource consuming treatment modality and is not a viable therapeutic option in our country. The purpose of this paper is to reiterate an anticipatory, proactive approach to LCOS: (1) methods for early detection of evolving LCOS and (2) timely initiation of individualized therapy. This paper also explores what is feasible with the refinement of “simple, conventional, inexpensive strategies” for the management of LCOS. Therapy for LCOS should be multimodal based on the type of circulation and physiology. Our approach to LCOS includes: (1) intraoperative strategies, (2) aggressive afterload reduction, (3) lusitropy, (4) exclusion of structural defects, (5) harnessing cardiopulmonary interactions, and (6) addressing metabolic and endocrine abnormalities. We have achieved a discharge survival rate of greater than 97% with these simple methods

  17. Investigating data envelopment analysis model with potential improvement for integer output values

    Science.gov (United States)

    Hussain, Mushtaq Taleb; Ramli, Razamin; Khalid, Ruzelan

    2015-12-01

    The decrement of input proportions in DEA model is associated with its input reduction. This reduction is apparently good for economy since it could reduce unnecessary cost resources. However, in some situations the reduction of relevant inputs such as labour could create social problems. Such inputs should thus be maintained or increased. This paper develops an advanced radial DEA model dealing with mixed integer linear programming to improve integer output values through the combination of inputs. The model can deal with real input values and integer output values. This model is valuable for situations dealing with input combination to improve integer output values as faced by most organizations.

  18. A novel continuous cardiac output monitor based on pulse wave transit time.

    Science.gov (United States)

    Sugo, Yoshihiro; Ukawa, Teiji; Takeda, Sunao; Ishihara, Hironori; Kazama, Tomiei; Takeda, Junzo

    2010-01-01

    Monitoring cardiac output (CO) is important for the management of patient circulation in an operation room (OR) or intensive care unit (ICU). We assumed that the change in pulse wave transit time (PWTT) obtained from an electrocardiogram (ECG) and a pulse oximeter wave is correlated with the change in stroke volume (SV), from which CO is derived. The present study reports the verification of this hypothesis using a hemodynamic analysis theory and animal study. PWTT consists of a pre-ejection period (PEP), the pulse transit time through an elasticity artery (T(1)), and the pulse transit time through peripheral resistance arteries (T(2)). We assumed a consistent negative correlation between PWTT and SV under all conditions of varying circulatory dynamics. The equation for calculating SV from PWTT was derived based on the following procedures. 1. Approximating SV using a linear equation of PWTT. 2. The slope and y-intercept of the above equation were determined under consideration of vessel compliance (SV was divided by Pulse Pressure (PP)), animal type, and the inherent relationship between PP and PWTT. Animal study was performed to verify the above-mentioned assumption. The correlation coefficient of PWTT and SV became r = -0.710 (p 〈 0.001), and a good correlation was admitted. It has been confirmed that accurate continuous CO and SV measurement is only possible by monitoring regular clinical parameters (ECG, SpO2, and NIBP). PMID:21095971

  19. High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old.

    Science.gov (United States)

    Teomete, Uygar; Gugol, Rubee Anne; Neville, Holly; Dandin, Ozgur; Young, Ming-Lon

    2016-01-01

    Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics. PMID:26885434

  20. Thermal dilution measurement of cardiac output in dogs using an analog computer.

    Science.gov (United States)

    Hendriks, F F; Schipperheyn, J J; Quanjer, P H

    1978-01-01

    Thermal dilution cardiac output determinations in dogs were compared to simultaneously performed Fick oxygen measurements. The purpose of this study was to validate in dog experiments a method for thermal dilution measurement which employs a double-thermistor catheter combined with an automatic computer as described by Olsson et al. Dilution and injectate temperature are entered directly into the calculation. The method does not employ logarithmic extrapolation, integration of the dilution signal being terminated when a preset cut-off level is reached. Errors due to recirculation, thermal capacitance of the right heart and heat exchange with the catheter's dead space require the use of an empirically derived correction factor, which in dogs was found to be significantly different from the factor used for human thermal dilution curves. With the appropriate cut-off level and correction factor a good agreement was found between the results of the thermal dilution and the Fick method. The regression equation for 47 experiments was found to be COtd = 0.95 COFick + 0.08; the correlation coefficient was 0.94. PMID:728031

  1. Non-invasive measurement of cardiac output by Finometer in patients with cirrhosis

    DEFF Research Database (Denmark)

    Kaltoft, Nicolai Stefan; Hobolth, L; Møller, S

    2010-01-01

    The Finometer measures haemodynamic parameters including cardiac output (CO) using non-invasive volume-clamp techniques. The aim of this study was to determine the accuracy of the Finometer in hyperdynamic cirrhotic patients using an invasive indicator dilution technique as control. CO was measured......(I) was 6.1 +/- 1.6 [3.9;9.7] l min(-1) (mean +/- SD [range]) compared to mean CO(F) of 7.2 +/- 2.3 [3.1;11.9] l min(-1). There was a mean difference between CO(F) and CO(I) of 1.0 +/- 1.8 [-2.1;4.0] l min(-1) and 95% confidence interval of [0.2;1.8], P<0.001. In patients with measurements before and...... after beta-blockade, mean DeltaCO(I) was 1.6 +/- 1.4 [-0.1;3.3] l min(-1) compared to mean DeltaCO(F) of 1.9 +/- 1.3 [0.4;3.8] l min(-1). Mean difference between DeltaCO(F) and DeltaCO(I) was 0.3 +/- 0.3 [-0.2;0.7] l min(-1) with a 95% confidence interval of [-0.1;0.6], P = 0.11. Compared with invasive...

  2. Analysis of the Dynamic Relationship among Financial Fund for Agriculture, Agricultural Output Value and Farmers’ income

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    By using the methods of co-integration, impulse response function and variance decomposition, I conduct the empirical research on the dynamic relationship among China’s financial fund for agriculture, agricultural output value, and farmers’ income from the year 1978 to the year 2009. The results indicate that the government’s financial fund for agriculture plays the significant role in promoting agricultural output value and farmers’ income in the long run, but this role of promoting is not prominent in the short run; in the mean time, agricultural output value plays insignificant role in promoting farmers’ income and the government’s financial fund for agriculture; farmers’ income plays the significant role in promoting agricultural output value and the government’s financial fund for agriculture.

  3. Predictors of Post Pericardiotomy Low Cardiac Output Syndrome in Patients With Pericardial Effusion

    Directory of Open Access Journals (Sweden)

    Sabzi Feridoun

    2015-03-01

    Full Text Available Introduction: Pathological involvement of pericardium by any disease that resulting in effusion may require decompression and pericardiectomy. The current article describes rare patients with effusion who after pericadiectomy and transient hemodynamic improvement rapidly developed progressive heart failure and subsequent multi organ failure.Methods: During periods of five years, 423 patients in our hospital underwent pericardiotomy for decompression of effusion. The clinical characteristics of those patient with postoperative low cardiac output (B group (14 cases recorded and compared with other patients without this postoperative complication (A group by test and X2. Significant variables in invariables (P≤0.1 entered in logistic regression analysis and odd ratio of these significant variables obtained. Results: Idiopathic pericardial effusion, malignancy, renal failure, connective tissue disease, viral pericarditis was found in 125 patients (27%, 105 patients (25.4%, 65 patients (15.6%, 50 (17.1% and 10 (2.4% of patients subsequently. The factors that predict post-operative death in logistic regression analysis were malignancy, radiotherapy, constrictive pericarditis inotropic drug using IABP using, pre-operative EF and pericardial calcification.Conclusion: Certain preoperative variables such as malignancy, radiotherapy, low EF, calcified pericardium and connective tissue disease are associated with POLCOS and post-operative risk of death. This paradoxical response to pericardial decompression may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion or thicken pericardium resulting in ventricular dilatation and failure or intra operative myocardial injury due to pericardiectomy of calcified pericardium, radiation and cardiomyopathy.

  4. 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)

  5. Addressing Assumptions for the Use of Non-invasive Cardiac Output Measurement Techniques During Exercise in COPD.

    Science.gov (United States)

    Perrault, Hélène; Richard, Ruddy; Kapchinsky, Sophia; Baril, Jacinthe; Bourbeau, Jean; Taivassalo, Tanja

    2016-01-01

    The multifactorial functional limitation of COPD increasingly demonstrates the need for an integrated circulatory assessment. In this study cardiac output (Qc) derived from non-inert (CO2-RB), inert (N2O-RB) gas rebreathing approaches and bioimpedance were compared to examine the limitations of currently available non-invasive techniques for exercise Qc determination in patients with chronic lung disease. Thirteen COPD patients (GOLD II-III) completed three constant cycling bouts at 20, 35, and 50% of peak work on two occasions to assess Qc with bioimpedance as well as using CO2-RB and N2O-RB for all exercise tests. Results showed significantly lower Qc using the N2O-RB or end-tidal CO2-derived Qc compared to the PaCO2-derived CO2-RB or the bioimpedance at rest and for all exercise intensities. End-tidal CO2-derived values are however not statistically different from those obtained using inert-gas rebreathing. This study show that in COPD patients, CO2-rebreathing Qc values obtained using PaCO2 contents which account for any gas exchange impairment or inadequate gas mixing are similar to those obtained using thoracic bioimpedance. Alternately, the lower values for N2O rebreathing derived Qc indicates the inability of this technique to account for gas exchange impairment in the computation of Qc. These findings indicate that the choice of a gas rebreathing technique to measure Qc in patients must be dictated by the ability to include in the derived computations a correction for either gas exchange inadequacies and/or a vascular shunt. PMID:26408087

  6. Effectiveness of Human Atrial Natriuretic Peptide Supplementation in Pulmonary Edema Patients Using the Pulse Contour Cardiac Output System

    OpenAIRE

    Sakamoto, Yuichiro; Mashiko, Kunihiro; Saito, Nobuyuki; Matsumoto, Hisashi; Hara, Yoshiaki; Kutsukata, Noriyoshi; Yokota, Hiroyuki

    2010-01-01

    Purpose Atrial natriuretic peptide (ANP) has a variety of pharmacologic effects, including natriuresis, diuresis, vasodilatation, and suppression of the renin-angiotensin system. A recent study showed that ANP infusion improved hypoxemia and pulmonary hypertension in a lung injury model. On the other hand, the pulse contour cardiac output (PiCCO™) system (Pulsion Medical Systems, Munich, Germany) allows monitoring of the intravascular volume status and may be used to guide volume therapy in s...

  7. Performance of a new pulse contour method for continuous cardiac output monitoring: validation in critically ill patients

    OpenAIRE

    Bendjelid, Karim; Marx, G.; Kiefer, N.; Simon, T P; Geisen, M; Hoeft, A.; Siegenthaler, Nils; Hofer, C K

    2013-01-01

    BACKGROUND: /st>A new calibrated pulse wave analysis method (VolumeView™/EV1000™, Edwards Lifesciences, Irvine, CA, USA) has been developed to continuously monitor cardiac output (CO). The aim of this study was to compare the performance of the VolumeView method, and of the PiCCO2™ pulse contour method (Pulsion Medical Systems, Munich, Germany), with reference transpulmonary thermodilution (TPTD) CO measurements. METHODS: /st>This was a prospective, multicentre observational study performed i...

  8. The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns

    OpenAIRE

    Reid, Robert Darren; Jayamaha, John

    2007-01-01

    A case of initial resuscitation of a patient with severe burns is described. Such patients can have hypotension and reduced organ perfusion for a number of reasons, and can remain in the emergency department for many hours while awaiting transfer to specialist centres. The case provides a comparison between resuscitation using traditional burns formulae and a relatively new and simple‐to‐use cardiac output (CO) monitor—the Vigileo monitor (Edwards Lifesciences, Irvine, California, USA). The c...

  9. HEART FAILURE WITH LOW CARDIAC OUTPUT AND RISK OF DEVELOPMENT OF LESIONS IN THE CEREBRAL WHITE MATTER

    OpenAIRE

    2005-01-01

    Aim: Diminished cardiac output can lead to the development of white matter lesions. White matter lesions are related to cognitive impairment, stroke risk and vascular death, yet the precise aetiology is uncertain. Methods: In this study we recruited 130 patients attending our medicine and neurology outpatient department, and divided them into those with a history of heart failure (n:24), atrial fibrillation (n:26), and those with atherosclerotic risk factors (n:80). The patients without low o...

  10. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Science.gov (United States)

    Auler, José Otavio C.; Torres, Marcelo L. A.; Cardoso, Mônica M.; Tebaldi, Thais C.; Schmidt, André P.; Kondo, Mario M.; Zugaib, Marcelo

    2010-01-01

    BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia. PMID:20835557

  11. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Directory of Open Access Journals (Sweden)

    José Otavio Costa Auler Junior

    2010-06-01

    Full Text Available BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements, after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia, at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01. Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001 and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

  12. 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

  13. Baseline cerebral oximetry values in cardiac and vascular surgery patients: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Matsagas Miltiadis

    2010-05-01

    Full Text Available Abstract Aim This study was conducted to evaluate baseline INVOS values and identify factors influencing preoperative baseline INVOS values in carotid endarterectomy and cardiac surgery patients. Methods This is a prospective observational study on 157 patients (100 cardiac surgery patients, 57 carotid endarterectomy patients. Data were collected on factors potentially related to baseline INVOS values. Data were analyzed with student's t-test, Chi-square, Pearson's correlation or Linear Regression as appropriate. Results 100 cardiac surgery patients and 57 carotid surgery patients enrolled. Compared to cardiac surgery, carotid endarterectomy patients were older (71.05 ± 8.69 vs. 65.72 ± 11.04, P Conclusion Compared to cardiac surgery, carotid endarterectomy patients are older, with higher baseline INVOS values and greater stroke frequency. Diabetes and high cholesterol are associated with lower baseline INVOS values in carotid surgery. Right and left side INVOS values are strongly correlated in both patient groups.

  14. Value of fetal cerebral MRI in sonographically proven cardiac rhabdomyoma

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, Matthias R.; Hamm, Bernd [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Rake, Annett [Charite - Universitaetsmedizin Berlin, Section for Prenatal Medicine, Department of Gynecology and Obstetrics, Berlin (Germany); Schwabe, Michael [Charite - Universitaetsmedizin Berlin, Department of Pathology, Berlin (Germany); Schmidt, Susanne [Charite - Universitaetsmedizin Berlin, Paediatric Radiology, Berlin (Germany); Kivelitz, Dietmar [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Leipzig Heart Center, Department of Radiology, Leipzig (Germany); Chaoui, Rabih [Prenatal Diagnosis and Human Genetics, Berlin (Germany)

    2007-05-15

    Tuberous sclerosis complex (TSC) is an autosomal dominant phakomatosis associated with intracardiac rhabdomyomas. The aim of our study was to examine the value of cerebral MRI in diagnosing TSC in fetuses with intracardiac rhabdomyomas, applying the TSC Consensus Conference (TSCCC) criteria. In a prospective manner six consecutive fetuses with cardiac rhabdomyomas (21-34 weeks' gestation) underwent cerebral MRI. The MRI results were correlated with clinical follow-up at 10-34 months after birth, histology, and genetic data. In five of the six fetuses the diagnosis of TSC was established. In two of five fetuses MRI demonstrated cerebral manifestations of TSC that correlated well with severe epilepsy manifesting during the follow-up period. In another two of five fetuses MRI as well as clinical follow-up were normal. One of five pregnancies was terminated and histology demonstrated microscopically small subependymal nodules not demonstrated by MRI. The results of our study agree with the available literature that fetal MRI is sufficient for the detection of cerebral lesions in TSC and should be better promoted. The TSCCC criteria can also be applied to fetal MRI. (orig.)

  15. Pulsatile flow simulator for comparison of cardiac output measurements by electromagnetic flow meter and thermodilution.

    Science.gov (United States)

    Jebson, P J; Karkow, W S

    1986-01-01

    This study examined a pulsatile flow simulator for the purpose of evaluating two measurement devices, an extracorporeal flow probe with an electromagnetic flow meter and several thermodilution catheters. We measured the performance of these devices in a range of low to high flows. Using either saline or blood as a perfusate, we obtained different results with these fluids (p less than 0.001). Each catheter behaved in a linear manner, although variation occurred among the catheters with both saline (minimum slope 1.090, maximum slope 1.190) and blood (minimum slope 1.107, maximum slope 1.154). An increase in rate and stroke volumes of the simulator did not demonstrate an identifiable trend in error. The thermodilution catheters were most accurate at 5.0 L/min irrespective of rate, stroke volume, or perfusate used. In contrast, the electromagnetic flow meter accurately represented flows across the wide range of outputs examined (2.4 to 10.7 L/min). (Slope with saline 1.091, slope with blood 1.080) Throughout the range of flow, the flow meter gave a calibration line 5% higher with blood than with saline. The results indicate that accurate measurement of pulsatile blood flow can be achieved in vitro with an electromagnetic flow meter using saline as a perfusate, provided a correction factor is determined and applied to convert values for saline to accurate values for blood. PMID:2940345

  16. Pulse Wave Velocity and Cardiac Output vs. Heart Rate in Patients with an Implanted Pacemaker Based on Electric Impedance Method Measurement

    International Nuclear Information System (INIS)

    The methods and device for estimation of cardiac output and measurement of pulse wave velocity simultaneously is presented here. The beat-to-beat cardiac output as well as pulse wave velocity measurement is based on application of electrical impedance method on the thorax and calf. The results are demonstrated in a study of 24 subjects. The dependence of pulse wave velocity and cardiac output on heart rate during rest in patients with an implanted pacemaker was evaluated. The heart rate was changed by pacemaker programming while neither exercise nor drugs were applied. The most important result is that the pulse wave velocity, cardiac output and blood pressure do not depend significantly on heart rate, while the stroke volume is reciprocal proportionally to the heart rate.

  17. [Dose output at an image intensifier with peak value- or mean value-control].

    Science.gov (United States)

    Bronder, T

    1985-01-01

    X-ray fluoroscopy equipment with automatic brightness control works either on the principle of peak value control or mean value control. The different modes of operation of both control types have the consequence that different dose rate values are regulated if a homogeneous phantom is used. The controlled value using peak value control lies a factor of 1.4 higher than by mean value control. A theoretical consideration about the effect of different dose rate contrast distributions at the image intensifier with regard to the peak and mean values of both types of brightness control results in conditions, which an inhomogeneous phantom must satisfy to yield the same mean dose rate in both cases. By means of an inhomogeneous phantom construction in accordance with these conditions it is possible to compare the dose rate and also image quality parameters of different X-ray units with different types of brightness control. PMID:3969693

  18. Comparison of transthoracic electrical bioimpedance cardiac output measurement with thermodilution method in post coronary artery bypass graft patients

    Directory of Open Access Journals (Sweden)

    Sharma Vikas

    2011-01-01

    Full Text Available Transthoracic electrical bioimpedance (TEB has been proposed as a non-invasive, continuous, and cost-effective method of cardiac output (CO measurement. In this prospective, non-randomized, clinical study, we measured CO with NICOMON (Larsen and Toubro Ltd., Mysore, India and compared it with thermodilution (TD method in patients after off-pump coronary artery bypass (OPCAB graft surgery. We also evaluated the effect of ventilation (mechanical and spontaneous on the measurement of CO by the two methods. Forty-six post-OPCAB patients were studied at five predefined time points during controlled ventilation and at five time points when breathing spontaneously. A total of 230 data pairs of CO were obtained. During controlled ventilation, TD CO values ranged from 2.29 to 6.74 L/min (mean 4.45 ± 0.85 L/min, while TEB CO values ranged from 1.70 to 6.90 L/min (mean 4.43 ± 0.94 L/min. The average correlation (r was 0.548 (P = 0.0002, accompanied by a bias of 0.015 L/min and precision of 0.859 L/min. In spontaneously breathing patients, TD CO values ranged from 2.66 to 6.92 L/min (mean 4.66 ± 0.76 L/min, while TEB CO values ranged from 3.08 to 6.90 L/min (mean 4.72 ± 0.82 L/min. Their average correlation was relatively poor (r = 0.469, P= 0.002, accompanied by a bias of −0.059 L/min and precision of 0.818 L/min. The overall percent errors between TD CO and TEB CO were 19.3% (during controlled ventilation and 17.4% (during spontaneous breathing, respectively. To conclude, a fair correlation was found between TD CO and TEB CO measurements among post-OPCAB patients during controlled ventilation. However, the correlation was weak in spontaneously breathing patients.

  19. At high cardiac output, diesel exhaust exposure increases pulmonary vascular resistance and decreases distensibility of pulmonary resistive vessels.

    Science.gov (United States)

    Wauters, Aurélien; Vicenzi, Marco; De Becker, Benjamin; Riga, Jean-Philippe; Esmaeilzadeh, Fatemeh; Faoro, Vitalie; Vachiéry, Jean-Luc; van de Borne, Philippe; Argacha, Jean-François

    2015-12-15

    Air pollution has recently been associated with the development of acute decompensated heart failure, but the underlying biological mechanisms remain unclear. A pulmonary vasoconstrictor effect of air pollution, combined with its systemic effects, may precipitate decompensated heart failure. The aim of the present study was to investigate the effects of acute exposure to diesel exhaust (DE) on pulmonary vascular resistance (PVR) under resting and stress conditions but also to determine whether air pollution may potentiate acquired pulmonary hypertension. Eighteen healthy male volunteers were exposed to ambient air (AA) or dilute DE with a particulate matter of effects of DE on PVR, on the coefficient of distensibilty of pulmonary vessels (α), and on right and left ventricular function were evaluated at rest (n = 18), during dobutamine stress echocardiography (n = 10), and during exercise stress echocardiography performed in hypoxia (n = 8). Serum endothelin-1 and fractional exhaled nitric oxide were also measured. At rest, exposure to DE did not affect PVR. During dobutamine stress, the slope of the mean pulmonary artery pressure-cardiac output relationship increased from 2.8 ± 0.5 mmHg · min · l (-1) in AA to 3.9 ± 0.5 mmHg · min · l (-1) in DE (P hypoxia-related upper shift of the mean pulmonary artery pressure-cardiac output relationship. Exposure to DE did not affect serum endothelin-1 concentration or fractional exhaled nitric oxide. In conclusion, acute exposure to DE increased pulmonary vasomotor tone by decreasing the distensibility of pulmonary resistive vessels at high cardiac output. PMID:26497960

  20. 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...

  1. Noninvasive cardiac output determination using applanation tonometry-derived radial artery pulse contour analysis in critically ill patients

    DEFF Research Database (Denmark)

    Compton, Friederike; Wittrock, Marc; Schaefer, Juergen-Heiner;

    2008-01-01

    Conventional thermodilution cardiac output (CO) monitoring is limited mainly to intensive care units and operating rooms because it requires the use of invasive techniques. To reduce the potential for complications and to broaden the applicability of hemodynamic monitoring, noninvasive methods for...... were analyzed with bias and precision statistics, a large bias of 2.03 L x min(-1) x m(-2) and a high percentage error of 85% were found between the invasive measurements and applanation tonometry-derived CO estimates, with the noninvasive CO results being significantly lower than the invasive ones (P...

  2. Growth, chlorophyll content and combined output value in eggplant/garlic relay intercropping systems

    International Nuclear Information System (INIS)

    A plastic tunnel experiment was conducted to investigate the effect of eggplant/garlic relay intercropping on the eggplant growth, chlorophyll content and combined output value in 2011 and 2012. The experimental design was randomized block with three replications consisting of eggplant monoculture (CK), eggplant relay intercropping with normal garlic (NG) and eggplant relay intercropping with green garlic (GG). It is showed that the eggplant stem in 2011 was first thicker then thinner in CK than NG, and it was always thicker in CK than GG; the plant height and stem diameter were both higher in relay intercropping treatments than CK in 2012. The chlorophyll content and chlorophyll a/b ratio were lower in NG compared with CK in most cases. In 2011, the eggplant yield and combined output value in GG were lower than CK, but in 2012, they were higher and the difference of combined output value between GG and CK was significant; for NG, they were always promoted both in 2011 and 2012. Different results between 2011 and 2012 may be due to the different time of green garlic uprooted in the spring. It is proved that uprooting green garlic before eggplant transplanting in 2012 was better to eggplant growth than uprooting them after eggplant transplanting in 2011. The conclusions are drawn that relay intercropping with normal or green garlic can improve the eggplant growth, increase the yield and the combined output value. As a result, eggplant/garlic relay intercropping systems may contribute to sustainable production of eggplant. (author)

  3. Sarcomere length dependence of power output is increased after PKA treatment in rat cardiac myocytes

    OpenAIRE

    Hanft, Laurin M.; McDonald, Kerry S.

    2009-01-01

    The Frank-Starling relationship of the heart yields increased stroke volume with greater end-diastolic volume, and this relationship is steeper after β-adrenergic stimulation. The underlying basis for the Frank-Starling mechanism involves length-dependent changes in both Ca2+ sensitivity of myofibrillar force and power output. In this study, we tested the hypothesis that PKA-induced phosphorylation of myofibrillar proteins would increase the length dependence of myofibrillar power output, whi...

  4. 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.

  5. Influence of water immersion, water gymnastics and swimming on cardiac output in patients with heart failure

    Science.gov (United States)

    Schmid, Jean‐Paul; Noveanu, Markus; Morger, Cyrill; Gaillet, Raymond; Capoferri, Mauro; Anderegg, Matthias; Saner, Hugo

    2007-01-01

    Background Whole‐body water immersion leads to a significant shift of blood from the periphery to the intrathoracic circulation, followed by an increase in central venous pressure and heart volume. In patients with severely reduced left ventricular function, this hydrostatically induced volume shift might overstrain the cardiovascular adaptive mechanisms and lead to cardiac decompensation. Aim To assess the haemodynamic response to water immersion, gymnastics and swimming in patients with chronic heart failure (CHF). Methods 10 patients with compensated CHF (62.9 (6.3) years, ejection fraction 31.5% (4.1%), peak oxygen consumption (V̇o2) 19.4 (2.8) ml/kg/min), 10 patients with coronary artery disease (CAD) but preserved left ventricular function (57.2 (5.6) years, ejection fraction 63.9% (5.5%), peak V̇o2 28 (6.3) ml/kg/min), and 10 healthy controls (32.8 (7.2) years, peak V̇o2 45.6 (6) ml/kg/min) were examined. Haemodynamic response to thermoneutral (32°C) water immersion and exercise was measured using a non‐invasive foreign gas rebreathing method during stepwise water immersion, water gymnastics and swimming. Results Water immersion up to the chest increased cardiac index by 19% in controls, by 21% in patients with CAD and by 16% in patients with CHF. Although some patients with CHF showed a decrease of stroke volume during immersion, all subjects were able to increase cardiac index (by 87% in healthy subjects, by 77% in patients with CAD and by 53% in patients with CHF). V̇o2 during swimming was 9.7 (3.3) ml/kg/min in patients with CHF, 12.4 (3.5) ml/kg/min in patients with CAD and 13.9 (4) ml/kg/min in controls. Conclusions Patients with severely reduced left ventricular function but stable clinical conditions and a minimal peak V̇o2 of at least 15 ml/kg/min during a symptom‐limited exercise stress test tolerate water immersion and swimming in thermoneutral water well. Although cardiac index and V̇o2 are lower than in patients

  6. 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

  7. Cardiac sarcoidosis &hypen; the value of magnetic resonance imaging.

    Science.gov (United States)

    Smedema, J. P.; Doubell, A. F.

    2000-08-01

    This report describes the management of a 40-year-old woman presenting with recurrent monomorphic ventricular tachycardias secondary to cardiac sarcoidosis. She was managed with a combination of steroids, azathioprine and mexiletine. Magnetic resonance imaging proved to be of great help in diagnosing this condition as well as in following up the response to therapy. A brief review on the management of this condition is presented. PMID:11447482

  8. The clinical value of cardiac sympathetic imaging in heart failure

    DEFF Research Database (Denmark)

    Christensen, Thomas Emil; Kjaer, Andreas; Hasbak, Philip

    2014-01-01

    The autonomic nervous system plays an important role in the pathology of heart failure. The single-photon emission computed tomography tracer iodine-123-metaiodobenzylguanidine ((123) I-MIBG) can be used to investigate the activity of the predominant neurotransmitter of the sympathetic nervous...... system, norepinephrine. Also, positron emission tomography tracers are being developed for the same purpose. With (123) I-MIBG as a starting point, this brief review introduces the modalities used for cardiac sympathetic imaging....

  9. Constructing Agri-food Industry Input-Output Data: A Value Chain Modelling Approach

    OpenAIRE

    Xayavong, Xila; Islam, Nazrul

    2009-01-01

    Various methods can be used to construct input-output data for sectoral modelling. These methods are broadly classified in the literature as commodity based survey, non-survey and hybrid approaches. Each approach has its own strengths and weaknesses. This paper presents an alternative approach to map the flows of goods and services. The case study of generating inputoutput data for agricultural industries in Western Australia is used to show how value chain modelling can accurately and reliab...

  10. Cardiac output measured by the FloTrac/Vigileo system: Does the „plug and play“ principle work?

    Directory of Open Access Journals (Sweden)

    H. Maxeiner

    2010-06-01

    Full Text Available Background: Determination of cardiac output by the classic thermodilution technique is widely accepted to be the gold standard, but it is not without additional risks due to invasive catheterisation. Therefore, we compared it with the less invasive FloTracTM/VigileoTM-system based on an automated pulse contour analysis.Methods: 34 patients who underwent cardiac surgery with extracorporal circulation were included. In each patient, four measurements were performed. A software update split the patients into two groups: 19 of them were measured using software version V1.07, 15 were measured using software version V1.10.Results: Overall, 120 measurements were performed. Software version V1.07 showed a bias of -0.45l•(min•m2-1 and a precision of 0.53l•(min•m2-1. The percentage error was 45%. Software version V1.10 showed a bias of -0.26l•(min•m2-1 and a precision of 0.42l•(min•m2-1, the percentage error was 36% in this case. The differences were statistically significant with respect to the bias but not to the precision.Conclusion: Although software version V1.10 led to an improvement in the concordance with thermodilution technique, the percentage error exceeds the acceptable threshold of 28.28%. Therefore, in the setting of cardiac surgery the FloTracTM/VigileoTM-system cannot replace the thermodilution technique at present.

  11. Measurement of cardiac output during exercise in healthy, trained humans using lithium dilution and pulse contour analysis

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the use of pulse contour analysis calibrated with lithium dilution in a single device (LiDCO™) for measurement of cardiac output (.Q) during exercise in healthy volunteers. We sought to; (a) compare pulse contour analysis (PulseCO) and lithium indicator dilution (LiDCO) for the measurement of .Q during exercise, and (b) assess the requirement for recalibration of PulseCO with LiDCO during exercise. Ten trained males performed multi-stage cycling exercise at intensities below and above ventilatory threshold before constant load maximal exercise to exhaustion. Uncalibrated PulseCO .Q (.Qraw) was compared to that calibrated with lithium dilution at baseline (.Qbaseline), during submaximal exercise below (.Qlow) and above (.Qhigh) ventilatory threshold, and at each exercise stage individually (.Qexercise). There was a significant difference between .Qbaseline and all other calibration methods during exercise, but not at rest. No significant differences were observed between other methods. Closest agreement with .Qexercise was observed for .Qhigh (bias ± limits of agreement: 4.8 ± 30.0%). The difference between .Qexercise and both .Qlow and .Qraw was characterized by low bias (4–7%) and wide limits of agreement (>±40%). Calibration of pulse contour analysis with lithium dilution prior to exercise leads to a systematic overestimation of exercising cardiac output. A single calibration performed during exercise above the ventilatory threshold provided acceptable limits of agreement with an approach incorporating multiple calibrations throughout exercise. Pulse contour analysis may be used for .Q measurement during exercise providing the system is calibrated during exercise. (paper)

  12. Impact of changes in systemic vascular resistance on a novel non-invasive continuous cardiac output measurement system based on pulse wave transit time: a report of two cases

    OpenAIRE

    Ishihara, Hironori; Tsutsui, Masato

    2013-01-01

    The inaccuracy of arterial waveform analysis for measuring continuos cardiac output (CCO) associated with changes in systemic vascular resistance (SVR) has been well documented. A new non-invasive continuous cardiac output monitoring system (esCCO) mainly utilizing pulse wave transit time (PWTT) in place of arterial waveform analysis has been developed. However, the trending ability of esCCO to measure cardiac output during changes in SVR remains unclear. After a previous multicenter study on...

  13. Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres

    International Nuclear Information System (INIS)

    Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). The authors conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress

  14. G16R single nucleotide polymorphism but not haplotypes of the ß2-adrenergic receptor gene alters cardiac output in humans

    DEFF Research Database (Denmark)

    Rokamp, Kim Z; Staalsø, Jonatan M; Gartmann, Martin;

    2013-01-01

    Variation in genes encoding the ß2-adrenergic receptor (ADRB2) and angiotensin-converting enzyme (ACE) may influence Q¿ (cardiac output). The 46G>A (G16R) SNP (single nucleotide polymorphism) has been associated with ß2-mediated vasodilation, but the effect of ADRB2 haplotypes on Q¿ has not been ...

  15. Uncovering Customer Value in the Cardiac Rhythm Management Industry in Malaysia

    OpenAIRE

    Lee, Augustin Kuan Lock

    2013-01-01

    In the Cardiac Rhythm Management (CRM) industry in Malaysia, customer value is derived from multiple touch points between the electrophysiologist (EP) and the industry employed allied professional (IEAP). Due to the hybrid nature of the product service elements of this business-to-business (B2B) interaction, according to industry assumptions, value to the customer is created along several dimensions such as product quality, service support and price. Customer value has been linked to customer...

  16. Use of a capillary input function with cardiac output for the estimation of lesion pharmacokinetic parameters: preliminary results on a breast cancer patient

    Science.gov (United States)

    Di Giovanni, P.; Ahearn, T. S.; Semple, S. I.; Azlan, C. A.; Lloyd, W. K. C.; Gilbert, F. J.; Redpath, T. W.

    2011-03-01

    The objective of this work was to propose and demonstrate a novel technique for the assessment of tumour pharmacokinetic parameters together with a regionally estimated vascular input function. A breast cancer patient T2*-weighted dynamic contrast enhanced MRI (DCE-MRI) dataset acquired at high temporal resolution during the first-pass bolus perfusion was used for testing the technique. Extraction of the lesion volume transfer constant Ktrans together with the intravascular plasma volume fraction vp was achieved by optimizing a capillary input function with a measure of cardiac output using the principle of intravascular indicator dilution theory. For a region of interest drawn within the breast lesion a vp of 0.16 and a Ktrans of 0.70 min-1 were estimated. Despite the value of vp being higher than expected, estimated Ktrans was in accordance with the literature values. In conclusion, the technique proposed here, has the main advantage of allowing the estimation of breast tumour pharmacokinetic parameters from first-pass perfusion T2*-weighted DCE-MRI data without the need of measuring an arterial input function. The technique may also have applicability to T1-weighted DCE-MRI data.

  17. Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure-Prone Rats

    Science.gov (United States)

    Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance...

  18. The non-invasive and continuous estimation of cardiac output using a photoplethysmogram and electrocardiogram during incremental exercise

    International Nuclear Information System (INIS)

    Cardiac output (CO) monitoring is not only essential for critically ill patients in the hospital, but also for patients at home and those undergoing cardiopulmonary exercise testing. However, CO is difficult to monitor during daily activities and exercise. In this paper, we aim at developing a novel CO estimation method that can be used under these challenging conditions. The tube model was utilized to derive a CO index, namely the pulse time reflection ratio (PTRR) from an electrocardiogram and photoplethysmogram. After calibration, the PTRR can be used to estimate beat-to-beat CO. The proposed method was verified against CO measured by impedance cardiography on 19 healthy subjects in an incremental intensity exercise test. Results showed that there were strong correlations (r) between the PTRR and reference CO in 18 subjects (mean r: 0.88, n = 245 trials). Two calibration approaches reported in the literature were applied to the proposed method and the corresponding bias ± precisions of estimation errors were 0 ± 1.89 L min−1 and −0.22 ± 2.12 L min−1, respectively. The percent errors were 21.94% and 24.90%, smaller than the clinical acceptance limit (30%). To conclude, after calibration, this method can be used to monitor CO on healthy subjects during incremental intensity exercise

  19. Cardiac output obtained from test bolus injections as a factor in contrast injection rate revision of following coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Konno, Masahiko [Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi (Japan); Yamagata Prefecture Comprehensive Rehabilitation and Education Center, Yamagata (Japan)], E-mail: mkonno@med.tohoku.ac.jp; Hosokai, Yoshiyuki; Usui, Akihito; Abe, Mitsuya; Tateishi, Toshiki; Kawasumi, Yusuke; Saito, Haruo [Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi (Japan); Tsuda, Masashi; Ota, Hideki; Takase, Kei [Division of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Miyagi (Japan)

    2012-12-15

    Background.. Optimal contrast enhancement is crucial for the detection of coronary artery stenoses and atherosclerotic changes in coronary CT angiography (CTA). Purpose To demonstrate the feasibility of using the cardiac output (CO) obtained from the test bolus injection data-set (CO test) as a factor in contrast injection rate revision of the following coronary CTA. Material and Methods. The test bolus injection data-sets of 52 consecutive coronary CTAs were examined. CO test was calculated from the test bolus data-set. Aortic peak enhancement (APE) was measured on the following coronary CTA. We simulated the APE at a fixed contrast injection rate of 4 mL/s (simAPE) in each patient. Results. The ranges of COtest and simAPE were 2.82-7.56 L/min and 194-527 Hounsfield Units, respectively. There was a significant negative correlation (R = -0.802, P < 0.001) between simAPE and COtest. Conclusion. COtest can be used for injection rate revision on coronary CTA.

  20. 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.

  1. Prognostic value of sympathetic innervation and cardiac asynchrony in dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, Alain; Hitzel, Anne; Vera, Pierre [Rouen University Hospital - Henri Becquerel Center, Nuclear Medicine, Rouen (France); Bernard, Mathieu; Bauer, Fabrice [Rouen University Hospital, Cardiology, Rouen (France); Menard, Jean-Francois [Rouen University Hospital, Biostatistics, Rouen (France); Sabatier, Remi [Caen University Hospital, Cardiology, Caen (France); Jacobson, Arnold [GE Healthcare, Princeton, NJ (United States); Agostini, Denis [Caen University Hospital, Nuclear Medicine, Caen (France)

    2008-11-15

    The purpose of the study is to examine prognostic values of cardiac I-123 metaiodobenzylguanidine (MIBG) uptake and cardiac dyssynchrony in patients with dilated cardiomyopathy (DCM). Ninety-four patients with non-ischemic DCM underwent I-123 MIBG imaging for assessing cardiac sympathetic innervation and equilibrium radionuclide angiography. Mean phase angles and SD of the phase histogram were computed for both right ventricular (RV) and left ventricular (LV). Phase measures of interventricular (RV-LV) and intraventricular (SD-RV and SD-LV) asynchrony were computed. Most patients were receiving beta-blockers (89%) and angiotensin-converting enzyme inhibitors (88%). One patient (1%) was lost to follow-up, six had cardiac death (6.4%), eight had heart transplantation (8.6%), and seven had unplanned hospitalization for heart failure (7.5%; mean follow-up: 37 {+-} 16 months). Patients with poor clinical outcome were older, had higher The New York Heart Association functional class, impaired right ventricular ejection fraction and left ventricular ejection fraction, and impaired cardiac I-123 MIBG uptake. On multivariate analysis, I-123 MIBG heart-to-mediastinum (H/M) uptake ratio <1.6 was the only predictor of both primary (cardiac death or heart transplantation, RR = 7.02, p < 0.01) and secondary (cardiac death, heart transplantation, or recurrent heart failure, RR = 8.10, p = 0.0008) end points. In patients receiving modern medical therapy involving beta-blockers, I-123 MIBG uptake, but not intra-LV asynchrony, was predictive of clinical outcome. The impact of beta-blockers on the prognostic value of ventricular asynchrony remains to be clarified. (orig.)

  2. Value of plasma ADMA in predicting cardiac structure and function of patients with chronic kidney diseases

    Institute of Scientific and Technical Information of China (English)

    叶建华

    2012-01-01

    Objective To explore the predicting value of plasma asymmetric dimethylarginine (ADMA) in cardiac structure and function of patients with chronic kidney diseases(CKD). Methods A total of 100 CKD patients were enrolled in this cross-sectional study. According to staging of the

  3. The effects of cardiac output and pulmonary arterial hypertension on volumetric capnography derived-variables during normoxia and hypoxia.

    Science.gov (United States)

    Mosing, Martina; Kutter, Annette P N; Iff, Samuel; Raszplewicz, Joanna; Mauch, Jacqueline; Bohm, Stephan H; Tusman, Gerardo

    2015-02-01

    The aim of this study was to test the effect of cardiac output (CO) and pulmonary artery hypertension (PHT) on volumetric capnography (VCap) derived-variables. Nine pigs were mechanically ventilated using fixed ventilatory settings. Two steps of PHT were induced by IV infusion of a thromboxane analogue: PHT25 [mean pulmonary arterial pressure (MPAP) of 25 mmHg] and PHT40 (MPAP of 40 mmHg). CO was increased by 50% from baseline (COup) with an infusion of dobutamine≥5 μg kg(-1) min(-1) and decreased by 40% from baseline (COdown) infusing sodium nitroglycerine≥30 μg kg(-1) min(-1) plus esmolol 500 μg kg(-1) min(-1). Another state of PHT and COdown was induced by severe hypoxemia (FiO2 0.07). Invasive hemodynamic data and VCap were recorded and compared before and after each step using a mixed random effects model. Compared to baseline, the normalized slope of phase III (SnIII) increased by 32% in PHT25 and by 22% in PHT40. SnIII decreased non-significantly by 4% with COdown. A combination of PHT and COdown associated with severe hypoxemia increased SnIII by 28% compared to baseline. The elimination of CO2 per breath decreased by 7% in PHT40 and by 12% in COdown but increased only slightly with COup. Dead space variables did not change significantly along the protocol. At constant ventilation and body metabolism, pulmonary artery hypertension and decreases in CO had the biggest effects on the SnIII of the volumetric capnogram and on the elimination of CO2. PMID:24908108

  4. Task completion report for investigating why output signal-variable values differ from their output component-parameter values in test problem MST2

    Energy Technology Data Exchange (ETDEWEB)

    Steinke, R.G.

