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Sample records for regional atrial blood

  1. Mid-regional pro-atrial natriuretic peptide and blood pressure in adolescents

    DEFF Research Database (Denmark)

    Goharian, Tina S; Gimsing, Anders N; Goetze, Jens P

    2015-01-01

    Little is known about blood pressure in relation to circulating natriuretic peptide concentrations and gender in generally healthy adolescents. We studied 15-year-old females and males (n = 335) from the Danish site of the European Youth Heart Study (EYHS). Blood pressure was measured using...... a standardized protocol, sexual maturity was assessed according to Tanner stage, and as a surrogate for atrial natriuretic peptide, we measured mid-regional pro-atrial natriuretic peptide (MR-proANP) in plasma. Compared with boys, girls had lower systolic blood pressure (SBP) (mean ± SD: 109.6 ± 9.9 mmHg vs 116.......9 ± 11.4 mmHg, p adolescents were further subdivided according to Tanner stage, there were no differences in blood pressure...

  2. Dynamic regulation of atrial coronary blood flow in healthy adult pigs.

    Science.gov (United States)

    van Bragt, Kelly A; Nasrallah, Hussein M; Kuiper, Marion; van Hunnik, Arne; Kuijpers, Nico H L; Schotten, Ulrich; Verheule, Sander

    2015-05-01

    There are several indications for a mismatch between atrial oxygen supply and demand during atrial fibrillation (AF), but atrial coronary flow regulation has not been investigated extensively. The purpose of this study was to characterize the dynamic regulation of atrial coronary flow in pigs. In anesthetized open-chest pigs, Doppler flow probes were placed around left atrial (LA) and left ventricular (LV) branches of the circumflex artery. Pressures and work indices were measured simultaneously. Systolic and diastolic flow contribution, flow response kinetics, and relationship between pressures, work, and flow were investigated during sinus rhythm, atrial pacing, and acute AF. During atrial systole, LA flow decreased. Only 2% of total LA flow occurred during atrial systole. Pacing with 2:1 AV block and infusion of acetylcholine revealed that atrial contraction itself impeded atrial coronary flow. The response to sudden changes in heart rate was slower in LA compared to LV. Both LA and LV vascular conductance were positively correlated with work. After the cessation of acute AF, the LA showed a more pronounced phase of supranormal vascular conductance than the LV, indicating a period of atrial reactive hyperemia. In healthy adult pigs, atrial coronary flow is impeded by atrial contraction. Although atrial coronary blood flow is positively correlated with atrial external work, it reacts more slowly to changes in rate than ventricular flow. The occurrence of a pronounced hyperemic phase after acute AF supports the notion of a significant supply-demand mismatch during AF. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  3. Blood pressure variability in patients with atrial fibrillation.

    Science.gov (United States)

    Corino, Valentina D A; Lombardi, Federico; Mainardi, Luca T

    2014-10-01

    The highly irregular ventricular rate during atrial fibrillation (AF) represents a unique and physiological experimental model to eliminate the influence of rhythmical components of RR variability on arterial pressure variability for investigating the origin of low frequency (LF) component in arterial pressure. Surface ECG, blood pressure and respiratory signals were recorded in thirty patients with persistent AF, at rest and during a passive orthostatic stimulus ("tilt test"). Short-term systolic (SAP) and diastolic arterial pressure (DAP) variability was estimated by autoregressive method. In 15 patients (group A), SAP significantly increased during tilt (from 98±16 to 114±18mmHg, p<0.001 rest vs. tilt), whereas in the remaining patients (group B) SAP remained almost unchanged (from 108±16 to 104±17mmHg, p=0.05, rest vs. tilt). No clinical differences were found between group A and B. When analyzing group A, a significant increase in the LF power in SAP and DAP variability was observed during tilt (SAP: 2.24±2.75 vs. 6.60±5.11mmHg(2), p<0.05, rest vs. tilt; DAP: 3.54±1.95 vs. 4.38±3.21mmHg(2), p<0.05, rest vs. tilt). No significant differences were found in group B. In AF patients, changes of arterial pressure variability during tilt were not uniform. Vascular regulatory mechanisms appeared to be still efficient only in the subgroup of patients who responded to a sympathetic stimulus with an increased SAP. In these subjects tilt increased the LF component in arterial pressure variability, thus mimicking the physiological response observed in subjects with sinus rhythm.

  4. Simple Model for Identifying Critical Regions in Atrial Fibrillation

    Science.gov (United States)

    Peters, Nicholas S.

    2015-01-01

    Atrial fibrillation (AF) is the most common abnormal heart rhythm and the single biggest cause of stroke. Ablation, destroying regions of the atria, is applied largely empirically and can be curative but with a disappointing clinical success rate. We design a simple model of activation wave front propagation on an anisotropic structure mimicking the branching network of heart muscle cells. This integration of phenomenological dynamics and pertinent structure shows how AF emerges spontaneously when the transverse cell-to-cell coupling decreases, as occurs with age, beyond a threshold value. We identify critical regions responsible for the initiation and maintenance of AF, the ablation of which terminates AF. The simplicity of the model allows us to calculate analytically the risk of arrhythmia and express the threshold value of transversal cell-to-cell coupling as a function of the model parameters. This threshold value decreases with increasing refractory period by reducing the number of critical regions which can initiate and sustain microreentrant circuits. These biologically testable predictions might inform ablation therapies and arrhythmic risk assessment. PMID:25635565

  5. White blood cell count and risk of incident atrial fibrillation (from the Framingham Heart Study)

    NARCIS (Netherlands)

    Rienstra, Michel; Sun, Jenny X.; Magnani, Jared W.; Sinner, Moritz F.; Lubitz, Steven A.; Sullivan, Lisa M.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2012-01-01

    Several studies have reported that inflammatory markers are associated with atrial fibrillation (AF). The white blood cell (WBC) count is a widely available and broadly used marker of systemic inflammation. We sought to investigate the association between an increased WBC count and incident AF and w

  6. Atrial supply-demand balance in healthy adult pigs: coronary blood flow, oxygen extraction, and lactate production during acute atrial fibrillation.

    Science.gov (United States)

    van Bragt, Kelly A; Nasrallah, Hussein M; Kuiper, Marion; Luiken, Joost J; Schotten, Ulrich; Verheule, Sander

    2014-01-01

    Little is known about how atrial oxygen supply responds to increased demand, and under which conditions it falls short (supply-demand mismatch). Here, we have investigated the vasodilator response, oxygen extraction, and lactate production of the left atrium (LA) and left ventricle (LV) in response to atrial pacing and atrial fibrillation (AF). Series A (n = 9 Dutch landrace pigs) was instrumented to measure LA and LV vascular conductance in branches of the circumflex artery. Coronary conductance reserve (CCR) was calculated as the ratio between conductance during adenosine infusion and baseline. Series B (n = 7) was instrumented with sampling catheters in LA and LV veins for determination of blood gases and lactate levels. LA CCR (1.76 ± 0.14) was significantly lower than LV CCR (3.16 ± 0.27, P = 0.002). However, basal oxygen extraction was lower in LA (27 ± 3%) than that in the LV (58 ± 6%, P = 0.0006), indicating a larger extraction reserve in the LA than that in the LV (4.68 ± 0.84 vs. 1.88 ± 0.26, P = 0.01). Atrial pacing caused an increase in LA conductance (Series A) and oxygen extraction (Series B). AF increased LA vascular conductance to 177 ± 14% at 1 min, 168 ± 14 at 5 min, and 164 ± 31% at 10 min of AF (P < 0.05 vs. baseline). Atrial oxygen extraction also increased from 26 ± 3% at baseline to 63 ± 5% (P < 0.01) at 5 min and 60 ± 11% (P < 0.01) at 10 min of AF. Arterio-venous lactate difference increased significantly (P = 0.02) during AF. In healthy pigs, the LA has a lower CCR, but a higher extraction reserve compared with the LV. Although both reserves were recruited during AF, atrial lactate production increased significantly.

  7. Estimated central blood volume in cirrhosis: relationship to sympathetic nervous activity, beta-adrenergic blockade and atrial natriuretic factor

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Gerbes, A L

    1992-01-01

    The estimated central blood volume (i.e., blood volume in the heart cavities, lungs and central arterial tree) was determined by multiplying cardiac output by circulatory mean transit time in 19 patients with cirrhosis and compared with sympathetic nervous activity and circulating level of atrial...

  8. EFFECT OF INCREASED WHOLE-BLOOD VISCOSITY ON REGIONAL BLOOD FLOWS IN CHRONICALLY HYPOXEMIC LAMBS

    NARCIS (Netherlands)

    DALINGHAUS, M; KNOESTER, H; GRATAMA, JWC; VANDERMEER, J; ZIJLSTRA, WG; KUIPERS, JRG

    1994-01-01

    In chronic hypoxemia blood flow and oxygen supply to vital organs are maintained, but to nonvital organs they are decreased. We measured organ blood flows (microspheres) and whole blood viscosity in 10 chronically hypoxemic lambs, with an atrial septal defect and pulmonary stenosis, and in 8 control

  9. Electrical cardioversion for atrial fibrillation improves microvascular flow independent of blood pressure changes.

    Science.gov (United States)

    Elbers, Paul W G; Prins, Wilhelmina B; Plokker, Herbert W M; van Dongen, Eric P A; van Iterson, Mat; Ince, Can

    2012-10-01

    This study tested the hypothesis that there is a discrepancy between global hemodynamic parameters and microvascular flow in patients before and after successful elective electrical cardioversion (ECV) for atrial fibrillation (AF). Prospective observational study. Preanesthesia holding area in a teaching hospital. Adult patients who underwent successful elective ECV for AF. ECV. Routine measurements of heart rate and noninvasive blood pressure were recorded and the sublingual microcirculation was visualized by sidestream darkfield imaging before and after the conversion of AF to sinus rhythm by elective ECV. The conversion to sinus rhythm significantly improved the microvascular flow index for smaller and larger microvessels. For smaller microvessels, perfused vessel density did not reach significance after conversion to sinus rhythm, whereas the proportion of perfused vessels was significantly larger and indices of heterogeneity for microvascular flow index decreased significantly. No correlation could be identified for the changes in mean blood pressure, perfused vessel density, and microvascular flow index for smaller microvessels. Successful ECV in patients with AF improves indices of sublingual microvascular perfusion. This change has no clear relation to the change in blood pressure and cannot be predicted from it. It may be prudent not to rely solely on global hemodynamic parameters to assess end-organ perfusion in this setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Far field R-wave sensing in Myotonic Dystrophy type 1: right atrial appendage versus Bachmann's bundle region lead placement.

    Science.gov (United States)

    Russo, Vincenzo; Nigro, Gerardo; Antonio Papa, Andrea; Rago, Anna; Di Meo, Federica; Cristiano, Anna; Molino, Antonio; Calabrò, Raffaele; Giovanna Russo, Maria; Politano, Luisa

    2014-10-01

    Aim of the present study was to investigate far field R-wave sensing (FFRS) timing and characteristics in 34 Myotonic Dystrophy type 1 (DM1) patients undergoing dual chamber pacemaker implantation, comparing Bachmann's bundle (BB) stimulation (16 patients) site with the conventional right atrial appendage (RAA) pacing site (18 patients). All measurements were done during sinus rhythm and in supine position, with unipolar (UP) and bipolar (BP) sensing configuration. The presence, amplitude threshold (FFRS trsh) and FFRS timing were determined. There were no differences between both atrial sites in the Pmin and Pmean values of sensed P-wave amplitudes, as well as between UP and BP sensing configurations. The FFRS trsh was lower at the BB region in comparison to the RAA site. The mean BP FFRS trsh was significantly lower than UP configuration in both atrial locations. There were no significant differences in atrial pacing threshold, sensing threshold and atrial lead impedances at the implant time and at FFRS measurements. Bachmann's bundle area is an optimal atrial lead position for signal sensing as well as conventional RAA, but it offers the advantage of reducing the oversensing of R-wave on the atrial lead, thus improving functioning of standard dual chamber pacemakers in DM1 patients.

  11. A Genetic Algorithm Optimization Method for Mapping Non-Conducting Atrial Regions: A Theoretical Feasibility Study.

    Science.gov (United States)

    Shiff, Shai; Swissa, Moshe; Zlochiver, Sharon

    2016-03-01

    Atrial ablation has been recently utilized for curing atrial fibrillation. The success rate of empirical ablation is relatively low as often the exact locations of the arrhythmogenic sources remain elusive. Guided ablation has been proposed to improve ablation technique by providing guidance regarding the potential localization of the sources; yet to date no main technological solution has been widely adopted as an integral part of the ablation process. Here we propose a genetic algorithm optimization technique to map a major arrhythmogenic substance-non-conducting regions (NCRs). Excitation delays in a set of electrodes of known locations are measured following external tissue stimulation, and the spatial distribution of obstacles that is most likely to yield the measured delays is reconstructed. A forward problem module was solved to provide synthetic time delay measurements using a 2D human atrial model with known NCR distribution. An inverse genetic algorithm module was implemented to optimally reconstruct the locations of the now unknown obstacle distribution using the synthetic measurements. The performance of the algorithm was demonstrated for several distributions varying in NCR number and shape. The proposed algorithm was found robust to measurements with a signal-to-noise ratio of at least -20 dB, and for measuring electrodes separated by up to 3.2 mm. Our results support the feasibility of the proposed algorithm in mapping NCRs; nevertheless, further research is required prior to clinical implementation for incorporating more complex atrial tissue geometrical configurations as well as for testing the algorithm with experimental data.

  12. Effect of lower on-treatment systolic blood pressure on the risk of atrial fibrillation in hypertensive patients

    DEFF Research Database (Denmark)

    Okin, Peter M; Hille, Darcy A; Larstorp, Anne Cecilie K

    2015-01-01

    UNLABELLED: There is a well-established association between hypertension and atrial fibrillation (AF); indeed, even upper normal systolic blood pressures (SBP) are long-term predictors of incident AF. These findings suggest that more aggressive BP control may reduce the risk of new AF. However, w...... whether targeting hypertensive patients without AF to lower SBP goals can reduce the burden of new AF in this high-risk population. CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov. Unique identifier: NCT00338260....

  13. Regional cerebral blood flow in schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  14. Automated measurement of office, home and ambulatory blood pressure in atrial fibrillation.

    Science.gov (United States)

    Kollias, Anastasios; Stergiou, George S

    2014-01-01

    1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives.

  15. Pulmonary vein region ablation in experimental vagal atrial fibrillation: role of pulmonary veins versus autonomic ganglia.

    Science.gov (United States)

    Lemola, Kristina; Chartier, Denis; Yeh, Yung-Hsin; Dubuc, Marc; Cartier, Raymond; Armour, Andrew; Ting, Michael; Sakabe, Masao; Shiroshita-Takeshita, Akiko; Comtois, Philippe; Nattel, Stanley

    2008-01-29

    Pulmonary vein (PV) -encircling radiofrequency ablation frequently is effective in vagal atrial fibrillation (AF), and there is evidence that PVs may be particularly prone to cholinergically induced arrhythmia mechanisms. However, PV ablation procedures also can affect intracardiac autonomic ganglia. The present study examined the relative role of PVs versus peri-PV autonomic ganglia in an experimental vagal AF model. Cholinergic AF was studied under carbachol infusion in coronary perfused canine left atrial PV preparations in vitro and with cervical vagal stimulation in vivo. Carbachol caused dose-dependent AF promotion in vitro, which was not affected by excision of all PVs. Sustained AF could be induced easily in all dogs during vagal nerve stimulation in vivo both before and after isolation of all PVs with encircling lesions created by a bipolar radiofrequency ablation clamp device. PV elimination had no effect on atrial effective refractory period or its responses to cholinergic stimulation. Autonomic ganglia were identified by bradycardic and/or tachycardic responses to high-frequency subthreshold local stimulation. Ablation of the autonomic ganglia overlying all PV ostia suppressed the effective refractory period-abbreviating and AF-promoting effects of cervical vagal stimulation, whereas ablation of only left- or right-sided PV ostial ganglia failed to suppress AF. Dominant-frequency analysis suggested that the success of ablation in suppressing vagal AF depended on the elimination of high-frequency driver regions. Intact PVs are not needed for maintenance of experimental cholinergic AF. Ablation of the autonomic ganglia at the base of the PVs suppresses vagal responses and may contribute to the effectiveness of PV-directed ablation procedures in vagal AF.

  16. Atrial Ectopics Precipitating Atrial Fibrillation

    OpenAIRE

    Johnson Francis

    2015-01-01

    Holter monitor tracing showing blocked atrial ectopics and atrial ectopic precipitating atrial fibrillation is being demonstrated. Initially it was coarse atrial fibrillation, which rapidly degenerated into fine atrial fibrillation.

  17. Estimated central blood volume in cirrhosis: relationship to sympathetic nervous activity, beta-adrenergic blockade and atrial natriuretic factor

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Bendtsen, F; Gerbes, A L

    1992-01-01

    The estimated central blood volume (i.e., blood volume in the heart cavities, lungs and central arterial tree) was determined by multiplying cardiac output by circulatory mean transit time in 19 patients with cirrhosis and compared with sympathetic nervous activity and circulating level of atrial...... natriuretic factor. Arterial norepinephrine level, an index of overall sympathetic nervous activity (3.08 nmol/L in patients vs. 1.36 nmol/L in controls; p blood volume (mean = 23 ml/kg in patients vs. 27 ml/kg in controls; p ....05). Similarly, renal venous norepinephrine level (an index of renal sympathetic tone; 4.26 nmol/L in patients vs. 1.78 nmol/L in controls; p blood volume (r = -0.53, n = 18, p

  18. Pulmonary vein isolation in patients with paroxysmal atrial fibrillation is associated with regional cardiac sympathetic denervation

    Science.gov (United States)

    2013-01-01

    Background Circumferential pulmonary vein isolation (PVI) is the cornerstone of the current state-of-the-art management of atrial fibrillation (AF). However, the precise mechanisms behind AF relapses post PVI are still unknown. Since the activity of the autonomous nervous system is crucial in triggering paroxysmal AF, we hypothesized that PVI is associated with changes of cardiac sympathetic activity. Methods Sixteen patients with paroxysmal AF underwent cardiac iodine-123-meta-iodobenzylguanidine (123I-mIBG) planar cardiac imaging and single-photon emission computed tomography with low-dose computed tomography (SPECT/CT) for attenuation correction before and 4 weeks after PVI. The heart-to-mediastinum ratio (H/M ratio), washout rate (WR), regional myocardial uptake, and regional washout were analyzed. Results The late H/M ratio was unchanged by PVI (pre, 2.9 ± 0.5 vs. post, 2.7 ± 0.6, p = 0.53). Four of the 16 patients (25%) displayed regional deficits before PVI. After PVI, regional deficits were present in ten patients (62.5%) with newly emerging deficits localized in the inferolateral wall. In a 6-month follow-up, four out of the ten patients (40%) with regional 123I-mIBG defects suffered from a recurrence of AF, while only one of the six patients (16.7%) without a regional 123I-mIBG defect experienced a recurrence. Conclusion A significant number of patients with paroxysmal AF show regional cardiac sympathetic innervation deficits at baseline. In addition, PVI is associated with newly emerging defects. The presence of regional sympathetic denervation after PVI may correlate with the risk of AF relapses. PMID:24360192

  19. Duration of Electrically Induced Atrial Fibrillation Is Augmented by High Voltage of Stimulus with Higher Blood Pressure in Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Tomomi Nagayama

    2014-01-01

    Full Text Available Objective. Many previous clinical studies have suggested that atrial fibrillation (AF is closely associated with hypertension. However, the benefits of antihypertensive therapy on AF are still inconsistent, and it is necessary to explore the factors augmenting AF in hypertensive rats. The aim of the present study was to investigate the correlation between arterial pressure or voltage stimulus and to the duration of electrically induced AF in normotensive or hypertensive rats. Methods. AF was reproducibly induced by transesophageal atrial burst pacing in spontaneously hypertensive rats (SHR and Wistar-Kyoto rats (WKY. We did the burst pacing at high (20 V or low (5 V voltage. Results. Duration of AF did not correlate with systolic blood pressure (SBP and stimulus voltage in WKY. However, only in SHR, duration of AF with high stimulus voltage significantly correlated with SBP and was significantly longer in high than in low voltage stimulus. Discussion and Conclusion. Duration of AF is augmented by high voltage stimulus with higher blood pressure in SHR.

  20. Regional cerebral blood flow in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, J.; Ohta, Y.; Nakane, Y.; Mori, H.; Hirota, N.; Yonekura, M.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of /sup 133/X in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., hypofrontality); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms.

  1. Termination of atrial spiral waves by traction into peripheral non 1:1 conducting regions - A numerical study.

    Science.gov (United States)

    Rozner, Amit; Zlochiver, Sharon

    2016-11-01

    Atrial ablation has been recently utilized to treat atrial fibrillation (AF) by isolation or destruction of arrhythmia drivers. In chronic or persistent AF patients these drivers often consist of one or few rotors at unknown locations, and several ablations are commonly conducted before arrhythmia is terminated. However, the irreversible damage done to the tissue may lead to AF recurrence. We propose an alternative strategy to terminate rotor activity by its attraction into a non 1:1 conducting region. The feasibility of the method was numerically tested in 2D models of chronic AF human atrial tissue. Left-to-right gradients of either acetylcholine (ACh) or potassium conductance were employed to generate regions of 1:1 and non 1:1 conduction, characterized by their dominant frequency (DF) ratios. Spiral waves were established in the 1:1 conducting region and raster scanning was employed using a stimulating probe to attract the spiral wave tip. The probe was then linearly moved towards the boundary between the two regions. Successful attraction of spiral waves to the probe was demonstrated when the probe was <8mm from the spiral wave tip. Maximal traction velocity without loss of anchoring increased in a non-linear way with increasing values of ACh. Success rate of spiral wave termination was over 90% for regional DF ratios of as low as 1:1.2. Given that normally much higher ratios are measured in physiological atrial tissues, we envision this technique to provide a feasible, safer alternative to ablation procedures performed in persistent AF patients. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  2. Circulating atrial natriuretic peptide (ANP) and central blood volume (CBV) in cirrhosis

    DEFF Research Database (Denmark)

    Schütten, H J; Henriksen, Jens Henrik Sahl; Bendtsen, F

    1986-01-01

    , P less than 0.02) and inversely correlated with portal pressure (r = 0.42, P less than 0.05), whereas total plasma volume was somewhat increased (3.51 +/- 0.2 vs. 3.19 +/- 0.2, 0.05 less than P less than 0.1). A high arterio-venous extraction of ANP was found in the splanchnic system (extraction......Endogenous alpha-atrial natriuretic peptide (ANP) in plasma is elevated in various hypervolaemic conditions. Possible relationships between circulating immunoreactive ANP and cardiovascular and splanchnic haemodynamics were therefore studied in patients with cirrhosis (n = 16) and controls (n = 12......). Arterial plasma concentration of ANP in supine patients was (mean +/- SEM) 33 +/- 4 vs 41 +/- 10 pg/ml (9.9 +/- 1.2 vs 12.3 +/- 3.0 fmol/l) in controls (n.s.), and there was a weak direct correlation with right atrial pressure (r = 0.36, P = 0.05). There was no relationship with the presence of ascites...

