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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. Low Cardiac Output Secondary to a Malpositioned Umbilical Venous Catheter: Value of Targeted Neonatal Echocardiography

    Directory of Open Access Journals (Sweden)

    Dany E. Weisz

    2014-05-01

    Full Text Available Systemic hypotension is common in very low birthweight preterm infants but the nature of the precipitating cause may be unclear. Targeted neonatal echocardiography (TnEcho is being increasingly used to support hemodynamic decisions in the neonatal intensive care unit (NICU, including identifying impairments in the transitional circulation of preterm infants, providing timely re-evaluation after institution of therapies and evaluating the placement of indwelling catheters. We present a case of a preterm infant with systemic hypotension and low cardiac output secondary to a large transatrial shunt induced by a malpositioned umbilical venous catheter. Repositioning of the line led to resolution of the hemodynamic disturbance and clinical instability, highlighting the utility of TnEcho in the NICU.

  3. 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...

  4. 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.

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

    Science.gov (United States)

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

    1990-04-01

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

  6. 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...

  7. Methods and apparatus for determining cardiac output

    Science.gov (United States)

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

    2010-01-01

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

  8. William Harvey, Peter Lauremberg and cardiac output.

    Science.gov (United States)

    Teichmann, G

    1992-11-01

    In 1636, the Rostock professor of medicine and the art of poetry, Peter Lauremberg (1585-1639), was one of the earliest to mention circulation which had been discovered by William Harvey and documented in his anatomical manual. In 1628 William Harvey proved the existence of the blood circulation by calculating the "cardiac output in a half an hour (semihora)". The answer to the question why Harvey chose half an hour as the time range can be found in the way of measuring time usual at that period. The sandglasses were turned half-hourly in maritime navigation and the wheel-clocks on shore had only the hour-hand. Improved chronometry was one of the prerequisites for measuring cardiac output. The minute-hand became usual after 1700 and the second-hand later on. Taking into consideration the alterations of cardiac output made the latter one of the most important circulation parameters in diagnostics, prognostication and therapeutics.

  9. Newer methods of cardiac output monitoring

    Institute of Scientific and Technical Information of China (English)

    Yatin; Mehta; Dheeraj; Arora

    2014-01-01

    Cardiac output(CO) is the volume of blood ejected by each ventricle per minute and is the product of stroke volume and heart rate. CO can thus be manipulated by alteration in heart rate or rhythm, preload, contractility and afterload. Moreover it gives important information about tissue perfusion and oxygen delivery. CO can be measured by various methods and thermodilution method using pulmonary artery catheter(PAC) is till date considered as gold standard method. Complications associated with PAC led to development of newer methods which are minimally or non-invasive. Newer methods fulfil other properties like continuous and reproducible reading, cost effective, reliable during various physiological states and have fast response time. These methods are validated against the gold standard with good level agreement. In this review we have discussed various newer methods of CO monitoring and their effectiveness in clinical use.

  10. Comparison of cardiac output measurement techniques

    DEFF Research Database (Denmark)

    Espersen, K; Jensen, E W; Rosenborg, D;

    1995-01-01

    at a workload of 50 W (EX). The agreements between the techniques, two by two, were expressed as the bias calculated as the averaged differences between the techniques. Precision was expressed as the standard deviation of the bias. The overall agreement (bias +/- precision) between TD, DOP and CR respectively...... and CR, respectively, and TD were 2.5 +/- 2.2 and 2.6 +/- 1.6 l/min. The overall agreement between DOP and CR was 0.1 +/- 1.6 l/min. In conclusion, TD overestimated cardiac output compared to the other techniques and the poor agreement has to be taken into consideration especially in measures of low...

  11. Measurement of cardiac output from dynamic pulmonary circulation time CT

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Seonghwan, E-mail: Seonghwan.Yee@Beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States); Scalzetti, Ernest M. [Department of Radiology, SUNY Upstate Medical University, Syracuse, New York 13210 (United States)

    2014-06-15

    Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA, which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.

  12. 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...

  13. Validation of Fick cardiac output calculated with assumed oxygen consumption : a study of cardiac output during epoprostenol

    NARCIS (Netherlands)

    Bergstra, A; van den Heuvel, A F M; Zijlstra, F; Berger, R M F; Mook, G A; van Veldhuisen, D J

    2004-01-01

    OBJECTIVE: To test the validity of using assumed oxygen consumption for Fick cardiac output during administration of epoprostenol. METHODS: In 24 consecutive patients Fick cardiac output calculated with assumed oxygen consumption according to LaFarge and Miettinen (COLM) and according to Bergstra et

  14. 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...

  15. 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...

  16. 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

  17. 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...

  18. Improvements in determination of cardiac output with a Swan-Ganz catheter.

    Science.gov (United States)

    Sakagami, M; Kuwana, K; Nakanishi, H; Sakai, K

    1990-01-01

    The time constant for heat transfer may affect exact determination of cardiac output with Swan-Ganz catheters. Commercially available Swan-Ganz catheters are provided with thermistors with varying time constants. Current monitoring of cardiac output is not corrected for these time constants, so the conventional method of determining cardiac output using the equation of Stewart-Hamilton produces marked errors. The authors propose a new method of determining cardiac output with Swan-Ganz catheters with varying time constants from thermal dilution curve data based on Newton's cooling law. Values for blood flow rate determined by the new method using a completely stirred tank of original design, mimicking the natural heart and using bovine blood, are almost the same as values observed at varying saline infusion volumes, saline temperatures, and saline infusion times.

  19. 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

  20. 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...

  1. Volume and its relationship to cardiac output and venous return.

    Science.gov (United States)

    Magder, S

    2016-09-10

    Volume infusions are one of the commonest clinical interventions in critically ill patients yet the relationship of volume to cardiac output is not well understood. Blood volume has a stressed and unstressed component but only the stressed component determines flow. It is usually about 30 % of total volume. Stressed volume is relatively constant under steady state conditions. It creates an elastic recoil pressure that is an important factor in the generation of blood flow. The heart creates circulatory flow by lowering the right atrial pressure and allowing the recoil pressure in veins and venules to drain blood back to the heart. The heart then puts the volume back into the systemic circulation so that stroke return equals stroke volume. The heart cannot pump out more volume than comes back. Changes in cardiac output without changes in stressed volume occur because of changes in arterial and venous resistances which redistribute blood volume and change pressure gradients throughout the vasculature. Stressed volume also can be increased by decreasing vascular capacitance, which means recruiting unstressed volume into stressed volume. This is the equivalent of an auto-transfusion. It is worth noting that during exercise in normal young males, cardiac output can increase five-fold with only small changes in stressed blood volume. The mechanical characteristics of the cardiac chambers and the circulation thus ultimately determine the relationship between volume and cardiac output and are the subject of this review.

  2. 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.

  3. Peripheral vasodilatation determines cardiac output in exercising humans

    DEFF Research Database (Denmark)

    Bada, A A; Svendsen, J H; Secher, N H;

    2012-01-01

    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...

  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. 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...

  6. Evaluation of noninvasive cardiac output methods during exercise

    Science.gov (United States)

    Moore, Alan D.; Barrows, Linda H.; Rashid, Michael; Siconolfi, Steven F.

    1992-01-01

    Noninvasive techniques to estimate cardiac output (Qc) will be used during future space flight. This retrospective literature survey compared the Qc techniques of carbon dioxide rebreathing (CO2-R), CO2 single breath (CO2-S), Doppler (DOP), impedance (IM), and inert gas (IG: acetylene or nitrous oxide) to direct (DIR) assessments measured at rest and during exercise.

  7. Impedance cardiography for estimating cardiac output during submaximal and maximal work.

    Science.gov (United States)

    Kobayashi, Y; Andoh, Y; Fujinami, T; Nakayama, K; Takada, K; Takeuchi, T; Okamoto, M

    1978-09-01

    Impedance cardiography was used to estimate cardiac output in 10 men during rest and within 5 s after exercise on a bicycle ergometer, including work up to and including maximal aerobic capacity. An indwelling venous catheter permitted simultaneous sampling of venous blood for observing changes in hematocrit associated with each exercise level. Cardiac output, calculated from a standard equation which assumes a constant value of 150 omega.cm for the electrical resistivity of blood, was compared with corresponding calculations in which blood resistivity was individually determined as a function of hematocrit. It is concluded that many of the discrepancies in the literature related to values for cardiac output obtained during exercise by the impedance method may be inherent in calculations that do not consider the changing electrical resistivity of the blood with a changing hematocrit.

  8. Turbo decoding using two soft output values

    Institute of Scientific and Technical Information of China (English)

    李建平; 潘申富; 梁庆林

    2004-01-01

    It is well known that turbo decoding always begins from the first component decoder and supposes that the apriori information is "0" at the first iterative decoding. To alternatively start decoding at two component decoders, we can gain two soft output values for the received observation of an input bit. It is obvious that two soft output values comprise more sufficient extrinsic information than only one output value obtained in the conventional scheme since different start points of decoding result in different combinations of the a priori information and the input codewords with different symbol orders due to the permutation of an interleaver. Summarizing two soft output values for erery bit before making hard decisions, we can correct more errors due to their complement. Consequently, turbo codes can achieve better error correcting performance than before in this way. Simulation results show that the performance of turbo codes using the novel proposed decoding scheme can get a growing improvement with the increment of SNR in general compared to the conventional scheme. When the bit error probability is 10-5, the proposed scheme can achieve 0.5 dB asymptotic coding gain or so under the given simulation conditions.

  9. 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.

  10. 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...

  11. 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...

  12. Non-invasive measurement of cardiac output in heart failure patients using a new foreign gas rebreathing technique

    DEFF Research Database (Denmark)

    Gabrielsen, Anders; Videbaek, Regitze; Schou, Morten;

    2002-01-01

    Values of effective pulmonary blood flow (Q(EP)) and cardiac output, determined by a non-invasive foreign gas rebreathing method (CO(RB)) using a new infrared photoacoustic gas analysing system, were compared with measurements of cardiac output obtained by the direct Fick (CO(FICK)) and thermodil......Values of effective pulmonary blood flow (Q(EP)) and cardiac output, determined by a non-invasive foreign gas rebreathing method (CO(RB)) using a new infrared photoacoustic gas analysing system, were compared with measurements of cardiac output obtained by the direct Fick (CO...... with significant shunt flow. In the eight patients without significant shunt flow, the agreement between Q(EP) and CO(FICK) was 0.3 +/- 0.9 litre x min(-1). In conclusion, a foreign gas rebreathing method with a new infrared photoacoustic gas analyser provided at least as reliable a measure of cardiac output...... as did thermodilution. In the absence of significant shunt flow, measurement of Q(EP) itself provides a reliable estimate of cardiac output in heart failure patients. The infrared photoacoustic gas analyser markedly facilitates clinical use of the rebreathing method in general, which makes the method...

  13. 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.)

  14. The value of cardiac genetic testing.

    Science.gov (United States)

    Ingles, Jodie; Semsarian, Christopher

    2014-08-01

    Genetic testing is an important and necessary aspect of the management of families with cardiac genetic conditions. Commercial genetic tests are available for most cardiac genetic diseases, and increasing uptake amongst patients has contributed to a vastly improved knowledge of the genetic basis of these diseases. The incredible advances in genetic technologies have translated to faster, more comprehensive, and inexpensive commercial genetic tests and has completely changed the landscape of commercial genetic testing in recent years. While there are enormous challenges, mostly relating to interpretation of variants, the value of a genetic diagnosis should not be underestimated. In almost all cases, the single greatest utility is for the predictive genetic testing of family members. This review will describe the value of cardiac genetic testing in the current climate of rapid genetic advancements.

  15. 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

  16. 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...

  17. 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...

  18. 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....

  19. ASSUMED OXYGEN-CONSUMPTION BASED ON CALCULATION FROM DYE DILUTION CARDIAC-OUTPUT - AN IMPROVED FORMULA

    NARCIS (Netherlands)

    BERGSTRA, A; VANDIJK, RB; HILLEGE, HL; LIE, KI; MOOK, GA

    1995-01-01

    This study was performed because of observed differences between dye dilution cardiac output and the Fick cardiac output, calculated from estimated oxygen consumption according to LaFarge and Miettinen, and to find a better formula for assumed oxygen consumption. In 250 patients who underwent left a

  20. 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.

  1. 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

  2. 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

  3. Cardiac output measurement : evaluation of methods in ICU patients

    NARCIS (Netherlands)

    Wilde, Robert Bernard Pieter de

    2009-01-01

    Accurate clinical assessment of the circulatory status is particular desirable in critically ill patients in the intensive care unit (ICU) and patients undergoing cardiac, thoracic, or vascular interventions. As the patient’s haemodynamic status may change rapidly, continuous monitoring of cardiac o

  4. 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;

    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...

  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

    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 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...... 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. Validation of MRI measurement of cardiac output in the dog: the effects of dobutamine and minoxidil.

    Science.gov (United States)

    Hockings, Paul D; Busza, Albert L; Byrne, Joanne; Patel, Bela; Smart, Sean C; Reid, David G; Lloyd, Heather L; White, Alan; Pointing, Karen; Farnfield, Belinda A; Criado-Gonzalez, Ana; Whelan, Greg A; Taylor, Gemma L; Birmingham, Jeffrey M; Slaughter, Mark R; Osborne, Janette A; Krebs-Brown, Axel; Templeton, David

    2003-01-01

    The use of magnetic resonance imaging (MRI) for the measurement of cardiac output parameters in anesthetized adult male beagle dogs has been validated against a widely accepted thermodilution method. Using a multislice cine gradient echo MRI method to acquire images of the entire heart, left ventricular lumen volumes were measured at systole and diastole in seven animals. Cardiac output correlated well (R 2 = 0.88) with thermodilution measurements made in a parallel manner, both before and during acute stimulation with the inotrope dobutamine. In a chronic study of changes in cardiac morphology and function brought about by the antihypertensive minoxidil, MRI reliably detected the expected increases in stroke volume (28%) and cardiac output (58%) resulting from neural reaction to decreased blood pressure. Left ventricular lumen enlarged as well in response to fluid retention and plasma volume increase. Two in four minoxidil-treated animals also developed clear MRI-visible pericardial effusion. PMID:20021181

  7. 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

  8. 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

  9. 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 corporation (MNC) networks......Value-chain networks are of major importance to multinational subsidiaries, yet they have failed to receive significant attention in the literature. We extend the knowledge-based view of the firm by exploring whether three different types of multinational subsidiary networks have dissimilar impact...

  10. 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

    -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...... 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 exchange....... This result contrasts with the predicted effect of cardiac output on (A-a)DO(2) using the model of Piiper and Scheid, and thus indicates that an elevation of cardiac output is not necessarily accompanied by a reduction of mean transit time and (or) diffusion limitation during submaximal exercise in acute...

  11. 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......: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans....

  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. 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...

  14. 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.

  15. 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...

  16. 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)

  17. Pacing to treat low cardiac output syndrome following elective aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Muhammad Ishaq

    2012-01-01

    Full Text Available We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV outflow obstruction after aortic valve replacement (AVR. This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.

  18. Pulmonary arterial hypertension combined with a high cardiac output state: Three remarkable cases

    Science.gov (United States)

    Spruijt, Onno A.; Bogaard, Harm-Jan; Vonk-Noordegraaf, Anton

    2013-01-01

    A congenital extrahepatic portosystemic venous shunt (CEPVS), also known as an Abernethy malformation, is a rare cause of pulmonary arterial hypertension (PAH). In this case series, we describe three male patients of 30, 23, and 27 years of age with PAH due to a CEPVS. In all three patients, a right heart catheterization revealed a high cardiac output. The aim of this case series is to make pulmonary hypertension physicians aware of the possibility of a CEPVS when PAH is accompanied with a high cardiac output state. PMID:24015348

  19. 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...

  20. Comparison of an advanced minimally invasive cardiac output monitoring with a continuous invasive cardiac output monitoring during lung transplantation.

    Science.gov (United States)

    Tomasi, Roland; Prueckner, Stephan; Czerner, Stephan; Schramm, Renè; Preissler, Gerhard; Zwißler, Bernhard; von Dossow-Hanfstingl, Vera

    2016-08-01

    The aim of this study was to compare a continuous non-calibrated left heart cardiac index (CI) measurement by arterial waveform analysis (FloTrac(®)/Vigileo(®)) with a continuous calibrated right heart CI measurement by pulmonary artery thermodilution (CCOmbo-PAC(®)/Vigilance II(®)) for hemodynamic monitoring during lung transplantation. CI was measured simultaneously by both techniques in 13 consecutive lung transplants (n = 4 single-lung transplants, n = 9 sequential double-lung transplants) at distinct time points perioperatively. Linear regression analysis and Bland-Altman analysis with percentage error calculation were used for statistical comparison of CI measurements by both techniques. In this study the FloTrac(®) system underestimated the CI in comparison with the continuous pulmonary arterial thermodilution (p waveform and continuous pulmonary artery thermodilution are, therefore, not interchangeable during these complex operations.

  1. 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

  2. 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

  3. 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

  4. 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)...

  5. 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.

  6. 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...... populations was considered inappropriate. Pooled analysis of 30 trials including critically ill patients not having cardiac surgery showed an association between levosimendan and mortality (RR 0.83, TSA-adjusted 95 % CI 0.59-0.97), while trials with lower risk of bias showed no significant difference (RR 0.......83, TSA-adjusted 95 % CI 0.48-1.55). Conventional meta-analysis of all 14 trials including cardiac surgery patients showed an association, while lower risk of bias trials showed no association between levosimendan and mortality (RR 0.52, 95 % CI 0.37-0.73 versus RR 1.02, 95 % CI 0.48-2.16). CONCLUSIONS...

  7. 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...

  8. 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/...

  9. Levosimendan in a neonate with severe coarctation of aorta and low cardiac output syndrome

    Directory of Open Access Journals (Sweden)

    Yann Olivier Boegli

    2013-01-01

    Full Text Available We report successful use of levosimendan after failed balloon angioplasty in a critically ill neonate with coarctation of aorta (CoA and severe low cardiac output syndrome (LCOS. Treatment with levosimendan improved left heart function, and decreased lactate and brain natriuretic peptide levels. To our knowledge, this is the first report on the safe and successful use of levosimendan in the management of LCOS due to severe CoA in a neonate awaiting surgical repair.

  10. 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...

  11. 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.)

  12. 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 ...

  13. The effects of long-term aerobic exercise on cardiac structure, stroke volume of the left ventricle, and cardiac output.

    Science.gov (United States)

    Lee, Bo-Ae; Oh, Deuk-Ja

    2016-02-01

    The purpose of this study is to investigate the effect of the long-term aerobic exercises on cardiac structure, left ventricular stroke volume, and cardiac output. To achieve the purpose of the study, a total of 22 volunteers-including 10 people who have continued regular exercises and 12 people as the control group-were selected as subjects. With regard to data processing, the IBM SPSS Statistics ver. 21.0 was used to calculate the mean and standard deviation, and the difference of the means between the groups was verified through an independent t-test. As a result, there were significant differences between groups in the left ventricular end-diastolic internal dimension, left ventricular end-systolic internal dimension, left ventricular end-diastolic septum thickness. There were significant differences between groups in left ventricular end-diastolic volume, left ventricular mass, and left ventricular mass index per body surface area. However, in cardiac function, only left ventricular stroke volume showed a significant difference between groups.

  14. 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

  15. Can we obtain a noninvasive and continuous estimation of cardiac output? Comparison between three noninvasive methods.

    Science.gov (United States)

    Raissuni, Zainab; Zores, Florian; Henriet, Odile; Dallest, Stephanie; Roul, Gerald

    2013-01-01

    Cardiac output (CO) is often desirable for assessing the hemodynamic condition of a patient, especially in critically ill cardiac patients. Various noninvasive methods are available for this purpose. Inert gas rebreathing (IGR) and 2D-Doppler echocardiography methods have been validated. Based on the relationship between pulse wave transit time and stroke volume, the VISMO® provides an estimated continuous cardiac output (esCCO) measurement using only an electrocardiogram, pulse oximeter wave, and cuff arterial blood pressure. Doppler echocardiography is being currently used in every day practice in this setting and IGR is a validated method, thus we wanted to assess the agreement between these 3 methods for noninvasive CO calculation and reproducibility of esCCO. Patients followed in our cardiology department received on the same day a CO analysis by esCCO, Doppler echocardiography and IGR. Thirty-four patients were included (16 women, mean age 65 ± 15 years). Bland and Altman plots showed a good agreement between IGR and 2D-Doppler echocardiography (bias = 0.31 L/minute). Though there was also an agreement between esCCO and the other 2, the bias was rather large: 1.18 L/minute with IGR and 1.51 L/min with 2D-Doppler echo. The intraclass correlation coefficient was poor whatever the methods. However, esCCO had a satisfactory reproducibility and accuracy compared rather well with the other 2. This method could be suitable for patient screening and monitoring. PMID:24309450

  16. High flow variant postural orthostatic tachycardia syndrome amplifies the cardiac output response to exercise in adolescents.

    Science.gov (United States)

    Pianosi, Paolo T; Goodloe, Adele H; Soma, David; Parker, Ken O; Brands, Chad K; Fischer, Philip R

    2014-08-01

    Postural orthostatic tachycardia syndrome (POTS) is characterized by chronic fatigue and dizziness and affected individuals by definition have orthostatic intolerance and tachycardia. There is considerable overlap of symptoms in patients with POTS and chronic fatigue syndrome (CFS), prompting speculation that POTS is akin to a deconditioned state. We previously showed that adolescents with postural orthostatic tachycardia syndrome (POTS) have excessive heart rate (HR) during, and slower HR recovery after, exercise - hallmarks of deconditioning. We also noted exaggerated cardiac output during exercise which led us to hypothesize that tachycardia could be a manifestation of a high output state rather than a consequence of deconditioning. We audited records of adolescents presenting with long-standing history of any mix of fatigue, dizziness, nausea, who underwent both head-up tilt table test and maximal exercise testing with measurement of cardiac output at rest plus 2-3 levels of exercise, and determined the cardiac output () versus oxygen uptake () relationship. Subjects with chronic fatigue were diagnosed with POTS if their HR rose ≥40 beat·min(-1) with head-up tilt. Among 107 POTS patients the distribution of slopes for the , relationship was skewed toward higher slopes but showed two peaks with a split at ~7.0 L·min(-1) per L·min(-1), designated as normal (5.08 ± 1.17, N = 66) and hyperkinetic (8.99 ± 1.31, N = 41) subgroups. In contrast, cardiac output rose appropriately with in 141 patients with chronic fatigue but without POTS, exhibiting a normal distribution and an average slope of 6.10 ± 2.09 L·min(-1) per L·min(-1). Mean arterial blood pressure and pulse pressure from rest to exercise rose similarly in both groups. We conclude that 40% of POTS adolescents demonstrate a hyperkinetic circulation during exercise. We attribute this to failure of normal regional vasoconstriction during exercise, such that patients must increase flow through an

  17. 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...

  18. 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 ...

  19. 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

  20. 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.

  1. 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;

    2003-01-01

    , the mean squared difference between CO(d) and CO(I) was 2.3 (l/min)2. A Bland-Altman plot revealed no trend with the level of cardiac output. The standard deviation (0.79 vs 0.30 l/min, P coefficient of variation (10.5 vs 4.2%, P ... 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...

  2. 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.

  3. A relative value method for measuring and evaluating cardiac reserve

    Directory of Open Access Journals (Sweden)

    Sun Xiaobo

    2002-12-01

    Full Text Available Abstract Background Although a very close relationship between the amplitude of the first heart sound (S1 and the cardiac contractility have been proven by previous studies, the absolute value of S1 can not be applied for evaluating cardiac contractility. However, we were able to devise some indicators with relative values for evaluating cardiac function. Methods Tests were carried out on a varied group of volunteers. Four indicators were devised: (1 the increase of the amplitude of the first heart sound after accomplishing different exercise workloads, with respect to the amplitude of the first heart sound (S1recorded at rest was defined as cardiac contractility change trend (CCCT. When the subjects completed the entire designed exercise workload (7000 J, the resulting CCCT was defined as CCCT(1; when only 1/4 of the designed exercise workload was completed, the result was defined as CCCT(1/4. (2 The ratio of S1 amplitude to S2 amplitude (S1/S2. (3 The ratio of S1 amplitude at tricuspid valve auscultation area to that at mitral auscultation area T1/M1 (4 the ratio of diastolic to systolic duration (D/S. Data were expressed as mean ± SD. Results CCCT(1/4 was 6.36 ± 3.01 (n = 67, CCCT(1 was 10.36 ± 4.2 (n = 33, S1/S2 was1.89 ± 0.94 (n = 140, T1/M1 was 1.44 ± 0.99 (n = 144, and D/S was 1.68 ± 0.27 (n = 172. Conclusions Using indicators CCCT(1/4 and CCCT(1 may be beneficial for evaluating cardiac contractility and cardiac reserve mobilization level, S1/S2 for considering the factor for hypotension, T1/M1 for evaluating the right heart load, and D/S for evaluating diastolic cardiac blood perfusion time.

  4. 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.

  5. 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)

  6. 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

  7. 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)

  8. Noninvasive assessment of cardiac output from arterial pressure profiles during exercise.

    Science.gov (United States)

    Antonutto, G; Girardis, M; Tuniz, D; di Prampero, P E

    1995-01-01

    , MAPin, HR, PP, MAP are the above parameters at rest and during exercise, respectively. Also in this case, the coefficients f to 1 were determined by a computerized statistical method using Z* as the experimental reference. The values of Zcor so obtained allowed us to calculate SV from arterial pulse contour analysis as SVF = As.Z-1cor. The mean percentage error between the SVF obtained and the values simultaneously determined by PDE, was 10.0 (SD 8.7)%. It is concluded that the SV of the left ventricle, and hence cardiac output, can be determined during exercise from photoplethysmograph tracings with reasonable accuracy, provided that an initial estimate of SV at rest is made by means an independent high quality reference method. PMID:8789565

  9. Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults

    Science.gov (United States)

    Eikendal, Anouk L. M.; Bots, Michiel L.; Haaring, Cees; Saam, Tobias; van der Geest, Rob J.; Westenberg, Jos J. M.; den Ruijter, Hester M.; Hoefer, Imo E.; Leiner, Tim

    2016-01-01

    Background Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. Materials and Methods In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25–30 and 30–35 years) and both sexes were tested. Results Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. Conclusion This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing. PMID:27732640

  10. Left ventricular atrioventricular 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;

    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...... resting longitudinal and radial pumping in elderly athletes, sedentary elderly and young sedentary subjects. Furthermore, we aimed to investigate determinants of maximal cardiac output in elderly. METHODS: 8 elderly athletes (63 ± 4 years), 7 elderly sedentary (66 ± 4 years) and 10 young sedentary...... subjects (29 ± 4 years) underwent cardiac MR. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using dye dilution technique. RESULTS: Longitudinal and radial contribution to stroke volume did not differ between groups...