    1997-09-10

    Signal-variable values and their component-parameter values differ in an end-of-timestep edit to the TRCOUT and TRCGRF files because signal variables have beginning-of-timestep values, and component parameters have end-of-timestep values. Oscillatory divergence in the MST2 standard test problem after 9000 s occurs because of TRAC-P`s numerical evaluation at a 1000 material Courant number. The magnitude of that divergence has diminished by a factor of 3.5 from Version 5.3.01 to 5.4.15 and by a factor of 25 from Version 5.4.15 to 5.4.28. That divergence can be eliminated by evaluating MST2 with a maximum material Courant number of 500.

  5. The 24 h pattern of arterial pressure in mice is determined mainly by heart rate‐driven variation in cardiac output

    OpenAIRE

    Kurtz, Theodore W.; Lujan, Heidi L.; DiCarlo, Stephen E.

    2014-01-01

    Abstract Few studies have systematically investigated whether daily patterns of arterial blood pressure over 24 h are mediated by changes in cardiac output, peripheral resistance, or both. Understanding the hemodynamic mechanisms that determine the 24 h patterns of blood pressure may lead to a better understanding of how such patterns become disturbed in hypertension and influence risk for cardiovascular events. In conscious, unrestrained C57BL/6J mice, we investigated whether the 24 h patter...

  6. Estimation of cardiac output and systemic vascular resistance using a multivariate regression model with features selected from the finger photoplethysmogram and routine cardiovascular measurements

    OpenAIRE

    Lee, Qim Y; Stephen J. Redmond; Chan, Gregory SH; Middleton, Paul M; Steel, Elizabeth; Malouf, Philip; Critoph, Cristopher; Flynn, Gordon; O’Lone, Emma; Lovell, Nigel H

    2013-01-01

    Background Cardiac output (CO) and systemic vascular resistance (SVR) are two important parameters of the cardiovascular system. The ability to measure these parameters continuously and noninvasively may assist in diagnosing and monitoring patients with suspected cardiovascular diseases, or other critical illnesses. In this study, a method is proposed to estimate both the CO and SVR of a heterogeneous cohort of intensive care unit patients (N=48). Methods Spectral and morphological features w...

  7. Differences of cardiac output measurements by open-circuit acetylene uptake in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: a cohort study

    Directory of Open Access Journals (Sweden)

    Schwaiblmair Martin

    2012-03-01

    Full Text Available Abstract Background As differences in gas exchange between pulmonary arterial hypertension (PAH and chronic thromboembolic pulmonary hypertension (CTEPH have been demonstrated, we asked if cardiac output measurements determined by acetylene (C2H2 uptake significantly differed in these diseases when compared to the thermodilution technique. Method Single-breath open-circuit C2H2 uptake, thermodilution, and cardiopulmonary exercise testing were performed in 72 PAH and 32 CTEPH patients. Results In PAH patients the results for cardiac output obtained by the two methods showed an acceptable agreement with a mean difference of -0.16 L/min (95% CI -2.64 to 2.32 L/min. In contrast, the agreement was poorer in the CTEPH group with the difference being -0.56 L/min (95% CI -4.96 to 3.84 L/min. Functional dead space ventilation (44.5 ± 1.6 vs. 32.2 ± 1.4%, p 2 gradient (9.9 ± 0.8 vs. 4.1 ± 0.5 mmHg, p Conclusion Cardiac output evaluation by the C2H2 technique should be interpreted with caution in CTEPH, as ventilation to perfusion mismatching might be more relevant than in PAH.

  8. Risk stratification for sudden cardiac death: current approaches and predictive value.

    Science.gov (United States)

    Lopera, Gustavo; Curtis, Anne B

    2009-01-01

    Sudden cardiac death (SCD) is a serious public health problem; the annual incidence of out-of-hospital cardiac arrest in North America is approximately 166,200. Identifying patients at risk is a difficult proposition. At the present time, left ventricular ejection fraction (LVEF) remains the single most important marker for risk stratification. According to current guidelines, most patients with LVEF strategies fail to identify patients at risk of SCD in larger population groups encompassing a greater number of potential SCD victims. However, the best approach to identifying patients and the value of various risk stratification tools is not entirely clear. The goal of this review is to discuss the problem of SCD and the value of the different risk stratification markers and their potential clinical use either alone or in combination with other risk stratification markers. PMID:20066150

  9. Reference values for quantitative left ventricular and left atrial measurements in cardiac computed tomography

    International Nuclear Information System (INIS)

    To assess reference values for left ventricular (LV) and left atrial (LA) dimensions, global LV function, and LV-myocardial mass for cardiac CT. We examined 120 subjects undergoing a coronary angiography using 64-slice and dual-source CT. All individuals had a low cardiovascular risk, normal ECG, negative biomarkers, and a normal cardiac CT examination. All subjects had a negative medical history of cardiovascular disease both on admission and at clinical 6-month follow-up. The following measurements were obtained: septal wall thickness (SWT), posterior wall thickness (PWT), LV inner diameter (LVID), LA anterior posterior diameter (LADsys), end-systolic volume (ESV), and end-diastolic volume (EDV), LV-myocardial mass (LVMM). We found significant gender-related differences for all LV dimensions (SWTsys, SWTdia,PWTsys,PWTdia,LVIDsys,LVIDdia). LADsys showed no significant difference between males and females. Significant differences were found for global LV functional parameters including ESV, EDV, and SV, whereas no significant differences were found for the EF. LV-myocardial mass parameters showed significant gender-related differences. No significant correlation was found between any of these parameters and age. All data were transferred to percentile ranks. This study provides gender-related reference values and percentiles for LV and LA quantitative measurements for cardiac CT and should assist in interpreting results. (orig.)

  10. The value of cardiac catheterization and cineangiography in infantile lobar emphysema

    International Nuclear Information System (INIS)

    Lobar emphysema is an uncommon cause of respiratory distress in infancy. Congenital heart disease is seen in about 20% of the patients with infantile (congenital) lobar emphysema. We described six infants with lobar emphysema. In three of them a congenital heart disease was demonstrated by cardiac catheterization and cineangiography; two had a tetralogy of Fallot with right aortic arch and the third infant a ventricular septal defect. The pulmonary angiography showed stretching of the arteries with very poor filling of the peripheral arteries and a characteristic smaller pulmonary vein in the affected lobe. In all the six patients the pulmonary artery pressure was normal. All the patients underwent lobectomy with good results. We feel that a preoperative cardiac catheterization and cineangiography is of value in this very sick group of infants. (orig.)

  11. Age-related normal structural and functional ventricular values in cardiac function assessed by magnetic resonance

    International Nuclear Information System (INIS)

    The heart is subject to structural and functional changes with advancing age. However, the magnitude of cardiac age-dependent transformation has not been conclusively elucidated. This retrospective cardiac magnetic resonance (CMR) study included 183 subjects with normal structural and functional ventricular values. End systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF) were obtained from the left and the right ventricle in breath-hold cine CMR. Patients were classified into four age groups (20–29, 30–49, 50–69, and ≥70 years) and cardiac measurements were compared using Pearson’s rank correlation over the four different groups. With advanced age a slight but significant decrease in ESV (r=−0.41 for both ventricles, P<0.001) and EDV (r=−0.39 for left ventricle, r=−0.35 for right ventricle, P<0.001) were observed associated with a significant increase in left (r=0.28, P<0.001) and right (r=0.27, P<0.01) ventricular EF reaching a maximal increase in EF of +8.4% (P<0.001) for the left and +6.1% (P<0.01) for the right ventricle in the oldest compared to the youngest patient group. Left ventricular myocardial mass significantly decreased over the four different age groups (P<0.05). The aging process is associated with significant changes in left and right ventricular EF, ESV and EDV in subjects with no cardiac functional and structural abnormalities. These findings underline the importance of using age adapted values as standard of reference when evaluating CMR studies

  12. THE VALUE OF RISK : MEASURING THE SERVICE OUTPUT OF U.S. COMMERCIAL BANKS

    NARCIS (Netherlands)

    Basu, Susanto; Inklaar, Robert; Wang, J. Christina

    2011-01-01

    Banks often charge implicitly for their services via interest spreads, instead of explicit fees. Much of bank output thus has to be estimated indirectly. In contrast to current statistical practice, dynamic optimizing models of banks argue that compensation for bearing systematic risk is not part of

  13. The Value of Risk : Measuring the Service Output of U.S. Commercial Banks

    NARCIS (Netherlands)

    Basu, Susanto; Inklaar, Robert; Wang, J. Christina

    2008-01-01

    Rather than charging direct fees, banks often charge implicitly for their services via interest spreads. As a result, much of bank output has to be estimated indirectly. In contrast to current statistical practice, dynamic optimizing models of banks argue that compensation for bearing systematic ris

  14. Comparing the accuracy of ES-BC, EIS-GS, and ES Oxi on body composition, autonomic nervous system activity, and cardiac output to standardized assessments

    Directory of Open Access Journals (Sweden)

    Lewis JE

    2011-09-01

    Full Text Available John E Lewis1, Stacey L Tannenbaum1, Jinrun Gao3, Angelica B Melillo1, Evan G Long1, Yaima Alonso2, Janet Konefal1, Judi M Woolger2, Susanna Leonard1, Prabjot K Singh1, Lawrence Chen1, Eduard Tiozzo1 1Department of Psychiatry and Behavioral Sciences, 2Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, 3State Farm Insurance, Bloomington, IL, USA Background and purpose: The Electro Sensor Complex (ESC is software that combines three devices using bioelectrical impedance, galvanic skin response, and spectrophotometry: (1 ES-BC (Electro Sensor-Body Composition; LD Technology, Miami, FL to assess body composition, (2 EIS-GS (Electro Interstitial Scan-Galvanic Skin; LD Technology to predict autonomic nervous system activity, and (3 ES Oxi (Electro Sensor Oxi; LD Technology to assess cardiac output. The objective of this study was to compare each to a standardized assessment: ES-BC to dual-energy X-ray absorptiometry (DXA, EIS-GS to heart rate variability, and ES Oxi to BioZ Dx Diagnostic System (BioZ Dx; SonoSite Inc, Bothell, WA. Patients and methods: The study was conducted in two waves. Fifty subjects were assessed for body composition and autonomic nervous system activity. Fifty-one subjects were assessed for cardiac output. Results: We found adequate relative and absolute agreement between ES-BC and DXA for fat mass (r = 0.97, P < 0.001 with ES-BC overestimating fat mass by 0.1 kg and for body fat percentage (r = 0.92, P < 0.001 with overestimation of fat percentage by 0.4%. For autonomic nervous system activity, we found marginal relative agreement between EIS-GS and heart rate variability by using EIS-GS as the predictor in a linear regression equation (adjusted R2 = 0.56, P = 0.03. For cardiac output, adequate relative and absolute agreement was found between ES Oxi and BioZ Dx at baseline (r = 0.60, P < 0.001, after the first exercise stage (r = 0.79, P < 0.001, and after the second exercise stage (r = 0.86, P

  15. A Value-Added Based Measure of Health System Output and Estimating the Efficiency of OECD Health Systems

    OpenAIRE

    Dennis Petrie; Kam Ki Tang; Prasada Rao, D.S.

    2009-01-01

    Life expectancy at birth is the most commonly used measure for health system output. However, there are a number of reasons why it may be a poor proxy. First, life expectancy assumes a stationary population and thus does not take into account the current demographic structure of a country; and second, the output of a health system should be measured in terms of the value-added to the population’s health status rather than health status itself. The paper develops a new measure of health system...

  16. Decentralized robust H-infinity descriptor output feedback control for value-bounded uncertain descriptor large-scale systems

    Institute of Scientific and Technical Information of China (English)

    Yongfang XIE; Weihua GUI; Zhaohui JIANG

    2006-01-01

    For a class of value-bounded uncertain descriptor large-scale interconnected systems, the decentralized robust H∞ descriptor output feedback control problem is investigated. A design method based on the bounded real lemma is developed for a decentralized descriptor dynamic output feedback controller, which is reduced to a feasibility problem for a nonlinear matrix inequality (NLMI). It is proposed to solve the NLMI iteratively by the idea of homotopy, where some of the variables are fixed alternately at each iteration to reduce the NLMI to a linear matrix inequality (LMI). A given example shows the efficiency of this method

  17. A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome

    OpenAIRE

    Porter, J; Al-Jarrah, Q.; Richardson, S

    2014-01-01

    Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally dia...

  18. Uncalibrated pulse power analysis fails to reliably measure cardiac output in patients undergoing coronary artery bypass surgery

    OpenAIRE

    Broch, Ole; Renner, Jochen; Höcker, Jan; Gruenewald, Matthias; Meybohm, Patrick; Schöttler, Jan; Steinfath, Markus; Bein, Berthold

    2011-01-01

    Introduction Uncalibrated arterial pulse power analysis has been recently introduced for continuous monitoring of cardiac index (CI). The aim of the present study was to compare the accuracy of arterial pulse power analysis with intermittent transpulmonary thermodilution (TPTD) before and after cardiopulmonary bypass (CPB). Methods Forty-two patients scheduled for elective coronary surgery were studied after induction of anaesthesia, before and after CPB respectively. Each patient was monitor...

  19. Input-output-based genuine value added and genuine productivity in China's industrial sectors (1995-2010)

    OpenAIRE

    Gao, Yuning; Zheng, Yunfeng; Hu, Angang; Meng, Bo

    2015-01-01

    The rapid growth of China's economy has brought about huge losses of natural capital in the form of natural resource depletion and damages from carbon emissions. This paper recalculates value added, capital formation, capital stock, and related multifactor productivity in China's industrial sectors by further developing the genuine savings method of the World Bank. The sector-level natural capital loss was calculated using China's official input–output table and their extensions for tracing...

  20. The value of solar: Prices and output from distributed photovoltaic generation in South Australia

    International Nuclear Information System (INIS)

    The Australian government's Solar Cities Program sees great value in so-called 'cost-reflective pricing', code for valuing solar at pool prices. We test that proposition in South Australia where pool prices and insolation are often high and we show that there were few days in 2004 when the pool price gives better outcomes than if the solar is valued at the regulated and fixed, so-called standing contract price. We also find that the illustrative day used in the Solar Cities Program literature to promote the notion of cost-reflective pricing is highly atypical. Finally, we consider ways in which the incentive to install distributed photovoltaic generation might be improved

  1. Low cardiac output as physiological phenomenon in hibernating, free-ranging Scandinavian brown bears (Ursus arctos) - an observational study

    DEFF Research Database (Denmark)

    Jørgensen, Peter Godsk; Arnemo, Jon; Swenson, Jon E;

    2014-01-01

    cardiac function associated with metabolic depression in the hibernating vs. active states in free-ranging Scandinavian brown bears. METHODS: We performed echocardiography on seven free-ranging brown bears in Dalarna, Sweden, anesthetized with medetomidine-zolazepam-tiletamine-ketamine during winter....... CONCLUSION: Free-ranging brown bears demonstrate hemodynamics comparable to humans during active state, whereas during hibernation, we documented extremely low-flow hemodynamics. Understanding these physiological changes in bears may help to gain insight into the mechanisms of cardiogenic shock and heart...

  2. Relationship between myocardial T2* values and cardiac volumetric and functional parameters in β-thalassemia patients evaluated by cardiac magnetic resonance in association with serum ferritin levels

    Energy Technology Data Exchange (ETDEWEB)

    Liguori, Carlo, E-mail: c.liguori@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Pitocco, Francesca, E-mail: f.pitocco@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Di Giampietro, Ilenia, E-mail: i.digiampietro@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Vivo, Aldo Eros de, E-mail: devivoeros@gmail.com [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Schena, Emiliano, E-mail: e.schena@unicampus.it [Unit of Measurements and Biomedical Instrumentation, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Cianciulli, Paolo, E-mail: CIANCIULLI.PAOLO@aslrmc.it [Thalassemia Unit, Ospedale Sant Eugenio, Piazzale dell’Umanesimo 10, 00143 Rome (Italy); Zobel, Bruno Beomonte, E-mail: b.zobel@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy)

    2013-09-15

    Purpose: Myocardial T2* cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2* value in myocardium and left–right ventricular volumetric and functional parameters and to evaluate the existing associations between left–right ventricles volumetric and functional parameter, myocardial T2* values and blood ferritin levels. Materials and methods: A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence. Results: A significant correlation was observed between EFLV and T2* (p = 0.0001), EFRV and T2* (p = 0.0279). An inverse correlation was present between DVLV and T2* (p = 0.0468), SVLV and T2* (p = 0.0003), SVRV and T2* (p = 0.0001). There was no significant correlation between cardiac T2* and LV–RV mass indices. A significant correlation was observed between T2* and serum ferritin levels (p < 0.001) and between EFLV and serum ferritin (p < 0.05). Conclusion: Myocardial iron load assessed by T2* cardiac magnetic resonance is associated with deterioration in left–right ventricular function; this is more evident when T2* values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients.

  3. Relationship between myocardial T2* values and cardiac volumetric and functional parameters in β-thalassemia patients evaluated by cardiac magnetic resonance in association with serum ferritin levels

    International Nuclear Information System (INIS)

    Purpose: Myocardial T2* cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2* value in myocardium and left–right ventricular volumetric and functional parameters and to evaluate the existing associations between left–right ventricles volumetric and functional parameter, myocardial T2* values and blood ferritin levels. Materials and methods: A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence. Results: A significant correlation was observed between EFLV and T2* (p = 0.0001), EFRV and T2* (p = 0.0279). An inverse correlation was present between DVLV and T2* (p = 0.0468), SVLV and T2* (p = 0.0003), SVRV and T2* (p = 0.0001). There was no significant correlation between cardiac T2* and LV–RV mass indices. A significant correlation was observed between T2* and serum ferritin levels (p < 0.001) and between EFLV and serum ferritin (p < 0.05). Conclusion: Myocardial iron load assessed by T2* cardiac magnetic resonance is associated with deterioration in left–right ventricular function; this is more evident when T2* values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients

  4. Prognostic Value of the Six-Minute Walk Test in Heart Failure Patients Undergoing Cardiac Surgery: A Literature Review

    Directory of Open Access Journals (Sweden)

    Dominika Zielińska

    2013-01-01

    Full Text Available Background. The prognostic value of cardiopulmonary exercise testing (CPET is known, but the predictive value of 6MWT in patients with heart failure (HF and patients undergoing coronary artery bypass grafting (CABG is not established yet. Objective. We conducted a systematic review exploring the prognostic value of 6MWT in HF patients undergoing cardiac surgery. The aim was to find out whether the change in the distance walked during follow-up visits was associated with prognosis. Data Source. We searched “PubMed” from January 1990 to December 2012 for any review articles or experimental studies investigating the prognostic value of 6MWT in HF patients and patients undergoing cardiac surgery. Results. 53 studies were included in the review, and they explored the role of 6MWT in cardiology, cardiac surgery, and rehabilitation. The results did not show the relation between the six-minute walk distance and adverse events after CABG. The predictive power of the distance walked for death in HF patients undergoing cardiac surgery was not found. It is not yet proved if the change in the six-minute walk distance is associated with prognosis. The predictive power of the six-minute walk distance for death in HF patients undergoing cardiac surgery remains unclear.

  5. Prognostic value of the six-minute walk test in heart failure patients undergoing cardiac surgery: a literature review.

    Science.gov (United States)

    Zielińska, Dominika; Bellwon, Jerzy; Rynkiewicz, Andrzej; Elkady, Mohamed Amr

    2013-01-01

    Background. The prognostic value of cardiopulmonary exercise testing (CPET) is known, but the predictive value of 6MWT in patients with heart failure (HF) and patients undergoing coronary artery bypass grafting (CABG) is not established yet. Objective. We conducted a systematic review exploring the prognostic value of 6MWT in HF patients undergoing cardiac surgery. The aim was to find out whether the change in the distance walked during follow-up visits was associated with prognosis. Data Source. We searched "PubMed" from January 1990 to December 2012 for any review articles or experimental studies investigating the prognostic value of 6MWT in HF patients and patients undergoing cardiac surgery. Results. 53 studies were included in the review, and they explored the role of 6MWT in cardiology, cardiac surgery, and rehabilitation. The results did not show the relation between the six-minute walk distance and adverse events after CABG. The predictive power of the distance walked for death in HF patients undergoing cardiac surgery was not found. It is not yet proved if the change in the six-minute walk distance is associated with prognosis. The predictive power of the six-minute walk distance for death in HF patients undergoing cardiac surgery remains unclear. PMID:23984074

  6. 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

  7. A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    J. Porter

    2014-01-01

    Full Text Available Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available.

  8. Use of transesophageal Doppler as a sole cardiac output monitor for reperfusion hemodynamic changes during living donor liver transplantation: An observational study

    Directory of Open Access Journals (Sweden)

    M Hussien

    2011-01-01

    Full Text Available Aims: To report the use of transesophageal Doppler (TED, a minimally invasive cardiac output (COP monitor, before, during and after reperfusion and study its effect on anesthetic management during living donor liver transplantation (LDLT. Setting and Design: A prospective observational study. Methods: A total of 25 consecutive recipients with a MELD score between 15 and 20 were enrolled. Data were recorded at baseline (TB; anhepatic phase (TA; and post-reperfusion - 1, 5, 10 and 30 minutes. Fluid therapy was guided by corrected flow time (FTc of the TED. Packed red blood cells (RBCs were only given when hematocrit was less than 25%. Rotational thromboelastometry (ROTEM and standard laboratory tests were used to guide component blood products requirements. Results: Post-reperfusion, the COP, Cardiac Index (CI and stroke volume (SV increased significantly at all points of measurements; this was associated with a significant decrease in systemic vascular resistance (SVR ( P <.05. Immediately post-reperfusion, for 5 minutes, mean arterial blood pressure (ABP dropped significantly (P<.05, and 14 out of the 25 patients required boluses of epinephrine (10 μg to restore the mean ABP; 3 of the 14 patients required norepinephrine infusion till the end of surgery. Central venous pressure (CVP and urine output (UOP at all measures were maintained adequately with FTc-guided fluid replacement. Eight out of the 25 patients required no blood transfusion, and 4 of the 8 patients required no catecholamine support. Conclusion: TED as a sole monitor for COP was able to present significant and reliable changes in the cardiovascular status of the recipients during reperfusion, which could help to guide fluid- and drug-supportive therapy in this population of patients. This preliminary study needs to be applied on a larger scale.

  9. 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

  10. Prognostic Value of the Six-Minute Walk Test in Heart Failure Patients Undergoing Cardiac Surgery: A Literature Review

    OpenAIRE

    Dominika Zielińska; Jerzy Bellwon; Andrzej Rynkiewicz; Mohamed Amr Elkady

    2013-01-01

    Background. The prognostic value of cardiopulmonary exercise testing (CPET) is known, but the predictive value of 6MWT in patients with heart failure (HF) and patients undergoing coronary artery bypass grafting (CABG) is not established yet. Objective. We conducted a systematic review exploring the prognostic value of 6MWT in HF patients undergoing cardiac surgery. The aim was to find out whether the change in the distance walked during follow-up visits was associated with prognosis. Data Sou...

  11. A Probe into the Mortgage Rates of Land Contract Management Rights Based on Unified Annual Output Value

    Institute of Scientific and Technical Information of China (English)

    Zhongjun; YI

    2013-01-01

    The mortgage of land contract management rights has launched a pilot project in Ningxia,Hubei,Henan,Guizhou,Chongqing and other provinces,municipalities and autonomous regions,which provides a good solution to the problem of funds for rural development and plays a huge role in promoting local rural economic development.In the mortgage financing of land contract management rights implemented in various regions,how to determine a scientific,accurate and reasonable mortgage rate of land contract management rights becomes a difficulty troubling the mortgage financing of land.On the basis of unified annual output value of land,this article uses survey method,income capitalization method,and comparison method to analyze the value of land contract management rights,and finally determine the mortgage rates of land contract management rights.

  12. Cardiac magnetic resonance imaging for myocardial perfusion and diastolic function-reference control values for women.

    Science.gov (United States)

    Bakir, May; Wei, Janet; Nelson, Michael D; Mehta, Puja K; Haftbaradaran, Afsaneh; Jones, Erika; Gill, Edward; Sharif, Behzad; Slomka, Piotr J; Li, Debiao; Shufelt, Chrisandra L; Minissian, Margo; Berman, Daniel S; Bairey Merz, C Noel; Thomson, Louise E J

    2016-02-01

    Angina, heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD) are more common in women and are associated with adverse cardiovascular prognosis. Cardiac magnetic resonance imaging (CMRI) is established for assessment of left ventricular (LV) morphology and systolic function and is increasingly used to assess myocardial perfusion and diastolic function. Indeed, stress CMRI allows measurement of myocardial perfusion reserve index (MPRI) using semi-quantitative techniques, and quantification of LV volumetric filling patterns provides valuable insight into LV diastolic function. The utility of these two techniques remains limited, because reference control values for MPRI and LV diastolic function in asymptomatic middle-aged, women have not previously been established. To address this limitation, we recruited twenty women, without clinical cardiovascular disease or cardiovascular risk factors, with normal maximal Bruce protocol exercise treadmill testing. Subjects underwent CMRI (1.5 tesla) using a standardized protocol of adenosine stress and rest perfusion and LV cinematic imaging. Commercially available with automated CMRI segmentation was used for calculation of MPRI, LV filling profiles, and ejection fraction. Mean age was 54±9 years and mean body mass index was 25±4 kg/m(3). The exercise treadmill testing results demonstrated a normotensive group with normal functional capacity and hemodynamic response. We report reference control values for semi-quantitative MPRI as well as measures of LV systolic and diastolic function including ejection fraction, stroke volume, peak filling rate (PFR), PFR adjusted for end-diastolic volume (EDV) and stroke volume, time to PFR, and EDV index. The data herein provide reference values for MPRI and diastolic function in a cohort of healthy, middle-aged of women. These reference values may be used for comparison with a

  13. Cardiac magnetic resonance imaging for myocardial perfusion and diastolic function—reference control values for women

    Science.gov (United States)

    Bakir, May; Wei, Janet; Nelson, Michael D.; Mehta, Puja K.; Haftbaradaran, Afsaneh; Jones, Erika; Gill, Edward; Sharif, Behzad; Slomka, Piotr J.; Li, Debiao; Shufelt, Chrisandra L.; Minissian, Margo; Berman, Daniel S.; Bairey Merz, C. Noel

    2016-01-01

    Angina, heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD) are more common in women and are associated with adverse cardiovascular prognosis. Cardiac magnetic resonance imaging (CMRI) is established for assessment of left ventricular (LV) morphology and systolic function and is increasingly used to assess myocardial perfusion and diastolic function. Indeed, stress CMRI allows measurement of myocardial perfusion reserve index (MPRI) using semi-quantitative techniques, and quantification of LV volumetric filling patterns provides valuable insight into LV diastolic function. The utility of these two techniques remains limited, because reference control values for MPRI and LV diastolic function in asymptomatic middle-aged, women have not previously been established. To address this limitation, we recruited twenty women, without clinical cardiovascular disease or cardiovascular risk factors, with normal maximal Bruce protocol exercise treadmill testing. Subjects underwent CMRI (1.5 tesla) using a standardized protocol of adenosine stress and rest perfusion and LV cinematic imaging. Commercially available with automated CMRI segmentation was used for calculation of MPRI, LV filling profiles, and ejection fraction. Mean age was 54±9 years and mean body mass index was 25±4 kg/m3. The exercise treadmill testing results demonstrated a normotensive group with normal functional capacity and hemodynamic response. We report reference control values for semi-quantitative MPRI as well as measures of LV systolic and diastolic function including ejection fraction, stroke volume, peak filling rate (PFR), PFR adjusted for end-diastolic volume (EDV) and stroke volume, time to PFR, and EDV index. The data herein provide reference values for MPRI and diastolic function in a cohort of healthy, middle-aged of women. These reference values may be used for comparison with a variety

  14. Predictive value of cardiac troponin T and I in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Faiza Rawas Kalaji

    2012-01-01

    Full Text Available Cardiac troponin T (cTnT and I (cTnI levels are considered as important diagnostic tools in acute coronary events. They could be of predictive value in hemodialysis (HD patients. The aim of this study was to determine the prevalence of increased cTnI and cTnT in HD patients and their prognostic relevance to all-cause mortality. We measured cTnT and cTnI at baseline in 145 asymptomatic HD patients. We used three different cut-off criteria to define elevated cardiac troponin levels as follows: the 99 th percentile of a reference population, the lowest concentration to give a 10% imprecision [10% coefficient of variation (10% CV] and the relative operating characteristic (ROC curve-determined value optimized for diagnostic sensitivity and specificity for detection of myocardial injury (MI. These concentrations were 0.01 ng/mL, 0.03 ng/mL and 0.1 ng/mL for cTnT and 0.2 ng/mL, 0.6 ng/mL and 1 ng/mL for cTnI, respectively. Patients were followed for all-cause mortality (median follow-up 551 days. Kaplan-Meier survival curves, log-rank test and Cox models were employed to determine whether baseline cTnT and cTnI levels were predictive of mortality. Greater percentages of patients had an increased cTnT versus cTnI at each cut-off as follows: 99 th percentile, 90.3% versus 35.2%; 10% CV, 73.1% versus 2.1%; and ROC, 20.7% versus 0.7%. During follow-up, 40 patients died. Elevated cTnT levels above the ROC concentration were associated with increased mortality, although it was not significant after adjustment for other risk factors. Univariate and adjusted hazard ratios were 2.3 [confidence intervals (CI, 1.2-4.5; P = 0. 01] and 1.9 (CI, 0.9-3.9; P = 0.07. No differences were found for cTnI levels. Diabetes mellitus was also an independent predictor of mortality. There is a high prevalence of positive cTnT and cTnI in asymptomatic HD patients, with a greater number of patients having an increased cTnT. Elevated troponin T, but not cTnI, seems to be

  15. Analysis of prognostic value of clinical information and myocardial perfusion imaging in diabetic patients on cardiac events occurrence

    International Nuclear Information System (INIS)

    Objective: To explore the risk factors of cardiac event (CE) occurrence and evaluate the prognostic value of myocardial perfusion imaging (MPI) in diabetic patients. Methods: We conducted a study with 172(16.4%) consecutively registered patients with diabetes (132 males, 40 females; age range 16-90 years, mean age 55.94±12.46 years) and 875(83.6%) patients without diabetes with known or suspected coronary artery disease (CAD) undergoing SPECT MPI. Follow-up information was obtained through telephone interviews. Patients were followed up for at least 18 months. End points were defined as death due to primary cardiac cause, or nonfatal acute myocardial infarction and revascularization. The mean time of follow-up was 33.25±14.95 (1∼56) months. Results: Logistic stepwise regression analysis evaluated history of smoking and drinking, hypertension, hyperlipemia and the family history of CAD as predictors. A multiple regression formula was obtained: Y=-5.593+0.958X1+0.921 X2+0.428X3, (Y=cardiac events, X1=diabetes, X2=the family history of CAD, X3=hypertension). Diabetes, the family history of CAD and hypertension were dangerous factors for cardiac events, but hyperlipemia, history of smoking and drinking were protective factors for cardiac events. Over the follow-up period, there are 42 cardiac events in diabetic group, 86 in non-diabetic group. Patients with diabetes had significantly higher rates of cardiac events (24.4% versus 9.8%; chi-square 28.5, P<0.0001), compared with rates among patients without diabetes (table 1). Kaplan-Meier survival curves analyzing the no-CE rates in the diabetic and non-diabetic groups, diabetic patients were significantly lower than non-diabetic ones (Log-rank statistic, chi-square 28.75, P <0.0001). Of 172 diabetic patients, 32.2% of the patients with abnormal MPI occurred cardiac events, but only 7.4% of the patients with normal ones did(chi-square 12.34, P <0.001) (figure 1). Abnormal SPECT MPI was associated with the higher rate

  16. Singular value decomposition of optically-mapped cardiac rotors and fibrillatory activity

    International Nuclear Information System (INIS)

    Our progress of understanding how cellular and structural factors contribute to arrhythmia is hampered in part because of controversies as to whether a fibrillating heart is driven by a single, several, or multiple number of sources, whether they are focal or reentrant and how to localize them. Here we demonstrate how a novel usage of the neutral singular value decomposition (SVD) method enables the extraction of the governing spatial and temporal modes of excitation from a rotor and fibrillatory waves. Those modes highlight patterns and regions of organization in the midst of the otherwise seemingly random propagating excitation waves. We apply the method to experimental models of cardiac fibrillation in rabbit hearts. We show that SVD analysis is able to enhance the classification of the heart electrical patterns into regions harboring drivers in the form of fast reentrant activity and other regions of by-standing activity. This enhancement is accomplished without any prior assumptions regarding the spatial, temporal or spectral properties of those drivers. The analysis corroborates that the dominant mode has the highest activation rate and further reveals a new feature: a transfer of modes from the driving to passive regions resulting in a partial reaction of the passive region to the driving region. (paper)

  17. Value of cardiac multislice spiral CT for the assessment of degenerative aortic stenosis: comparison with echocardiography

    International Nuclear Information System (INIS)

    Objective: To non-invasively assess the severity of aortic valve stenosis (AS) by the determination of aortic valve calcification (AVC) using multislice spiral computed tomography (MSCT). Materials and Methods: Forty-one consecutive patients (17 male, 24 female, mean age 71.0±7.9 years) with a history of AS and an aortic valve area ≤2 cm2 underwent retrospectively ECG-gated 4-slice MSCT and echocardiography. The AVCs were quantitatively assessed using the score described by Agatston as well as by calculating the calcium mass. The echocardiographically determined aortic valve area (AVA) and the severity of AS according to the ACC/AHA guidelines were compared to the degree of a aortic valve calcifications. Pearson's correlation coefficient, cut-off values, kappa test and F-test with post hoc Boneferroni t-tests were calculated. Results: Calcium scores were significantly higher in patients with severe AS, when compared to mild or moderate AS (p<0.001). In patients suffering from severe AS, the mean Agatston score was 4125.5±1168.9 (calcium mass 904.1±263.3) while in patients with moderate and mild AS the corresponding values were 1596.3±987.0 (319.1±208.3) and 785.9±390.1 (149.1±90.2), respectively. Pearson's correlation coefficients were r-=0.75 for the Agatston score and r=-0.72 for the calcium mass. There was a moderate agreement between severity of AS according to the ACC/AHA guidelines and the degree of AS determined from AVC scores with κ=0.6091 and κ=0.6985, respectively. Conclusion: Severe AS may be differentiated from moderate or mild AS using cardiac MSCT. Extensive calcifications of the aortic valve presenting with an Agatston-Score ≥2824 (calcium mass ≥611) indicate a severe AS and should be taken as an indication for further diagnostic workup. (orig.)

  18. Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.; Videbæk, Lars; Villadsen, Henrik D.; Haghfelt, Torben

    2006-01-01

    accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography and...

  19. 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...

  20. Groundwater and stream threshold values for targeted and differentiated output based regulation of nutrient loadings to ecosystems

    Science.gov (United States)

    Hinsby, Klaus; Refsgaard, Jens Christian

    2015-04-01

    even field scale based on estimated acceptable nutrient loadings to transitional and coastal waters (or any other protected aquatic ecosystem in the river basin) according to the requirements of the EU Water Framework and Groundwater directives, and use these to monitor and plan sustainable water and land use management, e.g. by differentiated practices in farming and land use within sub-catchments. Specifically, we suggest that monitoring of the nitrogen outputs from catchments, sub-catchment and even delineated specific fields with new cost-effective monitoring systems in combination with coupled soil-groundwater-surface water models has a large potential for the development of efficient differentiated measures controlling nutrient loadings to aquatic ecosystems. Here we present initial considerations and suggestions for the development of new governance concepts targeted at differentiated output based regulations using threshold values for N in groundwater and streams derived from acceptable loadings to a small Danish estuary.

  1. Transoesophageal echocardiography improves the diagnostic value of cardiac ultrasound in patients with carcinoid heart disease.

    OpenAIRE

    Lundin, L.; Landelius, J; Andrén, B; Oberg, K.

    1990-01-01

    Transthoracic and transoesophageal cardiac echocardiography and Doppler investigations were performed in 31 consecutive patients with malignant midgut carcinoid tumours. The transoesophageal images allowed measurement of the thickness of the atrioventricular valve leaflets and the superficial wall layers on the cavity side of both atria. The mean thickness of the anterior tricuspid leaflet was significantly greater than that of the mitral valve--a difference not seen in a control group of age...

  2. REGULATION OF INSTANTANEOUS POWER OUTPUT VALUE IN MAGNETRON WITH CONTINUOUS GENERATION MODE (M-105-, M-112-TYPES BEING PART OF PLASMA TECHNOLOGICAL UNIT

    Directory of Open Access Journals (Sweden)

    S. V. Bordusov

    2010-01-01

    Full Text Available The paper presents results of investigations pertaining to the possibility of regulating instantaneous power output  in a magnetron of M-105 (M-112-type by changing the capacity value of a capacitor in structure diagram for doubling voltage of high-voltage power supply on the basis of a step-up transformer operating in the saturation regime.

  3. Postoperative myocardial infarction and cardiac death. Predictive value of dipyridamole-thallium imaging and five clinical scoring systems based on multifactorial analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lette, J.; Waters, D.; Lassonde, J.; Dube, S.; Heyen, F.; Picard, M.; Morin, M. (Maisonneuve-Rosemont Hospital, Montreal (Canada))

    1990-01-01

    Sixty-six patients unable to complete a standard preoperative exercise test because of physical limitations were studied to determine the predictive value of individual clinical parameters, of clinical scoring systems based on multifactorial analysis, and of dipyridamole-thallium imaging before major general and vascular surgery. Study endpoints were limited to postoperative myocardial infarction or cardiac death before hospital discharge. There were nine postoperative cardiac events (seven deaths and two nonfatal infarctions). There was no statistical correlation between cardiac events and preoperative clinical descriptors, including individual clinical parameters, the Dripps-American Surgical Association score, the Goldman Cardiac Risk Index score, the Detsky Modified Cardiac Risk Index score, Eagle's clinical markers of low surgical risk, and the probability of postoperative events as determined by Cooperman's equation. There were no cardiac events in 30 patients with normal dipyridamole-thallium scans or in nine patients with fixed myocardial perfusion defects. Of 21 patients with reversible perfusion defects who underwent surgery, nine had a postoperative cardiac event (sensitivity, 100%; specificity, 43%). In the six other patients with reversible defects, preoperative angiography showed severe coronary disease or cardiomyopathy. Thus in patients unable to complete a standard exercise stress test, postoperative outcome cannot be predicted clinically before major general and vascular surgery, whereas dipyridamole-thallium imaging successfully identified all patients who sustained a postoperative cardiac event.

  4. Postoperative myocardial infarction and cardiac death. Predictive value of dipyridamole-thallium imaging and five clinical scoring systems based on multifactorial analysis

    International Nuclear Information System (INIS)

    Sixty-six patients unable to complete a standard preoperative exercise test because of physical limitations were studied to determine the predictive value of individual clinical parameters, of clinical scoring systems based on multifactorial analysis, and of dipyridamole-thallium imaging before major general and vascular surgery. Study endpoints were limited to postoperative myocardial infarction or cardiac death before hospital discharge. There were nine postoperative cardiac events (seven deaths and two nonfatal infarctions). There was no statistical correlation between cardiac events and preoperative clinical descriptors, including individual clinical parameters, the Dripps-American Surgical Association score, the Goldman Cardiac Risk Index score, the Detsky Modified Cardiac Risk Index score, Eagle's clinical markers of low surgical risk, and the probability of postoperative events as determined by Cooperman's equation. There were no cardiac events in 30 patients with normal dipyridamole-thallium scans or in nine patients with fixed myocardial perfusion defects. Of 21 patients with reversible perfusion defects who underwent surgery, nine had a postoperative cardiac event (sensitivity, 100%; specificity, 43%). In the six other patients with reversible defects, preoperative angiography showed severe coronary disease or cardiomyopathy. Thus in patients unable to complete a standard exercise stress test, postoperative outcome cannot be predicted clinically before major general and vascular surgery, whereas dipyridamole-thallium imaging successfully identified all patients who sustained a postoperative cardiac event

  5. Value of cardiac 320-multidetector computed tomography and cardiac magnetic resonance imaging for assessment of myocardial perfusion defects in patients with known chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Qayyum, Abbas Ali; Kühl, Jørgen T; Mathiasen, Anders B;

    2013-01-01

    The challenge for therapies targeting perfusion abnormalities is to identify and evaluate the region of interest. The aim of this study was to compare rest and stress myocardial perfusion measured by cardiac multi-detector computed tomography (MDCT) and cardiac magnetic resonance (CMR) imaging in...

  6. Value of In-111 antimyosin in the diagnosis of cardiac transplant rejection

    International Nuclear Information System (INIS)

    The authors have tested the clinical reliability and utility of 111-In antimyosin (IN-AM) in patients with suspected cardiac transplant rejection and in 20 control patients. They have studied 36 patients within 4 days before or after endomyocardial biopsy (EMB). Single-photon emission CT (SPECT) images were obtained 48 hours after injection. The images were interpreted visually and by calculation of a heart-to-lung ratio (H/L). H/L > 1.6 demonstrated various stages of rejection episodes. In six false-negative studies, four patients were treated with a bolus injection of high-dose steroids before IN-AM injection. Two patients developed human antimouse antibodies (HAMA) after repeated injection. A normalizing in EMB finding always correlated with a decrease in the H/L ratio

  7. Left ventricular AV-plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output

    DEFF Research Database (Denmark)

    Steding-Ehrenborg, Katarina; Boushel, Robert C; Calbet, José A; Åkeson, Per; Mortensen, Stefan P

    2015-01-01

    BACKGROUND: Age-related decline in cardiac function can be prevented or postponed by lifelong endurance training. However, effects of normal ageing as well as of lifelong endurance exercise on longitudinal and radial contribution to stroke volume are unknown. The aim of this study was to determine...

