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Sample records for cardiography

  1. Reliability of impedance cardiography in measuring central haemodynamics

    DEFF Research Database (Denmark)

    Mehlsen, J; Bonde, J; Stadeager, C;

    1991-01-01

    The purpose of the study described here was to investigate the reliability of impedance cardiography (IC) in measuring cardiac output (CO) and central blood volume. Absolute values and changes in these variables obtained by impedance cardiography and by isotope- or thermodilution techniques were...... healthy subjects and in 25 unmedicated patients with ischaemic heart disease. We obtained significant correlations between absolute values (y = 0.68x + 1.48) and changes (y = 1.00x + 0.0003) in CO measured by IC and isotope- or thermodilution. IC significantly overestimated absolute values of CO (P less...... suitable for repeated measurements in studies on the haemodynamic effects of physiological or pharmacological intervention. Impedance cardiography is sufficiently reliable for comparison of absolute values of CO between different groups of patients. We cannot recommend impedance cardiography for...

  2. [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

  3. The IMPACT shirt: textile integrated and portable impedance cardiography

    International Nuclear Information System (INIS)

    Measurement of hemodynamic parameters such as stroke volume (SV) via impedance cardiography (ICG) is an easy, non-invasive and inexpensive way to assess the health status of the heart. We present a possibility to use this technology for monitoring risk patients at home. The IMPACT Shirt (IMPedAnce Cardiography Textile) has been developed with integrated textile electrodes and textile wiring, as well as with portable miniaturized hardware. Several textile materials were characterized in vitro and in vivo to analyze their performance with regard to washability, and electrical characteristics such as skin-electrode impedance, capacitive coupling and subjective tactile feeling. The small lightweight hardware measures ECG and ICG continuously and transmits wireless data via Bluetooth to a mobile phone (Android) or PC for further analysis. A lithium polymer battery supplies the circuit and can be charged via a micro-USB. Results of a proof-of-concept trial show excellent agreement between SV assessed by a commercial device and the developed system. The IMPACT Shirt allows monitoring of SV and ECG on a daily basis at the patient’s home. (paper)

  4. A hybrid approach for quantifying aortic valve stenosis using impedance cardiography and echocardiography

    OpenAIRE

    Daralammouri, Yunis; Ayoub, Khubaib; Badrieh, Najwan; Lauer, Bernward

    2016-01-01

    Background Impedance cardiography (IC) is a noninvasive modality that utilizes changes in impedance across the thorax to assess hemodynamic parameters, including stroke volume (SV). This study compared aortic valve area (AVA) as assessed by a hybrid approach of transthoracic echocardiography (TTE) and impedance cardiography (IC) to AVA determined at cardiac catheterization using the Gorlin equation. Methods A total of 30 patients with moderate to severe aortic stenosis underwent AVA measureme...

  5. Hemodynamic evaluation in pregnancy: limitations of impedance cardiography

    International Nuclear Information System (INIS)

    Impedance cardiography (ICG) has been proposed to estimate the stroke volume (SV) and cardiac output (CO) in various medical indications. The aim of this study was to explore the reliability of ICG during pregnancy with respect to SV and CO measurements. Blood pressure, heart rate and thoracic impedance were monitored during the course of pregnancy and related ICG patterns analyzed. We determined thoracic impedance (Z0), left ventricular ejection time (LVET) and the maximum value of the first derivative of the impedance waveform (dZ/dt)max beat-to-beat. The two main components of non-invasive SV estimation, LVET and (dZ/dt)max, decreased in week 35 relative to week 12 by 7.6% ± 4.8% and by 36.0% ± 14.0%, respectively, based on a decrease in R–R interval of 9.9% ± 9.7%, whereas changes in Z0 did not play a significant role. Furthermore, the decrease of (dZ/dt)max was greater in the third compared to the second trimester of pregnancy. Taking into account an 18.2% ± 6.8% body weight increase, the calculated SV decreased in week 35 relative to week 12 by 19.2% ± 14.3%. The normalized term ((dZ/dt)max)/Z0 explained 85–94% of the variance of SV change after week 20. These results were confirmed for fixed R–R interval at a constant value across the repeated measurements. Based on beat-to-beat analysis of the main components of non-invasive SV estimation by ICG, measured repeatedly throughout normal pregnancy, we conclude that SV calculations render invalid data. Our findings strongly suggest that CO cannot be reliably assessed with ICG in pregnant women. (paper)

  6. 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...

  7. Impedance cardiography: Pulsatile blood flow and the biophysical and electrodynamic basis for the stroke volume equations

    OpenAIRE

    Bernstein, Donald P.

    2010-01-01

    Impedance cardiography (ICG) is a branch of bioimpedance pimarily concerned with the determination of left ventricular stroke volume (SV). As implemented, using the transthoracic approach, the technique involves applying a current field longitudinally across a segment of thorax by means of a constant magnitude, high frequency, low amplitude alternating current (AC). By Ohm's Law, the voltage difference measured within the current field is proportional to the electrical impedance Z (&Omega...

  8. Textrode-enabled transthoracic electrical bioimpedance measurements - towards wearable applications of impedance cardiography

    OpenAIRE

    Juan Carlos Márquez Ruiz; Markus Rempfler; Fernando Seoane; Kaj Lindecrantz

    2013-01-01

    During the last decades the use of Electrical Bioimpedance (EBI) in the medical field has been subject of extensive research, especially since it is an affordable, harmless and non-invasive technology. In some specific applications such as body composition assessment where EBI has proven a good degree of effectiveness and reliability, the use of textile electrodes and measurement garments have shown a good performance and reproducible results. Impedance Cardiography (ICG) is another modality ...

  9. Non-invasive measurement of stroke volume and left ventricular ejection fraction. Radionuclide cardiography compared with left ventricular cardioangiography

    DEFF Research Database (Denmark)

    Kelbaek, H; Svendsen, Jesper Hastrup; Aldershvile, J;

    2011-01-01

    The stroke volume (SV) was determined by first passage radionuclide cardiography and the left ventricular ejection fraction (LVEF) by multigated radionuclide cardiography in 20 patients with ischemic heart disease. The results were evaluated against those obtained by the invasive dye dilution...... or thermodilution and left ventricular cardioangiographic techniques. In a paired comparison the mean difference between the invasive and radionuclide SV was -1 ml (SED 3.1) with a correlation coefficient of 0.83 (p less than 0.01). Radionuclide LVEF values also correlated well with cardioangiographic measurements...

  10. 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.

  11. A comparison of systolic time intervals measured by impedance cardiography and carotid pulse tracing

    DEFF Research Database (Denmark)

    Mehlsen, J; Bonde, J; Rehling, Michael;

    1990-01-01

    .001) and found that left ventricular ejection times were longer when determined by the carotid technique (p less than 0.01). We found a significant correlation between drug-induced changes in STI-variables measured by the two methods (p less than 0.001). Both methods had a high degree of reproducibility......The purpose of this study was to compare the systolic time intervals (STI) obtained by impedance cardiography and by the conventional carotid technique. This comparison was done with respect to: 1) correlations between variables obtained by the two methods, 2) ability to reflect drug......-induced changes, 3) reliability in terms of reproducibility and 4) heart rate dependency of the variables measured. The study included 25 unmedicated patients with ischaemic heart disease and 36 healthy subjects. We obtained significant correlations between STI-variables measured by the two methods (p less than 0...

  12. 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.

  13. Computer program for analysis of impedance cardiography signals enabling manual correction of points detected automatically

    Science.gov (United States)

    Oleksiak, Justyna; Cybulski, Gerard

    2014-11-01

    The aim of this work was to create a computer program, written in LabVIEW, which enables the visualization and analysis of hemodynamic parameters. It allows the user to import data collected using ReoMonitor, an ambulatory monitoring impedance cardiography (AICG) device. The data include one channel of the ECG and one channel of the first derivative of the impedance signal (dz/dt) sampled at 200Hz and the base impedance signal (Z0) sampled every 8s. The program consist of two parts: a bioscope allowing the presentation of traces (ECG, AICG, Z0) and an analytical portion enabling the detection of characteristic points on the signals and automatic calculation of hemodynamic parameters. The detection of characteristic points in both signals is done automatically, with the option to make manual corrections, which may be necessary to avoid "false positive" recognitions. This application is used to determine the values of basic hemodynamic variables: pre-ejection period (PEP), left ventricular ejection time (LVET), stroke volume (SV), cardiac output (CO), and heart rate (HR). It leaves room for further development of additional features, for both the analysis panel and the data acquisition function.

  14. Textrode-enabled transthoracic electrical bioimpedance measurements - towards wearable applications of impedance cardiography

    Directory of Open Access Journals (Sweden)

    Juan Carlos Márquez Ruiz

    2013-10-01

    Full Text Available During the last decades the use of Electrical Bioimpedance (EBI in the medical field has been subject of extensive research, especially since it is an affordable, harmless and non-invasive technology. In some specific applications such as body composition assessment where EBI has proven a good degree of effectiveness and reliability, the use of textile electrodes and measurement garments have shown a good performance and reproducible results. Impedance Cardiography (ICG is another modality of EBI that can benefit from the implementation and use of wearable sensors. ICG technique is based on continuous impedance measurements of a longitudinal segment across the thorax taken at a single frequency. The need for specific electrode placement on the thorax and neck can be easily ensured with the use of a garment with embedded textile electrodes, textrodes. The first step towards the implementation of ICG technology into a garment is to find out if ICG measurements with textile sensors give a good enough quality of the signal to allow the estimation of the fundamental ICG parameters. In this work, the measurement performance of a 2-belt set with incorporated textrodes for thorax and neck was compared against ICG measurements obtained with Ag/AgCl electrodes. The analysis was based on the quality of the fundamental ICG signals (∆Z, dZ/dt and ECG, systolic time intervals and other ICG parameters. The obtained results indicate the feasibility of using textrodes for ICG measurements with consistent measurements and relatively low data dispersion. Thus, enabling the development of measuring garments for ICG measurements.

  15. Design and Implementation of a Portable Impedance Cardiography System for Noninvasive Stroke Volume Monitoring.

    Science.gov (United States)

    Yazdanian, Hassan; Mahnam, Amin; Edrisi, Mehdi; Esfahani, Morteza Abdar

    2016-01-01

    Measurement of the stroke volume (SV) and its changes over time can be very helpful for diagnosis of dysfunctions in the blood circulatory system and monitoring their treatments. Impedance cardiography (ICG) is a simple method of measuring the SV based on changes in the instantaneous mean impedance of the thorax. This method has received much attention in the last two decades because it is noninvasive, easy to be used, and applicable for continuous monitoring of SV as well as other hemodynamic parameters. The aim of this study was to develop a low-cost portable ICG system with high accuracy for monitoring SV. The proposed wireless system uses a tetrapolar configuration to measure the impedance of the thorax at 50 kHz. The system consists of carefully designed precise voltage-controlled current source, biopotential recorder, and demodulator. The measured impedance was analyzed on a computer to determine SV. After evaluating the system's electronic performance, its accuracy was assessed by comparing its measurements with the values obtained from Doppler echocardiography (DE) on 5 participants. The implemented ICG system can noninvasively provide a continuous measure of SV. The signal to noise ratio of the system was measured above 50 dB. The experiments revealed that a strong correlation (r = 0.89) exists between the measurements by the developed system and DE (P measured simply and reliably by the developed system, but more detailed validation studies should be conducted to evaluate the system performance. There is a good promise to upgrade the system to a commercial version domestically for clinical use in the future. PMID:27014612

  16. Comparison of norepinephrine and dopamine in the management of septic shock using impedance cardiography

    Directory of Open Access Journals (Sweden)

    Mathur Sharad

    2007-01-01

    Full Text Available Objective: Vasoconstrictors are one of the therapeutic modalities in the treatment of septic shock. In the present study, we have compared the effects of dopamine and norepinephrine in the treatment of septic shock with pre-defined end-points and continuous non-invasive cardiac output monitoring using impedance cardiography. Design: Randomized controlled trial. Settings: Sixteen-bedded mixed intensive care unit of a tertiary care teaching institution. Materials and Methods: The study included 50 consecutive patients presenting with septic shock and divided randomly into two groups with 25 patients in each group. Group I patients were treated with dopamine and those in Group II were treated with norepinephrine. They were optimized with fluid resuscitation upto CVP>10 cm of H 2 O, packed red cells transfusion upto hematocrit> 30, oxygenation and ventilation upto PaO 2 >60 mmHg before the inotropes were started. The goal of therapy was to achieve and maintain for six hours, all of the following: (1 SBP> 90 mm Hg, (2 SVRI> 1100 dynes.s/cm 5 m 2 , (3 Cardiac Index> 4.0L/min/m 2 , (4 IDO 2 > 550 ml/min/m 2 and (5 IVO 2 > 150 ml/min/m 2 . Measurements: The demographic data, baseline parameters and post-treatment parameters were statistically analyzed by using t-test. Results: The post-treatment parameters were statistically significant showing the superiority of norepinephrine over dopamine in optimization of hemodynamics and patient survival. Significant improvement in systolic blood pressure, heart rate, cardiac index, SVRI, IVO 2 and urine output were found in norepinephrine group than the dopamine group. Dopamine showed a response in 10 out of 25 patients up to a maximum dose of 25 mcg/kg/min while with norepinephrine, 19 patients responded up to a maximum dose of 2.5 mcg/kg/min The hemodynamic parameters were preserved in norepinephrine group with better preservation of organ perfusion and oxygen utilization with maintenance of splanchnic and

  17. Automated Classification of Disease Patterns from Echo-cardiography Images Based on Shape Features of the Left Ventricle

    International Nuclear Information System (INIS)

    Computer assisted diagnosis using analysis of medical images is an area of active research in health informatics. This paper proposes a technique for indication of heart diseases by using information related to shapes of the left ventricle (LV). LV boundaries are tracked from echo-cardiography images taken from LV short axis view, corresponding to two disease conditions viz. dilated cardiomyopathy and hypertrophic cardiomyopathy, and discriminated from the normal condition. The LV shapes are modeled using shape histograms generated by plotting the frequency of normalized radii lengths drawn from the centroid to the periphery, against a specific number of bins. A 3-layer neural network activated by a log-sigmoid function is used to classify the shape histograms into one of the three classes. Experimentations on a dataset of 240 images show recognition accuracies of the order of 80%.

  18. Impedance cardiography: Pulsatile blood flow and the biophysical and electrodynamic basis for the stroke volume equations

    Directory of Open Access Journals (Sweden)

    Donald P Bernstein

    2010-01-01

    Full Text Available Impedance cardiography (ICG is a branch of bioimpedance pimarily concerned with the determination of left ventricular stroke volume (SV. As implemented, using the transthoracic approach, the technique involves applying a current field longitudinally across a segment of thorax by means of a constant magnitude, high frequency, low amplitude alternating current (AC. By Ohm's Law, the voltage difference measured within the current field is proportional to the electrical impedance Z (Ω. Without ventilatory or cardiac activity, Z is known as the transthoracic, static base impedance Z0. Upon ventricular ejection, a characteristic time dependent cardiac-synchronous pulsatile impedance change is obtained, ΔZ(t, which, when placed electrically in parallel with Z0, constitutes the time-variable total transthoracic impedance Z(t. ΔZ(t represents a dual-element composite waveform, which comprises both the radially-oriented volumetric expansion of and axially-directed forward blood flow within both great thoracic arteries. In its majority, however, ΔZ(t is known to primarily emanate from the ascending aorta. Conceptually, commonly implemented methods assume a volumetric origin for the peak systolic upslope of ΔZ(t, (i.e. dZ/dtmax, with the presumed units of Ω·s-1. A recently introduced method assumes the rapid ejection of forward flowing blood in earliest systole causes significant changes in the velocity-induced blood resistivity variation (Δρb(t, Ωcm·s-1, and it is the peak rate of change of the blood resistivity variation dρb(t/dtmax (Ωcm·s-2 that is the origin of dZ/dtmax. As a consequence of dZ/dtmax peaking in the time domain of peak aortic blood acceleration, dv/dtmax (cm·s-2, it is suggested that dZ/dtmax is an ohmic mean acceleration analog (Ω·s-2 and not a mean flow or velocity surrogate as generally assumed. As conceptualized, the normalized value, dZ/dtmax/Z0, is a dimensionless ohmic mean acceleration equivalent (s-2

  19. Preliminary data from {gamma}-cardiography during the abatement of an asthmatic attack (1961); Premieres donnees de la {gamma}-cardiographie au decours de l'etat de mal asthmatique (1961)

    Energy Technology Data Exchange (ETDEWEB)

    Georges, R.; Vernejoul, P. de; Raynaud, C.; Blanchon, P.; Kellershohn, C.; Turiaf, J. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1961-07-01

    The authors used gamma cardiology during the abatement of 16 cases of asthma with a view to detecting heart attacks not otherwise visible with routine methods of examination: clinical, radiological and electro-cardio-graphical. In gamma cardiology, a radioactive indicator is used and its path followed in the cavities of the heart. The method makes it possible to study the circulation in the right heart, the pulmonary crossing, and the left heart, as well as evaluation of the heart-flow. As a result of their investigations the authors, after having discussed the significance of the data obtained with the method, suggest that it is possible by the use of gamma cardiography during the abatement of an asthma attack: 1- To confirm attacks of the right heart which have already been detected by ordinary methods. 2- To confirm the presence of modifications in the recorded curves which suggest, in the case of the left heart, possible attack; such on attack is also indicated, in a small number of cases, by electrocardiography curves. Some considerations are put forward by the authors concerning the physiopathology of attacks on the left heart. (authors) [French] Les auteurs ont fait appel a la gammacardiographie au decours de 16 cas d'etat de mal asthmatique, dans le but d'objectiver des atteintes cardiaques incapables d'etre revelees par les moyens d'exploration de routine: cliniques, radiologiques et electrocardiographiques. La gammacardiographie est un procede qui enregistre a l'aide d'un indicateur radioactif, le trajet de celui-ci dans les cavites cardiaques. Elle permet l'etude de la circulation dans le coeur droit, de la traversee pulmonaire, et le coeur gauche, de meme que le calcul du debit cardiaque. Au terme de leurs investigations, les auteurs apres avoir discute la signification des donnees fournies par la methode admettent que la gammacardiographie objective au secours de l'etat de mal asthmatique: 1- La confirmation de l

  20. Normal left atrial dimensions in indians by echo-cardiography

    Directory of Open Access Journals (Sweden)

    Kulkarni D

    1979-01-01

    Full Text Available One hundred normal Indian subjects were studied to establish the normal left atrial dimension (LAD, left atrial dimension cor-rected to body surface area (LA index and left atrium to aorta ratio (LA/AO for this population. Normal mean LAD was 21.9 ± 3.6 mm (12 mm to 30 mm. Elderly subjects had higher mean LAD (25.2 ± 3.6 mm. The LA index for adults was 14.1 ± 2.5 mm. LA index for younger subjects was higher because of low body sur-face area. Mean LA/AO was 0.95± 0.22;LA/AO greater than 1.17 is suggested as a criterion for LA enlargement.

  1. Development of a wearable multi-frequency impedance cardiography device.

    Science.gov (United States)

    Weyer, Sören; Menden, Tobias; Leicht, Lennart; Leonhardt, Steffen; Wartzek, Tobias

    2015-02-01

    Cardiovascular diseases as well as pulmonary oedema can be early diagnosed using vital signs and thoracic bio-impedance. By recording the electrocardiogram (ECG) and the impedance cardiogram (ICG), vital parameters are captured continuously. The aim of this study is the continuous monitoring of ECG and multi-frequency ICG by a mobile system. A mobile measuring system, based on 'low-power' ECG, ICG and an included radio transmission is described. Due to the high component integration, a board size of only 6.5 cm×5 cm could be realized. The measured data can be transmitted via Bluetooth and visualized on a portable monitor. By using energy-efficient hardware, the system can operate for up to 18 hs with a 3 V battery, continuously sending data via Bluetooth. Longer operating times can be realized by decreased transfer rates. The relative error of the impedance measurement was less than 1%. The ECG and ICG measurements allow an approximate calculation of the heart stroke volume. The ECG and the measured impedance showed a high correlation to commercial devices (r=0.83, p<0.05). In addition to commercial devices, the developed system allows a multi-frequency measurement of the thoracic impedance between 5-150 kHz. PMID:25559781

  2. 4D embryonic cardiography using gated optical coherence tomography

    Science.gov (United States)

    Jenkins, M. W.; Rothenberg, F.; Roy, D.; Nikolski, V. P.; Hu, Z.; Watanabe, M.; Wilson, D. L.; Efimov, I. R.; Rollins, A. M.

    2006-01-01

    Simultaneous imaging of very early embryonic heart structure and function has technical limitations of spatial and temporal resolution. We have developed a gated technique using optical coherence tomography (OCT) that can rapidly image beating embryonic hearts in four-dimensions (4D), at high spatial resolution (10-15 μm), and with a depth penetration of 1.5 - 2.0 mm that is suitable for the study of early embryonic hearts. We acquired data from paced, excised, embryonic chicken and mouse hearts using gated sampling and employed image processing techniques to visualize the hearts in 4D and measure physiologic parameters such as cardiac volume, ejection fraction, and wall thickness. This technique is being developed to longitudinally investigate the physiology of intact embryonic hearts and events that lead to congenital heart defects.

  3. Assessing cardiac preload by the Initial Systolic Time Interval obtained from impedance cardiography

    Directory of Open Access Journals (Sweden)

    Jan H Meijer

    2010-01-01

    Full Text Available The Initial Systolic Time Interval (ISTI, obtained from the electrocardiogram (ECG and impedance cardiogram (ICG, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart and reflects an early active period of the cardiac cycle. The clinical relevance of this time interval is subject of study. This paper presents preliminary results of a pilot study investigating the use of ISTI in evaluating and predicting the circulatory response to fluid administration in patients after coronary artery bypass graft surgery, by comparing ISTI with cardiac output (CO responsiveness. Also the use of the pulse transit time (PTT, earlier recommended for this purpose, is investigated. The results show an inverse relationship between ISTI and CO at all moments of fluid administration and also an inverse relationship between the changes ΔISTI and ΔCO before and after full fluid administration. No relationships between PTT and CO or ΔPTT and ΔCO were found. It is concluded that ISTI is dependent upon preload, and that ISTI has the potential to be used as a clinical parameter assessing preload.

  4. [Usefulness of exercise electro-cardiography in a THP (Total Health Promotion Plan)].

    Science.gov (United States)

    Mitsumune, T; Matsuo, K; Funaki, K; Morikawa, A; Takamura, K; Aoi, T; Senoh, E; Kayashima, E; Hara, Y

    1997-09-01

    We conducted ergometer exercise electrocardiography (ergometry) on 3,477 subjects in a THP (Total Health Promotion Plan). One hundred cases in which abnormal findings were detected by ergometry were analyzed. In the hundred cases there were 3 patterns: abnormal ST change, 50 cases; abnormal reaction, 22 cases; and extreme increase in blood pressure, 28 cases. Electrocardiograms (ECG) in 78 of these 100 cases indicated no abnormalities. Of the 31 subjects who underwent further examinations, in 18 cases abnormal findings were detected, and further observation or treatment was necessary. They were over two thirds of the 26 cases requiring observation or treatment on further examination. In other words, exercise electrocardiography revealed more than 3 times as many problem cases as electrocardiography only. One hundred and four cases were analyzed, and among them abnormal findings on ECG made further examination or treatment necessary. Of 68 subjects with an abnormal ECG and who needed to undergo exercise electrocardiography, 51 (75%) had no need to undergo further examinations, because there were no abnormal findings on ergometry in the THP. Of the 104 subjects who underwent ECG examination at rest, 51 no longer needed to waste time, effort and expense on further medical evaluation. Ergometry in a THP serves as a medical check and as a means to decide the strength of exercise before the initiation of exercise training, which is very important in preventing coronary artery disease, rather than in detecting the disease. Ergometry is expensive and it takes a lot of time and labor, but it is necessary in ensuring the safety of exercise training and in prescribing proper exercise. This analysis has shown that ergometry in THP is very useful and cost effective in improving the accuracy of health examinations. PMID:9368971

  5. Assessment of systolic and diastolic function in heart failure using ambulatory monitoring with acoustic cardiography.