  11. Pulmonary Carbon Dioxide Elimination for Cardiac Output Monitoring in Peri-operative and Critical Care Patients: History and Current Status

    Directory of Open Access Journals (Sweden)

    Philip J. Peyton

    2013-01-01

    Full Text Available Minimally invasive measurement of cardiac output as a central component of advanced haemodynamic monitoring has been increasingly recognised as a potential means of improving perioperative outcomes in patients undergoing major surgery. Methods based upon pulmonary carbon dioxide elimination are among the oldest techniques in this field, with comparable accuracy and precision to other techniques. Modern adaptations of these techniques suitable for use in the perioperative and critical are environment are based on the differential Fick approach, and include the partial carbon dioxide rebreathing method. The accuracy and precision of this approach to cardiac output measurement has been shown to be similar to other minimally invasive techniques. This paper reviews the underlying principles and evolution of the method, and future directions including recent adaptations designed to deliver continuous breath-by-breath monitoring of cardiac output.

  12. 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...

  13. 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....... Objective. To assess the validity of these methods in AF, a new inert gas rebreathing device and impedance cardiography was tested with echocardiography as reference. Methods. Using a cross-sectional design, 127 patients with AF and 24 in SR were consecutively recruited. Resting CO was measured using inert...... gas rebreathing (n = 62) or impedance measurement of intrathoracic blood flow (n = 89) in separate studies with echocardiographic measurement as reference. Results. CO determined with impedance cardiography was mean 4.77 L/min ± 2.24(SD) compared to 4.93 L/min ± 1.17 by echocardiography (n = 89, n...

  14. 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.

  15. The relationship between cardiac output, cerebral electrical activity, cerebral fractional oxygen extraction and peripheral blood flow in premature newborn infants.

    Science.gov (United States)

    Victor, Suresh; Appleton, Richard E; Beirne, Margaret; Marson, Anthony G; Weindling, A Michael

    2006-10-01

    Cardiac output is a determinant of systemic blood flow and its measurement may therefore be a useful indicator of abnormal hemodynamics and tissue oxygen delivery. The purpose of this study was to investigate in very premature newborn infants the relationships between cardiac output (left and right ventricular outputs), systemic blood pressure, peripheral blood flow (PBF) and two indicators of cerebral oxygen delivery (cerebral electrical activity and cerebral fractional oxygen extraction (CFOE)). This was a prospective observational study performed on 40 infants of less than 30 wk gestation. Digital electroencephalograms (EEGs) were recorded for one hour every day during the first four days after birth and subjected to qualitative and quantitative analysis. Left and right ventricular outputs, mean blood pressure (MBP), CFOE, PBF and arterial blood gases were measured at the same time. Within the ranges studied, there was no apparent relationship between left or right ventricular output (RVO), PBF and indicators of cerebral perfusion (cerebral electrical activity and CFOE). The EEG was normal in infants with low left and right ventricular outputs ( 30 mm Hg. Infants with low cardiac output and normal MBP seem able to maintain cerebral perfusion, possibly through vasodilatation of the cerebral microvasculature. PMID:16940235

  16. 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

  17. 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.

  18. Correlation between radius and respiration variation of inferior vena cava and hemodynamicmonitoring values of pulse-indicated continuous cardiac output(PiCCO)in septic shock pigs%脓毒症休克猪下腔静脉管径及呼吸变异指数与血流动力学的关系

    Institute of Scientific and Technical Information of China (English)

    王海峰; 刘笑雷; 陆海涛; 齐志伟; 闫圣涛; 顾承东; 张国强

    2012-01-01

    目的 探讨脓毒症休克时下腔静脉管径及呼吸变异指数与脉搏指示连续心排出量(PiCCO)血流动力学指标的关系.方法 取8只幼年猪,颈内静脉推注大肠杆菌内毒素(LPS,100tμg/kg)制作脓毒症休克模型,出模后予生理盐水进行液体复苏.分别在动物模型制作前、休克时、液体复苏1h及6h时点超声探测下腔静脉最大径(IVCmax)、最小径(IVCmin)并计算呼吸变异指数(IVCrvi),同时记录PiCCO血流动力学指标,包括:胸廓内血容量(ITBV)、全心舒张末容积(GEDV)、每搏输出量变异指数(SVV)和心脏指数(CI).采LSD-t检验比较液体复苏前后IVCmax、IVCmin、IVCrvi及PiCCO血流动力学指标的变化;采用Pearson相关性分析了解IVCmax、IVCmin及IVCrvi与PiCCO血流动力学指标的相关性.结果 液体复苏1 h IVCmax、IVC min、GEDV、ITBV及CI均显著大于休克时(P<0.01),SVV及IVCrvi均显著小于休克时(P<0.01);液体复苏6 h IVCmax、IWCmin、GEDV、ITBV及CI均显著大于休克时(P<0.01)及液体复苏1h(P<0.01),SVV及IVCrvi均显著小于休克时(P<0.01)及液体复苏1 h(P<0.01).IVCmax与SVV有相关性(P =0.024),与GEDV、ITBV及CI无相关性;IVCmin与SVV、GEDV、ITBV及CI均有相关性(分别P=0.009、P=0.003、P=0.001和P=0.015);IVCrvi与SVV、GEDV、ITBV及CI均有相关性(分别P=0.007、P<0.01、P<0.01和P<0.01).结论 下腔静脉管径及呼吸变异指数与PiCC0血流动力学指标具有相关性,可以为临床医师快速评估血容量提供依据.%Objective To explore the correlation between radius and respiratory variation of inferior vena cava(IVC)and hemodynamic monitoring values of pulse-indicated continuous cardiac output(PiCCO)in septic shock pigs.Methods A total of 8 pigs were used to establish animal model of septic shock by intravenous infusing LPS(100 μg/kg),and fluid resuscitation was followed with normal saline.Ultrasound was used to measure the maximum radius

  19. Influence of lung injury on cardiac output measurement using transpulmonary ultrasound dilution: a validation study in neonatal lambs

    NARCIS (Netherlands)

    Vrancken, S.L.A.G.; Boode, W.P. de; Hopman, J.C.W.; Looijen-Salamon, M.G.; Liem, K.D.; Heijst, A.F. van

    2012-01-01

    BACKGROUND: /st> Transpulmonary ultrasound dilution (TPUD) is a promising method for cardiac output (CO) measurement in severely ill neonates. The incidence of lung injury in this population is high, which might influence CO measurement using TPUD because of altered lung perfusion. We evaluated t

  20. 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;

    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 d...

  1. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  2. Early predictors of acute kidney injury in patients with cirrhosis and bacterial infection: urinary neutrophil gelatinase-associated lipocalin and cardiac output as reliable tools

    Science.gov (United States)

    Ximenes, Rafael O.; Farias, Alberto Q.; Helou, Claudia M.B.

    2015-01-01

    Background Hemodynamic abnormalities and acute kidney injury (AKI) are often present in infected cirrhotic patients. Hence, an early diagnosis of AKI is necessary, which might require the validation of new predictors as the determinations of urinary neutrophil gelatinase-associated lipocalin (uNGAL) and cardiac output. Methods We evaluated 18 infected cirrhotic patients subdivided into two groups at admission (0 hours). In Group I, we collected urine samples at 0 hours, 6 hours, 24 hours, and 48 hours for uNGAL and fractional excretion of sodium determinations. In Group II, we measured cardiac output using echocardiography. Results The age of patients was 55.0±1.9 years, and 11 patients were males. The Model for End-Stage Liver Disease score was 21±1, whereas the Child–Pugh score was C in 11 patients and B in 7 patients. Both patients in Group I and Group II showed similar baseline characteristics. In Group I, we diagnosed AKI in 5 of 9 patients, and the mean time to this diagnosis by measuring serum creatinine was 5.4 days. Patients with AKI showed higher uNGAL levels than those without AKI from 6 hours to 48 hours. The best accuracy using the cutoff values of 68 ng uNGAL/mg creatinine was achieved at 48 hours when we distinguished patients with and without AKI in all cases. In Group II, we diagnosed AKI in 4 of 9 patients, and cardiac output was significantly higher in patients who developed AKI at 0 hours. Conclusion Both uNGAL and cardiac output determinations allow the prediction of AKI in infected cirrhotic patients earlier than increments in serum creatinine. PMID:26484038

  3. Left ventricular atrioventricular plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output.

    Science.gov (United States)

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

    2015-12-01

    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 resting longitudinal and radial pumping in elderly athletes, sedentary elderly and young sedentary subjects. Furthermore, we aimed to investigate determinants of maximal cardiac output in elderly. Eight elderly athletes (63 ± 4 years), seven elderly sedentary (66 ± 4 years) and ten young sedentary subjects (29 ± 4 years) underwent cardiac magnetic resonance imaging. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using a dye dilution technique. Longitudinal and radial contribution to stroke volume did not differ between groups (longitudinal left ventricle (LV) 52-65%, P = 0.12, right ventricle (RV) 77-87%, P = 0.16, radial 7.9-8.6%, P = 1.0). Left ventricular atrioventricular plane displacement (LVAVPD) was higher in elderly athletes and young sedentary compared with elderly sedentary subjects (14 ± 3, 15 ± 2 and 11 ± 1 mm, respectively, P cardiac output (R(2) = 0.61, P Longitudinal and radial contributions to stroke volume did not differ between groups. However, how longitudinal pumping was achieved differed; elderly athletes and young sedentary subjects showed similar AVPD whereas this was significantly lower in elderly sedentary subjects. Elderly sedentary subjects achieved longitudinal pumping through increased short-axis area of the ventricle. Large AVPD was a determinant of maximal cardiac output and exercise capacity.

  4. Effects of water immersion on cardiac output of lean and fat male subjects at rest and during exercise.

    Science.gov (United States)

    Haffor, A S; Mohler, J G; Harrison, A C

    1991-02-01

    To investigate the combined effect of water immersion (WI) and lean body mass on cardiac output (Q), 12 healthy young men, 6 lean (fat less than 9%) and 6 fat (fat greater than 18%), were studied at rest and during steady state exercise approximating 30-40% Vo2 max under three experimental conditions. There were on land at 24 degrees C (LND), and immersed in water at 33-34 degrees C to hip level (HIP), and to the xiphoid (XIP). Metabolic measures were determined during 30-s periods from the average breath measurements. Mixed venous PCO2 (PVCO2) was estimated using rebreathing equilibration technique. Cardiac output was calculated by the indirect Fick's principle. In the lean individuals the average Q rose from a resting value of 5.43 +/- 0.43 (LND) to an exercise value of 7.25 +/- 0.40 L/min (XIP), and from resting value of 5.62 +/- 0.40 to an exercise 6.47 +/- 0.5 L/min in the fat individuals. During exercise, the associated increase in Q with increasing WI was significantly (p less than 0.05) higher compared with the land experiments. Inspection of the mean profile corresponding to this increase indicated that an increase in the level of immersion results in a significant (p less than 0.05) increase in the average Q for the lean group. For the fat group, the average Q was significantly (p less than 0.05) larger only at XIP level. At rest, heart rate dropped from 67 +/- 3.36 (LND) to 60 +/- 4.13 (XIP), and from 79 +/- 3.73 to 73 +/- 4.10 BPM for the lean and fat group, respectively. MANOVA analysis showed a significant (p less than 0.05) interaction between WI and group membership, indicating that the effect of WI is significantly different between the two groups. These data indicate that the change in central blood volume with WI depends, in part, on the lean mass of the body.

  5. Estimation of cardiac output and peripheral resistance using square-wave-approximated aortic flow signal

    Directory of Open Access Journals (Sweden)

    Nima eFazeli

    2012-07-01

    Full Text Available This paper presents a model-based approach to estimation of cardiac output (CO and total peripheral resistance (TPR. In the proposed approach, the response of cardiovascular system (CVS, described by the windkessel model, is tuned to the measurements of systolic, diastolic and mean arterial blood pressures (BP so as to yield optimal individual- and time-specific system time constant that is used to estimate CO and TPR. Unique aspects of the proposed approach are that it approximates the aortic flow as a train of square waves, and that it also assumes pressure-dependent arterial compliance, as opposed to the traditional windkessel model in which aortic flow is approximated as a train of impulses and constant arterial compliance is assumed. It was shown that the proposed model encompasses the standard windkessel model as a limiting case, and that it also yields more realistic BP waveform response than the standard windkessel model. The proposed approach has potential to outperform its standard counterpart by treating systolic, diastolic and mean BP as independent features in estimating CO and TPR, rather than solely resorting to pulse pressure as in the case of the standard windkessel model. Experimental results from in-vivo data collected from a number of animal subjects supports the viability of the proposed approach in that it could achieve approximately 29% and 24% reduction in CO and TPR errors when compared with its standard counterpart.

  6. Resistance reconstructed estimation of total peripheral resistance from computationally derived cardiac output - biomed 2013.

    Science.gov (United States)

    Hill, Labarron K; Sollers Iii, John J; Thayer, Julian F

    2013-01-01

    Efficient functioning of the peripheral vasculature is an essential component in healthy cardiovascular regulation. Alterations in this functioning have been linked to the etiology and pathophysiological course of cardiovascular disease (CVD), especially hypertension. Given its significant role in the maintenance of both healthy and pathological blood pressure, total peripheral resistance (TPR), an index of the vasoconstrictive and elastic properties of the peripheral vasculature, has received much attention in this regard. However, obtaining a reliable estimate of TPR remains a complex and costly endeavor, primarily due to the necessity for sophisticated instrumentation as well as associated limitations in deriving cardiac output (CO). We have previously described a simple estimation method for CO using only arterial blood pressure and heart rate (Hill et al, 2012). In the present study we extend this technique to the estimation of TPR using beat-to-beat blood pressure data from the same sample of 67 young (mean age = 20.04± 2.8), healthy men (n = 30) and women (n = 37). Estimated TPR (TPRest) was calculated from the computationally-derived estimate of CO and mean arterial pressure (MAP). Correlation between TPR obtained via the validated Model-Flow technique and TPRest was moderate (r =.73, p <. 000) and stronger in men (r =.78, p <. 000) compared to women (r =.66, p <. 001). These data further suggest that reconstructed measures of hemodynamic functioning may be validly and adequately estimated from limited data sources.

  7. Mechanisms of increase in cardiac output during acute weightlessness in humans

    DEFF Research Database (Denmark)

    Petersen, Lonnie G; Damgaard, Morten; Petersen, Johan Casper Grove;

    2011-01-01

    Based on previous water immersion results, we tested the hypothesis that the acute 0-G-induced increase in cardiac output (CO) is primarily caused by redistribution of blood from the vasculature above the legs to the cardiopulmonary circulation. In seated subjects (n = 8), 20 s of 0 G induced...... increase in CO during 0 G + CI was entirely caused by a lower heart rate (HR). Thus blood from vascular beds above the legs in seated subjects can alone account for some 50% of the increase in CO during acute 0 G. The remaining increase in CO is caused by a higher HR, of which the origin of blood...... is unresolved. In supine subjects, CO increased from 7.1 ± 0.7 to 7.9 ± 0.8 l/min (P = 0.037) when entering 0 G, which was solely caused by an increase in HR, because stroke volume was unaffected. In conclusion, blood originating from vascular beds above the legs can alone account for one-half of the increase...

  8. 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;

    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...... albumin and 99mTc albumin into the right atrium and subsequent sampling from the femoral artery. RESULTS: The mean CO(d) and CO(I) were similar (7.20 vs 7.15 l/min, NS). A highly significant correlation was present between CO(d) and CO(I) (r = 0.86, P ..., the mean squared difference between CO(d) and CO(I) was 2.3 (l/min)2. A Bland-Altman plot revealed no trend with the level of cardiac output. The standard deviation (0.79 vs 0.30 l/min, P coefficient of variation (10.5 vs 4.2%, P

  9. 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

  10. 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

  11. Dynamic vs. fixed bag filling: impact on cardiac output rebreathing protocol.

    Science.gov (United States)

    Zavorsky, Gerald S; Beck, Kenneth C; Cass, Lauren M; Artal, Raul; Wagner, Peter D

    2010-04-15

    The purpose of this study was to compare the repeatability (2.77 multiplied by the within-subject SD)between two different rebreathing protocols on cardiac output ( ˙Q ), pulmonary diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO), and pulmonary capillary blood volume (Vc). This study compared two bag volume protocols [Fixed Bag Volume (FBV) = bag volume fixed at 60% of forced vital capacity; Dynamic Bag Volume (DBV) = bag volume matched to tidal volume at each stage of exercise].Ten females (age = 27±8 yrs; ˙VO2, (peak)=2.5±0.6 L/min had measurements at rest (12%), 52%, 88%, and 100% of ˙VO2, (peak) on two study days. Neither the slope nor intercept of ˙Q vs. ˙VO2 were different between either bag volume protocols. The slope of DLCO vs. ˙Q was the same but the intercept was higher for the FBV protocol. The bag volume affected the slope and the intercept between DLNO vs. ˙Q (p DLNO (p ≤ 0.06). Measurement error was lower for Vc when using the FBV protocol (p = 0.02). Also, the pattern of bag volume used during rebreathing maneuvers affected the relation between DLNO vs. ˙Q more than it affected DLCO vs. ˙Q , or Vc vs. ˙Q. Additionally, the FBV protocol provided less measurement error for Vc compared to the DBV protocol [corrected].

  12. 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.

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

    International Nuclear Information System (INIS)

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

  14. 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

  15. 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...

  16. 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...

  17. Signal processing technique for non-invasive real-time estimation of cardiac output by inductance cardiography (thoracocardiography).

    Science.gov (United States)

    Bucklar, G B; Kaplan, V; Bloch, K E

    2003-05-01

    Inductance cardiography (thoracocardiography) non-invasively monitors changes in stroke volume by recording ventricular volume curves with an inductive plethysmographic transducer encircling the chest at the level of the heart. Clinical application of this method has been hampered, as data analysis has not been feasible in real time. Therefore a novel, real-time signal processing technique for inductance cardiography has been developed. Its essential concept consists in performance of multiple tasks by several, logically linked signal processing modules that have access to common databases. Based on these principles, a software application was designed that performs acquisition, display, filtering and ECG-triggered ensemble averaging of inductance signals and separates cardiogenic waveforms from noise related to respiration and other sources. The resulting ventricular volume curves are automatically analysed. Performance of the technique for monitoring cardiac output in real time was compared with thermodilution in four patients in an intensive care unit. The bias (mean difference) among 76 paired thoracocardiographic and thermodilution derived changes in cardiac output was 0%; limits of agreement (+/- 2 SD of the bias) were +/- 25%. It is concluded that the proposed signal processing technique for inductance cardiography holds promise for non-invasive, real-time estimation of changes in cardiac output.

  18. 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.

  19. 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

  20. Cardiac Output Monitoring Managing Intravenous Therapy (COMMIT) to Treat Emergency Department Patients with Sepsis

    Science.gov (United States)

    Hou, Peter C.; Filbin, Michael R.; Napoli, Anthony; Feldman, Joseph; Pang, Peter S.; Sankoff, Jeffrey; Lo, Bruce M.; Dickey-White, Howard; Birkhahn, Robert H.; Shapiro, Nathan I.

    2016-01-01

    ABSTRACT Objective: Fluid responsiveness is proposed as a physiology-based method to titrate fluid therapy based on preload dependence. The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. Methods: Prospective, 10-center, randomized interventional trial. Inclusion criteria: suspected sepsis and lactate 2.0 to 4.0 mmol/L. Exclusion criteria (abbreviated): systolic blood pressure more than 90 mmHg, and contraindication to aggressive fluid resuscitation. Intervention: fluid responsiveness protocol using Non-Invasive Cardiac Output Monitor (NICOM) to assess for fluid responsiveness (>10% increase in stroke volume in response to 5 mL/kg fluid bolus) with balance of a liter given in responsive patients. Control: standard clinical care. Outcomes: primary—change in Sepsis-related Organ Failure Assessment (SOFA) score at least 1 over 72 h; secondary—fluids administered. Trial was initially powered at 600 patients, but stopped early due to a change in sponsor's funding priorities. Results: Sixty-four patients were enrolled with 32 in the treatment arm. There were no significant differences between arms in age, comorbidities, baseline vital signs, or SOFA scores (P > 0.05 for all). Comparing treatment versus Standard of Care—there was no difference in proportion of increase in SOFA score of at least 1 point (30% vs. 33%) (note bene underpowered, P = 1.0) or mean preprotocol fluids 1,050 mL (95% confidence interval [CI]: 786–1,314) vs. 1,031 mL (95% CI: 741–1,325) (P = 0.93); however, treatment patients received more fluids during the protocol (2,633 mL [95% CI: 2,264–3,001] vs. 1,002 mL [95% CI: 707–1,298]) (P < 0.001). Conclusions: In this study of a “preshock” population, there was no change in progression of organ dysfunction with a fluid responsiveness protocol

  1. The decreased oxygen uptake during progressive exercise in ischemia-induced heart failure is due to reduced cardiac output rate

    Directory of Open Access Journals (Sweden)

    N.P.L. Rolim

    2006-02-01

    Full Text Available We tested the hypothesis that the inability to increase cardiac output during exercise would explain the decreased rate of oxygen uptake (VO2 in recent onset, ischemia-induced heart failure rats. Nine normal control rats and 6 rats with ischemic heart failure were studied. Myocardial infarction was induced by coronary ligation. VO2 was measured during a ramp protocol test on a treadmill using a metabolic mask. Cardiac output was measured with a flow probe placed around the ascending aorta. Left ventricular end-diastolic pressure was higher in ischemic heart failure rats compared with normal control rats (17 ± 0.4 vs 8 ± 0.8 mmHg, P = 0.0001. Resting cardiac index (CI tended to be lower in ischemic heart failure rats (P = 0.07. Resting heart rate (HR and stroke volume index (SVI did not differ significantly between ischemic heart failure rats and normal control rats. Peak VO2 was lower in ischemic heart failure rats (73.72 ± 7.37 vs 109.02 ± 27.87 mL min-1 kg-1, P = 0.005. The VO2 and CI responses during exercise were significantly lower in ischemic heart failure rats than in normal control rats. The temporal response of SVI, but not of HR, was significantly lower in ischemic heart failure rats than in normal control rats. Peak CI, HR, and SVI were lower in ischemic heart failure rats. The reduction in VO2 response during incremental exercise in an ischemic model of heart failure is due to the decreased cardiac output response, largely caused by depressed stroke volume kinetics.

  2. 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

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

    Science.gov (United States)

    Soukup, Ladislav; Vondra, Vlastimil; Viščor, Ivo; Jurák, Pavel; Halámek, Josef

    2013-04-01

    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.

  4. 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.

  5. 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;

    2009-01-01

    and 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......, the estimated pulmonary artery diastolic pressure (ePAD) was analysed. RESULTS: The magnitude of CO response to AVD changes was greater in CRT patients than in controls (0.25 vs. 0.20 L/min, P

  6. 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.)

  7. 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.

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

    Science.gov (United States)

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

    2016-02-01

    Giraffes--the tallest extant animals on Earth--are renowned for their high central arterial blood pressure, which is necessary to secure brain perfusion. Arterial pressure may exceed 300 mmHg and has historically been attributed to an exceptionally large heart. Recently, this has been refuted by several studies demonstrating that the mass of giraffe heart is similar to that of other mammals when expressed relative to body mass. It thus remains unexplained how the normal-sized giraffe heart generates such massive arterial pressures. We hypothesized that giraffe hearts have a small intraventricular cavity and a relatively thick ventricular wall, allowing for generation of high arterial pressures at normal left ventricular wall tension. In nine anaesthetized giraffes (495±38 kg), we determined in vivo ventricular dimensions using echocardiography along with intraventricular and aortic 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. End-diastolic and end-systolic volumes were 521±61 ml and 228±42 ml, respectively, yielding an ejection fraction of 56±4% and a stroke volume of 0.59 ml kg(-1). Left ventricular circumferential wall stress was 7.83±1.76 kPa. We conclude that, relative to body mass, a small left ventricular cavity and a low stroke volume characterizes the giraffe heart. The adaptations result in typical mammalian left ventricular wall tensions, but produce a lowered cardiac output. PMID:26643090

  9. 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

  10. GASTO CARDÍACO MATERNO COMO PREDICTOR DEL SÍNDROME DE PREECLAMPSIA-ECLAMPSIA / Maternal cardiac output as a predictor of preeclampsia-eclampsia syndrome

    Directory of Open Access Journals (Sweden)

    Luis A. Díaz Moreno

    2012-03-01

    approximately 30% of systolic volume. The research objective was to predict the onset of preeclampsia-eclampsia syndrome by identifying alterations in cardiac output. Methods: An observational, descriptive, longitudinal, analytical study of prospective cohort was performed, in which by echocardiography, the cardiac output in 31 pregnant women between weeks 11 and 13.6 of gestation was determined as the only value, and through prenatal monitoring, the presence or absence of preeclampsia-eclampsia syndrome was observed. Results: The follow-up of 31 pregnant women was achieved, to whom cardiac output was measured, with the following findings: a prevalence of disease of 12.9% with 64.5% of patients correctly diagnosed, with a sensitivity of 75%, positive predictive value of 23%, specificity of 62% and negative predictive value of 94% with a relative risk of 4.1 (95% confidence interval, 0.48 to 35.6. Conclusions: It is possible to establish cardiac output measurement as screening study to predict the onset of preeclampsia syndrome from prenatal care, thus contributing to the decline in maternal death.

  11. 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...

  12. 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...

  13. [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

  14. Pulmonary Artery Catheter (PAC Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM: An Ovine Cardiac Output Validation

    Directory of Open Access Journals (Sweden)

    Robert A. Phillips

    2012-01-01

    Full Text Available Background. The pulmonary artery catheter (PAC is an accepted clinical method of measuring cardiac output (CO despite no prior validation. The ultrasonic cardiac output monitor (USCOM is a noninvasive alternative to PAC using Doppler ultrasound (CW. We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP, in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (=280, range 1.9 L/min to 11.7 L/min. Percentage bias and precision between FP and PAC, and FP and USCOM was −17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66% compared with FP, while USCOM measures varied from FP by 3% (relative 10%. PAC reliably detected −30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC, while USCOM reliably detected ±5% changes in CO (AUC>0.70. Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.

  15. Derivation of cardiac output and alveolar ventilation rate based on energy expenditure measurements in healthy males and females.