  8. NONINVASIVE CARDIAC OUTPUT MONITORING DURING EXERCISE TESTING: NEXFIN PULSE CONTOUR ANALYSIS COMPARED TO AN INERT GAS REBREATHING METHOD AND RESPIRED GAS ANALYSIS

    NARCIS (Netherlands)

    S.A. Bartels; W.J. Stok; R. Bezemer; R.J. Boksem; J Goudoever; T.G.V. Cherpanath; J.J. van Lieshout; B.E. Westerhof; J.M. Karemaker; C. Ince

    2011-01-01

    Purpose. Exercise testing is often used to assess cardiac function during physical exertion to obtain diagnostic information. However, this procedure is limited to measuring the electrical activity of the heart using electrocardiography and intermittent blood pressure (BP) measurements and does not

  9. Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental Veno-arterial difference of carbondioxide as a predictor of low cardiac output in an experimental pediatric model

    Directory of Open Access Journals (Sweden)

    Franco Díaz

    2012-01-01

    Full Text Available Background: Cardiac output (CO measurement is not a standard of care for critically ill children, but it can be estimated by indirect methods such as veno-arterial pCO2 difference (ΔVACO2. Aim: To determine the correlation between CO and ΔVACO2 and evaluate the usefulness of ΔVACO2 in the diagnosis of low CO in an experimental pediatric model. Materials and Methods: Thirty piglets weighing 4.8 ± 0.35 kg were anesthetized and monitored with transpulmonary thermodilution. Lung injury was induced with tracheal instillation of Tween 20®. Serial measurements of central venous and arterial blood gases, as well as CO, were obtained at baseline, 1, 2 and 4 h after lung injury induction. Low cardiac output (LCO was defined as CO lower than 2.5 Llminlm². Results: There was an inverse correlation between CO and ΔVACO2 (r = -0.36, p < 0.01. ΔVACO2 was 14 ± 8 mmHg in LCO state and 8 ± 6 mmHg when this condition was not present (p < 0.01. Area under the receiver operating characteristic (ROC curves of ΔVACO2 and LCO state was 0.78 (0.68-0.86. The best cut-point was 8.9 mmHg to determine LCO with a sensibility 0.78, specificity 0.7, positive predictive value 0.27 and negative predictive value 0.96. Conclusions: In this model there was an inverse correlation between ΔVACO2 and CO. The best cutoff value to discard LCO was ΔVACO2 of 8.9 mmHg, indicating that under this value the presence of LCO is very unlikely.

  10. 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.

  11. Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry

    Directory of Open Access Journals (Sweden)

    Peter Agergaard

    2011-02-01

    Full Text Available Peter Agergaard1, Anders Hebert2, Jesper Bjerre3, Karina Meden Sørensen4, Charlotte Olesen3, John Rosendal Østergaard31Department of Pediatrics, Viborg Hospital, Viborg, Denmark; 2Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Denmark; 3Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark; 4Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, DenmarkIntroduction: The present study was conducted to establish the positive predictive value of congenital cardiac malformation diagnoses registered in the Danish National Patient Registry (NPR, thereby exploring whether the NPR can serve as a valid tool for epidemiologic studies of congenital cardiac malformations.Materials and methods: The study population comprised every individual born from 2000 to 2008 who was registered in the NPR with a congenital cardiac malformation diagnosis and treated at one of the two national departments of pediatric cardiology. Positive predictive values were established comparing NPR information with the clinical record of each individual.Results: A total of 2952 patients with a total of 3536 diagnoses were eligible for validation. Review of their clinical records unveiled no patient without cardiac malformation. In 98% (98%–99% of the cases, the NPR diagnosis could be found as the discharge diagnosis in the patient's clinical record, and in 90% (89%–91% of the cases the NPR diagnosis was considered a true reflection of the patient's actual malformation.Conclusions: Our study verifies that the present study population retrieved from the NPR is a valid tool for epidemiological research within the topic of congenital cardiac malformations, given that the research question is not dependent on a fully established sensitivity of the NPR. Precautions should be made regarding cardiac malformations characterized by low prevalence or poor predictive values, and the reported validity should not be

  12. Implementation, validation and review of a critical values list in a cardiac emergency room

    Directory of Open Access Journals (Sweden)

    Dilênia de Oliveira Cipriano Torres

    2014-10-01

    Full Text Available Introduction: Laboratory critical values (CV can indicate threatening conditions that require rapid clinical intervention. The aim of this study was to implement, validate and review a critical values list (CVL at Pronto-Socorro Cardiológico de Pernambuco - Universidade de Pernambuco (PROCAPE-UPE. Method: This study was conducted between 2011 and 2013. To formulate the CVL, laboratory tests performed at PROCAPE were analyzed and compared with those of the Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC and the College of American Pathologists (CAP. A draft CVL was validated by physicians; staff training and the standard operating procedure were developed covering the entire clinical analysis laboratory, in order to formalize the procedure of critical result reporting. The CVL was updated every six months. Results: Changes were made in CV intervals for the measurement of total serum calcium, serum sodium, serum potassium, the international normalized ratio (INR and total leukocyte count. Thyroid-stimulating hormone (TSH was also included in the CVL. In the pediatric CVL, dosages of serum sodium and INR were included, and a change in the value of serum potassium was made. Thus, periodic reviews of CVL allowed greater adequacy to the needs of the study population and avoided overloading the notification process. Conclusion: Clinical laboratories must be responsible for the implementation, validation and review of their CVL to ensure patients’ health.

  13. Age- and gender-specific reference values for cardiac chamber geometry and function using three-dimensional echocardiography

    OpenAIRE

    Badano, Luigi P.

    2014-01-01

    Background. Three-dimensional echocardiography (3DE) enables a comprehensive, accurate and reproducible quantification of cardiac chamber size and function without any geometric assumption about their shape. Superior accuracy and reproducibility of 3DE over stabdard two-dimensional (2DE) approach for cardiac chamber volume measurements in comparison to cardiac magnetic resonance (CMR) has been well documented in a number of studies. Both the European Association of Cardiovascular Imag...

  14. Estimation of utility values from visual analog scale measures of health in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Oddershede L

    2014-01-01

    Full Text Available Lars Oddershede,1,2 Jan Jesper Andreasen,1 Lars Ehlers2 1Department of Cardiothoracic Surgery, Center for Cardiovascular Research, Aalborg University Hospital, Aalborg, Denmark; 2Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Aalborg East, Denmark Introduction: In health economic evaluations, mapping can be used to estimate utility values from other health outcomes in order to calculate quality adjusted life-years. Currently, no methods exist to map visual analog scale (VAS scores to utility values. This study aimed to develop and propose a statistical algorithm for mapping five dimensions of health, measured on VASs, to utility scores in patients suffering from cardiovascular disease. Methods: Patients undergoing coronary artery bypass grafting at Aalborg University Hospital in Denmark were asked to score their health using the five VAS items (mobility, self-care, ability to perform usual activities, pain, and presence of anxiety or depression and the EuroQol 5 Dimensions questionnaire. Regression analysis was used to estimate four mapping models from patients' age, sex, and the self-reported VAS scores. Prediction errors were compared between mapping models and on subsets of the observed utility scores. Agreement between predicted and observed values was assessed using Bland–Altman plots. Results: Random effects generalized least squares (GLS regression yielded the best results when quadratic terms of VAS scores were included. Mapping models fitted using the Tobit model and censored least absolute deviation regression did not appear superior to GLS regression. The mapping models were able to explain approximately 63%–65% of the variation in the observed utility scores. The mean absolute error of predictions increased as the observed utility values decreased. Conclusion: We concluded that it was possible to predict utility scores from VAS scores of the five

  15. The predictive value of gastric reactance for postoperative morbidity and mortality in cardiac surgery patients

    International Nuclear Information System (INIS)

    No useful method to directly monitor the level of end organ tissue injury is currently available clinically. Gastric reactance has been proposed to measure changes in a tissue structure caused by ischemia. The purpose of this study was to assess whether gastric reactance is a reliable, clinically relevant predictor of complications and a potentially useful tool to assess hypoperfusion in cardiovascular surgery patients. The value of gastric reactance measurements, standard hemodynamic and regional perfusion variables, and scores to predict postoperative complications were compared in 55 higher risk cardiovascular surgery patients with cardiopulmonary bypass. Low frequency gastric reactance, XL, had a significant predictive value of postoperative persistent shock requiring more than 48 h of vasopressors and associated complications, before, during and after surgery (p L > 26) before surgery had a significantly higher incidence of complications, higher mortality and more days in the ICU than patients with a low reactance (XL L was found to be a reliable and clinically relevant measurement. These results justify further clinical research to explore how this information may be used to improve patient management

  16. 金融业总产出与不变价增加值核算探析%Accounting Gross Output and Value Added in Constant Prices of Financial Industry

    Institute of Scientific and Technical Information of China (English)

    陈维义; 李凯; 张东光

    2005-01-01

    This paper discusses the problem of the financial total output and real value added accounting method in theory, and connect it with the current accounting system. Then provide some views on improving the financial total output accounting method, especially provide concrete train of thought about improving the real total output and real value added accounting method in finance through comprehensive deposit rate index and loan rate index.

  17. The Economic Value of Korean Nuclear Power Industry in the National Economy: An Input-Output Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M. K.; Kim, S. S.; Lee, J. H.; Kim, S. H. [Nuclear Policy Research Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    In 1978, Korea introduced the first nuclear power plant, Kori-1 unit, in parallel with the nation's industrialization policy. Thereafter, Korea has carried out a very ambitious nuclear power program and sustained a strong commitment to nuclear power development. Thus, nuclear is a prime energy source which presently meets about 30 percent of Korea's power demands. Also, Korea won a contract for APR-1400 NPPs to the UAE in 2009 which led to Korea as a significant exporter in the world nuclear market. Recently, the new government of Korea has been launching 'Creative Economy', from this perspective, the quantitative contributions of nuclear sector to the national economic growth are required to be estimated. This paper is to estimate quantitatively the economic values created by nuclear power industry in the framework of national economy. The total economic values created by nuclear power industry are estimated to be 63.6 trillion won for the study period.

  18. The Economic Value of Korean Nuclear Power Industry in the National Economy: An Input-Output Analysis

    International Nuclear Information System (INIS)

    In 1978, Korea introduced the first nuclear power plant, Kori-1 unit, in parallel with the nation's industrialization policy. Thereafter, Korea has carried out a very ambitious nuclear power program and sustained a strong commitment to nuclear power development. Thus, nuclear is a prime energy source which presently meets about 30 percent of Korea's power demands. Also, Korea won a contract for APR-1400 NPPs to the UAE in 2009 which led to Korea as a significant exporter in the world nuclear market. Recently, the new government of Korea has been launching 'Creative Economy', from this perspective, the quantitative contributions of nuclear sector to the national economic growth are required to be estimated. This paper is to estimate quantitatively the economic values created by nuclear power industry in the framework of national economy. The total economic values created by nuclear power industry are estimated to be 63.6 trillion won for the study period

  19. Determinación y análisis comparativo de gasto cardíaco en enfermos críticos mediante Doppler transesofágico y termodilución en bolos: Experiencia preliminar Comparison of cardiac output measurement in critical patients using transesophageal Doppler or thermodilution: A preliminary report

    Directory of Open Access Journals (Sweden)

    Max Andresen H

    2005-07-01

    Full Text Available Background: Cardiac output can be measured non invasively by transesophageal Doppler. This is an alternative to measure it by thermodilution with a catheter in the pulmonary artery. Aim: To compare both methods of cardiac output measurement. Material and methods: Simultaneous measurement of cardiac output by transesophageal Doppler and thermodilution with a catheter in the pulmonary artery in four male critical patients, aged 60±12 years, hospitalized in a University Hospital. The Bland and Altman method to compare the concordance between two measurements, was used. Results: Forty measurements were performed. The results of both methods had a correlation coefficient of 0.98. According to the Bland and Altman method, the difference between both methods was -0.5 L with a precision of 0.52 L/min (95% confidence interval -1.51 to 0.52 L/min. Considering that a change between two sequential measurements is considered significant when the difference is more than 15%, both measurements agreed in 83% of cases, that there was a change in cardiac output. Conclusions:Transesophageal Doppler is a promising non invasive technique to measure cardiac output in critical care patients. It becomes a valid alternative to the thermodilution technique. This preliminary experience must be confirmed in a larger series

  20. Troponin not just a simple cardiac marker: prognostic significance of cardiac troponin

    Institute of Scientific and Technical Information of China (English)

    Benny Mulyanto Setiadi; LEI Han; CHANG Jing

    2009-01-01

    Objective The object of this study was to review the role of cardiac troponin as a prognostic factor in acute coronary syndrome patients of varying circumstances.Data sources The data used in this review were obtained mainly from the studies of cardiac troponin reported in pubmed from 1981 to 2006.Study selection Relevant articles on studies of cardiac troponin were selected.Results Elevated cardiac troponin in patients with ST elevation and non ST elevation myocardial infarction was associated with adverse outcomes, including a higher incidence of congestive heart failure, shock, and death. Patients with elevated cardiac troponin value seemed to benefit more from invasive strategies including a percutaneous coronary intervention and bypass surgery, but elevated cardiac troponin was also correlated with adverse outcomes, including a higher degree of failure, shock, and mortality in patients undergoing percutaneous coronary intervention; a higher degree of perioperative myocardial infarction, low cardiac output syndrome, cardiopulmonary resuscitation, and new-onset ventricular arrhythmia in patients undergoing bypass surgery were also observed. Elevated troponin after a percutaneous coronary intervention seemed to be associated with short-term adverse outcomes rather than long-term adverse outcomes, unless the elevation of the troponin post percutaneous coronary intervention was quite high (about 5 times above normal). On the contrary, elevated cardiac troponin after bypass surgery was more confusing to analyze since it happened in almost all patients. Furthermore, differences in cutoff values and time measurements in some studies add more confusion; thus, further research is warranted.Conclusions The prognostic value of cardiac troponin is demonstrated in almost all acute coronary syndrome patients. In addition to its high sensitivity and specificity, the prognostic value of cardiac troponin is another reason to make it the "golden cardiac marker' of this time.

  1. Verification of Fourier phase and amplitude values from simulated heart motion using a hydrodynamic cardiac model

    International Nuclear Information System (INIS)

    Using pusher-plate-type artificial hearts, changes in the degree of synchrony and stroke volume were compared to phase and amplitude calculations from the first Fourier component of individual-pixel time-activity curves generated from gated radionuclide images (RNA) of these hearts. In addition, the ability of Fourier analysis to quantify paradoxical volume shifts was tested using a ventricular aneurysm model by which the Fourier amplitude was correlated to known increments of paradoxical volume. Predetermined phase-angle differences (incremental increases in asynchrony) and the mean phase-angle difference calculated from RNAs showed an agreement of -70+-4.40 (mean +-SD). A strong correlation was noted between stroke volume and Fourier amplitude (r=0.98; P<0.0001) as well as between the paradoxical volume accepted by the 'aneurysm' and the Fourier amplitude (r=0.97; P<0.0001). The degree of asynchrony and changes in stroke volume were accurately reflected by the Fourier phase and amplitude values, respectively. In the specific case of ventricular aneurysms, the data demonstrate that using this method, the paradoxically moving areas may be localized, and the expansile volume within these regions can be quantified. (orig.)

  2. Reference absolute and indexed values for left and right ventricular volume, function and mass from cardiac computed tomography

    International Nuclear Information System (INIS)

    Left ventricular (LV) and right ventricular (RV) volumetric and functional parameters are important biomarkers for morbidity and mortality in patients with heart failure. To retrospectively determine reference mean values of LV and RV volume, function and mass normalised by age, gender and body surface area (BSA) from retrospectively electrocardiographically gated 64-slice cardiac computed tomography (CCT) by using automated analysis software in healthy adults. The study was approved by the institutional review board with a waiver of informed consent. Seventy-four healthy subjects (49% female, mean age 49.6±11) free of hypertension and hypercholesterolaemia with a normal CCT formed the study population. Analyses of LV and RV volume (end-diastolic, end-systolic and stroke volumes), function (ejection fraction), LV mass and inter-rater reproducibility were performed with commercially available analysis software capable of automated contour detection. General linear model analysis was performed to assess statistical significance by age group after adjustment for gender and BSA. Bland–Altman analysis assessed the inter-rater agreement. The reference range for LV and RV volume, function, and LV mass was normalised to age, gender and BSA. Statistically significant differences were noted between genders in both LV mass and RV volume (P-value<0.0001). Age, in concert with gender, was associated with significant differences in RV end-diastolic volume and LV ejection fraction (P-values 0.027 and 0.03). Bland–Altman analysis showed acceptable limits of agreement (±1.5% for ejection fraction) without systematic error. LV and RV volume, function and mass normalised to age, gender and BSA can be reported from CCT datasets, providing additional information important for patient management.

  3. Prognostic value of cardiac magnetic resonance imaging for idiopathic pulmonary arterial hypertension before initiating intravenous prostacyclin therapy

    International Nuclear Information System (INIS)

    Because few have reported the prognostic significance of cardiac magnetic resonance imaging (CMR) for idiopathic pulmonary arterial hypertension (IPAH), in this study we evaluated the value of CMR measurements as a prognostic predictor of IPAH before starting intravenous prostacyclin therapy. A total of 121 consecutive CMR studies for evaluating right ventricular (RV) function were reviewed. Forty-one patients were diagnosed with IPAH and served as the study group. Factors, such as age, sex, New York Heart Association functional class (NYHAFC), 6-min walk test, plasma brain natriuretic peptide level, serum uric acid level and CMR measurements were analyzed as predictors of first hospitalization and death. The mean follow-up period was 1,350±769 days. Nine patients were hospitalized because of heart failure, and 4 patients died from cardiopulmonary causes. The univariate analyses suggested that the left ventricular (LV) mass index, the left and right ventricular end-diastolic volume indices (LVEDVI, RVEDVI), the LV and RV end-systolic volume indices (LVESVI, RVESVI) and NYHAFC predicted the risk for hospitalization and that RVEDVI, RVESVI and NYHAFC predicted mortality. The multivariate analyses suggested that RVEDVI and NYHAFC are independent predictors of both hospitalization and mortality. The effects of RVEDVI and NYHAFC on hospitalization were not substantially affected by the concomitant medication. In IPAH patients, the RVEDVI predicts both hospitalization for right heart failure and mortality before initiating intravenous prostacyclin therapy. (author)

  4. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  5. Application and Nursing of Pulse Index Continuous Cardiac Output Monitoring in Patients with Post-cardiac Arrest Syndrome%脉波指示剂连续心排血量监测在心搏骤停后综合征患者中的应用与护理

    Institute of Scientific and Technical Information of China (English)

    陈淑兰; 刘刚; 张秋真; 陈秋恋

    2011-01-01

    Objective To investigate the application effect and nursing of the pulse index continuous cardiac output (PICCO) monitoring technique in patients with post-cardiac arrest syndrome (PCAS). Methods The precautions and nursing points were developed for the flowsheet of operation, cooperation for the vein catheterization and measurements. Results Of the 15 patients using the PICCO monitoring technique in early stage,no complication occurred ,except one patient died of multiple organ failure and 3 abandoned the treatment,and the rest 11 patients survived. Conclusion PCAS patients undergoing PICCO monitoring device in the early stage can efficiently assist the fluid management,maintain the vital signs of the patients,and save their lives.%目的 探讨脉波指示剂连续心排血量监测( pulse index continuous cardiac output,PICCO)在心搏骤停后综合征(postcardiac arrest syndrome,PCAS)患者中的应用效果及护理.方法 制定操作流程、置管配合、测量的注意事项和护理要点.结果 15例患者通过早期采用了PICCO监测,并采取了相应的护理措施,均未出现并发症,除了1例患者因多器官功能衰竭死亡外,3例患者放弃治疗,其余11例患者均存活.结论 对PCAS患者早期进行PICCO监测,能对患者进行更准确的血流动力学监测,可以有效协助液体管理,维持患者生命体征的稳定,挽救患者生命.

  6. Prognostic value of iodine-123-metaiodobenzylguanidine imaging and cardiac natriuretic peptide levels in patients with left ventricular dysfunction resulting from cardiomyopathy

    International Nuclear Information System (INIS)

    This study assessed the prognostic value of Iodine-123-metaiodobenzylguanidine (MIBG) imaging and of the plasma level of cardiac natriuretic peptides in patients with left ventricular dysfunction resulting from cardiomyopathy. Predictors of cardiac death or hospitalization related to progressive heart failure were examined in 171 patients with chronic heart failure (96 patients with idiopathic cardiomyopathy and 75 patients with ischemic cardiomyopathy). All patients underwent MIBG imaging at rest and other hemodynamic studies. During a mean (±SD) follow-up period of 27±11 months, 11 patients died from heat failure and 16 required hospitalization. High MIBG washout was an independent predictor of cardiac death (relative risk [RR]=1.158, p0.0001) and high MIBG washout (relative risk [RR]=1.094, p<0.0001) were predictors of progressive heart failure (ie, combined cardiac death and hospitalization). Accelerated myocardial adrenergic nerve activity as assessed by MIBG imaging and the plasma levels of BNP are powerful predictors of the patient's prognosis. (author)

  7. Indirect calorimetry can be used to measure cardiac output in septic patients? A calorimetria indireta pode ser utilizada para medir o débito cardíaco em pacientes sépticos?

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Martins

    2008-01-01

    Full Text Available PURPOSE: The aim of this study was to compare two different cardiac output (CO monitoring systems based on the thermodilution principle (Thermo-CO and indirect calorimetry (Fick mixed-CO in septic patients. METHODS: Prospective study in septic patients admitted in an intensive care unit of a university hospital. Nineteen patients aged on average 45.4 ± 21.5 years were enrolled in the study. Four series of hourly measurements by the two techniques were carried out simultaneously. RESULTS: No significant differences were observed between Thermo-CO and Fick mixed-CO (7.0 ± 1.8 L.min-1 and 6.4 ± 1.7 L.min-1.. Parallel analysis of Fick mixed-CO and Fick atrial-CO was performed introducing a correction factor for the eight atrial samples in order to adjust the values of oxygen saturation obtained from atrial blood (Fick corrected atrial-CO to those obtained from mixed venous blood. No significant differences could be detected between Fick mixed-CO and Fick corrected atrial-CO. The correlation coefficients of Thermo CO/Fick mixed-CO and Fick mixed-CO/Fick corrected atrial-CO were 0.84 and 0.94, respectively. CONCLUSION: We observed that the agreement between the two methods was satisfactory on the basis of the decisions made for treatment. Indirect calorimetry is useful to measure CO in patients with septic shock.OBJETIVO: O objetivo deste estudo foi comparar as medidas do débito cardíaco (DC obtidas pela termodiluição (DC-termo e pela calorimetria indireta (DC-Fick misto em pacientes com choque séptico. MÉTODOS: Estudo prospectivo em pacientes sépticos internados em unidade de terapia intensiva de um hospital universitário. Foram estudados 19 pacientes (45,4 ± 21,5 anos. Foram realizadas quatro séries de medidas do DC pelos dois métodos, simultaneamente. RESULTADOS: Não houve diferenças significativas entre os valores do DC-termo e DC-Fick misto (7,0 ± 1,8 L.min-1 e 6,4 ± 1,7 L.min-1, respectivamente. Na avaliação dos oito casos

  8. Prognostic value of dipyridamole thallium-201 screening to minimize perioperative cardiac complications in diabetics undergoing kidney or kidney-pancreas transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Mistry, B.M.; Solomon, H.; Hoff, J.; Aridge, D.L.; Lindsey, L.M.; Garvin, P.J. [Saint Louis Univ. Health Sciences Center, Div. of Abdominal Transplant, St. Louis, Missouri (United States); Bastani, B. [Saint Louis Univ. Health Sciences Center, Div. of Nephrology, St. Louis, Missouri (United States); Chaitman, B.R. [Saint Louis Univ. Health Sciences Center, Div. of Cardioiogy, St. Louis, Missouri (United States)

    1998-04-01

    To minimize perloperative cardiac events, we utilize a screening protocol consisting of intravenous dipyridamole thallium-201 myocardial imaging (DPT), with the selective use of coronary angiography based on the presence of reversible defect(s) on DPT test. A retrospective study was performed to determine the prognostic value of this protocol and to identify any clinical parameters predictive of an abnormal DPT test. To accomplish this, a detailed chart analysis of 176 consecutive kidney (n = 89) and kidney-pancreas (n = 87) transplant recipients who had undergone pre-transplant DPT testing was performed. The results of the DPT test were interpreted as normal in 111, fixed defect in 15, and reversible defect(s) in 50 patients. Forty-two of the 50 patients with reversible defect(s) underwent coronary angiography. Twelve of the 27 patients with significant coronary artery disease (CAD, > 50% stenosis in one or more coronary arteries) underwent pre-transplant revascularization and the remaining 15 were treated medically. Cardiac events (documented acute myocardial infarction or sudden cardiac death) within 6 wk of transplant were stratified by the results of this protocol. Also, various clinical parameters were compared between patients with normal and abnormal (fixed and reversible defect) DPT tests. Only one of the 111 (0.9%) transplant recipients with a normal DPT test had a perioperative cardiac event. None of the 15 (0%) patients with a fixed defect and none of the 15 (0%) patients with reversible defect(s), but a nonsignificant (<50% narrowing) coronary angiogram, had a perioperative cardiac event. Three of the 27 (11.1%) patients with reversible defect(s) and significant disease on coronary angiography, who had undergone pre-transplant revascularization of were managed medically, had a perioperative coronary event. Of 14 recipients parameters analyzed, age > 50 yr was the only variable predictive of an abnormal DPT test. (au) 33 refs.

  9. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens

    DEFF Research Database (Denmark)

    Elming, H; Holm, E; Jun, L; Torp-Pedersen, C; Køber, L; Kircshoff, M; Malik, M; Camm, J

    1998-01-01

    ratios, adjusted for age, gender, myocardial infarct, angina pectoris, diabetes mellitus, arterial hypertension, smoking habits, serum cholesterol level, and heart rate were 2.9 for the QT interval (95% confidence interval 1.1-7.8) and 4.4 for QT interval dispersion (95% confidence interval 1......AIMS: To evaluate the prognostic value of the QT interval and QT interval dispersion in total and in cardiovascular mortality, as well as in cardiac morbidity, in a general population. METHODS AND RESULTS: The QT interval was measured in all leads from a standard 12-lead ECG in a random sample of.......0-19-1). Fatal and non-fatal cardiac morbidity relative risk ratios were similar, at 2.7 (95% confidence interval 1.4-5.5) for the QT interval and 2.2 (95% confidence interval 1.1-4.0) for QT interval dispersion. CONCLUSION: Prolongation of the QT interval and QT interval dispersion independently affected the...

  10. Application of cardiac output measurement by bioelectrical impedance in critically ill patients%生物电阻抗法监测心输出量在危重病中的应用

    Institute of Scientific and Technical Information of China (English)

    刘紫锰; 杨春华; 陈娟; 欧阳彬; 管向东

    2009-01-01

    目的 探讨生物电阻抗法测量无创心输出量(CO)在危重病中应用的准确性和有效性.方法 选择2008年1月至5月间本院外科重症监护中心(SICU)收治的12例需放置SWAN-GANZ导管进行血流动力学监测的患者,同时用生物电阻抗法和SWAN-GANZ导管热稀释法测定患者CO曲线平稳后0、1、6、12、24、48 h的CO值,并应用Pearson相关对两种方法测得的CO值与时间进行分析.结果 生物电阻抗法测最的CO值在所有时间点均低于SWAN-GANZ导管热稀释法的测最值[0 h:(5.5±0.9)L/min比(7.7±1.4)L/min;1h:(5.3±0.7)L/min比(7.4±1.5)L/min;6 h:(4.6±0.6)L/min比(6.8±1.4)L/min;12 h:(5.1±0.9)L/min比(7.6±1.6)L/min;24 h:(6.1±1.1)L/min比(9.0±1.6)L/min;48 h:(6.3±1.3)L/min比(9.5±1.5)L/min;均P<0.05].两种方法测量的CO值均随着时间的延长而呈升高趋势(r=0.818,P=0.047和r=0.884,P=0.020).结论 生物电阻抗法测量的无创CO与SWAN-GANZ导管测定的患者CO同样呈时间依赖性,是一种有效的CO监测方法.%Objective To evaluate the efficacy and accuracy of non-invasive bioelectrical impedance measurement of cardiac output (CO) in critically ill patients. Methods Between January and May 2008, 12 patients who needed hemodynamics monitoring using SWAN-GANZ catheterization in surgical intensive care unit (SICU) of our hospital were measured for CO by bioelectrical impedance and SWAN-GANZ catheterization thermodilution approaches. These values were recorded at 0, 1, 6, 12, 24 and 48 hours after the CO curve became stable in these patients. Pearson correlation analysis was performed for CO values over time recorded by these two approaches. Results At all the time points, CO measurement by bioelectrical impedance yielded lower values than those by SWAN-GANZ catheterization thermodilution approach [0 h: (5.5±0.9) L/min vs (7.7±1.4) L/min; 1 h: (5.3±0.7) L/min vs (7.4±1.5) L/min; 6 h: (4.6±0.6) L/min vs (6.8±1.4) L/min; 12 h: (5.1±0.9) L/min vs (7.6±1.6) L

  11. Cardiac Time Intervals by Tissue Doppler Imaging M-Mode: Normal Values and Association with Established Echocardiographic and Invasive Measures of Systolic and Diastolic Function

    Science.gov (United States)

    Mogelvang, Rasmus; de Knegt, Martina Chantal; Olsen, Flemming Javier; Galatius, Søren; Jensen, Jan Skov

    2016-01-01

    Purpose To define normal values of the cardiac time intervals obtained by tissue Doppler imaging (TDI) M-mode through the mitral valve (MV). Furthermore, to evaluate the association of the myocardial performance index (MPI) obtained by TDI M-mode (MPITDI) and the conventional method of obtaining MPI (MPIConv), with established echocardiographic and invasive measures of systolic and diastolic function. Methods In a large community based population study (n = 974), where all are free of any cardiovascular disease and cardiovascular risk factors, cardiac time intervals, including isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and ejection time (ET) were obtained by TDI M-mode through the MV. IVCT/ET, IVRT/ET and the MPI ((IVRT+IVCT)/ET) were calculated. We also included a validation population (n = 44) of patients who underwent left heart catheterization and had the MPITDI and MPIConv measured. Results IVRT, IVRT/ET and MPI all increased significantly with increasing age in both genders (p<0.001 for all). IVCT, ET, IVRT/ET, and MPI differed significantly between males and females, displaying that women, in general exhibit better cardiac function. MPITDI was significantly associated with invasive (dP/dt max) and echocardiographic measures of systolic (LVEF, global longitudinal strain and global strainrate s) and diastolic function (e’, global strainrate e)(p<0.05 for all), whereas MPIConv was significantly associated with LVEF, e’ and global strainrate e (p<0.05 for all). Conclusion Normal values of cardiac time intervals differed between genders and deteriorated with increasing age. The MPITDI (but not MPIConv) is associated with most invasive and established echocardiographic measures of systolic and diastolic function. PMID:27093636

  12. Cardiac Time Intervals by Tissue Doppler Imaging M-Mode: Normal Values and Association with Established Echocardiographic and Invasive Measures of Systolic and Diastolic Function.

    Directory of Open Access Journals (Sweden)

    Tor Biering-Sørensen

    Full Text Available To define normal values of the cardiac time intervals obtained by tissue Doppler imaging (TDI M-mode through the mitral valve (MV. Furthermore, to evaluate the association of the myocardial performance index (MPI obtained by TDI M-mode (MPITDI and the conventional method of obtaining MPI (MPIConv, with established echocardiographic and invasive measures of systolic and diastolic function.In a large community based population study (n = 974, where all are free of any cardiovascular disease and cardiovascular risk factors, cardiac time intervals, including isovolumic relaxation time (IVRT, isovolumic contraction time (IVCT, and ejection time (ET were obtained by TDI M-mode through the MV. IVCT/ET, IVRT/ET and the MPI ((IVRT+IVCT/ET were calculated. We also included a validation population (n = 44 of patients who underwent left heart catheterization and had the MPITDI and MPIConv measured.IVRT, IVRT/ET and MPI all increased significantly with increasing age in both genders (p<0.001 for all. IVCT, ET, IVRT/ET, and MPI differed significantly between males and females, displaying that women, in general exhibit better cardiac function. MPITDI was significantly associated with invasive (dP/dt max and echocardiographic measures of systolic (LVEF, global longitudinal strain and global strainrate s and diastolic function (e', global strainrate e(p<0.05 for all, whereas MPIConv was significantly associated with LVEF, e' and global strainrate e (p<0.05 for all.Normal values of cardiac time intervals differed between genders and deteriorated with increasing age. The MPITDI (but not MPIConv is associated with most invasive and established echocardiographic measures of systolic and diastolic function.

  13. Prognostic value of cardiac time intervals measured by tissue Doppler imaging M-mode in the general population

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; Jensen, Jan Skov

    2015-01-01

    -mode through the mitral leaflet. IVCT/ET, IVRT/ET and the myocardial performance index (MPI=(IVRT+IVCT)/ET) were calculated. RESULTS: During follow-up (median 10.8 years), 383 (20%) participants reached the combined endpoint MACE (ischaemic heart disease, heart failure or cardiac death). After multivariable...... adjustment for clinical predictors and conventional echocardiography, only the combined indexes, including information on both systolic and diastolic performance (IVRT/ET and MPI), remained significant prognosticators (p<0.05 for both). Adding IVRT/ET or MPI to a model already including all other...... echocardiographic parameters resulted in a significant increase in the c-statistics (0.76 vs 0.75 p<0.01 for both). IVRT/ET or MPI improved reclassification significantly when added to the clinical predictors (p<0.05 for both). CONCLUSIONS: In the general population, the combined cardiac time intervals that include...

  14. Multi-slice CT (MSCT) in cardiac function imaging: threshold-value-supported 3D volume reconstructions to determine the left ventricular ejection fraction in comparison to MRI

    International Nuclear Information System (INIS)

    Purpose: To assess MSCT of the heart to determining left ventricular ejection fraction (EF) based on threshold-value-supported 3D volume reconstructions compared to MRI. Methods: Cardiac MSCT was performed in 7 patients. Images were reconstructed during end-systolic and end-diastolic phases of the cardiac cycle and transformed to 3D volumes to determine end-systolic (ESV) and end-diastolic volume (EDV) by using different lower threshold values: besides fixed lower threshold values, identical for each image sequence, individual lower threshold values dependent on contrast enhancement of the left ventricle were applied. The latter represent the mean value calculated by combining the average CT-density of the myocardium and the contrast-enhanced blood in the left ventricle. The EF derived from ESV and EDV. Results: The best correlation with MR imaging was obtained for ESV and EDV by using the individual lower threshold values for the respective sequence. The correlation coefficient for ESV was 0.95 and for EDV it was 0.93. On average, the ESV was overestimated by 3.72 ml, while the ESD was underestimated by 2.85 ml. The respective standard deviation for the ESV was 14,87 ml, for the EDV it was 26.83 ml. On average, the EF was underestimated by 3.57% with a standard deviation of 9.43% and a correlation coefficient of 0.83 in comparison to MRI. Conclusion: The threshold-value-supported 3D volume reconstruction of the left ventricle represents a good method to determine the left ventricular function parameters. Due to the differences in the contrast enhancement, the use of an individual lower threshold value for every image sequence is of particular importance. (orig.)

  15. Diagnostic and prognostic value of minor elevated cardiac troponin levels for percutaneous coronary intervention-related myocardial injury: a prospective, single-center and double-blind study

    OpenAIRE

    Zhang, Min; He, Huiwei; Wang, Ze-mu; Xu, Zhihui; ZHOU, NINGTIAN; Tao, Zhengxian; Chen, Bo; Li, Chunjian; Zhu, Tiebing; Yang, Di; Wang, Liansheng; Yang, Zhijian

    2014-01-01

    Abstract Cardiac troponin-I (cTnI) and -T (cTnT) are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention (PCI)-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT (cTns) in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pe...

  16. Value of haemodynamic supervision by radiocardiography in human heart transplants

    International Nuclear Information System (INIS)

    Cardiac output measurements were carried out by radiocardiography on 13 transplant patients and 9 terminal comas. The indicator used was siderophiline labelled with indium-113m, which has such a short physical half-life (102 minutes) that repeated examinations are possible. The harmlessness of the method was proved by these 300 measurements, performed without inconvenience or mishap. By showing the haemodynamic possibilities of the graft they participate in the choice of the most suitable receiver for a given donor. After transplantation the cardiac output at rest is a basic element in the supervision of the patient, the experiments showing that a drop in this delivery is the first sign of early rejection. On a long-term basis the resting cardiac output is an excellent means of observation. The working output could be of great value for the early diagnosis of chronic rejection

  17. EVALUACIÓN ECOCARDIOGRÁFICA DEL GASTO CARDÍACO SISTÉMICO EN LA ATRESIA PULMONAR CON SEPTO INTERVENTRICULAR INTACTO / Echocardiographic evaluation of cardiac output in pulmonary atresia with intact ventricular septum

    Directory of Open Access Journals (Sweden)

    Giselle Serrano Ricardo

    2013-07-01

    hemodynamic performance, influencing cardiac output and generating potential conditions for short-term prognosis. Method: A descriptive, prospective and applied study was conducted. It included 43 patients who were referred to the William Soler Pediatric Cardiology Hospital from January 1992 to November 2011 with a diagnosis of the disease. In each subject, the profiles of eight echocardiographic variables were assessed, as well as the heart rate profile. Their level of association and mutual dependence were statistically assessed by simple regression models. Results: There are considerable variations in heart rate, in the volume index and in the ejection fraction of the patients´ left ventricle compared with those in the reference control group. Conclusions: The increased size of the atrial septal defect and the prolongation of transmitral diastasis favor left ventricular volume increment. Heart rate, the restrictive nature of the left ventricular myocardium and its ejection fraction are regulatory factors of cardiac output in this disease.

  18. The reduction in DAP values possible with operator education and additional filtration in a cardiac catheterisation laboratory

    International Nuclear Information System (INIS)

    Radiation doses were recorded for over 1,000 patients undergoing interventional procedures at a cardiac catheterisation laboratory at a local teaching hospital. The laboratory was equipped with two Toshiba DRX C-arms units. The only differing factor between the units was the inclusion of a tantalum rare-earth filter on Unit B. Each unit was fitted with a DAP meter which readily allowed the collection of dose-area product (DAP) readings for all patients. Information was collected over a 12-month period and data analysis showed that the median radiation doses from Unit B was on average 50% lower than those delivered from unit A for the same radiographic procedure and operator. Further analysis also showed that there was a large variation in dose given by the operators and as expected for the type of examination performed. (author)

  19. Output gaps: uses and limitation

    OpenAIRE

    Roc Armenter

    2011-01-01

    The concept of resource slack is central to understanding the dynamics between employment, output, and inflation. But what amount of slack is consistent with price stability? To answer this question, economists define baseline values for unemployment and output known as the natural rate of unemployment and potential output. The concepts of output and employment gaps can be useful to economists in several ways. First, they often guide the inflation forecasts of Federal Reserve staff and other ...

  20. Predictors of cardiac morbidity in diabetic, new-onset diabetic and non-diabetic high-risk hypertensive patients: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial.

    Science.gov (United States)

    Aksnes, Tonje A; Kjeldsen, Sverre E; Rostrup, Morten; Holzhauer, Björn; Hua, Tsushung A; Julius, Stevo

    2016-08-01

    Diabetic and new-onset diabetic patients with hypertension have higher cardiac morbidity than patients without diabetes. We aimed to investigate whether baseline predictors of cardiac morbidity, the major constituent of the primary endpoint in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, were different in patients with diabetes and new-onset diabetes compared to patients without diabetes. In total, 15,245 high-risk hypertensive patients in the VALUE trial were followed for an average of 4.2 years. At baseline, 5250 patients were diabetic by the 1999 World Health Organization criteria, 1298 patients developed new-onset diabetes and 8697 patients stayed non-diabetic during follow-up. Cardiac morbidity was defined as a composite of myocardial infarction and heart failure requiring hospitalization, and baseline predictors were identified by univariate and multivariate stepwise Cox regression analyses. History of coronary heart disease (CHD) and age were the most important predictors of cardiac morbidity in both diabetic and non-diabetic patients. History of CHD, history of stroke and age were the only significant predictors of cardiac morbidity in patients with new-onset diabetes. Predictors of cardiac morbidity, in particular history of CHD and age, were essentially the same in high-risk hypertensive patients with diabetes, new-onset diabetes and without diabetes who participated in the VALUE trial. PMID:26808585

  1. Value-Addes Tax and Shadow Economy : the Role of Input-Output Linkages (revision of CentER Discussion Paper 2013-036)

    NARCIS (Netherlands)

    Hoseini, Mohammad

    2015-01-01

    Under the VAT, formal traders report their purchases to the administration for a deduction in their VAT bill. This paper models this third-party reporting feature of the VAT in an input-output economy and quantifies it among different activities using a forward linkages index. The administration can

  2. Estimación del gasto cardíaco: Utilidad en la práctica clínica. Monitorización disponible invasiva y no invasiva Estimating cardiac output: Utility in the clinical practice. Available invasive and non-invasive monitoring

    Directory of Open Access Journals (Sweden)

    X. García

    2011-12-01

    Full Text Available Esta revisión pretende profundizar en el conocimiento del gasto cardíaco, sus variables y sus condicionantes, así como repasar exhaustivamente las diferentes técnicas disponibles para su monitorización y establecer las situaciones en que el conocimiento del gasto cardíaco nos aporta una información fundamental en el manejo del paciente crítico. La técnica de Fick, utilizada en los inicios para calcular el gasto cardíaco de los pacientes, ha sido sustituida hoy en día en la práctica clínica por los métodos de termodilución (transcardíaca o transpulmonar, litiodilución, biorreactancia, la tecnología basada en el efecto Doppler o la ecocardiografía. El análisis de la onda de pulso ha permitido la obtención de una medida continua y mínimamente invasiva del gasto cardíaco. Otros métodos, como la biorrectancia, el Doppler o la ecocardiografía nos permiten, en la actualidad, obtener medidas del gasto cardíaco de forma no invasiva, rápida y fiable.This aim of this review is to provide a detailed review of the physiologic conditions and variables of the cardiac output, as well as review the different techniques available for its measurement. We also want to establish the clinical situations in which the measurement of cardiac output can add valuable information for the management of critically ill patients. The Fick technique, used in the beginning to calculate cardiac output, has been replaced today by thermodilution techniques (transcardiac or transpulmonary, lithium dilution, bioreactance, Doppler technique or echocardiography. Pulse wave analysis allows a continuous minimally invasive cardiac output measurement. Other methods, such bioreactance, Doppler technique or echocardiography currently provide a valid, fast and non-invasive measurement of cardiac output.