    Science.gov (United States)

    Dillier, Roger; Zuber, Michel; Arand, Patricia; Erne, Susanne; Erne, Paul

    2011-08-01

    INTRODUCTION. The circadian variation of heart function and heart sounds in patients with and without heart failure (HF) is poorly understood. We hypothesized HF patients would exhibit less circadian variation with worsened cardiac function and sleep apnea. METHODS. We studied 67 HF patients (age 67.4 ± 8.2 years; 42% acute HF) and 63 asymptomatic control subjects with no history of HF (age 61.6 ± 7.7 years). Subjects wore a heart sound/ECG/respiratory monitor. The data were analyzed for sleep apnea, diastolic heart sounds, and systolic time intervals. RESULTS. The HF group had significantly greater prevalence of the third heart sound and prolongation of electro-mechanical activation time, while the control group had an age-related increase in the prevalence of the fourth heart sound. The control group showed more circadian variation in cardiac function. The HF subjects had more sleep apnea and higher occurrence of heart rate non-dipping. CONCLUSIONS. The control subjects demonstrated an increasing incidence of diastolic dysfunction with age, while systolic function was mostly unchanged with aging. Parameters related to systolic function were significantly worse in the HF group with little diurnal variation, indicating a constant stimulation of sympathetic tone in HF and reduction of diurnal regulation. PMID:21361859

  6. The effect of peripheral resistance on impedance cardiography measurements in the anesthetized dog.

    Science.gov (United States)

    Critchley, Lester A H; Peng, Zhi Y; Fok, Benny S; James, Anthony E

    2005-06-01

    In the vasodilated and septic patient, the impedance method of measuring cardiac output (CO) may underestimate the true value. In this study, we sought to determine whether impedance CO (COIC) measurements are influenced by total peripheral resistance (TPR). In eight anesthetized and ventilated dogs, a high-precision flowprobe was placed on the ascending aorta, and direct CO was measured (CO flowprobe (COFP)). Mean arterial blood pressure was measured from the femoral artery. Simultaneous COIC measurements were made. TPR (mean arterial blood pressure x 80/COFP) was varied over 1-2 h by using infusions of phenylephrine and adrenaline and inhaled halothane. The bias between methods of CO measurement (COIC-COFP) was calculated and compared with TPR by using correlation and regression analysis. A total of 547 pairs of CO measurements were collected from the 8 dogs as TPR was varied. COFP changed by a mean of 190% (range, 89%-425%), and TPR changed by a mean of 266% (range, 94%-580%) during the experiment. The impedance method underestimated CO when TPR was low and overestimated CO when TPR was high. There was a logarithmic relationship between the CO bias and TPR. Correlation coefficients (r) between the CO bias and TPR ranged from 0.46 to 0.89 (P TPR halved or doubled. This finding explains the poor agreement between COIC and other methods of CO measurement found in validation studies involving critically ill patients.

  7. Impedance cardiography using band and regional electrodes in supine, sitting, and during exercise.

    Science.gov (United States)

    Patterson, R P; Wang, L; Raza, S B

    1991-05-01

    The electrical impedance and its first derivative (dZ/dt) were measured at 100 kHz on 10 normal males in supine, sitting, and during upright bicycle exercise in order to compare the contribution of regional electrodes to the standard band electrode signal and to evaluate the possible use of spot electrodes for stroke volume (SV) measurements. Simultaneous measurements were made from band electrodes placed around the neck and lower thorax and from spot electrodes which recorded signals from the neck, upper thorax, and lower thorax. The results showed that approximately equal parts of the dZ/dt waveform came from the neck and upper thorax with the lower thorax contribution small but providing important features of the band signal. Changing from supine to sitting showed percentage decreases of 35% and 46% for the band and neck signals, respectively, with an increase of 19% for the upper thorax signal. The percentage increases in SV with upright exercise were 34%, 52%, and 24% for the bands, neck, and upper thorax signals, respectively. Band signal is made up of different signals from various regions of the thorax. Its ability to predict correct changes in SV may result from some "lucky" coincidences. The use of regional electrodes will probably not give the same SV information but may be important in measuring regional activities of the central circulation.

  8. Design and evaluation of a portable device for the measurement of bio-impedance cardiography

    OpenAIRE

    Shi, Qinghai; Heinig, Andreas; Kanoun, Olfa

    2011-01-01

    Electrical impedance of biological matter is known as electrical bio-impedance or simply as bio-impedance. Bio-impedance devices are of great value for monitoring the pathological and physiological status of biological tissues in clinical and home environments. The technological progress in instrumentation has significantly contributed to the progress that has been observed during the last past decades in impedance spectroscopy and electrical impedance cardiograph. Although bio-impedance is n...

  9. The Initial Systolic Time Interval in patients with spinal cord injury measured with impedance cardiography

    Science.gov (United States)

    Hoekstra, Femke; Martinsen, Ørjan G.; Verdaasdonk, Rudolf M.; Janssen, Thomas W. J.; Meijer, Jan H.

    2012-12-01

    The Initial Systolic Time Interval (ISTI), obtained from the electrocardiogram and impedance cardiogram, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart. This time delay is influenced by the sympathetic nerve system. Therefore, an observational study was performed in a group of patients (SCI) with spinal cord injuries. The relationship between the ISTI and the total heart cycle (RR-interval) was established by varying the RR-interval using an exercise stimulus to increase the heart rate. The slope of this relationship was observed to be significantly higher in the SCI-group as compared with a control group, although there was no difference in ISTI in the range of common heart rates during the test between the groups. This slope and the ISTI was observed to be significantly different in an acute patient having a recent spinal cord injury at a high level. Because of the variety in injury levels and incompleteness of the injuries further, more specific research is necessary to draw decisive conclusions with respect to the contribution of autonomic nervous control on the ISTI in SCI, although the present observations are notable.

  10. Variable impedance cardiography waveforms: how to evaluate the preejection period more accurately

    Science.gov (United States)

    Ermishkin, V. V.; Kolesnikov, V. A.; Lukoshkova, E. V.; Mokh, V. P.; Sonina, R. S.; Dupik, N. V.; Boitsov, S. A.

    2012-12-01

    Impedance method has been successfully applied for left ventricular function assessment during functional tests. The preejection period (PEP), the interval between Q peak in ECG and a specific mark on impedance cardiogram (ICG) which corresponds to aortic valve opening, is an important indicator of the contractility state and its neurogenic control. Accurate identification of ejection onset by ICG is often problematic, especially in the cardiologic patients, due to peculiar waveforms. An essential obstacle is variability of the shape of the ICG waveform during the exercise and subsequent recovery. A promissing solution can be introduction of an additional pulse sensor placed in the nearby region. We tested this idea in 28 healthy subjects and 6 cardiologic patients using a dual-channel impedance cardiograph for simultaneous recording from the aortic and neck regions, and an earlobe photoplethysmograph. Our findings suggest that incidence of abnormal complicated ICG waveforms increases with age. The combination of standard ICG with ear photoplethysmography and/or additional impedance channel significantly improves the efficacy and accuracy of PEP estimation.

  11. Role of 2-dimensional Doppler echo-cardiography in screening portopulmonary hypertension in portal hypertension patients

    Institute of Scientific and Technical Information of China (English)

    Rong Hua; Yong-Wei Sun; Zhi-Yong Wu; Wei Cheng; Qing Xu; Hui Cao; Meng Luo

    2009-01-01

    BACKGROUND:Portopulmonary hypertension (PPH) is dififcult to recognize in the early and middle stages because it is frequently asymptomatic. As right ventricular function is impaired in patients with moderate and severe PPH, any dramatic hemodynamic changes in liver transplantation or other procedures may result in death from pulmonary and cardiac events. In this study, we investigated the prevalence of PPH in patients with portal hypertension (PHT) mainly caused by hepatitis B virus, and evaluated the effect of 2-dimensional Doppler echocardiography (2D-ECHO) in screening for PPH. METHODS:One hundred and ifve PHT patients received transthoracic 2D-ECHO preoperatively, systolic pulmonary arterial pressure (SPAP, normal range 30 mmHg. The mean PAT of all patients was 140± 23 msec and 5 were <100 msec. Twenty-two patients were screened out by 2D-ECHO and 4 were diagnosed by RHC. A positive signiifcant correlation (r=0.55,P<0.01) was found between SPAP measured by 2D-ECHO and mean pulmonary artery pressure (MPAP) measured by RHC, and a weak but signiifcant negative correlation (r=-0.27, P=0.005) existed between PAT and pulmonary vascular resistance (PVR). The sensitivity, speciifcity, agreement rate, positive predictive value and negative predictive value of the screening test were 100%, 82%, 83%, 18% and 100%, respectively. CONCLUSIONS:The prevalence of PPH in this study is lower than in Western countries. As a screening test, 2D-ECHO has very high sensitivity and negative predictive value. A negative test result can directly be used to exclude PPH, while a positive result should be conifrmed by RHC.

  12. Method to measure autonomic control of cardiac function using time interval parameters from impedance cardiography

    NARCIS (Netherlands)

    Meijer, J.H.; Boesveldt, S.; Elbertse, E.; Berendse, H.W.

    2008-01-01

    The time difference between the electrocardiogram and impedance cardiogram can be considered as a measure for the time delay between the electrical and mechanical activities of the heart. This time interval, characterized by the pre-ejection period (PEP), is related to the sympathetic autonomous ner

  13. Evaluation of left-to-right shunts in adults with atrial septal defect using first-pass radionuclide cardiography

    DEFF Research Database (Denmark)

    Kelbaek, H; Aldershvile, J; Svendsen, Jesper Hastrup;

    1992-01-01

    outputs of the right and left ventricle was 0.04 l.min-1, the limits of agreement -0.80 to 0.88 l.min-1 and the 95% confidence interval for the bias -0.14 to 0.22 l.min-1. Right-sided cardiac catheterization was performed to assess the severity of the arterio-venous shunt by oximetry in 18 adult patients...

  14. The comparison of some hemodynamics parameters, obtained by two non-invasive measurement methods - echocardiography and impedance cardiography (HOTMAN System) by patients with systemic hypertension

    OpenAIRE

    SASSMANNOVÁ, Anna

    2007-01-01

    Echocardiography is an investigation of heart via scan. This enables to intend the moving and the locality of heart structures via scan pulse waves which are repulsed with acoustic interfaces. Impedance measuring of the thorax hemodynamics is based on changes of electrical impedance. These changes happen mainly because of the heart function. By its rhytmical function the heart periodically changes the conditions of blood flow through all vessels. By this we can explain periodical changes of i...

  15. Noninvasive Assessment of Cardiac Index in Healthy Volunteers: A Comparison Between Thoracic Impedance Cardiography and Doppler Echocardiography%健康志愿者心脏指数的无创性评估:胸阻抗心动图与多普勒超声心动图的对比研究

    Institute of Scientific and Technical Information of China (English)

    Jean-Luc Fellahi; Vincent Caille; Cyril Charron; Pierre-Hervé Deschamps-Berger; Antoine Vieillard-Baron; 黄建廷

    2011-01-01

    背景 胸阻抗心动图(ICG),一直被认为是一种无创性、连续性、可独立操作且经济有效的方法,用于监测心输出量.本研究比较了在静息状态下改变健康志愿者血流动力学参数时,胸阻抗心动图(Niccomo装置)与经胸超声多普勒心动图对心脏指数(CI)的测量情况.方法 本研究共纳入了25例健康志愿者(7例男性,18例女性;平均年龄36±6岁;体表面积1.75±O.17 m2),分别在3种实验条件进行测定:基础水平、呼气末正压通气(+10 cm H2O)、下半身加压(用医疗抗休克裤对腹部施加30 cm H2O的压力).结果 在所有测量中,胸阻抗心动图的信号质量>89%.胸阻抗心动图与多普勒心动图测定的心脏指数(CITTE和CICG)间存在着较弱但有统计学意义的相关性(r=0.36;P=0.002).2种技术测得的心脏指数的一致性数值为0.94 L·min-1·m-2(95%可信区间0.77~1.11);一致性可变范围为-0.47~2.35 L·min-1·m-2,误差百分率为53%.施加呼气末正压+10 cm H2O(r=0.21;P=0.31)或医疗抗休克裤(r=0.22;P=0.30)后,CITTE和CIICG的变化率之间的相关性没有统计学意义.结论 采用胸阻抗心动图与多普勒心动图测量健康志愿者静息状态下的CI,两者测量所得CI的绝对值相关性较差,缺乏一致性.在血流动力学变化时,使用Niccomo装置测量心脏指数的变化也缺乏可靠性.

  16. 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...

  17. Assessment of left ventricular function by noninvasive methods.

    Science.gov (United States)

    Luisada, A A; Singhal, A; Portaluppi, F

    1985-01-01

    The possibility of evaluating left ventricular function by noninvasive methods is discussed in detail. The methods that are considered are electrocardiograph, phonocardiography, apex cardiography, sphygmography, impedance cardiography, electrokymography, and echocardiography. Following a brief section of 'definitions', each method is described in detail including technical problems, difficulties, and results. The systolic time intervals and the stress tests are briefly discussed. Based on modern experimental studies, the stress test should include both an electro- and a phonocardiogram. In the latter, one would measure the amplitude of the first heart sound as an index of contractility. The conclusion is that combined methods give the best results. They are electrocardiography, phonocardiography, impedance cardiography, and echocardiography. An alternative, dictated by technical problems, is to use at first phonocardiography and impedance plus electrocardiography; then echocardiography plus electrocardiography; and then, if indicated, a stress test might complete the study; the latter should include both an electrocardiogram and a phonocardiogram. PMID:4003144

  18. Combined first pass and equilibrium radionuclide cardiographic determination of stroke volume for quantitation of valvular regurgitation

    DEFF Research Database (Denmark)

    Kelbaek, H; Aldershvile, J; Svendsen, Jesper Hastrup;

    1988-01-01

    A new noninvasive procedure for quantitation of cardiac valve regurgitation was evaluated using a combination of first pass and gated equilibrium radionuclide cardiography in 38 subjects with and without cardiac valve disease. Left-sided cardiac catheterization was performed to determine the seve......A new noninvasive procedure for quantitation of cardiac valve regurgitation was evaluated using a combination of first pass and gated equilibrium radionuclide cardiography in 38 subjects with and without cardiac valve disease. Left-sided cardiac catheterization was performed to determine...... with mild mitral incompetence and 2+ aortic regurgitation, 37% in patients with moderate mitral incompetence and 3+ aortic regurgitation and 57% in patients with severe mitral incompetence and 4+ aortic regurgitation. These findings suggest that combined first pass and gated equilibrium radionuclide...... cardiography, being insensitive to intracardiac shunts and right-sided valve disorders, constitutes a valid noninvasive technique for quantitation of left-sided cardiac valve regurgitation....

  19. Hyperkalaemic paralysis--a bizarre presentation of renal failure.

    Science.gov (United States)

    Cumberbatch, G L; Hampton, T J

    1999-05-01

    Paralysis due to hyperkalaemia is rare and the diagnosis may be overlooked in the first instance. However it is rapidly reversible and so long as electro-cardiography and serum potassium measurement are urgently done in all patients presenting with paralysis, it will not be missed. A case of hyperkalaemic paralysis is described and a review of the emergency management discussed. PMID:10353058

  20. Hyperkalaemic paralysis--a bizarre presentation of renal failure.

    OpenAIRE

    Cumberbatch, G L; Hampton, T. J.

    1999-01-01

    Paralysis due to hyperkalaemia is rare and the diagnosis may be overlooked in the first instance. However it is rapidly reversible and so long as electro-cardiography and serum potassium measurement are urgently done in all patients presenting with paralysis, it will not be missed. A case of hyperkalaemic paralysis is described and a review of the emergency management discussed.

  1. Impact of filtration elements on bioelectrical signal

    Science.gov (United States)

    Grigoriev, M.; Babich, L.

    2016-04-01

    Filtering of the wanted signal from the noise caused by power lines, magnetic pickup, interference from body movement, etc. in the field of medical data processing is a weighty problem of cardiography. To date, different types of digital filters have been used to clear the signal from unnecessary frequency bands. This paper presents the results of the filter simulation in MATLAB package.

  2. Wavelet analysis of the impedance cardiogram waveforms

    Science.gov (United States)

    Podtaev, S.; Stepanov, R.; Dumler, A.; Chugainov, S.; Tziberkin, K.

    2012-12-01

    Impedance cardiography has been used for diagnosing atrial and ventricular dysfunctions, valve disorders, aortic stenosis, and vascular diseases. Almost all the applications of impedance cardiography require determination of some of the characteristic points of the ICG waveform. The ICG waveform has a set of characteristic points known as A, B, E ((dZ/dt)max) X, Y, O and Z. These points are related to distinct physiological events in the cardiac cycle. Objective of this work is an approbation of a new method of processing and interpretation of the impedance cardiogram waveforms using wavelet analysis. A method of computer thoracic tetrapolar polyrheocardiography is used for hemodynamic registrations. Use of original wavelet differentiation algorithm allows combining filtration and calculation of the derivatives of rheocardiogram. The proposed approach can be used in clinical practice for early diagnostics of cardiovascular system remodelling in the course of different pathologies.

  3. Experience of treatment of heart rhabdomyomas in combination with various arrhythmias and conduction disorders

    OpenAIRE

    Bockeria L. A.; Bockeria O. L.; Rubtsov P.P.; Akhobekov A.A.; Alekhina M. A.

    2014-01-01

    Оbjective. Presentation the experience of diagnosis and treatment of heart rhabdomyomas in combination withvarious arrhythmias and conduction disorders.Material and methods. In archival material found 9 records of pediatric patients treated in A.N. BakoulevCenter for Cardiovascular Surgery from June 2004 to September 2013 with cardiac rhabdomyomas. The ageofpatients ranged from 19 days to 17 years. Along with the general clinical studies patients perfomed electro-cardiography (ECG), Holter EC...

  4. Normotensive sodium loading in normal man: Regulation of renin secretion during beta-receptor blockade

    DEFF Research Database (Denmark)

    Mølstrøm, Simon; Larsen, Nils Heden; Simonsen, Jane Angel;

    2008-01-01

    +/-14 micromol min(-1); 13+/-2 to 55+/-13 micromol min(-1), respectively). Na-loading did not increase plasma atrial natri-uretic peptide (pANP), glomerular filtration rate (GFR by (51)Cr-EDTA), MAP, or cardiac output (CO by impedance cardiography), but increased central venous pressure (CVP) by approxi-mately 2.......0 mmHg (pmmHg. Concomitantly, plasma vasopressin decreased by 30-40% (p

  5. 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 ...

  6. Hemodynamic findings in patients with brain stroke

    OpenAIRE

    Siebert, Janusz; Gutknecht, Piotr; Molisz, Andrzej; Trzeciak, Bartosz; Nyka, Walenty

    2012-01-01

    Introduction Standard procedures carried out at a stroke department in patients after a cerebral event may prove insufficient for monitoring hemodynamic indices. Impedance cardiography enables hemodynamic changes to be monitored non-invasively. The aim of the work was to describe hemodynamic parameters in patients with acute phase of ischemic and hemorrhagic stroke and to analyse the correlation between the type of hemodynamic response and long-term prognosis. Material and methods The 45 cons...

  7. Comparative evaluations of hygienic aspects of the new labor organization forms at coal mines in the Kuzbass

    Energy Technology Data Exchange (ETDEWEB)

    Davydova, N.N.; Dyatlova, L.A. (Meditsinskii Institut, Kemerovo (USSR))

    1990-12-01

    Reports on investigations into the effect of labor organization on the health and sickness rate of miners working in seams with similar geologic and technical conditions. Chronometric observations were conducted, dust, noise and vibration doses were measured, and 196 miners were interviewed. Electro-encephalography, cardiography, miography and measurement of blood pressure, pulse rate and breathing volume were carried out on 180 miners. Measurement results are presented and compared for miners working with contractual (task rate with bonus) work organization forms and miners paid by the job. The conclusion is reached that task rate organization forms cause increased action of mine environment on a miner's body. 10 refs.

  8. [Stress-protective properties of lithium nicotinate--a new derivative of nicotinic acid].

    Science.gov (United States)

    Kresiun, V I

    1984-03-01

    Experiments were made to study stress-protective properties of a new psychotropic agent lithium nicotinate developed on the basis of natural metabolites. Prophylactic treatment of the drug given in courses entails an increase in the physical endurance and work fitness, improvement of animals' orientation under stress, facilitating the avoidance behavior. These effects were particularly demonstrable in highly emotional animals. In these animals, stress produced a paralyzing action. According to the electro- and ballisto-cardiography, the drug prevented the stress-induced disorders of cardiovascular function. PMID:6538449

  9. Pulmonary valve insufficiency in the postoperative out of tetralogy of Fallot: contribution of conventional transthoracic echocardiography for decision making

    International Nuclear Information System (INIS)

    Pulmonary valve regurgitation is one of the main problems in the late post-op of Tetralogy of F allot, having a great incidence and depending on many aspects . In these paper a review is done considering the usefulness of conventional transtoracic eco cardiography as a tool to evaluate patients with pulmonary regurgitation in the late post-op of Tetralogy of F allot. Main pathophysiologic concepts about these entity are presented, and as a function of that, the most important eco cardiographic parameters to be considered evaluating these patients are also described. Finally guidelines on the opportunity for pulmonary valve replacement are considered

  10. High spatial and temporal resolution 4D FEM simulation of the thoracic bioimpedance using MRI scans

    International Nuclear Information System (INIS)

    In this work, a finite element model was created using MRI scans of the main author to analyze sources of the dynamic thoracic bioimpedance. This model can be used to identify limitations of impedance cardiography (ICG) in practice. Heart beat (8.3 ms temporal resolution) and aortic wave propagation (2.6 ms temporal resolution) were implemented. The static volume contains all major organs of the thorax in high spatial resolution. Simulations were successfully conducted and a high correlation (r = 0.9) between the simulated aortic ICG signal and a measured signal of the same subject was obtained.

  11. High spatial and temporal resolution 4D FEM simulation of the thoracic bioimpedance using MRI scans

    Science.gov (United States)

    Ulbrich, Mark; Marleaux, Bastian; Mühlsteff, Jens; Schoth, Felix; Koos, Ralf; Teichmann, Daniel; Leonhardt, Steffen

    2013-04-01

    In this work, a finite element model was created using MRI scans of the main author to analyze sources of the dynamic thoracic bioimpedance. This model can be used to identify limitations of impedance cardiography (ICG) in practice. Heart beat (8.3 ms temporal resolution) and aortic wave propagation (2.6 ms temporal resolution) were implemented. The static volume contains all major organs of the thorax in high spatial resolution. Simulations were successfully conducted and a high correlation (r = 0.9) between the simulated aortic ICG signal and a measured signal of the same subject was obtained.

  12. A comparative study for the echo cardiographic, radiologic and electrocardiographic presentation of the sport heart hypertrophy

    International Nuclear Information System (INIS)

    In this work the three most important non-invasive methods - X-ray pictures, electrocardiography and echo cardiography - were compared as to their ability to evaluate the physiological heart enlargement as a result of physical training. Important also was the study of the value of ultrasonic cardiographs. The subjects used were 162 athletes, 36 patients with cardiovascular diseases, and 22 non-athletic control persons. Radiologically the changes in the total size of the heart were determined. For the question of the adapting reaction of the heart because of athletic training the weight-related heart volume is more meaningful than the absolute value. Electrocardiographically it is not possible to come up with any statistically significant statements about the physiological heart enlargement using the Sokoloff-Lyon indexes. Echo cardiographically the regulative heart enlargements can be differentiated into myocardial hypertrophy or ventricular dilation. As a result of this a line can be drawn between physiological and pathological changes. Female athletes show qualitatively, but not quantitatively, the same adapting reaction. The synopsis of the three procedures shows that echo cardiography and radiology show better results than does electrocardiography. Together the methods complement each other in their diagnostic power. (orig./TRV)

  13. Peripartum heart disease in cows.

    Science.gov (United States)

    Yamagishi, N; Okada, H; Koiwa, M; Kudo, K; Matsuo, N; Naito, Y

    1995-11-01

    Thirteen Holstein dairy cows aged 5.1-10.6 years died or were killed as a result of severe illness during the peripartum period, associated with lateral recumbency, moaning, tachycardia and dyspnoea. They were all high milk producers (> 9000 kg/year) and had experienced at least three pregnancies. The average duration of the clinical course was 2.5 +/- 1.7 days. Electro-cardiography revealed marked tachycardia associated with atrial fibrillation or atrioventricular dissociation. Serum clinical chemistry showed severe hypocalcaemia (3.6 +/- 1.3 mg/dl) and at necropsy multifocal myocardial necrosis was invariably found. Myocardial necrosis was accompanied by neutrophilic and mononuclear cellular infiltrates with interstitial fibrosis. The cause of this lesion was not established. PMID:8746959

  14. [Simultaneous operation of WPW syndrome combined with mitral regurgitation caused by infective endocarditis].