    Science.gov (United States)

    Brochu, Pierre; Brodeur, Jules; Krishnan, Kannan

    2012-08-01

    Physiologically based pharmacokinetic modeling and occupational exposure assessment studies often use minute ventilation rates (VE), alveolar ventilation rates (VA) and cardiac outputs (Q) that are not reflective of the physiological variations encountered during the aggregate daytime activities of individuals from childhood to adulthood. These variations of VE, VA and Q values were determined for healthy normal-weight individuals aged 5-96 years by using two types of published individual data that were measured in the same subjects (n = 902), namely indirect calorimetry measurements and the disappearance rates of oral doses of deuterium (²H) and heavy-oxygen (¹⁸O) in urine monitored by gas-isotope-ratio mass spectrometry. Arteriovenous oxygen content differences (0.051-0.082 ml of O₂ consumed ml⁻¹ of blood) and ratios of the physiological dead space to the tidal volume (0.232-0.419) were determined for oxygen consumption rates (0.157-0.806 l min⁻¹) required by minute energy expenditures ranging from 0.76 to 3.91 kcal min⁻¹. Generally higher values for the 2.5th up to the 99th percentile for VE (0.132-0.774 l kg⁻¹ min⁻¹, 4.42-21.69 l m⁻² min⁻¹), VA (0.093-0.553 l kg⁻¹ min⁻¹, 3.09-15.53 l m⁻² min⁻¹), Q (0.065-0.330 l kg⁻¹ min⁻¹, 2.17 to 9.46 l m⁻² min⁻¹) and ventilation-perfusion ratios (1.12-2.16) were found in children and teenagers aged 5-<16.5 years compared with older individuals. The distributions of cardiopulmonary parameters developed in this study should be useful in facilitating a scientifically sound characterization of the inter-individual differences in the uptake and health risks of lipophilic air pollutants, particularly as they relate to younger children.

  16. 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.

  17. 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

  18. Assessment of Stroke Volume Variation Perioperatively by Using Arterial Pressure with Cardiac Output

    Institute of Scientific and Technical Information of China (English)

    Wen-jing Li; Yi-ping Hu; Min-min Zhu

    2015-01-01

    Objective To observe the sensitivity of stroke volume variation (SVV) for assessing volume change during induction period of general anesthesia. Methods Patients who underwent orthopaedic surgery under general anesthesia and mechanical ventilation were divided into two groups randomly. Patients in the groupⅠwere subjected to progressive central hypovolemia and correction of hypovolemia sequentially;patients in the Group Ⅱ were exposed to hypervolemia alone. Each step was implemented after 5 minutes when the hemodynamics was stable. SVV and cardiac index (CI) were recorded, and Pearson’s product-moment correlation was used to analyze correlation between SVV and CI. Results Forty patients were included in this study, 20 cases in each group. For group Ⅰpatients, SVV was increased significantly along with blood volume reduction, and changes in CI were negatively correlated with changes in SVV (r=-0.605, P0.05). Conclusion SVV is a useful indicator for hypovolemia, but not for hypervolemia.

  19. 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...

  20. 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

  1. 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 ...

  2. 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...

  3. 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.

  4. 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

  5. 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.)

  6. 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

  7. Cardiac output monitoring

    NARCIS (Netherlands)

    de Waal, Eric. E. C.; Wappler, Frank; Buhre, Wolfgang F.

    2009-01-01

    Purpose of review The primary goal of hemodynamic therapy is the prevention of inadequate tissue perfusion and inadequate oxygenation. Advanced cardiovascular monitoring is a prerequisite to optimize hemodynamic treatment in critically ill patients prone to cardiocirculatory failure. The most ideal

  8. Accuracy and precision of minimally-invasive cardiac output monitoring in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Suehiro, Koichi; Joosten, Alexandre; Murphy, Linda Suk-Ling; Desebbe, Olivier; Alexander, Brenton; Kim, Sang-Hyun; Cannesson, Maxime

    2016-10-01

    Several minimally-invasive technologies are available for cardiac output (CO) measurement in children, but the accuracy and precision of these devices have not yet been evaluated in a systematic review and meta-analysis. We conducted a comprehensive search of the medical literature in PubMed, Cochrane Library of Clinical Trials, Scopus, and Web of Science from its inception to June 2014 assessing the accuracy and precision of all minimally-invasive CO monitoring systems used in children when compared with CO monitoring reference methods. Pooled mean bias, standard deviation, and mean percentage error of included studies were calculated using a random-effects model. The inter-study heterogeneity was also assessed using an I(2) statistic. A total of 20 studies (624 patients) were included. The overall random-effects pooled bias, and mean percentage error were 0.13 ± 0.44 l min(-1) and 29.1 %, respectively. Significant inter-study heterogeneity was detected (P residual heterogeneity remained after conducting sensitivity and subgroup analyses based on the various study characteristics. By meta-regression analysis, we found no independent effects of study characteristics on weighted mean difference between reference and tested methods. Although the pooled bias was small, the mean pooled percentage error was in the gray zone of clinical applicability. In the sub-group analysis, electrical cardiometry was the device that provided the most accurate measurement. However, a high heterogeneity between studies was found, likely due to a wide range of study characteristics. PMID:26315477

  9. 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

  10. 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...

  11. 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...

  12. 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.

  13. Importance of re-calibration time on pulse contour analysis agreement with thermodilution measurements of cardiac output: a retrospective analysis of intensive care unit patients.

    Science.gov (United States)

    Scully, Christopher G; Gomatam, Shanti; Forrest, Shawn; Strauss, David G

    2016-10-01

    We assessed the effect of re-calibration time on cardiac output estimation and trending performance in a retrospective analysis of an intensive care unit patient population using error grid analyses. Paired thermodilution and arterial blood pressure waveform measurements (N = 2141) from 222 patient records were extracted from the Multiparameter Intelligent Monitoring in Intensive Care II database. Pulse contour analysis was performed by implementing a previously reported algorithm at calibration times of 1, 2, 8 and 24 h. Cardiac output estimation agreement was assessed using Bland-Altman and error grid analyses. Trending was assessed by concordance and a 4-Quadrant error grid analysis. Error between pulse contour and thermodilution increased with longer calibration times. Limits of agreement were -1.85 to 1.66 L/min for 1 h maximum calibration time compared to -2.70 to 2.41 L/min for 24 h. Error grid analysis resulted in 74.2 % of points bounded by 20 % error limits of thermodilution measurements for 1 h calibration time compared to 65 % for 24 h. 4-Quadrant error grid analysis showed analysis method and thermodilution showed poor agreement to monitor changes in cardiac output.

  14. 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.

  15. Substrate stiffness-regulated matrix metalloproteinase output in myocardial cells and cardiac fibroblasts: implications for myocardial fibrosis.

    Science.gov (United States)

    Xie, Jing; Zhang, Quanyou; Zhu, Ting; Zhang, Yanyan; Liu, Bailin; Xu, Jianwen; Zhao, Hucheng

    2014-06-01

    Cardiac fibrosis, an important pathological feature of structural remodeling, contributes to ventricular stiffness, diastolic dysfunction, arrhythmia and may even lead to sudden death. Matrix stiffness, one of the many mechanical factors acting on cells, is increasingly appreciated as an important mediator of myocardial cell behavior. Polydimethylsiloxane (PDMS) substrates were fabricated with different stiffnesses to mimic physiological and pathological heart tissues, and the way in which the elastic modulus of the substrate regulated matrix-degrading gelatinases in myocardial cells and cardiac fibroblasts was explored. Initially, an increase in cell spreading area was observed, concomitant with the increase in PDMS stiffness in both cells. Later, it was demonstrated that the MMP-2 gene expression and protein activity in myocardial cells and cardiac fibroblasts can be enhanced with an increase in PDMS substrate stiffness and, moreover, such gene- and protein-related increases had a significant linear correlation with the elastic modulus. In comparison, the MMP-9 gene and protein expressions were up-regulated in cardiac fibroblasts only, not in myocardial cells. These results implied that myocardial cells and cardiac fibroblasts in the myocardium could sense the stiffness in pathological fibrosis and showed a differential but positive response in the expression of matrix-degrading gelatinases when exposed to an increased stiffening of the matrix in the microenvironment. The phenomenon of cells sensing pathological matrix stiffness can help to increase understanding of the mechanism underlying myocardial fibrosis and may ultimately lead to planning cure strategies.

  16. 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.)

  17. 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

  18. Prognostic value of high-sensitivity cardiac troponin T in patients with en-domyocardial-biopsy proven cardiac amyloidosis

    Institute of Scientific and Technical Information of China (English)

    Geng QIAN; Chen WU; Yang ZHANG; Yun-Dai CHEN; Wei DONG; Yi-Hong REN

    2014-01-01

    Objective To investigate prognostic predictors of long-term survival of patients with cardiac amyloidosis (CA), and to determine predictive value of high-sensitivity cardiac troponin T (hs-cTnT) in CA patients. Methods We recruited 102 consecutive CA cases and followed these patients for 5 years. We described their clinical characteristics at presentation and used a new, high-sensitivity assay to determine the concentration of cTnT in plasma samples from these patients. Results The patients with poor prognosis showed older age (56 ±12 years vs. 50 ±15 years, P=0.022), higher incidences of heart failure (36.92%vs. 16.22%, P=0.041), pericardial effusion (60.00%vs. 35.14%, P=0.023), greater thickness of interventricular septum (IVS) (15 ±4 mm vs. 13 ±4 mm, P=0.034), higher level of hs-cTnT (0.186 ±0.249 ng/mL vs. 0.044 ±0.055 ng/mL, P=0.001) and higher NT-proBNP (N-terminal pro-B-type natriuretic pep-tide) levels (11,742 ± 10,464 pg/mL vs. 6,031 ± 7,458 pg/mL, P=0.006). At multivariate Cox regression analysis, heart failure (HR:1.78, 95%CI:1.09-2.92, P=0.021), greater wall thickness of IVS (HR:1.44, 95%CI:1.04-3.01, P=0.0375) and higher hs-cTnT level (HR:6.16, 95%CI:2.20-17.24, P=0.001) at enrollment emerged as independent predictors of all-cause mortality. Conclusions We showed that hs-cTnT is associated with a very ominous prognosis, and it is also the strongest predictor of all-cause mortality in multivariate analysis. Examination of hs-cTnT concentrations provides valuable prognostic information concerning long-term outcomes.

  19. 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

  20. 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

  1. Prognostic value of cardiac biomarkers in the risk stratification of syncope: a systematic review.

    Science.gov (United States)

    Thiruganasambandamoorthy, Venkatesh; Ramaekers, Rosa; Rahman, Mohammed Omair; Stiell, Ian Gilmour; Sikora, Lindsey; Kelly, Sarah-Louise; Christ, Michael; Claret, Pierre-Geraud; Reed, Matthew James

    2015-12-01

    The role of cardiac biomarkers in risk stratification of syncope is unclear. We undertook a systematic review to assess their predictive value for short-term major adverse cardiovascular events (MACE). We conducted a systematic review using MEDLINE, EMBASE, DARE and Cochrane databases from inception to July 2014. We included studies involving adult syncope patients that evaluated cardiac biomarker levels for risk stratification during acute management and excluded case reports, reviews and studies involving children. Primary outcome (MACE) included death, cardiopulmonary resuscitation, myocardial infarction (MI), structural heart disease, pulmonary embolism, significant hemorrhage or cardiac procedural interventions. Secondary outcome analysis assessed for prediction of MI, cardiac syncope and death. Two reviewers extracted patient-level data based on the cut-off reported. Pooled sensitivities and specificities were calculated using patient-level data. A total of 1862 articles were identified, and 11 studies with 4246 patients were included. Studies evaluated 3 biomarkers: contemporary troponin (2693 patients), natriuretic peptides (1353 patients) and high-sensitive troponin (819 patients). The pooled sensitivities and specificities for MACE were: contemporary troponin 0.29 (95 % CI 0.24, 0.34) and 0.88 (95 % CI 0.86, 0.89); natriuretic peptides 0.77 (95 % CI 0.69, 0.85) and 0.73 (95 % CI 0.70, 0.76); high-sensitive troponin 0.74 (95 % CI 0.65, 0.83) and 0.65 (95 % CI 0.62, 0.69), respectively. Natriuretic peptides and high-sensitive troponin showed good diagnostic characteristics for both primary and secondary outcomes. Natriuretic peptides and high-sensitive troponin might be useful in risk stratification.

  2. 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...

  3. 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

  4. 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...

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. Using a sensitivity study to facilitate the design of a multi-electrode array to measure six cardiac conductivity values.

    Science.gov (United States)

    Johnston, Barbara M

    2013-07-01

    When using the bidomain model to model the electrical activity of the heart, there are potentially six cardiac conductivity values involved: conductivity values in directions along and normal to the cardiac fibres with a sheet, as well as a conductivity value in the normal direction between the sheets, and these occur for both the extracellular and intracellular domains in the model. To date it has been common to assume that the two normal direction conductivity values are the same. However, recent work has demonstrated that six cardiac conductivity values, rather than four, are necessary for accurate modelling, which can then facilitate understanding of cardiovascular disease. To design a method to determine these conductivities, it is also necessary to design a suitable multi-electrode array, which can be used, in conjunction with an inversion technique, to retrieve conductivity values from measurements of potential made on the array. This work uses the results of a study, into the sensitivity of the measuring potentials to variability in the input conductivities, to facilitate the design of an array that could be used to retrieve six cardiac conductivity values, as well as fibre rotation angle. It is found that if an electrode in the array has a much lower value of potential than the other electrodes, then it tends to be much more sensitive to the input conductivities than the other electrodes. It also appears that inclusion of this type of electrode in the set of measuring electrodes is essential for accurately retrieving conductivity values. This technique is used to identify electrodes to be included in the array and using the final design it is demonstrated, using synthetic values of potential, that the six cardiac conductivity values, and the fibre rotation angle, can be retrieved very accurately.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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...

  17. 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.

  18. Prognostic value of coronary anatomy and myocardial innervation imaging in cardiac disease

    NARCIS (Netherlands)

    Veltman, Caroline Emma

    2016-01-01

    Over the last decade, there has been an exponential development in cardiac imaging technology. Currently, cardiac imaging plays a central role in clinical management and decision making in the diverse and growing population of patients encountered in daily cardiology practice. Important outcome-rela

  19. 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

  20. Prevalence of nursing diagnosis of decreased cardiac output and the predictive value of defining characteristics in patients under evaluation for heart transplant Prevalencia del diagnóstico de enfermería de disminución del gasto cardíaco y valor predictivo de las características definidoras en pacientes en fase de evaluación para trasplante cardíaco Prevalência do diagnóstico de enfermagem de débito cardíaco diminuído e valor preditivo das características definidoras em pacientes em avaliação para transplante cardíaco

    Directory of Open Access Journals (Sweden)

    Lígia Neres Matos

    2012-04-01

    Full Text Available The purposes of the study were to identify the prevalence of defining characteristics (DC of decreased cardiac output (DCO in patients with cardiac insufficiency under evaluation for heart transplantation, and to ascertain the likelihood of defining characteristics being predictive factors for the existence of reduction in cardiac output. Data was obtained by retrospective documental analysis of the clinical records of right-sided heart catheterizations in 38 patients between 2004 and 2009. The results showed that 71.1% of the patients had decreased cardiac output (measured by cardiac index. The majority of the NANDA-International defining characteristics for DCO were more frequent in individuals with reduced cardiac index levels. The study emphasizes the odds ratio (OR for increased Systemic Vascular Resistance of OR=4.533, of the third heart sound with OR=3.429 and the reduced ejection fraction with OR=2.850. By obtaining the predictive values for the defining characteristics the study identifies them as diagnostic indicators of decreased cardiac output.El estudio tiene como objetivos identificar la prevalencia de las características definitorias de la disminución del gasto cardíaco (DGC en pacientes con insuficiencia cardíaca (IC en evaluación para el trasplante de corazón y ver la probabilidad de las características definitorias sean factores predictivos de la existencia de una disminución del gasto cardíaco. Los datos se obtuvieron mediante el análisis documental retrospectivo de historias clínicas de cateterismo cordiaco derecho en 38 pacientes con insuficiencia cardíaca en la evaluación para el trasplante de corazón entre 2004 y 2009. Los resultados mostraron que el 71% de los pacientes habían reducido el gasto cardíaco (medido por el índice cardíaco. La mayoría de las características definitorias de la NANDA-International para el DGC fueron más frecuentes en individuos con índice cardíaco reducido. Los aspectos m

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

    Science.gov (United States)

    Rabinovitch, A.; Biton, Y.; Braunstein, D.; Friedman, M.; Aviram, I.; Yandrapalli, S.; Pandit, S. V.; Berenfeld, O.

    2015-03-01

    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.

  2. Direct recording of cardiac output- and venous return-curves in the dog heart-lung preparation for a graphical analysis of the effects of cardioactive drugs.

    Science.gov (United States)

    Ishikawa, N; Taki, K; Hojo, Y; Hagino, Y; Shigei, T

    1978-09-01

    The dog heart-lung preparations were prepared. The "equilibrium point", which could be defined as the point at which the cardiac output (CO)-curve and the venous return (VR)-curve crossed, when the CO and VR were plotted against the right atrial pressure, was recorded directly by utilizing an X-Y recorder. The CO-curve was obtained, as a locus of the equilibrium point, by raising and lowering the level of blood in the venous reservoir (competence test). The meaning of the procedure was shown to increase or decrease the mean systemic pressure, and to cause the corresponding parallel shift in the VR-curve. The VR-curve was obtained by changing myocardial contractility. When heart failure was induced by pentobarbital or by chloroform, the equilibrium point shifted downwards to the right, depicting the VR-curve. During development of the failure, the slopes of CO-curves decreased gradually. Effects of cinobufagin and norepinephrine were also analyzed. Utilization of the X-Y recorder enabled us to settle the uniform experimental conditions more easily, and to follow the effects of drugs continuously on a diagram equating the CO- and VR-curves (Gyton's scheme).

  3. Single session of sprint interval training elicits similar cardiac output but lower oxygen uptake versus ramp exercise to exhaustion in men and women

    Science.gov (United States)

    Horn, Trevor; Roverud, Garret; Sutzko, Kandice; Browne, Melissa; Parra, Cristina; Astorino, Todd A

    2016-01-01

    Sprint interval training (SIT) elicits comparable long-term adaptations versus continuous exercise training (CEX) including increased maximal oxygen uptake (VO2max) and fat utilization. However, there is limited research examining acute hemodynamic responses to SIT. The aim of this study was to examine hemodynamic responses to low-volume SIT. Active men (n=6, VO2max = 39.8 ± 1.7 mL/kg/min) and women (n=7, VO2max = 37.3 ± 5.7 mL/kg/min) performed a ramp-based VO2max test (RAMP) to determine workload for the SIT session. Subjects returned within 1 wk and completed a session of SIT consisting of six 30-s bouts of “all-out” cycling at 130% maximal workload (Wmax) interspersed with 120 s of active recovery. Continuously during RAMP and exercise and recovery in SIT, VO2 was obtained and thoracic impedance was used to estimate heart rate (HR), stroke volume (SV), and cardiac output (CO). Results revealed no significant differences in COmax (p = 0.12, 19.7 ± 2.4 L/min vs. 20.3 ± 1.8 L/min) but lower SVmax (p = 0.004, 110.4 ± 15.7 mL vs. 119.4 ± 15.5 mL) in RAMP versus SIT. HRmax from SIT (179.0 ± 11.8 b/min) was lower (p = 0.008) versus RAMP (184.4 ± 7.9 b/min). Peak VO2 (L/min) was lower (p Sprint interval training consisting of 3 min of supramaximal exercise elicits similar CO yet lower VO2 compared to RAMP.

  4. 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.

  5. 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...

  6. Cardiac output in idiopathic normal pressure hydrocephalus: association with arterial blood pressure and intracranial pressure wave amplitudes and outcome of shunt surgery

    Directory of Open Access Journals (Sweden)

    Eide Per K

    2011-02-01

    Full Text Available Abstract Background In patients with idiopathic normal pressure hydrocephalus (iNPH responding to shunt surgery, we have consistently found elevated intracranial pressure (ICP wave amplitudes during diagnostic ICP monitoring prior to surgery. It remains unknown why ICP wave amplitudes are increased in these patients. Since iNPH is accompanied by a high incidence of vascular co-morbidity, a possible explanation is that there is reduced vascular compliance accompanied by elevated arterial blood pressure (ABP wave amplitudes and even altered cardiac output (CO. To investigate this possibility, the present study was undertaken to continuously monitor CO to determine if it is correlated to ABP and ICP wave amplitudes and the outcome of shunting in iNPH patients. It was specifically addressed whether the increased ICP wave amplitudes seen in iNPH shunt responders were accompanied by elevated CO and/or ABP wave amplitude levels. Methods Prospective iNPH patients (29 were clinically graded using an NPH grading scale. Continuous overnight minimally-invasive monitoring of CO and ABP was done simultaneously with ICP monitoring; the CO, ABP, and ICP parameters were parsed into 6-second time windows. Patients were assessed for shunt surgery on clinical grade, Evan's index, and ICP wave amplitude. Follow-up clinical grading was performed 12 months after surgery. Results ICP wave amplitudes but not CO or ABP wave amplitude, showed good correlation with the response to shunt treatment. The patients with high ICP wave amplitude did not have accompanying high levels of CO or ABP wave amplitude. Correlation analysis between CO and ICP wave amplitudes in individual patients showed different profiles [significantly positive in 10 (35% and significantly negative in 16 (55% of 29 recordings]. This depended on whether there was also a correlation between ABP and ICP wave amplitudes and on the average level of ICP wave amplitude. Conclusions These results gave no

  7. 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.

  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. Value of blood-pool subtraction in cardiac indium-111-labeled platelet imaging

    Energy Technology Data Exchange (ETDEWEB)

    Machac, J.; Vallabhajosula, S.; Goldman, M.E.; Goldsmith, S.J.; Palestro, C.; Strashun, A.; Vaquer, R.; Phillips, R.A.; Fuster, V. (Mt. Sinai Medical Center, New York, NY (USA))

    1989-09-01

    Blood-pool subtraction has been proposed to enhance {sup 111}In-labeled platelet imaging of intracardiac thrombi. We tested the accuracy of labeled platelet imaging, with and without blood-pool subtraction, in ten subjects with cardiac thrombi of varying age, eight with endocarditis being treated with antimicrobial therapy and ten normal controls. Imaging was performed early after labeled platelet injection (24 hr or less) and late (48 hr or more). Blood-pool subtraction was carried out. All images were graded subjectively by four experienced, blinded readers. Detection accuracy was measured by the sensitivity at three fixed levels of specificity estimated from receiver operator characteristic curve analysis and tested by three-way analysis of variance. Detection accuracy was generally improved on delayed images. Blood-pool subtraction did not improve accuracy. Although blood-pool subtraction increased detection sensitivity, this was offset by decreased specificity. For this population studied, blood-pool subtraction did not improve subjective detection of abnormal platelet deposition by 111In platelet imaging.

  10. Infliximab reduces cardiac output in rheumatoid arthritis patients without heart failure Infliximabe reduz débito cardíaco em pacientes com artrite reumatoide sem insuficiência cardíaca

    Directory of Open Access Journals (Sweden)

    Rodrigo Cardoso Santos

    2012-12-01

    Full Text Available OBJECTIVE: Human anti-tumor necrosis factor (TNF-α monoclonal antibody (infliximab is used to treat autoimmune diseases such as rheumatoid arthritis (RA. Although the risk of worsening heart failure has been described in patients under chronic treatment, the acute cardiovascular effects of this drug are unknown in RA patients without heart failure. METHODS: 14 RA patients with normal echocardiography and no history of heart failure were evaluated during the 2-hour infliximab (3-5 mg/kg infusion period, using a noninvasive hemodynamic beat-to-beat system (Portapres. Stroke volume (SV; systolic, diastolic and mean blood pressures (SBP, DBP and MBP, respectively; cardiac output (CO; heart rate (HR; and total peripheral vascular resistance (PVR were recorded. All patients also received saline infusion instead of infliximab as a control. Significant differences in hemodynamic parameters were determined using Tuckey's test. All values were expressed as mean ± standard deviation (SD. RESULTS: Fourteen RA patients (6M/8F with mean age of 47.2 ± 8.8 years were evaluated. A significant decrease was found in cardiac output and stroke volume (7.04 ± 2.3 to 6.12 ± 2.1 l/min and 91 ± 29.0 to 83 ± 28.8 mL/beat, respectively after infliximab infusion. Although not statistically significant, a progressive increase was detected in SBP, DBP and total PVR during infusion. Saline infusion did not cause significant hemodynamic changes in the same group of RA patients. No adverse effects were observed during the infusion period. CONCLUSION: Acute infliximab administration decreased cardiac output due to low stroke volume in RA patients without heart disease. The results also demonstrated that, in spite of its negative inotropic effect, infliximab enhanced BP, probably by increasing PVR.OBJETIVO: O inibidor de fator de necrose tumoral (TNF-α infliximabe é usado no tratamento de doenças autoimunes como a artrite reumatoide (AR. Embora o risco de piora de

  11. 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.

  12. The Value of Conventional Echocardiographic and Tissue Doppler Imaging in the Diagnosis of Cardiac Amyloidosis

    Institute of Scientific and Technical Information of China (English)

    Li ZHANG; Mingxing XIE; Xinfang WANG; Yali YANG; Junhong HUANG; Ming CHENG; Feixiang XIANG; Qing LU

    2008-01-01

    Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA),a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septunm. Lateral, inferior and anterior comers of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group.Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.

  13. The Application of LM-BP Neural Network in the Prediction of Total Output Value of Agriculture

    Institute of Scientific and Technical Information of China (English)

    Zimin; ZHANG; Yanying; FAN; Guanping; CHEN

    2015-01-01

    Gross agricultural product is an important indication to measure the agricultural development level of a region. It would be affected by many factors,having the characteristics of non- linearity. For this reason,LM- BP neural network was put forward as the model and method for predicting gross agricultural product. Taking the indications of the sown area of crop,the output of grain,sugarcane,cassava,tea,meat,aquatic products,turpentine and camellia seed,etc. as inputs,during 2000 to 2012 in Guangxi,the gross agricultural product data from the analysis of simulation experiment show that the prediction of LM- BP neural network fits well with actual results.

  14. 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

  15. Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study.

    Directory of Open Access Journals (Sweden)

    Gitsios Gitsioudis

    Full Text Available We sought to investigate the association of epicardial adipose tissue (eCAT volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD.177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing 3 risk factors, presence of CAD, hs-CRP and hs-TnT.Epicardial adipose tissue volume is independently associated with plaque burden and maximum luminal narrowing by CCTA and may serve as an independent predictor for cardiac outcomes in patients at intermediate risk for CAD.