  3. Predictive value of cardiac autonomic indexes and MIBG washout in ICD recipients with mild to moderate heart failure

    International Nuclear Information System (INIS)

    We aimed at evaluating the combined use of heart rate variability (HRV), baroreflex sensitivity (BRS), and metaiodobenzylguanidine (MIBG) imaging in the risk stratification for sudden cardiac death (SCD) of patients with mild to moderate heart failure. Twenty-five patients (17 male and 8 female, mean age 63±5 years, mean left ventricular ejection fraction (LVEF) 36±3%) with a recently implanted cardioverter-defibrillator (ICD) and mild (NYHA I-II) heart failure due to either ischemic (n=15) or dilated (n=10) cardiomyopathy were studied. One week after ICD implantation they underwent baroreflex sensitivity (BRS) evaluation to bolus phenylephrine by the Oxford method, 24-h heart rate variability (HRV) assessment, and MIBG imaging. The mean patient follow-up was 32±10 months. Simple correlation and stepwise multiple regression analysis was performed to evaluate if the number of sustained ventricular tachycardia (cycle length <330 ms) or fibrillation episodes per month is related to one or more of MIBG, BRS, and HRV indexes and if MIBG % washout is related to HRV and/or BRS. The frequency of fast ventricular arrhythmic episodes (FVAE) demonstrated an inverse relation to BRS (p<0.0001), rMSSD (p=0.001), and pNN50 (p=0.0034), while it was positively related to low frequency (LF) (p<0.0001) and MIBG % washout (p=0.001). BRS, LF, rMSSD, and MIBG washout were also independent predictors of FVAE. MIBG washout was related to only one HRV marker (SDNN-I, p<0.0001), while no correlation was observed with BRS. In ICD recipients with well-compensated heart failure, autonomic markers derived from BRS, HRV, and MIBG studies are related to FVAE. These markers have limited inter-dependency and constitute useful means for SCD risk stratification in this subgroup of patients. (author)

  4. Low radiation dose non-contrast cardiac CT: is it of value in the evaluation of mechanical aortic valve

    International Nuclear Information System (INIS)

    Background: Prosthetic bileaflet mechanical valve function has been traditionally evaluated using echocardiography and fluoroscopy. Multidetector computed tomography (MDCT) is a novel technique for cardiac evaluation. Purpose: To evaluate bileaflet mechanical aortic valves using a low-milliampere (mA), non-contrast MDCT protocol with a limited scan range. Material and Methods: Forty patients with a bileaflet mechanical aortic valve were evaluated using a non-contrast, low-mA, ECG-gated 64 MDCT protocol with a limited scan range. MDCT findings of opening and closing valve angles were correlated to fluoroscopy and echocardiography. Also, the valve visibility was evaluated on MDCT and fluoroscopy according to a 3-point grading scale. Results: The visualization score with the MDCT was significantly superior to the fluoroscopy (3 vs. 2.7). A strong correlation was noted between the opening (r = 0.82) and closing (r = 0.96) valve angles with MDCT and fluoroscopy without a statistically significant difference (P = 0.31 and 0.16, respectively). The mean effective radiation dose of the suggested protocol was 4 ± 0.5 mSv. Five valves were evaluated using transesophageal echocardiography because the valves were difficult to evaluate with transthoracic echocardiography, and all of these valves were evaluated optimally with MDCT. A high-pressure gradient was noted in nine valves, and the MDCT showed that seven of these valves inadequately opened, and two valves opened well, which resulted in patient valve mismatch. Incomplete valve closure was noted in five valves, and the echocardiography showed significant transvalvular regurgitation in all five valves. Conclusion: MDCT can provide a precise measurement of valve function and can potentially evaluate high-pressure gradients and transvalvular regurgitation

  5. The value of FDG-PET/CT in the diagnostic work-up of extra cardiac infectious manifestations in infectious endocarditis

    DEFF Research Database (Denmark)

    Ozcan, C; Asmar, A; Gill, S;

    2013-01-01

    Infectious endocarditis (IE) is a serious condition with a high morbidity and mortality. The optimal management of IE depends not only on correct antibiotic therapy and surgery when needed, but involves identification of the portal of entry and detection of extracardiac infectious manifestations...... supplemental method to standard work-up in evaluating primary and distant infective foci. A retrospective cohort study of 72 IE patients admitted from 2008 to 2010, which had an (18)F-FDG-PET/CT performed. Findings were assessed in relation to the routine work-up, which served as the "gold standard". One...... hundred-fifty-nine infectious lesions were identified. (18)F-FDG-PET identified 64 of these, and suggested another 50. Overall sensitivity and positive predictive value was 40 and 56 %, respectively, in detecting both cardiac and extracardiac infective foci. When excluding lungs and organs with high...

  6. Correlation of cardiac T2* value with cardiac iron overload in myelodysplastic syndrome patients%骨髓增生异常综合征患者MRI检查心脏T2*值与心脏铁过载关系的初步探讨

    Institute of Scientific and Technical Information of China (English)

    肖超; 顾树程; 张曦; 赵佑山; 常春康

    2013-01-01

    Objective To determine the cardiac T2* value of magnetic resonance imaging and the related index of cardiac iron overload-left ventricular ejection fraction in myelodysplastic syndrome patients and analyze the relationship between cardiac T2* value and cardiac function. Methods Cardiac T2* and liver T2* value were measured by MRI examination in 20 MDS patients, MIC (myocardial iron concentration) and LIC (liver iron concentration) were calculated from cardiac T2* and liver T2*, respectively. And LVEF (left ventricular ejection fraction) was measured by echocardiographic examination. Results Correlation of cardiac T2* value with LVEF was statistically significant (r=0.565, P=0.009). However, cardiac T2* value had no correlation with WHO classification, IPSS score, gender, blood transfusion, disease time, LIC and SF (serum ferritin). Conclusions Cardiac T2* value has considerable predictability for cardiac function and is superior to serum ferritin and liver iron.%目的:检测骨髓增生异常综合征(MDS)患者MRI检查中心脏T2*值和心脏铁过载的相关指标——左心室射血分数(LVEF),并探讨心脏T2*值与心脏功能的关系.方法:20例MDS患者行MRI检查,得到心脏、肝脏I2*数值,并换算成心铁、肝铁浓度(LIC),同时进行心脏超声检测,得到LVEF.结果:MDS患者的心脏T2*值与LVEF间存在相关性(r=-0.565,P=0.009),而心脏T2*值与国际预后积分系统(IPSS)评分、患者病程时间、LIC、SF间则均无相关性(P>0.05).不同WHO分型、IPSS分层、性别、是否输血、近一年输血量患者间的心脏T2*值无统计学差异.结论:心脏T2*值对MDS患者心脏功能有一定预测性,比同期的LIC及血清铁蛋白可能更有价值.

  7. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  8. Prognostic value, clinical effectiveness and cost-effectiveness of high sensitivity C-reactive protein as a marker in primary prevention of major cardiac events

    Directory of Open Access Journals (Sweden)

    Klauß, Volker

    2009-05-01

    Full Text Available Background: In a substantial portion of patients (= 25% with coronary heart disease (CHD, a myocardial infarction or sudden cardiac death without prior symptoms is the first manifestation of disease. The use of new risk predictors for CHD such as the high-sensitivity C-reactive Protein (hs-CRP in addition to established risk factors could improve prediction of CHD. As a consequence of the altered risk assessment, modified preventive actions could reduce the number of cardiac death and non-fatal myocardial infarction. Research question: Does the additional information gained through the measurement of hs-CRP in asymptomatic patients lead to a clinically relevant improvement in risk prediction as compared to risk prediction based on traditional risk factors and is this cost-effective? Methods: A literature search of the electronic databases of the German Institute of Medical Documentation and Information (DIMDI was conducted. Selection, data extraction, assessment of the study-quality and synthesis of information was conducted according to the methods of evidence-based medicine. Results: Eight publications about predictive value, one publication on the clinical efficacy and three health-economic evaluations were included. In the seven study populations of the prediction studies, elevated CRP-levels were almost always associated with a higher risk of cardiovascular events and non-fatal myocardial infarctions or cardiac death and severe cardiovascular events. The effect estimates (odds ratio (OR, relative risk (RR, hazard ratio (HR, once adjusted for traditional risk factors, demonstrated a moderate, independent association between hs-CRP and cardiac and cardiovascular events that fell in the range of 0.7 to 2.47. In six of the seven studies, a moderate increase in the area under the curve (AUC could be detected by adding hs-CRP as a predictor to regression models in addition to established risk factors though in three cases this was not

  9. Evidence towards Improved Estimation of Respiratory Muscle Effort from Diaphragm Mechanomyographic Signals with Cardiac Vibration Interference Using Sample Entropy with Fixed Tolerance Values

    Science.gov (United States)

    Sarlabous, Leonardo; Torres, Abel; Fiz, José A.; Jané, Raimon

    2014-01-01

    The analysis of amplitude parameters of the diaphragm mechanomyographic (MMGdi) signal is a non-invasive technique to assess respiratory muscle effort and to detect and quantify the severity of respiratory muscle weakness. The amplitude of the MMGdi signal is usually evaluated using the average rectified value or the root mean square of the signal. However, these estimations are greatly affected by the presence of cardiac vibration or mechanocardiographic (MCG) noise. In this study, we present a method for improving the estimation of the respiratory muscle effort from MMGdi signals that is robust to the presence of MCG. This method is based on the calculation of the sample entropy using fixed tolerance values (fSampEn), that is, with tolerance values that are not normalized by the local standard deviation of the window analyzed. The behavior of the fSampEn parameter was tested in synthesized mechanomyographic signals, with different ratios between the amplitude of the MCG and clean mechanomyographic components. As an example of application of this technique, the use of fSampEn was explored also in recorded MMGdi signals, with different inspiratory loads. The results with both synthetic and recorded signals indicate that the entropy parameter is less affected by the MCG noise, especially at low signal-to-noise ratios. Therefore, we believe that the proposed fSampEn parameter could improve estimates of respiratory muscle effort from MMGdi signals with the presence of MCG interference. PMID:24586436

  10. 我国农业总产值影响因素的实证分析%Empirical Analysis on Influencing Factors of Total Agricultural Output Value in China

    Institute of Scientific and Technical Information of China (English)

    武金金; 苏建兰; 谢彦明; 扈立家

    2016-01-01

    基于柯布一道格拉斯生产函数,利用EVIEWS软件,应用多元线性回归分析1978—2013年直接因素和间接因素对我国农业总产值的影响,建立了我国农业总产值生产函数并分析了各影响因素的弹性系数。得出结论:我国农业总产值显著受到农作物总播种面积,第一产业就业人员,化肥施用量和农产品生产价格指数,农业支出的影响。最后提出促进农业发展的建议。%Based on the Cobb-Douglas function, use EVIEWS software, multiple linear regression analyzed the 1978-2013 direct influence factors and indirect factors on China's agricultural output value, established the production function of China's total agricultural output value, and analyzed the elasticity of each factor. The conclusion showed that total agricultural output value significantly affected by the total sown area, the first industry labor force, chemical fertilizer, price index of agricultural products, agricultural expenditure. Finally, offering some proposals to promote agricultural development.

  11. Regulation of Cardiac Hypertrophy: the nuclear option

    OpenAIRE

    Kuster, Diederik

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, cardiac hypertrophy is an independent risk factor for the development of heart failure and is therefore called pathological hypertrophy. That hypertrophy is not bad per se, is illustrated by the hyp...

  12. Normal value of functional parameters in gated myocardial perfusion SPECT in patients with low risk of coronary artery disease: emory cardiac tool box program

    Energy Technology Data Exchange (ETDEWEB)

    Kang, D. Y.; Kim, M. H.; Kim, Y. D.; Kim, D. K. [Donga University College of Medicine, Busan (Korea, Republic of)

    2002-07-01

    Absolute value of the functional data of gated myocardial perfusion SPECT is necessary to determine that individual patient is normal or not. Tc-99m MIBI gated myocardial perfusion SPECT was performed using emory cardiac tool box program. All patients (M:F=15:36, age 64{+-}10 yrs) showed normal myocardial perfusion. The patients with following characteristics were excluded; previous angina or MI, ECG change with Q wave or ST-T change, diabetes mellitus, hypercholesterolemia, typical chest pain and hypertension. In all patients, myocardial mass is 117{+-}23 g in stress gated SPECT, 106{+-}22 g in stress ungated SPECT and 102{+-}21 g in rest ungated SPECT. EDV is 90{+-}28 ml, ESV 26{+-}20 ml, SV 66{+-}21 ml, EF 73{+-}10 % and TID 1.06{+-}0.14. Myocardial mass in rest ungated SPECT is significantly different between men and women (p=0.025). Myocardial mass is significantly different between stress gated SPECT and stress ungated SPECT (p=0.000), and between stress ungated SPECT and rest ungated SPECT (p=0.003). We provide normal value of functional parameters to determine the abnormality of individual patients in patients with low risk of coronary artery disease.

  13. Normal value of functional parameters in gated myocardial perfusion SPECT in patients with low risk of coronary artery disease: emory cardiac tool box program

    International Nuclear Information System (INIS)

    Absolute value of the functional data of gated myocardial perfusion SPECT is necessary to determine that individual patient is normal or not. Tc-99m MIBI gated myocardial perfusion SPECT was performed using emory cardiac tool box program. All patients (M:F=15:36, age 64±10 yrs) showed normal myocardial perfusion. The patients with following characteristics were excluded; previous angina or MI, ECG change with Q wave or ST-T change, diabetes mellitus, hypercholesterolemia, typical chest pain and hypertension. In all patients, myocardial mass is 117±23 g in stress gated SPECT, 106±22 g in stress ungated SPECT and 102±21 g in rest ungated SPECT. EDV is 90±28 ml, ESV 26±20 ml, SV 66±21 ml, EF 73±10 % and TID 1.06±0.14. Myocardial mass in rest ungated SPECT is significantly different between men and women (p=0.025). Myocardial mass is significantly different between stress gated SPECT and stress ungated SPECT (p=0.000), and between stress ungated SPECT and rest ungated SPECT (p=0.003). We provide normal value of functional parameters to determine the abnormality of individual patients in patients with low risk of coronary artery disease

  14. Application of pulse index continuous cardiac output monitoring to improve efficiency of acute heart failure care%应用脉搏指数连续心输出量监测提升急性心力衰竭护理效果

    Institute of Scientific and Technical Information of China (English)

    孙秀月; 张领; 赵书琴

    2015-01-01

    Objective To ihvestigate the effect of pulse index continuous cardiac output (PiCCO) monitoring to nursing care of acute heart failure care.Methods The clinical data of 43 acute heart failure patients were retrospectively analyzed,patients were given pulse index continuous cardiac output monitoring and care,the patient' s nursing outcomes were observed,and the intrathoracic blood volume,cardiac output and oxygen consumption before and after the intervention were compared.Results After the implementation of PiCCO and nursing intervention,43 patients had no serious complications,improved 42 cases discharged,the other 1 patient in critical condition due to old age and heart function improvement sustained no automatic discharge.Oxygen consumption,cardiac output and intrathoracic blood volume were improved after the intervention,there was a significant difference (P < 0.05) compared to the previous indicators and intervention after intervention.Conclusions Application of pulse index continuous cardiac output can effectively improve patient's clinical parameters such as cardiac output,through the implementation of appropriate care can improve symptoms and reduce complications.%目的 探讨急性心力衰竭患者护理中应用脉搏指数连续心输出量监测(PiCCO)的效果.方法 选取平顶山市第二人民医院收治的43例急性心力衰竭患者作为研究对象,收集患者的临床资料并对其做回顾性分析,对患者实施脉搏指数连续心输出量监测和护理,对患者的护理效果进行观察,并对其干预前后的胸腔内血容量、心排血量与氧耗量进行对比观察.结果 实施PiCCO和护理干预,本研究43例患者均无严重并发症产生,42例好转出院,1例由于病情危重、高龄及心功能持续无改善自动出院.患者干预后的氧耗量、心排血量与胸腔内血容量均有所改善,干预后各项指标与干预前比较差异有统计学意义(P<0.05).结论 应用脉搏指数连续心

  15. Economic values of growth and feed efficiency for fish farming in recirculating aquaculture system with density and nitrogen output limitations: a case study with African catfish (Clarias gariepinus)

    NARCIS (Netherlands)

    Besson, M.; Komen, H.; Aubin, J.; Boer, de I.J.M.; Poelman, M.; Quillet, E.; Vancoillie, C.; Vandeputte, M.; Arendonk, van J.A.M.

    2014-01-01

    In fish farming, economic values (EV) of breeding goal traits are lacking, even though they are key parameters when defining selection objectives. The aim of this study was to develop a bioeconomic model to estimate EV of 2 traits representing production performances in fish farming: the thermal gro

  16. Prognostic Value of Cardiac Time Intervals by Tissue Doppler Imaging M-Mode in Patients With Acute ST-Segment-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; Søgaard, Peter;

    2013-01-01

    Background- Color tissue Doppler imaging M-mode through the mitral leaflet is an easy and precise method to estimate all cardiac time intervals from 1 cardiac cycle and thereby obtain the myocardial performance index (MPI). However, the prognostic value of the cardiac time intervals and the MPI...... examined by echocardiography a median of 2 days after the ST-segment-elevation MI. Outcome was assessed according to death (n=33), hospitalization with heart failure (n=53), or new MI (n=25). Follow-up time was a median of 25 months. The population was stratified according to tertiles of the MPI. The risk...... of new MI, being admitted with congestive heart failure or death, increased with increasing tertile of MPI, being ≈3 times as high for the third tertile compared with the first tertile (hazard ratio, 2.8; 95% confidence interval, 1.7-4.7; P...

  17. 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

  18. A new era for the music industry: How new technologies and the internet affect the way music is valued and have an impact on output quality

    Directory of Open Access Journals (Sweden)

    Patokos Tassos

    2008-01-01

    Full Text Available Since its early days, the Internet has been used by the music industry as a powerful marketing tool to promote artists and their products. Nevertheless, technology developments of the past ten years, and especially the ever-growing phenomenon of file sharing, have created the general impression that the Internet is responsible for a crisis within the industry, on the grounds that music piracy has become more serious than it has ever been. The purpose of this paper is to present the impact of new technologies and the Internet on the three main actors of the music industry: consumers, artists and record companies. It is claimed that the Internet has changed the way music is valued, and also, that it may have a direct effect on the quality of the music produced, as perceived by both artists and consumers alike.

  19. Prognostic value, clinical effectiveness and cost-effectiveness of high sensitivity C-reactive protein as a marker in primary prevention of major cardiac events

    OpenAIRE

    Klauß, Volker; Siebert, Uwe; Wasem, Jürgen; Grabein, Kristin; Stollenwerk, Björn; Grandi, Norma; Schnell-Inderst, Petra; Schwarzer, Ruth; Göhler, Alexander

    2009-01-01

    Background: In a substantial portion of patients (= 25%) with coronary heart disease (CHD), a myocardial infarction or sudden cardiac death without prior symptoms is the first manifestation of disease. The use of new risk predictors for CHD such as the high-sensitivity C-reactive Protein (hs-CRP) in addition to established risk factors could improve prediction of CHD. As a consequence of the altered risk assessment, modified preventive actions could reduce the number of cardiac death and non-...

  20. Economic values of growth and feed efficiency for fish farming in recirculating aquaculture system with density and nitrogen output limitations: a case study with African catfish (Clarias gariepinus).

    Science.gov (United States)

    Besson, M; Komen, H; Aubin, J; de Boer, I J M; Poelman, M; Quillet, E; Vancoillie, C; Vandeputte, M; van Arendonk, J A M

    2014-12-01

    In fish farming, economic values (EV) of breeding goal traits are lacking, even though they are key parameters when defining selection objectives. The aim of this study was to develop a bioeconomic model to estimate EV of 2 traits representing production performances in fish farming: the thermal growth coefficient (TGC) and the feed conversion ratio (FCR). This approach was applied to a farm producing African catfish (Clarias gariepinus) in a recirculating aquaculture system (RAS). In the RAS, 2 factors could limit production level: the nitrogen treatment capacity of the biofilter or the fish density in rearing tanks at harvest. Profit calculation includes revenue from fish sales, cost of juveniles, cost of feed, cost of waste water treatment, and fixed costs. In the reference scenario, profit was modeled to zero. EV were calculated as the difference in profit per kilogram of fish between the current population mean for both traits (µt) and the next generation of selective breeding (µt+Δt) for either TGC or FCR. EV of TGC and FCR were calculated for three generations of hypothetical selection on either TGC or FCR (respectively 6.8% and 7.6% improvement per generation). The results show that changes in TGC and FCR can affect both the number of fish that can be stocked (number of batches per year and number of fish per batch) and the factor limiting production. The EV of TGC and FCR vary and depend on the limiting factors. When dissolved NH3-N is the limiting factor for both µt and µt+Δt, increasing TGC decreases the number of fish that can be stocked but increases the number of batches that can be grown. As a result, profit remains constant and EVTGC is zero. Increasing FCR, however, increases the number of fish stocked and the ratio of fish produced per kilogram of feed consumed ("economic efficiency"). The EVFCR is 0.14 €/kg of fish, and profit per kilogram of fish increases by about 10%. When density is the limiting factor for both µt and µt+Δt, the

  1. Consenso brasileiro de monitorização e suporte hemodinâmico - parte III: métodos alternativos de monitorização do débito cardíaco e da volemia Brazilian consensus of monitoring and hemodynamic support - part III: alternative methods for cardiac output monitoring and volemia estimation

    Directory of Open Access Journals (Sweden)

    Guilherme Schettino

    2006-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A interpretação do débito cardíaco e da pré-carga como números absolutos não traz grandes informações sobre a hemodinâmica do paciente crítico. Em contrapartida, a monitorização da resposta do débito cardíaco à expansão volêmica ou suporte inotrópico é uma ferramenta muito útil na unidade de terapia intensiva, quando o paciente apresenta algum sinal de má perfusão tecidual. Apesar do CAP ser considerado como " padrão-ouro" na avaliação destes parâmetros, foram desenvolvidas tecnologias alternativas bastante confiáveis para a sua monitorização. MÉTODO: O processo de desenvolvimento de recomendações utilizou o método Delphi modificado para criar e quantificar o consenso entre os participantes. A AMIB determinou um coordenador para o consenso, o qual escolheu seis especialistas para comporem o comitê consultivo. Outros 18 peritos de diferentes regiões do país foram selecionados para completar o painel de 25 especialistas, médicos e enfermeiros. Um levantamento bibliográfico na MEDLINE de artigos na língua inglesa foi realizado no período de 1966 a 2004. RESULTADOS: Foram apresentadas recomendações referentes à análise da variação da pressão arterial durante ventilação mecânica, débito cardíaco contínuo por contorno de pulso arterial, débito cardíaco por diluição do lítio, Doppler transesofágico, bioimpedância transtorácica, ecocardiografia e reinalação parcial de gás carbônico. CONCLUSÕES: As novas e menos invasivas técnicas para medida do débito cardíaco, pré-carga e fluidoresponsividade apresentam adequada precisão e podem ser uma alternativa ao uso do CAP em pacientes graves.BACKGROUND AND OBJECTIVES: Cardiac output and preload as absolute data do not offer helpful information about the hemodynamic of critically ill patients. However, monitoring the response of these variables to volume challenge or inotropic drugs is a very useful tool in the

  2. 脉搏指示连续心排血量监测技术救治重症胰腺炎并发急性呼吸窘迫综合征患儿二例%Pulse indicator continuous cardiac output measurement-guided treatment aids two pediatric patients with severe acute pancreatitis complicated with acute respiratory distress syndrome

    Institute of Scientific and Technical Information of China (English)

    颜卫源; 王丽杰

    2014-01-01

    Objective To evaluate the clinical value of the pulse indicator continuous cardiac output (PiCCO) system in patients with severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS).Method Two cases of SAP with ARDS were monitored using PiCCO during comprehensive management in the Pediatric Intensive Care Unit (PICU) of Shengjing Hospital,China Medical University.To guide fluid management,the cardiac index (CI) was measured to assess cardiac function,the global end-diastolic volume index (GEDVI) was used to evaluate cardiac preload,and the extravascular lung water index (EVLWI) was used to evaluate the pulmonary edema.Result Case 1 was diagnosed with type L2 acute lymphoblastic leukemia (intermediate risk) and received the sixth maintenance phases of chemotherapy this time.After a 1-week dosage of chemotherapeutic drugs (pegaspargase and mitoxantrone),he suffered SAP combined with ARDS.Except comprehensive treatment (life supporting,antibiotic,etc.) and applying continuous veno-venous hemodiafiltration (CVVHDF) to remove inflammatory mediators.PiCCO monitor was utilized to guide fluid management.During the early stage of PiCCO monitoring,the patient showed no significant manifestations of pulmonary edema in the bedside chest X-ray (bedside ultrasound showed left pleural effusion),and had an oxygenation index 223 mmHg (1 mmHg =0.133 kPa),GEDVI 450 ml/m2,and ELVWI 7 ml/kg.We increased cardiac output to increase tissue perfusion and dehydration speed of CVVHDF was set at 70 ml/h.Two hours later,GEDVI significantly increased to 600 ml/m2 and ELVWI significantly increased to 10 ml/kg,the oxygenation index declined to 155 mmHg,the bedside chest X-ray showed a significant decrease of permeability (right lung) and PEEP was adjusted to 5 cmH2O (1 cmH2O =0.098 kPa),indicating circulating overload.ARDS subsequently occurred,upon which the fluid infusion was halted,the dehydration rate of CVVHDF raised (adjusted to 100-200 ml/h).On day 3 in the

  3. 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.

  4. 基于ARIMA的民勤绿洲水资源承载产值时间序列预测%A Time Series Forecasting Based on ARIMA for Minqin Value of Output Related to Water Resource

    Institute of Scientific and Technical Information of China (English)

    李兴东; 武耀华

    2012-01-01

    长期以来水资源的合理利用关系着民勤绿洲的经济、生态、社会效益.对民勤缘洲1956-2009年的水资源承栽产值进行分析,确定自回归移动平均模型(ARIMA),预测得到民勤绿洲2010-2015年水资源承载产值.结果表明:建立的ARIMA模型是有效的,预测值是可信赖的.%For a long timeithe rational utilization of water resources has influenced Minqin economic,ecological and social benefits. On the basis of analyzing Minqin value of output related to water resource from 1956 to 2009,the appropriate autoregressive intergrated moving average model (ARIMA) is determined and the value of output related to water resource in Minqin from 2010 to 2015 is predicted. The results show that the ARIMA model is effective and the forecast data can be trusted.

  5. Value of the first post-transplant biopsy for predicting long-term cardiac allograft vasculopathy (CAV and graft failure in heart transplant patients.

    Directory of Open Access Journals (Sweden)

    Carlos A Labarrere

    Full Text Available BACKGROUND: Cardiac allograft vasculopathy (CAV is the principal cause of long-term graft failure following heart transplantation. Early identification of patients at risk of CAV is essential to target invasive follow-up procedures more effectively and to establish appropriate therapies. We evaluated the prognostic value of the first heart biopsy (median: 9 days post-transplant versus all biopsies obtained within the first three months for the prediction of CAV and graft failure due to CAV. METHODS AND FINDINGS: In a prospective cohort study, we developed multivariate regression models evaluating markers of atherothrombosis (fibrin, antithrombin and tissue plasminogen activator [tPA] and endothelial activation (intercellular adhesion molecule-1 in serial biopsies obtained during the first three months post-transplantation from 172 patients (median follow-up = 6.3 years; min = 0.37 years, max = 16.3 years. Presence of fibrin was the dominant predictor in first-biopsy models (Odds Ratio [OR] for one- and 10-year graft failure due to CAV = 38.70, p = 0.002, 95% CI = 4.00-374.77; and 3.99, p = 0.005, 95% CI = 1.53-10.40 and loss of tPA was predominant in three-month models (OR for one- and 10-year graft failure due to CAV = 1.81, p = 0.025, 95% CI = 1.08-3.03; and 1.31, p = 0.001, 95% CI = 1.12-1.55. First-biopsy and three-month models had similar predictive and discriminative accuracy and were comparable in their capacities to correctly classify patient outcomes, with the exception of 10-year graft failure due to CAV in which the three-month model was more predictive. Both models had particularly high negative predictive values (e.g., First-biopsy vs. three-month models: 99% vs. 100% at 1-year and 96% vs. 95% at 10-years. CONCLUSIONS: Patients with absence of fibrin in the first biopsy and persistence of normal tPA in subsequent biopsies rarely develop CAV or graft failure during the next 10 years and potentially could be monitored less invasively

  6. Diagnostic value of neutrophil gelatinase-associated lipocalin for early diagnosis of cardiac surgery-associated acute kidney injury: a meta-analysis.

    Science.gov (United States)

    Zhou, Fangfang; Luo, Qun; Wang, Lailiang; Han, Lina

    2016-03-01

    Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as one of the most sensitive and specific biomarkers for predicting cardiac surgery-associated acute kidney injury (CSA-AKI); however, variable performance characteristics have been reported. We therefore performed a diagnostic meta-analysis to investigate the diagnostic accuracy of NGAL in early (within 12 h postoperatively) diagnosis of CSA-AKI using established guidelines. The search was carried out electronically with Medline (through PubMed interface), Embase, Cochrane library, ISI Web of Science, Scopus and ClinicalTrials.gov (up to 5 September 2014), and hand-searching was also done. Two reviewers conducted study inclusion, data extractions and quality assessment of the studies independently. The diagnostic capacity of NGAL for CSA-AKI was assessed using pooled sensitivity and specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic curve (AUC). Meta-Disc 1.4 and STATA 12.0 were used to investigate the source of heterogeneity and to perform the meta-analysis. Twenty-four studies (33 data sets of 4066 patients) were considered, which were all of good methodological quality. The overall pooled sensitivity of NGAL for the diagnosis of AKI was 0.68 [95% confidence interval (CI), 0.65-0.70], and specificity was 0.79 (95% CI, 0.77-0.80). The overall pooled positive likelihood ratio and negative likelihood ratio were 3.98 (95% CI, 3.05-5.20) and 0.33 (95% CI, 0.24-0.45), respectively, with a DOR of 13.05 (95% CI, 7.85-21.70). The receiver operating characteristic analysis showed an AUC [standard error (SE)] of 0.86 (0.02) and with a Q*-value (SE) of 0.79 (0.02). Subgroup analysis showed that NGAL had better predictive ability in neonates/children compared with adults (DOR, 19.37; AUC, 0.89 vs DOR, 8.98; AUC, 0.83), and adults without pre-existing renal insufficiency (PRI) had higher diagnostic value than adults without PRI to predict CSA-AKI (DOR, 15

  7. Probabilistic Output Analysis by Program Manipulation

    DEFF Research Database (Denmark)

    Rosendahl, Mads; Kirkeby, Maja Hanne

    The aim of a probabilistic output analysis is to derive a probability distribution of possible output values for a program from a probability distribution of its input. We present a method for performing static output analysis, based on program transformation techniques. It generates a probability...

  8. Effects of Different Organic Fertilizers on Growing, Yield and Output Value of‘Honghuadajinyuan’%不同有机肥对‘红花大金元’生长及产量产值的影响

    Institute of Scientific and Technical Information of China (English)

    张杨; 宗浩; 赵峰; 李义强; 肖志新; 林跃平; 张本强

    2013-01-01

    This test was carried out in Baoshan in order to provide theoretical references for the organic fertilizer applying properly. The effect of three kinds of organic fertilizers (oil cake, farm manure and straw stalk) and the different amount of application on growing, yield and output value of‘Honghuadajinyuan’was researched. The results showed that: the growth vigor was weakened with the amount of farm manure increased. Using straw stalk was not good in the prior period, but with the amount increasing, the growth vigor was enhanced after budding stage. Meanwhile the differences in growing vigor of different amount of oil cake were not significant. Compared in economical character, there were significant differences of yield between different treatments, but opposite to output value, average price and rate of first class of flue-cured tobacco. Yield and output value showed a trend of reducing with the amount of farm manure increasing, but average price and rate of first class of flue-cured tobacco increased. However as the increasing of amount of oil cake the economical characters increased at the beginning but reduced after. The effect of different amounts of straw stalk showed low yield and high average price. Compared to compound fertilizer output value of straw stalk was lower obviously. In a word, the economical characters were batter with using oil cake 150-300 kg/hm2 and using farm manure 7500- 15000 kg/hm2.%  为给保山‘红花大金元’合理施用有机肥提供理论依据,研究了菜籽饼、农家肥、秸秆3种有机肥不同施用量对‘红花大金元’生长发育和产质量的影响。结果表明:从烟株长势上看,农家肥处理随着用量的增加长势减弱;秸秆处理在前期生长长势较差,但随着生育期推进,现蕾期以后随着秸秆施用量的增加,烟株长势增强;菜籽饼处理不同用量之间烟株长势在各生育期差别不明显。从经济性状比较,处理间产量差

  9. The Effect of Threshold Values and Weighting Factors on the Association between Entropy Measures and Mortality after Myocardial Infarction in the Cardiac Arrhythmia Suppression Trial (CAST)

    OpenAIRE

    Christopher Mayer; Martin Bachler; Andreas Holzinger; Stein, Phyllis K.; Siegfried Wassertheurer

    2016-01-01

    Heart rate variability (HRV) is a non-invasive measurement based on the intervals between normal heart beats that characterize cardiac autonomic function. Decreased HRV is associated with increased risk of cardiovascular events. Characterizing HRV using only moment statistics fails to capture abnormalities in regulatory function that are important aspects of disease risk. Thus, entropy measures are a promising approach to quantify HRV for risk stratification. The purpose of this study was to ...

  10. The predictive value of plasma B-type natriuretic peptide levels on outcome in children with pulmonary hypertension undergoing congenital heart surgery

    Directory of Open Access Journals (Sweden)

    Ayse Baysal

    2014-09-01

    Full Text Available Background and objectives: In children undergoing congenital heart surgery, plasma brain natriuretic peptide levels may have a role in development of low cardiac output syndrome that is defined as a combination of clinical findings and interventions to augment cardiac output in children with pulmonary hypertension. Methods: In a prospective observational study, fifty-one children undergoing congenital heart surgery with preoperative echocardiographic study showing pulmonary hypertension were enrolled. The plasma brain natriuretic peptide levels were collected before operation, 12, 24 and 48 h after operation. The patients enrolled into the study were divided into two groups depending on: (1 Development of LCOS which is defined as a combination of clinical findings or interventions to augment cardiac output postoperatively; (2 Determination of preoperative brain natriuretic peptide cut-off value by receiver operating curve analysis for low cardiac output syndrome. The secondary end points were: (1 duration of mechanical ventilation ≥72 h, (2 intensive care unit stay >7days, and (3 mortality. Results: The differences in preoperative and postoperative brain natriuretic peptide levels of patients with or without low cardiac output syndrome (n = 35, n = 16, respectively showed significant differences in repeated measurement time points (p = 0.0001. The preoperative brain natriuretic peptide cut-off value of 125.5 pg mL−1 was found to have the highest sensitivity of 88.9% and specificity of 96.9% in predicting low cardiac output syndrome in patients with pulmonary hypertension. A good correlation was found between preoperative plasma brain natriuretic peptide level and duration of mechanical ventilation (r = 0.67, p = 0.0001. Conclusions: In patients with pulmonary hypertension undergoing congenital heart surgery, 91% of patients with preoperative plasma brain natriuretic peptide levels above 125.5 pg mL−1 are at risk of developing low cardiac

  11. The value of right lateral decubitus position to decrease artificial defect of cardiac anterior wall in 99Tcm-MIBI SPECT myocardial perfusion imaging for women

    International Nuclear Information System (INIS)

    Objective: To explore the value of right lateral decubitus position MPI for differentiating myocardial perfusion defect from cardiac anterior wall attenuation artificial defect, caused by breast of woman. Methods: Forty-nine patients(average age (61.5±8.4) years) who had low likelihood of coronary artery disease and had perfusion defect in the anterior wall after exercise stress 99Tcm-MIBI MPI were included. All underwent supine and right lateral decubitus position during resting SPECT images. The myocardial perfusion SPECT images at left ventricle were reconstructed and were measured by Bull's-eye, based on the counts. Results from both supine position imaging and right lateral decubitus position imaging were compared. Paired t test was used to statistically analyse the data by SPSS 13.0. Results: Compared with supine position, the counts of the anterior, inferior, apex and lateral wall in right lateral decubitus position were significantly higher: (71.30±3.53)% vs (66.50±3.85)%, (70.06±4.45)% vs (65.44±4.16)%, (77.90±3.00)% vs (75.81±4.08)%,(79.30±2.26)% vs (72.60±3.87)% (t=6.731, 5.286, 3.555, 10.885, all P<0.01). The counts of septal wall were significantly lower ((66.60±3.98)% vs (70.06±4.51)%, t=-4.625, P<0.01) in right lateral decubitus position than that in supine position. Among the different regions of anterior wall, the counts of the anterior-middle ((76.40 ± 3.80)% vs (68.60 ± 4.76)%) and anterior-apex region ((77.10±3.24)% vs (69.00±3.54)%) were significantly higher (t=9.916, 8.870, both P<0.01) in right lateral decubitus position than those in supine position, but there was insignificance ((56.94±6.06)% vs (58.50±4.98)%, t=-1.493, P>0.05) at anterior-basal region. The artificial defect of different degrees in anterior wall was observed in all patients in supine position, 23 cases (46.9%, 23/49) showed artificial defect in the anterior-middle region and 16 cases (32.7%, 16/49) in the anterior-apex region. All artificial defect

  12. Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

    Energy Technology Data Exchange (ETDEWEB)

    Wissner, Erik; Wellnitz, Clinton V.; Srivathsan, Komandoor; Scott, Luis R. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States); Altemose, Gregory T. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States)], E-mail: altemose.gregory@mayo.edu

    2009-11-15

    Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 {+-} 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

  13. Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

    International Nuclear Information System (INIS)

    Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 ± 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

  14. Factors influencing the development of low output state in patients with right ventricular infarction

    International Nuclear Information System (INIS)

    Right ventricular infarction is frequently accompanied by a low output state, but the factors influencing the development of this state remain unknown. To elucidate these factors, clinical findings, hemodynamic findings and left ventricular infarct size (Tl-score) calculated from thallium-201 myocardial scintigrams by a circumferential profile method were evaluated in 147 consecutive patients with acute transmural inferior myocardial infarction. They were divided into two groups: 44 patients with right ventricular involvement (RVI group) and 103 patients without right ventricular involvement (IMI group). A low cardiac output state was defined when the cardiac index was less than 2.2 L/min/M2. There was a good correlation between Tl-score and any of peak value of serum creatine phosphokinase (CPKmax), total released CPK (CPKr) and left ventricular ejection fraction (LVEF) (r=o.66, 0.74 and -0.54, respectively), indicating the usefulness of Tl-score as an index of left ventricular damage. Compared to the IMI group, the RVI group showed a higher average of age (p<0.01), lower systemic blood pressure (p<0.01), higher right atrial pressure (p<0.001) and lower cardiac index (p<0.01). Furthermore, t he incidence of a low output state (RVI group:47.7% vs IMI group:14.6%, p<0.001) and mortality (25.0% vs 7.8%, p<0.01) were higher in the RVI group. However, CPKmax, CPKr, LVEF and Tl-score, which were considered to reflect the severity of left ventricular damage, were not different between the two groups. Tl-score was inversely correlated with cardiac index in the RVI group (r=-0.49, p<0.05), and with left ventricular stroke work index in the both groups (RVI group;r=-0.46, p<0.01, IMI group; r=-0.64, p<0.01). (J.P.N.)

  15. Effects of environmental hypoxia on cardiac energy metabolism and performance in tilapia.

    Science.gov (United States)

    Speers-Roesch, Ben; Sandblom, Erik; Lau, Gigi Y; Farrell, Anthony P; Richards, Jeffrey G

    2010-01-01

    The ability of an animal to depress ATP turnover while maintaining metabolic energy balance is important for survival during hypoxia. In the present study, we investigated the responses of cardiac energy metabolism and performance in the hypoxia-tolerant tilapia (Oreochromis hybrid sp.) during exposure to environmental hypoxia. Exposure to graded hypoxia (> or =92% to 2.5% air saturation over 3.6 +/- 0.2 h) followed by exposure to 5% air saturation for 8 h caused a depression of whole animal oxygen consumption rate that was accompanied by parallel decreases in heart rate, cardiac output, and cardiac power output (CPO, analogous to ATP demand of the heart). These cardiac parameters remained depressed by 50-60% compared with normoxic values throughout the 8-h exposure. During a 24-h exposure to 5% air saturation, cardiac ATP concentration was unchanged compared with normoxia and anaerobic glycolysis contributed to ATP supply as evidenced by considerable accumulation of lactate in the heart and plasma. Reductions in the provision of aerobic substrates were apparent from a large and rapid (in tilapia and likely contributes to hypoxic survival. PMID:19864337

  16. 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 ...