    Science.gov (United States)

    Sueda, T; Nakashima, Y; Hamanaka, Y; Ishihara, H; Matsuura, Y; Isobe, F

    1990-03-01

    A case of WPW syndrome combined with mitral regurgitation caused by infective endocarditis underwent surgical division of accessory pathway and mitral valve replacement preserving posterior leaflet simultaneously. A 56-years old woman suffered atrial fibrillation with pseudo VT and cardiac failure caused by mitral regurgitation. Electro-physiological study (EPS) revealed accessory pathway in postero-lateral wall in left atrium and atrio-fascicular pathway like James bundle in AV node. ECHO cardiography showed mitral valve prolapse and severe regurgitation. Accessory pathway was divided surgically and deep freeze coagulation was followed. Perforation of anterior leaflet and chordal rupture of posterior leaflet caused by infective endocarditis were repaired by annuloplasty (Kay and McGoon method) at first, but regurgitation retained moderately. After re-clamping of aorta, mitral valve was replaced with prosthesis (SJM 29 mm) preserving posterior leaflet. Postoperative examination revealed division of accessory pathway and no regurgitation of mitral prosthesis. PMID:2348136

  15. Clinical application of magnetic resonance angiography for coronary arteries. Correlation with conventional angiography and evaluation of imaging time

    Energy Technology Data Exchange (ETDEWEB)

    Nitatori, Toshiaki; Hanaoka, Hideto; Yoshino, Ayako [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine] [and others

    1995-08-01

    Magnetic resonance angiography (MRA) of the coronary arteries is a particularly difficult task because of the small size of the vessels and cardio-respiratory motion. The authors describe a method of performing of ultrafast MRA of the coronary arteries with a standard MR system and body coil. Each image was obtained within a single breath hold by `segmented Turbo FLASH` sequences using an electro-cardiography gate. Clinical application was performed in 20 patients with ischemic heart disease, and a comparison was made with conventional coronary angiography. The imaging time was shortened significantly by our methods. The diagnosis was made by at least two different images to avoid false positives. The results indicated a good correlation between MRA and conventional angiography. (author).

  16. Non-Intrusive Device for Real-Time Circulatory System Assessment with Advanced Signal Processing Capabilities

    Science.gov (United States)

    Pinheiro, E.; Postolache, O.; Girão, P.

    2010-01-01

    This paper presents a device that uses three cardiography signals to characterize several important parameters of a subject's circulatory system. Using electrocardiogram, finger photoplethysmogram, and ballistocardiogram, three heart rate estimates are acquired from beat-to-beat time interval extraction. Furthermore, pre-ejection period, pulse transit time (PTT), and pulse arrival time (PAT) are computed, and their long-term evolution is analyzed. The system estimates heart rate variability (HRV) and blood pressure variability (BPV) from the heart rate and PAT time series, to infer the activity of the cardiac autonomic system. The software component of the device evaluates the frequency content of HRV and BPV, and also their fractal dimension and entropy, thus providing a detailed analysis of the time series' regularity and complexity evolution, to allow personalized subject evaluation.

  17. Echocardiographic Partition Values and Prevalence of Left Ventricular Hypertrophy in Hypertensive Jamaicans

    Directory of Open Access Journals (Sweden)

    Chiranjivi Potu

    2012-02-01

    Full Text Available Left ventricular hypertrophy (LVH detected by either electrocardiography or echo- cardiography has been shown to be an extremely strong predictor of morbidity and mortality in patients with essential hypertension and in members of the general population. Alternative to LVH, left ventricular geometrical patterns offer incremental prognostic value beyond that provided by the other cardiovascular risk factors including left ventricular mass (LVM. Combination of LVM and relative wall thickness (RWT can be used to identify different left ventricular geometrical patterns. Various indexation methods normalised for LVM have been shown to offer prognostic significance. There was no prior study on the prevalence of LVH and geometric patterns in hypertensive patients in Jamaica using multiple partition values. Our study was designed to estimate the prevalence of LVH and geometrical patterns in a hypertensive Caribbean population in Jamaica using 10 different published cut-off values.

  18. Fabrication and characterization of a MEMS nano-Tesla ferromagnetic-piezoelectric magnetic sensor array

    Science.gov (United States)

    Qu, Peng; Gollapudi, Sreenivasulu; Bidthanapally, Rao; Srinivasan, Gopalan; Petrov, Vladimir; Qu, Hongwei

    2016-06-01

    A self-biased MEMS magnetic sensor array with ferromagnetic-piezoelectric composites has been fabricated and characterized. The array with two Quartz-Nickel-Metglas cantilevers with nano-tesla sensitivity was fabricated by MEMS processes including silicon-quartz low temperature bonding, quartz wafer thinning, and electroplating of thick nickel thin films. Under self-biasing due to magnetization grading of ferromagnetic layer, magnetoelectric coefficients of 6.6 and 5.6 V/cm Oe and resolutions of ˜0.58 and ˜0.75 nT are obtained at the mechanical resonant frequencies of 191.5 and 184.8 Hz for the two sensors in the array, respectively. Such arrays have the potential for applications in biomagnetic imaging technologies including magneto-cardiography.

  19. Berardinelli–Seip syndrome type 2 – An Egyptian child

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2015-04-01

    Full Text Available We report a 2.5 year old male, first in order of birth of first cousin consanguineous parents with the typical features of Berardinelli–Seip congenital lipodystrophy 2 (BSCL2 since birth with moderate mental retardation. He had generalized lipodystrophy with various dermatologic and systemic manifestations. The patient looked older than his age with the loss of buccal pad of fat, hypertrichosis mainly on the back and lower limbs, thick scalp hair, mild prognathism, large hands and feet with prominent joints and muscular hypertrophy. Acanthosis nigricans was evident over the neck and both axillae inspite of the normal level of sugar and insulin. The abdomen was markedly prominent with mild hepatosplenomegaly and enlarged external genitals. Echo-cardiography demonstrated cardiac hypertrophy. Triglyceride level was high with reduced high density lipoproteins (HDL.

  20. Methods of estimation of bodily condition of sportsmen of different qualification, specialized in at run on short and middle distances

    Directory of Open Access Journals (Sweden)

    Kryvoruchenko O.V.

    2012-06-01

    Full Text Available The method of estimation of bodily condition of sportsmen of different qualification, which are specialized in at run on short and middle distances, is presented. A method takes into account the informing criteria of estimation of physical preparedness and functional state of the cardiovascular system of sportsmen. It contains the complex of pedagogical tests, evaluation tables, model indexes of cardiography, determinations of type of the vegetative adjusting of cardiac rhythm and classification of the functional states of sportsmen. 110 skilled sportsmen took part in an experiment (men, age is 16 - 21 year. Indexes, which possibility operatively to estimate the bodily condition of sportsmen, select leaders from the group of sportsmen with an identical sporting result for the subsequent including in the complement of collapsible command is on, are set. Directions of prognostication of sporting result of concrete sportsman are rotined.

  1. Robust pulse wave velocity estimation by application of system identification to proximal and distal arterial waveforms.

    Science.gov (United States)

    Xu, Da; Ryan, Kathy L; Rickards, Caroline A; Zhang, Guanqun; Convertino, Victor A; Mukkamala, Ramakrishna

    2010-01-01

    Pulse wave velocity (PWV) is a marker of arterial stiffness and may permit continuous, non-invasive, and cuff-less monitoring of blood pressure. Here, robust PWV estimation was sought by application of system identification to proximal and distal arterial waveforms. In this approach, the system that optimally couples the proximal waveform to the distal waveform is identified, and the time delay of this system is then used to calculate PWV. To demonstrate proof-of-concept, a standard identification technique was applied to non-invasive impedance cardiography and peripheral arterial blood pressure waveforms from six humans subjected to progressive reductions in central blood volume induced by lower body negative pressure. This technique estimated diastolic pressure with an overall root-mean-squared-error of 5.2 mmHg. For comparison, the conventional detection method for estimating PWV yielded a corresponding error of 8.3 mmHg. PMID:21097042

  2. Role of cardiopulmonary mechanoreceptors in the postural regulation of renin

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, R.A.; Marco, E.J.; Oliveri, C.; Otero, F.J.; Degrossi, O.; Moledo, L.I.; Julius, S.

    1987-04-01

    To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end-systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans.

  3. Daily Liquorice Consumption for Two Weeks Increases Augmentation Index and Central Systolic and Diastolic Blood Pressure

    Science.gov (United States)

    Leskinen, Miia H.; Hautaniemi, Elina J.; Tahvanainen, Anna M.; Koskela, Jenni K.; Päällysaho, Marika; Tikkakoski, Antti J.; Kähönen, Mika; Kööbi, Tiit; Niemelä, Onni; Mustonen, Jukka; Pörsti, Ilkka H.

    2014-01-01

    Background Liquorice ingestion often elevates blood pressure, but the detailed haemodynamic alterations are unknown. We studied haemodynamic changes induced by liquorice consumption in 20 subjects versus 30 controls with average blood pressures of 120/68 and 116/64 mmHg, respectively. Methods Haemodynamic variables were measured in supine position before and after two weeks of liquorice consumption (daily glycyrrhizin dose 290–370 mg) with tonometric recording of radial blood pressure, pulse wave analysis, and whole-body impedance cardiography. Thirty age-matched healthy subjects maintaining their normal diet were studied as controls. Results Two weeks of liquorice ingestion elevated peripheral and central systolic and diastolic blood pressure (by 7/4 and 8/4 mmHg, 95% confidence intervals [CI] 2-11/1-8 and 3-13/1-8, respectively, P ClinicalTrials.gov NCT01742702 PMID:25153328

  4. LIGHT WEIGHT SECURITY AND AUTHENTICATION IN WIRELESS BODY AREA NETWORK

    Directory of Open Access Journals (Sweden)

    A.Siva Sangari

    2014-01-01

    Full Text Available In recent year, the increasing number of wearable sensors on human can serve for many purposes like emergency care, health care remote monitoring, personal entertainment and communication etc. The healthcare application is used for 24 hours constant monitoring without disturbing day to day activities. The WBAN enables the medical applications to be developed using electronic devices and sensors. The WBAN is created by wearing small sensors on the human body. In this paper we propose a low cost and high quality electro cardiography and diagnostic system for healthcare applications . A major issue is how to preserve security and privacy of patient’s medical healthcare information over wireless communication. The energy consumption and data security are still major challenges in healthcare applications. This paper based on light weight security algorithm. Skipjack is the secret key encryption algorithm which provide the secure communication between sensor node and mobile node. The proposed algorithm protect the patient data against eavesdropping attack.

  5. Loeffler endocarditis: magnetic resonance imaging features of pre- and post-operation

    Institute of Scientific and Technical Information of China (English)

    FAN Zhan-ming; LI Yu; YE Hong; YU Jing; GENG Ji; ZHANG Zhao-qi

    2010-01-01

    @@ Loeffler endocarditis is clinically presented as restrictive cardiomyopathy, which is the least common of the three major categories of cardiomyopathic disorders.1 The endomyocardial fibrosis was considered as its main pathophysiologic changes.2-4 Generally speaking, the characteristics include thickening of the apex and inflow tracts of one or both ventricles, and the papillary muscle and chordae tendineae also can be involved in some cases. The onset of apical thrombosis is very common. In the aspect of showing all of these characteristics, ultrasound cardiography (UCG) has low diagnostic accuracy (not more than 80%);5 CT has been reported rarely; cardiac magnetic resonance (CMR) imaging has dramatic advantages. We present the CMR findings in a typical case of Loeffler endocarditis pre- and post-operation.

  6. Research of echocardiography on coronary artery lesion of Kawasaki disease%川崎病冠状动脉损害的超声研究现状

    Institute of Scientific and Technical Information of China (English)

    王嘉俊

    2012-01-01

    Coronary artery lesions caused by Kawasaki disease have main effect to its prognosis.The lesions can be showed as arteriitis,arteriectasis,aneurysm and arterial stenosis stenosis.Ultrasonic cardiography is the first choice to detect the lesions,especially in dilatation and aneurysm formation of the coronary artery.It can definitely show the diameter and the degree of dilatation of the coronary artery.With the development of ultrasonic equipments as well as the applications of new technique,ultrasonic cardiography is playing an important role in Kawasaki disease of early diagnosis,therapeutic effect,prognosis estimation and Iongterm follow -up.%川崎病冠状动脉损害是影响患儿预后的主要因素.冠状动脉损害可表现为动脉炎、动脉扩张、动脉瘤和动脉狭窄等.超声心动图检查是检测川崎病并发冠状动脉损害的首选方法,尤其对冠状动脉扩张和冠状动脉瘤形成的诊断具有特异性,能清晰地显示冠状动脉内径及扩张程度.随着超声设备的升级及相关新技术的应用,超声心动图对川崎病的早期诊断、疗效观察、评估预后和长期随访发挥着愈来愈重要的作用.

  7. Decoding carotid pressure waveforms recorded by laser Doppler vibrometry: Effects of rebreathing

    Science.gov (United States)

    Casaccia, Sara; Sirevaag, Erik J.; Richter, Edward; O'Sullivan, Joseph A.; Scalise, Lorenzo; Rohrbaugh, John W.

    2014-05-01

    The principal goal of this study was to assess the capability of the laser Doppler vibrometry (LDV) method for assessing cardiovascular activity. A rebreathing task was used to provoke changes within individuals in cardiac and vascular performance. The rebreathing task is known to produce multiple effects, associated with changes in autonomic drive as well as alterations in blood gases. The rise in CO2 (hypercapnia), in particular, produces changes in the cerebral and systemic circulation. The results from a rebreathing task (involving rebreathing the same air in a rubber bag) are presented for 35 individuals. The LDV pulse was measured from a site overlying the carotid artery. For comparison and validation purposes, several conventional measures of cardiovascular function were also obtained, with an emphasis on the electrocardiogram (ECG), continuous blood pressure (BP) from the radial artery, and measures of myocardial performance using impedance cardiography (ICG). During periods of active rebreathing, ventilation increased. The conventional cardiovascular effects included increased mean arterial BP and systemic vascular resistance, and decreased cardiac stroke volume (SV) and pulse transit time (PTT). These effects were consistent with a pattern of α-adrenergic stimulation. During the immediate post-rebreathing segments, in contrast, mean BP was largely unaffected but pulse BP increased, as did PTT and SV, whereas systemic vascular resistance decreased-a pattern consistent with β-adrenergic effects in combination with the direct effects of hypercapnia on the vascular system. Measures of cardiovascular activity derived from the LDV pulse velocity and displacement waveforms revealed patterns of changes that mirrored the results obtained using conventional measures. In particular, the ratio of the maximum early peak in the LDV velocity pulse to the maximum amplitude of the LDV displacement pulse (in an early systolic interval) closely mirrored the conventional

  8. Early Poststroke Rehabilitation Using a Robotic Tilt-Table Stepper and Functional Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Alexey N. Kuznetsov

    2013-01-01

    Full Text Available Background. Stroke frequently leaves survivors with hemiparesis. To prevent persistent deficits, rehabilitation may be more effective if started early. Early training is often limited because of orthostatic reactions. Tilt-table stepping robots and functional electrical stimulation (FES may prevent these reactions. Objective. This controlled convenience sample study compares safety and feasibility of robotic tilt-table training plus FES (ROBO-FES and robotic tilt-table training (ROBO against tilt-table training alone (control. A preliminary assessment of efficacy is performed. Methods. Hemiparetic ischemic stroke survivors (age years, days after stroke were assigned to 30 days of ROBO-FES (, ROBO (, or control ( in addition to conventional physical therapy. Impedance cardiography and transcranial doppler sonography were performed before, during, and after training. Hemiparesis was assessed using the British Medical Research Council (MRC strength scale. Results. No serious adverse events occurred; 8 patients in the tilt-table group prematurely quit the study because of orthostatic reactions. Blood pressure and CBFV dipped % during robot training. In 52% of controls mean arterial pressure decreased by %. ROBO-FES increased leg strength by points, ROBO by more than control (, . CBFV increased in both robotic groups more than in controls (. Conclusions. Robotic tilt-table exercise with or without FES is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone.

  9. [Development of a handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method].

    Science.gov (United States)

    Song, Yi-lin; Gao, Shu-mei; Ikarashi, Akira; Yamakoshi, Ken-ichi

    2009-03-01

    A handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method is developed. In this system, the inconvenient and discomfort due to cuff occlusion of the biological segment for BP measurement is improved by developing a new device using a local pressurization method, the stability for the physiological information detection is improved by developing a new detecting system, and the noise during detection using the system is greatly reduced by using a newly developed nozzle-flapper type electro-pneumatic converter. Also, for electrical admittance cardiography to estimate CO, the applicability of a two-compartment coaxial cylindrical model and the optimal position of a spot-electrode array that is used to replace the conventional band-electrode are discussed in this research. Experimental result shows that the monitoring system should satisfy non-invasive BP and CO measurement on beat by beat, and the comfort of measurement is significantly improved. PMID:19771888

  10. Prevalence of rheumatic fever and rheumatic heart disease in school children in a rural community of the hill region of Nepal.

    Science.gov (United States)

    Shrestha, U K; Bhattarai, T N; Pandey, M R

    1991-01-01

    A survey of school children aged 5 to 16 years living in a rural community of the hill region of Nepal, situated about 15-22 km outside Kathmandu city, was conducted to determine the prevalence of rheumatic fever (RF) and rheumatic heart disease (RHD). Of the 4,816 eligible children enrolled in the selected schools, 4,452 (92.4%) were examined. WHO expert committee criteria (1966) was used for the diagnosis and classification of rheumatic fever. Chest x-ray, electro-cardiography, echocardiography and Doppler study were done in all suspected cases of rheumatic heart disease. Six cases of RHD (1 pure mitral stenosis, 3 mitral regurgitation and 2 combined mitral stenosis and regurgitation) were identified giving overall prevalence rate of 1.35 per thousand. No case with active rheumatic fever could be identified. This is the first study on prevalence of RF/RHD in Nepal. The prevalence rate is lower than that reported from neighbouring countries. PMID:1894300

  11. Study on toxicity of danshensu in beagle dogs after 3-month continuous intravenous infusion.

    Science.gov (United States)

    Li, Guisheng; Gao, Yonglin; Li, Shenjun; Li, Chunmei; Zhu, Xiaoyin; Li, Min; Liu, Zhifeng

    2009-09-01

    Danshensu (3-(3,4-dihydroxyphenyl) lactic acid), a natural phenolic acid, is isolated from root of Salvia miltiorrhiza, and is widely used as a traditional Chinese medicine for treatment of various cardiovascular diseases. In the present study, toxicity of danshensu was evaluated in male and female dogs after 3-month continuous intravenous infusion. Beagle dogs were treated with danshensu at doses of 17, 50, and 150 mg/kg/day, and observed for 90 days followed by recovery periods. Measurements included clinical observations, body weight, food consumption, temperature, electro-cardiography (EGC), hematology, blood chemistry, urinalysis, gross necropsy, organ weight, and histopathology. No significant adverse effects on these parameters were observed. The only treatment-related finding was a hard knot at injection site observed in the 150 mg/kg group after 2-3 weeks continuous administration, and returned to normal after 3-4 days withdrawal. From these results, it might be concluded that danshensu did not produce any significant cumulative toxicity at the doses administered, as reflected by the various parameters investigated. PMID:19778246

  12. [Intra-graft balloon pumping--a clinical case report].

    Science.gov (United States)

    Nagata, M; Tashiro, T; Tanaka, K; Haruta, Y; Todo, K

    1991-12-01

    A 29-year-old female underwent tube graft replacement of distal aortic arch and descending aorta for dissecting aneurysm. After 42 minutes of aortic cross-clamping the patient was initially weaned satisfactorily from cardiopulmonary bypass (CPB). However, cardiac arrhythmia and cardiac arrest necessitated reestablishment of CPB. Electro-cardiography showed inferior myocardial infarction. To wean CPB intraaortic balloon pumping (IABP) was mandatory. But because of dissecting aortic aneurysm IABP in conventional method was contra-indicated. Intra graft balloon pumping (IGBP) was initiated while the patient was on full CPB. A low-porosity woven Dacron tube graft (22 mm) was anastomosed end-to-side to ascending aorta. A balloon was inserted into the tube graft to establish IGBP. This IGBP provided effective circulatory assist. The patient was weaned from CPB 1 hours after reestablishment of IGBP. Postoperative course was stable. The patient was returned to the operating room for removal of the balloon 3 days postoperatively. We reported the case for whom IGBP was effective. IGBP was effective circulatory support for the patient when conventional use of IABP was contra-indicated. PMID:1774515

  13. Critical analysis of the vectorcardiogram's reliability in the quantitative diagnosis of old myocardial infarction.

    Science.gov (United States)

    Fischer, D M; Benini, A; Andraghetti, A; Pirazzini, L; Patroncini, A; Fabbri, M

    1983-01-01

    The purpose of this work is to verify if the vectorcardiogram (VCG) can be used for the quantification of old myocardial infarction (OMI). 50 cases of acute myocardial infarction were studied by mean of seriate determination of MB-CK isoenzyme and Sobel Index (SI); 4 weeks later, Frank's VCG was recorded. The studied cases did not show any conduction disturbances or other electrical abnormalities besides the sign of OMI. The 50 cases were divided into two groups according to the site of the necrosis: Group A, including 27 cases of inferior and/or posterior infarction and Group B, including 23 cases of septal and/or anterior infarction. On the VCG records, the variables related to OMI and to the general shape of ventricular depolarization and repolarization were measured. The electrical variables and the SI were compared by means of the methods of linear regression and of principal components analysis. No significant correlations were detected. Therefore, we conclude that the VCG is useless in the quantitative assessment of OMI; that such terms as "extensive, localized" and so on, at present widely used in electro- and vector-cardiography, are misleading if based only on surface electrical records obtained at distance from the acute phase of infarction and should therefore be avoided; that the work is consistent with the hypothesis that the electrical pattern of OMI could depend mainly upon peripheral intraventricular conduction disturbances. PMID:6884641

  14. Cardiac manifestations of sickle cell anaemia in Sudanese children.

    Science.gov (United States)

    Ali, Ghada O M; Abdal Gader, Yahya S; Abuzedi, Elfatih S; Attalla, Bakhieta A I

    2012-01-01

    Sickle cell anaemia (SCA) is one of the commonest chronic hemolytic anaemias in the Sudan; it is a disease with high mortality and morbidity. This study was conducted aiming to observe the clinical pattern of cardiac abnormalities in children with sickle cell anaemia, and to assess the relationship between the cardiac abnormalities and the severity of the disease. The study was conducted in sickle cell disease clinic at Khartoum Children Emergency Hospital. The study group consisted of 289 patients with sickle cell anaemia, age range from 6 months to 18 years. Data were collected using a questionnaire which include full history, clinical examination findings, chest x-rays, and Electro-cardiography. Tachycardia, systolic murmurs, and cardiomegaly were detected in 28%, 61%, and 54% of patients with SCA respectively. Left ventricular dilatation was observed in 51% of the study group, while right ventricular dilatation was observed in 22% of the patients. Left and right atrial dilatations were observed in 16% and 6% of the patients respectively. Contractility, ejection fraction (EF) were found almost always normal in all study subjects. Chamber dilatations were not associated with any abnormality in Left ventricular functions. Hemglobin (Hb) levels correlated negatively with cardiomegaly. Left Ventricular End Diastolic Dimension (LVEDD) correlates negatively with Hb levels and positively with the severity index. Only four patients (1%) had abnormal valves. In conclusion, cardiac abnormalities in patients with SCA correlate with the age of the patients and the severity of the disease. PMID:27493331

  15. 心电散点图快速诊断普通12导心电图难以判别的心律失常三例%Rapid diagnosis by ECG scatterplot in three cases with arrhythmia hard to be differentiated by ordinary 12-lead ECG

    Institute of Scientific and Technical Information of China (English)

    吕航; 刘鸣; 向黎明

    2015-01-01

    ECG scatterplot can be utilized in diagnosing arrhythmias which are difficult for ordi-nary ECG to specify or capture.This paper selects three patients who underwent ambulatory electro-cardiography in hospital.Their characteristic graphs of ECG scatterplots were analyzed and used for diagnosis.ECG scatterplot not only records a large amount of information,but also gives specific qualitative diagnosis easy to be understood,which avoids missed diagnosis and misdiagnosis,and provides references in diagnosing arrhythmia clinically.%运用心电散点图诊断普通心电图难以明确或捕捉的心律失常。本文对我院住院期间行动态心电图检查的三例患者的特征性心电散点图图形进行分析诊断。心电散点图不仅记录信息量大,且定性诊断明确,简单易懂,避免了漏诊及误诊,能够给临床提供一定的帮助。

  16. Heart Rate Variability During Early Adaptation to Space

    Science.gov (United States)

    Toscano, W. B.; Cowings, P. S.