  16. Predictive value of assessing diastolic strain rate on survival in cardiac amyloidosis patients with preserved ejection fraction.

    Directory of Open Access Journals (Sweden)

    Dan Liu

    Full Text Available Since diastolic abnormalities are typical findings of cardiac amyloidosis (CA, we hypothesized that speckle-tracking-imaging (STI derived longitudinal early diastolic strain rate (LSRdias could predict outcome in CA patients with preserved left ventricular ejection fraction (LVEF >50%.Diastolic abnormalities including altered early filling are typical findings and are related to outcome in CA patients. Reduced longitudinal systolic strain (LSsys assessed by STI predicts increased mortality in CA patients. It remains unknown if LSRdias also related to outcome in these patients.Conventional echocardiography and STI were performed in 41 CA patients with preserved LVEF (25 male; mean age 65±9 years. Global and segmental LSsys and LSRdias were obtained in six LV segments from apical 4-chamber views.Nineteen (46% out of 41 CA patients died during a median of 16 months (quartiles 5-35 months follow-up. Baseline mitral annular plane systolic excursion (MAPSE, 6 ± 2 vs. 8 ± 3 mm, global LSRdias and basal-septal LSRdias were significantly lower in non-survivors than in survivors (all p < 0.05. NYHA class, number of non-cardiac organs involved, MAPSE, mid-septal LSsys, global LSRdias, basal-septal LSRdias and E/LSRdias were the univariable predictors of all-cause death. Multivariable analysis showed that number of non-cardiac organs involved (hazard ratio [HR] = 1.96, 95% confidence interval [CI] 1.17-3.26, P = 0.010, global LSRdias (HR = 7.30, 95% CI 2.08-25.65, P = 0.002, and E/LSRdias (HR = 2.98, 95% CI 1.54-5.79, P = 0.001 remained independently predictive of increased mortality risk. The prognostic performance of global LSRdias was optimal at a cutoff value of 0.85 S-1 (sensitivity 68%, specificity 67%. Global LSRdias < 0.85 S-1 predicted a 4-fold increased mortality in CA patients with preserved LVEF.STI-derived early diastolic strain rate is a powerful independent predictor of survival in CA patients with preserved LVEF.

  17. 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.

  18. 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...

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. 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 patients with invasive coronary angiography demonstrated occluded vessels. Twenty-four patients with refractory angina due to occluded coronary arteries underwent perfusion imaging obtained by 320-MDCT scanner and 1.5 T MR scanner. Rest and adenosine stress images were obtained and interpreted using......) or 1 (abnormal). The summed rest and stress scores were calculated. MDCT and CMR had a high probability to identify perfusion defects. An excellent correlation between MDCT and CMR summed rest (r = 0.916) and stress scores (r = 0.915) was found. The interobserver reproducibility was high for MDCT...

  5. 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;

    1998-01-01

    of 1658 women and 1797 men aged 30-60 years. QT interval dispersion was calculated from the maximal difference between QT intervals in any two leads. All cause mortality over 13 years, and cardiovascular mortality as well as cardiac morbidity over 11 years, were the main outcome parameters. Subjects......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...... with a prolonged QT interval (430 ms or more) or prolonged QT interval dispersion (80 ms or more) were at higher risk of cardiovascular death and cardiac morbidity than subjects whose QT interval was less than 360 ms, or whose QT interval dispersion was less than 30 ms. Cardiovascular death relative risk ratios...

  6. 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)

  7. 超声心动图对中晚孕正常胎儿心排血量及主动脉峡部血流量的研究%Research on cardiac output and blood flow of aortic isthmus of normal fetus in middle and late pregnancy by echocardiography

    Institute of Scientific and Technical Information of China (English)

    陈桂红; 张燕宏; 米杰; 张晓云; 李伟娟; 孙聪欣; 梁丽华; 刘涛; 王玮婧

    2014-01-01

    Objective To explore the changes of cardiac output and distribution with the increasing of pregnancy week in normal fetuses of middle and late pregnancy and establish the normal reference range.Methods Three hundred and thirteen normal fetuses in 20-40 pregnancy weeks underwent fetal echocardiography.The largest diameters of aortic valve,pulmonary valve,ductus arteriosus,aortic isthmus were measured respectively in the left ventricular outflow view,right ventricular outflow view,three vessels view and aortic arch longitudinal view.The blood flow spectrums of these parts were acquired and its velocity time integral (VTI) and heart rate (HR) were got by automatic envelope model.According to the formula of Q =(diameter/2)2 × 3.14 × VTI × HR,the cardiac output of left and right ventricle,the blood flow of aortic isthmus and ductus arteriosus were calculated.Results The cardiac outputs of left and right ventricle,combined cardiac output and the blood flow of aortic isthmus and ductus arteriosus of normal fetuses in middle and late pregnancy gradually increased with the increasing of gestational age and there were linear positive correlation between them.The blood flow of aortic isthmus increased with fetal weight,and there was significant correlation between them.The ratio of blood flow of aortic isthmus and ductus arteriosus decreased gradually with the increasing pregnancy week,and there was linear negative relationship between them.The ratio of blood flow of aortic isthmus and output of left ventricle and the ratio of blood flow of aortic isthmus and cardiac output were relatively constant,and there was poor correlation with gestational age.Conclusions Quantification of cardiac output and blood flow of AI can improve understanding about fetal circulation system physiology and help to identify abnormal pathological conditions,especially prompt the late morphological changes because of early abnormal flow of aortic isthmus.There was high clinical value for

  8. 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

    -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 physiological FDG-uptake....../secretion, the corresponding values increased to 87 and 52 %, respectively. (18)F-FDG-PET/CT may be an important diagnostic tool in detecting extra cardiac infections in patients with IE, particularly in organs with low physiological glucose uptake........ To discover the latter an (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET)/CT examination has been proposed. However, the diagnostic value of a PET/CT in this setting remains unresolved. Thus, we wished to assess the usefulness of a PET/CT study in patients with IE as a supplemental...

  9. 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

    OBJECTIVE: Tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to estimate the cardiac time intervals. The aim was to evaluate the usability of the cardiac time intervals in predicting major cardiovascular events (MACE) in the general population. METHODS......: In a large prospective community-based study, cardiac function was evaluated in 1915 participants by both conventional echocardiography and TDI. The cardiac time intervals, including the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET), were obtained by TDI M...... echocardiographic parameters resulted in a significant increase in the c-statistics (0.76 vs 0.75 ptime intervals that include...

  10. 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

  11. 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.

  12. 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 a...... 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......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...

  13. 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

  14. 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.

  15. 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

  16. Predictive value of interleukin-6 in post-cardiac arrest patients treated with targeted temperature management at 33 °C or 36 °C

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Stammet, Pascal;

    2016-01-01

    AIM: Post-cardiac arrest syndrome (PCAS) is characterized by systemic inflammation, however data on the prognostic value of inflammatory markers is sparse. We sought to investigate the importance of systemic inflammation, assessed by interleukin-6 (IL-6) in comatose survivors of out-of-hospital c......AIM: Post-cardiac arrest syndrome (PCAS) is characterized by systemic inflammation, however data on the prognostic value of inflammatory markers is sparse. We sought to investigate the importance of systemic inflammation, assessed by interleukin-6 (IL-6) in comatose survivors of out......-of-hospital cardiac arrest. METHODS: A total of 682 patients enrolled in the Target Temperature Management (TTM) trial, surviving >24h with available IL-6 data were included. IL-6 was measured on days 1, 2 and 3 after return of spontaneous circulation. Severity of PCAS was assessed daily by the Sequential Organ...... Failure Assessment score. Survival status was recorded at 30 days. RESULTS: High levels of IL-6 at day 1-3 (all p

  17. 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.

  18. Predictive factors related to low cardiac output syndrome following aortic valve replacement%主动脉瓣置换术后发生低心排出量综合征的预测因素探讨

    Institute of Scientific and Technical Information of China (English)

    马红; 张其霞; 李晓静; 郑晓燕

    2014-01-01

    Objective To investigate the predictive factors related to postoperative low cardiac output syndrome in pa-tients after aortic valve replacement due to aortic stenosis or regurgitation. Methods Three hundred patients with aortic valve defect due to aortic stenosis (AS, n=150) or aortic incompetence (AI, n=150), who underwent isolated aortic valve replacement were included in the study. Low cardiac output syndrome(LOS) was defined as the need for high dosages of inotropic medication, and/or intra- aortic bal oon pumping to sustain adequate hemodynamic status. Results Postoperative low cardiac output syn-drome developed in 86 patients (28.6%), including 39 patients with AS (26.0%) and 47 patients with AI (31.3%). The development of postoperative LOS were associated with the fol owing factors (odds ratio in parentheses): for AS group: advanced age (OR=4.7), obesity (OR=1.8), history of heart failure (OR=1.7), end- systolic (OR=5.5) and end- diastolic intraventricular septum thickness (OR=4.2), left atrial diameter (OR=1.6), mitral and tricuspid regurgitation (OR=1.9, 1.5) before surgery, LVEF≤50.0%(OR=5.4), left ventricular end systolic diameter (OR=1.7), left ventricular end diastolic diameter (OR=1.9) and mitral regurgitation (OR=4.1) in early postoperative period; for AI group:advanced age (OR=1.9), obesity (OR=4.8), history of heart failure (OR=1.7), LVEF≤50.0%(OR=1.8), left ventricular end- systolic (OR=4.5), end- diastolic diameters (OR=6.4), left ventricular end systolic di-ameter (OR=1.5), left ventricular end diastolic diameter(OR=1.6), and tricuspid regurgitation (OR=1.5) in preoperative period and left ventricular end- systolic (OR=4.7) and end- diastolic diameters (OR=6.1), and LVEF≤50.0% (OR=7.2) in early postoperative period. Conclusion The patients at high risk for the development of low cardiac output syndrome should be the focus of trials of new techniques of myocardial protection to effectively resuscitate the ischemic myocardium and

  19. 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...

  20. 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.

  1. Application of peritoneal dialysis in the treatment of children with low cardiac output after cardiosurgery%腹膜透析在小儿先天性心脏病术后低心排的应用

    Institute of Scientific and Technical Information of China (English)

    王风

    2014-01-01

    Objective To investigate the effect of peritoneal dialysis in the treatment of children with low cardiac output after cardiosurgery .Methods A retrospective analysis was performed on the therapeutic effect of 12 children with low cardiac output after surgery of congenital heart disease by the early peritoneal dialysis in our hospital , 2.5%low calcium peritoneal dialysis solution was selected .The single amount of peritoneal dialysis was 15~20 ml/kg, and dialysis fluid retention time was 20~30 min.After 30 min reservation, dialysis fluid was drained for about 20 min according to the blood pressure .Peritoneal dialysis interval time was extended gradually after the urine occurred .Re-tention time of peritoneal dialysis was extended if patients were suffered from hyperlactacidemia .The frequency of di-alysis was adjusted according to the the level of serum creatinine and lactate .The blood glucose , electrolytes as well as arterial and venous blood gas was monitored , and the colloid was supplied when necessary .The peritoneal dialysis start, duration and the urine recovery time was recorded .Results The urine recovery time was 5~22 h.The appli-cation time of ventilator was 70~128 h, and the time in ICU was 5~18 d.The complications of peritoneal dialysis included catheter blockage (3 cases), hypoglycemia(3 cases), hyperglycemia(1 case) and hypokalemia (2 cases). No patients suffered from peritonitis and intestinal perforation .Two cases of tetralogy of fallot were died of severe low cardiac output and multiple organ dysfunction .Conclusion Early application of peritoneal dialysis can reduce the burden of heart , lung and kidney , maintain the stability of internal environment , and reduce mortality .%目的观察腹膜透析对小儿先天性心脏病术后的低心排治疗效果。方法回顾性分析该院12例先天性心脏病术后低心排早期治疗使用腹膜透析效果。腹透液选择百特公司2.5%低钙腹膜透析液。单次腹膜透析量15

  2. 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)

  3. 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

  4. The application of pulse indication contour cardiac output to early fluid resuscitation in patients with septic shock%脉搏轮廓法在感染性休克早期液体复苏中的运用

    Institute of Scientific and Technical Information of China (English)

    李家琼; 李茂琴; 许继元; 史载祥; 张舟; 李琳; 卢飞; 莫逊; 许艳军

    2011-01-01

    液体复苏及血管活性药应用,能更精确进行液体管理,减少盲目补液,减少机械通气时间,缩短住ICU时间.%Objective To explore the use of pulse indication contour cardiac output (PiCCO) as a guidance for fluid resuscitation and vasopressors employment in patients with septic shock in order to find out the efficacy of this resuscitation strategy in the respect of outcome of patients. Mtthod A total of 30 patients with septic shock were treated with the EDGT fluid treatment protocol as the conventional treatment group from December 2006 to June 2008; and another 26 patients were given fluid treatment under the guidance of PiCCO as PiCCO group from July 2008 to October 2009. Exclusion criteria included patients with history of heart and lung diseases, and liver and kidney dysfunction. The mean arterial blood pressure was maintained above or equal to 65mmHg in PiCCO group,and fluid resuscitation was concluded when global end-diastolic volume index reached 600~750 mL·-2 with the stroke volume variation in < 10% and without auricular fibrillation. Nor-epinephrine was administrated to adiust the systemic peripheral vascular resistance index during 1300~1500 d·s·cm-5·m-2.Dobutamine was empoyed when global ejection fraction was compromised. The options of liquid and diuretics depend upon the presence d extra-vascular lung water. Central venous oxygen saturation and the level of lactate were observed 6hours after resuscitation. The liquid equilibrium for 3 days and the dosage of vasopressors were also recorded. The rate of survival, the time taken for weaning from mechanical ventilation, the days of ICU stay and rate of intact organ function within 28 days were compared between two groups. Results The demphics of patients of two goups were similar. There were no significant difference between PiCCO and the conventional group in values of central venous oxygen saturation and lactate 6 hours after admission to ICU (P > 0.05). And 6 h and 1d

  5. 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

  6. Acute and Chronic Changes and Predictive Value of Tpeak-Tend for Ventricular Arrhythmia Risk in Cardiac Resynchronization Therapy Patients

    Science.gov (United States)

    Xue, Cong; Hua, Wei; Cai, Chi; Ding, Li-Gang; Liu, Zhi-Min; Fan, Xiao-Han; Zhao, Yun-Zi; Zhang, Shu

    2016-01-01

    Background: Prolongation of the Tpeak-Tend (TpTe) interval as a measurement of transmural dispersion of repolarization (TDR) is an independent risk factor for chronic heart failure mortality. However, the cardiac resynchronization therapy's (CRT) effect on TDR is controversial. Therefore, this study aimed to evaluate CRTs acute and chronic effects on repolarization dispersion. Furthermore, we aimed to investigate the relationship between TpTe changes and ventricular arrhythmia. Methods: The study group consisted of 101 patients treated with CRT-defibrillator (CRT-D). According to whether TpTe was shortened, patients were grouped at immediate and 1-year follow-up after CRT, respectively. The echocardiogram index and ventricular arrhythmia were observed and compared in these subgroups. Results: For all patients, TpTe slightly increased immediately after CRT-D implantation, and then decreased at the 1-year follow-up (from 107 ± 23 to 110 ± 21 ms within 24 h, to 94 ± 24 ms at 1-year follow-up, F = 19.366, P arrhythmia. PMID:27625093

  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. 应用Swan-Ganz导管测定肺动脉高压犬模型肺循环阻力及心输出量的实验研究%Application of Swan-Ganz catheter to measure pulmonary vascular resistance and cardiac output of canine model with pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    林约瑟; 李淑娟; 李轩狄; 李运泉; 王慧深

    2015-01-01

    ObjectiveTo explore the value of Swan-Ganz catheter to measure pulmonary vascular resistance (PVR) and cardiac output (CO) of canine model with pulmonary arterial hypertension (PAH).MethodsSixteen Beagle dogs were randomly divided into two groups, the control group(n=8) and the pulmonary arterial hypertension group (n=8). Arterial blood was obtained to test arterial oxygen saturation. A Swan-Ganz catheter was advanced through the the right jugular vein way to the pulmonary artery and the pulmonary arterial pressure (PAP) were measured. Blood was obtained to test the pulmonary arterial oxygen saturation and plasma concentration of brain natriuretic peptide (BNP). Cardiac output and pulmonary vascular resistance were then calculated according to formula. The pulmonary arterial hypertension group were injected dehydromonocrataline 2.5 mg/kgto set up pulmonary arterial hypertension model. Hemodynamic measure was repeated after eight weeks.ResultsEight weeks after injection of dehydromonocrotaline, the pulmonary arterial systolic pressure, mean pulmonary arterial pressure of the pulmonary arterial hypertension group were significantly increased from (20.33±1.86) mmHg to (50.10±3.72) mmHg, (10.42±1.48) mmHg to (34.30±2.35) mmHg, the pulmonary arterial resistance, pulmonary vascular resistance were significantly increased from (1.10±0.24) Wood to (12.60±0.29) Wood, (2.34±0.33) Wood to (15.68±0.68) Wood, respectively, cardiac output was significantly decreased from (4.60±0.64) L/min to (2.30±0.35) L/min (P<0.05).ConclusionIt is an accurate, stable and repeatable method to apply Swan-Ganz catheter for measuring pulmonary vascular resistance and cardiac output in Beagle models with pulmonary arterial hypertension.%目的:探讨Swan-Ganz导管在肺动脉高压犬模型肺循环阻力及心输出量测定中的应用价值。方法16只比格犬随机分为2组,正常对照组(n=8)、肺动脉高压组(n=8)。穿刺动脉取血检测血氧饱和度。

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

    Energy Technology Data Exchange (ETDEWEB)

    Bazeed, Mohamed Fayez (Dept. of Diagnostic Radiology, Faculty of Medicine, Mansoura Univ. (Egypt)), email: m_bazeed@yahoo.com; Moselhy, Mohamed Saleh (Cardiology Dept. Faculty of Medicine, Suez Canal Univ. (Egypt)); Rezk, Ahmad Ibrahim (Dept. of Cardiac Surgery, Faculty of Medicine, Aim Shams Univ. (Egypt)); Al-Murayeh, Mushabab Ayedh (Dept. of Cardiac Services, Armed Forces Hospitals Southern Region (Saudi Arabia))

    2012-05-15

    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

  10. 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.

  11. THE METHOD OF DETERMINATION OF ERROR IN THE REFERENCE VALUE OF THE DOSE DURING THE LINEAR ACCELERATOR RADIATION OUTPUT CALIBRATION PROCEDURE. Part 3. The dependence of the radiation beam characteristics

    Directory of Open Access Journals (Sweden)

    E. V. Titovich

    2016-01-01

    Full Text Available To ensure the radiation protection of oncology patients is needed to provide the constancy of functional characteristics of the medical linear accelerators, which affect the accuracy of dose delivery. For this purpose, their quality control procedures are realized including calibration of radiation output of the linac, so the error in determining the dose reference value during this procedure must not exceed 2 %. The aim is to develop a methodology for determining the error in determining this value, depending on the characteristics of the radiation beam. Dosimetric measurements of Trilogy S/N 3567 linac dose distributions have been carried out for achievement of the objectives, on the basis of which dose errors depending on the dose rate value, the accuracy of the beam quality and output factors determination, the symmetry and uniformity of the radiation field, the angular dependence of the linac radiation output were obtained. It was found that the greatest impact on the value of the error has the error in the output factors determination (up to 5.26 % for both photon energy. Dose errors caused by changing dose rate during treatment were different for two photon energies, and reached 1.6 % for 6 MeV and 1.4 % for 18 MeV. Dose errors caused by inaccuracies of the beam quality determination were different for two photon energies, and reached 1.1 % for 18 MeV and –0.3 % for 6 MeV. Errors caused by the remaining of the characteristic do not exceed 1 %. Thus, there is a possibility to express the results of periodic quality control of the linear accelerator in terms of dose and use them to conduct a comprehensive assessment of the possibility of clinical use of a linear accelerator for oncology patients irradiation on the basis of the calibration of radiation output.

  12. 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

  13. 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

  14. 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...

  15. 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

  16. 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.

  17. Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco Transthoracic impedance compared to magnetic resonance imaging in the assessment of cardiac output

    Directory of Open Access Journals (Sweden)

    Humberto Villacorta Junior

    2012-12-01

    Full Text Available FUNDAMENTO: A ressonância magnética cardíaca é considerada o método padrão-ouro para o cálculo de volumes cardíacos. A bioimpedância transtorácica cardíaca avalia o débito cardíaco. Não há trabalhos que validem essa medida comparada à ressonância. OBJETIVO: Avaliar o desempenho da bioimpedância transtorácica cardíaca no cálculo do débito cardíaco, índice cardíaco e volume sistólico, utilizando a ressonância como padrão-ouro. MÉTODOS: Avaliados 31 pacientes, com média de idade de 56,7 ± 18 anos, sendo 18 (58% do sexo masculino. Foram excluídos os pacientes cuja indicação para a ressonância magnética cardíaca incluía avaliação sob estresse farmacológico. A correlação entre os métodos foi avaliada pelo coeficiente de Pearson, e a dispersão das diferenças absolutas em relação à média foi demonstrada pelo método de Bland-Altman. A concordância entre os métodos foi realizada pelo coeficiente de correlação intraclasses. RESULTADOS: A média do débito cardíaco pela bioimpedância transtorácica cardíaca e pela ressonância foi, respectivamente, 5,16 ± 0,9 e 5,13 ± 0,9 L/min. Observou-se boa correlação entre os métodos para o débito cardíaco (r = 0,79; p = 0,0001, índice cardíaco (r = 0,74; p = 0,0001 e volume sistólico (r = 0,88; p = 0,0001. A avaliação pelo gráfico de Bland-Altman mostrou pequena dispersão das diferenças em relação à média, com baixa amplitude dos intervalos de concordância. Houve boa concordância entre os dois métodos quando avaliados pelo coeficiente de correlação intraclasses, com coeficientes para débito cardíaco, índice cardíaco e volume sistólico de 0,78, 0,73 e 0,88, respectivamente (p BACKGROUND: Cardiac magnetic resonance imaging is considered the gold-standard method for the calculation of cardiac volumes. Transthoracic impedance cardiography assesses the cardiac output. No studies validating this measurement, in comparison to that obtained

  18. Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco Transthoracic impedance compared to magnetic resonance imaging in the assessment of cardiac output

    Directory of Open Access Journals (Sweden)

    Humberto Villacorta Junior

    2012-01-01

    Full Text Available FUNDAMENTO: A ressonância magnética cardíaca é considerada o método padrão-ouro para o cálculo de volumes cardíacos. A bioimpedância transtorácica cardíaca avalia o débito cardíaco. Não há trabalhos que validem essa medida comparada à ressonância. OBJETIVO: Avaliar o desempenho da bioimpedância transtorácica cardíaca no cálculo do débito cardíaco, índice cardíaco e volume sistólico, utilizando a ressonância como padrão-ouro. MÉTODOS: Avaliados 31 pacientes, com média de idade de 56,7 ± 18 anos, sendo 18 (58% do sexo masculino. Foram excluídos os pacientes cuja indicação para a ressonância magnética cardíaca incluía avaliação sob estresse farmacológico. A correlação entre os métodos foi avaliada pelo coeficiente de Pearson, e a dispersão das diferenças absolutas em relação à média foi demonstrada pelo método de Bland-Altman. A concordância entre os métodos foi realizada pelo coeficiente de correlação intraclasses. RESULTADOS: A média do débito cardíaco pela bioimpedância transtorácica cardíaca e pela ressonância foi, respectivamente, 5,16 ± 0,9 e 5,13 ± 0,9 L/min. Observou-se boa correlação entre os métodos para o débito cardíaco (r = 0,79; p = 0,0001, índice cardíaco (r = 0,74; p = 0,0001 e volume sistólico (r = 0,88; p = 0,0001. A avaliação pelo gráfico de Bland-Altman mostrou pequena dispersão das diferenças em relação à média, com baixa amplitude dos intervalos de concordância. Houve boa concordância entre os dois métodos quando avaliados pelo coeficiente de correlação intraclasses, com coeficientes para débito cardíaco, índice cardíaco e volume sistólico de 0,78, 0,73 e 0,88, respectivamente (p BACKGROUND: Cardiac magnetic resonance imaging is considered the gold-standard method for the calculation of cardiac volumes. Transthoracic impedance cardiography assesses the cardiac output. No studies validating this measurement, in comparison to that obtained

  19. 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.

  20. 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

  1. Application of pulse contour cardiac output monitoring technique in hemodynamic monitoring in critical patients%脉搏轮廓心排血量监测技术在危重病患者血流动力学监测中的应用

    Institute of Scientific and Technical Information of China (English)

    房贺; 郑兴锋; 夏照帆

    2014-01-01

    Pulse contour cardiac output (PiCCO) monitoring is a new type of invasive hemodynamic monitoring technology,which is more and more often applied in perioperative period and the patients suffering from multiple injuries,septic shock,and extensive burn.With PiCCO one is able to monitor patients' hemodynamic indexes safely,timely,accurately,and continuously to provide reference for judgment of patients' condition and proper quality and quantity of fluid administration.This technique has a good prospect in clinical application.