  3. Predictors of regional variations in hospitalizations following emergency department visits for atrial fibrillation.

    Science.gov (United States)

    Barrett, Tyler W; Self, Wesley H; Jenkins, Cathy A; Storrow, Alan B; Heavrin, Benjamin S; McNaughton, Candace D; Collins, Sean P; Goldberger, Jeffrey J

    2013-11-01

    The emergency department (ED) is often where atrial fibrillation (AF) is first detected and acutely treated and affected patients dispositioned. We used the Nationwide Emergency Department Sample to estimate the percentage of visits resulting in hospitalization and investigate associations between patient and hospital characteristics with hospitalization at the national and regional levels. We conducted a cross-sectional study of adults with AF listed as the primary ED diagnosis in the 2007 to 2009 Nationwide Emergency Department Sample. We performed multivariate logistic regression analyses investigating the associations between prespecified patient and hospital characteristics with hospitalization. From 2007 to 2009, there were 1,320,123 weighted ED visits for AF, with 69% hospitalized nationally. Mean regional hospitalization proportions were: Northeast (74%), Midwest (68%), South (74%), and West (57%). The highest odds ratios for predicting hospitalization were heart failure (3.85, 95% confidence interval [CI] 3.66 to 4.02), chronic obstructive pulmonary disease (2.47, 95% CI 2.34 to 2.61), and coronary artery disease (1.65, 95% CI 1.58 to 1.73). After adjusting for age, privately insured (0.77, 95% CI 0.73 to 0.81) and self-pay (0.77 95% CI 0.66 to 0.90) patients had lower odds compared with Medicare recipients, whereas Medicaid (1.21, 95% CI 1.11 to 1.32) patients tended to have higher odds. Patients living in low-income zip codes (1.18, 95% CI 1.12 to 1.25) and patients treated at large metropolitan hospitals (1.75, 95% CI 1.59 to 1.93) had higher odds. In conclusion, our analysis showed considerable regional variation in the management of patients with AF in the ED and in associations between patient socioeconomic and hospital characteristics with ED disposition; adapting best practices from among these variations in management could reduce hospitalizations and health-care expenses. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Storage time of intraoperative transfused allogeneic red blood cells is not associated with new-onset postoperative atrial fibrillation in cardiac surgery

    DEFF Research Database (Denmark)

    Gu, Jiwei; Skals, Regitze Kuhr; Torp-Pedersen, Christian

    2017-01-01

    BACKGROUND: Allogeneic red blood cell (RBC) transfusion has been associated with new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Prolonged storage time of RBC may increase the risk. The primary aim of the study was to evaluate whether the storage time of RBC is assoc......BACKGROUND: Allogeneic red blood cell (RBC) transfusion has been associated with new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Prolonged storage time of RBC may increase the risk. The primary aim of the study was to evaluate whether the storage time of RBC...... is associated with development of POAF. MATERIALS AND METHODS: Pre-, per- and postoperative data were retrieved from the Western Denmark Heart Registry and local blood banks regarding patients who underwent coronary artery bypass surgery, valve surgery or combined procedures in Aalborg or Aarhus University...

  5. Regional differences in presentation and treatment of patients with atrial fibrillation in Europe: a report from the EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry.

    Science.gov (United States)

    Lip, Gregory Y H; Laroche, Cécile; Boriani, Giuseppe; Dan, Gheorghe-Andrei; Santini, Massimo; Kalarus, Zbigniew; Rasmussen, Lars Hvilsted; Oliveira, Mário Martins; Mairesse, Georges; Crijns, Harry J G M; Simantirakis, Emmanouil; Atar, Dan; Maggioni, Aldo P; Tavazzi, Luigi

    2015-02-01

    Country differences in management practices are evident, and the publication of management guidelines by the European Society of Cardiology (ESC) and other learned societies has tried to recommend a uniform evidence-based approach to management. Despite the availability of guidelines and efforts to improve implementation, differences in guideline adherence are evident, and differences between countries and regions within Europe are therefore likely. In this analysis from the baseline dataset of the EORP-AF Pilot survey, we examined regional differences in presentation and treatment of contemporary patients with atrial fibrillation (AF) in Europe, as managed by European cardiologists. We focused on a subgroup of 902 hospital admitted patients in whom no rhythm control was performed or planned. Chronic heart failure was more common in East countries (P < 0.0001) while hypertension and peripheral artery disease were more common in South countries (both P < 0.0001). Previous bleeding and chronic kidney disease were more common in South countries (both P < 0.0001). A CHA2DS2-VASc score of ≥2 was highest in East and South countries (93.0 and 95.3%, respectively) compared with 80.8% in West countries (P < 0.0001). A HAS-BLED score of ≥3 was also highest in East and South countries (18.0 and 29.2% respectively) compared with 4.8% in West countries (P < 0.0001). Oral anticoagulation (OAC) use (either as OAC or OAC plus antiplatelet therapy) in West, East, and South countries was 72.0, 74.7, and 76.2%, respectively. Only antiplatelet therapy was used in 13.6, 15.4, and 12.4%, respectively. An initial rate control strategy only was most common in South countries (77.8%) (P < 0.0001). From the systematic collection of contemporary data regarding the management and treatment of AF in nine participating member ESC countries, we provide hypothesis-generating insights into regional management practices in Europe with regard to patient characteristics and treatment options

  6. Atrial fibrillation

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    patients with atrial fibrillation managed in a referral hospital in Port Harcourt, southern Nigeria. ... treatment despite all the patients having moderate to high risk of stroke ... Keywords: Atrial fibrillation, thrombosis, CHADS2 Score, stroke risk, ...

  7. Regional patterns of cortical blood flow distinguish extraverts from introverts

    OpenAIRE

    Stenberg, Georg; Risberg, Jarl; Warkentin, S.; Rosén, Ingmar

    1990-01-01

    Eysenck's hypothesis of higher cortical arousal in introverts was examined using regional cerebral blood flow measurement in 37 healthy subjects . The measurement was made at rest, using the133Xe-inhalation method. Estimates of gray matter flow were obtained for 32 brain regions. There was no significant evidence of personality differences in general arousal, as measured by the mean flow level, averaged over all regions. There were, however, regional differences. An overall test of the blood ...

  8. Blood pressure control and stroke or bleeding risk in anticoagulated patients with atrial fibrillation: Results from the ROCKET AF Trial.

    Science.gov (United States)

    Vemulapalli, Sreekanth; Hellkamp, Anne S; Jones, W Schuyler; Piccini, Jonathan P; Mahaffey, Kenneth W; Becker, Richard C; Hankey, Graeme J; Berkowitz, Scott D; Nessel, Christopher C; Breithardt, Günter; Singer, Daniel E; Fox, Keith A A; Patel, Manesh R

    2016-08-01

    We conducted a retrospective analysis examining the association between systolic blood pressure (SBP) or hypertension bracket and stroke risk in patients with atrial fibrillation (AF). The study included 14,256 anticoagulated patients in the ROCKET AF trial. Cox proportional hazards models were used to compare the risk of adverse outcomes by European Society of Cardiology hypertension bracket and screening SBP. In total, 90.5% of patients had hypertension (55.8% controlled, 34.6% uncontrolled). The adjusted risk of stroke or systemic embolism (SE) increased significantly for every 10-mm Hg increase in screening SBP (hazard ratio [HR] 1.07, 95% CI 1.02-1.13). There was a trend toward an increased adjusted risk of stroke or SE in patients with controlled (HR 1.22, 95% CI 0.89-1.66) and uncontrolled hypertension (HR 1.42, 95% CI 1.03-1.95) (P = .06). In contrast, the adjusted risk of major bleeding was similar between hypertensive brackets and did not vary significantly by screening SBP. The benefit of rivaroxaban versus warfarin in preventing stroke or SE was consistent among patients regardless of SBP (P interaction = .69). In a trial of anticoagulated patients with AF, increasing screening SBP was independently associated with stroke and SE, and one-third of patients had uncontrolled hypertension. The relative effectiveness and safety of rivaroxaban versus warfarin were consistent across all levels of screening SBP. A single SBP may be an important factor in reducing the overall risk of stroke and SE in anticoagulated patients with AF. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Blood Lipid Levels, Lipid Lowering Medications, and the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

    Science.gov (United States)

    Lopez, Faye L.; Agarwal, Sunil K.; MacLehose, Richard F.; Soliman, Elsayed Z.; Sharrett, A. Richey; Huxley, Rachel R.; Konety, Suma; Ballantyne, Christie M.; Alonso, Alvaro

    2012-01-01

    Background Several cardiovascular risk factors have been associated with the risk of atrial fibrillation (AF). Limited and inconsistent evidence exists on the association of blood lipid levels and lipid lowering medication use with AF risk. Methods and Results We analyzed 13,969 participants (25% African-American, 45% men) free of AF at baseline from the Atherosclerosis Risk in Communities (ARIC) study. Fasting HDL cholesterol (HDLc), LDL cholesterol (LDLc), triglycerides, and total cholesterol were measured at baseline (1987–89) and each of three follow-up visits. Incidence of AF was ascertained through 2007. The association of the use of statins and other lipid lowering medications with AF was estimated in 13,044 ARIC participants attending visit 2 (1990–92), adjusting for covariates from the previous visit. During a median follow-up of 18.7 years there were 1433 incident AF cases. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) of AF associated with a one standard deviation increase in lipid levels were: HDLc: 0.97 (0.91–1.04); LDLc: 0.90 (0.85–0.96); total cholesterol: 0.89 (0.84–0.95); and triglycerides: 1.00 (0.96–1.04). Participants taking lipid lowering medications had an adjusted HR (95% CI) of AF of 0.96 (0.82–1.13) compared to those not on medications, while those taking statins had an adjusted HR of 0.91 (0.66–1.25) compared to those taking other lipid lowering mediations. Conclusions Higher levels of LDLc and total cholesterol were associated with a lower incidence of AF. HDLc and triglycerides, however, were not independently associated with AF incidence. No association was found between the use of lipid lowering medications and incident AF. PMID:22227953

  10. Repeated Microsphere Delivery for Serial Measurement of Regional Blood Perfusion in the Chronically Instrumented, Conscious Canine

    Science.gov (United States)

    Bartoli, Carlo R.; Okabe, Kazunori; Akiyama, Ichiro; Coull, Brent; Godleski, John J.

    2008-01-01

    INTRODUCTION For chronic, repeated hemodynamic studies in conscious dogs, we designed and tested a chronically instrumented canine, microsphere delivery model. The goals of this study were to investigate the accuracy of repeated estimations of blood perfusion using fluorescent-labeled microspheres and to develop and validate a chronic preparation that permits consecutive estimations in the same conscious animal over an extended protocol. METHODS Via thoracotomy, 9 dogs were instrumented with left atrial appendage and aortic vascular access catheters connected to subcutaneous vascular access ports (VAPs). Four animals received 7 serial injections of 1.6 million 15μm microspheres (total: 11.2 million), and five animals received 8 serial injections of 2.25 million microspheres (total: 18 million) over the course of 11 or 18 weeks. RESULTS All catheters have remained bidirectionally patent during protocol for 14.9±0.8 (Mean±SEM) weeks. Sphere accumulation did not significantly alter global myocardial (p=0.69, p=0.25), renal (p=0.92, p=0.12), hepatic (p=0.84, p=0.32), or splenic (p=0.33, p=0.70) blood perfusion in either set of animals. CONCLUSIONS Catheters remained bidirectionally patent for months, did not interfere with the hemodynamic responses of the preparation, and allowed repeat percutaneous injection of microspheres and withdrawal of reference arterial blood from within conscious canines. Eight serial injections totaling 18 million microspheres over 18 weeks did not alter regional myocardial, hepatic, renal, or splenic blood flow. This dependable, chronic, percutaneous arterial access preparation provides a means for examining acute and long-term effects of pathophysiological, pharmaceutical, and environmental influences on regional arterial blood perfusion in conscious, large animals. PMID:17632127

  11. The Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open Label, Clinical Trial (Substrate Modification with Aggressive Blood Pressure Control: SMAC- AF).

    Science.gov (United States)

    Parkash, Ratika; Wells, George A; Sapp, John L; Healey, Jeffrey S; Tardif, Jean-Claude; Greiss, Isabelle; Rivard, Léna; Roux, Jean-Francois; Gula, Lorne; Nault, Isabelle; Novak, Paul G; Birnie, David H; Ha, Andrew C; Wilton, Stephen B; Mangat, Iqwal; Gray, Christopher J; Gardner, Martin J; Tang, Anthony S L

    2017-02-22

    Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation. The primary outcome was symptomatic recurrence of AF/atrial tachycardia/atrial flutter lasting greater than 30 seconds, determined 3 months beyond catheter ablation by a blinded endpoint evaluation. Results -The median follow-up was 14 months. At six months, the mean systolic BP in the aggressive BP treatment group was 123.2±13.2 versus 135.4±15.7mm Hg (p<0.001) in the standard treatment group. The primary outcome occurred in 106 patients, 54 (61.4%) in the aggressive BP treatment group, compared to 52 (61.2%) in the standard treatment group, (Hazard Ratio 0.94, 95% Confidence Interval 0.65-1.38, p=0.763). In the prespecified subgroup analysis of the influence of age, patients aged ≥ 61 years had a lower primary outcome event rate with aggressive BP (Hazard Ratio 0.58, 95% Confidence Interval (0.34, 0.97), p=0.013). There was a higher rate of hypotension requiring medication adjustment in the aggressive BP group (26% versus 0%). Conclusions -In this study, this duration of aggressive BP treatment did not reduce atrial arrhythmia recurrence after catheter ablation for AF, but resulted in more hypotension. Clinical Trial Registration -Clinicaltrials.gov Identifier: NCT00438113.

  12. Innervation of the sinu-atrial node and neighbouring regions in two human embryos.

    Science.gov (United States)

    Orts Llorca, F; Domenech Mateu, J M; Puerta Fonolla, J

    1979-03-01

    In human embryos of 20 to 23 mm (36 to 40 days) it is possible to identify on the right side a nerve that we may call the sinusal, which originates by several roots from the nervus vagus dexter (Figs. 1A, B, D), descending through the right ventrolateral face of the primary trachea and right bronchus (Fig. 2, arrows). Beaded in appearance, it gives a fine anastomotic branch which, passing in front of the arteria pulmonalis dextra, passes to the left side (Figs. 2B, C, D; AN). At this level it gives the large branch for the nodus sinoatrialis which, penetrating through the wall of the superior vena cava, provides a rich innervation for the nodus sinoatrialis which is already in an advanced stage of differentiation (Fig. 3, 2; Cy, D, AN). Afterwards it gives fine branches which, following the atrial fold, are distributed throughout the posterior face of the atrium dextrum (Fig. 3). It increases in diameter and, passing through the angle formed by the right pulmonary veins with the atrium dextrum, reaches the intrapericardial portion of the inferior vena cava in the vicinity of its outlet from the atrium (Fig. 3, arrows). The whole innervation is parasympathetic at the stages studied.

  13. Regional cerebral blood flow in focal cortical epilepsy

    DEFF Research Database (Denmark)

    Hougaard, Kristina Dupont; Oikawa, T; Sveinsdottir, E

    1976-01-01

    Regional cerebral blood flow (rCBF) was studied in ten patients with focal cortical epilepsy. The blood flow was measured by the intra-arterial injection of xenon 133 (133Xe), and the isotope clearance was recorded by a multidetector scintillation camera with 254 detectors. Three patients were st...

  14. Regional cerebral blood flow in fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K. [The Queen Elizabeth Hospital , Adelaide, SA (Australia)

    1998-06-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  15. Relation of Mitochondrial DNA Copy Number in Peripheral Blood to Postoperative Atrial Fibrillation After Isolated Off-Pump Coronary Artery Bypass Grafting.

    Science.gov (United States)

    Zhang, Jian; Xu, Shu; Xu, Yinli; Liu, Yu; Li, Zhi; Zhang, Yuji; Jin, Yan; Xue, Xiaodong; Wang, Huishan

    2017-02-01

    Oxidative stress has been considered to be an important factor contributing to postoperative atrial fibrillation (PoAF). Mitochondrial DNA (mtDNA) copy number in peripheral blood has been found to be associated with a patient's oxidative stress. Therefore, we sought to determine whether there was association between mtDNA copy number and the onset of atrial fibrillation. mtDNA copy numbers were measured using the quantitative real-time polymerase chain reaction in peripheral blood from 485 consecutive patients with sinus rhythm undergoing coronary artery bypass grafting. The blood was collected before surgery. In the cohort, the incidence of PoAF was 20.8% (101/485). The mean mtDNA copy number was significantly higher in patents with PoAF than in those with sinus rhythm (36.43 vs 16.63, p copy number could predict PoAF with good sensitivity and specificity (area under the curve = 0.814, cutoff = 20.91, sensitivity = 70.3%, specificity = 80.2%, p copy number was shown to be a significant independent risk factor for PoAF (odds ratio = 10.01, p copy number and malondialdehyde in patients with PoAF (r = 0.449, p = 0.01). In conclusion, we showed that elevated mtDNA copy number in peripheral blood is associated with PoAF. Further investigation is needed to validate mtDNA copy number as a predictive biomarker for PoAF and to explore its potential role in arrhythmogenesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  17. Amino Acids That Centrally Influence Blood Pressure and Regional Blood Flow in Conscious Rats

    Directory of Open Access Journals (Sweden)

    Yumi Takemoto

    2012-01-01

    Full Text Available Functional roles of amino acids have increasingly become the focus of research. This paper summarizes amino acids that influence cardiovascular system via the brain of conscious rats. This paper firstly describes why amino acids are selected and outlines how the brain regulates blood pressure and regional blood flow. This section includes a concise history of amino acid neurotransmitters in cardiovascular research and summarizes brain areas where chemical stimulations produce blood pressure changes mainly in anesthetized animals. This is followed by comments about findings regarding several newly examined amino acids with intracisternal stimulation in conscious rats that produce changes in blood pressure. The same pressor or depressor response to central amino acid stimulations can be produced by distinct mechanisms at central and peripheral levels, which will be briefly explained. Thereafter, cardiovascular actions of some of amino acids at the mechanism level will be discussed based upon findings of pharmacological and regional blood flow measurements. Several examined amino acids in addition to the established neurotransmitter amino acids appear to differentially activate brain structures to produce changes in blood pressure and regional blood flows. They may have physiological roles in the healthy brain, but pathological roles in the brain with cerebral vascular diseases such as stroke where the blood-brain barrier is broken.

  18. Improvement of regional myocardial blood flow and function and reduction of infarct size with ivabradine: protection beyond heart rate reduction.

    Science.gov (United States)

    Heusch, Gerd; Skyschally, Andreas; Gres, Petra; van Caster, Patrick; Schilawa, Dustin; Schulz, Rainer

    2008-09-01

    Effects of the bradycardic agent ivabradine on regional blood flow, contractile function, and infarct size were studied in a pig model of myocardial ischaemia/reperfusion. Heart rate reduction by beta-blockade is associated with negative inotropism and unmasked alpha-adrenergic coronary vasoconstriction. Ivabradine is the only available bradycardic agent for clinical use. Anaesthetized pigs were subjected to 90 min controlled left anterior descending coronary artery hypoperfusion and 120 min reperfusion. Regional blood flow was measured with microspheres, regional function with sonomicrometry, and infarct size with triphenyl tetrazolium chloride staining. Pigs received placebo or ivabradine (0.6 mg/kg i.v.) before or during ischaemia or before reperfusion, respectively. Pre-treatment with ivabradine reduced infarct size from 35 +/- 4 (SEM) to 19 +/- 4% of area at risk (AAR). Ivabradine 15-20 min after the onset of ischaemia increased regional myocardial blood flow from 2.12 +/- 0.31 to 3.55 +/- 0.56 microL/beat/g and systolic wall thickening from 6.7 +/- 1.0 to 16.3 +/- 3.0%; infarct size was reduced from 12 +/- 4 to 2 +/- 1% of AAR. Ivabradine 5 min before reperfusion still reduced infarct size from 36 +/- 4 to 21 +/- 5% of AAR. The benefit of ivabradine on flow and function was eliminated by atrial pacing, but part of the reduction of infarct size by ivabradine was not. Ivabradine's protection goes beyond heart rate reduction.

  19. Effect of pregnancy on regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Ikeda, Tomoaki; Mori, Norimasa [Miyazaki Medical Coll., Kiyotake (Japan)

    1993-12-01

    Regional cerebral blood flow (r-CBF) of 10 pregnant women were quantified by {sup 133}Xe SPECT study with inhalation method before and after artificial abortion. During pregnancy, value of r-CBF in each region except occipital lobe was significantly higher than that of the post abortion. Arterial blood gas was analyzed after SPECT procedure. P{sub co2} concentration increased significantly after artificial abortion. Although its mechanism is unknown, our preliminary work demonstrates that r-CBF increased by pregnancy. (author).

  20. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R

    1993-01-01

    This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized on electroencepha......This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized...... electroencephalography-verified generalized seizures....

  1. Patterns of regional cerebral blood flow in acute stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Skriver, E B

    1981-01-01

    In a consecutive group of 56 stroke patients the regional cerebral blood flow was measured within 84 hours after stroke. A 254 multidetector scintillation camera and the intracarotid Xenon-133 injection method was used to study rCBF. Typical rCBF-patterns are described and compared to the findings...

  2. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R

    1993-01-01

    This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized on electroencepha...

  3. Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Salih A Bin Salih

    2011-01-01

    Full Text Available Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF in a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Results: Documented acute and chronic AF was present in 157 (21.8% and 563 (78.1% patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems (chest infection, bronchial asthma, and pulmonary embolism were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus (DM in 68.8%, hypertension (HTN in 59.3%, chronic lung diseases (bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease (IHD in 23.1%. In 9 (1.3% patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF (P<0.01. Conclusions : Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

  4. Regional neurohypophysial and hypothalamic blood flow in rats during hypercapnia

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, R.M. Jr.; Myers, C.L.; Page, R.B.

    1988-08-01

    Regional cerebral blood flow (rCBF) was measured in the neurohypophysis and hypothalamus in normocapnic and hypercapnic rats using (/sup 14/C)isopropyliodoamphetamine. Rats were surgically prepared using nitrous oxide and halothane and placed in plaster restraining casts. Hypercapnia was produced by increasing the fractional concentration of inspired CO/sub 2/ (FICO/sub 2/). rCBF in normocapnic rats was higher in the paraventricular nucleus, supraoptic nucleus, median eminence, and neural lobe than rates previously measured by use of diffusible tracers. During hypercapnia blood flow increased linearly with arterial PCO/sub 2/ (PACO/sub 2/) in all regions except the median eminence and neural lobe, which were not affected by hypercapnia. When rats were pretreated with phentolamine (1 mg/kg) to block the alpha-adrenergic receptors, blood flow in the median eminence and neural lobe increased significantly during hypercapnia. We conclude that blood flow in the cell bodies of the paraventricular nucleus and supraoptic nucleus is regulated differently during hypercapnia than blood flow in the nerve terminals in the median eminence and neural lobe. Furthermore, vasodilation produced by increased CO/sub 2/ is offset by alpha-receptor stimulation in the median eminence and neural lobe.