  17. 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 ...

  18. 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...

  19. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake

    International Nuclear Information System (INIS)

    Primary dysfunction of the autonomic nervous system can be observed in patients with Parkinson's disease and those with multiple system atrophy. However, the fate of the two diseases differs considerably and leads to different strategies for patient management. Differentiation of the two diseases currently requires a combination of several clinical and electrophysiological tests. First studies of myocardial innervation using iodine-123 metaiodobenzylguanidine (MIBG) indicated a possible role of scintigraphy for this purpose. An increase in the pulmonary uptake of 123I-MIBG has been reported in secondary dysautonomias. Whether sympathetic innervation of the lung is affected in primary dysautonomias is currently unknown. Therefore, cardiac and pulmonary uptake of 123I-MIBG was studied in 21 patients with Parkinson's disease, 7 patients with multiple system atrophy and 13 age- and sex-matched controls. Thoracic images were obtained in the anterior view 4 h after intravenous injection of 185 MBq 123I-MIBG, at which time the maximum neuronal uptake is reached. All patients with Parkinson's disease had significantly lower cardiac uptake of 123I-MIBG than patients with multiple system atrophy and controls. Sympathetic innervation of the lung was not affected in either disease. It is concluded that scintigraphy with 123I-MIBG appears to be a useful tool for differentiation between Parkinson's disease and multiple system atrophy early after onset of autonomic dysfunction. (orig.)

  20. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, M.J.; Juengling, F.D.; Krause, T.M. [Dept. of Nuclear Medicine, Freiburg University Hospital (Germany); Braune, S. [Dept. of Neurology, Freiburg University Hospital (Germany)

    2000-05-01

    Primary dysfunction of the autonomic nervous system can be observed in patients with Parkinson's disease and those with multiple system atrophy. However, the fate of the two diseases differs considerably and leads to different strategies for patient management. Differentiation of the two diseases currently requires a combination of several clinical and electrophysiological tests. First studies of myocardial innervation using iodine-123 metaiodobenzylguanidine (MIBG) indicated a possible role of scintigraphy for this purpose. An increase in the pulmonary uptake of {sup 123}I-MIBG has been reported in secondary dysautonomias. Whether sympathetic innervation of the lung is affected in primary dysautonomias is currently unknown. Therefore, cardiac and pulmonary uptake of {sup 123}I-MIBG was studied in 21 patients with Parkinson's disease, 7 patients with multiple system atrophy and 13 age- and sex-matched controls. Thoracic images were obtained in the anterior view 4 h after intravenous injection of 185 MBq {sup 123}I-MIBG, at which time the maximum neuronal uptake is reached. All patients with Parkinson's disease had significantly lower cardiac uptake of {sup 123}I-MIBG than patients with multiple system atrophy and controls. Sympathetic innervation of the lung was not affected in either disease. It is concluded that scintigraphy with {sup 123}I-MIBG appears to be a useful tool for differentiation between Parkinson's disease and multiple system atrophy early after onset of autonomic dysfunction. (orig.)

  1. Value of cardiac magnetic resonance imaging in diagnosing coronary heart disease%心脏磁共振在冠心病诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    赵世华

    2011-01-01

    @@ 心脏磁共振(cardiac magnetic resonance,CMR)扫描不仅无电离辐射,且与超声、CT及核素等常见的无创性检查相比,其空间和时间分辨率的组合堪称最佳.不仅如此,CMR具有大视野、多成像序列、高度的组织分辨力及不断呈现的新方法、新技术,能对心脏形态、功能、心肌灌注、血管造影、动脉斑块及分子显像等进行"一站式"检查.

  2. Value of cardiac work index in treadmill exercise test%平板运动试验中心脏作功指数价值探讨

    Institute of Scientific and Technical Information of China (English)

    罗琳; 赵水平; 曹阳; 刘颖望; 李乔华

    2003-01-01

    @@ 目前,平板运动试验已成为临床诊断冠心病的常规无创检查手段,但仍存在一定比例的假阳性及假阴性.在亚极量运动试验时,常以极量心率的85%作为运动终点,使假阴性增多,因而有其局限性[1].本文通过回顾性分析203例患者平板运动耐量试验(treadmill exercise tolerance test,TETT)时的心率(heart rate, HR)、血压(blood pressure, BP)反应,以探讨心脏作功指数(cardiac work index,CWI)[即心率血压乘积(rate-pressure product , RPP)] 的价值.

  3. The Effect of Threshold Values and Weighting Factors on the Association between Entropy Measures and Mortality after Myocardial Infarction in the Cardiac Arrhythmia Suppression Trial (CAST

    Directory of Open Access Journals (Sweden)

    Christopher Mayer

    2016-04-01

    Full Text Available Heart rate variability (HRV is a non-invasive measurement based on the intervals between normal heart beats that characterize cardiac autonomic function. Decreased HRV is associated with increased risk of cardiovascular events. Characterizing HRV using only moment statistics fails to capture abnormalities in regulatory function that are important aspects of disease risk. Thus, entropy measures are a promising approach to quantify HRV for risk stratification. The purpose of this study was to investigate this potential for approximate, corrected approximate, sample, fuzzy, and fuzzy measure entropy and its dependency on the parameter selection. Recently, published parameter sets and further parameter combinations were investigated. Heart rate data were obtained from the "Cardiac Arrhythmia Suppression Trial (CAST RR Interval Sub-Study Database" (Physionet. Corresponding outcomes and clinical data were provided by one of the investigators. The use of previously-reported parameter sets on the pre-treatment data did not significantly add to the identification of patients at risk for cardiovascular death on follow-up. After arrhythmia suppression treatment, several parameter sets predicted outcomes for all patients and patients without coronary artery bypass grafting (CABG. The strongest results were seen using the threshold parameter as a multiple of the data’s standard deviation ( r = 0 . 2 · σ . Approximate and sample entropy provided significant hazard ratios for patients without CABG and without diabetes for an entropy maximizing threshold approximation. Additional parameter combinations did not improve the results for pre-treatment data. The results of this study illustrate the influence of parameter selection on entropy measures’ potential for cardiovascular risk stratification and support the potential use of entropy measures in future studies.

  4. Input-output supervisor

    International Nuclear Information System (INIS)

    The input-output supervisor is the program which monitors the flow of informations between core storage and peripheral equipments of a computer. This work is composed of three parts: 1 - Study of a generalized input-output supervisor. With sample modifications it looks like most of input-output supervisors which are running now on computers. 2 - Application of this theory on a magnetic drum. 3 - Hardware requirement for time-sharing. (author)

  5. 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.)

  6. 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.

  7. 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

  8. 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

  9. Output hardcopy devices

    CERN Document Server

    Durbeck, Robert

    1988-01-01

    Output Hardcopy Devices provides a technical summary of computer output hardcopy devices such as plotters, computer output printers, and CRT generated hardcopy. Important related technical areas such as papers, ribbons and inks, color techniques, controllers, and character fonts are also covered. Emphasis is on techniques primarily associated with printing, as well as the plotting capabilities of printing devices that can be effectively used for computer graphics in addition to their various printing functions. Comprised of 19 chapters, this volume begins with an introduction to vector and ras

  10. VMS forms Output Tables

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These output tables contain parsed and format validated data from the various VMS forms that are sent from any given vessel, while at sea, from the VMS devices on...

  11. Output and error messages

    International Nuclear Information System (INIS)

    This document describes the output data and output files that are produced by the SYVAC A/C 1.03 computer program. It also covers the error messages generated by incorrect input data, and the run classification procedure. SYVAC A/C 1.03 simulates the groundwater mediated movement of radionuclides from underground facilities for the disposal of low and intermediate level wastes to the accessible environment, and provides an estimate of the subsequent radiological risk to man. (author)

  12. Effects of Pure Organic Fertilizer on Flue-cured Tobacco Yield,Output Value and Quality%纯施有机肥对烤烟产量、产值和品质的影响

    Institute of Scientific and Technical Information of China (English)

    吴照辉; 郭芳阳; 李柏杰; 程森; 桂炎伟; 刘巧真; 曹华民; 陈廷贵

    2012-01-01

    In order to explore the effect of pure organic fertilizers on tobacco production and seek a suitable model of the pure organic fertilizer in Henan tobacco production regions,different models of pure organic fertilizers were studied compared with the control group of field conventional fertilization (300 kg/ha goods sesame cake + inorganic fertilizer, CK). The results showed that the flue-cured tobacco grew better by applying pure organic fertilizers. Its output changed little,and the production value and the average price increased compared with CK. [The nicotine and total nitrogen content decreased obviously, while the total sugar, potassium, chlorine and sugar/nicotine ratio, nitrogen/nicotine ratio, potassium/chloride ratio had an increase. The vigorous growth by the treatment of 300 kg/ha pure sesame cake+150 kg/ha butter+7 500 kg/ha decomposed cow dung was the best among all treatments. By applying 300 kg/ha pure sesame cake+150 kg/ha butter + 7 500 kg/ha decomposed cow dung,the plant height,stem circumference,leaf number and maximum leaf length and width increased by 24. 84%, 18. 87% ,29. 17% ,3. 31 % and 20. 42%, respectively; the tobacco had more oil;the output value,average price and the proportion of superior tobacco leaves were 40 885. 20 yuan/ha, 15. 02 yuan/kg,48. 28% , respectively; the tobacco chemical composition was most coordinated and the total sugar,reducing sugar,sugar/nicotine ratio,nitrogen/nicotine ratio and total sugar/reducing sugar ratio increased 2. 1,2.43,1. 95,0. 014,0. 03 percentage points,respectively;it had the best sensory evaluation and the highest score (35. 5) a-mong under the different models of pure organic fertilizers,as well as a good aroma quality and quantity. In summary,the model using 300 kg/ha pure sesame cake+150 kg/ha butter+7 500 kg/ ha decomposed cow dung was the best for the current tobacco production in Henan.%为探索纯施有机肥对河南烟区烟叶生产的影响,寻求适宜河南烟区的纯施有机肥

  13. 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...

  14. 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.

  15. Effects of Exercise Training on Haematology and Maximal Cardiac Output

    DEFF Research Database (Denmark)

    Bonne, Thomas Christian

    the heart ultra structure possibly also play a role for improving Qmax. Other mechanisms that can improve exercise capacity include hypoxia. It is universally accepted that hypoxia is a main stimulant of erythropoiesis and altitude training is considered a possibility to increase red blood cell volume...... of the exercise induced increase in Qmax whereas structural changes to the heart may require years of training to exert an effect. Classical altitude training has the potential to further increase Hbmass and BV through an elevation in RCV and a strong tendency towards improvements in performance was......Qmax may increase within a few weeks of exercise and the underlying mechanisms leading to this are likely to be multi-factorial. Plasma volume is generally thought to rapidly increase in response to exercise training driving an increase in Qmax and hence VO2max. Structural and functional changes to...

  16. 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

  17. 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

  18. Effects of sedation with low-dosage dexmedetomidine on cardiac function in elderly surgical patients

    Directory of Open Access Journals (Sweden)

    Yu LANG

    2011-09-01

    Full Text Available Objective To investigate the influence of continuous infusion of low-dose dexmedetomidine(DEX for sedation on cardiac function index in elderly surgical patients,and assess the impacts on circulation.Methods Sixty elderly surgical patients were randomized into DEX group and control group(30 each.The sex ratio of the patients was 24/36(male/female,and age from 65 to 89 years.After the cannulation of left radial artery,the arterial pressure continuous cardiac output(APCO monitor(Edwards,USA was connected,and the cardiac function index was continuously monitored,including cardiac output index(CI,stroke volume index(SVI,heart rate(HR and mean arterial pressure(MAP.The patients in DEX group were infused with DEX at 0.4μg(kg·h for 10min following intrathecal anesthesia,then the infusion rate was adjusted from 0.2 to 0.4μg(kg·h to keep the bispectral index values(BIS maintained between 75 and 85.Normal saline was administered with an equal volume in control group.The MAP,HR,respiration rate(RR,pulse oxygen saturation(SpO2,the partial pressure of end-tidal carbon dioxide(PETCO2 and BIS were recorded immediately at the DEX infusion(T0,and 10min(T1,20min(T2,30min(T3,60min(T4 after DEX infusion,and the end of surgery(T5.All cardiac function data were statistically analyzed,and P 0.05.Conclusion The sedation with continuous infusion of small-dosage DEX during intrathecal anesthesia in elderly surgical patients may have little impact on cardiac function index,but the conclusion remains to be verified with large sample and multicenter research.

  19. 脉搏指示连续心排血量监测技术在骨盆骨折合并失血性休克患者中的应用及护理%Nursing of pulse-indicated continuous cardiac output technique in pelvic fracture patients with hemorrhagic shock

    Institute of Scientific and Technical Information of China (English)

    赵文静; 程人佳; 张庆红; 赵文州

    2015-01-01

    Objective To investigate the clinical nursing methods of pulse-indicated con-tinuous cardiac output(PICCO)system in pelvic fracture patients with hemorrhagic shock.Methods The clinical data of 82 pelvic fracture patients with hemorrhagic shock treated in emergency inten-sive care unit (EICU)were retrospectively analyzed.Results In 82 patients,74 improved patients transferred to other departments or discharged and 8 patients died including 6 patients with acute re-nal failure.Conclusion Pelvic fracture patients with hemorrhagic shock using PICCO technology can accurately reflect the volume state.The PICCO management and PICCO safety is the key to en-sure successful treatment.%目的:探讨脉搏指示连续心排血量监测技术(PICCO)在骨盆骨折合并失血性休克患者中的应用及护理方法。方法对急诊重症监护室(EICU)收治的82例骨盆骨折合并失血性休克患者的临床及护理资料进行回顾性分析。结果82例患者中,病情好转转科或出院74例,死亡8例,其中并发急性肾衰竭6例。结论骨盆骨折合并失血性休克患者采用 PICCO技术能精准反映患者的容量状态,在 PICCO 的管理和观察中保证 PICCO 监测安全有效是救治成功的关键。

  20. Practical value of cardiac magnetic resonance imaging in unstable angina diagnosis%心脏核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    唐新宇; 欧阳容

    2012-01-01

    Objective To investigate the value of magnetic resonance imaging of heart in diagnosis of unstable angina pectoris.Methods A total of 24 patients with unstable angina pectoris including 15 male and 9 female confirmed by coronary angiography (CAG) were enrolled.All 24 patients were scanned by cardiac magnetic resonance imaging ( CMR),and then the analyses of the first pass images and the delayed contrast enhancement images were carried out for comparison.The findings of cardiac structure,cardiac function,myocardial ischemia,myocardial necrosis,myocardial edema were taken for answering to the images made by echocardiography (UCG) and coronary angiography (CAG) linked with conventional examinations for the diagnosis of coronary disease.Results Compared with the UCG,CMR provided more detailed information about the right ventricle,and the information about left ventricular structure and function given by UCG was very good consistent with that offered by CMR,and CMR could detect myocardial ischemia,myocardial edema and the myocardial necrosis,which were of good consistency with findings often observed by conventional inspection methods.Conclusions Cardiac magnetic resonance imaging (CMR) is of high value in diagnosis and evaluation of unstable angina pectoris and is far superior over other conventional methods for examinations of unstable angina pectoris.%目的 研究心脏核磁共振在不稳定型心绞痛诊治中的价值.方法 选择确诊不稳定性心绞痛患者24例,其中男性15例,女性9例,均行冠脉造影.对24例患者进行心脏核磁共振(CMR)扫描,对图像进行首过灌注和延迟扫描分析(LEG),记录其在心脏结构、功能、心肌缺血、坏死、水肿等方面的信息,并使之与超声心动图(UCG)、冠脉造影(CAG)等传统检查结果对比.结果 CMR与UCG相比,可以提供更多右心室方面的信息.在左心室结构及功能方面,两者有很好的一致性;CMR能发现并检测心肌缺血、水肿及坏死,

  1. Incremental prognostic value of cardiac function assessed by ECG-gated myocardial perfusion SPECT for the prediction of future acute coronary syndrome

    International Nuclear Information System (INIS)

    The prognostic value of electrocardiogram (ECG)-gated rest 201T1/stress 99mTc-tetrofosmin myocardial perfusion single-photon emission computed tomography for the prediction of acute coronary syndrome (ACS: myocardial infarction (MI) and unstable angina (UA)) and the implications of ejection fraction (EF) has not yet been defined in Japanese. The 1,895 patients were followed up for the occurrence ACS. The mean follow-up interval was 26.9±15.5 months. The 142 patients with revascularization within 60 days were censored. Summed stress score (SSS) and summed difference score (SDS) were calculated. The 19 MI and 29 UA occurred (1.1% and 1.6%, respectively). Univariate Cox analysis showed that hypertension (Wald 5.09, p<0.05), poststress EF (Wald 10.9, p<0.01), SSS (Wald 12.4, p<0.001) and SDS (Wald 18.7, p<0.001) were significant predictors of ACS. Multivariate Cox analysis showed that hypertension (Wald 4.27, p<0.05) and SDS (Wald 8.59, p<0.01) were independent predictors. When multiple clinical risk factors (number of coronary risk factors ≥2), significant ischemia (SDS≥4) and low EF (EF<45%) were applied to multivariate Cox analysis, the combination of significant ischemia and low EF showed the highest predictive value (Wald 11.9; p<0.001) for future ACS. Poststress EF added incremental prognostic value for the prediction of ACS. (author)

  2. Oil output's changing fortunes

    International Nuclear Information System (INIS)

    The Petroleum Economist, previously the Petroleum Press Service, has been making annual surveys of output levels of petroleum in all the oil-producing countries since its founding in 1934. This article documents trends and changes in the major oil-producing countries output from 1934 until the present. This analysis is linked with the political and historical events accompanying these changes, notably the growth of Middle Eastern oil production, the North Sea finds and most recently, Iraq's invasion of Kuwait in 1990. (UK)

  3. 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 ...

  4. CARDIAC SIZE IN THE SUPINE CHESTFILM

    NARCIS (Netherlands)

    VANDERJAGT, EJ; SMITS, HJ

    1992-01-01

    The aim of this study was to find a normal value for the cardiac size in the supine position because such a standard is hardly known in the literature. Cardiac size in the erect and supine positions were compared in 165 patients in whom both chest radiographs were performed prior to kidney transplan

  5. Acute kidney injury after cardiac arrest

    OpenAIRE

    Tujjar, Omar; Mineo, Giulia; Dell’Anna, Antonio; Poyatos-Robles, Belen; Donadello, Katia; Scolletta, Sabino; Vincent, Jean-Louis; Taccone, Fabio Silvio

    2015-01-01

    Introduction The aim of this study was to evaluate the incidence and determinants of AKI in a large cohort of cardiac arrest patients. Methods We reviewed all patients admitted, for at least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October 2012. AKI was defined as oligo-anuria (daily urine output

  6. Three-dimensional display and measurement of cardiac dynamic indexes from MR images

    International Nuclear Information System (INIS)

    The cardiac dynamic index, to which such variables as cardiac output, ejection fraction, and wall motion contribute, is routinely determined using various modalities such as angiography, radionuclide imaging, US, and x-ray CT. Each of these modalities, however, has some disadvantages in regard to evaluating the cardiac dynamic index. The authors have obtained precise multidirectional projection images of the heart by means of computer graphics and reformatted data of cardiac MR images obtained with cardiac gating. The contiguous coronal MR images of the heart are made at an interimage distance of 5 mm. In each section, five or six cardiac images can be obtained, depending on the systolic or diastolic phase. These images are stored in a computer, and a three-dimensional display of the heart with biocular observation and with multiplex holograms is made possible with computer graphics. Three-dimensional measurement of the cardiac index is now being attempted, including cardiac output, ejection fraction, and wall motion

  7. Tenure and Output

    OpenAIRE

    Kathryn Shaw; Edward P. Lazear

    2007-01-01

    A key tenet of the theory of human capital is that investment in skills results in higher productivity. The previous literature has estimated the degree of investment in human capital for individuals by looking at individual wage growth as a proxy for productivity growth. In this paper, we have both wage and personal productivity data, and thus are able to measure of the increase in workers' output with tenure. The data is from an autoglass company. Most of production occurs at the individual...

  8. SODIUM BICARBONATE INFUSION: TO PREVENT CARDIAC SURGERY - ASSOCIATED ACUTE KIDNEY INJURY

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-02-01

    Full Text Available OBJECTIVES: The incidence of cardiac surgery – associated acute kidney injury is 50% of patients and is associated with increased mortality and morbidity. This study aimed to determine if perioperative urinary and plasma alkalization with sodium bicarbonate infusion re duces the incidence of cardiac surgery – associated acute kidney injury. SETTING AND DESIGN: This study is double blind randomized control trial conducted at U N Mehta Institute of Cardiology and Research Center , India. METHOD S AND RESULT: A total of 140 pat ients scheduled to undergo elective cardiac surgery , who were at increased risk of development of cardiac surgery – associated acute kidney injury using recognized risk factors. Patients were randomly allocated to receive either sodium bicarbonate (n = 70 o r sodium chloride (n = 70 infusion , commencing at the start of anesthesia , in a dose of 4 mmol/kg over 24 hour. The primary outcome measure was the number of patients with development of CSA - AKI , defined as an increase in creatinine greater than 25% from baseline to peak value within the first three postoperative days. Significant differences among the groups in both plasma and urinary pH were achieved 6 hours after commencement of the infusion , and these changes persisted for more than 24 hours. A total o f 7 out of 70(10% patients in the sodium bicarbonate group and 16 out of 70(22.85% patients in the sodium chloride group developed acute kidney injury within the first three postoperative days with p value of 0.06 which is statistically not significant . There were also no significant differences in ventilation hours , ICU or hospital length of stay , or mortality. CONCLUSIONS: Perioperative alkalization of blood and urine using an infusion of sodium bicarbonate did not result in a decrease in the incidence of acute kidney injury in patients undergoing cardiac surgery. KEYWORDS: Acute kidney injury; Cardiac surgery; Cardiopulmonary bypass; Creatinine

  9. The effect of age on the relationship between cardiac and vascular function

    OpenAIRE

    Houghton, David; Jones, Thomas W.; Cassidy, Sophie; Siervo, Mario; MacGowan, Guy A.; Trenell, Michael I; Jakovljevic, Djordje G.

    2016-01-01

    Age-related changes in cardiac and vascular function are associated with increased risk of cardiovascular mortality and morbidity. The aim of the present study was to define the effect of age on the relationship between cardiac and vascular function. Haemodynamic and gas exchange measurements were performed at rest and peak exercise in healthy individuals. Augmentation index was measured at rest. Cardiac power output, a measure of overall cardiac function, was calculated as the product of car...

  10. 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

  11. Input-output theory of the unconventional photon blockade

    OpenAIRE

    Flayac, H.; Savona, V.

    2013-01-01

    We study the unconventional photon blockade, recently proposed for a coupled-cavity system, in the presence of input and output quantum fields. Mixing of the input or output channels still allows strong photon antibunching of the output field, but for optimal values of the system parameters that differ substantially from those that maximize antibunching of the intracavity field. This result shows that the specific input-output geometry in a photonic system determines the optimal design in vie...

  12. Changes in cardiac performance and sympathetic stimulation during and after fractionated radiotherapy in a rat model

    International Nuclear Information System (INIS)

    The consequences of fractionated irradiation on the number of cardiac α- and β-adrenergic receptors, myocardial norepinephrine concentration and in vitro assessed heart function were studied in Sprague-Dawley rats. Animals were locally irradiated on the thorax with a total dose of 50 Gy, in 5 weeks, using two different fractionation schemes (5 x 2.0 Gy/week and 3 x 3.3 Gy/week). Functional and biochemical assays were performed during treatment and at 6 months after initiation of treatment. During fractionated irradiation, the numbers of α- and β-adrenergic receptors tended to rise. During this period, myocardial norepinephrine concentration remained fairly constant and no decrease in cardiac output was observed. At 6 months, a significant increase of the numbers of α- and β-adrenergic receptors was observed in the 3.3 Gy/fraction group compared to age-matched controls, p = 0.012 and p = 0.02, respectively. At this time point, the myocardial norepinephrine concentration had decreased below control levels (p = 0.008 for the 3.3. Gy/fraction schedule, and p = 0.03 for the 2.0 Gy/fraction schedule). At 6 months, the cardiac output declined to 61% (p = 0.009) and 69% (p = 0.04) of control values for the 3.3 and 2.0 Gy/fraction schedules, respectively. The present data clearly show development of late cardiac sequelae caused by fractionated thorax irradiation with a total dose of 50 Gy. Moreover, this study lends support to the importance of fraction size with regard to the severity of the radiation-induced cardiac damage

  13. VALUE OF CARDIAC TROPONIN I IN CHILDREN OF SEVERE PNEUMONIA WITH MYOCARDIAL DAMAGE%心肌肌钙蛋白I检测在重症肺炎儿童心肌损害中价值探讨

    Institute of Scientific and Technical Information of China (English)

    聂军红; 杨丽

    2014-01-01

    Objective To investigate the value of cardiac troponin I (CTnI)in children of severe pneumonia with myocardial damage.Methods A total of 200 children with severe pneumonia in our hospital were collected as observation group,180 children with mild pneumonia in our hospital in the same period were collected as mild group,200 cases of healthy children in the same period were collected as control group,CTnI level,creatine kinase MB(CK-MB)level of three groups were analyzed and compared.Results The cTnI,CK-MB,creatine Kinase (CK), lactate dehydrogenase(LDH)and aspartate amino-transferase,AST(AST)levels of observation group were significantly higher than those of mild group (P0.05).Conclusion Most children of severe pneumonia are associated with varying degrees of myocardial damage,cTnI can be used to monitor the condition of the children as an important marker of myocardial inj ury.Early detection of cTnI is favorable to the early diagnosis and treatment of severe pneumonia with myocardial damage,thereby preventing the occurrence of cardiac failure in the children.%目的:探讨小儿重症肺炎并发心肌损害中心肌钙蛋白I(cardiac troponin I,cTnI)的测定及其意义。方法选取重症肺炎患儿200例为观察组,轻症肺炎患儿180例为轻症组,正常儿童200例为对照组,对比3组儿童cTnI水平、肌酸激酶同工酶(creatine kinase MB,CK-MB)水平。结果观察组 cTnI、CK-MB、肌酸激酶(creatine kinase,CK)、乳酸脱氢酶(lactate dehydrogenase,LDH)及天冬氨酸转氨酶(aspartate amino-transferase,AST)水平高于轻症组(P<0.05),观察组和轻症组 cTnI、CK-MB、LDH、AST水平高于对照组(P<0.05)。观察组 cTnI阳性率高于轻症组(P<0.05)。观察组与轻症组CK-MB阳性率差异无统计学意义(P>0.05)。结论重症肺炎患儿多伴有不同程度的心肌损害,cTnI可作为监测心肌损伤的重要标志物。早期检测 cTnI有

  14. MRI in cardiac sarcoidosis and amyloidosis

    International Nuclear Information System (INIS)

    Sarcoidosis and amyloidosis are both multisystem disorders, which may involve the heart; however, isolated cardiac disease is rare. Diagnosis of cardiac sarcoidosis and amyloidosis is crucial because the patient prognosis is dependent on cardiac involvement and early treatment. Echocardiography is the first line imaging modality in the diagnostic work-up of both diseases, possibly giving hints towards the correct diagnosis. Besides myocardial biopsy and radionuclide studies cardiac magnetic resonance imaging (MRI) is routinely performed in patients suspect of having infiltrative cardiomyopathy. The T1 mapping procedure is currently being evaluated as a new technique for detection and quantification of global myocardial enhancement, as seen in cardiac amyloidosis. Sensitivities and specificities for detection of cardiac sarcoidosis and amyloidosis can be significantly improved by MRI, especially with late gadolinium enhancement (LGE) imaging. In cardiac sarcoidosis the use of LGE is outcome-related while in amyloidosis analysis of T1-mapping may be of prognostic value. If cardiac involvement in sarcoidosis or amyloidosis is suspected cardiac MRI including LGE should be performed for establishing the diagnosis. (orig.)

  15. Avaliação dos valores séricos de troponina I cardíaca em crianças menores de 1 ano de idade Evaluation of serum cardiac troponin I values in children less than 1 year of age

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Arruda Souto

    2008-09-01

    Full Text Available OBJETIVO: Verificar os valores séricos para troponina I cardíaca em crianças abaixo de um ano de idade, sem disfunção cardíaca clínica. MÉTODOS: Os níveis séricos de troponina I cardíaca foram determinados em 99 crianças com idade abaixo de um ano, incluindo-se recém-nascidos a termo, sem doenças relacionadas a comprometimento da função cardíaca identificável clinicamente, por meio do kit específico Opus T Troponin I (cTn (Dade Behring Inc. - Newalk, DE 19714, USA. RESULTADOS: A dosagem sérica de troponina I cardíaca apresentou, em todos os pacientes, valor menor que 0,1 ng/ml. CONCLUSÃO: Verificamos que o valor da dosagem sérica de troponina I cardíaca é menor do que 0,1 ng/ml para pacientes pediátricos, sem disfunção cardíaca, desde recém-nascidos a termo até um ano de idade, quando realizada por meio do kit Opus T Troponin I (cTn test modules.OBJECTIVE: The objective is to verify the cardiac troponin I values in children less than 1 year of age without clinical cardiac dysfunction. METHODS: The cardiac troponin I values were determined in 99 children less than 1 year of age, including term infants without diseases related to cardiac dysfunction using the specific kit Opus T Troponin I (cTn (Dade Behring Inc. -Newalk, DE 19714, USA. RESULTS: All children have values of cardiac troponin I less than 0.1 ng/ml. CONCLUSION: We verified that the cardiac troponin I value is less than 0.1 ng/ml in children less than 1 year, including term infants without cardiac dysfunction, when analized by the kit Opus T Troponin I (cTn test modules.

  16. Cardiac oxygen limitation during an acute thermal challenge in the European perch: effects of chronic environmental warming and experimental hyperoxia.

    Science.gov (United States)

    Ekström, Andreas; Brijs, Jeroen; Clark, Timothy D; Gräns, Albin; Jutfelt, Fredrik; Sandblom, Erik

    2016-08-01

    Oxygen supply to the heart has been hypothesized to limit cardiac performance and whole animal acute thermal tolerance (CTmax) in fish. We tested these hypotheses by continuously measuring venous oxygen tension (Pvo2) and cardiovascular variables in vivo during acute warming in European perch (Perca fluviatilis) from a reference area during summer (18°C) and a chronically heated area (Biotest enclosure) that receives warm effluent water from a nuclear power plant and is normally 5-10°C above ambient (24°C at the time of experiments). While CTmax was 2.2°C higher in Biotest compared with reference perch, the peaks in cardiac output and heart rate prior to CTmax occurred at statistically similar Pvo2 values (2.3-4.0 kPa), suggesting that cardiac failure occurred at a common critical Pvo2 threshold. Environmental hyperoxia (200% air saturation) increased Pvo2 across temperatures in reference fish, but heart rate still declined at a similar temperature. CTmax of reference fish increased slightly (by 0.9°C) in hyperoxia, but remained significantly lower than in Biotest fish despite an improved cardiac output due to an elevated stroke volume. Thus, while cardiac oxygen supply appears critical to elevate stroke volume at high temperatures, oxygen limitation may not explain the bradycardia and arrhythmia that occur prior to CTmax Acute thermal tolerance and its thermal plasticity can, therefore, only be partially attributed to cardiac failure from myocardial oxygen limitations, and likely involves limiting factors on multiple organizational levels. PMID:27280433

  17. On-chip SIDO buck converter with independent outputs

    OpenAIRE

    Martínez García, Herminio; Silva-Martínez, José

    2013-01-01

    The portable electronics market is rapidly migrating towards more compact devices requiring multiple high-integrity high-efficiency voltage supplies for empowering the systems. This paper demonstrates a single inductor used in a buck converter with two output voltages from an input battery with voltage of value 3 V. The main targets are low cross regulation between the two outputs to supply independent load current levels while maintaining desired output voltage values well within the accepta...

  18. 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

  19. Cardiac assessment of African hedgehogs (Atelerix albiventris).

    Science.gov (United States)

    Black, Peter A; Marshall, Cecilia; Seyfried, Alice W; Bartin, Anne M

    2011-03-01

    Cardiomyopathy is a common finding in captive African hedgehogs (Atelerix albiventris) at postmortem exam. To date, treatment attempts have been mostly empirical and unrewarding. The objective of this study was to determine reference cardiac values for captive African hedgehogs based on echocardiogram, electrocardiogram (ECG), and radiographs. Adult African hedgehogs with no clinical signs of cardiac disease (n = 13) were selected. Each animal was anesthetized with isoflurane via facemask and an echocardiogram, ECG, and radiographs were performed. Standard measurements were taken and the descriptive statistics performed. Values were comparable to limited data available in other hedgehog species and other similar-sized exotic species. Two animals were removed from consideration of reference values due to valvular defects that were considered significant. These data are the first establishing cardiac parameters in normal African hedgehogs using radiographic cardiac measurement, echocardiogram, and ECG. Evaluating animals with possible cardiomyopathy may allow for earlier diagnosis and more successful treatment. PMID:22946370

  20. Predictive value of fragmented QRS on nonresponse to cardiac resynchronization therapy%碎裂QRS波对心脏再同步治疗无反应的预测价值

    Institute of Scientific and Technical Information of China (English)

    吕钢; 陈康玉; 严激; 胡凯

    2015-01-01

    目的:探讨碎裂QRS波( fQRS)对心脏再同步治疗( CRT)无反应的预测价值。方法选择150例患者,按心电图是否有fQRS分为fQRS组和无fQRS组。 CRT术前及术后6个月行纽约心功能分级,心电图和超声心动图检查。以术后6个月时心功能分级改善Ⅰ级以上或左室射血分数( LVEF)增加≥5%作为CRT有反应的标准,未达到该标准或患者心源性死亡定义为CRT无反应。用单因素和多因素Logistic回归分析fQRS对CRT无反应的预测价值。结果① fQRS组较无 fQRS 组 CRT 无反应发生率高(52.6% vs 18.7%,P<0.01)。②单因素及多因素Logistic回归分析均提示fQRS是CRT无反应的独立危险因素。结论 fQRS对CRT无反应有一定的预测价值。%Objective To explore the value of fragmented QRS( fQRS) in predicting the incidence of nonresponse to cardiac resynchronization therapy( CRT) . Methods One hundred and fifty patients were enrolled in this study. Study populations were divided into fQRS group and non-fQRS group according to the existence of fQRS on electro-cardiography ( ECG) . Before CRT implantation as well as 6 months after implantation,New York Heart Association ( NYHA) class, ECG and echocardiography were evaluated. Response to CRT was defined as improvement of at least one NYHA class or improvement of left ventricular ejection fraction ( LVEF) ≥5% 6 months after implana-tion. Patients were defined as nonresponders if they did not reach the prespecified standard or died of cardiac cau-ses. The univariate and multivariate Logistic regression analysis was performed to evaluate the predictive value of fQRS on nonresponse to CRT. Results ①Patients in fQRS group had a higher chance of nonresponse to CRT than in non-fQRS group (52. 6% vs 18. 7% P<0. 01). ②Both univariate and multivariate Logistic regression analysis showed that fQRS was an independent predictor of nonresponse to CRT. Conclusion fQRS is valuable in predic-ting the incidence of

  1. A new nonlinear output tracking controller via output-feedback

    Institute of Scientific and Technical Information of China (English)

    Yun ZHANG; Yungang LIU; Yuqin DING

    2006-01-01

    In this paper, the output tracking control is investigated for a class of nonlinear systems when only output is available for feedback. Based on the multivariable analog of circle criterion, an observer is first introduced. Then, the observer-based output tracking controller is constructively designed by using the integral backstepping approach together with completing square. It is shown that, under relatively mild conditions, all the closed-loop signals are uniformly bounded.Meanwhile the system output asymptotically tracks the desired output. A simulation example is given to illustrate the effectiveness of the theoretical results.

  2. Mongolia; Measuring the Output Gap

    OpenAIRE

    Julia Bersch; Tara M. Sinclair

    2011-01-01

    This paper compares the output gap estimates for Mongolia based on a number of different methods. Special attention is paid to the substantial role of mining in the Mongolian economy. We find that a Blanchard and Quah-type joint model of output and inflation provides a more robust estimate of the output gap for Mongolia than the traditional statistical decompositions.

  3. Application Value of Milrinone in the Treatment of Rheumatic Valvular Heart Disease With Cardiac Insufifciency%探讨米力农治疗风湿性心脏瓣膜病心功能不全中的应用价值

    Institute of Scientific and Technical Information of China (English)

    张磊

    2015-01-01

    目的 探讨米力农治疗风湿性心脏瓣膜病心功能不全的应用价值.方法 将120例风湿性心脏瓣膜病患者随机分为对照组和治疗组,每组60例,其中对照组实施常规治疗,治疗组在对照组基础上加用米力农,评估两组患者的心功能,测定心脏指数.结果 治疗组总有效率明显高于对照组,差异具有统计学意义(P<0.05);心排量、射血分数、心脏指数均优于对照组,各指标差异具有统计学意义(P<0.05).结论米力农治疗风湿性心脏瓣膜病心功能不全效果显著,不良反应少.%Objective To explore the therapeutic effect of milrinone for rheumatic valvular heart disease with cardiac insufficiency. Methods 120 cases were divided randomly into two groups of 60 cases each, the therapeutic group were given add-on milrinone by intravenous drip based on conventional therapy while control group were only given conventional therapy. Results The total effective rate of the therapeutic group was higher than control group (P < 0.05) . The cardiac output, cardiac index and ejection fraction in the therapeutic group had obviously increased, there was a significant difference compared with control group (P < 0.05). Conclusion Milrinone are effective and safe drugs for rheumatic valvular heart disease with cardiac insufifciency.

  4. Cardiac function in growth hormone deficient patients before and after 1 year with replacement therapy: a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens Oscar; Petersen, Claus Leth;

    2011-01-01

    gold standard method cardiac magnetic resonance imaging (CMRI) and measurements of circulating levels of B-type natriuretic peptides. Sixteen patients (8 males and 8 females, mean age 49 years (range 18-75)) with severe GHD and 16 matched control subjects were included. CMRI was performed at baseline......Assessed by conventional echocardiography the influence of growth hormone deficiency (GHD) and effects of replacement therapy on left ventricle (LV) function and mass (LVM) have shown inconsistent results. We aimed to evaluate cardiac function before and during replacement therapy employing the...... (range 63-80%), cardiac output index and levels of BNP and NT-proBNP were similar at baseline in patients compared to controls (P-values from 0.09 to 0.37). The patients had significantly smaller LV end-diastolic volume index (P = 0.032) and end-systolic volume index (P = 0.038). No significant change in...

  5. Débito cardíaco e fração de ejeção fetal por meio do spatio-temporal image correlation (STIC: comparação entre fetos masculinos e femininos Fetal cardiac output and ejection fraction by spatio-temporal image correlation (STIC: comparison between male and female fetuses

    Directory of Open Access Journals (Sweden)

    Christiane Simioni

    2012-06-01

    Full Text Available OBJETIVO: Comparar do débito cardíaco (DC e a fração de ejeção (FE do coração de fetos masculinos e femininos obtidos por meio da ultrassonografia tridimensional, utilizando o spatio-temporal image correlation (STIC. MÉTODOS: Realizou-se um estudo de corte transversal com 216 fetos normais, entre 20 a 34 semanas de gestação, sendo 108 masculinos e 108 femininos. Os volumes ventriculares no final da sístole e diástole foram obtidos por meio do STIC, sendo as avaliações volumétricas realizadas pelo virtual organ computer-aided analysis (VOCAL com rotação de 30º. Para o cálculo do DC utilizou-se a fórmula: DC= volume sistólico/frequência cardíaca fetal, enquanto que para a FE utilizou-se a fórmula: FE= volume sistólico/volume diastólico final. O DC (combinado, feminino e masculino e a FE (masculina e feminina foram comparadas utilizando-se o teste t não pareado e ANCOVA. Foram criados gráficos de dispersão com os percentis 5, 50 e 95. RESULTADOS: A média do DC combinado, DC direito, DC esquerdo, FE direita e FE esquerda, para feminino e masculino, foram 240,07 mL/min; 122,67 mL/min; 123,40 mL/min; 72,84%; 67,22%; 270,56 mL/min; 139,22 mL/min; 131,34 mL/min; 70,73% e 64,76%, respectivamente; sem diferença estatística (P> 0,05. CONCLUSÕES: O DC e a FE fetal obtidos por meio da ultrassonografia tridimensional (STIC não apresentaram diferença significativa em relação ao gênero.OBJECTIVE: To compare the cardiac output (CO and ejection fraction (EF of the heart of male and female fetuses obtained by 3D-ultrasonography using spatio-temporal image correlation (STIC. METHODS: We conducted a cross-sectional study with 216 normal fetuses, between 20 and 34 weeks of gestation, 108 male and 108 female. Ventricular volumes at the end of systole and diastole were obtained by STIC, and the volumetric assessments performed by the virtual organ computer-aided analysis (VOCAL rotated 30º. To calculate the DC used the formula

  6. 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 ...