  2. 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

  3. Pulse Indicator Continuous Cardiac Output for Hemodynamics Monitoring in Patients with Septic Shock%脉搏指示连续心排血量监测(PiCCO)在脓毒症休克患者血流动力学监测中的临床价值

    Institute of Scientific and Technical Information of China (English)

    伊敏; 么改琦; 朱曦; 郭向阳

    2013-01-01

    目的 探讨脉搏指示连续心排血量监测技术(pulse indicator continuous cardiac output,PiCCO)在脓毒症休克患者血流动力学监测中的临床价值. 方法 2012年1~8月,前瞻性队列研究比较常规监测(n=12)与PiCCO监测(n=19)脓毒症休克患者的血流动力学,应用PiCCO监测指导脓毒症休克患者的液体复苏、血管收缩药和正性肌力药物的使用. 结果 2组脓毒症休克患者性别、年龄、原发病、既往病史、多器官功能不全综合征(MODS)的发生和发生MODS器官数、急性生理学及慢性健康状况评分系统(APACHE)Ⅱ、脓毒症相关器官衰竭评分(SOFA)、应用去甲肾上腺素剂量和入ICU后7天总的输液量差异均无显著性,PiCCO组初始平均动脉压(MAP)明显低于常规组[(52.00±5.00)mm Hg vs.(59.58±3.42)mm Hg,t=4.603,P=0.000],而对于PiCCO组存在心功能损害的患者应用正性肌力药治疗后达到与常规组相同的MAP达标值[(68.00±2.43)mm Hg vs.(68.58±2.88)mm Hg,t=0.607,P=0.549],2组MAP达标值差异无显著性. 结论 在PiCCO监测指导下,可以对于存在心功能损害的患者应用正性肌力药物,而不是仅应用血管收缩药升高血压.%Objective To investigate the clinical value of pulse indicator continuous cardiac output ( PiCCO) in hemodynamics monitoring for patients with septic shock. Methods A prospective cohort study comparing routine hemodynamics monitoring (n = 12) and PiCCO (n = 19) for patients with septic shock were carried out from January to August 2012. The PiCCO monitor provided a continuous assessment of fluid resuscitation, vasopressors and inotropes infusion in septic shock patients. Results There were no significant difference between the two groups in sex, age, etiology of critical illness, medical history, incidence of MODS, number of MODS involved organ, APACHE Ⅱ and SOFA scores, usage of noradrenaline, and total volume of fluid infusion in a week. In the PiCCO group, the original MAP

  4. Pulse Indicator Continuous Cardiac Output for Hemodynamics Monitoring in Patients with Septic Shock%脉搏指示连续心排血量监测(PiCCO)在脓毒症休克患者血流动力学监测中的临床价值

    Institute of Scientific and Technical Information of China (English)

    陈涛

    2015-01-01

    Objective To observe and analyze patients with septic shock pulse wave indicates continuous cardiac output monitoring (Picco) clinical value, to provide a reference for future clinical use. Methods January 2013—2014 in March during outpatient sep-sis patients admitted to 40 cases for the study, depending on the admission of hemodynamic monitoring methods divided into two groups, the study group and the control group 20 cases. Two were used for routine monitoring (control group), Picco monitoring (study group) to guide clinical treatment (fluid resuscitation, inotropic drugs, vasoconstrictor drugs, etc.). Results The mean arterial pressure in the two groups of patients after treatment of the initial value and compare, P 0.05). Conclusion Picco be monitored in patients with septic shock hemodynamic parameters with good results, it is worth further study in late.%目的:观察脓毒症休克患者采用脉波指示连续心排血量监测(PiCCO)的效果,并分析其临床应用价值。方法将医院2012年1月—2014年3月期间门诊收入的脓毒症50例患者选为研究对象,按照患者就诊时血动力指标的监测方式不同分成两组:研究组25例,对照组25例。两组分别采用常规监测(对照组)、PiCCO监测(研究组)指导临床治疗(液体复苏、正性肌力药物、血管收缩药物等)。结果两组患者的平均动脉压在初始值比较(P<0.01);研究组患者入院3 d内不同时点GEDI、PPV、SVV检测值比较,组间差异有统计学意义(P<0.05)。组间在去甲肾上腺素和就诊1周输液量比较,差异无统计学意义(P>0.05)。结论脓毒症休克患者予以PiCCO监测血流动力学指标具有良好效果,值得在后期进一步研究。

  5. 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

  6. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  7. Prediction Model and Algorithm of Industrial Gross Output Value Based on Electric Power Consumption%基于电力消耗的行业总产值预测模型及算法研究

    Institute of Scientific and Technical Information of China (English)

    陈晔; 王国瑞; 方彦军

    2014-01-01

    在“大数据”技术背景下,获取广东省规模以上工业企业电力消耗及总产值月度数据,基于人工神经网络结构建立行业总产值预测模型,并提出一种新的带抱团行为的粒子群优化算法完成对神经网络预测模型的参数优化,进而实现各行业基于电力消耗的总产值有效预测。仿真分析表明,新的改进型带抱团行为的粒子群优化算法具有更快的收敛速度和更高的寻优精度,能够有效地优化神经网络模型参数,实现基于电力消耗的行业总产值的有效、可靠预测。%In the context of big data technology,a prediction model for industrial gross output value based on artificial neural network was built by achieving monthly data of electric power consumption and output value of industrial enterprises above Guangdong provincial designated size. Meanwhile,a kind of new particle swarm optimization with gathering behavior was proposed to finish optimization on parameters of ANN prediction model and realize effective prediction on gross value based on electric consumption of all industries. Simulation analysis indicated that the new improved PSO was provided with faster convergence speed and higher optimizing precision which was able effectively optimize parameters of ANN model and realize effective and reliable prediction on gross output value of industries based on electric power consumption.

  8. Input-Output Economics and Material Flows

    OpenAIRE

    Faye Duchin

    2004-01-01

    This paper argues that resources constitute the fundamental area of overlap between the interests of input-output economists and industrial ecologists. Three misconceptions about input-output economics obscure this fact: the frequent failure to utilize combined quantity and price input-output models, treatment of value-added as a monetary concept only, and the belief that all input-output models assume a linear relationship between output and final deliveries. The paper dispels these misconce...

  9. 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

  10. 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.

  11. 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

  12. The predictive value of CHADS₂ risk score in post myocardial infarction arrhythmias - a Cardiac Arrhythmias and RIsk Stratification after Myocardial infArction (CARISMA) substudy

    DEFF Research Database (Denmark)

    Ruwald, Anne Christine; Gang, Uffe; Thomsen, Poul Erik Bloch;

    2014-01-01

    ventricular ejection fraction (LVEF) ≤40%. All patients were implanted with an implantable cardiac monitor (ICM) within 5 to 21 days post-MI and followed every three months for two years. Atrial fibrillation, bradyarrhythmias and ventricular tachycardias were diagnosed using the ICM, pacemaker or ICD......BACKGROUND: Previous studies have shown substantially increased risk of cardiac arrhythmias and sudden cardiac death in post-myocardial infarction (MI) patients. However it remains difficult to identify the patients who are at highest risk of arrhythmias in the post-MI setting. The purpose...... of this study was to investigate if CHADS₂ score (congestive heart failure, hypertension, age ≥75 years, diabetes and previous stroke/TCI [doubled]) can be used as a risk tool for predicting cardiac arrhythmias after MI. METHODS: The study included 297 post-MI patients from the CARISMA study with left...

  13. 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-...

  14. 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.

  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).

    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

  16. 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

  17. 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.

  18. 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

  19. 氮肥用量对旱地玉米产量及产值的影响%Effects of Nitrogen Fertilizer Rate on Yield and Output Value of Maize from Dry-land

    Institute of Scientific and Technical Information of China (English)

    刘淑军; 黄晶; 梁海军; 秦道珠

    2012-01-01

    A field experiment was carried out to study the relationship between different nitrogen fertilizer rates and yield or output value of maize planted in the quaternary red soil dry land in southern Hunan red soil hilly region. The results showed that applying nitrogen could increase weight of single ear and 100 kernel weight of maize, and it had little effect on effective ear number, plant height, stem diameter and ear diameter. Applying suitable amount of nitrogen could significantly increase yield and output value of maize. The grain yield and output value of maize in N225 treatment were the highest by 4 570.6 kg/hm2 and 6 730.0 yuan/hm2, respectively, which increased by 37.3% and 21.3% compared with no nitrogen treatment. The application of nitrogen fertilizer could increase the total nitrogen uptake of grain and straw, and nitrogen use efficiency of all nitrogen treatment ranged from 3.8% to 16.6%, the highest was in N225 treatment.%在湘南红壤丘陵区第四纪红壤旱地,通过田间试验研究不同氮肥用量与玉米产量、产值的关系.结果表明:施用氮肥能提高玉米的单穗粒重和百粒重,对有效穗数、株高、茎粗、穗粗影响不明显.施用合适的氮肥能明显提高玉米的籽粒产量以及产值,以N225处理的籽粒产量和产值最高,分别为4 570.6 kg/hm2、6 730.0元/hm2,比不施氮肥的处理分别增产37.3%、增收21.3%.施用氮肥可以提高籽粒和秸秆的总吸氮量,各施氮处理的氮肥利用率为3.8%~16.6%,以N225处理的氮肥利用率最高.

  20. Cardiac abnormalities in children with hyperthyroidism.

    Science.gov (United States)

    Lester, L A; Sodt, P C; Rich, B H; Lucky, A W; Hutcheon, N; Arcilla, R A

    1982-01-01

    The cardiac status of 18 hyperthyroid (HT) children (9 black and 9 white) was evaluated by echocardiography. Mitral regurgitation (MR) was diagnosed clinically in 33% (6 of the 9 blacks). None of the 9 white children had MR. Left ventricular end-diastolic diameter (LVEDD) and volume (LVEDV) did not differ from the predicted normal (PN) based on body surface area and heart rate, except in those with MR where increased LVEDD and LVEDV were noted (p less than 0.02). LV mass was +1.75 standard deviations (sigma) of the PN (p less than 0.01), due to increased wall thickness of LVEDV. Left ventricular output (LVO) was +0.35 sigma PN (p = ns); however, when compared to that of normal children, LVO of HT was higher (p less than 0.001) due to the increased heart rate. Enhanced left ventricular contractility was suggested by increased rate of dimensional change during ejection (peak dD/dt-syst), with a mean value of -11.39 cm/sec as compared to the normal of -9.54 cm/sec (p less than 0.01). A linear multivariate regression equation differentiated the cardiac status of HT from that of normal children. Following treatment to euthyroid state, MR disappeared in 2 and became less in 4 patients. LVO, LV mass, and peak dD/dt-syst also became less. Significant cardiac changes occur in children with hyperthyroidism, which may be reversible in part after euthyroidism is restored.

  1. Predictive value of local and core laboratory echocardiographic assessment of cardiac function in patients with chronic stable angina: The ACTION study

    NARCIS (Netherlands)

    A.M. Dart (Anthony); J.E. Otterstad (Jan Erik); B.A. Kirwan (Bridget Anne); J.D. Parker (John); S. de Brouwer (Sophie); P. Poole-Wilson (Philip); J. Lubsen (Jacobus)

    2007-01-01

    textabstractAims: To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina. Methods: Baseline echo left ventricular ejection fraction and volume data measured in a central laboratory was available for 7016 patients (92% of the tot

  2. Suggested cut-off values for vitamin D as a risk marker for total and cardiac death in patients with suspected acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Patrycja Anna Naesgaard

    2016-02-01

    Full Text Available Background: Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut off levels are still under debate. Objectives: To assess two cut-off levels, 40 nmol/L and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D [25(OHD] in chest pain patients with suspected acute coronary syndrome.Methods: We investigated 1853 patients from coastal-Norway and inland Northern-Argentina. A similar database was used for pooling of data. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death in the total patient population were analyzed, applying univariate and multivariable analysis. Results: 255 patients with known vitamin D concentrations died. In the multivariable analysis, there was a decrease in total mortality above a cut-off level of 40 nmol/L and a decrease in cardiac death above a cut-off level of 70 nmol/L, [HRs of 0.66 (95% CI, 0.50 – 0.88, p = 0.004 and 0.46 (95% CI, 0.22 – 0.94, p = 0.034, respectively].Conclusion: Vitamin D cut-off levels of 40 nmol/L and 70 nmol/L, were related to total mortality and cardiac death, respectively.

  3. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  4. TECHNIQUE OF ESTIMATION OF ERROR IN THE REFERENCE VALUE OF THE DOSE DURING THE LINEAR ACCELERATOR RADIATION OUTPUT CALIBRATION PROCEDURE. Part 2. Dependence on the characteristics of collimator, optical sourse-distance indicator, treatment field, lasers and treatment couch

    Directory of Open Access Journals (Sweden)

    Y. V. Tsitovich

    2016-01-01

    Full Text Available To ensure the safety of radiation oncology patients needed to provide consistent functional characteristics of the medical linear accelerators, which affect the accuracy of dose delivery. To this end, their quality control procedures, which include the calibration of radiation output of the linac, the error in determining the dose reference value during which must not exceed 2 %, is provided. The aim is to develop a methodology for determining the error (difference between a measured value of quantity and its true value in determining this value, depending on the characteristics of the collimator, the source to surface distance pointer, lasers, radiation field and treatment table. To achieve the objectives have been carried out dosimetric measurements of Trilogy S/N 3567 linac dose distributions, on the basis of which dose errors depending on the accuracy setting the zero position of the collimator, the deviation of the collimator rotation isocenter, the sourcesurface distance pointer accuracy, field size accuracy, the accuracy of lasers and treatment table positioning were obtained. It was found that the greatest impact on the value of the error has the error in the optical SSD indication and the error in the lasers position in the plane perpendicular to the plane of incidence of the radiation beam (up to 3.64 % for the energy of 6 MV. Dose errors caused by error in the field size were different for two photon energies, and reached 2.54 % for 6 MeV and 1.33% for 18 MeV. Errors caused by the rest of the characteristic do not exceed 1 %. Thus, it is possible to express the results of periodic quality control of these devices integrated in linac in terms of dose and use them to conduct a comprehensive assessment of the possibility of clinical use of a linear accelerator for oncology patients irradiation on the basis of the calibration of radiation output in case of development of techniques that allow to analyze the influence dosimetric

  5. 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

  6. Changes in heart rate, arrhythmia frequency, and cardiac biomarker values in horses during recovery after a long-distance endurance ride

    DEFF Research Database (Denmark)

    Madsen, Mette Flethøj; Kanters, Jørgen K.; Haugaard, Maria Mathilde;

    2016-01-01

    and SDNN was decreased during the recovery versus preride period. Frequency of ventricular premature complexes increased during recovery, albeit not significantly, whereas frequency of supraventricular premature complexes was not significantly different between preride and recovery periods. Serum cardiac......-km endurance ride. PROCEDURES: ECG recordings were obtained from each horse before (preride) and after (recovery) an endurance ride to evaluate changes in heart rate and the SD of normal R-R intervals (SDNN) during the initial 12 hours of recovery. Frequencies of supraventricular and ventricular...... premature complexes before and after the ride were evaluated. Blood samples were obtained before the ride and twice during recovery. Hematologic analyses included measurement of serum cardiac troponin I concentration and creatine kinase isoenzyme MB activity. RESULTS: Heart rate was significantly increased...

  7. Imaging of cardiac innervation: when will it reach clinical value?; Bildgebung der kardialen Innervation: Wann gelingt der Sprung in die Klinik?

    Energy Technology Data Exchange (ETDEWEB)

    Schaefers, M. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany); Inst. fuer Arterioskleroseforschung, Westfaelische Wilhelms-Univ., Muenster (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany)

    2004-09-01

    The autonomic nervous system is involved in the regulation of the majority of basic cardiac and vascular functions, e.g. the control of perfusion, rhythm, metabolism and contraction. This results in an involvement of the autonomic nervous system in many pathophysiologic processes affecting the heart. Furthermore, in clinical medicine the autonomic nervous system is a target of specific pharmacological treatment such as {beta}-blockade. Imaging of the autonomic nervous system in a clinical context should therefore proof useful in clinical decision making and therapy control of cardiovascular diseases. Today, scintigraphic techniques are a unique mean to image and quantify sympathetic and parasympathetic cardiac innervation non-invasively in vivo. Although these technologies are already available, these are not yet implemented in clinical algorithms. (orig.)

  8. 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

  9. 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

  10. 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 ...

  11. 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.

  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

    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.

  13. Relationship between cardiac function and resting cerebral blood flow

    DEFF Research Database (Denmark)

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

    2014-01-01

    a gender-related inverse association of increased low-to-high-frequency power ratio with CBF and fractional brain flow. The findings do not support a direct effect of cardiac function on CBF, but demonstrates gender-related differences in cardiac output distribution. We propose fractional brain flow......) 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) = 0.22, P...... = 0.008) and furthermore lower in males than in females (8.6% versus 12.5%, P = 0.003). Fractional brain flow was also inversely correlated with cerebral white matter lesion grade, although this effect was not significant when adjusted for age. Frequency analysis of heart rate variability showed...

  14. 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.)

  15. 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.)

  16. 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.)

  17. 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.

  18. Probabilistic Output Analysis by Program Manipulation

    OpenAIRE

    Rosendahl, Mads; Kirkeby, Maja H.

    2015-01-01

    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 function as a possibly uncomputable expression in an intermediate language. This program is then analyzed, transformed, and approximated. The result is a closed form expression that computes an over...

  19. High-output heart failure in a newborn.

    Science.gov (United States)

    Mascarenhas, Maria Inês; Moniz, Marta; Ferreira, Sofia; Goulão, Augusto; Barroso, Rosalina

    2012-07-10

    High-output cardiac failure is rare in newborns. Emergent diagnosis and management of this pathology is crucial. We report the case of a child, currently 12-months old; obstetric background is non-contributory. Clinic observation on D1 was normal except for the presence of a systolic cardiac murmur; cardiological evaluation revealed mild ventricular dysfunction of the right ventricle. On the third day of life, she developed cardiac failure with gallop rhythm, hepatomegaly and a murmur in the anterior fontanel; an echocardiogram confirmed clinic aggravation with biventricular dysfunction and right cavities and superior vena cava dilatation. The cranial MRI confirmed the presence of a pial arteriovenous malformation (AVM) involving the anterior and middle cerebral arteries with an associated fronto-parietal ischaemic lesion. The infant underwent embolisations of AVM with successful flow reduction and cardiac failure improvement. The multidisciplinary follow-up showed no cardiac dysfunction or permanent lesions but confirmed a severe psycho-motor delay and left hemiparesia.

  20. 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.

  1. 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.

  2. Exercise efficiency of low power output cycling.

    Science.gov (United States)

    Reger, M; Peterman, J E; Kram, R; Byrnes, W C

    2013-12-01

    Exercise efficiency at low power outputs, energetically comparable to daily living activities, can be influenced by homeostatic perturbations (e.g., weight gain/loss). However, an appropriate efficiency calculation for low power outputs used in these studies has not been determined. Fifteen active subjects (seven females, eight males) performed 14, 5-min cycling trials: two types of seated rest (cranks vertical and horizontal), passive (motor-driven) cycling, no-chain cycling, no-load cycling, cycling at low (10, 20, 30, 40 W), and moderate (50, 60, 80, 100, 120 W) power outputs. Mean delta efficiency was 57% for low power outputs compared to 41.3% for moderate power outputs. Means for gross (3.6%) and net (5.7%) efficiencies were low at the lowest power output. At low power outputs, delta and work efficiency values exceeded theoretical values. In conclusion, at low power outputs, none of the common exercise efficiency calculations gave values comparable to theoretical muscle efficiency. However, gross efficiency and the slope and intercept of the metabolic power vs mechanical power output regression provide insights that are still valuable when studying homeostatic perturbations.

  3. [Cardiac amyloidosis].

    Science.gov (United States)

    Hoyer, Caroline; Angermann, Christiane E; Knop, Stefan; Ertl, Georg; Störk, Stefan

    2008-03-15

    Amyloidoses are a heterogeneous group of multisystem disorders, which are characterized by an extracellular deposition of amyloid fibrils. Typically affected are the heart, liver, kidneys, and nervous system. More than half of the patients die due to cardiac involvement. Clinical signs of cardiac amyloidosis are edema of the lower limbs, hepatomegaly, ascites and elevated jugular vein pressure, frequently in combination with dyspnea. There can also be chest pain, probably due to microvessel disease. Dysfunction of the autonomous nervous system or arrhythmias may cause low blood pressure, dizziness, or recurrent syncope. The AL amyloidosis caused by the deposition of immunoglobulin light chains is the most common form. It can be performed by monoclonal gammopathy. The desirable treatment therapy consists of high-dose melphalan therapy twice followed by autologous stem cell transplantation. Due to the high peritransplantation mortality, selection of appropriate patients is mandatory. The ATTR amyloidosis is an autosomal dominant disorder caused by the amyloidogenic form of transthyretin, a plasmaprotein that is synthesized in the liver. Therefore, liver transplantation is the only curative therapy. The symptomatic treatment of cardiac amyloidosis is based on the current guidelines for chronic heart failure according to the patient's New York Heart Association (NYHA) state. Further types of amyloidosis with possible cardiac involvement comprise the senile systemic amyloidosis caused by the wild-type transthyretin, secondary amyloidosis after chronic systemic inflammation, and the beta(2)-microglobulin amyloidosis after long-term dialysis treatment. PMID:18344065

  4. [Cardiac support and replacement therapies].

    Science.gov (United States)

    Lotz, Christopher; Roewer, Norbert; Muellenbach, Ralf M

    2016-09-01

    Circulatory support represents an integral part within the treatment of the critically ill patient. Sophisticated pharmacologic regimens help to maintain systemic perfusion pressure by increasing vascular tone as well as mediating positive inotropic effects. Besides the administration of catecholamines and phosphodiesterase-III-inhibitors, in particular the administration of levosimendan represents a promising alternative during low-cardiac-output. Nevertheless, sufficient evidence demonstrating a survival benefit for any pharmacologic regimen is nonexistent. In case pharmacological measures do not suffice mechanical cardiopulmonary support (MCS) may be used. MCS may be used during cardiopulmonary resuscitation or a "low-cardiac-output-syndrome" as bridging towards decision, recovery or long-term support. Venoarterial extracorporeal membrane oxygenation (vaECMO) may take over cardiopulmonary function and may improve survival as well as neurological outcome after cardiogenic shock or cardiopulmonary resuscitation. PMID:27631451

  5. 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

  6. 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...

  7. 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...

  8. INFLUENCE OF MIMIC CARDIAC RATE ON HYDRODYNAMICS OF DIFFERENT MECHANICAL PROSTHETIC CARDIAC VALVES IN VITRO

    Institute of Scientific and Technical Information of China (English)

    Yin-ping Chu; Jin-lian Cheng; Ru-kun Chen; Yu-bo Fan; Fang Pu

    2005-01-01

    Objective To assess the influence of mimic cardiac rate on hydrodynamics of different mechanical prosthetic cardiac valves.Methods US-made CarboMedics bileaflet valve, China-made Jiuling bileaflet valve and C-L tilting disc valve were tested via a pulsatile flow simulator in the aortic position. Testing conditions were set at mimic cardiac rates of 55 bpm, 75 bpm, 100bpm with a constant mimic cardiac output of 4 L/min. The mean pressure differences (△P), leakage volumes (LEV) and closing volumes (CLV) across each valve, and effective orifice areas (EOA) were analyzed.Results Within physiological range, △p, LEV, and CLV decreased as mimic cardiac rate increased, with a large extent of variance. EOA increased along with an increase in mimic cardiac rate. It was a different response in terms of cardiac rate alteration for different types of mechanical prosthetic cardiac valves.Conclusion Mimic cardiac rate change affects hydrodynamics of mechanical prosthetic cardiac valves. Within physiological range, the hydrodynamic of prosthetic bileaflet valve is better than that of tilting disc valve.

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

    DEFF Research Database (Denmark)

    Bonne, Thomas Christian

    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 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...... and hence exercise performance in elite athletes. However, the efficacy of altitude training for sea level performance is still debated and the literature is divergent on this matter. Even if the haematological changes following altitude training may be inadequate to substantially improve performance...

  10. 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.

  11. 采用点状电极进行无创性心输出量检测时胸部圆柱模型的适用性%Applicability of the Two-compartment Coaxial Cylindrical Model for Ambulatory Measuring of Cardiac Output with Spot-electrodes

    Institute of Scientific and Technical Information of China (English)

    宋义林; 高树枚; 五十岚朗; 山越宪一

    2013-01-01

    The principle of ambulatory cardiac output (CO) measuring technique is introduced in this paper.Experimental studies about the applicability of the two-compartment coaxial cylindrical model for ambulatory measurement of cardiac output with spot-electrodes have been carried out with using our newly-developed multi-channel impedance mapping system.The key factors using a spot-electrode array instead of a conventional band-electrode array for noninvasive CO measurement are elaborated.The variations of the electric impedance pulsatile component (△Z wave form) and the two kinds of typical modes of △Z distributions measured by six electrodes on the midsternal (midian)line from the medial portion at the level of clavicle to the portion above the xiphisternum are discussed.The applicability of the two-compartment coaxial cylindrical model for ambulatory measurement of CO with spot-electrodes is analyzed.Synthesizing the △Z distributions and their typical changing models on the midsternal (midian) line during blood inflowing into aorta is the optimal positions of a pair of spot-electrodes for voltage pick-up at the level of clavicle for the upper electrode and the position at the level of nipple for the lower electrode when spot-electrode is being used to measure non-invasive CO.%介绍了基于电阻抗法的无拘束心输出量(CO)检测技术与原理.利用开发的多通道电阻抗分布检测装置,对采用点状电极进行无拘束CO检测时胸部圆柱模型的适应性进行了实验研究,阐述了用点状电极替代带状电极进行无创性CO检测的关键因素,探讨了胸部正中线上6个检测电极检测到的从锁骨位置到剑凸位置电阻抗的波动部分(△Z)波形大小的变化规律及其两种典型的分布模式,分析了采用点状电极进行无拘束CO测量时胸部圆柱模型的适用性.综合实验结果中得到的胸廓正中附近血液泵出时所引起的△Z分布规律和变化模式,得出当采用点状电

  12. 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。

  13. 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

  14. 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,

  15. Measuring the mechanical efficiency of a working cardiac muscle sample at body temperature using a flow-through calorimeter.

    Science.gov (United States)

    Taberner, Andrew J; Johnston, Callum M; Pham, Toan; June-Chiew Han; Ruddy, Bryan P; Loiselle, Denis S; Nielsen, Poul M F

    2015-08-01

    We have developed a new `work-loop calorimeter' that is capable of measuring, simultaneously, the work-done and heat production of isolated cardiac muscle samples at body temperature. Through the innovative use of thermoelectric modules as temperature sensors, the development of a low-noise fluid-flow system, and implementation of precise temperature control, the heat resolution of this device is 10 nW, an improvement by a factor of ten over previous designs. These advances have allowed us to conduct the first flow-through measurements of work output and heat dissipation from cardiac tissue at body temperature. The mechanical efficiency is found to vary with peak stress, and reaches a peak value of approximately 15 %, a figure similar to that observed in cardiac muscle at lower temperatures.

  16. Cardiac autonomic nervous test value to the diagnosis of plant diabetic neuropathy%心脏自主神经试验对糖尿病合并植物神经病变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    何煜暐

    2015-01-01

    目的:对46例糖尿病患者心脏自主神经试验进行分析,探讨心脏自主神经试验对糖尿病合并植物神经病变的诊断价值。方法:根据临床表现把糖尿病患者分为糖尿病合并植物神经病变组和糖尿病不合并植物神经病变组。行心脏自主神经试验,并对两组数据进行比较。结果:糖尿病合并植物神经病变组呼吸差,乏氏指数、30/15比值均低于不合并植物神经病变组。结论:心脏自主神经试验方法简单方便,容易掌握,重复性好,可作为评估糖尿病合并植物神经病变的敏感指标。%Objective46 cases of diabetic cardiac autonomic nervous test were analyzed, and discuss the heart autonomic nervous test value to the diagnosis of plant diabetic neuropathy.MethodsThe diabetes patients according to clinical manifestations of divided into diabetic neuropathy group and diabetes do not merge plants group of neuropathy. Heart the heart nerve test, and carries on the comparison to 2 sets of data.ResultsPlant diabetic neuropathy group of poor breathing, lack of index, the ratio of 30/15 were less merger plant neuropathy group.Conclusions Cardiac autonomic nervous test method is simple and convenient, easy to learn, good repeatability, can be used as evaluation of sensitive indicator of plant diabetic neuropathy.