  5. Regional cerebral blood flow in focal cortical epilepsy

    DEFF Research Database (Denmark)

    Hougaard, Kristina Dupont; Oikawa, T; Sveinsdottir, E

    1976-01-01

    Regional cerebral blood flow (rCBF) was studied in ten patients with focal cortical epilepsy. The blood flow was measured by the intra-arterial injection of xenon 133 (133Xe), and the isotope clearance was recorded by a multidetector scintillation camera with 254 detectors. Three patients were....... This finding accords with earlier studies. All nine patients studied in the interictal phase showed, either spontaneously or during activation by intermittent light, focal flow increases in areas presumed to comprise the epileptic focus. These interictal hyperemic foci probably reflect subictal neuronal...

  6. Regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE).

    Science.gov (United States)

    Gückel, Friedemann J; Brix, Gunnar; Hennerici, Michael; Lucht, Robert; Ueltzhöffer, Christine; Neff, Wolfgang

    2007-10-01

    The aim of the present study was a detailed analysis of the regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE) by means of functional magnetic resonance imaging (MRI). A group of 26 patients with SAE and a group of 16 age-matched healthy volunteers were examined. Using a well-established dynamic susceptibility contrast-enhanced MRI method, the regional cerebral blood flow (rCBF) and blood volume (rCBV) were quantified for each subject in 12 different regions in the brain parenchyma. As compared to healthy volunteers, patients with SAE showed significantly reduced rCBF and rCBV values in white matter regions and in the occipital cortex. Regions containing predominantly grey matter show almost normal rCBF and rCBV values. In conclusion, quantitative analysis of rCBF and rCBV values demonstrates clearly that SAE is a disease that is associated with a reduced microcirculation predominantly in white matter.

  7. Narcolepsy: regional cerebral blood flow during sleep and wakefulness

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, F.; Meyer, J.S.; Karacan, I.; Yamaguchi, F.; Yamamoto, M.

    1979-01-01

    Serial measurements of regional cerebral blood flow were made by the 135Xe inhalation method during the early stages of sleep and wakefulness in eight normal volunteers and 12 patients with narcolepsy. Electroencephalogram, electro-oculogram, and submental electromyogram were recorded simultaneously. In normals, mean hemispheric gray matter blood flow (Fg) during stages I and II sleep was significantly less than waking values. Maximum regional blood flow decreases during sleep occurred in the brainstem-cerebellar, right inferior temporal, and bilateral frontal regions. In patients with narcolepsy, mean hemispheric Fg while awake was 80.5 +- 13 ml per 100 gm brain per minute. During REM sleep, mean hemispheric Fg increased concurrently with large increases in brainstem-cerebellar region flow. During stages I and II sleep without REM, there were significant increases in mean hemispheric Fg and brainstem-cerebellar Fg, just the opposite of changes in normals. In narcolepsy, there appears to be a reversal of normal cerebral deactivation patterns, particularly involving the brainstem, during stages I and II sleep.

  8. Analysis of inventory strategies for blood components in a regional blood center using process simulation.

    Science.gov (United States)

    Baesler, Felipe; Nemeth, Matías; Martínez, Cristina; Bastías, Alfonso

    2014-02-01

    The storage of blood components is an important concern in the blood supply chain. Because these are perishable products, the definition of good inventory policies is crucial to reduce shortages and spills. To analyze and propose inventory policies in a regional blood center, a discrete event simulation model was created using simulation software (Arena 12.0, Rockwell Software). The model replicates the activities that are performed along the supply chain including donation arrivals, testing, production, inventory management, and dispatching. Twelve different scenarios were analyzed, with each one representing different inventory policies composed of a combination of an optimal inventory, a reorder point, and a level of extra donations. The best scenario demonstrates that it is possible to decrease unsatisfied demand and wastage of red blood cell units by 2.5 and 3%, respectively, when compared to current practices. This study shows that simulation is an alternative that can be used to model inventory components in blood centers. A responsible selection of inventory variables can improve the capability of the system to respond to the final patient requirements. © 2013 American Association of Blood Banks.

  9. Atrial fibrillation

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Fauchier, Laurent; Freedman, Saul B;

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, and increases in prevalence with increasing age and the number of cardiovascular comorbidities. AF is characterized by a rapid and irregular heartbeat that can be asymptomatic or lead to symptoms such as palpitations...

  10. Atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Morten S; Nielsen, Morten W; Haunsø, Stig;

    2014-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1-2% of the general population. A number of studies have demonstrated that AF, and in particular lone AF, has a substantial genetic component. Monogenic mutations in lone and familial AF, although rare, have been recognized...

  11. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  12. Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hyoung; Chung, Yong An; Seo, Ye Young; Yoo, Ik Dong; Na, Sae Jung; Jung, Hyun Suk; Kim, Ki Jun [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-04-15

    The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4 weeks (male: 7, female: 5, age range: 19approx52 years, average age: 29.3+-9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19approx53 years, average age: 31.4+-9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated

  13. The association of mid-regional pro-adrenomedullin and mid-regional pro-atrial natriuretic peptide with mortality in an incident dialysis cohort.

    Directory of Open Access Journals (Sweden)

    Ghazaleh Gouya

    Full Text Available High levels of the plasma peptides mid-regional pro-adrenomedullin (MR-proADM and mid-regional pro-atrial natriuretic peptide (MR-proANP are associated with clinical outcomes in the general population. Data in patients with chronic kidney disease are sparse. We therefore investigated the association of MR-proANP and MR-proADM levels with all-cause and cardiovascular (CV mortality, CV events and peripheral arterial disease in 201 incident dialysis patients of the INVOR-Study prospectively followed for a period of up to more than 7 years. The overall mortality rate was 43%, thereof 43% due to CV events. Both baseline MR-proANP and MR-proADM were associated with higher risk of all-cause (HR = 1.44, p = 0.001 and HR = 1.32, p = 0.002, respectively and CV mortality (HR = 1.75, p<0.001 and HR = 1.41, p = 0.007, respectively after adjustment for age, sex, previous CV events, diabetes mellitus and time-dependent type of renal replacement therapy. We then stratified patients in high risk (both peptides in the upper tertile, intermediate risk (only one of the two peptides in the upper tertile and low risk (none in the upper tertile. Although demographic, clinical and laboratory variables were similar among the intermediate and high risk group, to be with both parameters in the upper tertile was associated with a 3-fold higher risk for all-cause (HR = 2.87, p<0.001 and CV mortality (HR = 3.58, p = 0.001. In summary, among incident dialysis patients MR-proANP and MR-proADM were shown to be associated with all-cause and CV mortality, with the highest risk when both parameters were in the upper tertiles.

  14. The association of mid-regional pro-adrenomedullin and mid-regional pro-atrial natriuretic peptide with mortality in an incident dialysis cohort.

    Science.gov (United States)

    Gouya, Ghazaleh; Sturm, Gisela; Lamina, Claudia; Zitt, Emanuel; Freistätter, Otto; Struck, Joachim; Wolzt, Michael; Knoll, Florian; Lins, Friederike; Lhotta, Karl; Neyer, Ulrich; Kronenberg, Florian

    2011-03-07

    High levels of the plasma peptides mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) are associated with clinical outcomes in the general population. Data in patients with chronic kidney disease are sparse. We therefore investigated the association of MR-proANP and MR-proADM levels with all-cause and cardiovascular (CV) mortality, CV events and peripheral arterial disease in 201 incident dialysis patients of the INVOR-Study prospectively followed for a period of up to more than 7 years. The overall mortality rate was 43%, thereof 43% due to CV events. Both baseline MR-proANP and MR-proADM were associated with higher risk of all-cause (HR = 1.44, p = 0.001 and HR = 1.32, p = 0.002, respectively) and CV mortality (HR = 1.75, p<0.001 and HR = 1.41, p = 0.007, respectively) after adjustment for age, sex, previous CV events, diabetes mellitus and time-dependent type of renal replacement therapy. We then stratified patients in high risk (both peptides in the upper tertile), intermediate risk (only one of the two peptides in the upper tertile) and low risk (none in the upper tertile). Although demographic, clinical and laboratory variables were similar among the intermediate and high risk group, to be with both parameters in the upper tertile was associated with a 3-fold higher risk for all-cause (HR = 2.87, p<0.001) and CV mortality (HR = 3.58, p = 0.001). In summary, among incident dialysis patients MR-proANP and MR-proADM were shown to be associated with all-cause and CV mortality, with the highest risk when both parameters were in the upper tertiles.

  15. Blood Clots

    Science.gov (United States)

    ... or prevent blood clots from dissolving properly. Risk factors for excessive blood clotting include Certain genetic disorders Atherosclerosis Diabetes Atrial fibrillation Overweight, obesity, and metabolic syndrome Some medicines Smoking deep vein ...

  16. Gender differences in the phosphorus content of the sino-atrial nodes and other cardiac regions of monkeys.

    Science.gov (United States)

    Tohno, Yoshiyuki; Tohno, Setsuko; Satoh, Hiroyasu; Hayashi, Motoharu; Oishi, Takao; Minami, Takeshi; Mahakkanukrauh, Pasuk

    2011-11-01

    To examine whether there were gender differences in the sino-atrial node (SAN), the authors investigated the gender difference in the SAN using monkey hearts by direct chemical analysis from a viewpoint of element contents. The used rhesus and Japanese monkeys consisted of 30 males (average age=6.5±7.5 years) and 30 females (average age=12.2±10.3 years), ranging in age from newborn to 30 years. The SAN tissues were removed from the anatomical position of monkey hearts and were confirmed by means of histological observation. After ashing with nitric acid and with perchloric acid, element contents of the SANs, such as Ca, P, S, Mg, Zn, Fe, and Na, were determined by inductively coupled plasma-atomic emission spectrometry. In addition, gender differences in the right atrial walls, left ventricular walls, mitral valves, and left coronary arteries of monkeys were also investigated as controls. It was found that the P content was significantly higher in females than in males in the SANs of monkeys, but the other six element contents, Ca, S, Mg, Zn, Fe, and Na, were not significantly different between males and females in the SANs of monkeys. Regarding the P content, a similar finding was also obtained in both the right atrial walls and the left ventricular walls of monkeys, but it was not obtained in the mitral valves and the left coronary arteries of monkeys. The P content of tissue is mostly determined by the nucleic acid (DNA and RNA) content and the phospholipid content of tissue. Nucleic acids in the cell nucleus and the cytosol, and phospholipids in the cell membrane are all indicators of metabolically active cells. It is reasonable to presume that the P content in the SAN indicates the active cell density, namely, the number of active cells per volume. Therefore, there is a possibility that the active cell density of the SAN is significantly higher in females than in males.

  17. Tomographic non-invasive measurements of regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Hedde, J.P.; Reischies, W.; Fiegler, R.; Felix, H.; Helmchen, H.; Kanowski, S.

    1984-02-01

    The measurement of the regional cerebral blood flow by means of the dynamic single-photon-emission-computed tomography is a method of examination which is completely free of risk for the patient, causes no inconvenience and can be repeated whenever it seems necessary. This method gives a quantitative explanation for the distribution of the effective cerebral perfusion and can only be substituted by the very complicated positron-emission-computed tomography. As well as the exact assessment of the hemodynamic relevance of cerebral vascular disease, this method enables us to prove whether or not in various types of psychiatric disorders an interference in the regional perfusion exists. This method can also contribute to the clarification of pathogenic mechanisms, as well as to the nosological classification of specific psychopathological conditions.

  18. Left atrial electrophysiologic feature specific for the genesis of complex fractionated atrial electrogram during atrial fibrillation.

    Science.gov (United States)

    Hoshiyama, Tadashi; Yamabe, Hiroshige; Koyama, Junjiroh; Kanazawa, Hisanori; Ogawa, Hisao

    2016-05-01

    Complex fractionated atrial electrogram (CFAE) has been suggested to contribute to the maintenance of atrial fibrillation (AF). However, electrophysiologic characteristics of the left atrial myocardium responsible for genesis of CFAE have not been clarified. Non-contact mapping of the left atrium was performed at 37 AF onset episodes in 24 AF patients. Electrogram amplitude, width, and conduction velocity were measured during sinus rhythm, premature atrial contraction (PAC) with long- (L-PAC), short- (S-PAC) and very short-coupling intervals (VS-PAC). These parameters were compared between CFAE and non-CFAE regions. Unipolar electrogram amplitude was higher in CFAE than non-CFAE during sinus rhythm, L-, S- and VS-PAC (1.82 ± 0.73 vs. 1.13 ± 0.38, p genesis of CFAE.

  19. Interactive retinal blood flow analysis of the macular region.

    Science.gov (United States)

    Tian, Jing; Somfai, Gábor Márk; Campagnoli, Thalmon R; Smiddy, William E; Debuc, Delia Cabrera

    2016-03-01

    The study of retinal hemodynamics plays an important role to understand the onset and progression of diabetic retinopathy. In this work, we developed an interactive retinal analysis tool to quantitatively measure the blood flow velocity (BFV) and blood flow rate (BFR) in the macular region using the Retinal Function Imager (RFI). By employing a high definition stroboscopic fundus camera, the RFI device is able to assess retinal blood flow characteristics in vivo. However, the measurements of BFV using a user-guided vessel segmentation tool may induce significant inter-observer differences and BFR is not provided in the built-in software. In this work, we have developed an interactive tool to assess the retinal BFV and BFR in the macular region. Optical coherence tomography data was registered with the RFI image to locate the fovea accurately. The boundaries of the vessels were delineated on a motion contrast enhanced image and BFV was computed by maximizing the cross-correlation of pixel intensities in a ratio video. Furthermore, we were able to calculate the BFR in absolute values (μl/s). Experiments were conducted on 122 vessels from 5 healthy and 5 mild non-proliferative diabetic retinopathy (NPDR) subjects. The Pearson's correlation of the vessel diameter measurements between our method and manual labeling on 40 vessels was 0.984. The intraclass correlation (ICC) of BFV between our proposed method and built-in software was 0.924 and 0.830 for vessels from healthy and NPDR subjects, respectively. The coefficient of variation between repeated sessions was reduced significantly from 22.5% to 15.9% in our proposed method (p<0.001). Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Cermik, Tevfik F. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Trakya Universitesi Hastanesi, Nukleer Tip Anabilim Dali, Gullapoglu Yerleskesi, Edirne (Turkey); Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Ugur-Altun, Betuel [Hospital of the University of Trakya, Department of Internal Medicine, Division of Endocrinology, Edirne (Turkey)

    2007-04-15

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 {+-} 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 {+-} 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms. (orig.)

  1. Atrial Fibrillation.

    Science.gov (United States)

    Zimetbaum, Peter

    2017-03-07

    This issue provides a clinical overview of atrial fibrillation, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  2. Subcutaneous blood flow in the temporal region of migraine patients

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, K.

    1987-01-01

    Subcutaneous blood flow in the temporal region (TSBF) was measured by the local 133 Xenon washout technique in 43 migraine patients; 19 were reexamined in the course of spontaneous attacks. During attacks, TSBF was normal compared to headache-free state. In 13 unilateral attacks, the median ipsilateral to contralateral ratio TSBF was 1: 1.276, (NS). During 30 deg C passive head-up tilt, TSBF descreased by a median of 27% during headache-free intervals and by a median, 21% during migraine attacks. The difference between the 2 occasions was not significant. Head-up tilt resulted in a median 4.5% increase in mean arterial blood pressure (MAP) and a median 5.3% increase in heart rate (HR) during headache-free intervals and 3.4% and 3.2% respectively during migraine attacks. These results are evidence against a vasomotor disturbance of the extracranial tissues during attacks of migraine. The cardio-vascular response to the orthostatic stimulus indicates a normal function of this part of the autonomic nervous system during migraine attacks.

  3. Accuracy Evaluation of Non-invasive Blood Pressure Monitor in Blood Pressure Measurement of Patients with Atrial Fibrillation%无创血压监护仪在心房纤颤病人血压测量中的准确性评价

    Institute of Scientific and Technical Information of China (English)

    胡文志; 周海波

    2014-01-01

    目的:探讨无创血压监护仪在心房纤颤病人血压测量中的准确性。方法对60例心房纤颤病人分别采用无创血压监护仪和汞柱台式血压计进行血压监测,对比其测量结果。结果无创血压监护仪和汞柱台式血压计血压测量结果比较,收缩压无显著差异(P>0.05),而舒张压有显著差异(P<0.05)。结论无创血压监护仪在心房纤颤病人血压测量中的准确性较差,值得临床注意。%Objective To investigate the accuracy of non-invasive blood pressure monitor in blood pressure measurement of patients with atrial fibrillation. Methods The blood pressure of 60 patients with atrial fibrillation was measured by using non-invasive blood pressure monitor and mercury sphygmomanometer, respectively. Then the measuring results of blood pressure of non-invasive blood pressure monitor were compared with those of mercury sphygmomanometer. Results There was no signiifcant difference between the measuring results of blood pressure of non-invasive blood pressure and those of mercury sphygmomanometer on systolic pressure (P>0.05) while there were signiifcant differences between the measuring results of blood pressure of non-invasive blood pressure and those of mercury sphygmomanometer on diastolic pressure (P<0.05). Conclusion It is inaccurate to measure the blood pressure of patients with atrial ifbrillation by using non-invasive blood pressure monitor, which should be paid attention to in clinic.

  4. Efficacy and Safety of Vernakalant for Cardioversion of Recent-onset Atrial Fibrillation in the Asia-Pacific Region: A Phase 3 Randomized Controlled Trial.

    Science.gov (United States)

    Beatch, Gregory N; Bhirangi, Kiran; Juul-Moller, Steen; Rustige, Jörg

    2017-02-01

    Atrial fibrillation (AF) is a common clinically significant cardiac arrhythmia. This phase 3 randomized, double-blind, placebo-controlled trial assessed the efficacy and safety of vernakalant hydrochloride for the pharmacological conversion of AF to sinus rhythm in patients with recent-onset (>3 hours to ≤7 days) symptomatic AF from the Asia-Pacific region. Patients received an infusion of vernakalant (3 mg/kg) or placebo for 10 minutes. If AF had not been terminated 15 minutes later, a second infusion of vernakalant (2 mg/kg) or placebo for 15 minutes was administered. The primary efficacy end point was conversion of AF to sinus rhythm for >1 minute within 90 minutes. The study was terminated early for administrative reasons; 123 patients from Korea, Taiwan, and India were randomized to receive vernakalant (n = 55) or placebo (n = 56). A greater proportion of patients who received vernakalant (52.7%) than placebo (12.5%) met the primary end point (P < 0.001), and cardioversion was faster in the vernakalant group than in the placebo group (P < 0.001). Vernakalant was generally well tolerated; the incidence of treatment-emergent adverse events was similar between the groups. We conclude that vernakalant is efficacious in the rapid cardioversion of recent-onset AF in patients from the Asia-Pacific region.

  5. MEASUREMENT OF REGIONAL BONE BLOOD FLOW IN THE CANINE MANDIBULAR RAMUS USING RADIOLABELLED TOAD RED BLOOD CELLS

    Institute of Scientific and Technical Information of China (English)

    毛驰; 王翰章

    1994-01-01

    Toad red blood cells were used to measure regional bone blood flow in the canine mandibular ramus.The blood cells were labelled with sodium pertechnetate and fixed in 10% formalin;they were 22×15 μm in size and had a specific gravity close to that of dog red blood cells.These cells had no discernible effect on systemic hemody-namics after injection,did not agglutinate,were well mixed and evenly distributed throughout the body,and were completely extracted in one circulation through the mandible.The mandibular ramus was divided into six regions,and the blood flow rates in each were found to be similar to those reported in previous studies with radiolabelled carbonized,microspheres.Furthermore,the blood flow distribution pattern of the mandibular ramus determined in this study was identical to that of our previous study using the bone-seeking radionuclide method.We suggest that radiolabelled toad red blood cells are an ideal marker for measuring regional blood flow in the canine mandible.

  6. What is the exact predictive role of preoperative white blood cell count for new-onset atrial fibrillation following open heart surgery?

    Directory of Open Access Journals (Sweden)

    Seyed Jalil Mirhosseini

    2013-01-01

    Full Text Available Background: Atrial fibrillation (AF occurs in 30% patients on the second or third day post operation; therefore, it is the most prevalent and complicated arrhythmia after open heart surgery. White blood cell (WBC count seems to be most significantly associated with cardiovascular disorders. This study was designed to evaluate the exact relationship between preoperative WBC count and post-Coronary artery bypass graft (CABG AF in patients with severe left ventricle (LV dysfunction who underwent elective off-pump coronary artery bypass. Methods: This study was conducted on 104 patients from among 400 patients with severe LV dysfunction undergoing elective off-pump CABG surgery from February 2011 to February 2012, in Afshar Cardiovascular Center, Yazd, Iran. Patients with emergency surgery, unstable angina creatinine higher than 2.0 mg/dL, malignancy, or immunosuppressive disease were excluded. Preoperative serological tests of the participants, such as WBC counts, were saved in their medical dossiers. Of the 400 patients undergoing CABG, AF was found in 54 cases; these 54 male patients formed the experimental group and 60 other patients in the intensive care unit (ICU and hospital stay without postoperative AF were part of the control group. Results: The average age of the patients was 68.5±12.8 years. WBC counts in patients with and without AF three days before surgery were 12,340±155 and 8,950±170, respectively. On surgical day, WBC counts in the patients with and without AF were 13,188±140 and 9,145±255, respectively (P value three days before surgery: 0.04; P value on surgical day: 0.01. Of the 54 male patients with postoperative AF (POAF, duration of AF was more in cases with elevated WBC count (12,000-14,000 than in those with lower elevated WBC count (10,000-12,000 ( P=0.025, but there was no relationship between frequency of recurrence of AF and grading of elevation of WBC count ( P=0.81. Conclusion: These findings show that three days

  7. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion

    Directory of Open Access Journals (Sweden)

    Asa'ah Nkohkwo

    2016-02-01

    Full Text Available Background: Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region.Objective: This review paper ascertains the role of pathogen reduction technology (PRT in improving blood safety and supply adequacy in the region.Method: The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization’s Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region.Results: Existing literature suggests that combining PRT with current blood safety measures (such as serology would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings.Conclusion: Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa.