    1994-01-01

    A recent report hypothesized that episodes of space motion sickness (SMS) were reliably associated with low frequency oscillations (less than 0.03 to less than 0.01 Hz) in heart rate variability. This paper archives a large data set for review of investigators in this field which may facilitate the evaluation of this hypothesis. Continuous recording of Electro-cardiography (ECG) and other measures were made for 6 to 12 hours per day (waking hours) of six Shuttle crewmembers for the first 3 mission days of two separate Shuttle flights. Spectral analyses of heart rate variability during approximately 200 hours of inflight is presented. In addition, nearly 200 hours of data collected on these same individuals during ground tests prior to the mission are presented. The Purpose of this Publication is to document the incidence of low frequency oscillations of heart rate in 4 people exposed to microgravity over a period of five days. In addition, this report contains spectral analyses of heart rate data collected on these same individuals during ground-based mission simulations. By archiving these data in this manner, it is our intention to make this information available to other investigators interested in studying this phenomena.

  17. Online Epileptic Seizure Prediction Using Wavelet-Based Bi-Phase Correlation of Electrical Signals Tomography.

    Science.gov (United States)

    Vahabi, Zahra; Amirfattahi, Rasoul; Shayegh, Farzaneh; Ghassemi, Fahimeh

    2015-09-01

    Considerable efforts have been made in order to predict seizures. Among these methods, the ones that quantify synchronization between brain areas, are the most important methods. However, to date, a practically acceptable result has not been reported. In this paper, we use a synchronization measurement method that is derived according to the ability of bi-spectrum in determining the nonlinear properties of a system. In this method, first, temporal variation of the bi-spectrum of different channels of electro cardiography (ECoG) signals are obtained via an extended wavelet-based time-frequency analysis method; then, to compare different channels, the bi-phase correlation measure is introduced. Since, in this way, the temporal variation of the amount of nonlinear coupling between brain regions, which have not been considered yet, are taken into account, results are more reliable than the conventional phase-synchronization measures. It is shown that, for 21 patients of FSPEEG database, bi-phase correlation can discriminate the pre-ictal and ictal states, with very low false positive rates (FPRs) (average: 0.078/h) and high sensitivity (100%). However, the proposed seizure predictor still cannot significantly overcome the random predictor for all patients. PMID:26126613

  18. Berberine attenuates doxorubicin-induced cardiotoxicity in mice.

    Science.gov (United States)

    Zhao, X; Zhang, J; Tong, N; Liao, X; Wang, E; Li, Z; Luo, Y; Zuo, H

    2011-01-01

    This study investigated the effects of berberine, a natural alkaloid, on doxorubicin-induced cardiotoxicity in mice. Mice were injected intraperitoneally with saline 10 ml/kg (n = 10), doxorubicin 2.5 mg/kg (n = 10), 60 mg/kg berberine 1 h before doxorubicin 2.5 mg/kg (n = 10), or 60 mg/kg berberine alone (n = 10) every other day for 14 days. Body weight, general condition and mortality were recorded over the 14-day study period. Electro cardiography was performed before the start of treatment and after 14 days and plasma lactate dehydrogenase (LDH) activity was measured after 14 days. At the end of the study period the heart was excised and examined histologically. An increase in mortality, an initial decrease in body weight, increased LDH activity, prolongation of QRS duration and increased myocardial injury were seen in the doxorubicin-treated group compared with the saline control group. These changes were significantly attenuated by pretreatment with berberine. The study suggests that berberine may have a potential protective role against doxorubicin-induced cardiotoxicity in mice. PMID:22117972

  19. Re-evaluation of normal splitting of the second heart sound in patients with classical left bundle branch block.

    Science.gov (United States)

    Xiao, H B; Faiek, A H; Gibson, D G

    1994-07-01

    To study the mechanism of normal splitting of the second heart sound in patients with classical left bundle branch block, we investigated 43 such patients and 15 normal controls, using electro-, phono- and echo-cardiography and comparing the relative timing of mechanical activity in the two ventricles. The splitting of the second heart sound is reversed in only two-thirds of the patients and normal in remaining one-third. Comparing patients with and without reversed splitting, there are no significant differences in left ventricular cavity size, heart rate, pre-ejection period and the distribution of age, gender, or aetiology. QRS duration is longer (P < 0.01) in patients with reversed splitting. Diastolic events of the left ventricle do not differ between groups. The onset of the left ventricular free wall motion is delayed compared with normal by a similar extent in the two groups. In patients with normal splitting, the onset of the right ventricular wall motion is also delayed, both with respect to normal and to those with reversed splitting to an extent similar to that seen in classical right bundle branch block. Normal splitting of the second heart sound associated with an electrocardiographic pattern of left bundle branch block therefore suggests bilateral block. This combination can be documented from the precise timing of the movement of the two ventricles by M-mode echocardiography and identified by simple auscultation. PMID:7960260

  20. Heart Failure Impairs Muscle Blood Flow and Endurance Exercise Tolerance in COPD.

    Science.gov (United States)

    Oliveira, Mayron F; Arbex, Flavio F; Alencar, Maria Clara; Souza, Aline; Sperandio, Priscila A; Medeiros, Wladimir M; Mazzuco, Adriana; Borghi-Silva, Audrey; Medina, Luiz A; Santos, Rita; Hirai, Daniel M; Mancuso, Frederico; Almeida, Dirceu; O'Donnell, Denis E; Neder, J Alberto

    2016-08-01

    Heart failure, a prevalent and disabling co-morbidity of COPD, may impair cardiac output and muscle blood flow thereby contributing to exercise intolerance. To investigate the role of impaired central and peripheral hemodynamics in limiting exercise tolerance in COPD-heart failure overlap, cycle ergometer exercise tests at 20% and 80% peak work rate were performed by overlap (FEV1 = 56.9 ± 15.9% predicted, ejection fraction = 32.5 ± 6.9%; N = 16), FEV1-matched COPD (N = 16), ejection fraction-matched heart failure patients (N = 15) and controls (N = 12). Differences (Δ) in cardiac output (impedance cardiography) and vastus lateralis blood flow (indocyanine green) and deoxygenation (near-infrared spectroscopy) between work rates were expressed relative to concurrent changes in muscle metabolic demands (ΔO2 uptake). Overlap patients had approximately 30% lower endurance exercise tolerance than COPD and heart failure (p COPD. Blunted limb perfusion was related to greater muscle deoxygenation and lactate concentration in overlap (r = 0.78 and r = 0.73, respectively; p COPD and heart failure add to decrease exercising cardiac output and skeletal muscle perfusion to a greater extent than that expected by heart failure alone. Treatment strategies that increase muscle O2 delivery and/or decrease O2 demand may be particularly helpful to improve exercise tolerance in COPD patients presenting heart failure as co-morbidity. PMID:26790095

  1. Role of cardiac CTA in estimating left ventricular volumes and ejection fraction

    Institute of Scientific and Technical Information of China (English)

    Robin; Man; Singh; Balkrishna; Man; Singh; Jawahar; Lal; Mehta

    2014-01-01

    Left ventricular ejection fraction(LVEF)is an impor-tant predictor of cardiac outcome and helps in makingimportant diagnostic and therapeutic decisions suchas the treatment of different types of congestive heartfailure or implantation of devices like cardiac resynchro-nization therapy-defibrillator.LVEF can be measuredby various techniques such as transthoracic echo-cardiography,contrast ventriculography,radionuclidetechniques,cardiac magnetic resonance imaging andcardiac computed tomographic angiography(CTA).Thedevelopment of cardiac CTA using multi-detector rowCT(MDCT)has seen a very rapid improvement in thetechnology for identifying coronary artery stenosis andcoronary artery disease in the last decade.During theacquisition,processing and analysis of data to studycoronary anatomy,MDCT provides a unique opportunityto measure left ventricular volumes and LVEF simulta-neously with the same data set without the need foradditional contrast or radiation exposure.The develop-ment of semi-automated and automated software to measure LVEF has now added uniformity,efficiency and reproducibility of practical value in clinical practice rather than just being a research tool.This article will address the feasibility,the accuracy and the limitations of MDCT in measuring LVEF.

  2. Effects of race and sex on blood pressure and hemodynamic stress response as a function of the menstrual cycle.

    Science.gov (United States)

    Ahwal; Mills; Kalshan; Nelesen

    1997-08-01

    OBJECTIVE: To examine the influence of race and sex on responses to cardiovascular stress during two menstrual cycle phases. METHODS: Subjects were exposed to two stressors, a mirror star-tracing task and a speaking task. Blood pressure, heart rate, and impedance cardiography measures of reactivity were recorded. Women were examined both during the follicular and during the luteal phase of their menstrual cycle with men matched for the number of days between testing sessions (approximately 6 weeks). The subjects were 33 black and white women and 37 black and white men who were healthy, normotensive, and not being administered medication. RESULTS: For black women, the reactivity of the diastolic blood pressure (DBP) to the speaking task was less in the luteal phase than it was in the follicular phase, whereas for white women (and men) there was no difference between the two phases (testing sessions) (P rate reactivities in both menstrual phases than did men (P speak, black and white women had greater DBP reactivities than did men; however, their DBP responses were attenuated during the luteal phase compared with the follicular phase (P influence this phenomenon. PMID:10234110

  3. Obesity Interacts with Cerebral Hypoperfusion to Exacerbate Cognitive Impairment in Older Adults with Heart Failure

    Directory of Open Access Journals (Sweden)

    Michael L. Alosco

    2012-10-01

    Full Text Available Background: Cerebral hypoperfusion accompanies heart failure (HF and is associated with reduced cognitive performance. Obesity is prevalent in persons with HF and is also a likely contributor to cognitive function, as it has been independently linked to cognitive impairment in healthy individuals. The current study examined the association between obesity and cognitive performance among older adults with HF and whether obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment. Methods: Patients with HF (n = 99, 67.46 ± 11.36 years of age completed neuropsychological testing and impedance cardiography. Cerebral blood flow velocity (CBF-V measured by transcranial Doppler sonography quantified cerebral perfusion and body mass index (BMI operationalized obesity. Results: A hierarchical regression analysis showed that lower CBF-V was associated with reduced performance on tests of attention/executive function and memory. Elevated BMI was independently associated with reduced attention/executive function and language test performance. Notably, a significant interaction between CBF-V and BMI indicated that a combination of hypoperfusion and high BMI has an especially adverse influence on attention/executive function in HF patients. Conclusions: The current findings suggest that cerebral hypoperfusion and obesity interact to impair cognitive performance in persons with HF. These results may have important clinical implications, as HF patients who are at high risk for cerebral hypoperfusion may benefit from weight reduction.

  4. [Evaluation of orthostatic regulation by saddle support test using thoracic impedance].

    Science.gov (United States)

    Gugova, F K; Lapin, V V

    2002-01-01

    We investigated 21 healthy volunteers (10 males and 11 females, mean age 23 +/- 4 years). All the subjects have undergone two 20 min head-up tilt tests using tilt table "TRI W.G. inc." (USA): the first with footplate support and the second with bicycle saddle. Thoracic electrical impedance was measured using impedance cardiography according to Kubicek et al. The protocols included an initial period of 20 min of supine rest while baseline thoracic impedance, blood pressure and heart rate were recorded and then followed by a tilt to 65 degrees. Changes of impedance were measured at min 1, 2, 3, 5, 7, 10, 15, 20 after the procedure. Women had higher values of thoracic impedance both at rest and during the tilt test than men. The value of impedance of the chest negatively correlated with the body mass index. We suppose that an increase of impedance more than 15% may be related with pathological venous pooling. Thoracic impedance may be used to monitor changes of thoracic fluid volumes with posture and possibly to assess orthostatic regulation. The contribution of leg muscles in orthostatic regulation does not reflect values of thoracic impedance.

  5. Cardiovascular responses to the ingestion of sugary drinks using a randomised cross-over study design: Does glucose attenuate the blood pressure-elevating effect of fructose?

    Science.gov (United States)

    Grasser, Erik K; Dulloo, Abdul; Montani, Jean-Pierre

    2014-07-28

    Overconsumption of sugar-sweetened beverages has been implicated in the pathogenesis of CVD. The objective of the present study was to elucidate acute haemodynamic and microcirculatory responses to the ingestion of sugary drinks made from sucrose, glucose or fructose at concentrations similar to those often found in commercial soft drinks. In a randomised cross-over study design, twelve young healthy human subjects (seven men) ingested 500 ml tap water in which was dissolved 60 g of either sucrose, glucose or fructose, or an amount of fructose equivalent to that present in sucrose (i.e. 30 g fructose). Continuous cardiovascular monitoring was performed for 30 min before and at 60 min after ingestion of sugary drinks, and measurements included beat-to-beat blood pressure (BP) and impedance cardiography. Additionally, microvascular endothelial function testing was performed after iontophoresis of acetylcholine and sodium nitroprusside using laser Doppler flowmetry. Ingestion of fructose (60 or 30 g) increased diastolic and mean BP to a greater extent than the ingestion of 60 g of either glucose or sucrose (Psugary drinks. In conclusion, ingestion of fructose, but not sucrose, increases BP in healthy human subjects. Although sucrose comprises glucose and fructose, its changes in TPR and CO are more related to glucose than to fructose.

  6. Do depressive symptoms "blunt" effort? An analysis of cardiac engagement and withdrawal for an increasingly difficult task.

    Science.gov (United States)

    Silvia, Paul J; Mironovová, Zuzana; McHone, Ashley N; Sperry, Sarah H; Harper, Kelly L; Kwapil, Thomas R; Eddington, Kari M

    2016-07-01

    Research on depression and effort has suggested "depressive blunting"-lower cardiovascular reactivity in response to challenges and stressors. Many studies, however, find null effects or higher reactivity. The present research draws upon motivational intensity theory, a broad model of effort that predicts cases in which depressive symptoms should increase or decrease effort. Because depressive symptoms can influence task-difficulty appraisals-people see tasks as subjectively harder-people high in depressive symptoms should engage higher effort at objectively easier levels of difficulty but also quit sooner. A sample of adults completed a mental effort challenge with four levels of difficulty, from very easy to difficult-but-feasible. Depressive symptoms were assessed with the CESD and DASS; effort-related cardiac activity was assessed via markers of contractility (e.g., the cardiac pre-ejection period [PEP]) obtained with impedance cardiography. The findings supported the theory's predictions. When the task was relatively easier, people high in depressive symptoms showed higher contractility (shorter PEP), consistent with greater effort. When the task was relatively harder, people high in depressive symptoms showed diminished contractility, consistent with quitting. The results suggest that past research has been observing a small part of a larger trajectory of trying and quitting, and they illustrate the value of a theoretically grounded analysis of depressive symptoms and effort-related cardiac activity. PMID:27174723

  7. Assessment of Myocardial Perfusion and Systolic Function in Patients with Coronary Artery Disease after Coronary Artery Bypass Surgery by Myocardial Contrast Echocardiography and Two-dimensional Strain Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Rong LIU; Youbin DENG; Xiaojun BI; Yani LIU; Li XIONG; Liuping CHEN

    2009-01-01

    The clinically applied value of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery using real-time myocardial contrast echo-cardiography (RT-MCE) combined with two-dimensional strain echocardiography was assessed.Twenty patients underwent intravenous RT-MCE by intravenous injections of Sono Vue before and after coronary artery bypass surgery. Two-dimensional images were recorded from the left ventricular four-chamber view, two-chamber view and the apical view before, and two weeks and three months af-ter coronary artery bypass surgery, and the peak systolic longitudinal strain was measured. The results showed that myocardial perfusion was significantly increased after coronary artery bypass surgery in about 71.6% segments. In the group that myocardial perfusion was improved, the peak systolic longitu-dinal strain three months after bypass surgery was significantly higher than that before operation [(-15.78±5.91)% vs (-10.45±8.31)%, P0.05]. It was con-cluded that whether or not the improvement of myocardial perfusion can mirror the recovery trend of regional systolic function, two-dimensional strain echocardiography can observe dynamic change of re-gional systolic function. The combination of myocardial perfusion with two-dimensional strain echocar-diography can more accurately assess the curative effectiveness of coronary artery bypass surgery.

  8. 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

  9. Preejection period can be calculated using R peak instead of Q.

    Science.gov (United States)

    Seery, Mark D; Kondrak, Cheryl L; Streamer, Lindsey; Saltsman, Thomas; Lamarche, Veronica M

    2016-08-01

    Preejection period (PEP) is a common measure of sympathetic nervous system activation in psychophysiological research, which makes it important to measure reliably for as many participants as possible. PEP is typically calculated as the interval between the onset or peak of the electrocardiogram Q wave and the impedance cardiography B point, but the Q wave can lack clear definition and even its peak is not visible for all participants. We thus investigated the feasibility of using the electrocardiogram R wave peak (Rpeak ) instead of Q because it can be consistently identified with ease and precision. Across four samples (total N = 408), young adult participants completed a variety of minimally metabolically demanding laboratory tasks after a resting baseline. Results consistently supported a close relationship between absolute levels of the Rpeak -B interval and PEP (accounting for approximately 90% of the variance at baseline and 89% during task performance, on average), but for reactivity values, Rpeak -B was practically indistinguishable from PEP (accounting for over 98% of the variance, on average). Given that using Rpeak rather than the onset or peak of Q saves time, eliminates potential subjectivity, and can be applied to more participants (i.e., those without a visible Q wave), findings suggest that Rpeak -B likely provides an adequate estimate of PEP when absolute levels are of interest and clearly does so for within-person changes. PMID:27080937

  10. PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    Silvana de Araújo SILVA

    2015-04-01

    Full Text Available The identification of predictors for the progression of chronic Chagas cardiomyopathy (CCC is essential to ensure adequate patient management. This study looked into a non-concurrent cohort of 165 CCC patients between 1985 and 2010 for independent predictors for CCC progression. The outcomes were worsening of the CCC scores and the onset of left ventricular dysfunction assessed by means of echo-Doppler cardiography. Patients were analyzed for social, demographic, epidemiologic, clinical and workup-related variables. A descriptive analysis was conducted, followed by survival curves based on univariate (Kaplan-Meier and Cox’s univariate model and multivariate (Cox regression model analysis. Patients were followed from two to 20 years (mean: 8.2. Their mean age was 44.8 years (20-77. Comparing both iterations of the study, in the second there was a statistically significant increase in the PR interval and in the QRS duration, despite a reduction in heart rates (Wilcoxon < 0.01. The predictors for CCC progression in the final regression model were male gender (HR = 2.81, Holter monitoring showing pauses equal to or greater than two seconds (HR = 3.02 increased cardiothoracic ratio (HR = 7.87 and time of use of digitalis (HR = 1.41. Patients with multiple predictive factors require stricter follow-up and treatment.

  11. Lower glomerular filtration rate is associated with higher systemic vascular resistance in patients without prevalent kidney disease.

    Science.gov (United States)

    Vääräniemi, Kati; Koskela, Jenni; Tahvanainen, Anna; Tikkakoski, Antti; Wilenius, Matias; Kähönen, Mika; Kööbi, Tiit; Niemelä, Onni; Mustonen, Jukka; Pörsti, Ilkka

    2014-10-01

    The authors examined the association between estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation, and hemodynamics in 556 normotensive or never-treated hypertensive patients without kidney disease (mean age, 46 years). Hemodynamic variables were recorded using pulse wave analysis and whole-body impedance cardiography. The mean eGFR was 98 mL/min/1.73 m(2) (range, 64-145 mL/min/1.73 m(2) and one third of the patients had values below 92, while none had proteinuria. In linear regression analyses adjusted for differences in age, weight:height ratio, low-density lipoprotein cholesterol, and sex, significant associations were found between lower eGFR and higher systolic (P=.001) and diastolic blood pressure (Pvolume. In the absence of clinical kidney disease, lower eGFR was associated with higher blood pressure and systemic vascular resistance. Therefore, early impairment in kidney function may be involved in the pathogenesis of essential hypertension. PMID:25228202

  12. Computational modelling of blood-flow-induced changes in blood electrical conductivity and its contribution to the impedance cardiogram.

    Science.gov (United States)

    Trakic, A; Akhand, M; Wang, H; Mason, D; Liu, F; Wilson, S; Crozier, S

    2010-01-01

    Studies have shown that blood-flow-induced change in electrical conductivity is of equal importance in assessment of the impedance cardiogram (ICG) as are volumetric changes attributed to the motion of heart, lungs and blood vessels. To better understand the sole effect of time-varying blood conductivity on the spatiotemporal distribution of trans-thoracic electric fields (i.e. ICG), this paper presents a segmented high-resolution (1 mm(3)) thoracic cardiovascular system, in which the time-varying pressures, flows and electrical conductivities of blood in different vessels are evaluated using a set of coupled nonlinear differential equations, red blood cell orientation and cardiac cycle functions. Electric field and voltage simulations are performed using two and four electrode configurations delivering a small alternating electric current to an anatomically realistic and electrically accurate model of modelled human torso. The simulations provide a three-dimensional electric field distribution and show that the time-varying blood conductivity alters the voltage potential difference between the electrodes by a maximum of 0.28% for a cardiac output of about 5 L min(-1). As part of a larger study, it is hoped that this initial model will be useful in providing improved insights into blood-flow-related spatiotemporal electric field variations and assist in the optimal placement of electrodes in impedance cardiography experiments.

  13. Chinese Medicine Shenfu Injection for Heart Failure: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Song Wen-Ting

    2012-01-01

    Full Text Available Objective. Heart failure (HF is a global public health problem. Early literature studies manifested that Shenfu injection (SFI is one of the most commonly used traditional Chinese patent medicine for HF in China. This article intended to systematically evaluate the efficacy and safety of SFI for HF. Methods. An extensive search was performed within 6 English and Chinese electronic database up to November 2011. Ninety-nine randomized controlled trails (RCTs were collected, irrespective of languages. Two authors extracted data and assessed the trial quality independently. RevMan 5.0.2 was used for data analysis. Results. Compared with routine treatment and/or device support, SFI combined with routine treatment and/or device support showed better effect on clinical effect rate, mortality, heart rate, NT-proBNP and 6-minute walk distance. Results in ultrasonic cardiography also showed that SFI combined with routine treatment improved heart function of HF patients. There were no significant difference in blood pressure between SFI and routine treatment groups. Adverse events were reported in thirteen trails with thirteen specific symptoms, while no serious adverse effect was reported. Conclusion. SFI appear to be effective for treating HF. However, further rigorously designed RCTs are warranted because of insufficient methodological rigor in the majority of included trials.

  14. Role of echocardiography in diagnosis of pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Srbinovska Kostovska Elizabeta

    2013-07-01

    Full Text Available Pulmonary hypertension (PH is a progressive process that leads to right ventricular (RV overload, hypertrophy, dilatation and RV failure. In cases with chronic heart failure, this condition is associated with more severe symptoms and worse outcomes.Transthoracic echocardiography can give several parameters which correlate with right heart haemodynamics, and should be performed in a case of suspected PH. Several parameters are important for estimation of the RV function, which can be reason for poor outcome: right atrial and ventricular dimensions and volumes, functional area changes, tricuspid annular plane systolic excursion (TAPSE, myocardial performance index, infe- rior vena cava size and collapsibility, S velocity estimated by Tissue Doppler Imaging, and additional information obtained from the advance echocardiograpic techniques, like strain, strain rate, three-dimensional echocardiography. Estimation of PH based on Doppler echo- cardiography measurements is not suitable for screening of mild, asymptomatic PH. Echocardiography can be recommended as a screening tool for specific diseases, follow up PH, and assessment when right heart catheterization is indicated.

  15. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure

    Science.gov (United States)

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziebło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-01-01

    Background Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. Material/Methods In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I–III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e’) assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR – CSR_ [−] (n=110). Results CSR_ [+] patients presented more advanced NYHA class (pCSR_ [+] were identified: NYHA class (OR=3.34 per class, pCSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR. PMID:27558771

  16. [Evaluation of orthostatic regulation by saddle support test using thoracic impedance].