  7. Cardiac chamber scintiscanning

    International Nuclear Information System (INIS)

    The two methods of cardiac chamber scintiscanning, i.e. 'first pass' and 'ECG-triggered' examinations, are explained and compared. Two tables indicate the most significant radiation doses of the applied radio tracers, i.e. 99m-Tc-pertechnetate and 99m-Tc-HSA, to which a patient is exposed. These averaged values are calculated from various data given in specialised literature. On the basis of data given in literature, an effective half-life of approximately 5 hours in the intravascular space was calculated for the erythrocytes labelled with technetium 99m. On this basis, the radiation doses for the patients due to 99m-Tc-labelled erythrocytes are estimated. The advantages and disadvantages of the two methods applied for cardiac chamber scintiscanning are put into contrast and compared with the advantages and disadvantages of the quantitative X-ray cardiography of the left heart. The still existing problems connected with the assessment of ECG-triggered images are discussed in detail. The author performed investigations of his own, which concerned the above-mentioned problems. (orig./MG)

  8. 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

  9. Avaliação da correlação entre o dióxido de carbono expirado e o débito cardíaco em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea Evaluación de la correlación entre el dióxido de carbono expirado y el débito cardíaco en pacientes sometidos a la cirugía cardíaca con circulación extracorpórea Correlation between end-tidal carbon dioxide levels and cardiac output during cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Karina Takesaki Miyaji

    2004-10-01

    reflects pulmonary blood perfusion, thus cardiac output (CO. This study aimed at evaluating the correlation between P ET CO2 levels and CO during cardiac surgery with cardiopulmonary bypass (CPB. METHODS: Participated in this study 25 patients submitted to coronary artery bypass grafting (CABG with CPB. End-tidal CO2 monitoring started after tracheal intubation. Cardiac output was determined by thermodilution with pulmonary artery catheter (Swan-Ganz. Carbon dioxide partial blood pressure (PaCO2 was obtained with arterial blood gases analysis. Studied parameters were evaluated in the following moments: immediately after general anesthesia induction, before cardiopulmonary bypass, at cardiopulmonary bypass completion and at surgery completion. RESULTS: Statistical analysis has not shown correlation between P ET CO2 and CO2, or between P ET CO2-PaCO2 gradient (Ga-eCO2 and CO. There has been correlation between P ET CO2, Ga-eCO2 and CO values variation as compared to baseline values before CPB, with loss of correlation after CPB until surgery completion. CONCLUSIONS: In this study, where patients submitted to cardiac surgery with CPB were evaluated, ventilation/perfusion changes throughout the procedure might have been the factors determining decreased correlation between cardiac output and end tidal CO2.

  10. Asymptomatic carotid disease and cardiac surgery consensus

    OpenAIRE

    Stansby, G.; MacDonald, S.; Allison, R; de Belder, M; Brown, MM; Dark, J; Featherstone, R; Flather, M; Ford, GA; Halliday, A.; Malik, I; R. Naylor; Pepper, J.; Rothwell, PM

    2011-01-01

    The Carotid Disease and Cardiac Surgery Consensus Meeting was convened as a multidisciplinary gathering to consider the management of patients undergoing cardiac surgery who are found to have asymptomatic carotid artery disease. There are no randomized trials concerning whether carotid interventions are of value in this situation and the natural history is unclear. Bilateral carotid artery disease (≥70% stenosis) should be regarded clinically relevant when considering hemodynamic and short-te...

  11. 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...

  12. Serial Input Output

    Energy Technology Data Exchange (ETDEWEB)

    Waite, Anthony; /SLAC

    2011-09-07

    Serial Input/Output (SIO) is designed to be a long term storage format of a sophistication somewhere between simple ASCII files and the techniques provided by inter alia Objectivity and Root. The former tend to be low density, information lossy (floating point numbers lose precision) and inflexible. The latter require abstract descriptions of the data with all that that implies in terms of extra complexity. The basic building blocks of SIO are streams, records and blocks. Streams provide the connections between the program and files. The user can define an arbitrary list of streams as required. A given stream must be opened for either reading or writing. SIO does not support read/write streams. If a stream is closed during the execution of a program, it can be reopened in either read or write mode to the same or a different file. Records represent a coherent grouping of data. Records consist of a collection of blocks (see next paragraph). The user can define a variety of records (headers, events, error logs, etc.) and request that any of them be written to any stream. When SIO reads a file, it first decodes the record name and if that record has been defined and unpacking has been requested for it, SIO proceeds to unpack the blocks. Blocks are user provided objects which do the real work of reading/writing the data. The user is responsible for writing the code for these blocks and for identifying these blocks to SIO at run time. To write a collection of blocks, the user must first connect them to a record. The record can then be written to a stream as described above. Note that the same block can be connected to many different records. When SIO reads a record, it scans through the blocks written and calls the corresponding block object (if it has been defined) to decode it. Undefined blocks are skipped. Each of these categories (streams, records and blocks) have some characteristics in common. Every stream, record and block has a name with the condition that each

  13. Output Model of Steel Plant

    Institute of Scientific and Technical Information of China (English)

    ZHANG Long-qiang; TIAN Nai-yuan; ZHANG Jin; XU An-jun

    2008-01-01

    Based on the requirement of compactivity, continuity, and high efficiency, and taking full advantage of cushion capability of flexible parts such as external refining in new generation steel plant, an output model of steel plant was established in terms of matching between BOF and caster. Using this model, the BOF nominal capacity is selected, the caster output and equipment amount are computed, and then the steel plant output is computed.

  14. Nonlinear input-output systems

    Science.gov (United States)

    Hunt, L. R.; Luksic, Mladen; Su, Renjeng

    1987-01-01

    Necessary and sufficient conditions that the nonlinear system dot-x = f(x) + ug(x) and y = h(x) be locally feedback equivalent to the controllable linear system dot-xi = A xi + bv and y = C xi having linear output are found. Only the single input and single output case is considered, however, the results generalize to multi-input and multi-output systems.

  15. 文化产业对于经济总产出的增值机理——基于V→I→P分析框架的中国观察%The Value-Added Mechanism of Cultural Industries to Economic Output ——Chinese Observation Based on V→I→P Analysis Framework

    Institute of Scientific and Technical Information of China (English)

    汪霏霏

    2012-01-01

    Recent historical facts since the industrial revolution in eighteenth century show that the value of cultural industries to economic output is increasing. The comparative analysis associated with the mainstream values in cultural tradition (V), the innovation process based on a market-oriented system (I) and the added value based on the development of cultural industries to economic output (P), which are established in five provinces of China, such as Shandong,Jiangsu,Shanghai,Zhejiang, Guangdong, shows that the "V →I →P" analytical framework on the value-added mechanism of cultural industries to economic output is largely reasonable. The mainstream values of society determine the supply and the demand of culture through the social system directly, And the social system determines the structure of cultural markets and the system of cultural enterprises. Thereby it determines the behavior choices of cultural enterprises. Finally, it determines the value-added situation about the development of cultural industries to economic output. Cultural industries have the inherent features of value-leading, innovation-driven, industrial integration and ecological value- added. It will eventually become a pillar industry of national economy under the protection of patent systems, industrial innovation support systems and new industries development support systems.%18世纪产业革命以来的史实表明,文化产业对于经济总产出的增值力越来越大。对中国山东、江苏、上海、浙江、广东五省市长期形成的人文传统中主流价值观(V)、以市场体制为取向的制度创新进程(I)和文化产业发展对于经济总产出的增值(P)的关联比较分析表明,文化产业发展对于经济总产出增值机理的“V→I→P”分析框架具有很大程度的合理性。社会主流价值观直接并通过决定社会制度决定文化供需,社会制度决定文化市场结构和文化企业制

  16. 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.

  17. The Economic Impact of Tourism. An Input-Output Analysis

    OpenAIRE

    Camelia SURUGIU

    2009-01-01

    The paper presents an Input-Output Analysis for Romania, an important source of information for the investigation of the inter-relations existing among different industries. The Input-Output Analysis is used to determine the role and importance of different economic value added, incomes and employment and it analyses the existing connection in an economy. This paper is focused on tourism and the input-output analysis is finished for the Hotels and Restaurants Sector.

  18. 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.

  19. Output noise of gaussian shaping filter based on wavelet analysis

    International Nuclear Information System (INIS)

    The output noise power spectrum and the output mean square noise voltage were calculated according to the frequency response of Gaussian shaping filter. The minimum mean square noise voltage can be achieved by choosing suitable scale parameter. For the case of no c noise, the relative signal-to-noise ratio is very coincident with theoretic value given in literature. (authors)

  20. Oscillations of cAMP with the cardiac cycle.

    Science.gov (United States)

    Wikman-Coffelt, J; Sievers, R; Coffelt, R J; Parmley, W W

    1983-03-16

    Oscillations of cAMP with the cardiac cycle were demonstrated in the rat heart using a stimulator-triggered rapid freeze-clamp to decrease the temperature of the heart from 37 degrees C to -80 degrees C in 5 msec (20,000 degrees/sec) at a predetermined phase of the cardiac cycle. The nucleotide, cAMP, oscillated 60% with the cardiac cycle during normal working conditions, the higher cAMP value occurring during systole. PMID:6301471

  1. Altered Cardiac Function and Ventricular Septal Defect in Avian Embryos Exposed to Low-Dose Trichloroethylene

    OpenAIRE

    Echoleah S Rufer; Hacker, Timothy A.; Flentke, George R.; Drake, Victoria J.; Brody, Matthew J.; Lough, John; Susan M. Smith

    2009-01-01

    Trichloroethylene (TCE) is the most frequently reported organic groundwater contaminant in the United States. It is controversial whether gestational TCE exposure causes congenital heart defects. The basis for TCE’s proposed cardiac teratogenicity is not well understood. We previously showed that chick embryos exposed to 8 ppb TCE during cardiac morphogenesis have reduced cardiac output and increased mortality. To further investigate TCE’s cardioteratogenic potential, we exposed in ovo chick ...

  2. Early goal-directed therapy in moderate to high-risk cardiac surgery patients

    OpenAIRE

    Kapoor Poonam; Kakani Madhava; Chowdhury Ujjwal; Choudhury Minati; Lakshmy R; Kiran Usha

    2008-01-01

    Early goal-directed therapy is a term used to describe the guidance of intravenous fluid and vasopressor/inotropic therapy by using cardiac output or similar parameters in the immediate post-cardiopulmonary bypass in cardiac surgery patients. Early recognition and therapy during this period may result in better outcome. In keeping with this aim in the cardiac surgery patients, we conducted the present study. The study included 30 patients of both sexes, with EuroSCORE ≥3 undergoing coro...

  3. Clinical assessment and C-reactive protein (CRP), haptoglobin (Hp), and cardiac troponin I (cTnI) values of brachycephalic dogs with upper airway obstruction before and after surgery

    OpenAIRE

    Planellas, Marta; Cuenca, Rafaela; Tabar, Maria-Dolores; Bertolani, Coralie; Poncet, Cyrill; Closa, Josep M; Lorente, Juan; Cerón, José J.; Pastor, Josep

    2015-01-01

    Brachycephalic dogs have unique upper respiratory anatomy with abnormal breathing patterns that are similar to those in humans with obstructive sleep apnea syndrome (OSAS). The objectives of this multicenter prospective study were to assess the effects of surgical correction on clinical signs in dogs with brachycephalic airway obstructive syndrome (BAOS) and to evaluate the levels of several biomarkers [C-reactive protein (CRP); haptoglobin (Hp), and cardiac troponin I (cTnI)] used to determi...

  4. Resumen del documento de consenso «Guías de práctica clínica para el manejo del síndrome de bajo gasto cardiaco en el postoperatorio de cirugía cardiaca» Summary of the consensus document: «Clinical practice guide for the management of low cardiac output syndrome in the postoperative period of heart surgery»

    Directory of Open Access Journals (Sweden)

    J.L. Pérez Vela

    2012-05-01

    Full Text Available El síndrome de bajo gasto cardiaco es una potencial complicación de los pacientes intervenidos de cirugía cardiaca y asocia un aumento de la morbimortalidad. La presente guía pretende proporcionar recomendaciones para el manejo de estos pacientes, en el postoperatorio inmediato, ingresados en UCI. Las recomendaciones se han agrupado en diferentes apartados, tratando de dar respuesta desde los conceptos más básicos como es la definición a los diferentes apartados de monitorización básica y avanzada, y terminando con el complejo manejo de este síndrome. Se propone un algoritmo de manejo inicial, así como otros de fracaso ventricular predominantemente izquierdo o derecho. La mayor parte de las recomendaciones están basadas en el consenso de expertos, debido a la falta de estudios clínicos aleatorizados, de adecuado diseño y tamaño muestral en este grupo de pacientes. La calidad de la evidencia y la fuerza de las recomendaciones se realizó siguiendo la metodología GRADE. La guía se presenta como una lista de recomendaciones (y nivel de evidencia de cada recomendación para cada pregunta del tema seleccionado. A continuación, en cada pregunta, se procede a la justificación de las recomendaciones.Low cardiac output syndrome is a potential complication in cardiac surgery patients and is associated with increased morbidity and mortality. This guide provides recommendations for the management of these patients, immediately after surgery and following admission to the ICU. The recommendations are grouped into different sections, addressing from the most basic concepts such as definition of the disorder to the different sections of basic and advanced monitoring, and culminating with the complex management of this syndrome. We propose an algorithm for initial management, as well as two others for ventricular failure (predominantly left or right. Most of the recommendations are based on expert consensus, due to the lack of randomized

  5. Supply Management: Analyzing the Values of Tradeable Output Quotas

    OpenAIRE

    Veeman, Michele M.

    1989-01-01

    This paper is coocemed with the analysis of some economic impacts of supply-management quota schemes based on evidence fran some of the Canadian quota programmes. Reasons underlying the wide acceptance of these programmes and the use of cost-increasing methods of quota administration are briefly explored. Some evidence from Canadian quota programmes is presented to illustrate the economic effects of restrictive quota transfer policies. An econometric analysis of economic factors affecting the...

  6. Correlation Degree and Correlation Coefficient of Multi- Output Functions

    Institute of Scientific and Technical Information of China (English)

    JU Gui-zhi; ZHAO Ya-qun

    2005-01-01

    We present definitions of the correlation degree and correlation coefficient of multi-output functions. Two relationships about the correlation degree of multi-output functions are proved. One is between the correlation degree and independency,the other is between the correlation degree and balance. Especially the paper discusses the correlation degree of affine multioutput functions. We demonstrate properties of the correlation coefficient of multi-output functions. One is the value range of the correlation coefficient, one is the relationship between the correlation coefficient and independency, and another is the sufficient and necessary condition that two multi-output functions are equivalent to each other.

  7. An inquiry into the role of cardiac filling pressure in acclimatization to heat.

    OpenAIRE

    Senay, L. C.

    1986-01-01

    During the first exposure of exercising subjects to hot environments (30-50 degrees C), cardiac output, heart rate, and body temperature increase over that seen in cool environments, while stroke volume decreases. If daily heat exposures occur, during the second heat exposure, heart rates and rectal temperatures are decreased from day 1 while cardiac output is maintained. This decrease in physiological strain occurs with little or no increase in evaporative heat loss. The alleviating agent ap...

  8. 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...

  9. New approach for simultaneous respiratory and cardiac motion correction in cardiac PET (NAMC-CPET)

    Science.gov (United States)

    Ahmed, Mohamed A. A.; Xiao, Peng; Xie, Qingguo

    2015-10-01

    Respiratory and cardiac motions are inevitable during the relatively long acquisition time of cardiac positron emission tomography (PET) scan. The correction of the resultant motion blur has become a significant challenge due to recent spatial resolution improvement of the PET scanners. The majority of current motion compensation algorithms are based on gating as a primary step. A new approach based on temporal basis functions is developed to correct respiratory and cardiac motion simultaneously in cardiac PET within the normal scanning time (NAMC-CPET). Simulation and experimental studies are conducted to evaluate and validate the final outputs in comparison to the existing gating methods. A dynamic digital phantom is used to simulate realistic human thorax and abdomen with respiratory and cardiac motions. GATE simulation was run at China National Grid Center to obtain realistic PET data in a reasonable time. Moreover, Tibet minipig experiments were conducted using a preclinical small animal PET scanner developed at HUST to validate the performance of the NAMC-CPET in real data. The results reveal that NAMC-CPET outperformed the existing gating methods (respiratory, cardiac, and dual) in cardiac imaging in term of noise reduction and contrast, especially in short acquisition duration. NAMC-CPET obtained better results in the conducted experiments in terms of contrast and the visibility of the heart. In contrast, the dual gating failed to obtain valuable images in the normal scan time due to the low 18F-FDG uptake. NAMC-CPET is advantageous in the low-statistic situation. The results are promising with great potential implications in cardiac PET imaging in terms of the radioactive dose and scan time reduction.

  10. New approach for simultaneous respiratory and cardiac motion correction in cardiac PET (NAMC-CPET)

    International Nuclear Information System (INIS)

    Respiratory and cardiac motions are inevitable during the relatively long acquisition time of cardiac positron emission tomography (PET) scan. The correction of the resultant motion blur has become a significant challenge due to recent spatial resolution improvement of the PET scanners. The majority of current motion compensation algorithms are based on gating as a primary step. A new approach based on temporal basis functions is developed to correct respiratory and cardiac motion simultaneously in cardiac PET within the normal scanning time (NAMC-CPET). Simulation and experimental studies are conducted to evaluate and validate the final outputs in comparison to the existing gating methods. A dynamic digital phantom is used to simulate realistic human thorax and abdomen with respiratory and cardiac motions. GATE simulation was run at China National Grid Center to obtain realistic PET data in a reasonable time. Moreover, Tibet minipig experiments were conducted using a preclinical small animal PET scanner developed at HUST to validate the performance of the NAMC-CPET in real data. The results reveal that NAMC-CPET outperformed the existing gating methods (respiratory, cardiac, and dual) in cardiac imaging in term of noise reduction and contrast, especially in short acquisition duration. NAMC-CPET obtained better results in the conducted experiments in terms of contrast and the visibility of the heart. In contrast, the dual gating failed to obtain valuable images in the normal scan time due to the low 18F-FDG uptake. NAMC-CPET is advantageous in the low-statistic situation. The results are promising with great potential implications in cardiac PET imaging in terms of the radioactive dose and scan time reduction. (paper)

  11. Output optics for laser velocimeters

    Science.gov (United States)

    Lynch, Dana H. (Inventor); Gunter, William D. (Inventor); Mcalister, Kenneth W. (Inventor)

    1993-01-01

    Space savings are effected in the optical output system of a laser velocimeter. The output system is comprised of pairs of optical fibers having output ends from which a beam of laser light emerges, a transfer lens for each light beam, and at least one final (LV) lens for receiving the light passing through the transfer lenses and for focussing that light at a common crossing point or area. In order to closely couple the transfer lenses to the final lens, each transfer lens is positioned relative to the final lens receiving light therefrom such that the output waist of the corresponding beam received by the final lens from the transfer lens is a virtual waist located before the transfer lens.

  12. Monitoring radiation use in cardiac fluoroscopy imaging procedures

    International Nuclear Information System (INIS)

    Purpose: Timely identification of systematic changes in radiation delivery of an imaging system can lead to a reduction in risk for the patients involved. However, existing quality assurance programs involving the routine testing of equipment performance using phantoms are limited in their ability to effectively carry out this task. To address this issue, the authors propose the implementation of an ongoing monitoring process that utilizes procedural data to identify unexpected large or small radiation exposures for individual patients, as well as to detect persistent changes in the radiation output of imaging platforms. Methods: Data used in this study were obtained from records routinely collected during procedures performed in the cardiac catheterization imaging facility at St. Andrew's War Memorial Hospital, Brisbane, Australia, over the period January 2008-March 2010. A two stage monitoring process employing individual and exponentially weighted moving average (EWMA) control charts was developed and used to identify unexpectedly high or low radiation exposure levels for individual patients, as well as detect persistent changes in the radiation output delivered by the imaging systems. To increase sensitivity of the charts, we account for variation in dose area product (DAP) values due to other measured factors (patient weight, fluoroscopy time, and digital acquisition frame count) using multiple linear regression. Control charts are then constructed using the residual values from this linear regression. The proposed monitoring process was evaluated using simulation to model the performance of the process under known conditions. Results: Retrospective application of this technique to actual clinical data identified a number of cases in which the DAP result could be considered unexpected. Most of these, upon review, were attributed to data entry errors. The charts monitoring the overall system radiation output trends demonstrated changes in equipment performance

  13. Monitoring radiation use in cardiac fluoroscopy imaging procedures

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, Nathaniel T.; Steiner, Stefan H.; Smith, Ian R.; MacKay, R. Jock [Department of Statistics and Actuarial Sciences, Business and Industrial Statistics Research Group, University of Waterloo, Waterloo, Ontario N2L 3G1 (Canada); St. Andrew' s Medical Institute, St. Andrew' s War Memorial Hospital, Brisbane, Queensland 4000 (Australia); Department of Statistics and Actuarial Sciences, Business and Industrial Statistics Research Group, University of Waterloo, Waterloo, Ontario N2L 3G1 (Canada)

    2011-01-15

    Purpose: Timely identification of systematic changes in radiation delivery of an imaging system can lead to a reduction in risk for the patients involved. However, existing quality assurance programs involving the routine testing of equipment performance using phantoms are limited in their ability to effectively carry out this task. To address this issue, the authors propose the implementation of an ongoing monitoring process that utilizes procedural data to identify unexpected large or small radiation exposures for individual patients, as well as to detect persistent changes in the radiation output of imaging platforms. Methods: Data used in this study were obtained from records routinely collected during procedures performed in the cardiac catheterization imaging facility at St. Andrew's War Memorial Hospital, Brisbane, Australia, over the period January 2008-March 2010. A two stage monitoring process employing individual and exponentially weighted moving average (EWMA) control charts was developed and used to identify unexpectedly high or low radiation exposure levels for individual patients, as well as detect persistent changes in the radiation output delivered by the imaging systems. To increase sensitivity of the charts, we account for variation in dose area product (DAP) values due to other measured factors (patient weight, fluoroscopy time, and digital acquisition frame count) using multiple linear regression. Control charts are then constructed using the residual values from this linear regression. The proposed monitoring process was evaluated using simulation to model the performance of the process under known conditions. Results: Retrospective application of this technique to actual clinical data identified a number of cases in which the DAP result could be considered unexpected. Most of these, upon review, were attributed to data entry errors. The charts monitoring the overall system radiation output trends demonstrated changes in equipment

  14. Research Output of Australian Universities

    OpenAIRE

    Malcolm Abbot; Hristos Doucouliagos

    2003-01-01

    Research plays an important role in underpinning a country’s economic and social life. Universities are at the centre of the research and human capital generating process. The aim of this paper is to explore the links between research output, research income, academic and non-academic labour and some of the characteristics of Australian universities. The results indicate that research income, academic staff and post-graduates are all positively associated with research output. There are notic...

  15. Uniform Practical Nonlinear Output Regulation

    OpenAIRE

    Marconi, Lorenzo; Praly, Laurent

    2008-01-01

    International audience In this paper, we present a solution to the problem of asymptotic and practical semiglobal regulation by output feedback for nonlinear systems. A key feature of the proposed approach is that practical regulation is achieved uniformly with respect to the dimension of the internal model and to the gain of the stabilizer near the zero error manifold. This property renders the approach interesting for a number of real cases by bridging the gap between output regulation t...

  16. Temperate climate - Innovative outputs nexus

    OpenAIRE

    Coccia, M.

    2014-01-01

    Technological change is a vital human activity that interacts with geographic factors and environment. The purpose of the study here is to analyse the relationship between geo-climate zones of the globe and technological outputs in order to detect favourable areas that spur higher technological change and, as a consequence, human development. The main finding is that innovative outputs are higher in geographical areas with a temperate climate (latitudes). In fact, warm temperate climates are ...

  17. 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

  18. Preventing Inductive Output Impedance of High-Frequency Emitter Follower Stages

    OpenAIRE

    Tozer, R. C.; J. Nerad

    1997-01-01

    Large output inductance is one of major issues of high-frequency emitter follower design. The most often suggested technique to reduce its value is the decreasing of AC transconductance which offers small output inductance at the expense of loosing low output resistance. The paper presents a different approach; it is shown that output inductance can be completely cancelled while keeping very low output resistance by introducing a pole at the input node which may be more suitable in many types...

  19. 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 ...

  20. 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...

  1. A comparison of sympathoadrenal activity and cardiac performance at rest and during exercise in patients with ventricular demand or atrial synchronous pacing.

    OpenAIRE

    Pehrsson, S K; Hjemdahl, P; Nordlander, R; Aström, H

    1988-01-01

    Cardiac sympathetic function was assessed by measuring the coronary sinus overflow of noradrenaline and dopamine at rest and during supine exercise in eight patients with high degree atrioventricular block treated with dual chamber pacemakers (DDD). Patients exercised (30-60 W) during both ventricular inhibited (VVI) and atrial synchronous (VAT) pacing. During exercise cardiac output increased less markedly in the VVI mode than in the VAT mode. The cardiac output response was entirely stroke ...

  2. Comparação dos efeitos da dobutamina e da milrinona sobre a hemodinâmica e o transporte de oxigênio em pacientes submetidos à cirurgia cardíaca com baixo débito cardíaco após indução anestésica Comparación de los efectos de la dobutamina y de la milrinona sobre la hemodinámica y el transporte de oxígeno en pacientes sometidos a cirugía cardiaca con bajo débito cardiaco después de inducción anestésica Comparison of the effects of dobutamine and milrinone on hemodynamic parameters and oxygen supply in patients undergoing cardiac surgery with low cardiac output after anesthetic induction

    Directory of Open Access Journals (Sweden)

    Maria José Carvalho Carmona

    2010-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Diversas classes de fármacos inotrópicos, com efeitos hemodinâmicos diferentes, são utilizadas no tratamento do baixo débito cardíaco em pacientes com disfunção sistólica submetidos a procedimento cirúrgico cardíaco. O objetivo deste estudo foi comparar o efeito da dobutamina e da milrinona sobre a hemodinâmica e o transporte de oxigênio nessa população de pacientes. MÉTODO: Após aprovação do Comitê de Ética institucional e obtenção do consentimento escrito pós-informado, 20 pacientes submetidos à cirurgia cardíaca e com índice cardíaco JUSTIFICATIVA Y OBJETIVOS: Diversas clases de fármacos inotrópicos con efectos hemodinámicos diferentes, se usan en el tratamiento del bajo débito cardíaco en pacientes con disfunción sistólica sometidos al procedimiento quirúrgico cardíaco. El objetivo de este estudio, fue comparar el efecto de la dobutamina y de la milrinona sobre la hemodinámica y el transporte de oxígeno en esa población de pacientes. MÉTODO: Después de la aprobación del Comité de Ética institucional y de la obtención del consentimiento informado, 20 pacientes sometidos a la cirugía cardíaca y con índice cardíaco BACKGROUND AND OBJECTIVES: Several classes of inotropic drugs with different hemodynamic effects are used in the treatment of low cardiac output in patients with diastolic dysfunction undergoing cardiac surgery. The objective of the present study was to compare the effects of dobutamine and milrinone on hemodynamic parameters and oxygen supply in this population of patients. METHODS: After approval by the Ethics Committee of the institution and signing of the informed consent, 20 patients undergoing cardiac surgery with cardiac index < 2 L.min-1.m2 after anesthetic induction and place ment of a pulmonary artery catheter were randomly divided to receive dobutamine 5 µg.kg-1. min-1 (n = 10, or milrinone 0.5 µg.kg-1.min-1 (n = 10. Hemodynamic parameters were

  3. Distinct properties and metabolic mechanisms of postresuscitation myocardial injuries in ventricular fibrillation cardiac arrest versus asphyxiation cardiac arrest in a porcine model

    Institute of Scientific and Technical Information of China (English)

    Wu Caijun; Li Chunsheng; Zhang Yi; Yang Jun

    2014-01-01

    Background The two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest (VFCA) and asphyxiation cardiac arrest (ACA).Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models.Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction.Methods Thirty-two pigs were randomized into two groups.The VFCA group (n=16) were subject to programmed electrical stimulation and the ACA group (n=16) underwent endotracheal tube clamping to induce cardiac arrest (CA).Once induced,CA remained untreated for a period of 8 minutes.Two minutes following initiation of cardiopulmonary resuscitation (CPR),defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess myocardial metabolism,18F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC.Results ROSC was 100% successful in VFCA and 50% successful in ACA.VFCA had better mean arterial pressure and cardiac output after ROSC than ACA.Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC (ROSC 0.5 hours,pH:7.01±0.06 vs.7.21±0.03,P<0.01; HCO3-:(15.83±2.31 vs.20.11±1.83) mmol/L,P<0.01; lactate:(16.22±1.76 vs.5.84±1.44) mmol/L,P<0.01).Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC (the maximum standardized uptake value of the whole left ventricular:1.00±0.17 vs.1.93±0.27,P<0.01).Lower contents of myocardial energy metabolism enzymes (Na+-K+-ATPase enzyme activity,Ca2+-ATPase enzyme activity,superoxide dismutase and phosphodiesterase) were found in ACA relative to VFCA.Conclusions Compared with VFCA,ACA causes more severe myocardium injury and metabolism hindrance,therefore they

  4. Impact of thoracic surgery on cardiac morphology and function in small animal models of heart disease: a cardiac MRI study in rats.

    Directory of Open Access Journals (Sweden)

    Peter Nordbeck

    Full Text Available BACKGROUND: Surgical procedures in small animal models of heart disease might evoke alterations in cardiac morphology and function. The aim of this study was to reveal and quantify such potential artificial early or long term effects in vivo, which might account for a significant bias in basic cardiovascular research, and, therefore, could potentially question the meaning of respective studies. METHODS: Female Wistar rats (n = 6 per group were matched for weight and assorted for sham left coronary artery ligation or control. Cardiac morphology and function was then investigated in vivo by cine magnetic resonance imaging at 7 Tesla 1 and 8 weeks after the surgical procedure. The time course of metabolic and inflammatory blood parameters was determined in addition. RESULTS: Compared to healthy controls, rats after sham surgery showed a lower body weight both 1 week (267.5±10.6 vs. 317.0±11.3 g, n<0.05 and 8 weeks (317.0±21.1 vs. 358.7±22.4 g, n<0.05 after the intervention. Left and right ventricular morphology and function were not different in absolute measures in both groups 1 week after surgery. However, there was a confined difference in several cardiac parameters normalized to the body weight (bw, such as myocardial mass (2.19±0.30/0.83±0.13 vs. 1.85±0.22/0.70±0.07 mg left/right per g bw, p<0.05, or enddiastolic ventricular volume (1.31±0.36/1.21±0.31 vs. 1.14±0.20/1.07±0.17 µl left/right per g bw, p<0.05. Vice versa, after 8 weeks, cardiac masses, volumes, and output showed a trend for lower values in sham operated rats compared to controls in absolute measures (782.2±57.2/260.2±33.2 vs. 805.9±84.8/310.4±48.5 mg, p<0.05 for left/right ventricular mass, but not normalized to body weight. Matching these findings, blood testing revealed only minor inflammatory but prolonged metabolic changes after surgery not related to cardiac disease. CONCLUSION: Cardio-thoracic surgical procedures in experimental myocardial infarction

  5. Cardiac adaptation to endurance exercise in rats.

    Science.gov (United States)

    Fenning, Andrew; Harrison, Glenn; Dwyer, Dan; Rose'Meyer, Roselyn; Brown, Lindsay

    2003-09-01

    Endurance exercise is widely assumed to improve cardiac function in humans. This project has determined cardiac function following endurance exercise for 6 (n = 30) or 12 (n = 25) weeks in male Wistar rats (8 weeks old). The exercise protocol was 30 min/day at 0.8 km/h for 5 days/week with an endurance test on the 6th day by running at 1.2 km/h until exhaustion. Exercise endurance increased by 318% after 6 weeks and 609% after 12 weeks. Heart weight/kg body weight increased by 10.2% after 6 weeks and 24.1% after 12 weeks. Echocardiography after 12 weeks showed increases in left ventricular internal diameter in diastole (6.39 +/- 0.32 to 7.90 +/- 0.17 mm), systolic volume (49 +/- 7 to 83 +/- 11 miccrol) and cardiac output (75 +/- 3 to 107 +/- 8 ml/min) but not left wall thickness in diastole (1.74 +/- 0.07 to 1.80 +/- 0.06 mm). Isolated Langendorff hearts from trained rats displayed decreased left ventricular myocardial stiffness (22 +/- 1.1 to 19.1 +/- 0.3) and reduced purine efflux during pacing-induced workload increases. 31P-NMR spectroscopy in isolated hearts from trained rats showed decreased PCr and PCr/ATP ratios with increased creatine, AMP and ADP concentrations. Thus, this endurance exercise protocol resulted in physiological hypertrophy while maintaining or improving cardiac function. PMID:14575304

  6. [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

  7. A Fixed-point Technique of Wavelet Transform Base on Bounded Input Bounded Output (BIBO) Plus Value in JPEG2000 Algorithm%JPEG2000算法中基于有界输入有界输出(BIBO)增益控制的小波变换定点实现技术

    Institute of Scientific and Technical Information of China (English)

    张静; 李云松; 郭杰; 王柯俨; 吴成柯

    2012-01-01

    A new efficient technique using the compatible hardware framework to realize the integer 5/3 wavelet transform and 9/7 wavelet transform is proposed. The bit depth of the temp coefficients in the wavelet transform is based on the Bounded Input Bounded Output (BIBO) plus value of 9/7 wavelet transform, at the same time, the quantization value of 9/7 wavelet transform and how to do quantization is decided by BIBO puls value of 5/3 wavelet transform. Finally, both the coefficients of 5/3 wavelet transform and 9/7 wavelet transform are saved in the same memories. The proposed technique not only saves the hardware memory resource and computational complexity of the wavelet transform module, but also saves the hardware memory resource and computational complexity of the bitplane arithmetric coding based on the context module and post-compression rate-distortion optimization module.%该文提出一种在JPEG2000算法中兼容5/3小波变换和9/7小波变换高效硬件定点实现技术.所提出的技术使用9/7提升小波变换的有界输入有界输出(Bounded Input Bounded Output,BIBO)增益来确定小波变换中间值的存储位深,使用5/3提升小波变换的BIBO增益来确定9/7提升小波变换中量化参数的选择方式和量化的实现方式,最终使用同一存储空间来存放定点5/3提升小波变换和定点9/7提升小波变换系数.该文提出的技术不仅大大节省了JPEG2000算法中小波实现模块中的硬件存储资源和算法计算量,而且也节省了后续基于上下文的位平面算术编码模块和率失真优化截取模块的存储资源和算法计算量.

  8. Practical textbook of cardiac CT and MRI

    International Nuclear Information System (INIS)

    Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

  9. Practical textbook of cardiac CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Tae-Hwan (ed.) [ASAN Medical Center, Seoul (Korea, Republic of). Dept. of Radiology

    2015-04-01

    Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

  10. Computing Dynamic Output Feedback Laws

    OpenAIRE

    Verschelde, Jan; Wang, Yusong

    2003-01-01

    The pole placement problem asks to find laws to feed the output of a plant governed by a linear system of differential equations back to the input of the plant so that the resulting closed-loop system has a desired set of eigenvalues. Converting this problem into a question of enumerative geometry, efficient numerical homotopy algorithms to solve this problem for general Multi-Input-Multi-Output (MIMO) systems have been proposed recently. While dynamic feedback laws offer a wider range of use...

  11. Exercise training improves aerobic endurance and musculoskeletal fitness in female cardiac transplant recipients

    OpenAIRE

    Warburton Darren; Kim Daniel; Figgures Linda; Riess Kenneth; Haykowsky Mark; Jones Lee; Tymchak Wayne

    2005-01-01

    Abstract Aim Female cardiac transplant recipients' aerobic capacity is 60% lower than sex and age-predicted values. The effect of exercise training on restoring the impaired aerobic endurance and muscle strength in female cardiac transplant recipients is not known. This study examined the effect that aerobic and strength training have on improving aerobic endurance and muscle strength in female cardiac transplant recipients. Methods 20 female cardiac transplant recipients (51 ± 11 years) part...

  12. 超声对快速判断胎儿心脏位置的应用价值%Application value of ultrasound to rapid fetal cardiac position diagnosis

    Institute of Scientific and Technical Information of China (English)

    卢祥章; 林芳芳

    2015-01-01

    Objective To investigate the clinical method for the rapid determination of fetal cardiac position by two-dimensional ultrasound imaging.Methods A retrospective analysis in our hospital underwent 3D ultrasound examination in 1000 cases of pregnant women,the fetal heart probe frequency,recording the gestational age,fetal position,marking the real-time image,combined with fe-tal ultrasound Beckoning figure,other auxiliary examination and postpartum neonatal review data,analysis of clinical factors of fetal heart azimuth determination.Results 8 cases of fetal cardiac malposition,992 cases were normal,2 cases of ultrasonic detection of false negative cases,false positive in 0 cases.Conclusion Fetal heart direction determination by checking instrument,the maternal abdominal wall thickness,the effect of fetal position and gestational weeks of various factors,the organ of fetal anatomy and heart struc-ture is the theoretical basis for the diagnosis of fetal cardiac malposition of disease.%目的:探讨超声三维成像快速判定胎儿心脏位置的应用价值。方法:通过回顾性分析,收集在本院行三维超声检查的孕妇1200例,利用频率为5MHz的腹部探头,记录受检孕周、胎位,标示实时图像,结合胎儿超声心动图、其他辅助检查及产后新生儿复查资料,分析影响胎儿心脏方位判定的临床因素。结果:胎儿心脏位置异常者79例,正常者1021例,超声检测假阴性病例1例,假阳性病例0例。结论:掌握正确的超声操作技巧有助于早期发现胎儿心脏位置异常,对优生优育有重要意义。

  13. [Effects of oxygen therapy on the hematocrit value in hypoxemic, chronic bronchopneumopathies].

    Science.gov (United States)

    Fumagalli, G; Ferrara, A; Gangarossa, C

    1974-12-22

    Changes in haematocrit values were studied in hypoxaemic chronic bronchitis patients subjected to oxygen-therapy. A statistically significant decrease was observed in all cases after respiration of oxygen. This was partly attributable to resolution of vasoconstrictive reflexes imposed by prior oxygen starvation, due to shifting of part of the circulating mass from the systemic to the pulmonary circulation, and partly to improved ventilation yield; this, couplled with reduced cardiac frequency and output, facilitates a more efficient thoracic aspiration of the reflux blood. PMID:4449623

  14. 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...

  15. [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

  16. 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....

  17. Cardiac tumors: leiomyosarcoma – a case report

    Science.gov (United States)

    Syska-Sumińska, Joanna; Zieliński, Piotr; Dłużniewski, Mirosław; Sadowski, Jerzy

    2015-01-01

    We present a case report of a 60-year-old woman with a long history of leiomyosarcoma in different locations. She was admitted to the clinic due to a left ventricular tumor diagnosed in ECHO examination. The patient was qualified for radical tumor resection. The early postoperative period was complicated due to low cardiac output syndrome and bradyarrhythmia requiring temporary cardiac pacing. Optimized pharmacological therapy resulted in a gradual reduction of symptoms and a clinical improvement of congestive heart failure (NYHA III – NYHA II). Due to the radical nature of the surgery, the patient was not referred for supplementary treatment. The follow-up currently exceeds 12 months – no new metastases have been found. This case provides an example of how to diagnose and treat heart tumors. PMID:26702284

  18. A Monte Carlo Study on Multiple Output Stochastic Frontiers

    DEFF Research Database (Denmark)

    Henningsen, Géraldine; Henningsen, Arne; Jensen, Uwe

    directional components as regressors. A number of studies have compared these specifications using real world data and have found significant differences in the inefficiency estimates. However, in order to get to the bottom of these differences, we apply a Monte-Carlo simulation. We test the robustness of......In the estimation of multiple output technologies in a primal approach, the main question is how to handle the multiple outputs. Often an output distance function is used, where the classical approach is to exploit its homogeneity property by selecting one output quantity as the dependent variable...... average none of the approaches is superior. However, considerable differences are found between the estimates at single replications. In the case of zero values in the output quantities, the SR clearly outperforms the OD, although this advantage nearly vanishes when zeros are replaced by a small number....

  19. On directional multiple-output quantile regression

    Czech Academy of Sciences Publication Activity Database

    Paindaveine, D.; Šiman, Miroslav

    2011-01-01

    Roč. 102, č. 2 (2011), s. 193-212. ISSN 0047-259X R&D Projects: GA MŠk(CZ) 1M06047 Grant ostatní: Commision EC(BE) Fonds National de la Recherche Scientifique Institutional research plan: CEZ:AV0Z10750506 Keywords : multivariate quantile * quantile regression * multiple-output regression * halfspace depth * portfolio optimization * value-at risk Subject RIV: BA - General Mathematics Impact factor: 0.879, year: 2011 http://library.utia.cas.cz/separaty/2011/SI/siman-0364128.pdf

  20. 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.

  1. Value of MRI in predicting sudden cardiac death in patients with ischemic cardiomyopathy%MRI预测缺血性心肌病患者并发心源性猝死的价值

    Institute of Scientific and Technical Information of China (English)

    林长坚; 金奇; 吴立群

    2011-01-01

    @@ 冠心病是心源性猝死(sudden cardiac death,SCD)者最常见的病因,所占百分率可达80%[1].由冠心病导致心肌瘢痕形成的缺血性心肌病患者,其SCD发生率明显升高[2-3].射血分数降低是此类患者发生SCD的重要预测因子,但该指标仍缺乏较高的特异度及灵敏度[4].目前,SCD的预测主要围绕心肌电不稳定机制展开,包括T波电交替、心率振荡和心率变异性等[5].但对于缺血性心肌病患者产生心肌电不稳定的病理基质,如心肌瘢痕、瘢痕边缘区的检测,同样能提供有效的预测价值.近年来迅速发展的心脏磁共振(cardiac magnetic resonance,CMR)技术具有很高的组织分辨率和无创性等优点,可显示缺血性心肌病患者的心肌瘢痕及瘢痕边缘区,有助于SCD的危险分层及预测.

  2. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study

    International Nuclear Information System (INIS)

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m2] undergoing stress 99mTc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD. (orig.)