  8. The effects of hypoxemia on myocardial blood flow during exercise.

    Science.gov (United States)

    Paridon, S M; Bricker, J T; Dreyer, W J; Reardon, M; Smith, E O; Porter, C B; Michael, L; Fisher, D J

    1989-03-01

    We evaluated the adequacy of regional and transmural blood flow during exercise and rapid pacing after 1 wk of hypoxemia. Seven mature mongrel dogs were made hypoxemic (mean O2 saturation = 72.4%) by anastomosis of left pulmonary artery to left atrial appendage. Catheters were placed in the left atrium, right atrium, pulmonary artery, and aorta. Atrial and ventricular pacing wires were placed. An aortic flow probe was placed to measure cardiac output. Ten nonshunted dogs, similarly instrumented, served as controls. Recovery time was approximately 1 wk. Cardiac output, mean aortic pressure, and oxygen saturation were measured at rest, with ventricular pacing, atrial pacing, and with treadmill exercise. Ventricular and atrial pace and exercise were at a heart rate of 200. Right ventricular free wall, left ventricular free wall, and septal blood flow were measured with radionuclide-labeled microspheres. Cardiac output, left atrial blood pressure, and aortic blood pressure were similar between the two groups of dogs in all testing states. Myocardial blood flow was significantly higher in the right and left ventricular free wall in the hypoxemic animals during resting and exercise testing states. Myocardial oxygen delivery was similar between the two groups of animals. Pacing resulted in an increase in myocardial blood flow in the control animals but not the hypoxemic animals.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Atrial Fibrillation

    Science.gov (United States)

    ... ventricles time to finish filling with blood. The electrical signal then leaves the AV node and travels to the ventricles. It causes the ventricles to contract and pump blood to the lungs and the rest of the body. The ventricles then relax, and the heartbeat process ...

  10. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L;

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  11. Blood flow and epithelial thickness in different regions of feline oral mucosa and skin.

    Science.gov (United States)

    Johnson, G K; Squier, C A; Johnson, W T; Todd, G L

    1987-07-01

    The relationship between epithelial thickness and blood flow was examined in 6 mucosal and 3 skin regions of the cat. Blood flow to these tissues was determined using the radiolabelled microsphere method. From histologic sections the proportion of the tissue biopsy occupied by epithelium and the average epithelial thickness were calculated. The oral tissues had a significantly higher blood flow than the skin regions (p less than 0.05). In terms of epithelial thickness, the tissues could be divided into 4 groups (p less than 0.05). These were: a) palate; b) gingival regions and dorsum of the tongue; c) lip and buccal mucosa; d) all skin regions. When epithelial thickness was related to blood flow there was a significant positive correlation (p less than 0.005) indicating that a thicker epithelium is associated with a higher blood flow. This finding may reflect the greater metabolic demands of the thicker epithelia.

  12. Atrial fibrillation.

    Science.gov (United States)

    Bang, Casper N

    2013-10-01

    Atrial fibrillation (AF) is a common complication after myocardial infarction (MI) and new-onset AF has been demonstrated to be associated with adverse outcome and a large excess risk of death in both MI and aortic stenosis (AS) patients. Prevention of new-onset AF is therefore a potential therapeutic target in AS and MI patients. Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent AF. Accordingly, statins are recommended as a class IIa recommendation for prevention of new-onset AF after coronary artery bypass grafting (CABG). However, this preventive effect has not been investigated on new-onset AF in asymptomatic patients with AS or a large scale first-time MI patient sample and data in patients not undergoing invasive cardiac interventions are limited. This PhD thesis was conducted at the Heart Centre, Rigshospitalet, Denmark, with the aim to investigate the three aforementioned questions and to add to the existing evidence of AF prevention with statins. This was done using three different settings: 1) a randomized patients sample of 1,873 from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, 2) a register patient sample of 97,499 with first-time MI, and 3) all published studies until beginning of June 2011 examining statin treatment on new-onset and recurrent AF in patients not undergoing cardiac surgery. This thesis revealed that statins did not lower the incidence or the time to new-onset AF in patients with asymptomatic AS. However, statin treatment showed an independently preventive effect on new-onset AF, including type-dependent effect and a trend to dosage-dependent effect. In addition, this thesis showed that good compliance to statin treatment was important to prevent new-onset AF. Finally, the meta-analysis in this PhD thesis showed a preventive effect in the observational studies although this effect was absent in the randomized controlled trials. Based on this PhD thesis

  13. Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal

    Directory of Open Access Journals (Sweden)

    Tiwari B

    2010-01-01

    Full Text Available Background and Objective : Hepatitis B and hepatitis C are significant health problems that might involve the late sequel of liver cirrhosis and hepatocellular carcinoma. A high prevalence of hepatitis B virus (HBV and hepatitis C virus (HCV in blood donors poses an increased risk of window period transmission through blood transfusion. The present study aimed to know the seroprevalence of hepatitis B virus (HBV and hepatitis C virus (HCV among blood donors in regional blood transfusion services of Nepal. Materials and Methods: This was a retrospective study conducted among blood donors in Banke (5,211, Morang (5,351, and Kaski (5,995 blood transfusion services. Serum samples were tested for hepatitis B surface antigen (HBsAg and anti-HCV antibodies using rapid enzyme immunoassays. The donors information was collected via the donor record register through their respective blood transfusion services. The software "Winpepi ver 3.8" was used for statistical analysis. Results: The seroprevalence rate of HBV was highest in the Banke (1.2% followed by Biratnagar (0.87% and Kaski (0.35% (P < 0.0001. The seroprevalence of HCV was highest in the Morang (0.26% followed by Kaski (0.16% and Banke (0.11% (P > 0.05. The seroprevalence of HBV was significantly higher than HCV in all three blood transfusion services. The burden of HBV as well as HCV seems to be higher in male donors (P > 0.05. Conclusion: The study revealed that the seroprevalence of HBV was alarmingly higher in two of the three blood transfusion services. Implementation of community-based preventive measures and improved strategies for safe blood supply might prove useful to decrease the seroprevalence.

  14. Involvement of calcitonin gene-related peptide in migraine: regional cerebral blood flow and blood flow velocity in migraine patients

    DEFF Research Database (Denmark)

    Lassen, L.H.; Jacobsen, V.B.; Haderslev, P.A.

    2008-01-01

    g/min) or placebo for 20 min was studied in 12 patients with migraine without aura outside attacks. Xenon-133 inhalation SPECT-determined regional cerebral blood flow (rCBF) and transcranial Doppler (TCD)-determined blood velocity (V-mean) in the middle cerebral artery (MCA), as well as the heart......Calcitonin gene-related peptide (CGRP)-containing nerves are closely associated with cranial blood vessels. CGRP is the most potent vasodilator known in isolated cerebral blood vessels. CGRP can induce migraine attacks, and two selective CGRP receptor antagonists are effective in the treatment...... of migraine attacks. It is therefore important to investigate its mechanism of action in patients with migraine. We here investigate the effects of intravenous human alpha-CGRP (h alpha CGRP) on intracranial hemodynamics. In a double-blind, cross-over study, the effect of intravenous infusion of haCGRP (2 mu...

  15. Prevalence of RhD variants among blood donors at Gulu Regional Blood Bank, Gulu, Northern Uganda

    Directory of Open Access Journals (Sweden)

    Ojok P

    2017-09-01

    Full Text Available Polycarp Ojok,1,2 Caesar Oyet,1 Fred Webbo,1,3 Bashir Mwambi,1 Ivan M Taremwa1 1Institute of Allied Health Sciences, International Health Sciences University, Kampala, 2Gulu Regional Blood Bank, Gulu, 3Lancet Laboratories, Kampala, Uganda Aim/objective: The aim of this study was to determine the prevalence of RhD variant ­phenotypes among voluntary non-remunerated blood donors (VNRBDs at Gulu Regional Blood Bank (GRBB, Northern Uganda. Materials and methods: We conducted a cross-sectional study, in which the first 4.0 mL of ethylenediaminetetraacetic acid (EDTA blood samples were collected from VNRBDs and typed for their ABO and RhD blood group status using IgM and IgG monoclonal typing antisera, respectively. Blood samples that tested as RhD negative were further investigated for RhD variant phenotypes using indirect antihuman globulin hemagglutination technique. Results: We assayed 138 RhD-negative blood samples obtained from VNRBDs. Of these, 66.7% (n=92 were males. Their median age was 24.4 years (range, 14–33 years. Majority of the participants were of ABO blood group O (62.8%, n=86, followed by A (19.7%, n=27, then B (13.9%, n=19 and least AB (3.6%, n=6. The prevalence of RhD variant phenotypes was 0.7% (n=1; 95% confidence interval, 0.5–0.9. There was no statistical association of RhD variant phenotypes with donor gender, tribe and their ABO blood groups. Conclusion: This study has revealed a high prevalence of RhD variant among blood donors at GRBB in Northern Uganda. It further highlights a potential risk of alloimmunization, as the present blood typing practices do not identify RhD variant phenotypes. Keywords: Rh blood group, D variants, D antigen, weak D, partial D, Uganda 

  16. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events in ...

  17. Scintigraphic control of blood vessels in regional perfusion with cytostatics

    Energy Technology Data Exchange (ETDEWEB)

    Blazek, J.; Broz, J. (Krajska Nemocnice s Poliklinikou, Ceske Budejovice (Czechoslovakia))

    1982-12-01

    After administration of sup(99m)Tc-MAA or sup(113m)In-MAA into the perfusion system during regional perfusion therapy with cytostatics of malignomas in the maxillo-facial area it is possible to obtain by subsequent scintigraphic visualization of the distribution of radioactivity an accurate topographic picture of the perfusion in the appropriate area. The method is free from complications and there are no contraindications. The paper is supplemented by scintigrams.

  18. Road blocks in achieving a 100% voluntary blood donation rate in the South Asian region

    Directory of Open Access Journals (Sweden)

    Woodfield Graeme

    2007-01-01

    Full Text Available Voluntary blood donation rates are not high in the South Asian region, except in a few countries. The reasons for this are outlined and the roadblocks for improvement of the situation noted. The need for increased planning, both regionally and nationally, is emphasized and some factors that inhibit voluntary blood donation are mentioned. There is a real need to move from a system of reliance on ′replacement′ donors to a fully nonremunerated voluntary blood donation system, and the examples and lessons from successful countries should be carefully studied.

  19. Genetic Peculiarities of Blood Group Distribution in Infants Born to Mothers With 0(I Rh(+ Blood Group in Bukovyna Region

    Directory of Open Access Journals (Sweden)

    Оksana G. Cherniukh

    2015-06-01

    Full Text Available The article presents the analysis of distribution of the group (according to AB0 system and rhesus characteristics (according to anti-D system in infants born to mothers with 0(I Rh(+ blood group in Chernivtsi region (Ukraine during the period of 2013-2014. The relationship of the umbilical bilirubin level and hemolytic disease of the newborn (HDN (erythroblastosis fetalis, the necessity of its careful monitoring during the first day of life of a newborn, especially in case a baby belongs to a certain risk group, has been analyzed. The issue concerning probable HDN occurrence from mothers with А(II Rh(+ blood group which is dominant in this region has been touched upon. The tasks for further work in this direction of ecopathophysiology in the areas of gene penetration have been assigned.

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

    Directory of Open Access Journals (Sweden)

    João Jackson Duarte

    2010-06-01

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

  1. Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women

    NARCIS (Netherlands)

    Georgiadis, Janniko R.; Kortekaas, Rudie; Kuipers, Rutger; Nieuwenburg, Arie; Pruim, Jan; Reinders, A. A. T. Simone; Holstege, Gert

    2006-01-01

    There is a severe lack of knowledge regarding the brain regions involved in human sexual performance in general, and female orgasm in particular. We used [(15)O]-H(2)O positron emission tomography to measure regional cerebral blood flow (rCBF) in 12 healthy women during a nonsexual resting state, cl

  2. A pilot study of regional cerebral blood flow in children with school phobia

    Institute of Scientific and Technical Information of China (English)

    钱昀

    2006-01-01

    Objective To explore the characteristics of the regional cerebral blood flow (rCBF) in children with school phobia. Methods The single - photon emission commputed tomography were performed in 17 children with school phobia and 11 normal controls. The rCBF distribution in regions of interest (ROIs) was compared

  3. Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women

    NARCIS (Netherlands)

    Georgiadis, Janniko R.; Kortekaas, Rudie; Kuipers, Rutger; Nieuwenburg, Arie; Pruim, Jan; Reinders, A. A. T. Simone; Holstege, Gert

    2006-01-01

    There is a severe lack of knowledge regarding the brain regions involved in human sexual performance in general, and female orgasm in particular. We used [(15)O]-H(2)O positron emission tomography to measure regional cerebral blood flow (rCBF) in 12 healthy women during a nonsexual resting state,

  4. Left-right cortical asymmetries of regional cerebral blood flow during listening to words

    DEFF Research Database (Denmark)

    Nishizawa, Y; Olsen, T S; Larsen, B

    1982-01-01

    1. Regional cerebral blood flow (rCBF) was measured during rest and during listening to simple words. The xenon-133 intracarotid technique was used and results were obtained from 254 regions of seven right hemispheres and seven left hemispheres. The measurements were performed just after carotid ...

  5. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik;

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  6. Regulation of regional cerebral blood flow during and between migraine attacks

    DEFF Research Database (Denmark)

    Lauritzen, M; Olsen, T S; Lassen, N A

    1983-01-01

    in 254 areas of one hemisphere. The partly hypoperfused hemisphere allowed for comparison of adjacent hypoperfused and normally perfused brain areas. During attacks the carbon dioxide reactivity was decreased to 2.8 +/- 0.8% per mm Hg in the oligemic regions compared with 5.8 +/- 0.8% per mm Hg...... in the normally perfused brain. Blood pressure autoregulation was normal in all brain regions. Regional blood flow increase in response to physiological activation was severely impaired in the hypoperfused brain areas, whereas neighboring normally perfused regions reacted normally. Confinement of the regulation...... abnormalities to the area of the oligemia supports our suggestion that the blood flow changes are caused by a change in local metabolism. Between attacks of migraine, the patients had normal regulation of brain circulation....

  7. Possible role for cryoballoon ablation of right atrial appendage tachycardia when conventional ablation fails.

    Science.gov (United States)

    Amasyali, Basri; Kilic, Ayhan

    2015-06-01

    Focal atrial tachycardia arising from the right atrial appendage usually responds well to radiofrequency ablation; however, successful ablation in this anatomic region can be challenging. Surgical excision of the right atrial appendage has sometimes been necessary to eliminate the tachycardia and prevent or reverse the resultant cardiomyopathy. We report the case of a 48-year-old man who had right atrial appendage tachycardia resistant to multiple attempts at ablation with use of conventional radiofrequency energy guided by means of a 3-dimensional mapping system. The condition led to cardiomyopathy in 3 months. The arrhythmia was successfully ablated with use of a 28-mm cryoballoon catheter that had originally been developed for catheter ablation of paroxysmal atrial fibrillation. To our knowledge, this is the first report of cryoballoon ablation without isolation of the right atrial appendage. It might also be an alternative to epicardial ablation or surgery when refractory atrial tachycardia originates from the right atrial appendage.

  8. Effects of beta-blockade on atrial and atrioventricular nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation in pigs

    NARCIS (Netherlands)

    van den Berg, MP; van de Ven, LLM; Witting, W; Crijns, JGM; Haaksma, J; Bel, KJ; de Langen, CDJ; Lie, KI

    1997-01-01

    Despite their widespread use in atrial fibrillation, the effects of beta-adrenoceptor blockers on atrial and atrioventricular (AV) nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation have been incompletely characterised. In particular, it is unknown whether additional sodiu

  9. Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers.

    Science.gov (United States)

    Lorenz, I H; Kolbitsch, C; Hörmann, C; Schocke, M; Felber, S; Zschiegner, F; Hinteregger, M; Kremser, C; Pfeiffer, K P; Benzer, A

    2001-10-01

    Both sevoflurane and isoflurane are used in moderate concentrations in neuroanesthesia practice. The limiting factors for using higher concentrations of inhalational anesthetics in patients undergoing neurosurgery are the agents' effects on cerebral blood flow (CBF) and cerebral blood volume (CBV). In particular, an increase in CBV, which is a key determinant of intracranial pressure, may add to the neurosurgical patient's perioperative risk. To compare the effects of a subanesthetic concentration (0.4 minimum alveolar concentration) of sevoflurane or isoflurane on regional CBF (rCBF), regional CBV (rCBV) and regional mean transit time (rMTT), contrast-enhanced magnetic resonance imaging perfusion measurements were made in spontaneously breathing human volunteers. Absolute changes in rCBF, regional CBV, and rMTT during administration of either drug in regions of interest outlined bilaterally in white and grey matter were nonparametrically (Mann-Whitney test) analyzed. Sevoflurane increased rCBF in practically all regions (absolute change, 4.44 +/- 2.87 to 61.54 +/- 2.39 mL/100g per minute) more than isoflurane did (absolute change, 12.91 +/- 2.52 to 52.67 +/- 3.32 mL/100g per minute), which decreased frontal, parietal, and white matter rCBF (absolute change, -1.12 +/- 0.59 to -14.69 +/- 3.03 mL/100g per minute). Regional CBV was higher in most regions during isoflurane administration (absolute change, 0.75 +/- 0.03 to 4.92 +/- 0.16 mL/100g) than during sevoflurane administration (absolute change, 0.05 +/- 0.14 to 3.57 +/- 0.14 mL/100g). Regional mean transit time was decreased by sevoflurane (absolute change, -0.18 +/- 0.05 to -0.60 +/- 0.04 s) but increased by isoflurane (absolute change, 0.19 +/- 0.03 to 0.69 +/- 0.04 s). In summary, regional CBV was significantly lower during sevoflurane than during isoflurane administration, although sevoflurane increased rCBF more than isoflurane, which even decreased rCBF in some regions. For sevoflurane and, even more

  10. Surgery for atrial fibrillation.

    Science.gov (United States)

    Lawrance, Christopher P; Henn, Matthew C; Damiano, Ralph J

    2014-11-01

    Atrial fibrillation is the most common cardiac arrhythmia, and its treatment options include drug therapy or catheter-based or surgical interventions. The surgical treatment of atrial fibrillation has undergone multiple evolutions over the last several decades. The Cox-Maze procedure went on to become the gold standard for the surgical treatment of atrial fibrillation and is currently in its fourth iteration (Cox-Maze IV). This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure. This article also reviews the literature describing the surgical results for both approaches including comparisons of the Cox-Maze IV to the previous cut-and-sew method.

  11. [The practice of neonatal umbilical blood gas analysis in the "Alsace" regional French perinatal network].

    Science.gov (United States)

    Kellenberger, F; Akladios, C Y; Sananes, N; Gaudineau, A; Langer, B

    2016-10-01

    The assessment of neonatal well-being is paramount in delivery rooms. For that purpose, it is recommended in France to carry out a systematic neonatal umbilical cord blood gas analysis. The aim of this study is to evaluate how umbilical cord blood gas sampling is realised, analysed and interpreted by midwives in a French regional perinatal network. We conducted a survey focused on randomly selected midwives partitioning in different maternities that constitute the "Alsace" regional perinatal network. A questionnaire concerning the modalities of umbilical cord blood sampling, its analysis and the interpretation of results was used during interviews with included midwives. Fifty-one midwives were included in the study (15.8% of whom were working in delivery rooms). Only 13% of maternities constituting the perinatal network did not realise systematic neonatal umbilical cord blood analysis. Among interviewed midwives, 78.4% reported umbilical cord clamping after the first breath of the child. Among the midwives included, 86.3% of them realise sampling from the umbilical artery and 29.4% from both umbilical artery and vein. For 86.3% of interviewed midwives, the leitmotif of realising umbilical blood sampling was medico-legal. More than two third of included midwives interpret blood gas taking into account two parameters (either pH and base excess, or lactate). They settled at 7.0-7.2, the limit below which a newborn might present sequelae. This study shows that the neonatal umbilical cord blood gas analysis at birth is almost systematic in this regional French perinatal network. It is realised primarily for medico-legal purpose. However, there are significant variations in sampling procedures and interpretation. This should lead to the establishment within each maternity of a neonatal umbilical cord blood gas sampling protocol along with a midwifery training program. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Effect of axillary blockade on regional cerebral blood flow during static handgrip

    DEFF Research Database (Denmark)

    Friedman, D B; Friberg, L; Mitchell, J H

    1991-01-01

    Regional cerebral blood flow (rCBF) was determined at rest and during static handgrip before and after regional blockade with lidocaine. A fast rotating single photon emission computer tomograph system with 133Xe inhalation was used at orbitomeatal plane (OM) +2.5 and +6.5 cm in eight subjects.......min-1 (P less than 0.05) to both the ipsilateral and contralateral sides during handgrip before, but not after, axillary blockade. There was no change in rCBF to other regions of the brain. Regional anesthesia with lidocaine did not alter resting rCBF. However, despite a greater sense of effort during...

  13. Left Atrial Ablation for Atrial Fibrillation

    Science.gov (United States)

    Sternik, Leonid; Schaff, Hartzel V.; Luria, David; Glikson, Michael; Kogan, Alexander; Malachy, Ateret; First, Maya; Raanani, Ehud

    2011-01-01

    The maze procedure is the gold standard for the ablation of atrial fibrillation, and the “box lesion” around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins). From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients. Of this number, 205 underwent operation by a hybrid maze technique and the remaining 35 (our study cohort) underwent the creation of a box lesion around the pulmonary veins by means of a bipolar radiofrequency device. Ablation lines were created by connecting the left atriotomy to the amputated left atrial appendage, with 2 ablation lines made with a bipolar radiofrequency device above and below the pulmonary veins. Lesions were made along the transverse and oblique sinuses by epicardial and endocardial application of a bipolar device. The left atrial isthmus was ablated by bipolar radiofrequency and cryoprobe. No complications were associated with the box lesion: 90% and 89% of patients were in sinus rhythm at 3 and 6 months of follow-up, respectively. By creating a box lesion around the pulmonary veins, we expect to improve transmurality by means of epicardial and endocardial ablation of 1 rather than 2 layers of atrial wall, as in epicardial pulmonary vein isolation. Isolation of the entire posterior wall of the left atrium is better electrophysiologically and renders dissection around the pulmonary veins unnecessary. PMID:21494518

  14. Regional cerebral blood flow during hypoxia-ischemia in immature rats

    Energy Technology Data Exchange (ETDEWEB)

    Vannucci, R.C.; Lyons, D.T.; Vasta, F.

    1988-02-01

    Immature rats subjected to a combination of unilateral common carotid artery ligation and hypoxia sustain brain damage confined largely to the ipsilateral cerebral hemisphere. To ascertain the extent and distribution of ischemic alterations in the brains of these small animals, we modified the Sakurada technique to measure regional cerebral blood flow using carbon-14 autoradiography. Seven-day-old rats underwent right common carotid artery ligation following which they were rendered hypoxic with 8% O2 at 37 degrees C. Before and during hypoxia, the rat pups received an injection of iodo(/sup 14/C)antipyrine for determination of regional cerebral blood flow. Blood flows to individual structures of the ipsilateral cerebral hemisphere were not influenced by arterial occlusion alone; flows to the contralateral hemisphere and to the brainstem and cerebellum actually increased by 25-50%. Hypoxia-ischemia was associated with decreases in regional cerebral blood flow of the ipsilateral hemisphere such that by 2 hours, flows to subcortical white matter, neocortex, striatum, and thalamus were 15, 17, 34, and 41% of control, respectively. The hierarchy of the blood flow reductions correlated closely with the distribution and extent of ischemic neuronal necrosis. However, unlike the pathologic pattern of this model, the degree of ischemia appeared homogeneous within each brain region. Blood flows to contralateral cerebral hemispheric structures were relatively unchanged from prehypoxic values, whereas flows to the brainstem and cerebellum nearly doubled and tripled, respectively. Thus, ischemia is the predominant factor that determines the topography of tissue injury to major regions of immature rat brain, whereas metabolic factors may influence the heterogeneous pattern of damage seen within individual structures.