    Science.gov (United States)

    Gugova, F K; Lapin, V V

    2002-01-01

    We investigated 21 healthy volunteers (10 males and 11 females, mean age 23 +/- 4 years). All the subjects have undergone two 20 min head-up tilt tests using tilt table "TRI W.G. inc." (USA): the first with footplate support and the second with bicycle saddle. Thoracic electrical impedance was measured using impedance cardiography according to Kubicek et al. The protocols included an initial period of 20 min of supine rest while baseline thoracic impedance, blood pressure and heart rate were recorded and then followed by a tilt to 65 degrees. Changes of impedance were measured at min 1, 2, 3, 5, 7, 10, 15, 20 after the procedure. Women had higher values of thoracic impedance both at rest and during the tilt test than men. The value of impedance of the chest negatively correlated with the body mass index. We suppose that an increase of impedance more than 15% may be related with pathological venous pooling. Thoracic impedance may be used to monitor changes of thoracic fluid volumes with posture and possibly to assess orthostatic regulation. The contribution of leg muscles in orthostatic regulation does not reflect values of thoracic impedance. PMID:12152425

  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. Spintronic platforms for biomedical applications.

    Science.gov (United States)

    Freitas, P P; Cardoso, F A; Martins, V C; Martins, S A M; Loureiro, J; Amaral, J; Chaves, R C; Cardoso, S; Fonseca, L P; Sebastião, A M; Pannetier-Lecoeur, M; Fermon, C

    2012-02-01

    Since the fundamental discovery of the giant magnetoresistance many spintronic devices have been developed and implemented in our daily life (e.g. information storage and automotive industry). Lately, advances in the sensors technology (higher sensitivity, smaller size) have potentiated other applications, namely in the biological area, leading to the emergence of novel biomedical platforms. In particular the investigation of spintronics and its application to the development of magnetoresistive (MR) biomolecular and biomedical platforms are giving rise to a new class of biomedical diagnostic devices, suitable for bench top bioassays as well as point-of-care and point-of-use devices. Herein, integrated spintronic biochip platforms for diagnostic and cytometric applications, hybrid systems incorporating magnetoresistive sensors applied to neuroelectronic studies and biomedical imaging, namely magneto-encephalography and magneto-cardiography, are reviewed. Also lab-on-a-chip MR-based platforms to perform biological studies at the single molecule level are discussed. Overall the potential and main characteristics of such MR-based biomedical devices, comparing to the existing technologies while giving particular examples of targeted applications, are addressed. PMID:22146898

  20. Detecting variations of blood volume shift due to heart beat from respiratory inductive plethysmography measurements in man

    International Nuclear Information System (INIS)

    The simultaneous study of the cardiac and respiratory activities and their interactions is of great physiological and clinical interest. For this purpose, we want to investigate if respiratory inductive plethysmography (RIP) can be used for cardiac functional exploration. We propose a system, based on RIP technology and time-scale approaches of signal processing, for the extraction of cardiac information. This study focuses on the monitoring of blood volume shift due to heart beat, noted ▵Vtrc and investigates RIP for the detection of ▵Vtrc variations by comparison to stroke volume (SV) variations estimated by impedance cardiography (IMP). We proposed a specific respiratory protocol assumed to induce significant variations of the SV. Fifteen healthy volunteers in the seated and supine positions were asked to alternate rest respiration and maneuvers, consisting in blowing into a manometer. A multi-step treatment including a variant of empirical mode decomposition was applied on RIP signals to extract cardiac volume signals and estimate beat-to-beat ▵Vtrc. These were averaged in quasi-stationary states at rest and during the respiratory maneuvers, and analysed in view of SV estimations from IMP signals simultaneously acquired. Correlation and statistical tests over the data show that RIP can be used to detect variations of the cardiac blood shift in healthy young subjects. (paper)

  1. A wideband high common mode rejection ratio amplifier and phase-locked loop demodulator for multifrequency impedance measurement.

    Science.gov (United States)

    Goovaerts, H G; Faes, T J; Raaijmakers, E; Heethaar, R M

    1998-11-01

    Design considerations and implementation of a multifrequency measuring channel for application in the field of bio-impedance measurement are discussed in this paper. The input amplifier has a differential configuration which is electrically isolated from the remaining circuits. Transformer coupling provides improved common mode rejection when compared to non-isolated input stages. The frequency characteristic of the section between input and demodulator is flat within +/- 0.1 dB between 4 kHz and 1024 kHz. The synchronous demodulator is based on a wideband switched video amplifier. In contrast to commonly used lock--in techniques, the carrier for demodulation is recovered from the input signal by means of a phase-locked loop. This method ensures zero phase shift with respect to the input signal and improves the accuracy of measurement. The system has been developed primarily for thoracic impedance cardiography (TIC) but has also successfully been applied in the field of total body bio-impedance analysis (BIA). At present an electrical impedance tomograph is under development based on the instrumentation described. Results regarding the measurement range and accuracy are given and some recordings of patient data are shown.

  2. Perfectionism and Effort-Related Cardiac Activity: Do Perfectionists Try Harder?

    Science.gov (United States)

    Harper, Kelly L; Eddington, Kari M; Silvia, Paul J

    2016-01-01

    Do perfectionists try harder? Previous research on perfectionism and effort has used self-report items and task performance as indicators of effort. The current study investigated whether individual differences in perfectionism predicted effort-related cardiac activity during a mental effort task. Based on past research that suggests adaptive perfectionism is associated with higher effort, it was hypothesized that self-oriented perfectionism (SOP) would predict increased effort on the task. One hundred and eleven college students completed the Multidimensional Perfectionism Scale (MPS) and a self-paced parity task in which they received a small cash reward (3 cents) for each correct response. Impedance cardiography was used to assess autonomic reactivity, and regression models tested whether SOP and socially prescribed perfectionism (SPP) explained autonomic reactivity. Overall, participants showed both sympathetic (faster pre-ejection period; PEP) and parasympathetic activation (elevated high-frequency heart rate variability; HRV) during the task, reflecting higher effort and engagement. Contrary to predictions, individual differences in perfectionism did not moderate cardiac reactivity. These findings draw attention to the importance of assessing physiological components of effort and motivation directly rather than inferring them from task performance or self-reported effort. PMID:27483467

  3. Detecting Aortic Valve Opening and Closing from Distal Body Vibrations

    CERN Document Server

    Wiens, Andrew D; Inan, Omer T

    2016-01-01

    Objective: Proximal and whole-body vibrations are well studied in seismocardiography and ballistocardiography, yet distal vibrations are still poorly understood. In this paper we develop two methods to measure aortic valve opening (AVO) and closing (AVC) from distal vibrations. Methods: AVO and AVC were detected for each heartbeat with accelerometers on the upper arm (A), wrist (W), and knee (K) of 22 consenting adults following isometric exercise. Exercise-induced changes were recorded with impedance cardiography, and nine-beat ensemble averaging was applied. Our first method, FilterBCG, detects peaks in distal vibrations after filtering with individually-tuned bandpass filters while RidgeBCG uses ridge regression to estimate AVO and AVC without peaks. Pseudocode is provided. Results: In agreement with recent studies, we did not find peaks at AVO and AVC in distal vibrations, and the conventional R-J interval method from the literature also correlated poorly with AVO (r2 = 0.22 A, 0.14 W, 0.12 K). Interestin...

  4. 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...

  5. Do depressive symptoms "blunt" effort? An analysis of cardiac engagement and withdrawal for an increasingly difficult task.

    Science.gov (United States)

    Silvia, Paul J; Mironovová, Zuzana; McHone, Ashley N; Sperry, Sarah H; Harper, Kelly L; Kwapil, Thomas R; Eddington, Kari M

    2016-07-01

    Research on depression and effort has suggested "depressive blunting"-lower cardiovascular reactivity in response to challenges and stressors. Many studies, however, find null effects or higher reactivity. The present research draws upon motivational intensity theory, a broad model of effort that predicts cases in which depressive symptoms should increase or decrease effort. Because depressive symptoms can influence task-difficulty appraisals-people see tasks as subjectively harder-people high in depressive symptoms should engage higher effort at objectively easier levels of difficulty but also quit sooner. A sample of adults completed a mental effort challenge with four levels of difficulty, from very easy to difficult-but-feasible. Depressive symptoms were assessed with the CESD and DASS; effort-related cardiac activity was assessed via markers of contractility (e.g., the cardiac pre-ejection period [PEP]) obtained with impedance cardiography. The findings supported the theory's predictions. When the task was relatively easier, people high in depressive symptoms showed higher contractility (shorter PEP), consistent with greater effort. When the task was relatively harder, people high in depressive symptoms showed diminished contractility, consistent with quitting. The results suggest that past research has been observing a small part of a larger trajectory of trying and quitting, and they illustrate the value of a theoretically grounded analysis of depressive symptoms and effort-related cardiac activity.

  6. Evaluation of myocardial perfusion and ventricular shape in hypertrophic cardiomyopathy using 99mTc-tetrofosmin scintigraphy

    International Nuclear Information System (INIS)

    Hypertrophic cardiomyopathy (HCM) is known to have the impairment of myocardial perfusion as well as irregularly hypertrophic myocardium. To evaluate myocardial perfusion and ventricular shape in HCM, 99mTc-Tetrofosmin scintigraphy was performed after exercise (Ex) and at resting state (Re) in 10 patients with HCM and was compared with early image (Ea) and delayed image (De) of 201Tl scintigraphy performed after exercise. SPECT images of both 99mTc-Tetrofosmin and 201Tl scintigraphy were analyzed with five scaled visual scores set in 18 segments. The complete concordance ratio between 99mTc-Tetrofosmin (Ex and Re) and 201Tl(Ea and De) images in segmental analysis was 75%. Image quality of 99mTc-Tetrofosmin was seemed to be superior to that of 201Tl scintigraphy. In 9 patients with HCM, 99mTc-Tetrofosmin scintigraphy was performed under the ECG gating and the thickness of septal and free wall was measured. Good correlation was observed with the data by ultrasound cardiography (r=0.79, p99mTc-Tetrofosmin scintigraphy is useful for the evaluation of myocardial morphology as well as perfusion abnormality. (author)

  7. National radiology standards in X-ray diagnostic incl. interventional radiology

    International Nuclear Information System (INIS)

    In 2004 the Ministry of Health care started within the frame of the program for support of quality in health care a project consisting of 4 separate tasks: creating of standards for medical irradiation in radiodiagnostics, in radiotherapy , in nuclear medicine and creating of standards for patients dose assessment in radiophysics. This document continues with description of a part of the project aimed on X-ray radiodiagnostics. The authors of the project were chosen based on their bids to the public grant issued by the Ministry of Health care. The authors used recommendations, guidelines and instructions of international professional societies and IAEA, as well as the already existing procedures and practices while considering possibilities and state of the praxis in the Czech Republic. The outcome of authors work is now an interim version of a document that will be published in the bulletin of the Ministry of Health care. The document contains a set of standards that cover the whole range o fall complimentarily performed ways of patients irradiation in X-ray diagnostics and interventional radiology . The standards are divided to several categories according to the requirement of the Ministry of Health care based on the diagnostic appliances used for diagnostic irradiation i.e. radiography , fluoroscopy, mammography, stomatology, computer tomography, angiography, interventional radiography and cardiography. (authors)

  8. Cardiovascular responses to the ingestion of sugary drinks using a randomised cross-over study design: Does glucose attenuate the blood pressure-elevating effect of fructose?

    Science.gov (United States)

    Grasser, Erik K; Dulloo, Abdul; Montani, Jean-Pierre

    2014-07-28

    Overconsumption of sugar-sweetened beverages has been implicated in the pathogenesis of CVD. The objective of the present study was to elucidate acute haemodynamic and microcirculatory responses to the ingestion of sugary drinks made from sucrose, glucose or fructose at concentrations similar to those often found in commercial soft drinks. In a randomised cross-over study design, twelve young healthy human subjects (seven men) ingested 500 ml tap water in which was dissolved 60 g of either sucrose, glucose or fructose, or an amount of fructose equivalent to that present in sucrose (i.e. 30 g fructose). Continuous cardiovascular monitoring was performed for 30 min before and at 60 min after ingestion of sugary drinks, and measurements included beat-to-beat blood pressure (BP) and impedance cardiography. Additionally, microvascular endothelial function testing was performed after iontophoresis of acetylcholine and sodium nitroprusside using laser Doppler flowmetry. Ingestion of fructose (60 or 30 g) increased diastolic and mean BP to a greater extent than the ingestion of 60 g of either glucose or sucrose (Psugary drinks. In conclusion, ingestion of fructose, but not sucrose, increases BP in healthy human subjects. Although sucrose comprises glucose and fructose, its changes in TPR and CO are more related to glucose than to fructose. PMID:24780643

  9. Relationship between changes in pulmonary V̇O₂ kinetics and autonomic regulation of blood flow.

    Science.gov (United States)

    McNarry, M A; Kingsley, M I C; Lewis, M J

    2014-08-01

    Various regulatory mechanisms of pulmonary oxygen uptake (V̇O2) kinetics have been postulated. The purpose of this study was to investigate the relationship between vagal withdrawal, measured using RMSSDRR, the root mean square of successive differences in cardiac interval (RR) kinetics, a mediator of oxygen delivery, and V̇O2 kinetics. Forty-nine healthy adults (23 ± 3 years; 72 ± 13 kg; 1.80 ± 0.08 m) performed multiple repeat transitions to moderate- and heavy-intensity exercise. Electrocardiography, impedance cardiography, and pulmonary gas exchange parameters were measured throughout; time domain measures of heart rate variability were subsequently derived. The parameters describing the dynamic response of V̇O2, cardiac output (Q) and RMSSDRR were determined using a mono-exponential model. During heavy-intensity exercise, the phase II τ of V̇O2 was significantly correlated with the τ of RR (r = 0.36, P kinetics and those of Q, RR, or RMSSDRR during moderate exercise. Vagal withdrawal kinetics support the concept of a centrally mediated oxygen delivery limitation partly regulating V̇O2 kinetics during heavy-, but not moderate-, intensity exercise.

  10. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure.

    Science.gov (United States)

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziębło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-01-01

    BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR - CSR_ [-] (n=110). RESULTS CSR_ [+] patients presented more advanced NYHA class (pCSR_ [+] were identified: NYHA class (OR=3.34 per class, pCSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR. PMID:27558771

  11. Simulation of 'pathologic' changes in ICG waveforms resulting from superposition of the 'preejection' and ejection waves induced by left ventricular contraction

    Science.gov (United States)

    Ermishkin, V. V.; Kolesnikov, V. A.; Lukoshkova, E. V.; Sonina, R. S.

    2013-04-01

    The impedance cardiography (ICG) is widely used for beat-to-beat noninvasive evaluation of the left ventricular stroke volume and contractility. It implies the correct determination of the ejection start and end points and the amplitudes of certain peaks in the differentiated impedance cardiogram. An accurate identification of ejection onset by ICG is often problematic, especially in the cardiologic patients, due to peculiar waveforms. Using a simple theoretical model, we tested the hypothesis that two major processes are responsible for the formation of impedance systolic wave: (1) the changes in the heart geometry and surrounding vessels produced by ventricular contraction, which occur during the isovolumic phase and precede ejection, and (2) expansion of aorta and adjacent arteries during the ejection phase. The former process initiates the preejection wave WpE and the latter triggers the ejection wave WEj. The model predicts a potential mechanism of generating the abnormal shapes of dZ/dt due to the presence of preejection waves and explains the related errors in ICG time and amplitude parameters. An appropriate decomposition method is a promising way to avoid the masking effects of these waves and a further step to correct determination of the onset of ejection and the corresponding peak amplitudes from 'pathologically shaped' ICG signals.

  12. A new mouse model of metabolic syndrome and associated complications

    Science.gov (United States)

    Wang, Yun; Zheng, Yue; Nishina, Patsy M; Naggert, Jürgen K.

    2010-01-01

    Metabolic Syndrome (MS) encompasses a clustering of risk factors for cardiovascular disease, including obesity, insulin resistance, and dyslipidemia. We characterized a new mouse model carrying a dominant mutation, C57BL/6J-Nmf15/+ (B6-Nmf15/+), which develops additional complications of MS such as adipose tissue inflammation and cardiomyopathy. A backcross was used to genetically map the Nmf15 locus. Mice were examined in the CLAMS™ animal monitoring system, and dual energy X-ray absorptiometry and blood chemistry analyses were performed. Hypothalamic LepR, SOCS1 and STAT3 phosphorylation were examined. Cardiac function was assessed by Echo- and Electro Cardiography. Adipose tissue inflammation was characterized by in situ hybridization and measurement of Jun kinase activity. The Nmf15 locus mapped to distal mouse chromosome 5 with a LOD score of 13.8. Nmf15 mice developed obesity by 12 weeks of age. Plasma leptin levels were significantly elevated in pre-obese Nmf15 mice at 8 weeks of age and an attenuated STAT3 phosphorylation in the hypothalamus suggests a primary leptin resistance. Adipose tissue from Nmf15 mice showed a remarkable degree of inflammation and macrophage infiltration as indicated by expression of the F4/80 marker and increased phosphorylation of JNK1/2. Lipidosis was observed in tubular epithelial cells and glomeruli of the kidney. Nmf15 mice demonstrate both histological and pathophysiological evidence of cardiomyopathy. The Nmf15 mouse model provides a new entry point into pathways mediating leptin resistance and obesity. It is one of few models that combine many aspects of metabolic syndrome and can be useful for testing new therapeutic approaches for combating obesity complications, particularly cardiomyopathy. PMID:19398498

  13. Echocardiography as an indication of continuous-time cardiac quiescence

    Science.gov (United States)

    Wick, C. A.; Auffermann, W. F.; Shah, A. J.; Inan, O. T.; Bhatti, P. T.; Tridandapani, S.

    2016-07-01

    Cardiac computed tomography (CT) angiography using prospective gating requires that data be acquired during intervals of minimal cardiac motion to obtain diagnostic images of the coronary vessels free of motion artifacts. This work is intended to assess B-mode echocardiography as a continuous-time indication of these quiescent periods to determine if echocardiography can be used as a cost-efficient, non-ionizing modality to develop new prospective gating techniques for cardiac CT. These new prospective gating approaches will not be based on echocardiography itself but on CT-compatible modalities derived from the mechanics of the heart (e.g. seismocardiography and impedance cardiography), unlike the current standard electrocardiogram. To this end, echocardiography and retrospectively-gated CT data were obtained from ten patients with varied cardiac conditions. CT reconstructions were made throughout the cardiac cycle. Motion of the interventricular septum (IVS) was calculated from both echocardiography and CT reconstructions using correlation-based, deviation techniques. The IVS was chosen because it (1) is visible in echocardiography images, whereas the coronary vessels generally are not, and (2) has been shown to be a suitable indicator of cardiac quiescence. Quiescent phases were calculated as the minima of IVS motion and CT volumes were reconstructed for these phases. The diagnostic quality of the CT reconstructions from phases calculated from echocardiography and CT data was graded on a four-point Likert scale by a board-certified radiologist fellowship-trained in cardiothoracic radiology. Using a Wilcoxon signed-rank test, no significant difference in the diagnostic quality of the coronary vessels was found between CT volumes reconstructed from echocardiography- and CT-selected phases. Additionally, there was a correlation of 0.956 between the echocardiography- and CT-selected phases. This initial work suggests that B-mode echocardiography can be used as a

  14. Hepatic hemodynamics and fetal growth: a relationship of interest for further research.

    Directory of Open Access Journals (Sweden)

    Sharona Vonck

    Full Text Available It is well known that hepatic hemodynamics is an important physiologic mechanism in the regulation of cardiac output (CO. It has been reported that maternal cardiac output relates to neonatal weight at birth.In this study, we assessed the correlation between maternal hepatic vein Doppler flow parameters, cardiac output and neonatal birth weight.Healthy women with uncomplicated second or third trimester pregnancy attending the outpatient antenatal clinic of Ziekenhuis Oost-Limburg in Genk (Belgium, had a standardized combined electrocardiogram-Doppler ultrasound with Impedance Cardiography, for measurement of Hepatic Vein Impedance Index (HVI  =  [maximum velocity - minimum velocity]/maximum velocity, venous pulse transit time (VPTT  =  time interval between corresponding ECG and Doppler wave characteristics and cardiac output (heart rate x stroke volume. After delivery, a population-specific birth weight chart, established from a cohort of 27000 neonates born in the index hospital, was used to define customized birth weight percentiles (BW%. Correlations between HVI, VPTT, CO and BW% were calculated using Spearman's ρ, linear regression analysis and R2 goodness of fit in SPSS 22.0.A total of 73 women were included. There was a negative correlation between HVI and VPTT (ρ = -0.719, p < 0.001. Both HVI and VPTT correlated with CO (ρ = -0.403, p < 0.001 and ρ = 0.332, p < 0.004 resp. and with BW% (ρ =  -0.341, p < 0.003 and ρ = 0.296, p < 0.011 resp..Our data illustrate that the known contribution of hepatic hemodynamics in the regulation of cardiac output is also true for women with uncomplicated pregnancies. Our study is the first to illustrate a potential link between maternal hepatic hemodynamics and neonatal birth weight. Whether this link is purely associative or whether hepatic vascular physiology has a direct impact on fetal growth is to be evaluated in more extensive clinical and experimental research.

  15. Cine MRI for quantifying regurgitant lesions using a volume method. Cine-MR zur Quantifizierung von Regurgitationsvitien mittels Volumenmethode

    Energy Technology Data Exchange (ETDEWEB)

    Neuhold, A.; Stiskal, M.; Wicke, L. (Rudolfinerhaus, Vienna (Austria)); Globits, S.; Frank, H.; Glogar, D.; Mayr, H. (Vienna Univ. (Austria). Kardiologische Klinik)

    1990-12-01

    We have examined 46 patients with angiographically confirmed regurgitant lesions (26 mitral insufficiency, 20 aortic insufficiency) using a 0.5 Tesla magnet. In each patient, mulit-plane and multi-phase spin-echo sequences were obtained in a plane angled in the sagittal and coronal direction in the long axis of the heart; left and right ventricular volumes, ejection fractions and regurgitation fractions were calculated. In addition, a blood-flow sensitive gradient echo sequence was obtained in order to determine the direction and extent of the regurgitant jet. The data was compared with the results of angiography and echo-cardiography. By means of the gradient echo technique, MRI was able to show the regurgitant jet in every patient. There was a linear correlation between volumes determined by MRI and angiography. The best agreement was found for left ventricular contraction volume (R = 0.82, p is <0.0001). Comparison of the non-invasive and angiographic method showed a linear correlation for AI patients of R = 0.91 (p is <0.0001), which is somewhat better than for patients with MI (R = 0.84, p <0.001). Seme-quantitative grading of MI with a gradient echo technique showed a linear correlation with angiography of R = 0.73 (p <0.001), for AI there was agreement between both methods in 72% of cases. A comparison between MRI and colour Doppler sonography showed only moderately good correlation R = 0.69 (p<0.01). (orig.).

  16. Myocardial fatty acid imaging using iodine-123-BMIPP in patients with hypertensive intracranial hemorrhage

    International Nuclear Information System (INIS)

    An evaluation of myocardial fatty acid metabolism in hypertensive patients with major complication has not been previously established. To assess the myocardial fatty acid metabolism in hypertensive patients with intracranial hemorrhage (IH), we performed myocardial image using 123I-15-p-iodophenyl-3-methyl pentadecanoic acid (BMIPP). Seventeen hypertensive patients with IH (HIH) and 27 hypertensive patients without IH (HT) were studied. A dose of 111 MBq of BMIPP was injected intravenously at rest, and a myocardial image was recorded 30 minutes after the injection. Myocardial perfusion image using Thallium-201 (Tl) was also performed within 2 weeks after BMIPP study. The regional myocardial uptakes of BMIPP and Tl were visually assessed in 17 segments with a four-point scoring system (0=absent to 3=normal uptake). Cardiac hypertrophy was evaluated by electrocardiogrpahy (ECG) and two-dimensional ultrasonic cardiography (UCG). Sum of uptake scores of Tl was similar in both groups (45.1±5.4 vs. 47.9±4.2), but that of BMIPP in HIH was lower than HT (35.9±7.9 vs 45.6±4.8, p<0.001). Evaluation of cardiac hypertrophy using ECG and UCG revealed no significant difference between two groups. HIH have much more eccentric hypertrophy in UCG study than HT (53% vs. 37%). These data suggest that hypertensive patients with intracranial hemorrhage have a more impaired myocardial fatty acid metabolism compared to the hypertensive patients with similar cardiac hypertrophy. BMIPP imaging might be useful to evaluate the severity of myocardial fatty acid metabolism in hypertensive patients. (author)

  17. Elucidating the Hemodynamic Origin of Ballistocardiographic Forces: Toward Improved Monitoring of Cardiovascular Health at Home.