  3. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji [Department of Cardiovascular Medicine, Gunma Prefectural Cardiovascular Center, Maebashi (Japan); Sato, Makito [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Tatebayashi Kosei Hospital, Department of Internal Medicine, Gunma (Japan); Sano, Hirokazu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Isesaki Municipal Hospital, Department of Cardiovascular Medicine, Isesaki (Japan); Ueda, Tetsuya [Fujioka General Hospital, Division of Cardiology, Fujioka (Japan); Sasaki, Toyoshi [Takasaki General Medical Center, Division of Cardiology, Takasaki (Japan); Nakahara, Takehiro; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Higuchi, Tetsuya; Tsushima, Yoshito [Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi (Japan)

    2016-02-15

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m{sup 2}] undergoing stress {sup 99m}Tc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD. (orig.)

  4. Effect of cardiac function on aortic peak time and peak enhancement during coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Shuji, E-mail: sakai@shs.kyushu-u.ac.j [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yabuuchi, Hidetake, E-mail: yabuuchi@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Chishaki, Akiko, E-mail: chishaki@shs.kyushu-u.ac.j [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Okafuji, Takashi, E-mail: oka-pu@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Matsuo, Yoshio, E-mail: yymatsuo@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Setoguchi, Taro, E-mail: taro-s@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.j [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

    2010-08-15

    Purpose: To examine the manner in which cardiac function affects the magnitude and timing of aortic contrast enhancement during coronary CT angiography (CTA). Materials and methods: Twenty-nine patients (21 men, 8 women; mean age, 64.4 {+-} 13.4 years; mean weight, 59.4 {+-} 10.3 kg) underwent measurement of cardiac output within 2 weeks of coronary CTA. The cardiac output of each patient was measured by the thermodilution technique and the cardiac index was calculated from the body surface area. During coronary CTA, attenuation of the descending aorta was measured at the workstation every 3 s. The aortic peak time (APT) and aortic peak enhancement (APE) of each patient were calculated. Pearson's correlation coefficient analysis was used to investigate the relationships between the cardiac output or cardiac index and APT or APE. Furthermore, the relationship between patient factors or parameters on test bolus injection and APT or APE was also evaluated. Results: The range of cardiac output, cardiac index, APT, and APE was 1.55-10.46 L/min (mean: 4.77 {+-} 2.13), 1.11-5.30 L/(min-m{sup 2}) (mean: 3.28 {+-} 1.08), 25-51 s (mean: 38.3 {+-} 7.5), and 273.1-598.1 HU (mean: 390.4 {+-} 72.1), respectively. With an increase in the cardiac index, both APT (r = -0.698, p < 0.0001) and APE (r = -0.573, p = 0.0009) decreased. There were significant correlations between the patient body weight and APT and APE with the test bolus injection, and with APT and APE during coronary CTA. Conclusion: The APT and APE during coronary CTA are closely related to cardiac function.

  5. World Input-Output Network.

    Directory of Open Access Journals (Sweden)

    Federica Cerina

    Full Text Available Production systems, traditionally analyzed as almost independent national systems, are increasingly connected on a global scale. Only recently becoming available, the World Input-Output Database (WIOD is one of the first efforts to construct the global multi-regional input-output (GMRIO tables. By viewing the world input-output system as an interdependent network where the nodes are the individual industries in different economies and the edges are the monetary goods flows between industries, we analyze respectively the global, regional, and local network properties of the so-called world input-output network (WION and document its evolution over time. At global level, we find that the industries are highly but asymmetrically connected, which implies that micro shocks can lead to macro fluctuations. At regional level, we find that the world production is still operated nationally or at most regionally as the communities detected are either individual economies or geographically well defined regions. Finally, at local level, for each industry we compare the network-based measures with the traditional methods of backward linkages. We find that the network-based measures such as PageRank centrality and community coreness measure can give valuable insights into identifying the key industries.

  6. World Input-Output Network.

    Science.gov (United States)

    Cerina, Federica; Zhu, Zhen; Chessa, Alessandro; Riccaboni, Massimo

    2015-01-01

    Production systems, traditionally analyzed as almost independent national systems, are increasingly connected on a global scale. Only recently becoming available, the World Input-Output Database (WIOD) is one of the first efforts to construct the global multi-regional input-output (GMRIO) tables. By viewing the world input-output system as an interdependent network where the nodes are the individual industries in different economies and the edges are the monetary goods flows between industries, we analyze respectively the global, regional, and local network properties of the so-called world input-output network (WION) and document its evolution over time. At global level, we find that the industries are highly but asymmetrically connected, which implies that micro shocks can lead to macro fluctuations. At regional level, we find that the world production is still operated nationally or at most regionally as the communities detected are either individual economies or geographically well defined regions. Finally, at local level, for each industry we compare the network-based measures with the traditional methods of backward linkages. We find that the network-based measures such as PageRank centrality and community coreness measure can give valuable insights into identifying the key industries. PMID:26222389

  7. Input/output interface module

    Science.gov (United States)

    Ozyazici, E. M.

    1980-01-01

    Module detects level changes in any of its 16 inputs, transfers changes to its outputs, and generates interrupts when changes are detected. Up to four changes-in-state per line are stored for later retrieval by controlling computer. Using standard TTL logic, module fits 19-inch rack-mounted console.

  8. Remote input/output station

    CERN Multimedia

    1972-01-01

    A general view of the remote input/output station installed in building 112 (ISR) and used for submitting jobs to the CDC 6500 and 6600. The card reader on the left and the line printer on the right are operated by programmers on a self-service basis.

  9. Coral Mortality and Bleaching Output

    Science.gov (United States)

    COMBO is a spreadsheet-based model for the use of managers, conservationists, and biologists for projecting the effects of climate change on coral reefs at local-to-regional scales. The COMBO (Coral Mortality and Bleaching Output) model calculates the impacts to coral reefs from...

  10. Judicial Influence on Policy Outputs?

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg

    2015-01-01

    ) social policy outputs. A taxonomy of judicial influence is constructed, and expectations of institutional and political conditions on judicial influence are presented. The analysis draws on an extensive novel data set and examines judicial influence on EU social policies over time, that is, between 1958...... political responses to attenuate unwelcome jurisprudence and constrain the legislative effect of judicial decisions....

  11. Temperate climate - Innovative outputs nexus

    NARCIS (Netherlands)

    Coccia, M.

    2014-01-01

    Technological change is a vital human activity that interacts with geographic factors and environment. The purpose of the study here is to analyse the relationship between geo-climate zones of the globe and technological outputs in order to detect favourable areas that spur higher technological chan

  12. Canards in a rheodynamic model of cardiac pressure pulsations

    Institute of Scientific and Technical Information of China (English)

    Xie Feng; Chen Xian-Feng

    2007-01-01

    This paper reports on the canard phenomenon occurring in a rheodynamic model of cardiac pressure pulsations. By singular perturbation techniques the corresponding parameter value at which canards exist is obtained. The physiological significance of canards in this model is given.

  13. Cardiac function and myocardial perfusion immediately following maximal treadmill exercise inside the MRI room

    Directory of Open Access Journals (Sweden)

    Ballinger Michelle R

    2008-01-01

    Full Text Available Abstract Treadmill exercise stress testing is an essential tool in the prevention, detection, and treatment of a broad spectrum of cardiovascular disease. After maximal exercise, cardiac images at peak stress are typically acquired using nuclear scintigraphy or echocardiography, both of which have inherent limitations. Although CMR offers superior image quality, the lack of MRI-compatible exercise and monitoring equipment has prevented the realization of treadmill exercise CMR. It is critical to commence imaging as quickly as possible after exercise to capture exercise-induced cardiac wall motion abnormalities. We modified a commercial treadmill such that it could be safely positioned inside the MRI room to minimize the distance between the treadmill and the scan table. We optimized the treadmill exercise CMR protocol in 20 healthy volunteers and successfully imaged cardiac function and myocardial perfusion at peak stress, followed by viability imaging at rest. Imaging commenced an average of 30 seconds after maximal exercise. Real-time cine of seven slices with no breath-hold and no ECG-gating was completed within 45 seconds of exercise, immediately followed by stress perfusion imaging of three short-axis slices which showed an average time to peak enhancement within 57 seconds of exercise. We observed a 3.1-fold increase in cardiac output and a myocardial perfusion reserve index of 1.9, which agree with reported values for healthy subjects at peak stress. This study successfully demonstrates in-room treadmill exercise CMR in healthy volunteers, but confirmation of feasibility in patients with heart disease is still needed.

  14. 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' ...

  15. 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 ...

  16. 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 & ...

  17. 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.

  18. 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, ...

  19. 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.

  20. Input-output interactions and optimal monetary policy

    DEFF Research Database (Denmark)

    Petrella, Ivan; Santoro, Emiliano

    2011-01-01

    context is of key importance to explore the welfare properties of the model economy. A flexible inflation targeting regime is close to optimal only if the central bank balances inflation and value added variability. Otherwise, targeting gross output variability entails a substantial increase in the loss......This paper deals with the implications of factor demand linkages for monetary policy design in a two-sector dynamic general equilibrium model. Part of the output of each sector serves as a production input in both sectors, in accordance with a realistic input–output structure. Strategic...... complementarities induced by factor demand linkages significantly alter the transmission of shocks and amplify the loss of social welfare under optimal monetary policy, compared to what is observed in standard two-sector models. The distinction between value added and gross output that naturally arises in this...

  1. The Quantitative Evaluation of Output Efficiency in Different Cropping Patterns

    Institute of Scientific and Technical Information of China (English)

    LIU Yu-hua; ZHANG Li-feng

    2006-01-01

    Quantitative indexes such as land equivalent ratio, yield equivalent and value of output equivalent were used to evaluate output efficiencies of different cropping patterns, i.e., sequential cropping, intercrops and crop rotation. Compared to single cropping, land use efficiencies under sequential cropping, intercrops and crop rotation were raised by 62, 38 and 21%, respectively. The unit area yield under sequential cropping, intercrops and crop rotation were raised by 63, 29 and 16%, respectively. The unit area value was also enhanced under sequential cropping and intercrops, 76 and 35% higher than that under single cropping. The paper provides a useful tool for comparing farm output efficiency and build up a theoretical basis for further research on output efficiency of various cropping patterns in the future.

  2. 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.

  3. 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 ...

  4. 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

  5. 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

  6. 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...

  7. State-shared model for multiple-input multiple-output systems

    Institute of Scientific and Technical Information of China (English)

    Zhenhua TIAN; Karlene A. HOO

    2005-01-01

    This work proposes a method to construct a state-shared model for multiple-input multiple-output (MIMO)systems. A state-shared model is defined as a linear time invariant state-space structure that is driven by measurement signals-the plant outputs and the manipulated variables, but shared by different multiple input/output models. The genesis of the state-shared model is based on a particular reduced non-minimal realization. Any such realization necessarily fulfills the requirement that the output of the state-shared model is an asymptotically correct estimate of the output of the plant, if the process model is selected appropriately. The approach is demonstrated on a nonlinear MIMO system- a physiological model of calcium fluxes that controls muscle contraction and relaxation in human cardiac myocytes.

  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. Analysis of Input and Output Ripples of PWM AC Choppers

    Directory of Open Access Journals (Sweden)

    Pekik Argo Dahono

    2008-11-01

    Full Text Available This paper presents an analysis of input and output ripples of PWM AC choppers. Expressions of input and output current and voltage ripples of single-phase PWM AC choppers are first derived. The derived expressions are then extended to three-phase PWM AC choppers. As input current and output voltage ripples specification alone cannot be used to determine the unique values of inductance and capacitance of the LC filters, an additional criterion based on the minimum reactive power is proposed. Experimental results are included in this paper to show the validity of the proposed analysis method.

  11. Automated synthesis of 8-output voltage distributor using incremental evolution

    OpenAIRE

    Sapargaliyev, Y; Kalganova, TG

    2010-01-01

    The automated synthesis of the analog electronic circuit, including both the topology and the numerical values for each of the circuit’s component, is recognized as a difficult problem. This problem is aggregating considerably when the size of a circuit and the number of its input/output pins increases. In this paper for the first time the method of automated synthesis of the analog electronic circuit by mean of evolution is applied to the synthesis of a multi-output circuit, namely 8-output ...

  12. Holographic velocimetry for evaluation of cardiac valves

    International Nuclear Information System (INIS)

    Holographic velocimetry is a noninvasive method for fluid flow analysis, making it possible to determine flow field characteristics for any instant in a flow cycle. The use of holographic velocimetry to assess prosthetic heart valve performance has never before been accomplished. However, it seems readily apparent that much pertinent information will be gained from it, such as the exact location and quantitative analysis of stagnation zones, high shear and high velocity regions. A comparison of the results from holographic velocimetry are made with those of laser Doppler anemometry. The first study deals with steady state flow analysis at peak systolic flow rates for normal cardiac outputs

  13. The impact of cardiac gating on the detection of coronary calcifications in dual-energy chest radiography: a phantom study

    Science.gov (United States)

    Sabol, John M.; Liu, Ray; Saunders, Rowland; Markley, Jonathan; Moreno, Nery; Seamans, John; Wiese, Scott; Jabri, Kadri; Gilkeson, Robert C.

    2006-03-01

    The detection of coronary calcifications with CT is generally accepted as a useful method for predicting early onset of coronary artery disease. Film-screen X-ray and fluoroscopy have also been shown to have high predictive value for coronary disease diagnosis, but have minimal sensitivity. Recently, flat-panel detectors capable of dual-energy techniques have enabled the separation of soft-tissue and bone from images. Clinical studies report substantially improved sensitivity for the detection of coronary calcifications using these techniques. However, heart motion causes minor artefacts from misregistration of both calcified and soft-tissue structures, resulting in inconsistent detection of calcifications. This research examines whether cardiac gating improves the reliability of calcification detection. Single-energy, gated, and non-gated dual-energy imaging techniques are examined in a dynamic phantom model. A gating system was developed to synchronize two dual-energy exposures to a specified phase of the cardiac cycle. The performance and repeatability of the gating system was validated with the use of a cyclical phantom. An anthropomorphic phantom was developed to simulate both cardiac and soft-tissue motion, and generate ECG-like output signals. The anthropomorphic phantom and motion artefact accuracy was verified by comparison with clinical images of patients with calcifications. The ability of observers to detect calcifications in non-gated, and gated techniques was compared through the use of an ROC experiment. Gating visibly reduces the effect of motion artifacts in the dual-energy images. Without gating, motion artefacts cause greater variability in calcification detection. Comparison of the average area-under-the-curve of the ROC curves show that gating significantly increases the accuracy of calcification detection. The effects of motion and gating on DE cardiac calcification detection have been demonstrated and characterized in a phantom model that

  14. 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)

  15. Input and output constraints affecting irrigation development

    Science.gov (United States)

    Schramm, G.

    1981-05-01

    In many of the developing countries the expansion of irrigated agriculture is used as a major development tool for bringing about increases in agricultural output, rural economic growth and income distribution. Apart from constraints imposed by water availability, the major limitations considered to any acceleration of such programs are usually thought to be those of costs and financial resources. However, as is shown on the basis of empirical data drawn from Mexico, in reality the feasibility and effectiveness of such development programs is even more constrained by the lack of specialized physical and human factors on the input and market limitations on the output side. On the input side, the limited availability of complementary factors such as, for example, truly functioning credit systems for small-scale farmers or effective agricultural extension services impose long-term constraints on development. On the output side the limited availability, high risk, and relatively slow growth of markets for high-value crops sharply reduce the usually hoped-for and projected profitable crop mix that would warrant the frequently high costs of irrigation investments. Three conclusions are drawn: (1) Factors in limited supply have to be shadow-priced to reflect their high opportunity costs in alternative uses. (2) Re-allocation of financial resources from immediate construction of projects to longer-term increase in the supply of scarce, highly-trained manpower resources are necessary in order to optimize development over time. (3) Inclusion of high-value, high-income producing crops in the benefit-cost analysis of new projects is inappropriate if these crops could potentially be grown in already existing projects.

  16. Incidence of cardiac events in burned patients.

    Science.gov (United States)

    Meyers, David G; Hoestje, Sara M; Korentager, Richard A

    2003-06-01

    Given the increased level of adrenergic stimulation in burn patients, it would be expected that they would experience an increased incidence of cardiac arrhythmias and other cardiac events. We performed a retrospective chart review of 56 acute burn patients matched by age, length of hospital stay, and sex to 56 trauma patients, all of whom had been continuously monitored electrocardiographically. Burn and trauma patients were similar in injury severity, admission laboratory values, and prior history of cardiopulmonary diseases. Arrhythmias were noted in 34% of burn patients and 28% of trauma patients. One myocardial infarction and six deaths occurred in burn patients. No myocardial infarctions or deaths were observed in trauma patients. A past history of cardiopulmonary disease increased the risk of myocardial infarction or death by 6.6 times. Cardiac arrhythmias and other events are relatively infrequent and benign in burn patients and are similar to those experienced by other patients with acute injuries. PMID:12781616

  17. Fractal fluctuations in cardiac time series

    Science.gov (United States)

    West, B. J.; Zhang, R.; Sanders, A. W.; Miniyar, S.; Zuckerman, J. H.; Levine, B. D.; Blomqvist, C. G. (Principal Investigator)

    1999-01-01

    Human heart rate, controlled by complex feedback mechanisms, is a vital index of systematic circulation. However, it has been shown that beat-to-beat values of heart rate fluctuate continually over a wide range of time scales. Herein we use the relative dispersion, the ratio of the standard deviation to the mean, to show, by systematically aggregating the data, that the correlation in the beat-to-beat cardiac time series is a modulated inverse power law. This scaling property indicates the existence of long-time memory in the underlying cardiac control process and supports the conclusion that heart rate variability is a temporal fractal. We argue that the cardiac control system has allometric properties that enable it to respond to a dynamical environment through scaling.

  18. UFO - The Universal FEYNRULES Output

    Science.gov (United States)

    Degrande, Céline; Duhr, Claude; Fuks, Benjamin; Grellscheid, David; Mattelaer, Olivier; Reiter, Thomas

    2012-06-01

    We present a new model format for automatized matrix-element generators, the so-called Universal FEYNRULES Output (UFO). The format is universal in the sense that it features compatibility with more than one single generator and is designed to be flexible, modular and agnostic of any assumption such as the number of particles or the color and Lorentz structures appearing in the interaction vertices. Unlike other model formats where text files need to be parsed, the information on the model is encoded into a PYTHON module that can easily be linked to other computer codes. We then describe an interface for the MATHEMATICA package FEYNRULES that allows for an automatic output of models in the UFO format.

  19. Industrial output restriction and the Kyoto protocol. An input-output approach with application to Canada

    International Nuclear Information System (INIS)

    The objective of this paper is to assess the economic impacts of reducing greenhouse gas emissions by decreasing industrial output in Canada to a level that will meet the target set out in the Kyoto Protocol. The study uses an ecological-economic Input-Output model combining economic components valued in monetary terms with ecologic components - GHG emissions - expressed in physical terms. Economic and greenhouse gas emissions data for Canada are computed in the same sectoral disaggregation. Three policy scenarios are considered: the first one uses the direct emission coefficients to allocate the reduction in industrial output, while the other two use the direct plus indirect emission coefficients. In the first two scenarios, the reduction in industrial sector output is allocated uniformly across sectors while it is allocated to the 12 largest emitting industries in the last one. The estimated impacts indicate that the results vary with the different allocation methods. The third policy scenario, allocation to the 12 largest emitting sectors, is the most cost effective of the three as the impacts of the Kyoto Protocol reduces Gross Domestic Product by 3.1% compared to 24% and 8.1% in the first two scenarios. Computed economic costs should be considered as upper-bounds because the model assumes immediate adjustment to the Kyoto Protocol and because flexibility mechanisms are not incorporated. The resulting upper-bound impact of the third scenario may seem to contradict those who claim that the Kyoto Protocol would place an unbearable burden on the Canadian economy. (author)

  20. Telecommunications dynamics, output and employment

    OpenAIRE

    Jungmittag, Andre; Welfens, Paul J.J.

    2006-01-01

    In EU countries, opening up of telecommunications markets and regulations have helped to reduce the price of digital services which is an important quasi-input factor in all firms. Integrating the use of telecommunications in a macroeconomic production function is the analytical starting point for our interdependent analysis of output, use of telecommunications and employment. Based on unit root and co-integration analysis as well as an error correction three-equation model which are estimate...

  1. Improving nuclear power station output

    International Nuclear Information System (INIS)

    The total annual output of Nuclear Electric's five advanced gas cooled reactor (AGR) stations has increased by more than 80% from 21.7 to 39.3 TW·h over the last four years since the company was formed. This has been achieved through increasing both the capability (maximum power output) and the availability of the reactors. The successive stages of technical modifications, testing and safety case preparation and approval by which the capability of each of the reactor units was raised, whilst ensuring safety, are detailed and the further stages that are planned for the future are outlined. The availability of the reactors has been increased by removing the constraints associated with refuelling operations, reducing statutory overhaul lengths and frequency, and reducing unplanned losses. In 1990, the fuel routes at four of the five stations operated too slowly to supply the fuel needed by the reactors and also required substantial periods of outage of the fuel route for modifications in order to consolidate their off-load refuelling safety cases. The programmes of work undertaken are outlined and the improved performance of the fuel route operations to match the increased output of reactor units is detailed. The future developments, particularly of on-load refuelling, are outlined. The lengths of statutory outages have been reduced by improved management and performance of plant operations and maintenance, and permission has also been received to extend the period between overhauls from 24 to 36 months. Unplanned losses have also been reduced. The improvements in output have not been achieved at the expense of safety nor by increasing the resources deployed. Indeed the reverse is true; key safety indicators show an improvement in both nuclear and industrial safety; and the manpower employed at the AGRs and the total annual expenditure in real terms have both decreased over the past four years. (author). 7 figs, 1 tab

  2. Early goal-directed therapy in moderate to high-risk cardiac surgery patients

    Directory of Open Access Journals (Sweden)

    Kapoor Poonam

    2008-01-01

    Full Text Available Early goal-directed therapy is a term used to describe the guidance of intravenous fluid and vasopressor/inotropic therapy by using cardiac output or similar parameters in the immediate post-cardiopulmonary bypass in cardiac surgery patients. Early recognition and therapy during this period may result in better outcome. In keeping with this aim in the cardiac surgery patients, we conducted the present study. The study included 30 patients of both sexes, with EuroSCORE ≥3 undergoing coronary artery bypass surgery under cardiopulmonary bypass. The patients were randomly divided into two groups, namely, control and early goal-directed therapy (EGDT groups. All the subjects received standardized care; arterial pressure was monitored through radial artery, central venous pressure through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour and frequent arterial blood gas analysis. In addition, cardiac index monitoring using FloTrac™ and continuous central venous oxygen saturation using PreSep™ was used in patients in the EGTD group. Our aim was to maintain the cardiac index at 2.5-4.2 l/min/m 2 , stroke volume index 30-65 ml/beat/m 2 , systemic vascular resistance index 1500-2500 dynes/s/cm 5 /m 2 , oxygen delivery index 450-600 ml/min/m 2 , continuous central venous oximetry more than 70%, stroke volume variation less than 10%; in addition to the control group parameters such as central venous pressure 6-8 mmHg, mean arterial pressure 90-105 mmHg, normal arterial blood gas analysis values, pulse oximetry, hematocrit value above 30% and urine output more than 1 ml/kg/h. The aims were achieved by altering the administration of intravenous fluids and doses of inotropic or vasodilator agents. Three patients were excluded from the study and the data of 27 patients analyzed. The extra volume used (330 ± 160 v/s 80 ± 80 ml, P = 0.043 number of adjustments of inotropic agents (3

  3. Contribution of Agricultural Input to Output in Hohhot City

    Institute of Scientific and Technical Information of China (English)

    Tinghe; DENG; Jie; TIAN

    2013-01-01

    Based on the research data from the economics and management platform of Inner Mongolia Agricultural University,we analyze the changes in the input of agricultural production factors,such as farmland,labor and capital in Hohhot City. Based on the principle of econometrics,we select the agricultural production input-output data in Hohhot City during the period 1992-2010,and establish the econometric model using Cobb-Douglas production factor,to estimate the rate of contribution of agricultural input to the growth of agricultural output value,and study the quantitative relations between agricultural input and agricultural output value. The results show that in Hohhot City,the contribution of chemical fertilizer input to the growth of agricultural output value is the greatest; the contribution of mechanical power to agricultural output value is still not brought into full play; the contribution of remaining production inputs ( including technical progress) accounts for 35. 69% . In the future,Hohhot City should pay more attention to the technical input to develop agriculture.

  4. The Value of Value

    DEFF Research Database (Denmark)

    Sørensen, Asger

    parts of business ethics given prominence to especially one term, namely `value'. The question that interests me is the following: What does the articulation of ethics and morality in terms of values mean for ethics and morality as such. Or, to put the question in a more fashionably way: What is the...... value of value for morality and ethics?To make things a bit more precise, we can make use of the common distinction between ethics and morality, i.e. that morality is the immediate, collective and unconscious employment of morals, whereas ethics is the systematic, individual and conscious reflections of...... morals and morality.2 The main question is then, what the use of `value' as the key-term in moral discourses means to morality as such. Accepting ethics as a part of morality - since one cannot be moral without sometimes reflecting on the validity of the morality employed andexperienced - I have...

  5. Adding value(s)

    DEFF Research Database (Denmark)

    Carré, David

    2015-01-01

    Most economic inquires revolve around agents making decisions. Getting the ‘best value’, it is assumed, drives such decisions: gaining most while risking least. This assumption has been debunked by showing that people does not always choose neither maximum benefit nor less risk (Kahneman & Tversky......, 1992). In response, behavioral economics (Camerer, 1999) has shown that agents have values other than optimization underpinning their decisions. Therefore, concerns arose regarding which values are guiding the agent but not about how such values became relevant for the agent. In this presentation, I...... will explore the consequences of shifting to the latter perspective, i.e. looking for the generative framework of values. Here I argue that economic behavior should also be seen as a sense-making process, guided by values that are chosen/rejected along with fellow human beings, in specific socio...

  6. Imaging features of cardiac myxoma

    International Nuclear Information System (INIS)

    Objective: To study the imaging features of cardiac myxoma and their diagnostic values. Methods: Twenty-two patrents with cardiac myxoma were reviewed retrospectively for the clinical, pathologic, and radiologic findings. Posteroanterior and lateral chest radiographs, American Imatron C-150 XP Electron Beam CT examination, and Germany Siemens 1.5T Magnetom Vision MR scan were performed on every patient. Results: (1) Radiographs of 17 patients with left atrial myxoma showed evidence of mitral valve obstruction in 14(82.3%), radiographs of 5 patients with right atrial myxoma demonstrated right atrium enlargement in 3(60%) respectively. (2) CT scans of 22 myxomas demonstrated 18 (81.8%) lesions were hypoattenuated and 4 (19.1%) were isoattenuated relative to the myocardium. Calcification or ossification was seen in 3 patients. All myxomas apart from massive one were found attaching to the atrial septum. Movie mode could dis- play the movement of myxoma across the atrioventicular valves. (3) MRI studies of 22 myxomas showed 19 (86.3%) heterogeneous signal intensity and 3 (13.7%) homogeneous. They exhibited slight high or homogeneous signal intensity with both T1- and T2-weighted sequences, and low signal intensity with cine gradient recalled echo sequences. Point of attachment was visible in 21 (95.4%) cases. Conclusion: The typical radiograph sign of cardiac myxomas is mitral valve obstruction, CT and MR can demonstrate intracavitary lobular masses attacthing to artrial spetum. The latter two kinds of examinations not only provide accurate assessment of the size, location, and attachment point of these lesions, but also have important qualitative diagnostic advantage. (authors)

  7. 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

  8. Living cardiac tissue slices: an organotypic pseudo two-dimensional model for cardiac biophysics research.

    Science.gov (United States)

    Wang, Ken; Terrar, Derek; Gavaghan, David J; Mu-U-Min, Razik; Kohl, Peter; Bollensdorff, Christian

    2014-08-01

    for up to 50 min. After release of sustained stretch, AP duration (APD) and CaT duration reverted to shorter values. Living cardiac tissue slices are a promising experimental model for the study of cardiac mechano-electric interactions. The methodology described here can be refined to achieve more accurate control over stretch amplitude and timing (e.g. using a computer-controlled motorised stage, or by synchronising electrical and mechanical events) and through monitoring of regional tissue deformation (e.g. by adding motion tracking). PMID:25124067

  9. Acupuncture Effects on Cardiac Functions Measured by Cardiac Magnetic Resonance Imaging in a Feline Model

    Directory of Open Access Journals (Sweden)

    Jen-Hsou Lin

    2010-01-01

    Full Text Available The usefulness of acupuncture (AP as a complementary and/or alternative therapy in animals is well established but more research is needed on its clinical efficacy relative to conventional therapy, and on the underlying mechanisms of the effects of AP. Cardiac magnetic resonance imaging (CMRI, an important tool in monitoring cardiovascular diseases, provides a reliable method to monitor the effects of AP on the cardiovascular system. This controlled experiment monitored the effect electro-acupuncture (EA at bilateral acupoint Neiguan (PC6 on recovery time after ketamine/xylazine cocktail anesthesia in healthy cats. The CMRI data established the basic feline cardiac function index (CFI, including cardiac output and major vessel velocity. To evaluate the effect of EA on the functions of the autonomic nervous and cardiovascular systems, heart rate, respiration rate, electrocardiogram and pulse rate were also measured. Ketamine/xylazine cocktail anesthesia caused a transient hypertension in the cats; EA inhibited this anesthetic-induced hypertension and shortened the post-anesthesia recovery time. Our data support existing knowledge on the cardiovascular benefits of EA at PC6, and also provide strong evidence for the combination of anesthesia and EA to shorten post-anesthesia recovery time and counter the negative effects of anesthetics on cardiac physiology.

  10. Acupuncture effects on cardiac functions measured by cardiac magnetic resonance imaging in a feline model.

    Science.gov (United States)

    Lin, Jen-Hsou; Shih, Chen-Haw; Kaphle, Krishna; Wu, Leang-Shin; Tseng, Weng-Yih; Chiu, Jen-Hwey; Lee, Tzu-Chi; Wu, Ying-Ling

    2010-06-01

    The usefulness of acupuncture (AP) as a complementary and/or alternative therapy in animals is well established but more research is needed on its clinical efficacy relative to conventional therapy, and on the underlying mechanisms of the effects of AP. Cardiac magnetic resonance imaging (CMRI), an important tool in monitoring cardiovascular diseases, provides a reliable method to monitor the effects of AP on the cardiovascular system. This controlled experiment monitored the effect electro-acupuncture (EA) at bilateral acupoint Neiguan (PC6) on recovery time after ketamine/xylazine cocktail anesthesia in healthy cats. The CMRI data established the basic feline cardiac function index (CFI), including cardiac output and major vessel velocity. To evaluate the effect of EA on the functions of the autonomic nervous and cardiovascular systems, heart rate, respiration rate, electrocardiogram and pulse rate were also measured. Ketamine/xylazine cocktail anesthesia caused a transient hypertension in the cats; EA inhibited this anesthetic-induced hypertension and shortened the post-anesthesia recovery time. Our data support existing knowledge on the cardiovascular benefits of EA at PC6, and also provide strong evidence for the combination of anesthesia and EA to shorten post-anesthesia recovery time and counter the negative effects of anesthetics on cardiac physiology. PMID:18955311

  11. Microwave Transmitter With Multimode Output Section

    Science.gov (United States)

    Hoppe, Daniel J.; Bhanji, Alaudin M.; Cormier, Reginald A.

    1988-01-01

    Output-waveguide structure transports 400 kW of continuous-wave signal power at 34.5 GHz. Transmitter generates 400 kW of continuous-wave (CW) signal power. Main feature of conceptual design of this microwave transmitter is output section. Output waveguide structure includes mode converter, directional coupler, polarization monitor, and corrugated overmoded output section. Output directional pattern suitable for antenna illumination without flared feedhorn.

  12. Ventilation and gas exchange management after cardiac arrest.

    Science.gov (United States)

    Sutherasan, Yuda; Raimondo, Pasquale; Pelosi, Paolo

    2015-12-01

    For several decades, physicians had integrated several interventions aiming to improve the outcomes in post-cardiac arrest patients. However, the mortality rate after cardiac arrest is still as high as 50%. Post-cardiac arrest syndrome is associated with high morbidity and mortality due to not only poor neurological outcome and cardiovascular failure but also respiratory dysfunction. To minimize ventilator-associated lung injury, protective mechanical ventilation by using low tidal volume ventilation and driving pressure may decrease pulmonary complications and improve survival. Low level of positive end-expiratory pressure (PEEP) can be initiated and titrated with careful cardiac output and respiratory mechanics monitoring. Furthermore, optimizing gas exchange by avoiding hypoxia and hyperoxia as well as maintaining normocarbia may improve neurological and survival outcome. Early multidisciplinary cardiac rehabilitation intervention is recommended. Minimally invasive monitoring techniques, that is, echocardiography, transpulmonary thermodilution method measuring extravascular lung water, as well as transcranial Doppler ultrasound, might be useful to improve appropriate management of post-cardiac arrest patients. PMID:26670813

  13. Clinical assessment and C-reactive protein (CRP), haptoglobin (Hp), and cardiac troponin I (cTnI) values of brachycephalic dogs with upper airway obstruction before and after surgery.

    Science.gov (United States)

    Planellas, Marta; Cuenca, Rafaela; Tabar, Maria-Dolores; Bertolani, Coralie; Poncet, Cyrill; Closa, Josep M; Lorente, Juan; Cerón, José J; Pastor, Josep

    2015-01-01

    Brachycephalic dogs have unique upper respiratory anatomy with abnormal breathing patterns that are similar to those in humans with obstructive sleep apnea syndrome (OSAS). The objectives of this multicenter prospective study were to assess the effects of surgical correction on clinical signs in dogs with brachycephalic airway obstructive syndrome (BAOS) and to evaluate the levels of several biomarkers [C-reactive protein (CRP); haptoglobin (Hp), and cardiac troponin I (cTnI)] used to determine systemic inflammation and myocardial damage. This study was conducted on 33 dogs with BAOS that were evaluated before and 1 to 2 mo after surgical correction. Palatoplasty was carried out by means of 2 different surgical techniques: carbon dioxide (CO2) laser (n = 12) and electrical scalpel (n = 21). Biomarker levels (CRP, Hp, and cTnI) were determined before and after surgery. There was a significant reduction in respiratory and gastrointestinal signs in dogs with BAOS after surgical treatment (P < 0.001). A greater reduction in respiratory signs (P < 0.002) was obtained using the CO2 laser. No statistical differences were found between CRP and cTnI levels, either before or after surgical correction. Haptoglobin concentration did increase significantly in the postsurgical period (P < 0.008). Surgical treatment in dogs with BAOS reduces clinical signs, regardless of the anatomical components present. Surgical treatment for BAOS is not useful to reduce CRP and Hp levels, probably because BAOS does not induce as obvious an inflammatory process in dogs as in human patients with OSAS. No reduction in cTnI levels was observed 1 mo after surgery in dogs with BAOS, which suggests that some degree of myocardial damage remains. PMID:25673910

  14. Increase in Cardiac Troponin I in a Lamb with Tetralogy of Fallot

    OpenAIRE

    NEUWALD, Elisa Barp; SOARES, Frederico Aécio Carvalho; DREYER, Cristina Terres; CARNESELLA, Samuel; WOUTERS, Angelica Terezinha Barth; GONZÁLEZ, Félix Hilario Diaz; DRIEMEIER, David

    2013-01-01

    ABSTRACT This study describes a case of tetralogy of Fallot in a lamb showing failure to thrive and signs of respiratory distress. Physical examination, electrocardiography, thoracic radiographies, echocardiography and cardiac troponin I evaluation were performed. The value of cardiac troponin I was compared with the values of 10 healthy lambs of the same age and breed, and the affected animal demonstrated an increase in cardiac troponin I. Due to the poor prognosis, euthanasia was indicated,...

  15. A Generalized Kernel Approach to Structured Output Learning

    CERN Document Server

    Kadri, Hachem; Preux, Philippe

    2012-01-01

    We study the problem of structured output learning from a regression perspective. We first provide a general formulation of the kernel dependency estimation (KDE) problem using operator-valued kernels. We show that some of the existing formulations of this problem are special cases of our framework. We then propose a covariance-based operator-valued kernel that allows us to take into account the structure of the kernel feature space. This kernel operates on the output space and encodes the interactions between the outputs without any reference to the input space. To address this issue, we introduce a variant of our KDE method based on the conditional covariance operator that in addition to the correlation between the outputs takes into account the effects of the input variables. Finally, we evaluate the performance of our KDE approach using both covariance and conditional covariance kernels on two structured output problems, and compare it to the state-of-the-art kernel-based structured output regression meth...

  16. Influence of gravity on cardiac performance

    Science.gov (United States)

    Pantalos, G. M.; Sharp, M. K.; Woodruff, S. J.; O'Leary, D. S.; Lorange, R.; Everett, S. D.; Bennett, T. E.; Shurfranz, T.

    1998-01-01

    Results obtained by the investigators in ground-based experiments and in two parabolic flight series of tests aboard the NASA KC-135 aircraft with a hydraulic simulator of the human systemic circulation have confirmed that a simple lack of hydrostatic pressure within an artificial ventricle causes a decrease in stroke volume of 20%-50%. A corresponding drop in stroke volume (SV) and cardiac output (CO) was observed over a range of atrial pressures (AP), representing a rightward shift of the classic CO versus AP cardiac function curve. These results are in agreement with echocardiographic experiments performed on space shuttle flights, where an average decrease in SV of 15% was measured following a three-day period of adaptation to weightlessness. The similarity of behavior of the hydraulic model to the human system suggests that the simple physical effects of the lack of hydrostatic pressure may be an important mechanism for the observed changes in cardiac performance in astronauts during the weightlessness of space flight.

  17. A New Frontier for Cardiac Monitoring

    Science.gov (United States)

    2001-01-01

    CardioDynamics International Corporation (CDIC) has created the BioZ(TM) System through a Small Business Innovation Research (SBIR) award from Johnson Space Center, providing patients and physicians with a cost-effective and highly accurate monitoring system.The BioZ non-invasive heart monitor is based on a technology known as Impedance Cardiography (ICG). BioZ provides the physician with vital information about the heart's ability to deliver blood to the body, the force one's heart exerts with each beat, and the amount of fluid in the chest. Specially designed bioimpedance sensors placed on the neck and chest monitor 12 different parameters, including cardiac output, contractility, systemic vascular resistance, and thoracic fluid content. These sensors monitor the electrical conductivity of the body-information that is converted into blood flow data and is displayed in real time on a monitoring screen. BioZ.com(TM) and BioZ.pc(TM) are two additional products that incorporate the same sensors present in the original BioZ system. The "com" in BioZ.com stands for cardiac output monitor. This fully integrated system is essentially a smaller version of the BioZ, combining the same abilities with a compact, lightweight design, while providing greater portability.

  18. A Monte Carlo study on multiple output stochastic frontiers

    DEFF Research Database (Denmark)

    Henningsen, Geraldine; Henningsen, Arne; Jensen, Uwe

    2015-01-01

    directional components asregressors. A number of studies have compared these specifications using real world dataand have found significant differences in the inefficiency estimates. However, in order to getto the bottom of these differences, we apply a Monte-Carlo simulation. We test the robustnessof both......In the estimation of multiple output technologies in a primal approach, the mainquestion is how to handle the multiple outputs. Often, an output distance function is used,where the classical approach is to exploit its homogeneity property by selecting one outputquantity as the dependent variable...... clearly outperforms the OD with observations with zero output quantities omitted and the OD with zero values replaced by a small positive number (ODz)....

  19. 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

  20. 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

  1. Age- and gender-specific differences in left and right ventricular cardiac function and mass determined by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    We examined possible age- and gender-specific differences in the function and mass of left (LV) and right (RV) ventricles in 36 healthy volunteers using cine gradient-recalled echo magnetic resonance imaging. Subjects were divided into four groups (nine men and nine women in each): men aged under 45 years (32 ± 7), women aged under 45 (27 ± 6), men aged over 45 (59 ± 8), and women aged over 45 (57 ± 9). Functional analysis of cardiac volume and mass and of LV wall motion was performed by manual segmentation of the endocardial and epicardial borders of the end-diastolic and end-systolic frame; both absolute and normalized (per square meter body surface area) values were evaluated. With age there was a significant decrease in both absolute and normalized LV and RV chamber volumes (EDV, ESV), while LV and RV masses remained unchanged. Gender-specific differences were found in cardiac mass and volume (for men and women, respectively: LV mass, 155 ± 18 and 110 ± 16 g; LV EDV, 118 ± 27 and 96 ± 21 ml; LV ESV, 40 ± 13 and 29 ± 9 ml; RV mass, 52 ± 10 and 39 ± 5 g; RV EDV, 131 ± 28 and 100 ± 23 ml; RV ESV, 53 ± 17 and 33 ± 15 ml). Normalization to body surface area eliminated differences in LV volumes but not those in LV mass, RV mass, or RV function. Functional parameters such as cardiac output and LV ejection fraction showed nonsignificant or only slight differences and were thus largely independent of age and gender. Intra- and interobserver variability ranged between 1.4 % and 5.9 % for all parameters. Cine magnetic resonance imaging thus shows age- and gender-specific differences in cardiac function, and therefore the evaluation of cardiac function in patients should consider age- and gender-matched normative values. (orig.)

  2. Range selecting apparatus of intermediate output monitor for nuclear reactor

    International Nuclear Information System (INIS)

    Object: To avoid unnecessary scrum by alleviating the burden of range selecting by an operator and eliminating errors in the range selection. Structure: The apparatus comprises an intermediate output monitor for detecting the neutron flux within the reactor and determining the neutron flux value of an intermediate output system through an amplifier having a switching range and a wide range of amplification degrees, a plurality of recording sections for recording a neutron flux value obtained by the monitor, and a computer for receiving said neutron flux range value and started by a range selection demand signal for setting the range position according to the neutron flux value. The preset signal for the range position is used to effect range selecting of the switching range and the degree of amplification of the amplifier, whereby a recording section suited to the neutron flux value is selected for recording. (Kamimura, M.)