  15. Prevalence of Chagas disease in blood donors at the Uberaba Regional Blood Center, Brazil, from 1995 to 2009

    Directory of Open Access Journals (Sweden)

    Laryssa Manso de Lima

    2012-12-01

    Full Text Available INTRODUCTION: A retrospective study was conducted to assess the occurrence of blood donations that were ineligible due to Chagas disease infection from 1995 to 2009 at the Uberaba Regional Blood Center (HRU, Brazil, verify the tendency of this ineligibility, and describe the epidemiologic profile of the donors. METHODS: Retrospective studies of serological ineligibility due to Chagas disease, statistical analysis by means of the chi-square test and odds ratio, study of the tendencies using a dispersion graph and the linear correlation coefficient (r were performed. RESULTS: In the period under study, a 0.2% serum prevalence of ineligibility due to Chagas disease was found, with a significant drop in ineligible donations from 2001 to 2009. Among the serum positive-donors, there was a significant predominance among those aged 30 years or above and non-single individuals. CONCLUSIONS: The results show a rate of occurrence that is lower than that described in literature, as well as a progressive drop during the 15 years under assessment. Such results are a consequence of systematic combat of the vector since the 70s and the progressive and consistent increase of returning donors, resulting in a drop of the contamination risk factor by means of blood transfusion and in the improvement of the quality of hemotherapy practices in the HRU.

  16. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  17. What Is Atrial Fibrillation?

    Science.gov (United States)

    ... regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump ... read your ECG to find out if the electric signals are normal. In atrial fibrillation (AFib), the heart’s ...

  18. [Role of quality control for improvement of blood components in the Regional Blood Centre of Ouagadougou in Burkina Faso, 2014].

    Science.gov (United States)

    Nebie, K; Sawadogo, S; Kafando, E; Bationo, E M; Dahourou, H; Ouattara, S; Kienou, K; Nana, S; Kaba, L; Fretz, C; Murphy, E L

    2017-06-02

    In Burkina Faso, blood components must comply with national standards. Then, all Transfusion services must implement a quality control process to ensure compliance. Our study aims to establish the main characteristics of blood components of the regional transfusion center of Ouagadougou, and evaluate the capability of this center to improve its manufacturing process. We conducted from marsh to December 2014 a pre-post study, assessing blood components' characteristics before and after the implementation of a six months' improvement plan. The assessed parameters were: volume, hematocrit (Ht) and hemoglobin (Hb) levels in RBCs; volume and the number of platelets in PPCs; and volume and concentration of clotting factor VIII in fresh frozen plasma (FFP), respectively. Three hundred and twelve RBCs and 280 PCs were randomly selected for the first series of controls, and 215 RBCs, 54 PCs and 60 FFP were selected for the second series of controls. We compared the mean values of the components parameters and the overall non-compliance rates for each series. The average Hb level of RBCs was respectively 47.8±8.9g and 54.7±7.2g in the first and second series compare to a standard of≥40g. Non-compliance rates of Hb level decreased significantly from 17.6% to 1.4%. For PCs units, the mean number of platelets was 0.14±0.10×10(11) and 0.30±0.15×10(11) in the first and second period compare to a standard of 0.5×10(11). Non-compliance rates for platelets number were high 97.1% and 72.2%. The study demonstrates that only RBCs complied with national standards. The study also demonstrates the capability of CRTSO to improve blood components' processing even if for PCs and FFP, NC rates remain high. QC must be maintained and expanded to the others regional blood centers of the country. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Computational models of atrial cellular electrophysiology and calcium handling, and their role in atrial fibrillation.

    Science.gov (United States)

    Heijman, Jordi; Erfanian Abdoust, Pegah; Voigt, Niels; Nattel, Stanley; Dobrev, Dobromir

    2016-02-01

    The complexity of the heart makes an intuitive understanding of the relative contribution of ion channels, transporters and signalling pathways to cardiac electrophysiology challenging. Computational modelling of cardiac cellular electrophysiology has proven useful to integrate experimental findings, extrapolate results obtained in expression systems or animal models to other systems, test quantitatively ideas based on experimental data and provide novel hypotheses that are experimentally testable. While the bulk of computational modelling has traditionally been directed towards ventricular bioelectricity, increasing recognition of the clinical importance of atrial arrhythmias, particularly atrial fibrillation, has led to widespread efforts to apply computational approaches to understanding atrial electrical function. The increasing availability of detailed, atrial-specific experimental data has stimulated the development of novel computational models of atrial-cellular electrophysiology and Ca(2+) handling. To date, more than 300 studies have employed mathematical simulations to enhance our understanding of atrial electrophysiology, arrhythmogenesis and therapeutic responses. Future modelling studies are likely to move beyond current whole-cell models by incorporating new data on subcellular architecture, macromolecular protein complexes, and localized ion-channel regulation by signalling pathways. At the same time, more integrative multicellular models that take into account regional electrophysiological and Ca(2+) handling properties, mechano-electrical feedback and/or autonomic regulation will be needed to investigate the mechanisms governing atrial arrhythmias. A combined experimental and computational approach is expected to provide the more comprehensive understanding of atrial arrhythmogenesis that is required to develop improved diagnostic and therapeutic options. Here, we review this rapidly expanding area, with a particular focus on Ca(2+) handling, and

  20. Disodium cromoglycate, a mast-cell stabilizer, alters postradiation regional cerebral blood flow in primates

    Energy Technology Data Exchange (ETDEWEB)

    Cockerham, L.G.; Doyle, T.F.; Pautler, E.L.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure, and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with systemic hypotension and a dramatic release of mast-cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomena and the postradiation decrease in cerebral blood flow, primates were given the mast-cell stabilizers disodium cromoglycate (DSCG) or BRL 22321 before exposure to 100 Gy whole-body gamma radiation. Hypothalamic and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. The data indicated that DSCG was successful in diminishing postradiation decrease in cerebral blood flow. Irradiated animals pretreated with DSCG, showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated, irradiated animals showed a 57% decrease. The cortical blood flow of DSCG treated, irradiated animals showed a triphasic response, with a decrease of 38% at 10 min postradiation, then a rise to 1% below baseline at 20 min, followed by a fall to 42% below baseline by 50 min postradiation. In contrast, the untreated, irradiated animals showed a steady decrease in cortical blood flow to 79% below baseline by 50 min postradiation. There was no significant difference in blood-pressure response between the treated and untreated, irradiated animals. Systemic blood pressure showed a 60% decrease at 10 min postradiation, falling to a 71% decrease by 60 min.

  1. Regional Myocardial Blood Volume and Flow: First-Pass MR Imaging with Polylysine-Gd-DTPA

    Science.gov (United States)

    Wilke, Norbert; Kroll, Keith; Merkle, Hellmut; Wang, Ying; Ishibashi, Yukata; Xu, Ya; Zhang, Jiani; Jerosch-Herold, Michael; Mühler, Andreas; Stillman, Arthur E.; Bassingthwaighte, James B.; Bache, Robert; Ugurbil, Kamil

    2010-01-01

    The authors investigated the utility of an intravascular magnetic resonance (MR) contrast agent, poly-L-lysine-gadolinium diethylenetriaminepentaacetic acid (DTPA), for differentiating acutely ischemic from normally perfused myocardium with first-pass MR imaging. Hypoperfused regions, identified with microspheres, on the first-pass images displayed significantly decreased signal intensities compared with normally perfused myocardium (P < .0007). Estimates of regional myocardial blood content, obtained by measuring the ratio of areas under the signal intensity-versus-time curves in tissue regions and the left ventricular chamber, averaged 0.12 mL/g ± 0.04 (n = 35), compared with a value of 0.11 mL/g ± 0.05 measured with radiolabeled albumin in the same tissue regions. To obtain MR estimates of regional myocardial blood flow, in situ calibration curves were used to transform first-pass intensity-time curves into content-time curves for analysis with a multiple-pathway, axially distributed model. Flow estimates, obtained by automated parameter optimization, averaged 1.2 mL/min/g ± 0.5 [n = 29), compared with 1.3 mL/min/g ± 0.3 obtained with tracer microspheres in the same tissue specimens at the same time. The results represent a combination of T1-weighted first-pass imaging, intravascular relaxation agents, and a spatially distributed perfusion model to obtain absolute regional myocardial blood flow and volume. PMID:7766986

  2. Regional blood flow during exercise in humans measured by near-infrared spectroscopy and indocyanine green

    DEFF Research Database (Denmark)

    Boushel, R; Langberg, Henning; Olesen, J

    2000-01-01

    Using near-infrared spectroscopy (NIRS) and the tracer indocyanine green (ICG), we quantified blood flow in calf muscle and around the Achilles tendon during plantar flexion (1-9 W). For comparison, blood flow in calf muscle was determined by dye dilution in combination with magnetic resonance...... imaging measures of muscle volume, and, for the peritendon region, blood flow was measured by (133)Xe washout. From rest to a peak load of 9 W, NIRS-ICG blood flow in calf muscle increased from 2.4+/-0.2 to 74+/-5 ml x 100 ml tissue(-1) x min(-1), similar to that measured by reverse dye (77+/-6 ml x 100...

  3. Regional cerebral blood flow during mechanical hyperventilation in patients with fulminant hepatic failure

    DEFF Research Database (Denmark)

    Strauss, Gitte Irene; Høgh, Peter; Møller, Kirsten;

    1999-01-01

    Hyperventilation is frequently used to prevent or postpone the development of cerebral edema and intracranial hypertension in patients with fulminant hepatic failure (FHF). The influence of such therapy on regional cerebral blood flow (rCBF) remains, however, unknown. In this study the CBF...

  4. Two methods for calculating regional cerebral blood flow from emission computed tomography of inert gas concentrations

    DEFF Research Database (Denmark)

    Kanno, I; Lassen, N A

    1979-01-01

    Two methods are described for calculation of regional cerebral blood flow from completed tomographic data of radioactive inert gas distribution in a slice of brain tissue. It is assumed that the tomographic picture gives the average inert gas concentration in each pixel over data collection periods...

  5. Regional cerebral blood flow distribution in newly diagnosed schizophrenia and schizophreniform disorder

    DEFF Research Database (Denmark)

    Rubin, P; Holm, S; Madsen, P L

    1994-01-01

    Regional cerebral blood flow distribution (rCBF) in 24 first admissions with schizophrenia or schizophreniform disorder and in 17 healthy volunteers was examined. Single photon emission computed tomography with a brain-retained tracer, technetium-99m-d,l-hexamethyl-propylene amine oxime, was used...

  6. Cognitive profiles and regional cerebral blood flow patterns in dementia of the Alzheimer type

    DEFF Research Database (Denmark)

    Waldemar, G; Bruhn, P; Schmidt, E

    1994-01-01

    Individual cognitive profiles and correlations between cognitive functions and regional cerebral blood flow (rCBF) were analyzed in 20 consecutive patients with a clinical diagnosis of probable Alzheimer's disease (AD). CBF was measured with high resolution single photon emission computed...

  7. Regional cerebral blood flow during mechanical hyperventilation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Høgh, Peter; Larsen, Fin Stolze

    2000-01-01

    in the frontal and parietal cortex as well as in the basal ganglia. Focal perfusion abnormalities were present in 10 of 12 patients. Regional cerebral blood flow abnormalities are frequent in patients with acute bacterial meningitis. Short-term hyperventilation does not enhance these abnormalities....

  8. The effect of the benzodiazepine antagonist flumazenil on regional cerebral blood flow in human volunteers

    DEFF Research Database (Denmark)

    Wolf, J; Friberg, L; Jensen, J

    1990-01-01

    The influence of the benzodiazepine antagonist flumazenil on regional cerebral blood flow (rCBF) was investigated in ten healthy, alert volunteers. The design was a randomized, placebo-controlled, double-blind, cross-over study. rCBF was measured by 133-Xe inhalation and single photon emission...

  9. Fibroblast growth factor-21 is positively associated with atrial fibrosis in atrial fibrillation patients with rheumatic heart disease.

    Science.gov (United States)

    Wang, Rui; Yi, Xin; Li, Xiaoyan; Jiang, Xuejun

    2015-01-01

    Fibroblast growth factor-21 (FGF-21) has been discovered as a strong hormone, plays an important role in lipid metabolism, glucose metabolism, associated with several diseases such as obesity, metabolic syndrome, diabetes mellitus, and cardiovascular events; however, no evidence is available concerning the relationship of FGF-21 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD). Twenty-four rheumatic heart disease patients were divided into two groups, 12 cases with AF and 12 cases with sinus rhythm (SR). Clinical characteristics and blood samples were collected before surgery; right atrial appendage samples were taken in the surgery of valve replacement. HE staining was performed to determine cross-sectional area of atrial myocytes; Masson stained sections and mRNA levels of cardiac fibrosis biomarkers were used to evaluate the degree of cardiac fibrosis; the level of FGF-21 was evaluated via enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, and real-time polymerase chain reaction (PCR). Compared with SR group, cross-sectional area of atrial myocytes and collagen volume fraction were significantly increased in the atrial tissue of AF group. The distribution of FGF-21 in the AF group was remarkably higher than SR group. In addition, plasma and mRNA levels of FGF-21 in atrial tissue of AF showed the same trend as the result of immunohistochemistry. Using linear correlation analysis, the expression level of FGF-21 was found to be positively related to the degree of atrial fibrosis. FGF-21 might involve in the development and maintenance of atrial fibrosis in atrial fibrillation with rheumatic heart disease, and FGF-21 could be used as a novel biomarker to evaluate myocardial fibrosis in the future.

  10. Patterns of fetal lamb regional cerebral blood flow during and after prolonged hypoxia.

    Science.gov (United States)

    Ashwal, S; Majcher, J S; Vain, N; Longo, L D

    1980-10-01

    In an effort to determine to what extent cerebral blood flow (CBF) varies in different parts of the brain during prolonged fetal hypoxia, we measured flow to 34 regions in 12 chronically catheterized fetal lambs 130 to 140 days gestation. Control values of PO2, PCO2 pH, heart rate, and blood pressure were obtained, and CBF was measured by use of radioactive labeled microspheres during a control period, during (15-, 30-, and 90-min) reduction of maternal inspired O2 concentration (fetal arterial PO2 was maintained at 12 to 15 torr), and 60 min after returning the ewe to room air. control blood flow to cortical, subcortical, and brainstem structures equaled 134, 186, and 254 ml x min-1 x 100 g-1, respectively. During hypoxia, CBF increased 92%, and 60 min after fetal oxygenation was restored, it remained 50% above control values. We noted a similar response in regional CBF to the cortex, subcortex, and brainstem during and after hypoxia. Blood flow to smaller areas within the three major regions were quite homogenous and had a similar pattern of response to hypoxia. We conclude that: (1) significant fetal regional CBF differences occurred in utero with brainstem and subcortical flows being substantially greater than flows to other regions of the brain; (2) during prolonged intrauterine hypoxia, total regional CBF increased 92%; (3) 1 hr after fetal oxygenation was restored, CBF still remained 50% above control values; and finally, (4) there was no significant preferential shunting of regional CBF during prolonged hypoxia in utero.

  11. Atrial Heterogeneity Generates Re-entrant Substrate during Atrial Fibrillation and Anti-arrhythmic Drug Action: Mechanistic Insights from Canine Atrial Models.

    Science.gov (United States)

    Varela, Marta; Colman, Michael A; Hancox, Jules C; Aslanidi, Oleg V

    2016-12-01

    Anti-arrhythmic drug therapy is a frontline treatment for atrial fibrillation (AF), but its success rates are highly variable. This is due to incomplete understanding of the mechanisms of action of specific drugs on the atrial substrate at different stages of AF progression. We aimed to elucidate the role of cellular, tissue and organ level atrial heterogeneities in the generation of a re-entrant substrate during AF progression, and their modulation by the acute action of selected anti-arrhythmic drugs. To explore the complex cell-to-organ mechanisms, a detailed biophysical models of the entire 3D canine atria was developed. The model incorporated atrial geometry and fibre orientation from high-resolution micro-computed tomography, region-specific atrial cell electrophysiology and the effects of progressive AF-induced remodelling. The actions of multi-channel class III anti-arrhythmic agents vernakalant and amiodarone were introduced in the model by inhibiting appropriate ionic channel currents according to experimentally reported concentration-response relationships. AF was initiated by applied ectopic pacing in the pulmonary veins, which led to the generation of localized sustained re-entrant waves (rotors), followed by progressive wave breakdown and rotor multiplication in both atria. The simulated AF scenarios were in agreement with observations in canine models and patients. The 3D atrial simulations revealed that a re-entrant substrate was typically provided by tissue regions of high heterogeneity of action potential duration (APD). Amiodarone increased atrial APD and reduced APD heterogeneity and was more effective in terminating AF than vernakalant, which increased both APD and APD dispersion. In summary, the initiation and sustenance of rotors in AF is linked to atrial APD heterogeneity and APD reduction due to progressive remodelling. Our results suggest that anti-arrhythmic strategies that increase atrial APD without increasing its dispersion are

  12. Regional cerebral blood flow change in a case of Alzheimer's disease with musical hallucinations.

    Science.gov (United States)

    Mori, Takaaki; Ikeda, Manabu; Fukuhara, Ryuji; Sugawara, Yoshifumi; Nakata, Shigeru; Matsumoto, Naomi; Nestor, Peter J; Tanabe, Hirotaka

    2006-06-01

    We examined alteration of regional cerebral blood flow (rCBF) in a case of Alzheimer's disease (AD) patient with musical hallucination. To detect regions related to musical hallucination, single-photon emission computed tomography (SPECT) imaging of the patient and nine sex, age, and cognitive function-matched AD patients without delusions and hallucinations were compared using statistical parametric mapping 99 (SPM99). In comparison with controls, the patient had increased rCBF in left temporal regions and left angular gyrus. This profile could be relevant to the neuroanatomical basis of musical hallucinations.

  13. Evaluation of regional cerebral blood flow in a patient with musical hallucinations.

    Science.gov (United States)

    Shoyama, Masaru; Ukai, Satoshi; Kitabata, Yuji; Yamamoto, Masahiro; Okumura, Masatoshi; Kose, Asami; Tsuji, Tomikimi; Shinosaki, Kazuhiro

    2010-02-01

    A 52-year-old woman with musical hallucinations was examined using brain single photon emission computed tomography (SPECT) with 99mTc-ECD. Changes in regional cerebral blood flow (rCBF) after carbamazepine treatment were assessed using a three-dimensional stereotaxic ROI template. Following treatment, rCBF was decreased in the subcortical structures and increased in the global cortical regions. From our findings, we propose that rCBF values in subcortical structures represent abnormalities similar to those reported in previous reports or other psychiatric disorders, while those in cortical regions suggest background brain dysfunctions that result in generation of musical hallucinations.

  14. Regional cerebral blood flow alterations remote from the site of intracranial tumors

    DEFF Research Database (Denmark)

    Endo, H; Larsen, B; Lassen, N A

    1977-01-01

    Regional cerebral blood flow (rCBF) was investigated in 12 patients with brain tumors, using a 254-channel dynamic gamma camera. In nine of the 12 cases, hyperemic regions with loss of autoregulation were seen in sites remote from the tumor (the area around the tumor was in most cases also...... hyperemic). These remote rCBF abnormalities were found in the lower posterior part of the hemisphere in six cases, and in the frontal region in three. The location of the remote rCBF abnormality seemed to depend on the site of the tumor: cases with frontal and posterior fossa mass lesions had hyperemia...

  15. Left atrium segmentation for atrial fibrillation ablation

    Science.gov (United States)

    Karim, R.; Mohiaddin, R.; Rueckert, D.

    2008-03-01

    Segmentation of the left atrium is vital for pre-operative assessment of its anatomy in radio-frequency catheter ablation (RFCA) surgery. RFCA is commonly used for treating atrial fibrillation. In this paper we present an semi-automatic approach for segmenting the left atrium and the pulmonary veins from MR angiography (MRA) data sets. We also present an automatic approach for further subdividing the segmented atrium into the atrium body and the pulmonary veins. The segmentation algorithm is based on the notion that in MRA the atrium becomes connected to surrounding structures via partial volume affected voxels and narrow vessels, the atrium can be separated if these regions are characterized and identified. The blood pool, obtained by subtracting the pre- and post-contrast scans, is first segmented using a region-growing approach. The segmented blood pool is then subdivided into disjoint subdivisions based on its Euclidean distance transform. These subdivisions are then merged automatically starting from a seed point and stopping at points where the atrium leaks into a neighbouring structure. The resulting merged subdivisions produce the segmented atrium. Measuring the size of the pulmonary vein ostium is vital for selecting the optimal Lasso catheter diameter. We present a second technique for automatically identifying the atrium body from segmented left atrium images. The separating surface between the atrium body and the pulmonary veins gives the ostia locations and can play an important role in measuring their diameters. The technique relies on evolving interfaces modelled using level sets. Results have been presented on 20 patient MRA datasets.

  16. Early development of arterial spin labeling to measure regional brain blood flow by MRI.

    Science.gov (United States)

    Koretsky, Alan P

    2012-08-15

    Two major avenues of work converged in the late 1980's and early 1990's to give rise to brain perfusion MRI. The development of anatomical brain MRI quickly had as a major goal the generation of angiograms using tricks to label flowing blood in macroscopic vessels. These ideas were aimed at getting information about microcirculatory flow as well. Over the same time course the development of in vivo magnetic resonance spectroscopy had as its primary goal the assessment of tissue function and in particular, tissue energetics. For this the measurement of the delivery of water to tissue was critical for assessing tissue oxygenation and viability. The measurement of the washin/washout of "freely" diffusible tracers by spectroscopic based techniques pointed the way for quantitative approaches to measure regional blood flow by MRI. These two avenues came together in the development of arterial spin labeling (ASL) MRI techniques to measure regional cerebral blood flow. The early use of ASL to measure brain activation to help verify BOLD fMRI led to a rapid development of ASL based perfusion MRI. Today development and applications of regional brain blood flow measurements with ASL continues to be a major area of activity.

  17. The Connexin40A96S mutation from a patient with atrial fibrillation causes decreased atrial conduction velocities and sustained episodes of induced atrial fibrillation in mice.