    Science.gov (United States)

    Javaid, Abdul Qadir; Ashouri, Hazar; Tridandapani, Srini; Inan, Omer T

    2016-01-01

    The ballistocardiogram (BCG), a signal describing the reaction forces of the body to cardiac ejection of blood, has recently gained interest in the research community as a potential tool for monitoring the mechanical aspects of cardiovascular health for patients at home and during normal activities of daily living. An important limitation in the field of BCG research is that while the BCG signal measures the forces of the body, the information desired (and understood) by clinicians and caregivers, regarding mechanical health of the cardiovascular system, is typically expressed as blood pressure or flow. This paper aims to explore, using system identification tools, the mathematical relationship between the BCG signal and the better-understood impedance cardiography (ICG) and arterial blood pressure (ABP) waveforms, with a series of human subject studies designed to asynchronously modulate cardiac output and blood pressure and with different magnitudes. With this approach, we demonstrate for 19 healthy subjects that the BCG waveform more closely maps to the ICG (flow) waveform as compared with the finger-cuff-based ABP (pressure) waveform, and that the BCG can provide a more accurate estimate of stroke volume ([Formula: see text], [Formula: see text]) as compared with pulse pressure changes ([Formula: see text]). We also examined, as a feasibility study, for one subject, the ability to calibrate the BCG measurement tool with an ICG measurement on the first day, and then track changes in stroke volume on subsequent days. Accordingly, we conclude that the BCG is a signal more closely related to blood flow than pressures, and that a key health parameter for titrating care-stroke volume-can potentially be accurately measured with BCG signals at home using unobtrusive and inexpensive hardware, such as a modified weighing scale, as compared with the state-of-the-art ICG and ABP devices, which are expensive and obtrusive for use at home. PMID:27620621

  18. Comparison of Two Methods for Noninvasive Determination of Stroke Volume During Orthostatic Challenge

    Science.gov (United States)

    Doerr, Donald F.; Ratliff, Duane A.; Sithole, Joseph; Convertino, Victor A.

    2005-01-01

    Background: The real time, beat-by-beat, non-invasive determination of stroke volume (SV) is an important parameter in many aerospace related physiologic protocols. In this study, we compared simultaneous estimates of SV calculated from peripheral pulse waveforms with a more conventional non-invasive technique. Methods: Using a prospective, randomized blinded protocol, ten males and nine females completed 12-mm tilt table protocols. The relative change (%(Delta)) in beat-to-beat SV was estimated non-invasively from changes in pulse waveforms measured by application of infrared finger photoplethysmography (IFP) with a Portapres(Registered TradeMark) blood pressure monitoring device and by thoracic impedance cardiography (TIC). The %(Delta) SV values were calculated from continuous SV measurements in the supine posture and over the first 10 s (T1), second 10 s (T2), and 3.5 minutes (T3) of 80deg head-up tilt (HUT). Results: The average %(Delta) SV measured by IFP at T1 (-11.7 +/- 3.7 %) was statistically less (P or = 0.322) than the average %(Delta) SV measured by TIC at T2 (-21.8 +/- 2.5 %), and T3 (-22.6 +/- 2.9 %). Correlation coefficients (r(sup 2)) between IFP and TIC were 0.117 (T1), 0.387 (T2), and 0.7 18 (T3). Conclusion: IFP provides beat-to-beat (real time) assessment of %(Delta) SV after 20 sec of transition to an orthostatic challenge that is comparable to the commonly accepted TIC. Our data support the notion that IFP technology which has flown during space missions can be used to accurately assess physiological status and countermeasure effectiveness for orth static problems that may arise in astronauts after space flight. While the peripherally measured IFP response is slightly delayed, the ease of implementing this monitor in the field is advantageous.

  19. Establishment of a chronic left ventricular aneurysm model in rabbit

    Institute of Scientific and Technical Information of China (English)

    Cang-Song XIAO; Chang-Qing GAO; Li-Bing LI; Yao WANG; Tao ZHAO; Wei-Hua YE; Chong-Lei REN; Zhi-Yong LIU; Yang WU

    2014-01-01

    Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm (LVA) in rabbits. Methods Acute myocardial infarction (AMI) was induced in 35 rabbits via concomitant ligation of the left anterior descending (LAD) coronary artery and the circumflex (Cx) branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure (LVESP) and diastolic pressure (LVEDP) were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum (IVS) and the left ventricular posterior wall (LVPW) left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV), and ejection fraction (EF) were recorded by echo-cardiography. Results Thirty one (88.6%) rabbits survived myocardial infarction and 26 of them developed aneurysm (83.9%). The mean area of aneurysm was 33.4% ± 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle (LV) that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%±2.4%which involves the apex, anterior wall and lateral wall of the LV.

  20. Daily liquorice consumption for two weeks increases augmentation index and central systolic and diastolic blood pressure.

    Directory of Open Access Journals (Sweden)

    Miia H Leskinen

    Full Text Available Liquorice ingestion often elevates blood pressure, but the detailed haemodynamic alterations are unknown. We studied haemodynamic changes induced by liquorice consumption in 20 subjects versus 30 controls with average blood pressures of 120/68 and 116/64 mmHg, respectively.Haemodynamic variables were measured in supine position before and after two weeks of liquorice consumption (daily glycyrrhizin dose 290-370 mg with tonometric recording of radial blood pressure, pulse wave analysis, and whole-body impedance cardiography. Thirty age-matched healthy subjects maintaining their normal diet were studied as controls.Two weeks of liquorice ingestion elevated peripheral and central systolic and diastolic blood pressure (by 7/4 and 8/4 mmHg, 95% confidence intervals [CI] 2-11/1-8 and 3-13/1-8, respectively, P<0.05, and increased extracellular volume by 0.5 litres (P<0.05 versus controls. Also augmentation index adjusted to heart rate 75/min (from 7% to 11%, 95% CI for change 0.3-7.5, P<0.05 and aortic pulse pressure (by 4 mmHg, 95% CI 1-7, P<0.05 were elevated indicating increased wave reflection from the periphery. In contrast, peripheral (-3/-0.3 mmHg and central blood pressure (-2/-0.5 mmHg, aortic pulse pressure (-1 mmHg, and augmentation index adjusted to heart rate 75/min (from 9% to 7% decreased numerically but not statistically significantly without changes in extracellular volume in the control group. Heart rate, systemic vascular resistance, cardiac output, and pulse wave velocity did not differ between the groups.Two weeks of daily liquorice consumption increased extracellular volume, amplified pressure wave reflection from the periphery, and elevated central systolic and diastolic blood pressure.EU Clinical Trials Register EudraCT 2006-002065-39 ClinicalTrials.gov NCT01742702.

  1. A Thorax Simulator for Complex Dynamic Bioimpedance Measurements With Textile Electrodes.

    Science.gov (United States)

    Ulbrich, Mark; Muhlsteff, Jens; Teichmann, Daniel; Leonhardt, Steffen; Walter, Marian

    2015-06-01

    Bioimpedance measurements on the human thorax are suitable for assessment of body composition or hemodynamic parameters, such as stroke volume; they are non-invasive, easy in application and inexpensive. When targeting personal healthcare scenarios, the technology can be integrated into textiles to increase ease, comfort and coverage of measurements. Bioimpedance is generally measured using two electrodes injecting low alternating currents (0.5-10 mA) and two additional electrodes to measure the corresponding voltage drop. The impedance is measured either spectroscopically (bioimpedance spectroscopy, BIS) between 5 kHz and 1 MHz or continuously at a fixed frequency around 100 kHz (impedance cardiography, ICG). A thorax simulator is being developed for testing and calibration of bioimpedance devices and other new developments. For the first time, it is possible to mimic the complete time-variant properties of the thorax during an impedance measurement. This includes the dynamic real part and dynamic imaginary part of the impedance with a peak-to-peak value of 0.2 Ω and an adjustable base impedance (24.6 Ω ≥ Z0 ≥ 51.6 Ω). Another novelty is adjustable complex electrode-skin contact impedances for up to 8 electrodes to evaluate bioimpedance devices in combination with textile electrodes. In addition, an electrocardiographic signal is provided for cardiographic measurements which is used in ICG devices. This provides the possibility to generate physiologic impedance changes, and in combination with an ECG, all parameters of interest such as stroke volume (SV), pre-ejection period (PEP) or extracellular resistance (Re) can be simulated. The speed of all dynamic signals can be altered. The simulator was successfully tested with commercially available BIS and ICG devices and the preset signals are measured with high correlation (r = 0.996). PMID:25148671

  2. 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.

  3. Relationship between electrocardiographic RR and QT interval variabilities and indices of ventricular function in healthy subjects.

    Science.gov (United States)

    Lewis, M J; Short, A L

    2008-01-01

    To date there has been no simultaneous characterization of the influence of physical exercise on cardiac ventricular function and cardiac electrical variability. Consequently, little is known about the relationship between the ventricular function and either heart rate (RR) or repolarization (QT) variability. In particular, the relationship between the QT variability index (QTVI) and ventricular function would be of clinical interest. Eight males of similar age (20.7 +/- 0.4 years (mean +/- SD)), mass (78.4 +/- 7.7 kg) and aerobic fitness (50.7 +/- 4.9 ml kg(-1) min(-1)) undertook progressive bicycle exercise. A three-lead Holter ECG was recorded continuously during pre-exercise, exercise and recovery, and mean values of RR and QT, their variabilities (RMSSD and SDNN) and their relative variability (QTVI) were determined. Traditional indices of ventricular function were determined beat to beat via impedance cardiography, and beat-to-beat blood pressure was recorded via photoplethysmography. Multiple linear regression analysis using the stepwise method resulted in significant models for each of the dependent variables (RR, QT, RR and QT variabilities, QTVI), using indices of the ventricular function as predictor variables. Notably, the QTVI reflected both the stroke volume index (SVI) and the acceleration index (ACI), which are measures of cardiac 'output' per contraction and the force of contraction, respectively. This relationship was largely unperturbed by physical exercise, in contrast with the results for all other dependent variables. We conclude that the QTVI is a reasonably consistent measure of the cardiac ventricular function, and as such is a more useful index than other parameters based on RR or QT interval alone. PMID:18175856

  4. Do mathematical model studies settle the controversy on the origin of cardiac synchronous trans-thoracic electrical impedance variations? A systematic review.

    Science.gov (United States)

    de Sitter, A; Verdaasdonk, R M; Faes, T J C

    2016-09-01

    Impedance cardiography (ICG) is a method to evaluate cardiac-stroke volume and cardiac-output by measuring the cardiac-synchronous changes in the dynamic trans-thoracic electrical impedance (ΔZ). Clinical evaluations on the accuracy of ICG showed varying results. Consequently, the classic assumption in ICG-the aorta as a main source of ΔZ-is questioned and subsequently investigated in simulation studies using mathematical models of the electrical resistivity of the human body. The aim is to review the consensus in mathematical modelling studies that investigate the origin of the ΔZ as measured in ICG. In a systematic literature search, studies were identified and surveyed with reference to characteristics, such as included organs and their resistivity and geometries, electrode positions and calculation of ΔZ, to review the consensus between mathematical modelling studies that investigate the origin of the ΔZ as measured in ICG. Thirteen papers showed considerable variation in the model's characteristics with varying or contradicting outcomes for the ΔZ 's origin. For instance, 11 studies excluded perfused muscle tissue, implying implicitly their insignificance, while 3 other studies included muscle tissue and indicated it as the most important origin of ΔZ. In conclusion, the reviewed papers show a lack of consensus with respect to both the modelled characteristics as well as the model outcomes and, as a result, these studies failed to settle the controversy on ΔZ 's origin. Recommendations have been added to improve future mathematical model studies.

  5. Study Of Cardic Valvular Calcification In ESRD Patients On Regular Hemodialysis (A Single Center Study

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    Abdel-Bassit El Shaarawy1, Mona Hosny1, Manar Raafat2 and Nelly

    2012-04-01

    Full Text Available Cardiac valve calcification are common among patients with chronic kidney disease (CKD. Risk factors include alterations in calcium and phosphorus metabolism, elevated calcium phosphorus product and persistent elevations in plasma parathyroid hormone (PTH. Echocardiography is a simple and inexpensive method for detection of valvular calcifications as suggested by KDIGO guidelines. 60 Patients on regular HD constituted group A (36 males and 24 females and 25 healthy volunteers constituted group B. Group A was subdivided into: Group I: 21 patients with no valvular calcification, group 2: 26 patients with aortic valve calcification and group 3: 13 patients with aortic and mitral valve calcification. For all, the following was done: clinical examination, serum Ca, serum P, serum albumin, serum creatinine, BUN and PTH level in blood. M-mode echo cardiography was done for all. Age, duration of dialysis and duration of 1ry kidney disease was higher in group 2 and 3 compared to group 1 (p = 0.0001. Calcium was higher in group 2 than group 1 (p = 0.09 and group 3 (p = 0.004 than group I phosphorus was higher in group 2 and 3 than group 1 (P = 0.001. P was higher in group 3 than group 2 (p = 0.0001. Ca x P was higher in group 2 and 3 than group 1 (p = 0.0001, in group 3 than group 2 (p = 0.01 PTH was higher in group 1 than group 2 (p = 0.06. Cardiac dysfunction by echocardiography was least in group 1, increasing in group 2 and being highest in group 3. It was found that calcified valve groups has taken higher doses of Calcium and Vitamin D3 .We have to take care on prescribing Ca and vitamin D3 to ESRD patients on regular HD.

  6. Effects of Vestibular Loss on Orthostatic Responses to Tilts in the Pitch Plane

    Science.gov (United States)

    Wood, Scott J.; Serrador, Jorge M.; Black, F. Owen; Rupert,Angus H.; Schlegel, Todd T.

    2004-01-01

    The purpose of this study was to determine the extent to which vestibular loss might impair orthostatic responses to passive tilts in the pitch plane in human subjects. Data were obtained from six subjects having chronic bilateral vestibular loss and six healthy individuals matched for age, gender, and body mass index. Vestibular loss was assessed with a comprehensive battery including dynamic posturography, vestibulo-ocular and optokinetic reflexes, vestibular evoked myogenic potentials, and ocular counterrolling. Head up tilt tests were conducted using a motorized two-axis table that allowed subjects to be tilted in the pitch plane from either a supine or prone body orientation at a slow rate (8 deg/s). The sessions consisted of three tilts, each consisting of20 min rest in a horizontal position, tilt to 80 deg upright for 10 min, and then return to the horizontal position for 5 min. The tilts were performed in darkness (supine and prone) or in light (supine only). Background music was used to mask auditory orientation cues. Autonomic measurements included beat-to-beat recordings of blood pressure (Finapres), heart rate (ECG), cerebral blood flow velocity in the middle cerebral artery (transcranial Doppler), end tidal CO2, respiratory rate and volume (Respritrace), and stroke volume (impedance cardiography). For both patients and control subjects, cerebral blood flow appeared to exhibit the most rapid adjustment following transient changes in posture. Outside of a greater cerebral hypoperfusion in patients during the later stages of tilt, responses did not differ dramatically between the vestibular loss and control subjects, or between tilts performed in light and dark room conditions. Thus, with the 'exception of cerebrovascular regulation, we conclude that orthostatic responses during slow postural tilts are not substantially impaired in humans following chronic loss of vestibular function, a result that might reflect compensation by nonvisual graviceptor

  7. Preoperative CT scanning of 70 cases of rheumatic valvular disease

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    Take, Akira; Matuzaki, Shigeru; Oki, Shinichi (Jichi Medical School, Minamikawachi, Tochigi (Japan)) (and others)

    1992-05-01

    Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3 g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14 g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases of aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. in detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation, 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface, 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes. (author).

  8. 16. Optimal guidance of percutaneous device closure of PDA by transthoracic echocardiography

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    M. Alobaidan

    2016-07-01

    Full Text Available Patent ductus arteriosus (PDA is common congenital cardiac lesion and the most accepted way of management is transcatheter occlusion by device which is usually done under fluoroscopy guidance. Transoesophageal echo cardiography and transaortic imaging were used in adult to guide the procedure which is with certain applications in pediatric age group transthoracic echocardiography (TTE in pediatric population provides excellent images for PDA and may replace the use of fluoroscopy to guide PDA closure at least in special situations. To highlight the feasibility of device closure under guidance of TTE to be applied in sick patients who are not suitable for transfer to cardiac catheter laboratory or those with contraindication to contrast and or radiation application. 18 patients from July 2013 to May 2015 underwent TTE guidance device closure of PDA, 1 patient was excluded after device embolization which necessitate retrieval under fluoroscopy (fluoro.. Conscious sedation was used in 17 patients except 1 who was sick and already ventilated in ICU, there were 11 female and 7 male, antegrade approach was used in 10 patients with partial fluoro and retrograde approach in 8 patients without fluoro. Median age is 7 months, median weight is 8 kg (3.2–11 kg, 2 patients with renal impairment, 2 with Leukemia, median procedure time is 35 min, median fluoro. is 2.2 min, PDA size were small in 13 patients and moderate in 5, immediate closure is achieved in all. The devices were ADOI, ADOS, ADOII, Occlutech, and AVP2. Device embolization in 1 with successful retrieval and second device was used with complete closure percutaneous PDA closure under TTE guidance is feasible, safe and recommended in selected patients with certain situation.

  9. Lifetime risk factors and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study.

    Science.gov (United States)

    Aatola, Heikki; Hutri-Kähönen, Nina; Juonala, Markus; Viikari, Jorma S A; Hulkkonen, Janne; Laitinen, Tomi; Taittonen, Leena; Lehtimäki, Terho; Raitakari, Olli T; Kähönen, Mika

    2010-03-01

    Limited and partly controversial data are available regarding the relationship of arterial pulse wave velocity and childhood cardiovascular risk factors. We studied how risk factors identified in childhood and adulthood predict pulse wave velocity assessed in adulthood. The study cohort consisted of 1691 white adults aged 30 to 45 years who had risk factor data available since childhood. Pulse wave velocity was assessed noninvasively by whole-body impedance cardiography. The number of conventional childhood and adulthood risk factors (extreme quintiles for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking) was directly associated with pulse wave velocity in adulthood (P=0.005 and P<0.0001, respectively). In multivariable regression analysis, independent predictors of pulse wave velocity were sex (P<0.0001), age (P<0.0001), childhood systolic blood pressure (P=0.002) and glucose (P=0.02), and adulthood systolic blood pressure (P<0.0001), insulin (P=0.0009), and triglycerides (P=0.003). Reduction in the number of risk factors (P<0.0001) and a favorable change in obesity status (P=0.0002) from childhood to adulthood were associated with lower pulse wave velocity in adulthood. Conventional risk factors in childhood and adulthood predict pulse wave velocity in adulthood. Favorable changes in risk factor and obesity status from childhood to adulthood are associated with lower pulse wave velocity in adulthood. These results support efforts for a reduction of conventional risk factors both in childhood and adulthood in the primary prevention of atherosclerosis. PMID:20083727

  10. Maternal functional hemodynamics in the second half of pregnancy: a longitudinal study.

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    Åse Vårtun

    Full Text Available Cardiovascular response to passive leg raising (PLR is useful in assessing preload reserve, but it has not been studied longitudinally during pregnancy. We aimed to investigate gestational age associated serial changes in maternal functional hemodynamics and establish longitudinal reference ranges for the second half of pregnancy.This was a prospective longitudinal study on 98 healthy pregnant women who were examined 3-5 times during 20-40 weeks of gestation (a total of 441 observations. Maternal cardiac function and systemic hemodynamics were assessed at baseline and 90 seconds after PLR using impedance cardiography (ICG. The main outcome measures were gestational age specific changes in ICG-derived variables of maternal cardiovascular function and functional hemodynamic response to PLR.Hemodynamic response to PLR varied during pregnancy. PLR led to an insignificant increase in stroke volume during 20+0 to 31+6 weeks, but later in gestation the stroke volume was slightly lower at PLR compared to baseline. PLR caused no significant change in cardiac output between 20+0 and 23+6 weeks and a significant decrease after 24+0 weeks. A decrease in heart rate, mean arterial pressure, and cardiac contractility was observed during PLR throughout the second half of pregnancy. Systemic vascular resistance was reduced by PLR up to 32+0 weeks, but increased slightly thereafter.Healthy pregnant women appear to have limited preload reserve and reduced cardiac contractility, especially in the third trimester, which makes them vulnerable to fluid overload and cardiac failure.

  11. Hemodynamic reactions to circulatory stress tests in patients with neurocirculatory dystonia.

    Science.gov (United States)

    Mäntysaari, M

    1984-01-01

    The hemodynamic reactions of 30 patients with neurocirculatory dystonia (NCD, DaCosta's syndrome) were compared to those of 30 healthy controls during the isometric handgrip test, orthostatic test, Valsalva test and the cold pressor test. The effects of hyperventilation on the ability to hold the breath were studied in both groups using the hyperventilation test. The patients and controls were young men, who were doing their conscript service, and the average age was 20 years in both groups. The diagnosis of NCD was made using the criteria described by Friedman (1947). The patients had several symptoms related to the cardiorespiratory system, the intensity of which varied from time to time and were not closely related to physical effort. In order to exclude organic diseases that could have caused the symptoms the patients were required to have no history of chronic organic diseases. They were also required to have no infectious diseases nor to be convalescents when participating in this study and to have a normal ECG and a normal thorax x-ray. The controls were anamnestically free from chronic diseases. The changes in the blood pressure, heart rate, stroke volume, cardiac index, peripheral vascular resistance and the systolic time intervals during the four tests were measured noninvasively using sphygmomanometry, electro-, phono- and impedance cardiography. The ability to hold the breath after a deep inspiration was similar in the two groups. Immediately after hyperventilation the ability to hold the breath did not improve in the NCD group as much as in the control group. In the orthostatic test the rise in the mean blood pressure was only momentarily greater in the control group than in the NCD group, and the heart rate increased about equally in the two groups. The transthoracic impedance increased significantly more in the controls than in the patients in the head-up position. The alterations in the systolic time intervals immediately after the changes of

  12. Quantitative evaluation of regional myocardial blood flow by digital subtraction angiography. Correlations with exercise electrocardiography and Tl-201 myocardial scintigraphy

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    Ikeda, Hisao; Shibao, Keigo; Yamaguchi, Ryutaro and others

    1987-04-01

    The study subjects consisted of 25 patients with angina pectoris and 14 patients with normal coronary arteries. Following the manual injection of contrast media into the left anterior descending coronary artery (LAD), a time-density curve was generated in the sectors of the myocardium which were perfused by the LAD and the T/sub 1/2/ was calculated. T/sub 1/2/ values correlated closely with double product (r = -0.73). They were significantly greater in patients with exercise-induced ST depression (8.3 +- 1.0 vs 5.8 +- 0.7, p < 0.005). In addition, there was a good correlation between T/sub 1/2/ values and washout ratio as determined by exercise thallium-201 myocardial scintigraphy, with r = -0.83. Although T/sub 1/2/ values were within the normal range (mean +- 2SD of control subjects) in all patients with LAD stenosis of 50 percent or less, these values were abnormally increased, exceeding the normal range, in 11 of the 12 patients with stenosis of 90 percent or more. Compared with exercise electro-cardiography, T/sub 1/2/ values were abnormally prolonged in 11 of the 13 patients with exercise-induced ST depression. Compared with exercise thallium-201 myocardial scintigraphy, T/sub 1/2/ values were abnormally prolonged in seven of the nine patients with transient perfusion defects. When an arteriographically significant degree of stenosis was assumed to be 75 percent or more, the accuracies of T/sub 1/2/ were; sensitivity, 80 %, specificity, 100 %, and diagnostic accuracy, 88 %. The results were comparable to those of exercise electrocardiography or exercise thallium-201 myocardial scintigraphy. In five patients with angina pectoris who underwent percutaneous translumial angioplasty (PTCA), T/sub 1/2/ values were significantly decreased after PTCA (from 8.5 +- 0.9 to 5.9 +- 0.9, p < 0.005), associated with an increase in double product. (J.P.N.).