  17. 心血管整体评分评估胎儿心功能不全的价值%The Value of Cardiovascular Profile Score to Assess Fetal Cardiac Insufficiency

    Institute of Scientific and Technical Information of China (English)

    武超; 王玲红; 刘丽萍

    2016-01-01

    Jan. 2016. Fetal cardiac insufficiency (enlarged heart and myocardial contraction fatigue) were found out. CVPS were recorded. Meanwhile fetal cadiography were performed to define if congenital heart disease were accompanied. All cases divided in two groups based on the follow up results:live birth group and adverse pregnancy outcome group. Results:38 cases of fetal cardiac insufficiency were found out. 35 cases were singleton pregnancy. 3 cases were twins pregnancy. 12 cases were in live birth group (all of them were singleton pregnancy), 10 cases were healthy children, 2 cases were accompanied by congenital heart disease: 1 case was mild pulmonicstenosis, 1 case was tetralogy of Fallot. 21 cases were in adverse pregnancy outcome group. 18 cases were singleton pregnancies: 9 cases were intrauterine fetal demise, 2 cases were stillbirth, 7 cases were induced labour: 5 cases progressed to heart failure because of CVPS declined continuously and fetal cadiac insufficiency worsen, 2 cases were accompanied by fatal congenital heart disease. 2 cases of twins pregnancy were intrauterine fetal demise because of twin to twin transfusion syndrome (TTTS). 1 case of twins pregnancy was induced labour because of hydrocephaly and intracranial hemorrhage. 5 cases were loss to follow up. CVPS of live birth was 7.62 (7.00) and CVPS of adverse pregnancy outcomes was 5.67 (3.50). Statistics analysis:ROC curve analysis, area under ROC:0.823, cut off value was 6.5, P=0.002, difference was statistically significant. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function in two groups were significant difference (P<0.05). Conclusions:CVPS declined when fetal cardiac insufficiency worse, dangerous cut off value of CVPS was 6.5, CVPS is an effective index for continuous dynamic assessment of fetal cardiac insufficiency. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function were valuable to predict adverse

  18. 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

  19. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  20. 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

  1. The significance of non invasive cardiac output monitoring system on evaluating circulatory and respiratory function in pig with acute respiratory distress syndrome%无创心排血量监测系统对急性呼吸窘迫综合征猪模型呼吸循环功能的评价意义

    Institute of Scientific and Technical Information of China (English)

    边伟帅; 晁彦公; 陈炜; 王兰; 李黎明; 关键; 盛博; 甄洁; 赵磊

    2014-01-01

    NICO监测系统测量的CO与PiCCO测量的CO有较好的相关性(r2=0.925,P<0.001)。结论应用NICO监测系统可以很好地监测ARDS时的呼吸功能及CO,并且通过NICO监测最低VD/VT可以作为滴定最佳PEEP的方法。%Objective To investigate the effect of non invasive cardiac output monitoring(NICO)system in pig model with acute respiratory distress syndrome(ARDS),and to provide experimental basis for clinical application. Methods Eleven anaesthetized and ventilated ARDS male pig models were induced by intravenously infusing 0.2 mL/kg oleic acid. Lung recruitment was condocted by pressure control ventilation on pigs with ARDS. The optimal positive end-expiratory pressure(PEEP)was determined by optimal dead space fraction〔the ratio of dead space to tidal volume(VD/VT)〕. Cardiac output(CO)was determined by NICO,the respiratory function was monitored, and the VD/VT,dynamic compliance(Cdyn),oxygenation index(PaO2/FiO2),the volume of alveolar ventilation(Valv) and arterial blood oxygen saturation(SaO2)were recorded before infusing oleic acid,after stabilization of ARDS model and at optimal PEEP level,and the intrapulmonary shunt fraction(Qs/Qt)was calculated. CO was also determined by application of pulse indicated continuous cardiac output(PiCCO),and the linear regression analysis between CO determined by NICO and CO determined by PiCCO was conducted. Results Seven experimental ARDS pigs model were successfully established. The optimal PEEP identified by the lowest VD/VT method was(15.71±1.80)cmH2O (1 cmH2O=0.098 kPa). Compared with before infusing oleic acid,VD/VT and Qs/Qt after stabilization of ARDS model were significantly increased〔VD/VT:(72.29±8.58)% vs.(56.00±11.06)%,Qs/Qt:(21.04±15.05)%vs.(2.00±1.32)%,both P0.05). There was linear correlation between CO determined by NICO and CO determined by PiCCO(r2=0.925,P<0.001). Conclusions NICO technique provides a useful and accurate non invasive estimation of CO and respiratory

  2. 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

  3. Improvement of cardiac function after kidney transplantation with dilated cardiomyopathy and long dialysis vintage.

    Science.gov (United States)

    Mimura, Imari; Kawarazaki, Hiroo; Momose, Toshimitsu; Shibagaki, Yugo; Fujita, Toshiro

    2009-12-01

    Patients with long dialysis vintage have low cardiac output for various reasons. Although kidney transplantation is known to improve cardiac mortality, patients are sometimes evaluated as contraindicated for transplantation because of cardiac risk. We successfully performed kidney transplantation for a patient with a long dialysis vintage and dilated cardiomyopathy. Sequential (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy suggested that amelioration of uraemia improved cardiac function. Kidney transplantation for patients with severely impaired cardiac function is safe and effective under careful perioperative monitoring irrespective of dialysis vintage. Sequential (123)I-MIBG scintigraphy can be used as an evaluation tool for the improvement in cardiac function.

  4. Biogalvanic aluminum--oxygen cells. [Al anode and O from body fluids; 240. mu. W output

    Energy Technology Data Exchange (ETDEWEB)

    Weidlich, E.; Wenzel, M.; Richter, G.; Von Strum, F.

    1973-01-01

    The cell consists of an Al anode between two activated carbon electrodes coated with tissue-compatible membranes that permit only the entrance of oxygen from body fluids. In vitro output is 240 ..mu..W and in vivo output is 200 ..mu..W. The cell can be used to power a cardiac pacemaker.

  5. 脉搏轮廓心排血量监测技术在成批特大面积烧伤患者延迟复苏中的应用效果%Effect of application of pulse contour cardiac output monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty

    Institute of Scientific and Technical Information of China (English)

    杨雯娴; 郭光华; 沈国良; 林伟; 赵小瑜; 祁强; 钱汉根; 谢文忠; 王志学

    2016-01-01

    Objective To investigate the effect of the application of pulse contour cardiac output (PiCCO) monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty.Methods The clinical data of 41 patients injured in Kunshan dash explosion hospitalized in the First Affiliated Hospital of Soochow University,the 100th Hospital of the People's Liberation Army,and Suzhou Municipal Hospital were retrospectively analyzed.The patients were divided into traditional monitoring group (T,n =22) and PiCCO monitoring group (P,n =19) according to the monitoring technic during delayed resuscitation.The input volumes of electrolyte,colloids,and water of patients in the two groups within 2 hours after admission,the first,second,and third 8 hours post injury (HPI),and the first 24 HPI were recorded.The fluid infusion coefficients of patients in the two groups within 2 hours after admission,the first,second,and third 8 HPI,and the first,second,third,and fourth 24 HPI were calculated.The urine volume,mean arterial pressure (MAP),and central venous pressure (CVP) of patients in the two groups at post injury hour (PIH) 8,16,24,48,72,and 96 were recorded.The blood lactate,base excess,hematocrit (HCT),and platelet count of patients in the two groups at PIH 24,48,72,and 96 were recorded.Complications and death of patients in the two groups were recorded.Data were processed with analysis of variance for repeated measurement,Chi-square test,t test,and Wilcoxon test.The deviations between figure 2 and the fluid infusion coefficients of the first or second 24 HPI,and the deviations between figure 1 and the fluid infusion coefficients of the second,third or fourth 24 HPI were calculated,and the three groups deviations were analyzed by Pearson correlation analysis.Results (1) The input volumes of electrolyte of patients in group P were significantly more than those in group T within the first 8 and 24 HPI (with Z values respectively-3.506 and-2.654,P < 0.05 or P

  6. 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...

  7. Probabilistic Output Analysis by Program Manipulation

    DEFF Research Database (Denmark)

    Rosendahl, Mads; Kirkeby, Maja Hanne

    2015-01-01

    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...... function as a possibly uncomputable expression in an intermediate language. This program is then analyzed, transformed, and approximated. The result is a closed form expression that computes an over approximation of the output probability distribution for the program. We focus on programs where...... the possible input follows a known probability distribution. Tests in programs are not assumed to satisfy the Markov property of having fixed branching probabilities independently of previous history....

  8. 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

  9. 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

  10. 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

  11. Dynamic NMR cardiac imaging in a piglet

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, M.; Rzedzian, R.; Mansfield, P. (Nottingham Univ. (UK). Dept. of Physics); Coupland, R.E. (Nottingham Univ. (UK). Queen' s Medical Centre)

    1983-12-01

    NMR echo-planar imaging (EPI) has been used in a real-time mode to visualise the thorax of a live piglet. Moving pictures are available on an immediate image display system which demonstrates dynamic cardiac function. Frame rates vary from one per cardiac cycle in a prospective stroboscopic mode with immediate visual output to a maximum of 10 frames per second yielding up to six looks in one piglet heart cycle, but using a visual playback mode. A completely new system has been used to obtain these images, features of which include a probe assembly with 22 cm access and an AP400 array processor for real-time data processing.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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

  17. 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

  18. In Vitro Study of Influence of Mimic Cardiac Rate on Hydrodynamics of the Different Mechanical Cardiac Valve Prostheses

    Institute of Scientific and Technical Information of China (English)

    CHU Yin-ping; CHENG Jin-lian; CHEN Ru-kun; FAN Yu-bo; PU Fang

    2005-01-01

    Objective:To assess the influence of mimic cardiac rate on hydrodynamics of the different mechanical prosthetic cardiac valves. Methods: US-made CarboMedics bileaflet valve and China-made Jiuling bileaflet valve and C-L tilting disc valve have been tested in a pulsatile flow simulator in the aortic position. The testing condition was set at the mimic cardiac rate of 55 beats/min,75 beats/min,100beats/min and a constant mimic cardiac output of 4L/min. The mean pressure differences (△P) ,leakage volumes (LEV) and closing volumes (CLV) across each valve,and the effective orifice areas(EOA) have been analyzed. Results:Within the range of physiology,the △P,LEV and CLV were falling as the increasing of mimic cardiac rate,and the extent of variance was larger. The EOA was increasing with the increase of the mimic cardiac rate. It is a different response as the altering of the cardiac rate for the different type of the mechanical prosthetic cardiac valves.Conclusions:The change of the mimic cardiac rate can affect the hydrodynamics of the mechanical prosthetic cardiac valves. The hydrodynamics of the bileaflet valve prosthesis is better than the tilting disc valve.

  19. 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.

  20. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    A.S. Amin; A. Asghari-Roodsari; H.L. Tan

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  1. 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

  2. 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...

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 脉波指示剂连续心排血量监测技术在早期目标导向治疗中的临床作用分析%Pulse Indicator Continuous Cardiac Output for Hemodynamics Monitoring in Patients with Septic Shock

    Institute of Scientific and Technical Information of China (English)

    陈刚; 王标; 郭小芙

    2014-01-01

    Objective To investigate the application of pulse index continuous cardiac output (PiCCO) in patients with septic shock.MethodsSixty patients with septic shock were randomly divided into two groups: routine monitoring group and PiCCO monitoring group, with 30 patients in each group. The rate of reaching standard of early goal directed therapy (EGDT) was observed after treatment for 6, 24 and 48 hours. In addition, blood lactic acid, central venous oxygen saturation (ScvO2), central venous pressure (CVP), mean arterial pressure (MAP) and urine volume were determined after treatment for 6, 24 and 48 hours, and positive fluid balance amount and dosages of dopamine and dobutamine were measured after treatment for 6, 24 and 48 hours. Mortality was observed in the patients of both groups.Results After treatment for 6, 24 and 48 hours, in PiCCO monitoring group, ScvO2 signifi cantly increased, blood lactic acid level, positivefl uid balance amount, dosages of dopamine and dobutamine signifi cantly decreased compared with routine monitoring group (P<0.05). The rate of reaching standard of EGDT in PiCCO monitoring group was signifi cantly higher than that in routine monitoring group after treatment for 6, 24 hours. There also was difference in mortality between the two groups (P<0.05).Conclusion PiCCO monitor has an important clinical guide signifi cance for the resuscitation of septic shock, which can help to reach the fast and effective treatment target, improve septic shock, avoid the damage of blindfl uid infusion, provide fast and right treatment evidence. So it is worth being spread in clinic treatment.%目的:探讨脉波指示剂连续心排血量监测(PiCCO)技术在脓毒性休克患者早期目标导向治疗(EGDT)中的临床指导价值。方法将60例脓毒性休克患者按随机数字表法分为常规监测组和PiCCO监测组各30例,PiCCO监测组在PiCCO技术指导下行EGDT,常规监测组患者放置中心静脉导管和桡动脉导

  11. Débito cardíaco diminuído: revisão sistemática das características definidoras Débito cardíaco disminuído: revisión sistemática de las características definidoras Decreased cardiac output: a systematic review of the defining characteristics

    Directory of Open Access Journals (Sweden)

    Vanessa de Souza

    2011-01-01

    explorada. Se constató la importancia del examen físico, la utilización de técnicas menos invasivas y la necesidad de revisar las características definidoras propuestas a fin de proporcionar claridad y objetividad en la identificación de ese diagnóstico de enfermeríaOBJECTIVES: To characterize the scientific articles related to the NANDA-I nursing diagnosis, decreased cardiac output. Verify those articles that describe the behavior of the defining characteristics of this diagnosis, identifying those that occur with the highest frequency. METHODS: A systematic review of literature published between the years 1985 - 2008 was conducted, using the following databases: Lilacs, SciELO, EMBASE, Medline, Pubmed and Cochrane. RESULTS: The sample included 13 articles which identified 50 defining characteristics. Ten characteristics were noted to occur with high frequency: altered heart rate/rhythm, dyspnea, labile blood pressure, rales, oliguria / anuria, edema, cold skin, fatigue / weakness, decreased peripheral pulses and decreased peripheral perfusion. CONCLUSION: This subject has not been explored in depth in the literature. The importance of physical examination, the use of less invasive techniques, and the need to review the proposed defining characteristics to provide clarity and objectivity in the identification of this nursing diagnosis was identified

  12. 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)

  13. 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 ...

  14. 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...

  15. 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...

  16. 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.

  17. Measuring temporal resolution of cardiac CT reconstructions

    Science.gov (United States)

    Matthews, David; Heuscher, Dominic

    2005-04-01

    Multi-slice CT today is capable of imaging the heart with excellent temporal resolution. Algorithms have been developed to perform reconstructions combining data from multiple cardiac cycles. This paper presents a simulation phantom that enables a direct measurement of the actual temporal resolution achieved by these algorithms. This is not only useful for assessing the temporal resolution but also for validating the algorithms themselves. A simulation phantom was developed that consists of a 20 cm. diameter water phantom containing an array of cylinders whose intensities are pulsed for various durations ranging from 10 msec. to 250 msec. The intensity varied between the background value of water (0 HU) and 800 HU. By measuring the nominal attenuation value at the center of each cylinder, a curve can be derived representing the response over the given temporal range. A temporal resolution representing the FWHM value is determined based on the half-max value of this curve. Reconstructions were performed using a multi-cycle cardiac algorithm described previously in the literature. The measured FWHM values agree quite well to the temporal resolution predicted by the cardiac algorithm itself. Even the variation along the longitudinal axis can be accounted for by the predicted values. A simulated phantom can be used to accurately assess the temporal resolution of cardiac reconstruction algorithms. Excellent agreement was achieved between the predicted and measured temporal resolution values for the multi-cycle algorithm used in this study.

  18. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  19. 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)

  20. Incremental value of a combination of cardiac troponin T, N-terminal pro-brain natriuretic peptide and C-reactive protein for prediction of mortality in end-stage renal disease

    DEFF Research Database (Denmark)

    Hallén, Jonas; Madsen, Lene Helleskov; Ladefoged, Søren;

    2011-01-01

    Abstract Objective. To determine the relative prognostic merits of C-reactive protein (CRP), cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) for prediction of all-cause death in patients with end-stage renal disease (ESRD) receiving haemodialysis. Material......-pro-BNP lost independent prognostic power. Addition of cTnT and CRP to established risk factors significantly improved the global fit of the model (p

  1. 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...

  2. Diagnostic value of serum myoglobin and cardiac troponin in patients with acute myocardial infarction and corresponding reference assessment%Mb和cTn对AMI诊断的价值及文献评价

    Institute of Scientific and Technical Information of China (English)

    招钜泉; 陆姣苑

    2008-01-01

    目的 运用循证医学(EBM)理论,研究和评价有关肌红蛋白(Mb)和肌钙蛋白(cTn)对急性心肌梗死(AMI)诊断的文献,探讨Mb和cTn对AMI诊断的价值.方法 按照EBM标准,对1994-2005年间、、中以Mb、肌钙蛋白I(cTnI)或肌钙蛋白T(cTnT)作为检测指标诊断AMI的全部文献(包括论文、综述、摘要)进行回顾性检索并作出评价.结果 1994-2005年间共检索到目标文献中文93篇,英文30篇,多数文献设有临床对照试验(中文占94.5% ,英文占53.3%)、盲法研究(中文占19.8% ,英文占10.0%)及随机对照组(中文占9.9% ,英文占16.7%);42篇文章未提供基线资料.结论 通过分析、研究和评价目前国内外应用Mb和cTn对AMI诊断的文献,表明Mb和 cTnI联合检测能体现最佳的灵敏度和特异性,对AMI的早期诊断具有非常重要的临床意义.%Objective To explore the diagnostic value of serum myoglobin (Mb) and cardiac troponin (cTn) in patients with acute myocardial infarction (AMI) by reviewing and evaluating the corresponding references with evidence-based medicine (EBM) theory.Methods All references (including papers,reviews and abstracts) of CNKI-CHKD,CMCC(1994-2005)and EMCC(1995-2005) were collected and retrospectively analyzed according to evidence based medicine (EBM) standard,with Mb cTn as the detected indices for diagnosing AMI.Results In the searched period of 1994-2005,123 papers were published (93 pieces were written in Chinese,and 30 were written in English). In most references,the authors set clinical control trial (CCT) (Chinese: 92.5%;English: 53.3%),blind control trial (Chinese: 19.4%;English: 10.0%) and/or random control trial (RCT) (Chinese: 9.7%;English: 16.7%). The respective reference ranges weren′t provided in 42 pieces of articles.Conclusion The analytic result of the references in home and aborad indicates combined detection of Mb and cTnI posseses favourite sensitivity and specificity,which contributes to the early diagnosis of

  3. 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...

  4. 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...

  5. 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 ...

  6. 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...

  7. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  8. 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 ...

  9. 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 ...

  10. 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

  11. 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

  12. 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

  13. 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

  14. [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

  15. 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.

  16. 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...

  17. 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...... 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....

  18. 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...

  19. 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.

  20. 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, ...

  1. 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 & ...

  2. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a 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......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  3. Cardiac function of the naked mole-rat: ecophysiological responses to working underground.

    Science.gov (United States)

    Grimes, Kelly M; Voorhees, Andrew; Chiao, Ying Ann; Han, Hai-Chao; Lindsey, Merry L; Buffenstein, Rochelle

    2014-03-01

    The naked mole-rat (NMR) is a strictly subterranean rodent with a low resting metabolic rate. Nevertheless, it can greatly increase its metabolic activity to meet the high energetic demands associated with digging through compacted soils in its xeric natural habitat where food is patchily distributed. We hypothesized that the NMR heart would naturally have low basal function and exhibit a large cardiac reserve, thereby mirroring the species' low basal metabolism and large metabolic scope. Echocardiography showed that young (2-4 yr old) healthy NMRs have low fractional shortening (28 ± 2%), ejection fraction (43 ± 2%), and cardiac output (6.5 ± 0.4 ml/min), indicating low basal cardiac function. Histology revealed large NMR cardiomyocyte cross-sectional area (216 ± 10 μm(2)) and cardiac collagen deposition of 2.2 ± 0.4%. Neither of these histomorphometric traits was considered pathological, since biaxial tensile testing showed no increase in passive ventricular stiffness. NMR cardiomyocyte fibers showed a low degree of rotation, contributing to the observed low NMR cardiac contractility. Interestingly, when the exercise mimetic dobutamine (3 μg/g ip) was administered, NMRs showed pronounced increases in fractional shortening, ejection fraction, cardiac output, and stroke volume, indicating an increased cardiac reserve. The relatively low basal cardiac function and enhanced cardiac reserve of NMRs are likely to be ecophysiological adaptations to life in an energetically taxing environment. PMID:24363308

  4. 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.

  5. 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.

  6. 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。

  7. 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.

  8. 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

  9. 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...

  10. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  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. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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...

  17. 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

  18. Prolonged hypoxia increases survival even in Zebrafish (Danio rerio showing cardiac arrhythmia.

    Directory of Open Access Journals (Sweden)

    Renate Kopp

    Full Text Available Tolerance towards hypoxia is highly pronounced in zebrafish. In this study even beneficial effects of hypoxia, specifically enhanced survival of zebrafish larvae, could be demonstrated. This effect was actually more pronounced in breakdance mutants, which phenotypically show cardiac arrhythmia. Breakdance mutants (bre are characterized by chronically reduced cardiac output. Despite an about 50% heart rate reduction, they become adults, but survival rate significantly drops to 40%. Normoxic bre animals demonstrate increased hypoxia inducible factor 1 a (Hif-1α expression, which indicates an activated hypoxic signaling pathway. Consequently, cardiovascular acclimation, like cardiac hypertrophy and increased erythrocyte concentration, occurs. Thus, it was hypothesized, that under hypoxic conditions survival might be even more reduced. When bre mutants were exposed to hypoxic conditions, they surprisingly showed higher survival rates than under normoxic conditions and even reached wildtype values. In hypoxic wildtype zebrafish, survival yet exceeded normoxic control values. To specify physiological acclimation, cardiovascular and metabolic parameters were measured before hypoxia started (3 dpf, when the first differences in survival rate occurred (7 dpf and when survival rate plateaued (15 dpf. Hypoxic animals expectedly demonstrated Hif-1α accumulation and consequently enhanced convective oxygen carrying capacity. Moreover, bre animals showed a significantly enhanced heart rate under hypoxic conditions, which reached normoxic wildtype values. This improvement in convective oxygen transport ensured a sufficient oxygen and nutrient supply and was also reflected in the significantly higher mitochondrial activity. The highly optimized energy metabolism observed in hypoxic zebrafish larvae might be decisive for periods of higher energy demand due to organ development, growth and increased activity. However, hypoxia increased survival only during a

  19. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  20. 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.

  1. Successful use of levosimendan as a primary inotrope in pediatric cardiac surgery: An observational study in 110 patients

    Directory of Open Access Journals (Sweden)

    Reena Khantwal Joshi

    2016-01-01

    Conclusions: Levosimendan-based inotropic regime offers optimized cardiac output with a well-controlled heart rate and a low incidence of arrhythmias in patients undergoing all categories of congenital heart surgeries.

  2. 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.

  3. Identification of Regional Value-Chain Cluster Based on Input-Output Table: A Case Study of Shanghai%基于投入产出表的区域价值链集群识别研究——以上海为例

    Institute of Scientific and Technical Information of China (English)

    卢戎; 于丽英

    2011-01-01

    区域价值链集群分析是集群分析作为区域经济创新性和竞争优势分析工具的重要表现形式.而区域价值链集群识别是进行区域价值链集群分析的第一步.为了实现区域价值链集群依据经济系统各部门间网络互动联系来确定其核心主导产业及其前后向密切关联产业的识别目标,本文选取了以最大值法和投入产出分析法相结合的区域价值链识别方法.由此进行的识别研究表明,上海共有通信、化工、通专、金属、石油核燃料五类价值链集群,它们通过内部和彼此间的互动交织构成了密切关联的网络,并在很大程度上反映了上海经济系统的核心组成.而相应的经济技术分析表明,通专价值链集群将很有可能在上海大力发展先进制造业的产业结构升级大背景下赶超通信价值链集群而成为新一轮发展的亮点.%Analysis of regional value-chain cluster is one of the important analysis tools of regional economic innovation and competitive advantages. And the identification of regional value-chain cluster is the first step of it. To fulfill the goal of identifying core sector and its closely related ones which compose a regional value-chain cluster based on input-output network, a different identification method has been chosen in this paper with the combination of method of maxima and input-output analysis. According to the results of the case study, there are five regional value-chain clusters in Shanghai, whose core sectors are Manufacture of Communication Equipment, Computers and Other Electronic Equipment(A) , Chemical Industries( B) , Manufacture of General and Special Purpose Machinery(C) , Smelting and Pressing of Metals(D)and Oil Processing, Coking and Nuclear Fuel Processing( E) respectively. The network created by inside and outside interaction among these five value-chain clusters largely covers the core composition of economic system in Shanghai. And the following

  4. 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.

  5. 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.)

  6. 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.)

  7. Control of heart rate variability by cardiac parasympathetic nerve activity during voluntary static exercise in humans with tetraplegia.