    Science.gov (United States)

    Lübkemeier, Indra; Andrié, René; Lickfett, Lars; Bosen, Felicitas; Stöckigt, Florian; Dobrowolski, Radoslaw; Draffehn, Astrid M; Fregeac, Julien; Schultze, Joachim L; Bukauskas, Feliksas F; Schrickel, Jan Wilko; Willecke, Klaus

    2013-12-01

    Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major cause of stroke. In the mammalian heart the gap junction proteins connexin40 (Cx40) and connexin43 (Cx43) are strongly expressed in the atrial myocardium mediating effective propagation of electrical impulses. Different heterozygous mutations in the coding region for Cx40 were identified in patients with AF. We have generated transgenic Cx40A96S mice harboring one of these mutations, the loss-of-function Cx40A96S mutation, as a model for atrial fibrillation. Cx40A96S mice were characterized by immunochemical and electrophysiological analyses. Significantly reduced atrial conduction velocities and strongly prolonged episodes of atrial fibrillation were found after induction in Cx40A96S mice. Analyses of the gating properties of Cx40A96S channels in cultured HeLa cells also revealed significantly lower junctional conductance and enhanced sensitivity voltage gating of Cx40A96S in comparison to Cx40 wild-type gap junctions. This is caused by reduced open probabilities of Cx40A96S gap junction channels, while single channel conductance remained the same. Similar to the corresponding patient, heterozygous Cx40A96S mice revealed normal expression levels and localization of the Cx40 protein. We conclude that heterozygous Cx40A96S mice exhibit prolonged episodes of induced atrial fibrillation and severely reduced atrial conduction velocities similar to the corresponding human patient.

  18. Structural disproportions in regional medical standards in treatment of blood circulatory disorders

    Directory of Open Access Journals (Sweden)

    Sazanova G.Yu.

    2012-03-01

    Full Text Available The research goal is to consider the opinion of physicians about the financial medical assistance standards to patients with blood circulatory disorders. Materials and methods: 530 doctors of different specialties were interviewed. Some sociological and statistical methods were used in the study. Results: The majority of respondents (83% considered that it was necessary to coordinate financial support of diagnostic and treatment expenditures with the standards of the regional program of rendering free medical aid to patients with blood circulatory disorders. Conclusion: The issue of medical standards fully depends on the staff organization and medicamentous provision

  19. Changes in regional cerebral blood flow during the course of classic migraine attacks

    DEFF Research Database (Denmark)

    Lauritzen, M; Skyhøj Olsen, T; Lassen, N A

    1983-01-01

    and were examined by a series of rCBF studies, spaced by intervals of 5 to 10 minutes. A wave of reduced blood flow originating in the posterior part of the brain and progressing anteriorly was observed in eight of the nine patients. The oligemia advanced at a speed of 2 mm per minute over the hemisphere......Regional cerebral blood flow (rCBF) following carotid arteriography was studied in thirteen patients with classic migraine. Using the 133xenon intraarterial injection method, rCBF was measured in 254 areas in one hemisphere. Nine patients developed a characteristic attack following arteriography...

  20. Assessing regional cerebral blood flow in depression using 320-slice computed tomography.

    Directory of Open Access Journals (Sweden)

    Yiming Wang

    Full Text Available While there is evidence that the development and course of major depressive disorder (MDD symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT, to assess regional cerebral blood flow (rCBF in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24 score > 20, and Self-Rating Depression Scale (SDS score > 53 and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI. 16 subjects (8 =  MDD; 8 =  healthy also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\\middle\\low shear rateand hematocrit (HCT were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

  1. Impact of red blood cell transfusion on global and regional measures of oxygenation.

    Science.gov (United States)

    Roberson, Russell S; Bennett-Guerrero, Elliott

    2012-01-01

    Anemia is common in critically ill patients. Although the goal of transfusion of red blood cells is to increase oxygen-carrying capacity, there are contradictory results about whether red blood cell transfusion to treat moderate anemia (e.g., hemoglobin 7-10 g/dL) improves tissue oxygenation or changes outcomes. Whereas increasing levels of anemia eventually lead to a level of critical oxygen delivery, increased cardiac output and oxygen extraction are homeostatic mechanisms the body uses to prevent a state of dysoxia in the setting of diminished oxygen delivery due to anemia. In order for cardiac output to increase in the face of anemia, normovolemia must be maintained. Transfusion of red blood cells increases blood viscosity, which may actually decrease cardiac output (barring a state of hypovolemia prior to transfusion). Studies have generally shown that transfusion of red blood cells fails to increase oxygen uptake unless oxygen uptake/oxygen delivery dependency exists (e.g., severe anemia or strenuous exercise). Recently, near-infrared spectroscopy, which approximates the hemoglobin saturation of venous blood, has been used to investigate whether transfusion of red blood cells increases tissue oxygenation in regional tissue beds (e.g., brain, peripheral skeletal muscle). These studies have generally shown increases in near-infrared spectroscopy derived measurements of tissue oxygenation following transfusion. Studies evaluating the effect of transfusion on the microcirculation have shown that transfusion increases the functional capillary density. This article will review fundamental aspects of oxygen delivery and extraction, and the effects of red blood cell transfusion on tissue oxygenation as well as the microcirculation.

  2. Quantitative assessment of regional myocardial blood flow with thallium-201 and SPECT.

    Science.gov (United States)

    Iida, H; Eberl, S

    1998-01-01

    Thallium-201 has been used extensively as a myocardial perfusion agent and to assess myocardial viability. Unlike other 99mTc-labeled agents such as 99mTc-sestamibi and 99mTc-tetrofosmine, the regional concentration of 201Tl varies with time, and its kinetics make it a potential candidate for estimating absolute physiologic parameters with kinetic model analysis. This article outlines a strategy for quantitative assessment of regional myocardial blood flow in man using 201Tl and dynamic single photon emission computed tomography (SPECT). Quantitatively accurate SPECT images that are proportional to the true radioactivity distribution are prerequisites for model-based kinetic analysis. Our technique for quantitative SPECT includes ordered-subset maximum likelihood-expectation maximization (ML-EM) reconstruction with transmission data-based attenuation correction and transmission-dependent convolution subtraction scatter correction. A three-compartment model was found to reproduce the observed regional time-activity curves well, and dog experiments demonstrated that influx rate constant (K1) values estimated from the dynamic SPECT data correlated well with absolute myocardial blood flow determined by in vitro microspheres for a physiologically wide range of flows. Several possible strategies for simplifying the study procedures, without compromising accuracy, are also presented, which should make absolute quantitation of regional myocardial blood flow feasible using 201Tl and a conventional SPECT camera in a clinical setting.

  3. RED-BLOOD-CELL TRANSFUSIONS FOR TOTAL HIP-REPLACEMENT IN A REGIONAL-HOSPITAL - A 6-YEAR ANALYSIS

    NARCIS (Netherlands)

    Biesma, Douwe H.; van Iperen, Charlotte E.; Kraaijenhagen, Rob J.; Marx, Joannes J. M.; van de Wiel, Harry B. M.; van De Wiel, Albert

    1994-01-01

    To evaluate changes in the need for homologous blood and to assess the imp act of autologous blood transfusion, red cell transfusions in unilateral total hip replacement surgery, performed electively in the period 1986-1991, were studied in a regional hospital. Transfusion data, perioperative blood

  4. Regional citrate anticoagulation in critically ill patients during continuous blood purification

    Institute of Scientific and Technical Information of China (English)

    龚德华; 季大玺; 徐斌; 谢红浪; 刘云; 黎磊石

    2003-01-01

    Objectives To evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding tendencies. Methods Forty critically ill patients being treated by continuous blood purification (CBP) were involved in this study. Due to their bleeding tendencies, regional citrate anticoagulation treatment was given to all of them. Those with hepatic function impairment (n=10) were classified as Group A, those with hypoxemia were classified as Group B (n=10), and the others as Group C (n=20). Blood samples were collected before treatment, and at 4, 12, 24, 36, and 48 hour intervals during CBP. These samples then were used arterial blood gas analysis, whole blood activated clotting time (WBACT) pre- and post-filter, and serum ionized calcium examination. Results WBACT pre-filter showed little fluctuant through the 48hr period of CBP, and WBACT post-filter showed obvious prolongation than that of the pre-filter (P<0.05) at all time points. Metabolic acidosis was found in Group A patients before CBP, and improved during CBP. Normal acid-base conditions of patients were disturbed and deteriorated in Group B during CBP, but not in Group C. Serum ionized calcium was maintained at a normal range during CBP in Group A and C patients, but declined significantly in Group B patients (vs. pre-treatment, P<0.05). Conclusions Regional citrate anticoagulation can be safely used in conjunction with CBP treatment for patients with hepatic function impairment , but may induce acidosis and a decline in serum ionized calcium when used with hypoxemic patients.

  5. Optical dynamic imaging of the regional blood flow in the rat mesentery under the effect of noradrenalin

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The regional blood flow in the rat mesentery under the effect of noradrenalin is monitored using the laser speckle imaging method. The results show that at the third minute of application of noradrenalin, the blood flow begins to decrease, and the venule blood flow decreases more rapidly than that in the arteriole. Five minutes later blood flow in part of blood vessels begins to resume and the blood flow in the arteriole recovers more quickly than that in the venule. These suggest that laser speckle imaging can obtain the temporal-spatial characteristic of blood flow in mesentery without the need of scanning. It provides a new approach for investigating the change of regional blood flow in the mesentery in microcirculation studies.

  6. Encircling endocardial ventriculotomy for refractory ischemic ventricular tachycardia. II. Effects on regional myocardial blood flow.

    Science.gov (United States)

    Ungerleider, R M; Holman, W L; Stanley, T E; Lofland, G K; Williams, J M; Smith, P K; Quick, G; Cox, J L

    1982-06-01

    Previous experimental studies of the encircling endocardial ventriculotomy (EEV) have shown a significant alteration of normal local electrical activity within the encompassed region. Although this procedure may result in isolation of ventricular arrhythmias, the data are more suggestive of a less specific effect on regional myocardial blood flow. This study examines the effect of EEV on local myocardial blood flow using the radioactive tracer microsphere technique in 10 dogs. Flows were determined before and after an EEV with the animals on cardiopulmonary bypass at controlled perfusion pressures, temperatures, and heart rates. Blood flow was studied at subepicardial and subendocardial levels inside, outside, and bordering the EEV. Prior to performance of the EEV, subepicardial blood flow in the left ventricular myocardium ranged from 0.81 +/- 0.07 to 0.89 +/- 0.08 ml/gm/min. Subendocardial flows ranged from 0.80 +/- 0.07 to 0.91 +/- 0.09 ml/gm/min. There was no significant difference between any of the flows across each respective layer of myocardium. Following the EEV procedure, blood flow to the subendocardium within the EEV fell to 0.33 +/- 0.07 ml/gm/min, while flow to the subendocardium of the normal regions of the same hearts actually increased to 1.21 +/- 0.23 ml/gm/min. Similar changes occurred at subepicardial levels, with flow at the center of the EEV falling to 0.66 +/- 0.10 ml/gm/min despite a tendency for normal subepicardial flow to increase to 1.78 +/- 0.24 ml/gm/min. Superimposed ischemia to the EEV-encompassed myocardium, created by occlusion of the distal left anterior descending coronary artery (LAD), accentuated this abnormality by demonstrating that the region continues to receive some flow from epicardially based coronary vessels. The data from this study show that the EEV decreased regional blood flow to the encompassed myocardium and suggests that myocardial ischemia may be responsible for ablation of the delicate re-entrant mechanisms

  7. Effect of blood donation-mediated volume reduction on regional right ventricular deformation in healthy subjects.

    Science.gov (United States)

    Açar, Göksel; Alizade, Elnur; Avci, Anıl; Cakir, Hakan; Efe, Suleyman Cagan; Kalkan, Mehmet Emin; Tabakci, Mehmet Mustafa; Toprak, Cuneyt; Tanboğa, Ibrahim Halil; Esen, Ali Metin

    2014-03-01

    Strain (S) and strain rate (SR) are known to be altered in diseases associated with right ventricular (RV) pressure/volume overload and RV myocardial dysfunction; however determinants of S/SR are incompletely understood. The aim of this study was to examine the effect of blood donation-mediated volume reduction on regional RV deformation in healthy young adults. Study population was composed of 61 consecutive healthy subjects who were volunteers for blood donation. All underwent standard echocardiography and two-dimensional S and SR imaging by speckle tracking before and after 450 mL blood donation. We found no change in RV lateral wall SR in all three segments. However, the S in the apical and mid segments of the RV lateral wall immediately decreased after blood donation [-26.2 ± 3.3 vs. -23.2 ± 3.3 % (p subjects caused a regional difference in RV longitudinal deformation with the lower mid and apical S that was related to parameters of volume load severity. However, RV systolic SR was found to be resistant to the effects of volume depletion.

  8. Regional myocardial blood flow, metabolism and function assessed noninvasively by positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schelbert, H.R.; Phelps, M.E.; Hoffman, E.; Huang, S.; Kuhl, D.E.

    1979-01-01

    Positron emission computed tomography is a new technique for the noninvasive measure of myocardial blood flow, mechanical function and, in particular, metabolism. The capability of this new study means is due to the technological innovations of the imaging device and the availability of radioactive tracers that are specific for blood flow and metabolism. The device permits recording of cross-sectional images of the left ventricular myocardium that reflect quantitatively regional tracer tissue concentrations. By employing tracer kinetic models this new technique permits the measurement of regional glucose and fatty acid metabolism of the heart. While already an important new tool for investigative studies into cardiac physiology and pathophysiology, the clinical utility of positron emission tomography remains to be defined.

  9. Pre- and postoperative changes of regional cortical cerebral blood flow in patients with cerebral arteriovenous malformation

    Institute of Scientific and Technical Information of China (English)

    石广志; 赵继宗; 王硕; 王永刚; 陆铮

    2003-01-01

    Objective To investigate pre- and postoperative changes of regional cerebral cortical blood flow in patients with cerebral arteriovenous malformation. Method Twenty-two adult patients with arteriovenous malformation(AVM) were recruited into this study at Beijing Tiantan Hospital from September 2001 to May 2002. Eight patients had giant cerebral AVM and the other 14 had a small one. Cortical cerebral blood flow (CBF) was measured by laser Doppler flowmetry (LDF) before and after AVM resections. After surgery, the probe of LDF was implanted adjacent to the area of AVM and monitored for 24 hours.Results CBF increased significantly after the resection in all patients regardless of AVM size. In patients with small AVM, CBF returned to the baseline level within 4 hours, but in patients with giant AVM, CBF remained high even after 24 hours.Conclusions Monitoring CBF is helpful to understand pre- and postoperative changes of regional cortical CBF in patients with cerebral AVM.

  10. Regional cerebral blood flow in stroke by 133Xenon inhalation and emission tomography

    DEFF Research Database (Denmark)

    Lassen, N A; Henriksen, L; Paulson, O

    1981-01-01

    A rapidly rotating single-photon emission tomograph was used to study regional cerebral blood flow by 133Xenon inhalation. Using a rotation speed of 180 degrees/5 sec a tomographic picture of the average Xenon concentration in 3 slices is obtained. By taking a sequence of 4 one-minute tomograms...... normal subjects and 10 unselected patients with stroke. The CBF tomograms localized appropriate ischemic areas in all 10 patients. In one patient the conventional x-ray tomogram was negative, while the flow tomogram clearly showed a decreased flow in consonance with the clinical findings. Regional...... cerebral blood flow measured tomographically by 133Xenon inhalation circumvents the extra-cranial contamination and the superposition of intracranial tissues that hamper 133Xenon inhalation flow studies using stationary detectors....

  11. Regional cerebral blood flow autoregulation in patients with fulminant hepatic failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Strauss, Gitte Irene; Møller, Kirsten;

    2000-01-01

    The absence of cerebral blood flow autoregulation in patients with fulminant hepatic failure (FHF) implies that changes in arterial pressure directly influence cerebral perfusion. It is assumed that dilatation of cerebral arterioles is responsible for the impaired autoregulation. Recently, frontal...... blood flow was reported to be lower compared with other brain regions, indicating greater arteriolar tone and perhaps preserved regional cerebral autoregulation. In patients with severe FHF (6 women, 1 man; median age, 46 years; range, 18 to 55 years), we tested the hypothesis that perfusion...... in the anterior cerebral artery would be less affected by an increase in mean arterial pressure compared with the brain area supplied by the middle cerebral artery. Relative changes in cerebral perfusion were determined by transcranial Doppler-measured mean flow velocity (V(mean)), and resistance was determined...

  12. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  13. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  14. Alteration of peripheral vasodilatory reserve capacity after cardioversion of atrial fibrillation

    NARCIS (Netherlands)

    Gosselink, ATM; Smit, AJ; Crijns, HJGM; Hillege, HH; Lie, KI

    1996-01-01

    In atrial fibrillation, exercise capacity is often reduced. This is usually ascribed to a decreased cardiac output as coin compared with sinus rhythm. Very few studies, however, have focused oil changes in the peripheral blood flow during atrial fibrillation as a potential mechanism for exercise lim

  15. [INFECTION OF BLOOD-SUCKING MOSQUITOES (DIPTERA: CULICIDAE) WITH DIROFILARIAE (SPIRURIDA, ONCHOCERCIDAE) IN THE TULA REGION].

    Science.gov (United States)

    Bogacheva, A S; Ganushkina, L A; Lopatina, Yu V

    2016-01-01

    Blood-sucking mosquitoes (n = 2277) collected in Tula and its Region in 2013-2014 were examined using a PCR assay for dirofilariae. A total of 12 species from 4 genera (Culiseta, Aedes, Ochlerotatus [foreign character] Culex) out of 18 found mosquito species were infected with Dirofilaria immitis and D. repens. The proportion of the infected mosquitoes was 2.5% (D. immitis, 1.5%; D.repens, 1%). According to preliminary data, the most efficient Dirofilaria vectors, in the Tula Region may be Ae. vexans, Ae. geniculatus, Och. cantans, and Cx. pipiens.

  16. Integrin β1 Participates in Atrial Remodeling in Rapid Atrial Pacing Induced Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Zhang wei; Yang guirong; Zheng zhaotong; Wang sujia; Zhang yun

    2004-01-01

    @@ Objective Integrin β1 regulates cell to cell and cell to extracellualr matrix interaction in heart. however, its pathop hysiological role in atrial fibrillation is unclear. The purpose of t his study was to determine whether atrial structural remodeling during atrial fibrillation is associated with altered integrinβ1.

  17. Cerebral Pulsatility Index Is Elevated in Patients with Elevated Right Atrial Pressure.

    Science.gov (United States)

    Lahiri, Shouri; Schlick, Konrad H; Padrick, Matthew M; Rinsky, Brenda; Gonzalez, Nestor; Jones, Heather; Mayer, Stephan A; Lyden, Patrick D

    2017-07-03

    Extracerebral venous congestion can precipitate intracranial hypertension due to obstruction of cerebral blood outflow. Conditions that increase right atrial pressure, such as hypervolemia, are thought to increase resistance to jugular venous outflow and contribute to cerebro-venous congestion. Cerebral pulsatility index (CPI) is considered a surrogate marker of distal cerebrovascular resistance and is elevated with intracranial hypertension. Thus, we sought to test the hypothesis that elevated right atrial pressure is associated with increased CPI compared to normal right atrial pressure. We retrospectively reviewed 61 consecutive patients with subarachnoid hemorrhage. We calculated CPI from transcranial Doppler studies and correlated these with echocardiographic measures of right atrial pressure. CPIs were compared from patients with elevated and normal right atrial pressure. There was a significant difference between CPI obtained from all patients with elevated right atrial pressure compared to those with normal right atrial pressure (P right and left hemispheric CPI from patients with both elevated and normal right atrial pressure. Patients with elevated right atrial pressure had significantly higher CPI compared to patients with normal right atrial pressure. These findings suggest that cerebro-venous congestion due to impaired jugular venous outflow may increase distal cerebrovascular resistance as measured by CPI. Since elevated CPI is associated with poor outcome in numerous neurological conditions, future studies are needed to elucidate the significance of these results in other populations. Copyright © 2017 by the American Society of Neuroimaging.

  18. Intra-atrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog.

    Science.gov (United States)

    Allessie, M A; Lammers, W J; Bonke, I M; Hollen, J

    1984-07-01

    In the isolated blood-perfused canine heart we produced episodes of rapid atrial flutter by continuous infusion of acetylcholine and rapid pacing. The spread of excitation during atrial flutter was mapped with the aid of two endocavitary mapping electrodes containing 960 leads and recording from 192 different sites simultaneously. The flutter maps clearly showed that intra-atrial reentry was the mechanism responsible for the arrhythmia. However, the localization and size of the intra-atrial circuits differed from case to case even in the same heart. The orifices of the venae cavae or the atrioventricular ring did not serve as a central anatomic obstacle for circus movement. We also failed to identify a special role of the internodal pathways in the formation of the loop. Instead, the intra-atrial circuits could be found everywhere, provided sufficient atrial mass was available to accommodate the circuit. The diameter of the circuits varied between 1.5 and 3 cm at a cycle length between 65 and 155 msec. The average conduction velocity of the circulating impulse varied between 60 and 80 cm/sec. Spontaneous termination of atrial flutter frequently occurred and was based on local conduction block in a narrow part of the circuit. Another interesting aspect of these studies is the finding that during continuous circus movement of the impulse, the amount of myocardium that is activated may vary considerably. This marked periodicity in excited tissue mass during atrial flutter could adequately explain the continuously undulating baseline or typical sawtoothlike F waves as seen in the surface electrocardiogram during atrial flutter.

  19. Stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-01-01

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal...... or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K...

  20. Blood

    Science.gov (United States)

    ... Also, blood is either Rh-positive or Rh-negative. So if you have type A blood, it's either A positive or A negative. Which type you are is important if you need a blood transfusion. And your Rh factor could be important ...

  1. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation : Role of duration of at atrial fibrillation

    NARCIS (Netherlands)

    Van Den Berg, MP; Crijns, HJGM; Van Veldhuisen, DJ; Van Gelder, IC; De Kam, PJ; Lie, KI

    1998-01-01

    The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial n

  2. Aneurysm of the Right Atrial Appendage

    Directory of Open Access Journals (Sweden)

    Silvio Henrique Barberato

    2002-02-01

    Full Text Available Atrial aneurysms involving the free wall or atrial appendage are rare entities in cardiology practice and may be associated with atrial arrhythmias or embolic phenomena. We review the literature and report a case of aneurysm of the right atrial appendage in a young adult, whose diagnosis was established with echocardiography after an episode of paroxysmal atrial flutter.