  13. Cardiac manifestations of the glycogen storage disease type Ⅲ%糖原累积病Ⅲ型的心脏表现

    Institute of Scientific and Technical Information of China (English)

    郭潇潇; 田庄; 郭立琳; 张抒扬; 朱文玲

    2011-01-01

    Objective:To summarize the cardiac manifestations of glycogen storage disease (GSD) type Ⅲ.Method:The clinical data of 46 GSD type Ⅲ patients were collected. Their electrocardiography (ECG) and echo cardiography (Echo) features were analyzed. Result: All the patients except one did not have cardiac symptoms.Ten patients had abnormalities with ECG. The abnormal electrocardiographic findings were ventricular hypertro phy (3 cases), prolonged PR intervals (3 cases), hypertrophy of both left and right ventricles with prolonged QT intervals (1 case) and T wave changes (1 case) respectively. Abnormalities of echo were found in 15 cases. Five cases had ventricular hypertrophy. Left atrial enlargement was observed in 4 cases. Congenital heart disease and pericardial effusion were found in three cases respectively. The cardiac abnormalities had no relationship with the level of liver function or creatine kinase (P>0.05). Conclusion: GSD type Ⅲ patients may present silent cardiac complications such as hypertrophic myocadiopathy. However, the onset was uneasy to detect. Therefore, electro cardiogram and echocardiography should be investigated regularly in respect of patients' clinical symptoms or mus cle status and proper treatment should be given.%目的:总结糖原累积病Ⅲ型(GSDⅢ型)患者心脏改变的临床特点.方法:收集46例GSDⅢ型患者的临床资料,分析其心电图(ECG)和超声心动图(Echo)结果.结果:45例(97.8%)无明显心脏相关症状,10例心电图异常,分别为左室肥厚3例,PR间期延长3例,T波改变2例,双心室肥厚伴QT间期延长、单纯QT间期延长各1例.Echo异常15例,其中心室肥厚5例,单纯左房增大4例,并发先天性心脏病、少量心包积液各3例.心脏异常与肝功能和肌酸激酶水平无关(P>0.05).结论:GSDⅢ型患者可能并发多种心脏损害,但起病隐匿,需提高警惕并定期行ECG和Echo检查,如出现心脏功能障碍,应进行相应药物治疗.

  14. Abdominal obesity and hypertension: a double burden to the heart.

    Science.gov (United States)

    Krzesiński, Paweł; Stańczyk, Adam; Piotrowicz, Katarzyna; Gielerak, Grzegorz; Uziębło-Zyczkowska, Beata; Skrobowski, Andrzej

    2016-05-01

    Abdominal obesity (AO) is strongly associated with increased cardiovascular risk in hypertensives. Visceral adipose tissue has an important part in water retention, the sympathetic nervous system and renin-angiotensin-aldosterone system activation, which may influence central and systemic hemodynamics. The aim of this study was to estimate the relationship between AO and the hemodynamic profile of patients with arterial hypertension (AH). The clinical evaluation of 144 hypertensives included the following: (1) echocardiographic assessment of the left ventricular ejection fraction (LVEF), the global longitudinal systolic strain (GLSS) and diastolic function (E/A-phase ratio of mitral flow early (E) and late (A) and E/e'-ratio of early mitral flow and mitral septal annulus early diastolic velocity (e')); (2) the applanation tonometry including the central pulse pressure (CPP) and augmentation index (AI); and (3) the impedance cardiography, acceleration index (ACI), velocity index (VI), systemic vascular resistance index (SVRI) and total artery compliance (TAC). Obese hypertensives in comparison with non-obese ones were characterized with the following values: (1) lower echocardiographic (GLSS: -17.2±2.5% vs. -19.0±2.8%, P=0.0002) and impedance indices of left ventricular performance (VI: 44.8±12.4 vs. 51.6±14.2 × 1000*Ω* s(-1), P=0.006; ACI: 66.7±27.8 vs. 79.1±31.2 100*Ω* s(-)(2), P=0.003) and (2) worse diastolic function (e': 9.08±2.69 vs. 10.39±2.34 cm*s(-1), P=0.003; E/e': 7.54±1.81 vs. 6.74±1.40, P=0.007; E/A: 1.02±0.34 vs. 1.15±0.33, P=0.008). No relevant differences for gender, age, blood pressure, heart rate, LVEF, SVRI, TAC, CPP and AI were identified. AH and AO have overlapping effects on cardiovascular hemodynamics. At the early asymptomatic stage, this overlap is exhibited in the impaired cardiac function. PMID:26791010

  15. Histamine H2 receptor blockade augments blood pressure responses to acute submaximal exercise in males.

    Science.gov (United States)

    Doh, Hyung-Woo; Stebbins, Charles L; Choi, Hyun-Min; Park, Joonsung; Nho, Hosung; Kim, Jong-Kyung

    2016-06-01

    Histamine is a potent vasodilator that has been found to increase during exercise. We tested the hypothesis that histamine would attenuate blood pressure (BP), cardiac output (CO), and vascular resistance responses to short-term, submaximal dynamic exercise during H2 receptor blockade. Fourteen healthy men (20-29 years of age) were studied. Systolic (SBP), diastolic (DBP), and mean arterial (MAP) BP and heart rate (HR) were assessed at rest and during the last minute of 10 min of submaximal cycling exercise (60% of peak oxygen consumption) in the absence and presence of histamine H2 receptor blockade (ranitidine, 300 mg). Stroke volume (SV) (impedance cardiography) and plasma norepinephrine (NE) were measured, and CO, rate × pressure product (RPP), and total peripheral resistance (TPR) were calculated. Plasma levels of histamine were also measured. H2 blockade had no effects on any variables at rest. During exercise, SBP (184 ± 3 mm Hg vs. 166 ± 2 mm Hg), MAP (121 ± 2 mm Hg vs. 112 ± 5 mm Hg), and RPP (25.9 ± 0.8 × 10(3) mm Hg·beats/min vs. 23.5 ± 0.8 × 10(3) mm Hg/beats·min) were greater during blocked conditions (P < 0.05), and an interaction was observed for TPR. SV, DBP, HR, and NE levels were unaffected by blockade. Plasma histamine increased from 1.83 ± 0.14 ng/mL at rest to 2.33 ± 0.23 ng/mL during exercise (P < 0.05) and was not affected by H2 blockade (1.56 ± 0.23 ng/mL vs. 1.70 ± 0.24 ng/mL). These findings suggest that, during submaximal exercise, histamine attenuates BP, vascular resistance, and the work of the heart via activation of H2 receptors and that these effects occurred primarily in the vasculature and not in the myocardium. PMID:27191340

  16. The significance of amlodipine on autonomic nervous system adjustment (ANSA method: A new approach in the treatment of hypertension

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    Milovanović Branislav

    2009-01-01

    Full Text Available Introduction. Cardiovascular autonomic modulation is altered in patients with essential hypertension. Objective To evaluate acute and long-term effects of amlodipine on cardiovascular autonomic function and haemodynamic status in patients with mild essential hypertension. Methods. Ninety patients (43 male, mean age 52.12 ±10.7 years with mild hypertension were tested before, 30 minutes after the first 5 mg oral dose of amlodipine and three weeks after monotherapy with amlodipine. A comprehensive study protocol was done including finger blood pressure variability (BPV and heart rate variability (HRV beat-to-beat analysis with impedance cardiography, ECG with software short-term HRV and nonlinear analysis, 24-hour Holter ECG monitoring with QT and HRV analysis, 24-hour blood pressure (BP monitoring with systolic and diastolic BPV analysis, cardiovascular autonomic reflex tests, cold pressure test, mental stress test. The patients were also divided into sympathetic and parasympathetic groups, depending on predominance in short time spectral analysis of sympathovagal balance according to low frequency and high frequency values. Results. We confirmed a significant systolic and diastolic BP reduction, and a reduction of pulse pressure during day, night and early morning hours. The reduction of supraventricular and ventricular ectopic beats during the night was also achieved with therapy, but without statistical significance. The increment of sympathetic activity in early phase of amlodipine therapy was without statistical significance and persistence of sympathetic predominance after a few weeks of therapy detected based on the results of short-term spectral HRV analysis. All time domain parameters of long-term HRV analysis were decreased and low frequency amongst spectral parameters. Amlodipne reduced baroreflex sensitivity after three weeks of therapy, but increased it immediately after the administration of the first dose. Conclusion. The results

  17. Analysis 90 patients with painless myocardial ischemia of Echocardiography diagnosis%超声心动图在无痛性心肌缺血诊断中的应用价值探讨

    Institute of Scientific and Technical Information of China (English)

    蒋晓玲

    2013-01-01

    目的:探讨超声心动图对无痛性心肌缺血(SMI)的诊断价值。方法:应用超声心动图对90例心电监护的冠心病患者在心肌缺血发作时和ST段最大压低时进行检查。结果:本组每例患者均有1~2个以上的室壁节段出现运动异常。结论:超声心动图结合心电监护能及早检出SMI的存在,超声心动图能准确评价SMI时的心功能状况,因而具有其独特的应用价值。%objective evaluation diagnosis value in echocardiography to painless myocardial ischemia (SMI) .Method echocardiography electrocardio monitoring 90 cases of myocardial ischemia in patients with coronary artery disease onset and ST segment biggest check When down .Results 90 pa-tients from myocardial ischemia attack CPC monitoring 10 .25 array times ,night and day ,the law of 12 :00 at 6 :00 attacks happened ,occurred 592 ar-ray times the highest financed ;Those with heart palpitations symptoms are not typical 14 cases ,accounting for 15 .6% ;Without any other symptom person ,accountedfor 76patients with complications ,accounting for 84 .4% .90 patients 67 times/mV average heart rate ,st -segment down with an average heart rate 94 times/min .ST segment by moves down 0 .1 ~ 0 .4 mV ,have 2 cases of 0 .5 ~ 0 .6 mV most every patients ,by echocardio-graphy monitoring all have 1 ~ 2 above the stage movement .Conclusion SMI is coronary heart disease ,the most common form of expression ,Echo-cardiography with early detection ,electrocardio monitoring the existence of SMI ,and thus has its unique application value .

  18. Haemodynamic response to exercise in healthy young and elderly subjects.

    Science.gov (United States)

    Bogaard, H J; Woltjer, H H; Dekker, B M; van Keimpema, A R; Postmus, P E; de Vries, P M

    1997-01-01

    Whereas with advancing age, peak heart rate (HR) and cardiac index (CI) are clearly reduced, peak stroke index (SI) may decrease, remain constant or even increase. The aim of this study was to describe the patterns of HR, SI, CI, arteriovenous difference in oxygen concentration (Ca-vO2), mean arterial pressure (MAP), systemic vascular resistance index (SVRI), stroke work index (SWI) and mean systolic ejection rate index (MSERI) in two age groups (A: 20-30 years, n = 20; B: 50-60 years n = 20). After determination of pulmonary function, an incremental bicycle exercise test was performed, with standard, gas-exchange measurements and SI assessment using electrical impedance cardiography. The following age-related changes were found: similar submaximal HR response to exercise in both groups and a higher peak HR in A than in B[185 (SD 9) vs 167 (SD 14) beats.min-1, P < 0.0005]; increase in SI with exercise up to 60-90 W and subsequent stabilization in both groups. As SI decreased towards the end of exercise in B, a higher peak SI was found in A [57.5 (SD 14.0) vs 43.6 (SD 7.7) ml.m-2, P < 0.0005]; similar submaximal CI response-to exercise, higher peak CI in A [10.6 (SD 2.5) vs 7.2 (SD 1.3) 1.min-1.m-2, P < 0.0005]; no differences in Ca-vO2 during exercise; higher MAP at all levels of exercise in B; higher SVRI at all levels of exercise in B; lower SWI in B after recovery; higher MSERI at all levels of exercise in A. The decrease in SI with advancing age would seem to be related to a decrease in myocardial contractility, which can no longer be compensated for by an increase in preload (as during submaximal exercise). Increases in systemic blood pressure may also compromise ventricular function but would seem to be of minor importance. PMID:9189732

  19. Experience of treatment of heart rhabdomyomas in combination with various arrhythmias and conduction disorders

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    Bockeria L. A.

    2014-12-01

    Full Text Available Оbjective. Presentation the experience of diagnosis and treatment of heart rhabdomyomas in combination withvarious arrhythmias and conduction disorders.Material and methods. In archival material found 9 records of pediatric patients treated in A.N. BakoulevCenter for Cardiovascular Surgery from June 2004 to September 2013 with cardiac rhabdomyomas. The ageofpatients ranged from 19 days to 17 years. Along with the general clinical studies patients perfomed electro-cardiography (ECG, Holter ECG, echocardiography with doppler, computed tomography (CT and cardiacmagnetic resonance imaging (MRI with contrast. Rhabdomyomas localized in the left ventricle with3patients, in the right ventricle with 3 patients, in the right atrium – 2 patients and in the left atrium –1patient. Intramural and mixed rhabdomyomas growth was accompanied by a variety of arrhythmias andconduction of the heart, which were observed in 6 patients. Among them one cases were registered: manifesting Wolff–Parkinson–White syndrome, continuous recurrent atrial tachycardia, atrial fibrillation/flutter,full blockade of the right bundle branch, atrioventricular (AV block 3rd degree, a weakness syndrome sinusnode and paroxysmal atrial tachycardia.Results. Surgical care was performed in 5 cases. In 4 cases the tumor was unresectable or surgical treatment has not been shown. These patients were released under the supervision of a cardiologist at the place of residence on drug therapy. The most frequent localization rhabdomyomas of the heart – the ventricles(66.7%. Rhabdomyomas of the heart in combination with disorders of rhythm and conduction was observedin 6 patient (66.7%. Surgery included resection of rhabdomyomas of the heart under conditions of artificialblood circulation and pharmacological cardioplegia. Patient with atrial fibrillation/flutter in 1 cases was performed radiofrequency modification operation Cox Maze. In this group of patients in-hospital mortality is 0

  20. EVALUATION OF CARDIAC MURMURS IN NEONATES

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    Chakravathy

    2015-10-01

    Full Text Available BACKGROUND: Cardio vascular malformations are the most common congenital malformations. Early recognition of congenital heart disease is important in the neonatal period, as many of them may be fatal if undiagnosed. AIM : To study the epidemiology of neonatal cardiac murmurs. To identify clinical characteristics which differentiates pathological murmur from functional murmurs to assess the reliability of clinical evaluation in diagnosing congenital heart diseas e? METHODS : The study population included all neonates admitted in a Hospital in Visakhapatnam to the NICU, postnatal ward, attending pediatric OPD and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16 months. A clinical diagnosis was made based on history and clinical examination. Then Chest X ray and ECG were done in symptomatic infants. Echo cardiography was done in all neonates for confirmation of diagnosis, the neonates were again examined daily till they were in hospital and during the follow up visit at 6 weeks. RESULTS : A total of 61 neonates were included and was conducted over a period of 16 months . T he incidence of cardiac murmurs among intramural neonates was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10[16.4%] cases. VSD was the most common diagnosis clinically in 19[31.47%] babies. The most frequent diagnosis was acyanotic complex congenital heart disease, Only intra mural neonates were considered for the incidence of murmurs and the incidence of cardiac murmurs among them babies was 13.5 for 1000 live in 23[37.7%] cases followed by 10[16.4%] cases each of VSD and ASD respectively. Overall in our study 73.77% [45 cases] of the murmurs were diagnosed correctly and confirmed by Echocardiography. INTERPRETATIONS & CONCLUSIONS: 1. It is possible to make clinical diagnosis in many cases of congenital heart diseases. 2. The functional murmurs could be differentiated from those arising from structural heart

  1. A new electric method for non-invasive continuous monitoring of stroke volume and ventricular volume-time curves

    Directory of Open Access Journals (Sweden)

    Konings Maurits K

    2012-08-01

    Full Text Available Abstract Background In this paper a new non-invasive, operator-free, continuous ventricular stroke volume monitoring device (Hemodynamic Cardiac Profiler, HCP is presented, that measures the average stroke volume (SV for each period of 20 seconds, as well as ventricular volume-time curves for each cardiac cycle, using a new electric method (Ventricular Field Recognition with six independent electrode pairs distributed over the frontal thoracic skin. In contrast to existing non-invasive electric methods, our method does not use the algorithms of impedance or bioreactance cardiography. Instead, our method is based on specific 2D spatial patterns on the thoracic skin, representing the distribution, over the thorax, of changes in the applied current field caused by cardiac volume changes during the cardiac cycle. Since total heart volume variation during the cardiac cycle is a poor indicator for ventricular stroke volume, our HCP separates atrial filling effects from ventricular filling effects, and retrieves the volume changes of only the ventricles. Methods ex-vivo experiments on a post-mortem human heart have been performed to measure the effects of increasing the blood volume inside the ventricles in isolation, leaving the atrial volume invariant (which can not be done in-vivo. These effects have been measured as a specific 2D pattern of voltage changes on the thoracic skin. Furthermore, a working prototype of the HCP has been developed that uses these ex-vivo results in an algorithm to decompose voltage changes, that were measured in-vivo by the HCP on the thoracic skin of a human volunteer, into an atrial component and a ventricular component, in almost real-time (with a delay of maximally 39 seconds. The HCP prototype has been tested in-vivo on 7 human volunteers, using G-suit inflation and deflation to provoke stroke volume changes, and LVot Doppler as a reference technique. Results The ex-vivo measurements showed that ventricular filling

  2. 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

  3. Angiography of double outlet of right ventricles%右心室双出口的心血管造影诊断

    Institute of Scientific and Technical Information of China (English)

    申玉良; 侯爱军; 武艳强; 袁芳

    2012-01-01

    目的 评价心血管造影对右心室双出口的诊断价值.方法 收集11例右心室双出口患者的临床及心血管造影资料并进行回顾性分析.全部患者均行X线、心电图、超声心动图心导管及心血管造影检查.结果 所有患者的心血管造影诊断与术后诊断完全相符,符合率为100%.11例主动脉、肺动脉同时显影,两大动脉起自右心室.8例室间隔缺损,3例心内膜垫缺损.其中5例室间隔缺损位于肺动脉瓣下,同时并右冠状动脉异位开口;3例室间隔缺损位于主动脉、肺动脉之间,同时合并左右心房互换、永存左上腔静脉;2例室间隔缺损远离肺动脉和主动脉,肺动脉发育差.另1例心内膜垫缺损合并二尖瓣、三尖瓣重度关闭不全.结论 心血管造影对右心室双出口及合并畸形可做出较准确诊断.%Objective To report 11 cases of double outlet of right ventricles and to evaluate the methods of angiography.Methods Angiocardiographies of 11 patients were collected.All patients underwent X-ray film,electro-cardiography,echocardiography,cardiac catheterization and angiocardiography.Results The coincidence rate between angiography and operation was 100%.Angiographies were performed in 11 patients.Both great arteries(Aorta and Pulmonary Artery) originated from the right ventricle in all the cases.8 patients had ventricular septal defect(VSD) and 3 patients had endocardial cushion defect.Five cases of the VSDs were found under the valve of pulmonary artery and were accompanied with anomalous origin of the right coronary artery;3 cases of the VSDs were found to be between the aorta and pulmonary artery and were accompanied with position interchange of two atria and persistent left superior vena cava;2 eases of the VSDs were found being away from aorta and pulmonary artery as well as agenesis of pulmonary artery.The last case of the endocrinal cushion defect were accompanied with mitral valve insufficiency and severe

  4. Investigations of the Cardiovascular and Respiratory Systems on Board the International Space Station: Experiments Puls and Pneumocard

    Science.gov (United States)

    Baranov, V. M.; Baevsky, R. M.; Drescher, J.; Tank, J.

    parameters describing the results of the function of these systems like heart rate, arterial pressure, cardiac output, or breathing frequency, concentration of O2 and CO2 , etc. Missing significant changes of these parameters during weightlessness supports the hypothesis that adaptational and compensatory mechanisms are sufficient and guarantee cardiovascular homeostasis under changing environmental conditions. characteristic changes of the vegetative balance and of the activity of different regulatory elements at the brainstem and subcortical level. This changes guaranteed the adaptation to long term weightlessness. However, it remains unclear to what extent the different levels are involved. Moreover, the criteria describing the efficacy of cardiorespiratory interaction for the different functional states are not defined yet. The investigation of this problems is highly relevant in order to improve the medical control, especially if considering that the disruption of regulatory systems mostly precedes dangerous destruction of homeostasis. cardiovascular and respiratory function on Board the International Space Station (ISS) aiming to obtain new insights into the interaction between different regulatory elements. "Puls" is measures ECG, photoplethysmogram (PPG), and the pneumotachogram (PTG). The ECG is used to measure time series of R-R intervals and to analyse HRV. PPG is used to define the pulse wave velocity, phases of the cardiac cycle, and an estimate of the filling of finger vessels. The variability of these parameters is also calculated and compared to HRV. The analysis of the PTG allows to describe the interaction of the regulatory parameters of the cardiovascular and respiratory systems. Hence, an important feature of the experiment "Puls" is the investigation of regulatory mechanisms rather than of cardiovascular homeostasis. cardiography) and left ventricular contractility (seismocardiography) will be obtained. This expansion is of major importance

  5. 右美托咪定镇静对老年患者血流动力学的影响%Effects of dexmedetomidine on hemodynamics in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    吕丹; 皋源; 杭燕南

    2011-01-01

    目的 评估右美托咪定持续静脉输注10 min对SICU老年患者血流动力学的影响.方法 选择全麻术后入SICU的患者38例,按照年龄分为老年组(年龄65~80岁,n=18)和中青年组(年龄18~64岁,n=20).在患者术后Ramsay评分≤3分时持续静脉输注右美托咪定6.0μg·kg-1·h-1 10 min后停药,应用阻抗心动图记录用药前即刻(基础值)及用药后5、10、30和60 min的SBP、DBP、HR、心脏指数(CI)、每搏量(SV)、外周循环阻力(SVR)、心室收缩加速度指数(ACI)及Ramsay评分.结果 两组用药后达到Ramsay评分为3分的时间差异无统计学意义,但老年组Ramsay评分持续在3分以上的时间为(62.28±24.79)min,长于中青年组的(40.57±19.19)min(P<0.05).与基础值相比,用药后两组SBP、DBP、HR和CI下降(P<0.05),而SV和ACI差异无统计学意义.结论 持续静脉输注右美托咪定6.0μg·kg-1·h-1用于SICU老年患者镇静时,可引起CI、BP下降和HR减慢.%Objective To investigate the effects of continuous intravenous dexmedetomidine on hemodynamics in the SICU elderly postoperative patients. Methods Thirty-eight postoperative patients underwent abdominal or thoracic surgeries under general anaesthesia were selected into two groups: the elderly group (65-80 years old, n=18) and the young group (18-64 years old, n=20).Dexmedetomidine 6.0 μg· kg-1 ·h-1 was intravenously infused for 10 minutes when Ramsay sedation scale was≤3 after operation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cardiac index (CI), stroke volume (SV), systemic vascular resistance (SVR), and acceleration index (ACI) were monitored by impedance cardiography and Ramsay sedation scale (RSS) was recorded before infusion (baseline) and at 5, 10, 30 and 60 min after dexmedetomidine administration. Results The time of RSS of 3 had no significant difference between the two groups.While the duration of RSS above 3 was longer in elderly group [(62.28

  6. Correlations between Fetal Congenital Cardiovascular Anomalies and Chromosomal karotypes%胎儿染色体核型与先天性心血管畸形发生的相关研究

    Institute of Scientific and Technical Information of China (English)

    郭辉; 林琳华; 任景慧; 李启运; 林秀华; 曾君; 梁灼健

    2014-01-01

    Objective To investigate the distribution of congenital cardiovascular malformations in fetuses with chromosomal abnormalities.Method Congenital cardiovascular malformations of fetuses were diagnosed by prenatal ultrasonic cardiography from Jan 2011 to Sep 2013,and whose chromosomal karotype were tested by amniocentesis or cordocentesis.The association between chromosomal karyotypes and distribution of congenital cardiovascular malformations was analyzed.Result In 173 Fetuses with chromosomal abnormalities,20(11.56%) cases had congenital cardiovascular malformations,including seven 21-trisomies,eight 18-trisomies,three 13-trisomies and two 45,X.64% (16/25) fetuses with congenital cardiovascular malformations accompanied with other malformations had chromosomal abnormalities.Only 1.87% (52/4379) fetuses with normal karotype had congenital cardiovascular malformations.Conclusion Chromosomal abnormality is the most reason of complicate CHD.Chromosomal karotype test should be detected in fetus with complicate CHD.%目的 对产前诊断中胎儿染色体核型异常与超声确诊的先天性心血管畸形的发生进行相关研究.方法 2011年1月至2013年9月在本院进行产前诊断的胎儿进行羊水或脐带血染色体核型检查,在孕中期胎儿超声心动图检查胎儿心血管发育状况,对核型与B超结果进行分析.结果 4482例行产前羊水或脐带血核型分析的胎儿中,核型异常173例(数目异常91例.结构异常74例,嵌合体8例),其中20例超声心动图检查发现心血管畸形(21-三体7例,18-三体8例,13-三体3例,X单体2例),心血管畸形发生率11.56%(20/173).染色体异常胎儿先天性心血管畸形合并心外畸形16例(21-三体5例,18-三体7例,13-三体3例,X单体1例),占所有合并心外畸形胎儿的64.00%(16/25).仅有先天性心血管畸形的胎儿染色体异常率8.51%(4/47).染色体核型未见异常的胎儿心血管畸形发生率1.87%(52/4379),其中9