  3. Random output and hospital performance.

    Science.gov (United States)

    Barros, Pedro Pita

    2003-11-01

    Many countries are under pressure to reform health care financing and delivery. Hospital care is one part of the health system that is under scrutiny. Private management initiatives are a possible way to increase efficiency in health care delivery. This motivates the interest in developing methodologies to assess hospital performance, recognizing hospitals as a different sort of firm. We present a simple way to describe hospital production: hospital output as a change in the distribution of survival probabilities. This output definition allows us to separate hospital production from patients' characteristics. The notion of "better performance" has a precise meaning: (first-order) stochastic dominance of a distribution of survival probabilities over another distribution. As an illustration, we compare, for an important DRG, private and public management and find that private management performs better, mainly in the range of high-survival probabilities. The measured performance difference cannot be attributed to input prices or to economies of scale and/or scope. It reflects pure technological and organisational differences. PMID:14686628

  4. 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

  5. Spinal cord motion. Influence of respiration and cardiac cycle

    Energy Technology Data Exchange (ETDEWEB)

    Winklhofer, S. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Schoth, F. [RWTH Aachen University Hospital (Germany). Dept. of Diagnostic Radiology; Stolzmann, P. [University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Krings, T. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology; Mull, M.; Wiesmann, M. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Stracke, C.P. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Alfried-Krupp-Hospital, Essen (Germany). Dept. of Neuroradiology

    2014-11-15

    To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements. Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion. A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion. MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

  6. Spinal cord motion. Influence of respiration and cardiac cycle

    International Nuclear Information System (INIS)

    To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements. Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion. A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion. MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

  7. 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...

  8. 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...

  9. Integration of TMVA Output into Jupyter notebooks

    CERN Document Server

    Saliji, Albulena

    2016-01-01

    The purpose of this report is to describe the work that I have been doing during these past eight weeks as a Summer Student at CERN. The task which was assigned to me had to do with the integration of TMVA Output into Jupyter notebooks. In order to integrate the TMVA Output into the Jupyter notebook, first, improvement of the TMVA Output in the terminal was required. Once the output was improved, it needed to be transformed into HTML output and at the end it would be possible to integrate that output into the Jupyter notebook.

  10. 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

  11. 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

  12. 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)

  13. 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 ...

  14. 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

  15. 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

  16. Moore's law, Dabbawalas, and pediatric cardiac care in Sri Lanka.

    Science.gov (United States)

    Samarasinghe, Duminda

    2015-01-01

    Sri Lanka is an island nation in Indian Ocean that provides free healthcare to all citizens through government healthcare system. It has commendable health indices in the region. Pediatric cardiac services have rapidly progressed over past few years helping to further bring down infant and under-five mortality rates. Lady Ridgeway Hospital for Children (LRH) is the only tertiary care referral center for children with heart disease in the country. Currently it performs approximately 1,000 cardiac catheterizations and 1,000 cardiac surgeries every year. Target is to double the surgical output to treat all children with heart diseases in a timely and appropriate manner. Being a middle-income country, this is not an easy task. Technology used in diagnosis and treatment of congenital heart diseases is rapidly advancing with its price tag. In such a setting, it is challenging to proceed to achieve this target in a resource-limited environment. PMID:26085764

  17. Characterization of glutamatergic neurons in the rat atrial intrinsic cardiac ganglia that project to the cardiac ventricular wall.

    Science.gov (United States)

    Wang, Ting; Miller, Kenneth E

    2016-08-01

    The intrinsic cardiac nervous system modulates cardiac function by acting as an integration site for regulating autonomic efferent cardiac output. This intrinsic system is proposed to be composed of a short cardio-cardiac feedback control loop within the cardiac innervation hierarchy. For example, electrophysiological studies have postulated the presence of sensory neurons in intrinsic cardiac ganglia (ICG) for regional cardiac control. There is still a knowledge gap, however, about the anatomical location and neurochemical phenotype of sensory neurons inside ICG. In the present study, rat ICG neurons were characterized neurochemically with immunohistochemistry using glutamatergic markers: vesicular glutamate transporters 1 and 2 (VGLUT1; VGLUT2), and glutaminase (GLS), the enzyme essential for glutamate production. Glutamatergic neurons (VGLUT1/VGLUT2/GLS) in the ICG that have axons to the ventricles were identified by retrograde tracing of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) injected in the ventricular wall. Co-labeling of VGLUT1, VGLUT2, and GLS with the vesicular acetylcholine transporter (VAChT) was used to evaluate the relationship between post-ganglionic autonomic neurons and glutamatergic neurons. Sequential labeling of VGLUT1 and VGLUT2 in adjacent tissue sections was used to evaluate the co-localization of VGLUT1 and VGLUT2 in ICG neurons. Our studies yielded the following results: (1) ICG contain glutamatergic neurons with GLS for glutamate production and VGLUT1 and 2 for transport of glutamate into synaptic vesicles; (2) atrial ICG contain neurons that project to ventricle walls and these neurons are glutamatergic; (3) many glutamatergic ICG neurons also were cholinergic, expressing VAChT; (4) VGLUT1 and VGLUT2 co-localization occurred in ICG neurons with variation of their protein expression level. Investigation of both glutamatergic and cholinergic ICG neurons could help in better understanding the function of the intrinsic cardiac

  18. Arterial Lactate Level Changes in First Day after Cardiac Operation

    OpenAIRE

    Shamsi Ghaffari; Majid Malaki

    2013-01-01

    Introduction: Lactate level is an important index for predicting cardiac events. There are some debates about time and type of sampling for defining of its prognostic values.Methods: To assess the prognostic importance of arterial lactate level in patients after cardiac surgery with regarding to operation factors serial arterial lactate levels during and after surgery was measured up to 24 hours, these data were processed by T-independent test and chi-square, P less than 0.01 was significant....

  19. [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

  20. A Wearable Contactless Sensor Suitable for Continuous Simultaneous Monitoring of Respiration and Cardiac Activity

    OpenAIRE

    Gargiulo, Gaetano D; Upul Gunawardana; Aiden O’Loughlin; Mohammad Sadozai; Elham Shabani Varaki; Breen, Paul P.

    2015-01-01

    A reliable system that can simultaneously and accurately monitor respiration and cardiac output would have great utility in healthcare applications. In this paper we present a novel approach to creating such a system. This noninvasive, low power, low cost, contactless sensor is suitable for continuous monitoring of respiration (tidal volume) and cardiac stroke volume. Furthermore, it is capable of delivering this data in true volume (i.e., mL). The current embodiment, specifically designed fo...

  1. Cardiac amyloidosis: a review and report of a new transthyretin (prealbumin) variant.

    OpenAIRE

    Hesse, A; Altland, K; Linke, R P; M.R. Almeida; Saraiva, M.J.; Steinmetz, A; Maisch, B

    1993-01-01

    Cardiac amyloidosis is caused by amyloid deposits derived from different human plasma proteins. It can lead to cardiac conduction disturbances, restrictive cardiomyopathy, and low output heart failure. The heart is variably involved during the development of systemic amyloidosis and seems to be more frequently affected in immunoglobulin (primary) than in reactive (secondary) amyloidosis. Amyloid is common in the elderly. Isolated atrial amyloid, for which a major subunit is the atrial natriur...

  2. High Altitude and Intracardiac Devices(Pacemaker and Intracardiac Defibrillator andCardiac Resynchronisation Therapy)

    OpenAIRE

    Gürsoy, Mustafa Ozan; Yıldız, Banu Şahin; Yıldız, Mustafa

    2013-01-01

    Cardiovascular system responds to high altitude short after exposure. Hypoxia induces increase in heart rate, myocardial contractility, and cardiac output. This may have clinical implications in patients with underlying heart disease such as coronary artery disease, heart failure and rhythm disorders. Past studies have showed that patients may experience altitude-induced arrhythmias. However, there are conflicting data for patients with cardiac devices such as permanent pacemaker, intracardia...

  3. In Vivo Measurement of Levofloxacin Penetration into Lung Tissue after Cardiac Surgery†

    OpenAIRE

    Hutschala, Doris; Skhirtladze, Keso; Zuckermann, Andreas; Wisser, Wilfried; Jaksch, Peter; Mayer-Helm, Bernhard Xaver; Burgmann, Heinz; Wolner, Ernst; Müller, Markus; Tschernko, Edda M.

    2005-01-01

    Nosocomial pneumonia is a severe complication after cardiac surgery (CS). Levofloxacin, a fluoroquinolone, qualifies for the therapy of postoperative pneumonia. However, penetration properties of levofloxacin into the lung tissue could be substantially affected by CS: atelectasis, low cardiac output after CS, high volume loads, and inflammatory capillary leak potentially influence drug distribution. The aim of our study was to gain information on interstitial antibiotic concentrations in lung...

  4. Evidence for increased cardiac compliance during exposure to simulated microgravity

    Science.gov (United States)

    Koenig, S. C.; Convertino, V. A.; Fanton, J. W.; Reister, C. A.; Gaffney, F. A.; Ludwig, D. A.; Krotov, V. P.; Trambovetsky, E. V.; Latham, R. D.

    1998-01-01

    We measured hemodynamic responses during 4 days of head-down tilt (HDT) and during graded lower body negative pressure (LBNP) in invasively instrumented rhesus monkeys to test the hypotheses that exposure to simulated microgravity increases cardiac compliance and that decreased stroke volume, cardiac output, and orthostatic tolerance are associated with reduced left ventricular peak dP/dt. Six monkeys underwent two 4-day (96 h) experimental conditions separated by 9 days of ambulatory activities in a crossover counterbalance design: 1) continuous exposure to 10 degrees HDT and 2) approximately 12-14 h per day of 80 degrees head-up tilt and 10-12 h supine (control condition). Each animal underwent measurements of central venous pressure (CVP), left ventricular and aortic pressures, stroke volume, esophageal pressure (EsP), plasma volume, alpha1- and beta1-adrenergic responsiveness, and tolerance to LBNP. HDT induced a hypovolemic and hypoadrenergic state with reduced LBNP tolerance compared with the control condition. Decreased LBNP tolerance with HDT was associated with reduced stroke volume, cardiac output, and peak dP/dt. Compared with the control condition, a 34% reduction in CVP (P = 0.010) and no change in left ventricular end-diastolic area during HDT was associated with increased ventricular compliance (P = 0.0053). Increased cardiac compliance could not be explained by reduced intrathoracic pressure since EsP was unaltered by HDT. Our data provide the first direct evidence that increased cardiac compliance was associated with headward fluid shifts similar to those induced by exposure to spaceflight and that reduced orthostatic tolerance was associated with lower cardiac contractility.

  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. A Monte Carlo Study on Multiple Output Stochastic Frontiers: Comparison of Two Approaches

    DEFF Research Database (Denmark)

    Henningsen, Geraldine; Henningsen, Arne; Jensen, Uwe

    In the estimation of multiple output technologies in a primal approach, the main question is how to handle the multiple outputs. Often an output distance function is used, where the classical approach is to exploit its homogeneity property by selecting one output quantity as the dependent variable......, dividing all other output quantities by the selected output quantity, and using these ratios as regressors (OD). Another approach is the stochastic ray production frontier (SR) which transforms the output quantities into their Euclidean distance as the dependent variable and their polar coordinates......, on average none of the approaches is superior. However, considerable differences are found between the estimates at single replications. In the case of zero values in the output quantities, the SR clearly outperforms the OD, although this advantage nearly vanishes when zeros are replaced by a small number....

  7. Changes in absolute and relative importance in the prognostic value of left ventricular systolic function and congestive heart failure after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Jørgensen, S;

    1998-01-01

    echocardiography, was assessed in 6,676 consecutive patients with an enzyme-confirmed AMI. So that changes in the prognostic value of WMI or CHF could be studied, separate analyses were performed at selected time periods. Average monthly mortality (deaths per 100 patients per month) was determined from life......) but decreased within the first year to low, stable values (0.6% +/- 0.1% and 0.4% +/- 0.1%, respectively, average monthly mortality after year 3). In patients who received thrombolytic therapy, the relative risk associated with a WMI < or = 1.2 decreased from 3.0 (CI 2.0 to 4.4) to 1.3 (CI 0.9 to 1.......6) and from 3.2 (CI 2.0 to 5.1) to 1.7 (CI 1.2 to 2.4) in patients with CHF. The risk of dying decreases steeply with time after an AMI with or without LV dysfunction or CHF and stabilizes at low values after 1 year. This is in contrast to the relative importance of these risk factors, which is...

  8. Computational Complexity of Input/Output Logic

    OpenAIRE

    Sun, Xin; Ambrossio, Diego Agustin

    2015-01-01

    Input/output logics are abstract structures designed to represent conditional norms. The complexity of input/output logic has been sparsely developed. In this paper we study the complexity of input/output logics. We show that the lower bound of the complexity of the fulfillment problem of 4 input/output logics is coNP, while the upper bound is either coNP or P^NP.

  9. Exceptional cardiac anoxia tolerance in tilapia (Oreochromis hybrid).

    Science.gov (United States)

    Lague, Sabine L; Speers-Roesch, Ben; Richards, Jeffrey G; Farrell, Anthony P

    2012-04-15

    Anoxic survival requires the matching of cardiac ATP supply (i.e. maximum glycolytic potential, MGP) and demand (i.e. cardiac power output, PO). We examined the idea that the previously observed in vivo downregulation of cardiac function during exposure to severe hypoxia in tilapia (Oreochromis hybrid) represents a physiological strategy to reduce routine PO to within the heart's MGP. The MGP of the ectothermic vertebrate heart has previously been suggested to be ∼70 nmol ATP s(-1) g(-1), sustaining a PO of ∼0.7 mW g(-1) at 15°C. We developed an in situ perfused heart preparation for tilapia (Oreochromis hybrid) and characterized the routine and maximum cardiac performance under both normoxic (>20 kPa O(2)) and severely hypoxic perfusion conditions (tilapia heart maintained a routine normoxic cardiac output (Q) and PO under all hypoxic conditions, a result that contrasts with the hypoxic cardiac downregulation previously observed in vivo under less severe conditions. Thus, we conclude that the in vivo downregulation of routine cardiac performance in hypoxia is not needed in tilapia to balance cardiac energy supply and demand. Indeed, the MGP of the tilapia heart proved to be quite exceptional. Measurements of myocardial lactate efflux during severe hypoxia were used to calculate the MGP of the tilapia heart. The MGP was estimated to be 172 nmol ATP s(-1) g(-1) at 22°C, and allowed the heart to generate a PO(max) of at least ∼3.1 mW g(-1), which is only 30% lower than the PO(max) observed with normoxia. Even with this MGP, the additional challenge of acidosis during severe hypoxia decreased maximum ATP turnover rate and PO(max) by 30% compared with severe hypoxia alone, suggesting that there are probably direct effects of acidosis on cardiac contractility. We conclude that the high maximum glycolytic ATP turnover rate and levels of PO, which exceed those measured in other ectothermic vertebrate hearts, probably convey a previously unreported anoxia tolerance

  10. Nonlinear internal models for output regulation

    OpenAIRE

    Byrnes, C. I.; Isidori, A.

    2003-01-01

    In this paper we show how nonlinear internal models can be effectively used in the design of output regulators for nonlinear systems. This result provides a significant enhancement of the non-equilibrium theory for output regulation, which we have presented in the recent paper entitled "Limit Sets, Zero Dynamics, and Internal Models in the Problem of Nonlinear Output Regulation".

  11. Low-dose exposure of silica nanoparticles induces cardiac dysfunction via neutrophil-mediated inflammation and cardiac contraction in zebrafish embryos.

    Science.gov (United States)

    Duan, Junchao; Yu, Yang; Li, Yang; Li, Yanbo; Liu, Hongcui; Jing, Li; Yang, Man; Wang, Ji; Li, Chunqi; Sun, Zhiwei

    2016-06-01

    The toxicity mechanism of nanoparticles on vertebrate cardiovascular system is still unclear, especially on the low-level exposure. This study was to explore the toxic effect and mechanisms of low-dose exposure of silica nanoparticles (SiNPs) on cardiac function in zebrafish embryos via the intravenous microinjection. The dosage of SiNPs was based on the no observed adverse effect level (NOAEL) of malformation assessment in zebrafish embryos. The mainly cardiac toxicity phenotypes induced by SiNPs were pericardial edema and bradycardia but had no effect on atrioventricular block. Using o-Dianisidine for erythrocyte staining, the cardiac output of zebrafish embryos was decreased in a dose-dependent manner. Microarray analysis and bioinformatics analysis were performed to screen the differential expression genes and possible pathway involved in cardiac function. SiNPs induced whole-embryo oxidative stress and neutrophil-mediated cardiac inflammation in Tg(mpo:GFP) zebrafish. Inflammatory cells were observed in atrium of SiNPs-treated zebrafish heart by histopathological examination. In addition, the expression of TNNT2 protein, a cardiac contraction marker in heart tissue had been down-regulated compared to control group using immunohistochemistry. Confirmed by qRT-PCR and western blot assays, results showed that SiNPs inhibited the calcium signaling pathway and cardiac muscle contraction via the down-regulated of related genes, such as ATPase-related genes (atp2a1l, atp1b2b, atp1a3b), calcium channel-related genes (cacna1ab, cacna1da) and the regulatory gene tnnc1a for cardiac troponin C. Moreover, the protein level of TNNT2 was decreased in a dose-dependent manner. For the first time, our results demonstrated that SiNPs induced cardiac dysfunction via the neutrophil-mediated cardiac inflammation and cardiac contraction in zebrafish embryos. PMID:26551753

  12. Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients

    DEFF Research Database (Denmark)

    Møller-Sørensen, Hasse; Cordtz, Johan Joakim; Østergaard, Morten;

    2016-01-01

    completed the study. Each patient were placed in the following successive positions: (1) supine, (2) head-down tilt, (3) head-up tilt, (4) supine, (5) supine with phenylephrine administration, (6) pace heart rate 80 beats per minute (bpm), (7) pace heart rate 110 bpm. The agreement of compared data...

  13. Preventing Inductive Output Impedance of High-Frequency Emitter Follower Stages

    Directory of Open Access Journals (Sweden)

    R. C. Tozer

    1997-04-01

    Full Text Available Large output inductance is one of major issues of high-frequency emitter follower design. The most often suggested technique to reduce its value is the decreasing of AC transconductance which offers small output inductance at the expense of loosing low output resistance. The paper presents a different approach; it is shown that output inductance can be completely cancelled while keeping very low output resistance by introducing a pole at the input node which may be more suitable in many types of design. Complete analytical evaluation based on the full hybrid-n model of the bipolar transistor device is given.

  14. Multiparameter Predictor of Fluid Responsiveness in Cardiac Surgical Patients Receiving Tidal Volumes Less Than 10 mL/kg.

    Science.gov (United States)

    Ikeda, Keita; Smith, Gregory; Renehan, John; Isbell, James; McMurry, Timothy; Rosner, Mitchell; Thiele, Robert

    2016-09-01

    Introduction We hypothesize that respiratory variation in the pulmonary artery tracing predicts fluid responsiveness (primary hypothesis) and that inclusion of multiple physiologic waveforms as well as ventilator settings in a predictive model of fluid responsiveness would lead to improvements in the clinical utility of this class of metrics (secondary hypothesis). Methods Blood pressure tracings were prospectively recorded in 35 patients immediately following cardiac surgery. Fluid bolus administration data, ventilator settings, and cardiac output were recorded prospectively before and after fluid boluses given at the discretion of the treating physician. Results We observed statistically significant but limited relationships between pulmonic (r(2) = .26, P = .0052) and systemic (r(2) = .13, P = .011) pulse pressure variation and changes in cardiac index. A multiparameter estimate of fluid responsiveness, which included respiratory variation in central venous pressure and pulmonary artery pressure, indexed tidal volumes, positive end-expiratory pressure, and mean airway pressure, was also correlated with change in cardiac index (r(2) = .42, P = .0056). Using the area under the curve (AUC) technique to compare specificity and sensitivity, dynamic indicators (AUC = 0.74, 0.67, and 0.81 for systemic arterial respiratory [pulse pressure] variation, pulmonic arterial respiratory [pulse pressure] variation, and the multiparameter estimate, respectively) outperformed static estimates (0.49 and 0.48 for central venous pressure and pulmonary artery diastolic pressure, respectively). Conclusion While integration of multiple physiologic waveforms as well as ventilator parameters improves the predictability of fluid responsive metrics in the setting of lung-protective ventilation, the composite index may still be of limited predictive value. PMID:27317553

  15. Model output: fact or artefact?

    Science.gov (United States)

    Melsen, Lieke

    2015-04-01

    As a third-year PhD-student, I relatively recently entered the wonderful world of scientific Hydrology. A science that has many pillars that directly impact society, for example with the prediction of hydrological extremes (both floods and drought), climate change, applications in agriculture, nature conservation, drinking water supply, etcetera. Despite its demonstrable societal relevance, hydrology is often seen as a science between two stools. Like Klemeš (1986) stated: "By their academic background, hydrologists are foresters, geographers, electrical engineers, geologists, system analysts, physicists, mathematicians, botanists, and most often civil engineers." Sometimes it seems that the engineering genes are still present in current hydrological sciences, and this results in pragmatic rather than scientific approaches for some of the current problems and challenges we have in hydrology. Here, I refer to the uncertainty in hydrological modelling that is often neglected. For over thirty years, uncertainty in hydrological models has been extensively discussed and studied. But it is not difficult to find peer-reviewed articles in which it is implicitly assumed that model simulations represent the truth rather than a conceptualization of reality. For instance in trend studies, where data is extrapolated 100 years ahead. Of course one can use different forcing datasets to estimate the uncertainty of the input data, but how to prevent that the output is not a model artefact, caused by the model structure? Or how about impact studies, e.g. of a dam impacting river flow. Measurements are often available for the period after dam construction, so models are used to simulate river flow before dam construction. Both are compared in order to qualify the effect of the dam. But on what basis can we tell that the model tells us the truth? Model validation is common nowadays, but validation only (comparing observations with model output) is not sufficient to assume that a

  16. Cardiac arrest in children

    Directory of Open Access Journals (Sweden)

    Tress Erika

    2010-01-01

    Full Text Available Major advances in the field of pediatric cardiac arrest (CA were made during the last decade, starting with the publication of pediatric Utstein guidelines, the 2005 recommendations by the International Liaison Committee on Resuscitation, and culminating in multicenter collaborations. The epidemiology and pathophysiology of in-hospital and out-of-hospital CA are now well described. Four phases of CA are described and the term "post-cardiac arrest syndrome" has been proposed, along with treatment goals for each of its four phases: immediate post-arrest, early post-arrest, intermediate and recovery phase. Hypothermia is recommended to be considered as a therapy for post-CA syndrome in comatose patients after CA, and large multicenter prospective studies are underway. We reviewed landmark articles related to pediatric CA published during the last decade. We present the current knowledge of epidemiology, pathophysiology and treatment of CA relevant to pre-hospital and acute care health practitioners.

  17. Cardiac arrest in children.

    Science.gov (United States)

    Tress, Erika E; Kochanek, Patrick M; Saladino, Richard A; Manole, Mioara D

    2010-07-01

    Major advances in the field of pediatric cardiac arrest (CA) were made during the last decade, starting with the publication of pediatric Utstein guidelines, the 2005 recommendations by the International Liaison Committee on Resuscitation, and culminating in multicenter collaborations. The epidemiology and pathophysiology of in-hospital and out-of-hospital CA are now well described. Four phases of CA are described and the term "post-cardiac arrest syndrome" has been proposed, along with treatment goals for each of its four phases: immediate post-arrest, early post-arrest, intermediate and recovery phase. Hypothermia is recommended to be considered as a therapy for post-CA syndrome in comatose patients after CA, and large multicenter prospective studies are underway. We reviewed landmark articles related to pediatric CA published during the last decade. We present the current knowledge of epidemiology, pathophysiology and treatment of CA relevant to pre-hospital and acute care health practitioners. PMID:20930971

  18. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social...

  19. Cardiac adaptations of bullfrog tadpoles in response to chytrid infection.

    Science.gov (United States)

    Salla, Raquel Fernanda; Gamero, Fernando Urban; Ribeiro, Larissa Rodrigues; Rizzi, Gisele Miglioranza; Medico, Samuel Espinosa Dal; Rissoli, Rafael Zanelli; Vieira, Conrado Augusto; Silva-Zacarin, Elaine Cristina Mathias; Leite, Domingos Silva; Abdalla, Fábio Camargo; Toledo, Luis Felipe; Costa, Monica Jones

    2015-08-01

    The chytrid fungus Batrachochytrium dendrobatidis (Bd) can result in heart failure in Bd-susceptible species. Since Bd infection generally does not cause mortality in North American bullfrogs, the aim of this work was to verify whether this species presents any cardiac adaptation that could improve the tolerance to the fungus. Thus, we analyzed tadpoles' activity level, relative ventricular mass, ventricle morphology, in loco heart frequency, and in vitro cardiac function. The results indicate that infected animals present an increase in both ventricular relative mass and in myofibrils' incidence, which accompanied the increase in myocytes' diameter. Such morphological alterations enabled an increase in the in vitro twitch force that, in vivo, would result in elevation of the cardiac stroke volume. This response requires much less energy expenditure than an elevation in heart frequency, but still enables the heart to pump a higher volume of blood per minute (i.e., an increase in cardiac output). As a consequence, the energy saved in the regulation of the cardiac function of Bd-infected tadpoles can be employed in other homeostatic adjustments to avoid the lethal effect of the fungus. Whether other species present this ability, and to what extent, remains uncertain, but such possible interspecific variability might explain different mortality rates among different species of Bd-infected amphibians. PMID:26055358

  20. DETERMINANTS OF AGRICULTURAL OUTPUT IN SYRIA

    Directory of Open Access Journals (Sweden)

    Adel Shakeeb MOHSEN

    2016-04-01

    Full Text Available This study investigates the determinants of agricultural output in Syria, 1980-2010. The Johansen cointegration test results indicate that agricultural outputs are positively related to the capital, food exports, expenditure and arable land, and negatively related to the oil price. Arable land has the biggest effect on agricultural outputs. The Granger causality test indicates bidirectional short-run causality relationships between capital, food exports, expenditure, arable land and agricultural outputs, and unidirectional short-run causality relationship running from oil price to agricultural outputs. There are also unidirectional long-run causality relationships moving from agricultural outputs to gross fixed capital formation of agriculture, oil price, food exports and arable land. However, there is no long-run causality relationships between final consumption expenditure and agricultural outputs. The result indicates that it is important to speed up the land reclamation process and encourage the investment in the agricultural sector.

  1. Cardiac metastases of osteosarcoma

    International Nuclear Information System (INIS)

    Osteosarcoma is a malignancy whose various sites of metastasis greatly modify its ultimate prognosis. We report a case of simultaneous pulmonary and cardiac metastases in a 41-year-old male patient with osteosarcoma of the tibia, presenting after more then one year of completion of adjuvant therapy with progressive dyspnea and cyanosis. Diagnosis was made on computerized tomogram and echocardiogram. The metastatic mass entirely occupying the right ventricle and the pulmonary artery proved fatal. (author)

  2. Cardiac Tissue Engineering

    OpenAIRE

    MILICA RADISIC; GORDANA VUNJAK-NOVAKOVIC

    2009-01-01

    We hypothesized that clinically sized (1-5 mm thick),compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3) can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of p...

  3. Cardiac developmental toxicity

    OpenAIRE

    Mahler, Gretchen J.; Jonathan T Butcher

    2011-01-01

    Congenital heart disease is a highly prevalent problem with mostly unknown origins. Many cases of CHD likely involve an environmental exposure coupled with genetic susceptibility, but practical and ethical considerations make nongenetic causes of CHD difficult to assess in humans. The development of the heart is highly conserved across all vertebrate species, making animal models an excellent option for screening potential cardiac teratogens. This review will discuss exposures known to cause ...

  4. Penetrating Cardiac Injuries

    OpenAIRE

    ÖZYAZICIOĞLU, Ahmet

    2002-01-01

    Objectives: To present our experience of penetrating cardiac injuries treated at Atatürk University hospital; in 17 years 38 patients were analyzed. Methods: Patients were classified into three groups: group A (stable), 12; group B (shock), 21; and group C (agonal), five. Five patients were treated by pericardial window and three by pericardiocentesis. Two patients in group C, 19 patients in group B and five patients in group A underwent median sternotomy or thoracotomy in the operating room...

  5. Effect of Reducing Chemical Fertilizer on Rice Yield,Output Value, Content of Soil Carbon and Nitrogen after Utilizing the Milk Vetch%紫云英利用后减施化肥对水稻产量、产值及土壤碳氮含量的影响

    Institute of Scientific and Technical Information of China (English)

    周兴; 李再明; 谢坚; 廖育林; 杨曾平; 鲁艳红; 聂军; 曹卫东

    2015-01-01

    with fertilizer application had a much more increase effect in rice yield. Under the condition of milk vetch application with 22 500 kg/hm2, the early rice yield of the treatment A1 was significantly increased by 7.7% compared with that of CF. And the yield of treatment A3 was basical y identical to or slight in-crease in comparison with that of CF. Decreasing amount of fertilizers cloud im-prove output value of rice in the case of the utilization of Chinese milk vetch. The treatment A1 increased output value of rice by 5.92% in comparison of CF, and treatment A2 was by 4.08% in the next. Treatment A4 showed much better effect in increasing soil organic carbon and total nitrogen in the paddy soil than those of treatments applying mineral fertilizer only. There was a significant reduction on soil organic carbon and TN in treatment A2 in comparison with that of CF. ln general, amount of application of milk vetch with 22 500 kg/hm2 could replace chemical fer-tilizer partial y, it also could improve rice yield, decrease the production cost, and raise the utilization efficiency of nutrients.

  6. Handling Input and Output for COAMPS

    Science.gov (United States)

    Fitzpatrick, Patrick; Tran, Nam; Li, Yongzuo; Anantharaj, Valentine

    2007-01-01

    Two suites of software have been developed to handle the input and output of the Coupled Ocean Atmosphere Prediction System (COAMPS), which is a regional atmospheric model developed by the Navy for simulating and predicting weather. Typically, the initial and boundary conditions for COAMPS are provided by a flat-file representation of the Navy s global model. Additional algorithms are needed for running the COAMPS software using global models. One of the present suites satisfies this need for running COAMPS using the Global Forecast System (GFS) model of the National Oceanic and Atmospheric Administration. The first step in running COAMPS downloading of GFS data from an Internet file-transfer-protocol (FTP) server computer of the National Centers for Environmental Prediction (NCEP) is performed by one of the programs (SSC-00273) in this suite. The GFS data, which are in gridded binary (GRIB) format, are then changed to a COAMPS-compatible format by another program in the suite (SSC-00278). Once a forecast is complete, still another program in the suite (SSC-00274) sends the output data to a different server computer. The second suite of software (SSC- 00275) addresses the need to ingest up-to-date land-use-and-land-cover (LULC) data into COAMPS for use in specifying typical climatological values of such surface parameters as albedo, aerodynamic roughness, and ground wetness. This suite includes (1) a program to process LULC data derived from observations by the Moderate Resolution Imaging Spectroradiometer (MODIS) instruments aboard NASA s Terra and Aqua satellites, (2) programs to derive new climatological parameters for the 17-land-use-category MODIS data; and (3) a modified version of a FORTRAN subroutine to be used by COAMPS. The MODIS data files are processed to reformat them into a compressed American Standard Code for Information Interchange (ASCII) format used by COAMPS for efficient processing.

  7. Benign cardiac tumours: cardiac CT and MRI imaging appearances

    International Nuclear Information System (INIS)

    Full text: Primary benign cardiac tumours are rarely found in clinical practice and are generally evaluated with echocardiography. However, with the increasing usage of helical multislice CT, the initial detection and evaluation of these masses may be made by the radiologist during routine daily practice for other indications. The echocardiographic, CT and cardiac MRI appearances of various benign cardiac tumours and masses are described and illustrated in this review

  8. Cardiac tissue engineering

    Directory of Open Access Journals (Sweden)

    MILICA RADISIC

    2005-03-01

    Full Text Available We hypothesized that clinically sized (1-5 mm thick,compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3 can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of perfluorocarbons, or with electrical stimulation (continuous application of biphasic pulses, 2 ms, 5 V, 1 Hz. Tissue constructs cultured without perfusion or electrical stimulation served as controls. Medium perfusion and addition of perfluorocarbons resulted in compact, thick constructs containing physiologic density of viable, electromechanically coupled cells, in contrast to control constructs which had only a ~100 mm thick peripheral region with functionally connected cells. Electrical stimulation of cultured constructs resulted in markedly improved contractile properties, increased amounts of cardiac proteins, and remarkably well developed ultrastructure (similar to that of native heart as compared to non-stimulated controls. We discuss here the state of the art of cardiac tissue engineering, in light of the biomimetic approach that reproduces in vitro some of the conditions present during normal tissue development.

  9. PREVIMER : Meteorological inputs and outputs

    Science.gov (United States)

    Ravenel, H.; Lecornu, F.; Kerléguer, L.

    2009-09-01

    PREVIMER is a pre-operational system aiming to provide a wide range of users, from private individuals to professionals, with short-term forecasts about the coastal environment along the French coastlines bordering the English Channel, the Atlantic Ocean, and the Mediterranean Sea. Observation data and digital modelling tools first provide 48-hour (probably 96-hour by summer 2009) forecasts of sea states, currents, sea water levels and temperatures. The follow-up of an increasing number of biological parameters will, in time, complete this overview of coastal environment. Working in partnership with the French Naval Hydrographic and Oceanographic Service (Service Hydrographique et Océanographique de la Marine, SHOM), the French National Weather Service (Météo-France), the French public science and technology research institute (Institut de Recherche pour le Développement, IRD), the European Institute of Marine Studies (Institut Universitaire Européen de la Mer, IUEM) and many others, IFREMER (the French public institute fo marine research) is supplying the technologies needed to ensure this pertinent information, available daily on Internet at http://www.previmer.org, and stored at the Operational Coastal Oceanographic Data Centre. Since 2006, PREVIMER publishes the results of demonstrators assigned to limited geographic areas and to specific applications. This system remains experimental. The following topics are covered : Hydrodynamic circulation, sea states, follow-up of passive tracers, conservative or non-conservative (specifically of microbiological origin), biogeochemical state, primary production. Lastly, PREVIMER provides researchers and R&D departments with modelling tools and access to the database, in which the observation data and the modelling results are stored, to undertake environmental studies on new sites. The communication will focus on meteorological inputs to and outputs from PREVIMER. It will draw the lessons from almost 3 years during

  10. Beneficial effects of high magnesium on alcohol-induced cardiac failure.

    Science.gov (United States)

    Zou, L Y; Wu, F; Altura, B T; Barbour, R L; Altura, B M

    Although alcohol has long been known to induce cardiac depression and cardiomyopathy, it is not known whether drug therapy or pharmacologic manipulation can be used to prevent or reverse these toxicities. With this in mind, high levels (15 mM) of magnesium (Mg) were investigated for their potential antialcohol effects on perfused rat hearts. A high concentration of ethanol (135 mM) was used to induce rapid cardiac failure as assessed by hemodynamic and metabolic parameters. During ethanol perfusion in normal 1.2 mM [Mg2+]o physiologic salt solution, coronary flow decreased immediately, and all of the hemodynamic parameters studied (except for heart rate) were depressed significantly. After 10 min of 135 mM ethanol perfusion, only 60% of the hearts kept beating; at 15 min, only 42% of the hearts continued to beat. Myocardial metabolism under such conditions as assessed by examination of coronary effluent concentrations of lactic acid (LA), lactic acid dehydrogenase (LDH) and creatine phosphokinase (CPK) was rapidly and severely compromised. Although 15 mM MgSO4 alone did not alter coronary flow and systolic pressure under the conditions studied, it did decrease cardiac output, heart rate and total pressure developed. However, when 15 mM MgSO4 was given 10 min before ethanol, and continued during ethanol perfusion, the usual depression in all assessed cardiac hemodynamic parameters (except heart rate) caused by ethanol was not observed. During 15 min of high [Mg2+]o perfusion, coronary flow recovered from 19.1 +/- 6.8% (ethanol alone) to 68.1 +/- 9.9% of control values (p CPK all went from elevated values towards normal levels. There were similar hemodynamic and metabolic responses to high [Mg2+]o given during ethanol perfusion to that given before ethanol perfusion. The hemodynamic and metabolic beneficial effects between groups pretreated or treated with high [Mg2+]o exhibited no significant differences. These results suggest that high [Mg2+]o (15 mM) given either

  11. Applications of cardiac MRI in pediatric heart diseases

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of magnetic resonance imaging in pediatric heart diseases. Methods: Ninety-seven cases received cardiac MR scanning in this present study. The age range was 2 day to 13 years including 62 boys and 35 girls, the median age was 6 years. They were performed on h 5 T scanner with cardiac phased-array coil and VCG. Results: Eighty-five of the 97 cases were positive. Those positive findings included cardiomyopathy in 41 cases, congenital heart disease in 20 cases, constrictive pericarditis in 4 cases, pericardiac effusions with or without other cardiovascular diseases in 17 cases, cardiac tumor in 2 cases,thrombus in 3 cases and in 5 other cases. Conclusion: Cardiac MRI is an excellent imaging modality for the anatomical and functional abnormalities of pediatric heart diseases. (authors)

  12. Role of external cardiac compression in truncal trauma.

    Science.gov (United States)

    Mattox, K L; Feliciano, D V

    1982-11-01

    External cardiac compression (ECC) was originally developed for patients with nontraumatic cardiac conditions, but it is now used for a wide variety of emergency conditions. As an integral part of cardiopulmonary resuscitation (CPR), ECC coupled with forced pulmonary ventilation may NOT be applicable to cases of cardiac arrest following penetrating and blunt thoracic and abdominal trauma. Review of 100 patients with penetrating or blunt truncal trauma who received CPR and ECC more than 3 minutes prehospital revealed NO survivors despite continued aggressive resuscitative efforts in 49 of the patients upon arrival at a trauma center. Major cardiovascular disruption was found at thoracotomy or autopsy in all patients. In another 12 patients receiving forced ventilation and prehospital ECC, air embolism to the coronary arteries was the cause of death. CPR by paramedics, physicians, nurses, or lay persons does not appear to be of value in patients who have sustained cardiac arrest from truncal trauma. PMID:7143499

  13. Indeterminacy of Spatiotemporal Cardiac Alternans

    CERN Document Server

    Zhao, Xiaopeng

    2007-01-01

    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  14. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac p...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....... characterized. An ongoing characterization of the molecular heterogeneity will help appreciate the biosynthetic capacity of the endocrine heart and could introduce new diagnostic possibilities. Notably, different biosynthetic products may not be equal markers of the same pathophysiological processes. An...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  15. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....

  16. An overview of cardiac morphogenesis.

    Science.gov (United States)

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile

    2013-11-01

    Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In this article we review the different steps of heart development, focusing on the processes of alignment and septation. We also show, as often as possible, the links between abnormalities of cardiac development and the main congenital heart defects. The development of animal models has permitted the unraveling of many mechanisms that potentially lead to cardiac malformations. A next step towards a better knowledge of cardiac development could be multiscale cardiac modelling. PMID:24138816

  17. Cardiac sarcoidosis—state of the art review

    Science.gov (United States)

    Hulten, Edward; Aslam, Saira; Osborne, Michael; Abbasi, Siddique; Bittencourt, Marcio Sommer

    2016-01-01

    Sarcoidosis is a multi-system inflammatory disorder of unknown etiology resulting in formation of non-caseating granulomas. Cardiac involvement—which is associated with worse prognosis—has been detected in approximately 25% of individuals based on autopsy or cardiac imaging studies. Nevertheless, the diagnosis of cardiac sarcoidosis is challenging due to the low yield of endomyocardial biopsy, and the limited accuracy of various clinical criteria. Thus, no gold standard diagnostic criterion exists. This review will summarize the pathophysiology, diagnosis, and treatment of cardiac sarcoidosis with a focus on advanced cardiovascular imaging, We review the evidence to support a role for cardiac magnetic resonance (CMR) imaging in the initial evaluation of selected patients with suspected cardiac sarcoidosis, with cardiac positron emission tomography (PET) as an alternative or complementary initial diagnostic test in a subgroup of patients in whom CMR may be contra-indicated or when CMR is negative with continued clinical concern for myocardial inflammation. In addition to the diagnostic value of these tests, CMR and PET are also useful in identifying patients who have higher risk of adverse events such as ventricular tachycardia or death, in whom preventive therapies such as defibrillators should be more strongly considered. Although no randomized controlled trials for treatment of cardiac sarcoidosis exist, immunosuppressive therapy is often used. We review emerging evidence regarding the use of cardiac PET to identify and quantity the amount of myocardial inflammation as well as to guide the use of immunotherapy. Future studies are needed to determine the benefit of imaging guided therapies aimed at improving patient outcomes. PMID:26885492

  18. Relationship between Multi-Output Partially Bent Functions and Multi-Output Bent Functions

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yaqun; JU Guizhi; WANG Jue

    2006-01-01

    In this paper, the definition of multi-output partially Bent functions is presented and some properties are discussed. Then the relationship between multi-output partially Bent functions and multi-output Bent functions is given in Theorem 4, which includes Walsh spectrum expression and function expression. This shows that multi-output partially Bent functions and multi-output Bent functions can define each other in principle. So we obtain the general method to construct multi-output partially Bent functions from multi-output Bent functions.

  19. Sudden Cardiac Death in Athletes.

    Science.gov (United States)

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B

    2016-01-01

    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  20. Cardiac Rehabilitation: Guidelines and Recommendations

    OpenAIRE

    Catherine Monpere

    1998-01-01

    Cardiac rehabilitation has been shown to improve exercise tolerance and symptomatology in patients experiencing angina or heart failure and reduce long term mortality after myocardial infarction, with a good cost-effectiveness ratio. In addition to these `hard' endpoints, cardiac rehabilitation improves the patient's quality of life and risk factor profile through a multifactorial intervention. Indeed, cardiac rehabilitation is no longer restricted to physical reconditioning, but should now b...