  3. Results of kidney function measurement and blood pressure in population from endemic region of Vitina

    Directory of Open Access Journals (Sweden)

    Stašević Zvonimir

    2008-01-01

    Full Text Available Introduction. The analysis of frequency of kidney diseases, causes of terminal renal failure in patients subjected to repeated dialysis in major dialysis centers in the region of Kosovo and Metohija as well as mortality rate in these patients showed a stable number of patients with kidney diseases, evidencing that the populations of Vitina and Gnjilane were the most commonly affected. These towns are designated as regions with the highest incidence of Balkan endemic nephropathy. The present analysis was aimed at: 1. establishing the incidence rate of hypertension and renal function impairment by using clinical and laboratory analyses in individuals from Vitina and neighboring villages, and 2. investigating the correlation between creatinine clearance, age and arterial blood pressure in the studied group. Material and methods. The analysis included 510 individuals (excluding diabetics over the one-month period during 2004 (201 males with their age ranging from 18 to 90 years. Blood pressure measurements were performed in all the individuals, while renal function was determined by glomerular filtration rate (GFR, as calculated according to Cockcroft-Gault formula. Results. Creatinine clearance was lower than 100 ml/min in 237 (46.5% individuals, out of whom 62 (12% had GFR below 60 ml/min. Among the remaining 273 (53.5% individuals with GFR above 100 ml/min, 68 individuals had GFR above 140 ml/min. The distribution of patients depending on their systolic blood pressure values revealed that systolic blood pressure was lower in 44 subjects and higher in 302 subjects (59%. The correlation test revealed significant association between the studied parameters. The positive correlation between patients' age and kidney function means the higher the age of subjects the lower creatinine clearance value (r=-0.622, p<0.001. The negative correlation of the systolic blood pressure value and kidney function was found, meaning that higher the systolic blood

  4. Modulation of atrial fibrillation

    NARCIS (Netherlands)

    Geuzebroek, G.S.C.

    2013-01-01

    In this thesis we investigate the results of various surgical procedures for atrial fibrillation which have been performed in the last 2 decades in the Sint Antonius Hospital, Nieuwegein, The Netherlands. In the 1990s the classical Maze III procedure was the main surgical technique for drug-refracto

  5. Lesson Five Atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2003-01-01

    @@ Atrial fibrillation(AF) may occur in paroxysmaland persistent forms. It may be seen in normal subjects,particularly during emotional stress or follow-ing surgery,exercise, or acute alcoholic intoxication.It also may occur in patients with heart or lungdisease who develop acute hypoxia, hypercapnia,ormetabolic or hemodynamic derangements.

  6. A new seeded region growing technique for retinal blood vessels extraction.

    Science.gov (United States)

    Sajadi, Atefeh Sadat; Sabzpoushan, Seyed Hojat

    2014-07-01

    Distribution of retinal blood vessels (RBVs) in retinal images has an important role in the prevention, diagnosis, monitoring and treatment of diseases, such as diabetes, high blood pressure, or heart disease. Therefore, detection of the exact location of RBVs is very important for Ophthalmologists. One of the frequently used techniques for extraction of these vessels is region growing-based Segmentation. In this paper, we propose a new region growing (RG) technique for RBVs extraction, called cellular automata-based segmentation. RG techniques often require manually seed point selection, that is, human intervention. However, due to the complex structure of vessels in retinal images, manual tracking of them is very difficult. Therefore, to make our proposed technique full automatic, we use an automatic seed point selection method. The proposed RG technique was tested on Digital Retinal Images for Vessel Extraction database for three different initial seed sets and evaluated against the manual segmentation of retinal images available at this database. Three quantitative criteria including accuracy, true positive rate and false positive rate, were considered to evaluate this method. The visual scrutiny of the segmentation results and the quantitative criteria show that, using cellular automata for extracting the blood vessels is promising. However, the important point at here is that the correct initial seeds have an effective role on the final results of segmentation.

  7. Effect of histamine on regional cerebral blood flow of the parietal lobe in rats.

    Science.gov (United States)

    Yang, Peng-Bo; Chen, Xin-Lin; Zhao, Jian-Jun; Zhang, Jian-Shui; Zhang, Jun-Feng; Tian, Yu-Mei; Liu, Yong

    2010-09-01

    Histamine is a powerful modulator that regulates blood vessels and blood flow. The effect of histamine on the extracortical vessels has been well described, while much less is known about the effect of histamine on intracortical vessels. In this study, we investigated the effect of histamine on regional cerebral blood flow in rat parietal lobe with laser Doppler flowmetry. The pharmacological characteristics of distinct ways (intracerebroventricular injection, intraperitoneal injection, and cranial window infusion) in applying histamine to the brain were also obtained and compared. Histamine applied in three ways all produced a decrease of rCBF in parietal lobe in a concentration-dependent manner. Cranial window infusion was the most effective way and intraperitoneal injection of L-histidine was the most ineffective, although it is a simple and applied way. To determine which type of receptor takes part in the vessel contraction induced by histamine, H1 receptor antagonist, diphenhydramine, and H2 receptor antagonist, cimetidine, were applied, respectively, before histamine administration. When the injection of cimetidine was conducted in advance, histamine still resulted in a decrease of infusion amount; while the injection of diphenhydramine was conducted in advance, the infusion of blood amount wasn't changed. These findings indicated that histamine could result in a reduction of rCBF in the rat parietal lobe and this effect of histamine may attribute partly to its combination with H1 receptor.

  8. Evaluation of blood glucose concentration measurement using photoacoustic spectroscopy in near-infrared region

    Science.gov (United States)

    Namita, Takeshi; Sato, Mitsuki; Kondo, Kengo; Yamakawa, Makoto; Shiina, Tsuyoshi

    2017-03-01

    Diabetes, a typical lifestyle-related disease, is an important disease presenting risks of various complications such as retinopathy, kidney failure, and nervous neuropathy. To treat diabetes, regular and continual self-measurement of blood glucose concentrations is necessary to maintain blood glucose levels and to prevent complications. Usually, daily measurements are taken using invasive methods such as finger-prick blood sampling. Some non-invasive optical techniques have been proposed to reduce pain and infection risk, however, few practical techniques exist today. To realize highly accurate and practical measurement of blood glucose concentrations, the feasibility of a photoacoustic method using near-infrared light was evaluated. A photoacoustic signal from a solution of glucose in water (+0-5 g/dl) or equine blood (+0-400 mg/dl) was measured using a hydrophone (9 mm diameter) at 800-1800 nm wavelengths. We investigated the relation between the glucose solution concentration and the photoacoustic signal intensity or peak position of the received photoacoustic signal (i.e. speed of sound in solutions). Results show that the signal intensity and sound speed of the glucose solution increase with increased glucose concentration for wavelengths at which light absorbance of glucose is high. For quantitative estimation of the glucose solution concentration, the photoacoustic signal intensity ratio between two wavelengths, at which dependence of the signal intensity on glucose concentration is high and low, was calculated. Results confirmed that the signal intensity ratios increase linearly with the glucose concentration. These analyses verified the feasibility of glucose level estimation using photoacoustic measurement in the near-infrared region.

  9. Analysis of immediate transfusion incidents reported in a regional blood bank

    Directory of Open Access Journals (Sweden)

    Adriana Lemos de Sousa Neto

    2011-10-01

    Full Text Available BACKGROUND: Blood transfusion is imperative when treating certain patients; however, it is not risk free. In addition to the possible transmission of contagious infectious diseases, incidents can occur immediately after transfusion and at a later time. AIMS: This study aimed to examine the immediate transfusion incidents reported in a regional blood bank in the state of Minas Gerais between December 2006 and December 2009. A retrospective quantitative epidemiological study was conducted. Data were obtained from 202 transfusion incident reports of 42 health institutions served by the blood bank. Data processing and analysis were carried out using the Statistical Package for the Social Sciences (SPSS software. RESULTS: The rate of immediate transfusion incidents reported in the period was 0.24%; febrile non-hemolytic reactions were the most common type of incident (56.4%. The most frequent clinical manifestations listed in transfusion incident reports were chills (26.9% and fever (21.6%. There was a statistically significant association (p-value < 0.05 between the infusion of platelet concentrates and febrile non-hemolytic reactions and between fresh frozen plasma and febrile non-hemolytic reaction. The majority (73.3% of transfused patients who suffered immediate transfusion incidents had already been transfused and 36.5% of the cases had previous transfusion incident reports. CONCLUSIONS: Data from the present study corroborate the implementation of new professional training programs aimed at blood transfusion surveillance. These measures should emphasize prevention, identification and reporting of immediate transfusion incidents aiming to increase blood transfusion quality and safety.

  10. Regional cerebral blood flow and glucose metabolism following transient forebrain ischemia.

    Science.gov (United States)

    Pulsinelli, W A; Levy, D E; Duffy, T E

    1982-05-01

    Progressive brain damage after transient cerebral ischemia may be related to changes in postischemic cerebral blood flow and metabolism. Regional cerebral blood flow (rCBF) and cerebral glucose utilization (rCGU) were measured in adult rats prior to, during (only rCBF), and serially after transient forebrain ischemia. Animals were subjected to 30 minutes of forebrain ischemia by occluding both common carotid arteries 24 hours after cauterizing the vertebral arteries. Regional CBF was measured by the indicator-fractionation technique using 4-iodo-[14C]-antipyrine. Regional CGU was measured by the 2-[14C]deoxyglucose method. The results were correlated with the distribution and progression of ischemic neuronal damage in animals subjected to an identical ischemic insult. Cerebral blood flow to forebrain after 30 minutes of moderate to severe ischemia (less than 10% control CBF) was characterized by 5 to 15 minutes of hyperemia; rCBF then fell below normal and remained low for as long as 24 hours. Post-ischemic glucose utilization in the forebrain, except in the hippocampus, was depressed below control values at 1 hour and either remained low (neocortex, striatum) or gradually rose to normal (white matter) by 48 hours. In the hippocampus, glucose utilization equaled the control value at 1 hour and fell below control between 24 and 48 hours. The appearance of moderate to severe morphological damage in striatum and hippocampus coincided with a late rise of rCBF above normal and with a fall of rCGU; the late depression of rCGU was usually preceded by a period during which metabolism was increased relative to adjacent tissue. Further refinement of these studies may help identify salvageable brain after ischemia and define ways to manipulate CBF and metabolism in the treatment of stroke.

  11. High blood pressure and obesity in indigenous ashaninkas of Junin region, Peru

    OpenAIRE

    Romero, Candice; Área de Investigación y Desarrollo, A. B. PRISMA, Lima, Perú. Médico cirujano.; Zavaleta, Carol; Unidad Salud Indígena-Fundación Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú.6 Departamento de Geografía, Universidad McGill. Montreal, Canadá. Médico cirujano.; Cabrera, Lilia; Área de Investigación y Desarrollo, A. B. PRISMA, Lima, Perú. enfermera, especialista en Salud Pública.; Gilman, Robert H.; Área de Investigación y Desarrollo, A. B. PRISMA, Lima, Perú. CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia. Lima, Perú. Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, EE. UU. médico, especialista en enfermedades infecciosas.; Miranda, J. Jaime; CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico, magíster y doctor en Epidemiología.

    2014-01-01

    In order to determine the prevalence of high blood pressure and obesity in indigenous Ashaninkas, with limited contact with Western culture, a cross-sectional study was conducted in 2008 in five Ashaninka communities of the Junin region in the jungle of Peru. Individuals aged 35 or older were included. 76 subjects were evaluated (average age 47.4 years old, 52.6 % women) corresponding to 43.2% of the eligible population. The prevalence of hypertension was 14.5% (CI 95%: 6.4-22.6) and the prev...

  12. Differences in regional cerebral blood flow during musical and verbal hallucinations.

    Science.gov (United States)

    Izumi, Yukiyo; Terao, Takeshi; Ishino, Yoichi; Nakamura, Jun

    2002-11-30

    A 51-year-old male patient suffered from both musical and verbal hallucinations with insight. We performed three single photon emission computed tomographic scans with the patient in different conditions: baseline without hallucinations, musical hallucinations, and verbal hallucinations. Clearly, different patterns of regional cerebral blood flow (rCBF) were observed during musical and verbal hallucinations. The findings suggest that musical and verbal hallucinations are associated with different patterns of rCBF, possibly reflecting the different causes of the two types of hallucinations.

  13. Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda.

    Science.gov (United States)

    Uchenna Tweteise, Patience; Natukunda, Bernard; Bazira, Joel

    2016-01-01

    Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2) are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2) antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA). Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2%) males and 139 (37.8%) females), only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out.

  14. Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda

    Directory of Open Access Journals (Sweden)

    Patience Uchenna Tweteise

    2016-01-01

    Full Text Available Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2 are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP; HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2 antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA. Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2% males and 139 (37.8% females, only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out.

  15. Regional cerebral blood flow in normal pressure hydrocephalus: diagnostic and prognostic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Larsson, A. (Dept. of Neurology, Sahlgren Hospital, Goeteborg (Sweden)); Bergh, A.C. (Dept. of Clinical Physiology, Sahlgren Hospital, Goeteborg (Sweden)); Bilting, M. (Dept. of Neurosurgery, Sahlgren Hospital, Goeteborg (Sweden)); Aerlig, AA. (Dept. of Radiation Physics, Sahlgren Hospital, Goeteborg (Sweden)); Jacobsson, L. (Dept. of Radiation Physics, Sahlgren Hospital, Goeteborg (Sweden)); Stephensen, H. (Dept. of Neurosurgery, Sahlgren Hospital, Goeteborg (Sweden)); Wikkelsoe, C. (Dept. of Neurology, Sahlgren Hospital, Goeteborg (Sweden))

    1994-02-01

    Relative regional cerebral blood flow (rrCBF) was measured by SPET using [sup 99m]Tc-HMPAO as flow tracer, in 23 patients with normal pressure hydrocephalus (NPH). 1000 MBq [sup 99m]Tc-HMPAO was given intravenously and the rrCBF calculated as regional/cerebellar count level ratios. The patients were examined before and 3-12 months after ventriculoperitoneal shunt surgery. rrCBF was also determined in ten healthy aged matched volunteers who served as controls. The NPH patients had decreased rrCBF in the hippocampal regions and in the frontal and parietal white matter as compared to the controls. The frontal/parietal rrCBF ratio correlated with both psychiatric disability and the preoperative degree of incontinence. Decreased flow in frontal white matter, frontoparietal and hippocampal grey matter and a low frontalparietal grey matter flow ratio preoperatively correlated with improvement in both Mini Mental State score and psychiatric disability after shunt surgery. After shunt surgery the rrCBF increased in the mesencephalon, frontal grey and white matter, parietal white matter and hippocampus. The flow increase in hippocampal regions and frontal white matter correlated with improvement in psychiatric symptomatology. The results of this study regarding the frontal and hippocampal rrCBF patterns, and the clinical correlation, support the hypothesis that CBF changes in these regions are of patohphysiological and prognostic importance in NPH. (orig./MG)

  16. HYPERTHYROIDISM AND ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    I. M. Marusenko

    2017-01-01

    Full Text Available Review on a problem of the development of atrial fibrillation in patients with thyrotoxicosis is presented. Thyrotoxicosis is one of the most frequent endocrine diseases, conceding only to a diabetes mellitus. The most frequent reasons of hyperthyroidism are Graves’ disease and functional thyroid autonomy. The authors give an analysis of data on the cardiac effects of thyrotoxicosis, features of heart remodeling under the influence of thyroid hyperfunction, prevalence of atrial fibrillation in thyrotoxicosis, depending on age, as well as the possibility of restoring sinus rhythm in the combination of these diseases. Particular attention is paid to the effect on the heart of subclinical thyrotoxicosis, which is defined as a dysfunction of the thyroid gland, characterized by low serum concentration of thyrotropin, normal values of free thyroxine and free triiodothyronine. Subclinical hyperthyroidism is also capable of causing heart remodeling and diastolic dysfunction.Prevalence of thyrotoxicosis in elderly people is higher in areas of iodine deficiency; it is relevant for our country due to the large territory of iodine deficiency. In elderly patients, the cardiac effects of thyrotoxicosis prevail in the clinical picture, that makes it difficult to diagnose endocrine disorders, and correction of thyrotoxicosis is critically important for the successful control of the heart rhythm. The article also discusses the problem of thyrotoxic cardiomyopathy, caused by the toxic effect of excess thyroid hormones: features of this heart disorder, factors affecting its formation, clinical significance and contribution to the development of rhythm disturbances. The greatest significance is the development of atrial fibrillation as a result of thyrotox-icosis in older patients who already have various cardiovascular diseases.Atrial fibrillation is the most frequent heart rhythm disorder in thyrotoxicosis. The main cause of arrhythmia in hyperthyroidism is the

  17. The influence of gravity on regional lung blood flow in humans: SPECT in the upright and head-down posture.

    Science.gov (United States)

    Ax, M; Sanchez-Crespo, A; Lindahl, S G E; Mure, M; Petersson, J

    2017-06-01

    Previous studies in humans have shown that gravity has little influence on the distribution of lung blood flow while changing posture from supine to prone. This study aimed to evaluate the maximal influence of posture by comparison of regional lung blood flow in the upright and head-down posture in 8 healthy volunteers, using a tilt table. Regional lung blood flow was marked by intravenous injection of macroaggregates of human albumin labeled with (99m)Tc or (113m)In, in the upright and head-down posture, respectively, during tidal breathing. Both radiotracers remain fixed in the lung after administration. The distribution of radioactivity was mapped using quantitative single photon emission computed tomography (SPECT) corrected for attenuation and scatter. All images were obtained supine during tidal breathing. A shift from upright to the head-down posture caused a clear redistribution of blood flow from basal to apical regions. We conclude that posture plays a role for the distribution of lung blood flow in upright humans, and that the influence of posture, and thereby gravity, is much greater in the upright and head-down posture than in horizontal postures. However, the results of the study demonstrate that lung structure is the main determinant of regional blood flow and gravity is a secondary contributor to the distribution of lung blood flow in the upright and head-down positions.NEW & NOTEWORTHY Using a dual-isotope quantitative SPECT method, we demonstrated that although a shift in posture redistributes blood flow in the direction of gravity, the results are also consistent with lung structure being a greater determinant of regional blood flow than gravity. To our knowledge, this is the first study to use modern imaging methods to quantify the shift in regional lung blood flow in humans at a change between the upright and head-down postures. Copyright © 2017 the American Physiological Society.

  18. Regional cerebral blood flow in stroke: hemispheric effects of cognitive activity.

    Science.gov (United States)

    Gur, R C; Gur, R E; Silver, F L; Obrist, W D; Skolnick, B E; Kushner, M; Hurtig, H I; Reivich, M

    1987-01-01

    Regional cerebral blood flow (rCBF) was measured with the xenon-133 inhalation technique in 15 patients with unilateral cerebral infarction and 12 matched controls. Measurements were performed during a standard resting baseline condition and during the performance of standardized verbal analogies and spatial line orientation tasks. Resting and activated CBF were lower in patients than in controls, and there were differences in the hemispheric pattern of activated CBF. Control subjects replicated earlier findings of asymmetric increase in CBF for the cognitive tasks, whereas patients showed abnormalities in lateralized CBF changes consistent with side of infarction. These findings underscore the utility of cognitive challenges in the study of rCBF in stroke. This can lead to an experimental paradigm in clinical studies of the relation between behavioral deficits and regional brain dysfunction and may also improve the utility of CBF measurements in clinical settings.

  19. Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery.

    Science.gov (United States)

    Rüffer, André; Tischer, Philip; Münch, Frank; Purbojo, Ariawan; Toka, Okan; Rascher, Wolfgang; Cesnjevar, Robert Anton; Jüngert, Jörg

    2017-01-01

    Cerebral protection during aortic arch repair can be provided by regional cerebral perfusion (RCP) through the innominate artery. This study addresses the question of an adequate bilateral blood flow in both hemispheres during RCP. Fourteen infants (median age 11 days [range, 3 to 108]; median weight, 3.6 kg [range, 2.8 to 6.0 kg]) undergoing RCP (flow rate 54 to 60 mL · kg(-1) · min(-1)) were prospectively included. Using combined transfontanellar/transtemporal two- and three-dimensional power/color Doppler sonography, cerebral blood flow intensity in the main cerebral vessels was displayed. Mean time average velocities were measured with combined pulse-wave Doppler in the basilar artery, and both sides of the internal carotid, anterior, and medial cerebral arteries. In addition, bifrontal regional cerebral oximetry (rSO2) was assessed. Comparing both hemispheres, measurements were performed at target temperature (28°C) during full-flow total body perfusion (TBP) and RCP. A regular circle of Willis with near-symmetric blood flow intensity to both hemispheres was visualized in all infants during both RCP and TBP. In the left internal carotid artery, blood flow direction was mixed (retrograde, n = 5; antegrade, n = 8) during TBP and retrograde during RCP. Comparison between sides showed comparable cerebral time average velocities and rSO2, except for higher time average velocities in the right internal carotid artery (TBP p = 0.019, RCP p = 0.09). Unilateral comparison between perfusion methods revealed significantly higher rSO2 in the right hemisphere during TBP (82% ± 9%) compared with RCP (74% ± 11%, p = 0.036). Bilateral assessment of cerebral rSO2 and time average velocity in the main great cerebral vessels suggests that RCP is associated with near-symmetric blood flow intensity to both hemispheres. Further neurodevelopmental studies are necessary to verify RCP for neuroprotection during aortic arch repair. Copyright © 2017 The Society of Thoracic

  20. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roberto A.Franken; Ronaldo F.Rosa; Silvio CM Santos

    2012-01-01

    This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted.

  1. [Evoked potentials and regional cerebral blood flow changes in conversion disorder: a case report and review].

    Science.gov (United States)

    Gürses, Nadide; Temuçin, Cağri Mesut; Lay Ergün, Eser; Ertuğrul, Aygün; Ozer, Suzan; Demir, Başaran

    2008-01-01

    Conversion disorder is defined as the presence of functional impairment in motor, sensory or neurovegetative systems which cannot be explained by a general medical condition. Although the diagnostic systems emphasize the absence of an organic basis for the dysfunction in conversion disorder, there has been a growing interest in the specific functional brain correlates of conversion symptoms in recent years, particularly by examining neuroimaging and neurophysiological measures. In this case report, regional cerebral blood flow changes and evoked potentials of a patient with conversion symptoms are presented. Somatosensory evoked potentials (SEP) of this patient with conversion disorder who had signs of movement disorder revealed that the latency to N20, P 25 waves were in normal limits while the amplitudes of the P25 and N33 components were extremely high (giant SEP). Regional cerebral blood flow assessment revealed hypoperfusion in the left parietal and temporal lobes of the brain. Three months after the first assessment, the control scans showed that the left parietal hypoperfusion disappeared while the left temporal hypoperfusion was still present. The following SEP evaluations which were repeated twice in three months intervals after the initial recordings, showed the persistence of the abnormalities in somatosensorial measures. The neurophysiological and neuroimaging findings in conversion disorder were reviewed and the results of the evaluations of this case were discussed in this article.