  7. 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

    < 0.001. Absolute agreement was found at baseline and after both bouts of exercise; ES Oxi overestimated baseline and stage 1 exercise cardiac output by 0.3 L/minute and 0.1 L/minute, respectively, but exactly estimated stage 2 exercise cardiac output. Conclusion: ES-BC and ES Oxi accurately assessed body composition and cardiac output compared to standardized instruments, whereas EIS-GS showed marginal predictive ability for autonomic nervous system activity. The ESC software managing the three devices would be useful to help detect complications related to metabolic syndrome, diabetes, and cardiovascular disease and to noninvasively and rapidly manage treatment follow-up. Keywords: fat mass, autonomic nervous system activity, Electro Sensor Complex, dual-energy X-ray absorptiometry, heart rate variability, and bioimpedance cardiography

  8. 优化起搏参数在提高心脏再同步化治疗疗效中的作用%Study on significance of optimal pacemaker parameters in improving the efficacy of cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    谢芳; 何亚峰; 邓成钢; 程光辉; 张劲林

    2015-01-01

    Objective To evaluate the efficacy of cardiac resynchronization therapy( CRT)in treatment of patients with AV or VV delay. Methods Forty-nine patients with chronic heart failure received cardiac resynchronous pacing,followed-up for 1 week,3 months,6 months and 1 year,the delay of AV had been optimized by ultrasound cardiography,and delay of VV had been optimized by tissue Doppler imaging. Re-sults Heart function in 45 cases had been improved after CRT. According to NYHA classification,these patients had been improved from classⅢ˜IV to class II˜III,and their 6 minutes walking distance had also been increased. The LVEF index and VTI of left ventricular systolic func-tion had been improved( P <0. 01). Left ventricular diastolic filling time was also increased. In 3 months and 6 months after the treatment,left ventricular end diastolic diameter and volume were significantly smaller than those before the treatment( P <0. 01,P <0. 05). Mitral regurgita-tion had been reduced,and the standard deviation of 12 segments time to peak had been decreased from(139 ± 33)ms to(110 ± 40)ms( P <0. 01). Conclusion Optimization of the pacemaker parameters is needed in order to enhance the efficacy of CRT.%目的:探讨优化A-V、V-V间期在提高心脏再同步化治疗( CRT)中的疗效。方法49例CRT治疗的慢性心力衰竭患者,于术后1周、3个月、6个月和12个月进行个体化参数程控(在超声心动图指导下优化A-V间期,在组织多普勒显像下优化V-V间期),观察心脏同步性和心功能变化,达到CRT最佳治疗目的。结果临床症状:45例CRT后心功能得到改善,心功能NYHA分级,从Ⅲ˜Ⅳ级提高为Ⅱ˜Ⅲ级,6分钟步行距离增加。超声指标:反映左室收缩功能的指标左室射血分数( P <0.01)、血流速度积分( VTI)增加,反映左室舒张功能的指标左室舒张充盈时间延长,评价心腔大小指标改善,术后3、6个月左心室舒张末期内

  9. 感染性心内膜炎赘生物超声心动图诊断的临床研究%Clinical study on infective endocarditis vegetations transthoracic echocardiography diagnosis

    Institute of Scientific and Technical Information of China (English)

    黄楠; 徐永通; 李建华; 张红

    2014-01-01

    目的:探讨超声心动图诊断感染性心内膜炎赘生物的临床价值,以期提高临床诊治水平。方法选取2005年1月-2013年4月46例感染性心内膜炎赘生物患者为研究对象,均采用超声心动图检查,所有患者均行手术治疗,手术后对病理产物进行病理诊断,比较经胸超声心动图检查诊断结果和手术病理诊断结果的符合度情况,采用SPSS13.0软件进行分析。结果超声心动图与手术诊断进行比较,总符合率为95.65%,其中1例主动脉瓣+三尖瓣瓣根处有赘生物,超声心动图诊断为右心室结节,另外1例瓣膜脱垂,超声心动图诊断为右冠瓣穿孔。结论超声心动图对感染性心内膜炎赘生物诊断准确率高,作为一种无创的诊断方法,对临床感染性心内膜炎赘生物高危人群具有较高的筛选价值,早确诊、早治疗,提高该类患者的治疗预后具有较高的价值和临床意义。%OBJECTIVE To investigate the clinical value of infective endocarditis vegetation by transthoracic echo-cardiographic diagnosis in order to improve the clinical diagnosis and treatment .METHODS From Jan 2005 to Apr 2013 ,a total of 46 cases of patients with infective endocarditis vegetation were selected as the objects of study .All were examined by transthoracic echocardiography and underwent surgery .After surgery ,they had pathological product diagnosis , so as to compare the compliance of transthoracic echocardiography diagnosis and surgical pathology results by SPSS13 .0 software .RESULTS The diagnosis and surgery were compared ;the total coinci-dence rate was 95 .65% ,including one case with vegetations at aortic root and tricuspid valve root ;transthoracic echocardiography diagnosis found right ventricular nodules ,while another case had valvular prolapse ;the tran-sthoracic echocardiography showed the right coronary leaflet perforation .CONCLUSION The transthoracic echo-cardiography has

  10. Research on ambulatory electrocardiography of long RP tachycardia%长 RP 心动过速的动态心电图研究

    Institute of Scientific and Technical Information of China (English)

    张麟; 李波; 纳志英; 尹琳; 王月; 冯夏

    2015-01-01

    Objective To study the manifestations of long RP tachycardia on ambulatory electro-cardiography(AECG)and its differential diagnostic basis.Methods By 12-channel AECG recorder, 35 patients with long RP tachycardia were monitored.At the attack of tachycardia,we made compara-tive analysis on its states of induction and termination,duration,frequency,P-wave polarity,clinical characteristics,etc.Results The enrolled 35 patients were divided into 3 groups:separately with persistent atrioventricular reentrant tachycardia(PAVRT),atrial tachycardia(AT),and fast-slow atri-oventricular nodal reentrant tachycardia(F-S-AVNRT).Among the 3 groups,P waves were inverted inⅡ,Ⅲ and aVF leads,aVR leads were upright,and RP intervals were all longer than PR intervals, at the onset of tachycardia.The attack of 6 cases of PAVRT was endless,tachycardia accounting for 32.8%—50.0% in the total heartbeats during 24 hours,with an attacking frequency ranging from 110 times/min to 160 times/min,which was induced by premature ventricular beats.AT was induced by atrial premature beats in 15 cases,with the number of onset episodes ranging from 1 to 186,and onset frequency 107—150 times/min.F-S-AVNRT in 2 cases was induced by atrial premature beats accom-panied with prolonged PR intervals,with an attack frequency ranging from 127 times/min to 182 times /min.Atrial flutter complicating 2 ∶1 atrioventricular conduction in 12 cases was induced by at-rial premature beats;Its onset ventricular rate ranged from 120 times/min to 165 times/min,and the ventricular rate reached 150 times/min when the conditions of the Bix law was met.Conclusion AECG monitoring plays a significant role in identifying the states of induction and termination,dura-tion,and frequency during the onset of long RP tachycardia.It helps to diagnose the disease.%目的:探讨长 RP 心动过速的动态心电图表现及其鉴别诊断依据。方法采用12通道动态心电图记录仪对35例长 RP 心动过速患者进

  11. 老年慢性心衰患者运动康复的效果%Effects of exercise rehabilitation in aged patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    李明娥; 霍红梅; 王梅林; 许红梅; 马敬霞

    2012-01-01

    (LVEDd) were determined by ultrasound cardiography,6min walking distance (6MWD) and oxygen metabolic equivalent (METs) also were determined,plasma level of brain natriuretic peptide (BNP) was examined.Minnesota living with heart failure questionnaire (MLHFQ) was used to represent quality of life.Rehospitalization rate and mortality rate within 12 months were recorded in all patients.Results:On 8 th weeks after treatment,the LVEF,LVEDd and NYHA class of two groups all significantly improved (P<0.05 all),compared with usual care group,there were significant improvement in LVEF [ (54.7 ± 6.2)% vs.65.4 ± 8.7)%],LVEDd [ (49.6±8.3) mm vs.(40.2±9.3) mm] and NYHA class [ (2.7±0.8) classes vs.(1.9±0.9) classes],P<0.05 all; 6MWD [ (122.7±9.2) m vs.(175.6±8.7) m] and METs [ (5.8±1.8) vs.(8.4±2.4)] also significantly increased (P<0.01),and plasma level of BNP [ (43.4±9.8) pg/ml vs.(31.7±8.9) pg/ml,P<0.05] significantly decreased in exercise rehabilitation group.No severe adverse events occurred in exercise rehabilitation group.After 12 months,compared with usual care group,there were significant increase in MLHFO score [ (45.6±8.2) scores vs.(68.9 ± 7.9) scores],significant decrease in rehospitalization rate caused by heart failure (24.4 % vs.9.5 % ),P <0.05 all in exercise rehabilitation group.Conclusion:Exercise rehabilitation is safe and effective in aged patients with chronic heart failure,which can significantly improve cardiac function,enhance exercise capacity and increase quality of life.

  12. The clinical value of multi-slice spiral CT angiography in the diagnosis of aortic coarctation%MSCT血管成像技术在主动脉缩窄诊断中的临床价值

    Institute of Scientific and Technical Information of China (English)

    姚凤明; 戴闽晔; 任峰; 付峰; 李晖

    2012-01-01

    Objective: To evaluate the clinical value of multi-slice spiral CT angiography (MSCTA) in the diagnosis of cardiac malformation associated with aortic coarctation (CoA). Methods: 11 cases of Co A underwent pre-and post-contrast enhanced MSCT.and the original data were post-processed with multi-planar reformation (MPR) .maximum intensity projection (MIP) .volume rendering (VR) and virtual endoscopy (VE) techniques. All of the patients were examined by echo-cardiography before surgery. The results of MSCTA were correlated with that of surgery and echocardiography.and the advantages and disadvantages of MSCTA in the diagnosis of CoA associated with cardiac malformation were analyzed. Results: Totally 35 extra-/intra-cardiac malformations were detected in those 11 patients. 26 lesions were diagnosed by MSCTA with the accuracy rate as 74. 3% .including 19 extra-cardiac malformations (accuracy rate,95%) ,however,1 case of patent duc-tus arteriosus was missed;7 intra-cardiac malformations were diagnosed (accuracy rate,46. 7%) .and 8 malformations were missed,with 2 cases of atrial septal defect and 6 valvular lesions. 29 malformations were diagnosed by echocardiography with the accuracy rate as 82. 9% .including 14 extra-cardiac malformations (accuracy,70%) ,6 malformations were missed, in which 5 cases of CoA and 1 case of pulmonary venous ectasia,however, all intra-cardiac malformations were diagnosed with the accuracy rate as 100%. Conclusion:The specific features of CoA could be directly displayed by MSCTA,the position, type and the status of collateral vessels could be clearly identified. MSCTA provides significant clinical values in the diagnosis, selection of treatment,observing of curative effect after-surgery and follow-up. MSCTA in combination with echocardiography is the best approach in the diagnosis of the complicated intra- and extra-cardiac malformations.%目的:评价MSCT血管成像(MSCTA)技术在主动脉缩窄伴心脏畸形

  13. Clinical Significance of Diurnal Rhythmic Fluctuations of Blood Pressures in Hypertensions%高血压患者血压昼夜节律变化的临床意义

    Institute of Scientific and Technical Information of China (English)

    陈卫文; 林靖宇; 李景霞

    2012-01-01

    律与临床意义.方法:对112例高血压患者根据超声心动图( ultrasonic cardiography,UCG)检查结果分成3组,其中UCG显示左室肥大30例,均伴单纯收缩压升高(isolated systolic hypertension,ISH)或收缩压和舒张压均升高(miscellaneous systolic and diastolic hypertension,MDH),平均年龄(58±12.1)岁,为LVH组;UCG正常的ISH患者48例为ISH组,平均年龄(62±15.2)岁;UCG正常的MDH患者34例为MDH组,平均年龄(51±12.0)岁.另选健康体检者中动态血压监测(ambulatory blood pressure monitoring,ABPM)正常的30例为对照组,平均年龄(54±10.3)岁.获取4组研究对象的24 h平均收缩压(24-hour mean systolic blood pressure,24 hSBP)和舒张压(24-hourmean diastolic blood pressure,24 h DBP)、白昼平均收缩压(daytime mean systolic blood pressure,dSBP)和舒张压(daytime mean diastolic blood pressure,dDBP)、夜间平均收缩压(nighttime mean systolic blood pressure,nSBP)和舒张压(nighttime mean diastolic blood pressure,nDBP)、夜间/白昼平均收缩压比值(nSBP/dSBP)和舒张压比值(nDBP/dDBP)、收缩压负荷值与舒张压负荷值.结果:(1)正常组和ISH组血压均值波动都具有昼夜规律性,但其曲线有所不同;MDH组夜间血压下降幅度减小,LVH组昼夜规律不明显;(2)ISH组、MDH组与LVH组24 hSBP、dSBP、nSBP均高于对照组,而以ISH组及LVH组更为显著(P<0.001);(3) MDH组与LVH组nDBP/dDBP均显著高于对照组;(4)LVH组nSBP/dSBP比值及nDBP/dDBP比值显著高于对照组;(5)SBP负荷值LVH组大于MDH组,DBP负荷值LVH组小于MDH组.结论:高血病患者应积极随访动态血压监测,以观察血压升高的水平及昼夜节律的变化,并有针对性地进行干预,这对降低心脑血管疾病发生的风险有重要意义.

  14. 老年主动脉瓣钙化患者的临床研究%Clinical study of aortic valve calcification in elderly patients

    Institute of Scientific and Technical Information of China (English)

    李康; 杨重庆; 鲁安怀; 汪芳; 李艳; 唐国栋; 朱梅倩; 褚德发

    2012-01-01

    目的 探讨老年人主动脉瓣钙化的发生率、瓣膜功能及与老年人常见疾病的相关性.方法 对在我院查体的966例患者进行超声心动图检查,根据年龄分为老年组733例和非老年组233例,老年组根据有无主动脉瓣钙化分为钙化组526例和非钙化组207例,测量主动脉瓣有无钙化、狭窄或关闭不全,用Logistic回归分析钙化发生的危险因素.结果 (1)老年组主动脉瓣钙化发生率高于非老年组71.8%(526例)与14.6%(34例),差异有统计学意义(x2=237.10,P<0.01);(2)钙化组、非钙化组合并主动脉瓣狭窄的发生率分别为2.1%(11/526)、1.9%(4/207),差异无统计学意义(x2=0.81,P>0.05);(3)老年性主动脉瓣钙化组、非钙化组合并主动脉瓣关闭不全的发生率分别为63.3%(333/526)、19.3%(40/207),差异有统计学意义(x2=116.10,P<0.01);(4)不同疾病发生主动脉瓣钙化的相对风险(OR)分别为:高血压(OR= 2.06,95%CI:1.400~3.031)、冠心病(OR= 3.46,95%CI:2.217~5.384),糖尿病(OR=2.66,95%CI:1.652~4.278)、慢性肾脏病(OR=2.34,95%CI:1.415~3.869,P<0.01),骨质疏松(OR=2.33,95%CI:1.119~4.838).结论 老年患者主动脉瓣钙化发生率较高,多为主动脉瓣关闭不全,高血压、冠心病、糖尿病、慢性肾脏疾病、骨质疏松患者更易发生主动脉瓣钙化.%Objective To evaluate the incidence of aortic valve calcification,and the correlation between valve function and commonly encountered disease in the aged patients.Methods Totally 996 patients who underwent ultrasonic cardiography (UCG) in our hospital were included.They were divide into elderly group and non elderly group,and the elderly group was divided into calcification subgroup and non calcification subgroup.The calcification,stenosis and regurgitation of aortic valve were detected by UCG,and risk factors of calcification were evaluated by Logistic regression analysis.Results The incidence of

  15. 冠心病高血压及无基础心血管病患者房性早搏对血流动力学的影响%The effects of premature atrial contractions on hemodynamics with coronary heart disease and hypertension without basic cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    郭元芳; 杨波; 成少永; 李美慧; 王卓清; 黄丛春; 王俊华; 王建昌

    2015-01-01

    Objective To explore the effects of premature atrial contractions on hemodynamics combined with coronary heart disease and hypertension .Methods According to the advance rate ,62 patients with premature atrial contractions were invided into 3 groups : 40% group(n= 24) .All of the patients were performed imped‐ance cardiography .The hemodynamics indexes at different times were compared ,and the variation rates in hemodynamics of the three groups combined with basic diseases were analyzed .Results Stroke volume(SV) ,stroke index(SI) ,aortic compliance(AC) , stroke work(SW) ,stroke work index(SWI) ,and heather index(HI) were smallest when premature atrial contractions ,which were middle when the first sinus beats before premature atrial contractions ,and largest when the first sinus beats after premature atrial contractions(P 40% group(P 40% group(P< 0 .05) .Conclusion The advance rate is relatively large in patients with basic cardiovascular disease .Premature atrial contractions has certain effects on hemodynamics ,and the effects are positively correlated with advance rate .%目的:结合冠心病、高血压探讨房性早搏对血流动力学的影响。方法选择冠心病、高血压及无基础心血管病的房性早搏患者62例,根据房性早搏提前率将患者分为提前率小于20%组18例、20%~40%组20例和大于40%组24例。所有患者均行无创血流动力学检查,比较所有患者房性早搏时及房性早搏前、后第1个窦性心搏的各项血流动力学指标,并结合基础疾病对3组患者的房性早搏血流动力学变化率进行比较分析。结果房性早搏时心搏出量(SV)、心搏指数(SI)、主动脉血管顺应性(AC)、每搏作功(SW)、搏功指数(SWI)、心缩力指数(HI)均最小,房性早搏前第1个窦性心搏居中,房性早搏后第1个窦性心搏最大(P<0.05)。房性早搏心搏出量、心搏指数、主动脉血管顺应性、每搏作

  16. Risk factor of mortality in systemic sclerosis of Han nationality%系统性硬化病患者死亡危险因素分析

    Institute of Scientific and Technical Information of China (English)

    姚中强; 栗占国; 于孟学; 刘湘源

    2010-01-01

    Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126~13.926,P=0.000),male sex (OR=5.531,95%CI 2.014~15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016~6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400~8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954~111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685~10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654~10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161~102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in

  17. 糖原合成酶激酶-3β与转化生长因子-β1在慢性充血性心力衰竭中的变化%Expression of hippocampus of glycogen synthase kinase-3β and transforming growth factor-β1 in rats with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    陈晞明; 李云和; 侯剑辉; 刘钰君; 叶博然; 黄兆琦; 陈盛强; 黄庆晖; 黄文晖

    2013-01-01

    ) in rats with chronic heart failure.Methods Totally 25 adult male SD rats were randomly assigned to 3 groups:normal group (n=5),sham operation group (n=10) and model group (n=10).Observation time of sham operation group and model group was 1 week,2 weeks,4 weeks and 8 weeks after operation.Chronic heart failure model was established by abdominal aortic constriction.Left ventricular end-diastolic dimension (LVEDd),interventricular septal thickness (IVST) and left ventricular posterior wall thickness (LVPWT) were monitored by ultrasound cardiography.Cardiac mass index,GSK-3β and TGF-β protein expression in hippocampal area were measured.Results LVEDd,IVST and LVPWT of model group 1 week after operation were (4.87±0.26) mm,(2.04±0.11) mm and (1.93±0.19) mm respectively,and they showed an increasing tendency afterwards,reaching to (6.94±0.12) mm,(2.98±0.21) mm and (3.63±0.18) mm 8 weeks after operation,significantly higher than those of normal group and sham operation group (P<0.01).LVEDd,IVST and LVPWT of sham operation group had no significant differences at different time points (P>0.05).Cardiac mass index and left ventricular mass index of model group were significantly higher than those of normal group and sham operation group (P<0.01).Western blotting values of GSK-3β among normal group,sham operation group and model group had no significant differences (P>0.01).Western blotting value of p-GSK-3β in model group 8 weeks after operation was significantly higher than those of normal group and sham operation group (P<0.05).Express of TGF-β1 of model group was significantly higher than those of normal group and sham operation group (P<0.05).Linear regression analysis indicated that expressions of p-GSK-3β and TGF-β1 had linear correlations with left ventricular mass index.Conclusions Proteins of p-GSK-3β and TGF-β1 in the hippocampus increase during the pathophysiologic processes of heart failure.

  18. 经冠状动脉自体骨髓间充质干细胞移植治疗急性心肌梗死:3个月疗效随访%Intracoronary transplantation of autologous bone marrow mesenchymal stem cells in the treatment of acute myocardial infarction: A 3-month follow-up on the therapeutic effect

    Institute of Scientific and Technical Information of China (English)

    林松; 吴承权; 何晓红; 段宝祥; 陈绍良; 叶飞; 方五旺; 马玉玲; 单守杰; 周陵; 张俊杰; 王峰

    2006-01-01

    percutaneous coronary intervention (PCI) to treat infarction-related blood vessel. Autologous bone marrow was taken from the patients, then stem cells were extracted to be performed in vitro induction, differentiation and proliferation, and transplanted infarction-related blood vessel through coronary artery at the mean number of (21.7±30.14)× 107 within 2 weeks. Before and 3 months after transplantation of stem cells, patients underwent gated dual-isotopic myocardial perfusion/metabolic imaging (18-fluoro-2-deoxy-glucose, 18F-FDG) examination. Survived and necrotic myocardia were predicted and infarction area was obtained. At the same time, wall motion and heart function index were evaluated with ultrasound cardiography (UCG)examination, and they were re-checked 3 months after operation to evaluate the amelioration of wall motion and heart function index. A 5-point scale was used in the evaluation of gated dual-isotopic myocardial perfusion/metabolic imaging (18F-FDG) examination: point 0: normal, 1: sparse, 2:obviously sparse, 3: defected. Evaluative standard of UCG: point 1: normal,2: reduced, 3: obviously reduced, 4: no ventricular wall motion or paradoxical motion; Wall motion with 2 points or more than 2 points suggests it is improved.MAIN OUTCOME MEASURES: ① Results of gated dual-isotopic myocardial perfusion/ metabolic imaging (18F-FDG-SPECT); ②Infarctionrelated myocardial segment score and heart function index before and after stem cell transplantation of patients in ECG follow-up observation.RESULTS: All the 20 patients participated in the result analysis.Results of gated dual-isotopic myocardial perrusion/metabolic imaging (18F-FDG-SPECT): The myocardial perfusion defect area of 20 patients was significantly reduced after therapy than before therapy [(33±15)%,-(44±18)% ,P < 0.05]; Metabolie defect area was significantly reduced after therapy than before therapy [(33±17)%, (43±21)% ,P < 0.05];Before therapy, there were 199 segments, in which blood flow

  19. Situação da assistência médico-sanitária e hospitalar no Estado do Ceará, Brasil Medical care situation in the State of Ceara, Brazil

    Directory of Open Access Journals (Sweden)

    João Yunes

    1973-06-01

    near to the required one unit per each 50,000 inhabitants. The qualitative appreciation, considered indirectly through the actual laboratory and human resources, seemed to be inefficient since only 16.7% of the health units have laboratory and 12.3% have no physicians; 21.7 (39 of the health center are closed because of the lack of this kind of professional related above. Paralel to this situation one can detect the existance of equipments completely out of date and the nearly absolute defficiency in the section of drug supply. From the 141 towns which compose the Region of Ceara, 31 (22% have no health unit and in 25 (17.7% we don't find any health resource. In the first presented case the population of medical care theoretically found out is of 378,449 inhabitants and in the second case it is of 232,900 inhabitants. From the 103 actual hospitals in this present Region 77.7% is on the responsability of the private section and 25% is concentrated in the capital of the Region. The quantitative standard of 1.84 beds/1000 inhabitants (7047 beds is extremely low when compared with the Brazilian average of 3.6 beds. The theoretically recomended average is 4.5 (beds. From the total number of beds 1.10/1000 are considered general and 0.74/1000 are specialized (tuberculosis, leprosy and psychiatry. The qualitative stantard of the hospital attendance is implicated since only 22.3% of the foundation have laboratory; 31.1% have X Ray apparatus and 11.6% present electro-cardiography. The most proeminent shortage of these resources occur in the countryside of this Region. More than 50.0% of the hospitals have no professional on health section, such us nursery, nutritionist, social work and technicians. From the 141 towns, 62.7% (89 have no hospitals, consequently about 1,300.000 inhabitants are theoretically in need of hospital care. Related to the 86 para-hospital units, through the lack of data is bigger, the situation is rather similar to the hospital care. There are 1207