    Science.gov (United States)

    Takahashi, Makoto; Matsukawa, Kanji; Nakamoto, Tomoko; Tsuchimochi, Hirotsugu; Sakaguchi, Akihiro; Kawaguchi, Kotaro; Onari, Kiyoshi

    2007-11-01

    Heart rate (HR) is controlled solely by via cardiac parasympathetic outflow in tetraplegic individuals, who lack supraspinal control of sympathetic outflows and circulating catecholamines but have intact vagal pathways. A high-frequency component (HF; at 0.15-0.40 Hz) of the power spectrum of HR variability and its relative value against total power (HF/Total) were assessed using a wavelet transform to identify cardiac parasympathetic outflow. The relative contribution of cardiac parasympathetic and sympathetic outflows to controlling HR was estimated by comparing the HF/Total-HR relationship between age-matched tetraplegic and normal men. Six tetraplegic men with complete cervical spinal cord injury performed static arm exercise at 35% of the maximal voluntary contraction until exhaustion. Although resting cardiac output and arterial blood pressure were lower in tetraplegic than normal subjects, HR, HF, and HF/Total were not statistically different between the two groups. When tetraplegic subjects developed the same force during exercise as normal subjects, HF and HF/Total decreased to 67-90% of the preexercise control and gradually recovered 1.5 min after exercise. The amount and time course of the changes in HF/Total during and after exercise coincided well between both groups. In contrast, the increase in HR at the start of exercise was blunted in tetraplegic compared with normal subjects, and the HR recovery following exercise was also delayed. It is likely that, although the withdrawal response of cardiac parasympathetic outflow is preserved in tetraplegic subjects, sympathetic decentralization impairs the rapid acceleration of HR at the onset of exercise and the rapid deceleration following exercise. PMID:17761788

  8. 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

  9. 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.

  10. Input-output interactions and optimal monetary policy

    DEFF Research Database (Denmark)

    Petrella, Ivan; Santoro, Emiliano

    2011-01-01

    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...

  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. 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.

  13. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  14. 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.

  15. 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

  16. 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)

  17. 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.

  18. 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...

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. The application value of spatiotemporal image correlation combined with tomographic ultrasound imaging in prenatal screening of common cardiac malposition%时间空间相关成像技术联合断层超声显像技术在产前筛查常见心脏位置异常中的应用价值

    Institute of Scientific and Technical Information of China (English)

    吴娟; 栗河舟; 丛娟; 刘云

    2012-01-01

    目的:探讨时间空间相关成像技术联合断层超声显像技术(TUI-STIC技术)在产前筛查常见心脏位置异常中的临床应用价值.方法:应用时间空间相关成像技术采集胎儿心脏的容积图像,再应用断层超声显像技术进行分析,要求清晰显示上腹部横切面及四腔心切面并标明左右方位.结果:199例心脏位置异常胎儿心脏容积数据经断层超声显像技术处理均获得满意的上腹部横切面及四腔心切面.其中右位心67例;左旋心5例;中位心7例;异位心2例;心脏移位107例;心脏异构11例.结论:判断胎儿心脏位置的主要切面是上腹部横切面和四腔心切面.时间空间相关成像技术联合断层超声显像技术简易、准确,可作为产前筛查胎儿心脏位置异常的有效方法.%Objective; To explore the clinical application value of spatiotemporal image correlation combined with tomographic ultrasound imaging (STIC -TUI technique) in prenatal screening of common cardiac malposition. Methods; STIC technique was used to collect fetal cardiac volume images, then TUI technique was used for analysis, the transverse section through the upper abdominal portion and four - chamber view were displayed clearly, and the positions were indicated. Results; Satisfactory transverse section through the upper abdominal portion and four - chamber view were obtained after analyzing the data of fetal cardiac volume of 199 cases with fetal cardiac malposition by TUI technique. Sixty -seven cases with dextrocardia, five cases with levoverted heart, seven cases with mesocardia, two cases with exocardia, one hundred and seven cases with displacement of heart, and eleven cases with heterogeneous heart were found. Conclusion; The main views to judge fetal cardiac position include transverse section through the upper abdominal portion and four - chamber view, STIC - TUI technique is simple and accurate, which can be used as an effective method for

  4. 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

  5. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  6. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  7. 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.

  8. 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,...

  9. Spike output jitter, mean firing time and coefficient of variation

    Science.gov (United States)

    Feng, Jianfeng; Brown, David

    1998-01-01

    To understand how a single neurone processes information, it is critical to examine the relationship between input and output. Marsalek, Koch and Maunsell's study focused on output jitter (standard deviation of output interpike interval) found that for the integrate-and-fire (I&F) model this response measure converges towards zero as the number of inputs increases indefinitely when interarrival times of excitatory inputs (EPSPs) are normally or uniformly distributed. In this work we present a complete, theoretical investigation, corroborated by numerical simulation, of output jitter in the I&F model with a variety of input distributions and a range of values of number of inputs, N. Our main results are: the exponential distribution input is a critical case and its output jitter is independent of N. For input distributions with tails which decrease faster than the exponential distribution, output jitter converges to zero as discovered by Marsalek, Koch and Maunsell; whereas an input distribution with a more slowly decreasing tail induces divergence of output jitter. Exact formulae for mean firing time are also obtained which enable us to estimate the coefficient of variation. The I&F model with leakage is also briefly considered.

  10. 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

  11. 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

  12. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  13. 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.)

  14. 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.

  15. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  16. 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

  17. 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

  18. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  19. 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

  20. 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

  1. Increasing fill volume reduces cardiac performance in peritoneal dialysis

    DEFF Research Database (Denmark)

    Ivarsen, Per; Povlsen, Johan V; Jensen, Jens Dam

    2007-01-01

    BACKGROUND: It is generally accepted that peritoneal dialysis (PD) affects systemic haemodynamics less than haemodialysis, but little is known about changes in haemodynamics during PD. It is unknown if increasing PD volume causes changes in cardiovascular haemodynamics possibly increasing...... the demand on the heart even during normal daily activities. METHODS: Fifteen stable PD patients were included in this randomized, controlled, open-label crossover study. After drainage, we measured blood pressure, pulse rate and cardiac output (CO) after 30 min in the supine position. The measurements were...... differences were found between drained and 2 l and 3 l fill. CONCLUSION: The present study showed that cardiac performance decreased when increasing fill volume from 2 to 3 l in the supine position. The decreased cardiac performance was already present after 2 l fill in the upright position and did not change...

  2. 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.

  3. Cardiac and vascular changes in cirrhosis: Pathogenic mechanisms

    Institute of Scientific and Technical Information of China (English)

    HongQun Liu; Seyed Ali Gaskari; Samuel S Lee

    2006-01-01

    Cardiovascular abnormalities accompany both portal hypertension and cirrhosis. These consist of hyperdynamic circulation, defined as reduced mean arterial pressure and systemic vascular resistance, and increased cardiac output. Despite the baseline increased cardiac output,ventricular inotropic and chronotropic responses to stimuli are blunted, a condition known as cirrhotic cardiomyopathy. Both conditions may play an initiating or aggravating pathogenic role in many of the complications of liver failure or portal hypertension including ascites,variceal bleeding, hepatorenal syndrome and increased postoperative mortality after major surgery or liver transplantation. This review briefly examines the major mechanisms that may underlie these cardiovascular abnormalities, concentrating on nitric oxide, endogenous cannabinoids, central neural activation and adrenergic receptor changes. Future work should address the complex interrelationships between these systems.

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. Judicial Influence on Policy Outputs?

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg

    2015-01-01

    The ability of courts to generate political change has long been debated in national, comparative, and international politics. In the examination of the interaction between judicial and legislative politics, scholars have disagreed on the degree of judicial power and the ability of politics...... to override unwanted jurisprudence. In this debate, the Court of Justice of the European Union (CJEU) has become famous for its central and occasionally controversial role in European integration. This article examines to what extent and under which conditions judicial decisions influence European Union (EU......) 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...

  9. Output regulation problem for discrete-time linear time-delay systems by output feedback control

    Institute of Scientific and Technical Information of China (English)

    Yamin YAN; Jie HUANG

    2016-01-01

    In this paper, we study the output regulation problem of discrete linear time-delay systems by output feedback control. We have established some results parallel to those for the output regulation problem of continuous linear time-delay systems.

  10. 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.

  11. System for adjusting frequency of electrical output pulses derived from an oscillator

    Science.gov (United States)

    Bartholomew, David B.

    2006-11-14

    A system for setting and adjusting a frequency of electrical output pulses derived from an oscillator in a network is disclosed. The system comprises an accumulator module configured to receive pulses from an oscillator and to output an accumulated value. An adjustor module is configured to store an adjustor value used to correct local oscillator drift. A digital adder adds values from the accumulator module to values stored in the adjustor module and outputs their sums to the accumulator module, where they are stored. The digital adder also outputs an electrical pulse to a logic module. The logic module is in electrical communication with the adjustor module and the network. The logic module may change the value stored in the adjustor module to compensate for local oscillator drift or change the frequency of output pulses. The logic module may also keep time and calculate drift.

  12. 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

  13. 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".

  14. 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...

  15. 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.

  16. 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

  17. 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

    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 maintained......Changes in the importance of left ventricular (LV) systolic dysfunction and congestive heart failure (CHF) with time after an acute myocardial infarction (AMI) after the introduction of thrombolytic therapy have not been studied. LV systolic function, measured as wall motion index (WMI......) by 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...

  18. Clinical significance of lactate in acute cardiac patients

    Institute of Scientific and Technical Information of China (English)

    Chiara; Lazzeri; Serafina; Valente; Marco; Chiostri; Gian; Franco; Gensini

    2015-01-01

    Lactate, as a metabolite of easy and quick assessment, has been studied over time in critically ill patients in order to evaluate its prognostic ability. The present review is focused on the prognostic role of lactate levels in acute cardiac patients(that is with acute coronary syndrome, cardiogenic shock, cardiac arrest, non including post cardiac surgery patients). In patients with STelevation myocardial infarction treated with mechanical revascularization, hyperlactatemia identified a subset of patients at higher risk for early death and in-hospital complications, being strictly related mainly to hemodynamic derangement. The prognostic impact of hyperlactatemia on mortality has been documented in patients with cardiogenic shock and in those with cardiac arrest even if there is no cut-off value of lactate to be associated with worse outcome or to guide resuscitation or hemodynamic management. Therapeutic hypothermia seems to affect per se lactate values which have been shown to progressively decrease during hypothermia. The mechanism(s) accounting for lactate levels during hypothemia seem to be multiple ranging from the metabolic effects of reduced temperatures to the hemodynamic effects of hypothermia(i.e., reduced need of vasopressor agents). Serial lactate measurements over time, or lactate clearance, have been reported to be clinically more reliable than lactate absolute value also in acute cardiac patients. Despite differences in study design, timing of lactate measurements and type of acute cardiac conditions(i.e., cardiogenic shock, cardiac arrest, refractory cardiac arrest), available evidence strongly suggests that higher lactate levels can be observed on admission in non-survivors and that higher lactate clearance is associated with better outcome.

  19. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  20. Inherited cardiac disease

    Directory of Open Access Journals (Sweden)

    Philippe Charron

    2012-06-01

    Full Text Available Major advances have been achieved over the two last decades in the field of genetic cardiovascular diseases, not only through increased recognition and understanding of underlying molecular defects but also through rapid translation of knowledge into clinical practice. Genetic counseling and organization of cardiac family screening has become part of the medical management of these diseases, and these should be performed systematically unless an acquired cause has been diagnosed...

  1. 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...

  2. 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 ...

  3. THE PARTICIPATION MODE AND POSITION IN GLOBAL VALUE CHAINS OF CHINA AND JAPAN S MANUFACTURING INDUSTRY---Based on World Input-output Tables%中日制造业参与全球价值链分工模式及地位分析*--基于世界投入产出表

    Institute of Scientific and Technical Information of China (English)

    尹伟华

    2016-01-01

    本文基于世界投入产出表数据,通过构建后向和前向垂直专业化率及全球价值链地位指数,较全面地分析了中日两国制造业参与全球价值链的程度、模式和地位变化情况。结果表明:(1)中国制造业出口中国内增加值占比低于同期日本,其获益能力相对较低。(2)中日两国制造业后向和前向垂直专业化率均呈上升趋势,其参与全球价值链程度不断加深。(3)中国制造业参与全球价值链主要是以后向模式,而日本制造业主要是以前向模式。(4)中国制造业中国外增加值以最终产品为主,主要从事加工组装生产环节,而日本制造业中国外增加值以中间产品为主,专业化于关键零部件生产环节。(5)中日两国制造业主要是通过间接增加值出口实现全球价值链前向参与,且其国内的生产分工程度均在不断加深。(6)中国制造业位于全球价值链下游位置,且有一定的攀升趋势,而日本制造业位于全球价值链上游位置,但有一定的下滑趋势。%According to the ratios of vertical specialization including backward-linkage (VS)and for-ward-linkage (VS1)and global value chains (GVC)index,this paper analyzes the participation mode and position in GVC of China and Japan�s manufacturing industry using 1995—2011 world input-output tables (WIOTs)Our studies indicate the following:(1)Domestic value-added (DVA)share in China�s exports is lower than Japan�s It means that China�s profit ability is relatively low (2)VS and VS1 present an upward trend from 1995—2011 It means that the participation levels in GVC are rising for China and Japan�s man-ufacturing industry (3 )The participation modes of China�s manufacturing industry in GVC are mainly backward,while the participation modes of Japan�s manufacturing industry in GVC are mainly forward (4) China�s manufacturing industry which is dominated by foreign value-added (FVA

  4. Reduced pallidal output causes dystonia

    Directory of Open Access Journals (Sweden)

    Atsushi eNambu

    2011-11-01

    Full Text Available Dystonia is a neurological disorder characterized by sustained or repetitive involuntary muscle contractions and abnormal postures. In the present article, we will introduce our recent electrophysiological studies in hyperkinetic transgenic mice generated as a model of DYT1 dystonia and in a human cervical dystonia patient, and discuss the pathophysiology of dystonia on the basis of these electrophysiological findings. Recording of neuronal activity in the awake state of DYT1 dystonia model mice revealed reduced spontaneous activity with bursts and pauses in both internal (GPi and external (GPe segments of the globus pallidus. Electrical stimulation of the primary motor cortex evoked responses composed of excitation and subsequent long-lasting inhibition, the latter of which was never observed in normal mice. In addition, somatotopic arrangements were disorganized in the GPi and GPe of dystonia model mice. In a human cervical dystonia patient, electrical stimulation of the primary motor cortex evoked similar long-lasting inhibition in the GPi and GPe. Thus, reduced GPi output may cause increased thalamic and cortical activity, resulting in the involuntary movements observed in dystonia.

  5. 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

  6. The left ventricle as a mechanical engine: from Leonardo da Vinci to the echocardiographic assessment of peak power output-to-left ventricular mass.

    Science.gov (United States)

    Dini, Frank L; Guarini, Giacinta; Ballo, Piercarlo; Carluccio, Erberto; Maiello, Maria; Capozza, Paola; Innelli, Pasquale; Rosa, Gian M; Palmiero, Pasquale; Galderisi, Maurizio; Razzolini, Renato; Nodari, Savina

    2013-03-01

    The interpretation of the heart as a mechanical engine dates back to the teachings of Leonardo da Vinci, who was the first to apply the laws of mechanics to the function of the heart. Similar to any mechanical engine, whose performance is proportional to the power generated with respect to weight, the left ventricle can be viewed as a power generator whose performance can be related to left ventricular mass. Stress echocardiography may provide valuable information on the relationship between cardiac performance and recruited left ventricular mass that may be used in distinguishing between adaptive and maladaptive left ventricular remodeling. Peak power output-to-mass, obtained during exercise or pharmacological stress echocardiography, is a measure that reflects the number of watts that are developed by 100 g of left ventricular mass under maximal stimulation. Power output-to-mass may be calculated as left ventricular power output per 100 g of left ventricular mass: 100× left ventricular power output divided by left ventricular mass (W/100 g). A simplified formula to calculate power output-to-mass is as follows: 0.222 × cardiac output (l/min) × mean blood pressure (mmHg)/left ventricular mass (g). When the integrity of myocardial structure is compromised, a mismatch becomes apparent between maximal cardiac power output and left ventricular mass; when this occurs, a reduction of the peak power output-to-mass index is observed.

  7. Downscaling GCM Output with Genetic Programming Model

    Science.gov (United States)

    Shi, X.; Dibike, Y. B.; Coulibaly, P.

    2004-05-01

    Climate change impact studies on watershed hydrology require reliable data at appropriate spatial and temporal resolution. However, the outputs of the current global climate models (GCMs) cannot be used directly because GCM do not provide hourly or daily precipitation and temperature reliable enough for hydrological modeling. Nevertheless, we can get more reliable data corresponding to future climate scenarios derived from GCM outputs using the so called 'downscaling techniques'. This study applies Genetic Programming (GP) based technique to downscale daily precipitation and temperature values at the Chute-du-Diable basin of the Saguenay watershed in Canada. In applying GP downscaling technique, the objective is to find a relationship between the large-scale predictor variables (NCEP data which provide daily information concerning the observed large-scale state of the atmosphere) and the predictand (meteorological data which describes conditions at the site scale). The selection of the most relevant predictor variables is achieved using the Pearson's coefficient of determination ( R2) (between the large-scale predictor variables and the daily meteorological data). In this case, the period (1961 - 2000) is identified to represent the current climate condition. For the forty years of data, the first 30 years (1961-1990) are considered for calibrating the models while the remaining ten years of data (1991-2000) are used to validate those models. In general, the R2 between the predictor variables and each predictand is very low in case of precipitation compared to that of maximum and minimum temperature. Moreover, the strength of individual predictors varies for every month and for each GP grammar. Therefore, the most appropriate combination of predictors has to be chosen by looking at the output analysis of all the twelve months and the different GP grammars. During the calibration of the GP model for precipitation downscaling, in addition to the mean daily

  8. 血浆大内皮素1对心脏再同步治疗反应性的预测价值%Predictive value of big endothelin-1 to responsiveness to cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    杨新玮; 华伟; 王靖; 丁立刚; 刘志敏; 李崇强; 陈柯萍; 张澍

    2013-01-01

    Objective To assess the predictive potency of big endothelin-1 (big ET-1) to response to cardiac resynchronization therapy (CRT).Methods We retrospectively analyzed the data of patients who underwent CRT-P/D implantation from Jan 2009 to Dec 2011.Big ET-1 and NT-proBNP were tested by ELISA kit at baseline.NYHA functional class,echocardiography were evaluated both at baseline and follow-up.Simpson method was applied to measure left ventricular ejection fraction (LVEF).Improvement of LVEF by 0.05 and reduction in NYHA class ≥ 1 grade was defined as responder.Improvement of LVEF by twice or the absolute level ≥ 0.50 with NYHA class Ⅰ or Ⅱ grade was defined as super-responder.Results Overall 93 patients aged (60.8 ± 11.0) years old included in this observational study.During 12 ~ 50 (27 ± 11.0) months follow-up,there were 34 non-responders,24 responders and 35 super-responders.Level of plasma big ET-1 in three groups were (1.2±0.9) pmol/L、(0.8±0.4) pmol/L and (0.8±0.6) pmol/L(P =0.003),respectively.Correlation between big ET-1 and NT-proBNP and between big ET-1 and response to CRT was r =0.469 (P =0.001) and r =-0.237(P=0.022),respectively.Conclusion Plasma big ET-1 correlated with the severity of heart failure.It could serve as a response predictor to CRT.High level of big ET-1 indicated non-responder.%目的 评价血浆大内皮素l(big ET-1)预测心脏再同步治疗(CRT)反应性的临床价值.方法 本研究回顾性分析了2009年1月至2011年12月间在阜外心血管病医院植入心脏再同步治疗起搏器和/或心脏再同步治疗除颤器(CRT-P/D)的患者.酶联免疫吸附试验(ELISA)测定基线big ET-1及氨基末端B型脑钠肽前体(NT-proBNP)水平,采集基线及随访期心功能(NYHA分级)和超声心动图指标,用Simpson法测定左心室射血分数(LVEF).心功能降低Ⅰ级同时LVEF提高≥0.05定义为有反应;LVEF提高2倍或绝对值≥0.50同时心功能改善至Ⅰ或

  9. 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.

  10. Activation of mitochondrial STAT-3 and reduced mitochondria damage during hypothermia treatment for post-cardiac arrest myocardial dysfunction.

    Science.gov (United States)

    Huang, Chien-Hua; Tsai, Min-Shan; Chiang, Chih-Yen; Su, Yu-Jen; Wang, Tzung-Dau; Chang, Wei-Tien; Chen, Huei-Wen; Chen, Wen-Jone

    2015-11-01

    While therapeutic hypothermia improves the outcomes of individuals in cardiac arrest, the hemodynamic responses and mechanisms which underlie hypothermia-induced cardioprotection are not fully understood. Therefore, we investigated the mechanism by which induced hypothermia preserves cardiac function and protects against mitochondrial damage following cardiac arrest. Cardiac arrest was induced in adult male Wistar rats by asphyxiation for 8.5 min. Following resuscitation, the animals were randomly assigned to a hypothermia (32 °C) or normothermia (37 °C) group. Monitoring results showed that cardiac output at the fourth hour after resuscitation was significantly better in rats treated with hypothermia when compared to rats treated with normothermia (P mitochondrial permeability transition pores occurred less frequently in the hypothermic group. While complex I/III activity in the electron transport reaction was damaged after cardiac arrest and resuscitation, the degree of injury was ameliorated by hypothermia treatment (P mitochondrial integrity and electron transport activity.

  11. 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...

  12. 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

  13. 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

  14. 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.

  15. Cardiac Alternans Arising from an Unfolded Border-Collision Bifurcation

    CERN Document Server

    Zhao, Xiaopeng; Berger, Carolyn M; Krassowska, Wanda; Gauthier, Daniel J

    2007-01-01

    Following an electrical stimulus, the transmembrane voltage of cardiac tissue rises rapidly and remains at a constant value before returning to the resting value, a phenomenon known as an action potential. When the pacing rate of a periodic train of stimuli is increased above a critical value, the action potential undergoes a period-doubling bifurcation, where the resulting alternation of the action potential duration is known as alternans in the medical literature. Existing cardiac models treat alternans either as a smooth or as a border-collision bifurcation. However, recent experiments in paced cardiac tissue reveal that the bifurcation to alternans exhibits hybrid smooth/nonsmooth behaviors, which can be qualitatively described by a model of so-called unfolded border-collision bifurcation. In this paper, we obtain analytical solutions of the unfolded border-collision model and use it to explore the crossover between smooth and nonsmooth behaviors. Our analysis shows that the hybrid smooth/nonsmooth behavi...

  16. Case Report: Penetrating Cardiac Injury

    Directory of Open Access Journals (Sweden)

    Adem Grbolar

    2013-10-01

    Full Text Available Summary: Penetrating cardiac injurys caused by gunshots and penetrating tools have high mortality rates. The way of injury, how the cardiac area is effected and the presence of cardiac tamponadecauses mortality in different rates. However the better treatment quality of hospitals, increasingoperative techniques, and internel care unit quality has not been change during the years. Searching the literature, we want to present a 42 years old male patient whowas injured by knife and had a 1 cm skin wound on chest with cardiac tamponade. After sternotomy a 7 cm laseration was observed in heart. Cardioraphy was performed.

  17. 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.

  18. Risk stratification for sudden cardiac death.

    Science.gov (United States)

    Sabir, Ian N; Usher-Smith, Juliet A; Huang, Christopher L-H; Grace, Andrew A

    2008-01-01

    Recent advances in pharmacological and device-based therapies have provided a range of management options for patients at risk of sudden cardiac death (SCD). Since all such interventions come with their attendant risks, however, stratification procedures aimed at identifying those who stand to benefit overall have gained a new degree of importance. This review assesses the value of risk stratification measures currently available in clinical practice, as well as of others that may soon enter the market. Parameters that may be obtained only by performing invasive cardiac catheterisation procedures are considered separately from those that may be derived using more readily available non-invasive techniques. It is concluded that effective stratification is likely to require the use of composite parameters and that invasive procedures might only be justified in specific sub-groups of patients. PMID:19351522

  19. Cardiac MRI for myocardial ischemia.

    LENUS (Irish Health Repository)

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  20. Chinese Reclaimed Rubber Output to Break 3 Million Tons This Year

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    In the first half year of 2011, according to the statistics of 46 member units of Waste Rubber Comprehensive Utilization Branch of China Rubber Industry Association, the waste rubber utilization industry was in reasonable and stable development status without dramatic fluctuation. The gross industrial output value, industrial added value, output, sales revenue of products, profit, profit & tax and the export delivery value all increased compared with the same period of last year.

  1. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

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

  2. Monetary Policy and Hysteresis in Potential Output

    OpenAIRE

    Kienzler, Daniel; Schmid, Kai Daniel

    2013-01-01

    We show that actively stabilizing economic activity plays a more prominent role in the conduct of monetary policy when potential output is subject to hysteresis. We augment a basic New Keynesian model by hysteresis in potential output and contrast simulation outcomes of this extended model to the standard model. We find that considering hysteresis allows for a more realistic propagation of macroeconomic shocks and persistent movements in output after monetary shocks. Our central policy implic...

  3. Engine Output Increase of Two-stroke Combustion with Exhaust System Optimization

    OpenAIRE

    Bigoš, Petar; Puškár, Michal

    2008-01-01

    In principle, an exhaust system influences the maximum output and characteristic of a two-stroke combustion engine. The first part of the contribution deals with the possibility of transformation in a maximum output and a range of exploitable speed values by means of the change of exhaust manifold length in exhaust pipe section. This knowledge covers an output curve variability of an engine operating speed range. The second part of this contribution deals with the combustion product's tempera...

  4. Circadian profile of cardiac autonomic nervous modulation in healthy subjects

    DEFF Research Database (Denmark)

    Bonnemeier, Hendrik; Richardt, Gert; Potratz, Jürgen;

    2003-01-01

    UNLABELLED: Circadian Profile of Heart Rate Variability. INTRODUCTION: Although heart rate variability (HRV) has been established as a tool to study cardiac autonomic activity, almost no data are available on the circadian patterns of HRV in healthy subjects aged 20 to 70 years. METHODS AND RESULTS......: We investigated 166 healthy volunteers (81 women and 85 men; age 42 +/- 15 years, range 20-70) without evidence of cardiac disease. Time-domain HRV parameters were determined from 24-hour Holter monitoring and calculated as hourly mean values and mean 24-hour values. All volunteers were fully mobile...

  5. Use of the cardiopulmonary flow index to evaluate cardiac function in thoroughbred horses

    International Nuclear Information System (INIS)

    The ratio of the cardiopulmonary blood volume to stroke volume is called the cardiopulmonary flow index (CPFI). The CPFI can be determined indirectly from the simultaneous recording of a radiocardiogram and an electrocardiogram. The CPFI and cardiac output were measured simultaneously in horses that were diagnosed as having cardiac disease. The results obtained from these subjects were compared with those from control animals and significant differences were found between the mean CPFI of the control horses and those with macroscopically visible myocardial fibrosis on post mortem examination. No significant differences were found between the means of the cardiac output measured in either of the groups of horses. The effect of pharmacological acceleration of the heart rate on the CPFI was also studied. Significant differences were found between the mean CPFI and the slopes of the regression lines of CPFI on heart rate of the control and principal groups of horses. These differences were greatest at heart rates near to the resting heart rates of the individuals. The CPFI was found to be a more sensitive measure of cardiac function than cardiac output, in the horses. 16 refs., 2 figs., 2 tabs

  6. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 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.

  7. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. PMID:20884217

  8. Interventional cardiac catheterization.

    Science.gov (United States)

    Pihkala, J; Nykanen, D; Freedom, R M; Benson, L N

    1999-04-01

    Over the past decade, transcatheter interventions have become increasingly important in the treatment of patients with congenital heart lesions. These procedures may be broadly grouped as dilations (e.g., septostomy, valvuloplasty, angioplasty, and endovascular stenting) or as closures (e.g., vascular embolization and device closure of defects). Balloon valvuloplasty has become the treatment of choice for patients in all age groups with simple valvar pulmonic stenosis and, although not curative, seems at least comparable to surgery for congenital aortic stenosis in newborns to young adults. Balloon angioplasty is successfully applied to a wide range of aortic, pulmonary artery, and venous stenoses. Stents are useful in dilating lesions of which the intrinsic elasticity results in vessel recoil after balloon dilation alone. Catheter-delivered coils are used to embolize a wide range of arterial, venous, and prosthetic vascular connections. Although some devices remain investigational, they have been successfully used for closure of many arterial ducts and atrial and ventricular septal defects. In the therapy for patients with complex CHD, best results may be achieved by combining cardiac surgery with interventional catheterization. The cooperation among interventional cardiologists and cardiac surgeons was highlighted in a report of an algorithm to manage patients with tetralogy of Fallot or pulmonary atresia with diminutive pulmonary arteries, involving balloon dilation, coil embolization of collaterals, and intraoperative stent placement. In this setting, well-planned catheterization procedures have an important role in reducing the overall number of procedures that patients may require over a lifetime, with improved outcomes.

  9. Ictal Cardiac Ryhthym Abnormalities.

    Science.gov (United States)

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy. PMID:27347227

  10. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  11. 心脏超声筛查在胎儿先天性心脏病诊断中的应用价值%Value evaluation of fetal cardiac ultrasound in the detection of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    黄聚财; 蔡媛媛; 赖江琼

    2016-01-01

    Objective To compare the value of conventional ultrasound and conventional ultrasound in the diagnosis of fetal congenital heart disease, and to analyze the risk factors of fetal congenital heart disease, and to reduce the incidence of neonatal con⁃genital heart disease. Methods A total of 4000 pregnant women April 2013 to August 2014 in our hospital were randomly divided into the observation group and the control group according to the digital table method. The observation group gave conventional ultrasound and fetal heart examination. Patients in control group were treated with routine ultrasound examination. To compare the test results with the actual situation;and to screen out risk factors of pregnant women with fetal congenital heart disease. Results 9 cases of congenital heart disease were detected by conventional ultrasound and fetal heart examination, of 8 cases were diagnosed with congenital heart dis⁃ease, and the diagnostic accuracy rate was 90%;3 cases were diagnosed with congenital heart disease by conventional ultrasound ex⁃amination, and the diagnostic accuracy rate was 40%. The difference was statistically significant ( P<0.05) . Conclusion The accu⁃racy of routine ultrasound examination and fetal heart examination in screening of congenital heart disease is higher than that of the con⁃trol group, which is worthy of clinical application.%目的:比较常规超声检查与常规超声检查加胎心检查在胎儿先天性心脏病诊断中的应用价值,并分析胎儿先天性心脏病的危险因素。方法以2013年4月-2014年8月在我院健康检查的4000名孕妇为研究对象,按照数字数表法随机分为观察组和对照组。观察组采用常规超声检查+胎心检查,对照组采用常规超声检查,比较两组的检查结果,对筛查出怀有先天性心脏病胎儿的孕妇进行危险因素调查。结果常规超声检查加胎心产前检查发现9例先天性心脏病胎儿,漏检1

  12. Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults

    International Nuclear Information System (INIS)

    We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. (orig.)

  13. Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Hye-Joung; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan [University of Ulsan College of Medicine, Department of Cardiology and Heart Institute, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won [University of Ulsan College of Medicine, Department of Cardiothoracic surgery, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of)

    2015-06-01

    We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. (orig.)

  14. Affect intensity and cardiac arousal.

    Science.gov (United States)

    Blascovich, J; Brennan, K; Tomaka, J; Kelsey, R M; Hughes, P; Coad, M L; Adlin, R

    1992-07-01

    Relationships between affect intensity and basal, evoked, and perceived cardiac arousal were investigated in 3 experiments. Affect intensity was assessed using Larsen and Diener's (1987) Affect Intensity Measure (AIM). Cardiac arousal was evoked with exercise in the 1st study and with mental arithmetic in the 2nd and 3rd. Perceived cardiac arousal was measured under optimal conditions using a standard heartbeat discrimination procedure. Women as a group scored higher on the AIM. Affect intensity was unrelated to basal or evoked cardiac arousal and was negatively related to perceived cardiac arousal in all 3 studies. Data suggest that affect intensity, although unrelated to actual physiological arousal, is negatively related to the accuracy with which individuals perceive their own arousal. Results are discussed within the context of an expanded arousal-regulation model (Blascovich, 1990). PMID:1494983

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

    Directory of Open Access Journals (Sweden)

    João Jackson Duarte

    2010-06-01

    ( a-v O2. Afterwards, these parameters were compared with the cardiac index determined by thermodilution. RESULTS: There was good correlation between SvO2, C(avO2 of the venous right atrial blood and cardiac index meansured by termodiluition method, with sensibility and especificity good and high positive predict value and negative predict value. The PvO2 demonstrated poor sensibility in the estimative of low output. CONCLUSION: In cardiac surgery postoperative, the SvO2and the C(a-vO2 were safe parameters correlated with low cardiac output. The PvO2 demonstrated poor sensibility in the estimative of low output in postoperative cardiac surgery.

  16. Input/output plugin architecture for MDSplus

    Energy Technology Data Exchange (ETDEWEB)

    Stillerman, Joshua, E-mail: jas@psfc.mit.edu [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Fredian, Thomas, E-mail: twf@psfc.mit.edu [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Manduchi, Gabriele, E-mail: gabriele.manduchi@igi.cnr.it [Consorzio RFX, Euratom-ENEA Association, Corso Stati Uniti 4, Padova 35127 (Italy)

    2014-05-15

    The first version of MDSplus was released in 1991 for VAX/VMS. Since that time the underlying file formats have remained constant. The software however has evolved, it was ported to unix, linux, Windows, and Macintosh. In 1997 a TCP based protocol, mdsip, was added to provide network access to MDSplus data. In 2011 a mechanism was added to allow protocol plugins to permit the use of other transport mechanisms such as ssh to access data users. This paper describes a similar design which permits the insertion of plugins to handle the reading and writing of MDSplus data at the data storage level. Tree paths become URIs which specify the protocol, host, and protocol specific information. The protocol is provided by a dynamically activated shared library that can provide any consistent subset of the data store access API, treeshr. The existing low level network protocol called mdsip, is activated by defining tree paths like “host::/directory”. Using the new plugin mechanism this is re-implemented as an instance of the general plugin that replaces the low level treeshr input/output routines. It is specified by using a path like “mdsip://host/directory”. This architecture will make it possible to adapt the MDSplus data organization and analysis tools to other underlying data storage. The first new application of this, after the existing network protocol is implemented, will be a plugin based on a key value store. Key value stores, can provide inexpensive scalable, redundant data storage. An example of this might be an Amazon G3 plugin which would let you specify a tree path such as “AG3://container” to access MDSplus data stored in the cloud.

  17. Prediction of cardiac risk in patients undergoing vascular surgery

    Energy Technology Data Exchange (ETDEWEB)

    Morise, A.P.; McDowell, D.E.; Savrin, R.A.; Goodwin, C.A.; Gabrielle, O.F.; Oliver, F.N.; Nullet, F.R.; Bekheit, S.; Jain, A.C.

    1987-03-01

    In an attempt to determine whether noninvasive cardiac testing could be used to assess cardiac risk in patients undergoing surgery for vascular disease, the authors studied 96 patients. Seventy-seven patients eventually underwent major vascular surgery with 11 (14%) experiencing a significant cardiac complication. Thallium imaging was much more likely to be positive (p less than 0.01) in patients with a cardiac complication; however, there was a significant number of patients with cardiac complications who had a positive history or electrocardiogram for myocardial infarction. When grouped by complication and history of infarction, thallium imaging, if negative, correctly predicted low cardiac risk in the group with a history of infarction. Thallium imaging, however, did not provide a clear separation of risk in those without a history of infarction. Age and coronary angiography, on the other hand, did reveal significant differences within the group without a history of infarction. The resting radionuclide ejection fraction followed a similar pattern to thallium imaging. It is concluded that a positive history of myocardial infarction at any time in the past is the strongest risk predictor in this population and that the predictive value of noninvasive testing is dependent on this factor. Considering these findings, a proposed scheme for assessing risk that will require further validation is presented.

  18. Effects of Lifestyle Modification Programs on Cardiac Risk Factors

    Science.gov (United States)

    Razavi, Moaven; Fournier, Stephen; Shepard, Donald S.; Ritter, Grant; Strickler, Gail K.; Stason, William B.

    2014-01-01

    Medicare conducted a payment demonstration to evaluate the effectiveness of two intensive lifestyle modification programs in patients with symptomatic coronary artery disease: the Dr. Dean Ornish Program for Reversing Heart Disease (Ornish) and Cardiac Wellness Program of the Benson-Henry Mind Body Institute. This report describes the changes in cardiac risk factors achieved by each program during the active intervention year and subsequent year of follow-up. The demonstration enrolled 580 participants who had had an acute myocardial infarction, had undergone coronary artery bypass graft surgery or percutaneous coronary intervention within 12 months, or had documented stable angina pectoris. Of these, 98% completed the intense 3-month intervention, 71% the 12-month intervention, and 56% an additional follow-up year. Most cardiac risk factors improved significantly during the intense intervention period in both programs. Favorable changes in cardiac risk factors and functional cardiac capacity were maintained or improved further at 12 and 24 months in participants with active follow-up. Multivariable regressions found that risk-factor improvements were positively associated with abnormal baseline values, Ornish program participation for body mass index and systolic blood pressure, and with coronary artery bypass graft surgery. Expressed levels of motivation to lose weight and maintain weight loss were significant independent predictors of sustained weight loss (p = 0.006). Both lifestyle modification programs achieved well-sustained reductions in cardiac risk factors. PMID:25490202

  19. Effects of lifestyle modification programs on cardiac risk factors.

    Directory of Open Access Journals (Sweden)

    Moaven Razavi

    Full Text Available Medicare conducted a payment demonstration to evaluate the effectiveness of two intensive lifestyle modification programs in patients with symptomatic coronary artery disease: the Dr. Dean Ornish Program for Reversing Heart Disease (Ornish and Cardiac Wellness Program of the Benson-Henry Mind Body Institute. This report describes the changes in cardiac risk factors achieved by each program during the active intervention year and subsequent year of follow-up. The demonstration enrolled 580 participants who had had an acute myocardial infarction, had undergone coronary artery bypass graft surgery or percutaneous coronary intervention within 12 months, or had documented stable angina pectoris. Of these, 98% completed the intense 3-month intervention, 71% the 12-month intervention, and 56% an additional follow-up year. Most cardiac risk factors improved significantly during the intense intervention period in both programs. Favorable changes in cardiac risk factors and functional cardiac capacity were maintained or improved further at 12 and 24 months in participants with active follow-up. Multivariable regressions found that risk-factor improvements were positively associated with abnormal baseline values, Ornish program participation for body mass index and systolic blood pressure, and with coronary artery bypass graft surgery. Expressed levels of motivation to lose weight and maintain weight loss were significant independent predictors of sustained weight loss (p = 0.006. Both lifestyle modification programs achieved well-sustained reductions in cardiac risk factors.

  20. Prognostic Impact of Myocardial Injury Related to Various Cardiac and Noncardiac Conditions

    DEFF Research Database (Denmark)

    Sarkisian, Laura; Saaby, Lotte; Poulsen, Tina S;

    2016-01-01

    were classified into 5 categories of plausible related conditions: cardiac ischemic, cardiac nonischemic, noncardiac, multifactorial, or indeterminate. Follow-up was a minimum of 3 years, with all-cause mortality as the single end-point. RESULTS: A total of 3762 patients were considered, of whom 1089......BACKGROUND: Elevated cardiac troponins in clinical conditions other than myocardial infarction are well known. For such occurrences, the term "myocardial injury" has been proposed. The long-term outcome in patients with myocardial injury related to various cardiac and noncardiac clinical disorders...... is unknown. METHODS: During January 2010 to January 2011, we prospectively studied hospitalized patients who had cardiac troponin I measured on clinical indication. Patients with cardiac troponin I values >30 ng/L and no evidence of myocardial ischemia were diagnosed as having myocardial injury. Patients...

  1. Sublingual nitroglycerin used in routine tilt testing provokes a cardiac output-mediated vasovagal response

    NARCIS (Netherlands)

    Gisolf, J.; Westerhof, B.E.; Dijk, N. van; Wesseling, K.H.; Wieling, W.; Karemaker, J.M.

    2004-01-01

    Objectives We set out to determine the effect of sublingual nitroglycerin (NTG), as used during routine tilt testing in patients with unexplained syncope, on hemodynamic characteristics and baroreflex control of heart rate (HR) and systemic vascular resistance (SVR). Background Nitroglycerin is used

  2. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity

    Science.gov (United States)

    Verbanck, S.; Larsson, H.; Linnarsson, D.; Prisk, G. K.; West, J. B.; Paiva, M.

    1997-01-01

    In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P capacity remained elevated (11%; P pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG.

  3. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity

    Science.gov (United States)

    Verbanck, S.; Larsson, H.; Linnarsson, D.; Prisk, G. K.; West, J. B.; Paiva, M.

    1997-01-01

    In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P volume, to the extent that it was no longer significantly different from preflight control. Diffusing capacity remained elevated (11%; P pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG.

  4. Non-invasive measurement of cardiac output by a single breath constant expiratory technique.

    OpenAIRE

    1984-01-01

    A new single breath test has been developed that measures pulmonary blood flow (Qc) and pulmonary tissue volume by using the fact that Qc is proportional to the relationship between the absorption rate of acetylene (C2H2) from the alveolar gas and the rate of change of lung volume during constant expiratory flow. To make these measurements a bag in bottle system with a rolling seal spirometer, a mass spectrometer, and a minicomputer with analogue to digital conversion have been used. Qc was c...

  5. Measurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable

    DEFF Research Database (Denmark)

    Møller-Sørensen, H; Graeser, K; Hansen, K L;

    2014-01-01

    was placed in the following successive positions: supine, head-down tilt, head-up tilt, supine, supine with phenylephrine administration, pace heart rate 80 beats per minute (bpm), pace heart rate 110 bpm. TEE CO and PAC CO were measured simultaneously. The agreement was analysed by Bland-Altman plots...

  6. Relationship between stroke volume, cardiac output and filling of the heart during tilt

    DEFF Research Database (Denmark)

    Bundgaard-Nielsen, M.; Sorensen, H.; Dalsgaard, M.;

    2009-01-01

    %) in LVEDV because HR increased 3 bpm and CO decreased 0.5 l/min (ns). CONCLUSION: This study confirmed that SV and CO are maximal in resting, supine, healthy humans and decrease during HUT. However, 90 degrees HDT was associated with increased LVEDV and induced a reduction in SV Udgivelsesdato: 2009/11...

  7. 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

    BACKGROUND: If blood pressure (BP) falls during haemodialysis (HD) [intradialytic hypotension (IDH)] a common clinical practice is to reduce the extracorporeal blood flow rate (EBFR). Consequently the efficacy of the HD (Kt/V) is reduced. However, only very limited knowledge on the effect of redu...

  8. Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically unstable patients

    DEFF Research Database (Denmark)

    Hansen, Marco Bo; Treschow, Frederik; Skielboe, Martin;

    2013-01-01

    Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring...

  9. Effects of ventilation on cardiac output determined by inert gas rebreathing

    DEFF Research Database (Denmark)

    Damgaard, Morten; Norsk, Peter

    2005-01-01

    had no effects. CO was 1.0 +/- 0.2 l min(-1) higher when, rebreathing was performed after a forced expiration than following a normal tidal expiration. Serial determinations of CO required a 3-min interval between the measurements to avoid effects of recirculation of N(2)O. Changing RF from 15 to 30...... breaths min(-1) or adding serial dead space by up to 600 ml did not affect the determination of CO. In conclusion, the rebreathing procedure for determination of CO at rest should be performed following a normal tidal expiration with a rebreathing bag volume of between 1.5 and 2.5 l and with manoeuvres...

  10. Estimation of cardiac output and total peripheral resistance in preterm infants by arterial waveform analysis.

    Science.gov (United States)

    Zhang, Ying; Chan, Gregory S H; Tracy, Mark B; Hinder, Murray; Redmond, Stephen J; Savkin, Andrey V; Lovell, Nigel H

    2013-01-01

    This study investigated whether arterial blood pressure waveform analysis could be useful for estimating left ventricular outflow (LVO) and total peripheral resistance (TPR) in preterm infants. A cohort of 27 infants were studied, with 89 measurements of left ventricular outflow (LVO) using Doppler echocardiography and arterial pressure using catheters, performed in 0, 12, 24 and 36 hours after birth. TPR was computed as mean arterial pressure divided by LVO. The diastolic decay rate (1/τ) was obtained via fitting an exponential function to the last one third of each arterial pulse, with the mean rate computed from 50 pulses selected from each infant. This decay rate was considered to be inversely related to TPR while positively related to LVO. The results of regression analysis have confirmed that the diastolic decay rate had significant positive and negative relationships with LVO and TPR respectively(r = 0.383, P = 0.0002 and r = -0.379, P = 0.0002 respectively). These preliminary results demonstrated the potential utility of arterial pressure waveform analysis for estimating LVO and TPR in preterm infants, but more advanced multi-parameter models may be needed to improve accuracy of the estimation.

  11. Evaluation of cerebral electrical activity and cardiac output after patent ductus arteriosus ligation in preterm infants.

    LENUS (Irish Health Repository)

    Leslie, A T F S

    2013-11-01

    To characterize and investigate the relationship between systemic blood flow and pre- and postoperative cerebral electrical activity in preterm neonates undergoing patent ductus arteriosus (PDA) ligation.

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

    DEFF Research Database (Denmark)

    Calbet, José A L; Boushel, Robert

    2015-01-01

    , standard error of the estimate: 1.452 l/min, P coefficients of variation close to 5% for Q̇, global end......-diastolic volume, and intrathoracic blood volume. The mean coefficient of variation of EVLW, assessed with both indicators (ICG and thermal) was 17% and was sensitive enough to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, TPTd with bolus injection...

  13. Practice Output in College Language Classroom

    Institute of Scientific and Technical Information of China (English)

    张岩

    2010-01-01

    <正>Practice output constitutes an indispensable part in second language learning.Relevant theories like"Interface Position"and"Comprehensible Output"are discussed in order to analyze in detail how this practice can actually facilitate acquisition and finally pave the way for communicative output—a goal all language learners are striving for.

  14. DIST/AVC Out-Put Definition.

    Science.gov (United States)

    Wilkinson, Gene L.

    The first stage of development of a management information system for DIST/AVC (Division of Instructional Technology/Audio-Visual Center) is the definition of out-put units. Some constraints on the definition of output units are: 1) they should reflect goals of the organization, 2) they should reflect organizational structure and procedures, and…

  15. The Role of Output in Grammar Learning

    Institute of Scientific and Technical Information of China (English)

    尹莉; 段薇; 谢璐

    2014-01-01

    In China, English teachers tend to emphasize a lot on the importance of grammar learning because knowledge of gram⁃mar is the base of the competence of communication. This thesis just focuses on how output affects students ’grammar learning by analyzing the role of output in learning of English and the strategies of English learning.

  16. Cardiac evaluation of liver transplant candidates

    Institute of Scientific and Technical Information of China (English)

    Mercedes Susan Mandell; JoAnn Lindenfeld; Mei-Yung Tsou; Michael Zimmerman

    2008-01-01

    Physicians previously thought that heart disease was rare in patients with end stage liver disease. However, recent evidence shows that the prevalence of ischemic heart disease and cardiomyopathy is increased in transplant candidates compared to most other surgical candidates. Investigators estimate that up to 26% of all liver transplant candidates have at least one critical coronary artery stenosis and that at least half of these patients will die perioperatively of cardiac complications. Cardiomyopathy also occurs in greater frequency. While all patients with advanced cardiac disease have defects in cardiac performance, a larger than expected number of patients have classical findings of dilated, restrictive and hypertropic cardiomyopathy. This may explain why up to 56% of patients suffer from hypoxemia due to pulmonary edema following transplant surgery. There is considerable controversy on how to screen transplant candidates for the presence of heart disease. Questions focus upon, which patients should be screened and what tests should be used. This review examines screening strategies for transplant candidates and details the prognostic value of common tests used to identify ischemic heart disease. We also review the physiological consequences of cardiomyopathy in transplant candidates and explore the specific syndrome of "cirrhotic cardiomyopathy".

  17. Analysis on Value of X-Ray in the Diagnosis of Early Left Cardiac Insufficiency in Patients with Hypertensive Heart Disease%高血压性心脏病早期左心功能不全的X线诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    翟锦添; 张训平

    2016-01-01

    目的 观察高血压性心脏病早期左心功能不全的X线诊断情况, 分析X线的临床诊断价值. 方法 选取2010年12月到2014年12月期间在我院检查确诊的高血压性心脏病早期左心功能不全患者300例作为研究对象. 300例患者根据有无临床症状分为有症状组和无症状组, 有症状组208例患者, 无症状组92例患者, 所有患者分别进行X线检查和超声检查, 对比两组患者的诊断情况. 结果 有症状组X线检查出202例患者, 无症状组检查出72例患者; 有症状组超声检查出206例患者, 无症状组检查出78例患者; X线检查与超声检查的结果基本一致, 差异无统计学意义 (P>0.05); 有症状组的检出率明显高于无症状组的检出率, 差异具有统计学意义 (P0.05). The detection rate of symptomatic group was significantly higher than that of asymptomatic group (P<0.05). Clinical representation of X-ray for 300 cases showed that 260 cases of superior vein dilatation, 70 cases of pulmonary blood flow redistribution, 195 cases of the lung fuzzy, 115 cases of the subpleural edema, 60 cases of rib phrenic angle drainage, 45 cases of Kerley's B line, 235 cases of cardiac enlargement. Conclusions X-ray has high detection rate for early left cardiac insufficiency in patients with hypertensive heart disease, especially for patients with clinical symptoms, which has a certain clinical application value.

  18. Crop Insurance, Premium Subsidy and Agricultural Output

    Institute of Scientific and Technical Information of China (English)

    XU Jing-feng; LIAO Pu

    2014-01-01

    This paper studied the effects of crop insurance on agricultural output with an economic growth model. Based on Ramsey-Cass-Koopmans (RCK) model, a basic model of agriculture economic growth was developed. Extending the basic model to incorporate uncertainty and insurance mechanism, a risk model and a risk-insurance model were built to study the inlfuences of risk and crop insurance on agricultural output. Compared with the steady states of the three models, the following results are achieved:(i) agricultural output decreases if we introduce uncertainty into the risk-free model;(ii) crop insurance promotes agriculture economic growth if insurance mechanism is introduced into the risk model;(iii) premium subsidy constantly improves agricultural output. Our contribution is that we studied the effects of crop insurance and premium subsidy from the perspective of economic growth in a dynamic framework, and proved the output promotion of crop insurance theoretically.

  19. A methodological approach to reporting corrected small field relative outputs

    International Nuclear Information System (INIS)

    Purpose: The goal of this work was to set out a methodology for measuring and reporting small field relative output and to assess the application of published correction factors across a population of linear accelerators. Methods and materials: Measurements were made at 6 MV on five Varian iX accelerators using two PTW T60017 unshielded diodes. Relative output readings and profile measurements were made for nominal square field sizes of side 0.5 to 1.0 cm. The actual in-plane (A) and cross-plane (B) field widths were taken to be the FWHM at the 50% isodose level. An effective field size, defined as FSeff=√(A·B), was calculated and is presented as a field size metric. FSeff was used to linearly interpolate between published Monte Carlo (MC) calculated kQclin,Qmsrfclin,fmsr values to correct for the diode over-response in small fields. Results: The relative output data reported as a function of the nominal field size were different across the accelerator population by up to nearly 10%. However, using the effective field size for reporting showed that the actual output ratios were consistent across the accelerator population to within the experimental uncertainty of ±1.0%. Correcting the measured relative output using kQclin,Qmsrfclin,fmsr at both the nominal and effective field sizes produce output factors that were not identical but differ by much less than the reported experimental and/or MC statistical uncertainties. Conclusions: In general, the proposed methodology removes much of the ambiguity in reporting and interpreting small field dosimetric quantities and facilitates a clear dosimetric comparison across a population of linacs

  20. PRESAGE 3D dosimetry accurately measures Gamma Knife output factors

    Science.gov (United States)

    Klawikowski, Slade J.; Yang, James N.; Adamovics, John; Ibbott, Geoffrey S.

    2014-12-01

    Small-field output factor measurements are traditionally very difficult because of steep dose gradients, loss of lateral electronic equilibrium, and dose volume averaging in finitely sized detectors. Three-dimensional (3D) dosimetry is ideal for measuring small output factors and avoids many of these potential challenges of point and 2D detectors. PRESAGE 3D polymer dosimeters were used to measure the output factors for the 4 mm and 8 mm collimators of the Leksell Perfexion Gamma Knife radiosurgery treatment system. Discrepancies between the planned and measured distance between shot centers were also investigated. A Gamma Knife head frame was mounted onto an anthropomorphic head phantom. Special inserts were machined to hold 60 mm diameter, 70 mm tall cylindrical PRESAGE dosimeters. The phantom was irradiated with one 16 mm shot and either one 4 mm or one 8 mm shot, to a prescribed dose of either 3 Gy or 4 Gy to the 50% isodose line. The two shots were spaced between 30 mm and 60 mm apart and aligned along the central axis of the cylinder. The Presage dosimeters were measured using the DMOS-RPC optical CT scanning system. Five independent 4 mm output factor measurements fell within 2% of the manufacturer’s Monte Carlo simulation-derived nominal value, as did two independent 8 mm output factor measurements. The measured distances between shot centers varied by ±0.8 mm with respect to the planned shot displacements. On the basis of these results, we conclude that PRESAGE dosimetry is excellently suited to quantify the difficult-to-measure Gamma Knife output factors.