  2. Diurnal variation in baseline human regional cerebral blood flow demonstrated by PET

    Energy Technology Data Exchange (ETDEWEB)

    Diehl, D.J.; Mintun, M.A.; Moore, R.Y. [Univ. of Pittsburgh, PA (United States)] [and others

    1994-05-01

    We have previously described the diurnal variation in regional cerebral blood flow (rCBF) response to bright light in human subjects as demonstrated by the positron emission tomography (PET) activation method. In this abstract, we report the differences in rCBF (an indicator of differences in regional neuronal activity) between the evening and midday dim light baseline scans which served as the control states in the above bright light activation study. Five right-handed, healthy volunteers underwent both an evening (8pm) and a midday (12N) O-15 water PET scanning session. Each scanning session was preceded by one hour of dim light adaptation (50 lux) and consisted of six rCBF scans at three different light intensities in an AABBCC sequence (A=50 lux, B=2500 lux, C=7000lux). Significant differences in rCBF between the evening and midday 50 lux states were identified using the statistical parametric mapping method developed by Friston et al (p<.001). The evening scans demonstrated areas of greater relative blood flow in the pineal gland, the lateral temporal cortex bilaterally, the right lateral prefrontal cortex, the superior aspect of the anterior cingulate, and the left thalamus. The midday scans showed areas of greater relative blood flow in the visual cortex, the left lateral prefrontal cortex. the inferior aspect of the anterior cingulate, the left parietal cortex and the cerebellum. Our results demonstrate an extensive diurnal variation in baseline human rCBF. This indicates that time of day may be an important variable in conducting and interpreting functional brain imaging studies. Furthermore, these results suggest possible neuroanatomical substrates through which the circadian system may regulate the various physiologic and behavioral processes that manifest circadian rhythms.

  3. Risk factors for atrial fibrillation incidence and progression

    NARCIS (Netherlands)

    Vermond, Robert Aldo

    2016-01-01

    During atrial fibrillation (AF) irregular activation of the hearts atria occur, causing an irregular heart rate and altered blood flow. AF is the most common heart rhythm disorder, causing stroke, heart failure, dementia, reduced quality of life and high health care expences. AF is diagnosed increas

  4. New oral anticoagulants for patients with nonvalvular atrial fibrillation.

    Science.gov (United States)

    Holden, Amber; Azimi, Nassir; Forest, Christopher P

    2015-11-01

    Four new oral anticoagulants have been approved for reducing stroke risk in patients with nonvalvular atrial fibrillation. Compared with warfarin, these agents offer a more predictable dose response with fewer food and drug interactions and no regular blood monitoring, although some of the drugs have an increased risk of major gastrointestinal bleeding. This article reviews the new drugs.

  5. Atrial natriuretic peptide induces postprandial lipid oxidation in humans.

    NARCIS (Netherlands)

    Birkenfeld, A.L.; Budziarek, P.; Boschmann, M.; Moro, C.; Adams, F.; Franke, G.; Berlan, M.; Marques, M.A.; Sweep, F.C.; Luft, F.C.; Lafontan, M.; Jordan, J.

    2008-01-01

    OBJECTIVE: Atrial natriuretic peptide (ANP) regulates arterial blood pressure. In addition, ANP has recently been shown to promote human adipose tissue lipolysis through cGMP-mediated hormone-sensitive lipase activation. We hypothesized that ANP increases postprandial free fatty acid (FFA) availabil

  6. The mechanisms of atrial fibrillation in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Bielecka-Dabrowa Agata

    2009-04-01

    Full Text Available Abstract Atrial fibrillation (AF is a complex condition with several possible contributing factors. The rapid and irregular heartbeat produced by AF increases the risk of blood clot formation inside the heart. These clots may eventually become dislodged, causing embolism, stroke and other disorders. AF occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and is more common in men and in patients with triiodothyronine (T3 toxicosis. The incidence of AF increases with advancing age. Also, subclinical hyperthyroidism is a risk factor associated with a 3-fold increase in development of AF. Thyrotoxicosis exerts marked influences on electrical impulse generation (chronotropic effect and conduction (dromotropic effect. Several potential mechanisms could be invoked for the effect of thyroid hormones on AF risk, including elevation of left atrial pressure secondary to increased left ventricular mass and impaired ventricular relaxation, ischemia resulting from increased resting heart rate, and increased atrial eopic activity. Reentry has been postulated as one of the main mechanisms leading to AF. AF is more likely if effective refractory periods are short and conduction is slow. Hyperthyroidism is associated with shortening of action potential duration which may also contribute to AF.

  7. Type of aphasia and regional cerebral blood flow. A study with /sup 133/Xe inhalation method

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru (National Cardiovascular Center, Suita, Osaka (Japan))

    1982-11-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with /sup 133/Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter.

  8. DISTRIBUTION OF ABO AND RH-D BLOOD GROUPS IN THE CACHAR DISTRICT OF BARAK VALLEY OF ASSAM: IMPLICATION FOR REGIONAL BLOOD TRANSFUSION SERVICE

    Directory of Open Access Journals (Sweden)

    Dharmakanta Kumbhakar

    2016-07-01

    Full Text Available BACKGROUND ABO and Rhesus (Rh-D blood group antigens are integrated parts of the red blood cell membranes. They are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly in compatibility test in blood transfusion and organ transplant practices. They show a wide geographical and racial variation. The knowledge of the distribution of ABO and Rh-D blood groups among different population is essential in health care and transfusion practices. AIMS AND OBJECTIVES To study the distribution of ABO and Rh-D blood groups amongst the population of Cachar district of Barak valley of Assam. MATERIALS AND METHODS We did a retrospective analysis of records of 1,60,500 blood samples grouped for ABO and Rh-D typing at Silchar Medical College and Hospital Blood Bank, Silchar, over a period of 10 years from 1st January 1999 to 31st December 2008. RESULTS AND OBSERVATIONS Out of total 1,60,500 blood samples grouped for ABO and Rh-D typing during the period in the centre, the distribution of phenotype A, B, AB and O were 24.80% (39,804, 32.00% (51,360, 5.60% (8,986 and 37.60% (60,350 respectively. The Rh-D positive phenotype was 95.40% (1, 53,117 and remaining 4.60% (7,383 was Rh-D negative. The frequency of Rh-D phenotypes in the various ABO blood groups was as - A Positive 23.70% (38,039, A Negative 1.10% (1,765, B Positive 30.80% (49,433, B Negative 1.20% (1,927, AB Positive 5.40% (8,665, AB Negative 0.20% (321, O Positive 35.50% (56,980 and O Negative 2.10% (3,370 respectively. DISCUSSION Silchar Medical College and Hospital Blood Bank receives blood samples for grouping of almost all population of Cachar district. Hence, the data revealed in the present study fairly reflects the prevalence of ABO and Rh-D groups distribution in the Cachar district in Barak valley of Assam. CONCLUSION The present study provide information on the status of ABO and Rh-D blood groups distribution of the region and

  9. Occlusion of left atrial appendage in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    О. Н. Ганеева

    2015-10-01

    Full Text Available The article reviews a new method of prophylaxis of thromboembolitic complications, specifically occlusion of left atrial appendage, in patients with atrial fibrillation. Indications and contraindications for the procedure, as well as a step-by-step process of the intervention itself are described. Special emphasis is placed on the up-to-date evidence and the review of clinical trials.

  10. Left atrial appendage occlusion for stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer;

    2015-01-01

    Aims: To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). Methods and results: Data from consecutive patients treated in 22 centres were collected...

  11. Abnormal atrial activation in young patients with lone atrial fibrillation

    DEFF Research Database (Denmark)

    Holmqvist, Fredrik; Olesen, Morten S; Tveit, Arnljot

    2011-01-01

    Aims Patients with a history of atrial fibrillation (AF) have previously been shown to have altered atrial conduction, as seen non-invasively using signal-averaged P-wave analysis. However, little is known about the P-wave morphology in patients in the early phases of AF with structurally normal ...

  12. Quantitative evaluation of regional blood flow in pulmonary sarcoidosis with Bull's eye analysis

    Energy Technology Data Exchange (ETDEWEB)

    Akaki, Shiro (Okayama Univ. (Japan). School of Medicine)

    1991-09-01

    Lung perfusion scintigraphy was performed in 23 patients with pulmonary sarcoidosis and in 11 normal volunteers. Bull's eye analysis was used to analyze regional pulmonary blood flow quantitatively. First, whole lung perfusion images were divided into three regions by three concentric circles. Then radial axes were projected from the center to define 36 x 10deg sectors. The counts for each sector were calculated and a Bull's eye image was displayed. The counts were compared with the lower limit of normal (mean -2SD), and as the indices of reduction in perfusion, extent score (ES) and severity score (SS) were calculated. ES and SS showed significant reduction in perfusion 16 patients (70%) with sarcoidosis. In stage II sarcoidosis, both ES and SS were significantly higher than in stage I sarcoidosis (p<0.05). In comparison with the findings of transbronchial lung biopsy, both ES and SS had correlation with the degree of alveolitis and ES had a correlation with the degree of angitis. Both ES and SS have no correlation with {sup 67}Ga scintigraphy findings. In comparison with clinical data, ES had a positive correlation with serum angiotensin-converting enzyme activity (p<0.05), and SS had a significant positive correlation with bronchoalveolar lavage fluid CD{sup +}/CD8{sup +} ratio (p<0.05). The Bull's eye analysis was considered useful for the quantitative evaluation of regional pulmonary blood flow in pulmonary sarcoidosis, and it was suggested that the mechanism of reduction in perfusion might result mainly in its alveolitis and angitis. Ventilation abnormality, which may happen prior to reduction in perfusion, may be an important factor of reduction in perfusion. (author).

  13. Relationship between local production of microRNA-328 and atrial substrate remodeling in atrial fibrillation.

    Science.gov (United States)

    Soeki, Takeshi; Matsuura, Tomomi; Bando, Sachiko; Tobiume, Takeshi; Uematsu, Etsuko; Ise, Takayuki; Kusunose, Kenya; Yamaguchi, Koji; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Wakatsuki, Tetsuzo; Shimabukuro, Michio; Sata, Masataka

    2016-12-01

    The underlying mechanism of atrial substrate remodeling in atrial fibrillation (AF) remains unknown. In this study, we investigated whether local and systemic levels of microRNA (miR) might be associated with the presence of AF and with left atrial (LA) substrate properties. Blood from the periphery, pulmonary vein (PV), and left atrial appendage (LAA) was sampled from 30 patients with AF undergoing PV isolation, and from 10 control subjects with Wolff-Parkinson-White syndrome and without AF. We measured peripheral, PV, and LAA plasma levels of miR-1, -26, -133a, -328, and -590 by reverse transcription-polymerase chain reaction. LA global contact mapping during sinus rhythm was performed before PV isolation. Plasma levels of miR-328 were higher in patients with AF than in control subjects. Plasma miR-328 levels were significantly higher in the LAA than in the periphery and PV in patients with AF, but not in control subjects. Plasma miR-1 levels were also higher in the LAA than in the PV in AF patients. Interestingly, LAA plasma levels of miR-328 showed a positive correlation with the LA voltage zone index (area with voltage <0.5mV divided by total LA surface area) and a weak correlation with LA volume. Local production of miR-328 in the left atrium may be involved in the process of atrial remodeling in patients with AF. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  14. Extra-atrial expression of the gene for atrial natriuretic factor.

    Science.gov (United States)

    Gardner, D G; Deschepper, C F; Ganong, W F; Hane, S; Fiddes, J; Baxter, J D; Lewicki, J

    1986-01-01

    Atrial natriuretic factor (ANF) is a group of peptides, originally isolated from the cardiac atria, that have a number of important effects on blood pressure, renal function, and salt balance. In the current study, expression of the ANF gene in certain extra-atrial tissues of the rat has been examined by radioimmunoassay of extracted ANF protein and by blot-hybridization, nuclease S1 analysis, and primer-extension analysis of the ANF mRNA. ANF peptides and mRNA were detected in cardiac ventricles, lung, and pituitary gland at levels generally less than or equal to 1% those of cardiac atria. The ANF transcripts in extra-atrial tissue appear to be very similar to those synthesized in the atria. They are polyadenylylated, are equivalent in overall length (950-1050 nucleotides), and have identical 5' termini. A secondary transcription start site mapping approximately 80 base pairs upstream from the primary start site is employed in atria and to a lesser extent in other tissues. The ANF transcript is present throughout the cardiac ventricles from apex to base and in the septum as well as the ventricular free walls. The transcript is more prevalent in the left ventricle and interventricular septum than in the right ventricle. Immunocytochemistry using various anti-rat ANF antibodies localized ANF immunoreactivity to the atrial myocytes; the ventricular myocytes, particularly along the endothelial surface of the ventricular chamber; perialveolar cells in the lung; and the gonadotropin-producing cells of the pituitary. The data indicate that the capacity for ANF gene expression extends beyond atrial tissue, albeit at much reduced levels, and may suggest alternative, perhaps paraendocrine, functions for the peptide in these tissues. Images PMID:2428040

  15. Ablation of the atrioventricular node executed after paranodal ablation of the atrioventricular node for the treatment of paroxysmal atrial-ventricular node of reentry tachycardia in conditions of artificial blood circulation

    Directory of Open Access Journals (Sweden)

    Melikulov A.Kh.

    2014-03-01

    Full Text Available In this clinical observation is shown the data of the patient who was previously undergone paranodal ablation of atrial-ventricular junction for the treatment of atrioventricular (AV nodal reentrant tachycardia. Radiofrequency ablation of right lower isthmus for treatment of the paroxysmal form of atrial flutter was made for the patient. Sick sinus node syndrome and paroxysmal form of atrial fibrillation were diagnosed. Then dual-chamber pacemaker was implanted. Antiarrhythmic therapy about the persistent form of atrial fibrillation had no effect. The decision for the implementation of radio frequency modification of atrioventricular connection using right ventriclar access failed because of the lack of verification of the His bundle's spike. Using retrograde access through the aorta we managed to create AV blockade of III degree. Taking into account the fact that in 1990-ies patients with atrioventricular nodal reentrant tachycardia were operated using paranodal ablation of the AV node using extracorporeal circulation, this case has a practical significance when endovascular catheter modification of AV nodal conduction in this category of patients is made.

  16. Evaluation of New Diagnostic Biomarkers in Pediatric Sepsis: Matrix Metalloproteinase-9, Tissue Inhibitor of Metalloproteinase-1, Mid-Regional Pro-Atrial Natriuretic Peptide, and Adipocyte Fatty-Acid Binding Protein.

    Science.gov (United States)

    Alqahtani, Mashael F; Smith, Craig M; Weiss, Scott L; Dawson, Susan; Ralay Ranaivo, Hantamalala; Wainwright, Mark S

    2016-01-01

    Elevated plasma concentrations of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), mid-regional pro-atrial natriuretic peptide (mrProANP), and adipocyte fatty-acid-binding proteins (A-FaBPs) have been investigated as biomarkers for sepsis or detection of acute neurological injuries in adults, but not children. We carried out a single-center, prospective observational study to determine if these measures could serve as biomarkers to identify children with sepsis. A secondary aim was to determine if these biomarkers could identify children with neurologic complications of sepsis. A total of 90 patients ≤ 18 years-old were included in this study. 30 with severe sepsis or septic shock were compared to 30 age-matched febrile and 30 age-matched healthy controls. Serial measurements of each biomarker were obtained, beginning on day 1 of ICU admission. In septic patients, MMP9-/TIMP-1 ratios (Median, IQR, n) were reduced on day 1 (0.024, 0.004-0.174, 13), day 2 (0.020, 0.002-0.109, 10), and day 3 (0.018, 0.003-0.058, 23) compared with febrile (0.705, 0.187-1.778, 22) and healthy (0.7, 0.4-1.2, 29) (psepsis.

  17. Dynamic change of collateral flow varying with distribution of regional blood flow in acute ischemic rat cortex

    Science.gov (United States)

    Wang, Zhen; Luo, Weihua; Zhou, Fangyuan; Li, Pengcheng; Luo, Qingming

    2012-12-01

    Cerebral blood flow (CBF) is critical for the maintenance of cerebral function by guaranteed constant oxygen and glucose supply to brain. Collateral channels (CCs) are recruited to provide alternatives to CBF to ischemic regions once the primary vessel is occluded during ischemic stroke. However, the knowledge of the relationship between dynamic evolution of collateral flow and the distribution of regional blood flow remains limited. In this study, laser speckle imaging was used to assess dynamic changes of CCs and regional blood flow in a rat cortex with permanent middle cerebral artery occlusion (MCAo). We found that CCs immediately provided blood flow to ischemic territories after MCAo. More importantly, there were three kinds of dynamic changes of CCs during acute stroke: persistent CC, impermanent CC, and transient CC, respectively, related to different distributions of regional blood flow. Although there was the possible occurrence of peri-infarct depolarization (PID) during ischemia, there was no obvious significance about the onset time and duration of CCs between rats with and without PID. These results suggest that the initial arising of CCs does not ensure their persistence, and that collateral flow could be varied with distribution of regional blood flow in acute ischemic stroke, which may facilitate the understanding of collateral recruitment and promote the development of collateral therapeutics in the future.

  18. The effect of clonidine infusion on distribution of regional cerebral blood flow in volunteers.

    Science.gov (United States)

    Bonhomme, Vincent; Maquet, Pierre; Phillips, Christophe; Plenevaux, Alain; Hans, Pol; Luxen, Andre; Lamy, Maurice; Laureys, Steven

    2008-03-01

    Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this observational study was to map brain regions whose activity is modified by clonidine infusion so as to better understand its loci of action, especially in relation to sedation. Six ASA I-II right-handed volunteers were recruited. Electroencephalogram (EEG) was monitored continuously. After a baseline H2(15)O activation scan, clonidine infusion was started at a rate ranging from 6 to 10 microg x kg(-1) x h(-1). A sequence of 11 similar scans was then performed at 8 min intervals. Plasma clonidine concentration was measured. Using statistical parametric mapping, we sought linear correlations between normalized regional cerebral blood flow (rCBF), an indicator of regional brain activity, and plasma clonidine concentration or spindle EEG activity. Clonidine induced clinical sedation and EEG patterns (spindles) comparable to early stage nonrapid eye movement sleep. A significant negative linear correlation between clonidine concentration and rCBF or spindle activity was observed in the thalamus, prefrontal, orbital and parietal association cortex, posterior cingulate cortex, and precuneus. The EEG patterns and decreases in rCBF of specific brain regions observed during clonidine-induced sedation are similar to those of early stage nonrapid eye movement sleep. Patterns of deactivated brain regions are also comparable to those observed during general anesthesia or vegetative state, reinforcing the hypothesis that alterations in the activity of a common network occur during these modified conscious states.

  19. Profile of Rh, Kell, Duffy, Kidd, and Diego blood group systems among blood donors in the Southwest region of the Paraná state, Southern Brazil.

    Science.gov (United States)

    Zacarias, Joana Maira Valentini; Langer, Ieda Bernadete Volkweis; Visentainer, Jeane Eliete Laguila; Sell, Ana Maria

    2016-12-01

    The aim of this study was to assess the distribution of alleles and genotypes of the blood group systems Rh, Kell, Duffy, Kidd, and Diego in 251 regular blood donors registered in the hemotherapy unit of the Southwestern region of Paraná, Southern Brazil. The frequencies were obtained by direct counting on a spreadsheet program and statistical analyses were conducted in order to compare them with other Brazilian populations using chi-squared with Yates correction on OpenEpi software. The frequencies of RHD* negative, RHCE*c/c and RHCE*e/e were higher than expected for the Caucasian population. A difference was also observed for FY alleles, FY*01/FY*01 genotype and FY*02N.01 -67T/C (GATA Box mutation). Two homozygous individuals were defined as a low frequency phenotype K + k- (KEL*01.01/KEL*01.01) and, for Diego blood group system the rare DI*01 allele was found in ten blood donors, of which one was DI*01/DI* 01 (0.4%). The allele and genotype frequencies of Kidd blood group system were similar to expected to Caucasians. The results showed the direction in which to choose donors, the importance of extended genotyping in adequate blood screening and the existence of rare genotypes in Brazilian regular blood donors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. The role of atrial electrical remodeling in the progression of focal atrial ectopy to persistent atrial fibrillation

    NARCIS (Netherlands)

    Hobbs, WJC; Van Gelder, IC; Fitzpatrick, AP; Crijns, HJGM; Garratt, CJ

    1999-01-01

    Focal Atrial Fibrillation and Electrical Remodeling. Although atrial fibrillation- (AF) induced changes in atrial refractoriness (atrial electrical remodeling) have been demonstrated in a number of different animal models, the clinical significance of this process is unknown. We describe a patient i

  1. Assessment of regional pulmonary blood flow using (68)Ga-DOTA PET.

    Science.gov (United States)

    Velasco, Carlos; Mateo, Jesus; Santos, Arnoldo; Mota-Cobian, Adriana; Herranz, Fernando; Pellico, Juan; Mota, Ruben A; España, Samuel; Ruiz-Cabello, Jesus

    2017-12-01

    In vivo determination of regional pulmonary blood flow (PBF) is a valuable tool for the evaluation of many lung diseases. In this study, the use of (68)Ga-DOTA PET for the in vivo quantitative determination of regional PBF is proposed. This methodology was implemented and tested in healthy pigs and validated using fluorescent microspheres. The study was performed on young large white pigs (n = 4). To assess the reproducibility and consistency of the method, three PET scans were obtained for each animal. Each radiotracer injection was performed simultaneously to the injection of fluorescent microspheres. PBF images were generated applying a two-compartment exchange model over the dynamic PET images. PET and microspheres values were compared by regression analysis and Bland-Altman plot. The capability of the proposed technique to produce 3D regional PBF images was demonstrated. The correlation evaluation between (68)Ga-DOTA PET and microspheres showed a good and significant correlation (r = 0.74, P PET imaging with the use of (68)Ga/(68)Ge generators. Thus, (68)Ga-DOTA PET emerges as a potential inexpensive method for measuring PBF in clinical settings with an extended use.

  2. Effects of trimetazidine on atrial structural remodeling and platelet activation in dogs with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    HAN Wei; LI Wei-min; ZHOU Hong-yan; HUO Hong; WEI Na; DONG Guo; CAO Yong; ZHOU Guo; YANG Shu-sen

    2009-01-01

    @@ Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. AF results in electrophysiological alterations which involve increased atrial effective refractory period and atrial effective refractory period dispersion, reduced rate adaptation of atrial effective refractory period, and slowed atrial conduction.

  3. Efeitos da estimulação com corrente elétrica contínua pulsátil sobre as propriedades eletrofisiológicas atriais: estudo experimental da fibrilação atrial em cães Effects of stimulation with pulsatile continuous electrical current on atrial electrophysiological properties: experimental study of atrial fibrillation in dogs

    Directory of Open Access Journals (Sweden)

    Dalmo Antonio Ribeiro Moreira

    2004-12-01

    posteroinferior region of the left atrium (LA. A pair of electrodes was sutured to the right atrial appendix for stimulation with a 9-volt alkaline battery connected to a system (LM 555 that transforms the linear continuous energy of the battery into a pulsatile continuous current for 60 minutes. Atrial epicardial biopsy was performed before and after atrial stimulation. RESULTS: No differences were observed in the durations of the effective atrial refractory periods. The times of intra-atrial and interatrial conduction, as well as that of atrial extrastimuli, were prolonged. The duration of atrial electrograms was prolonged during sinus rhythm and programmed atrial stimulation; in 68% of the dogs, atrial fibrillation was induced and was sustained. Interstitial edema and bands of cellular contraction were observed in the subepicardium on optical microscopy, as were intense myofibrillar disorganization and an increase in the size of the mitochondria on electron microscopy. CONCLUSION: That technique of atrial stimulation induces atrial fibrillation and causes atrial changes that increase atrial vulnerability to the appearance of atrial fibrillation.

  4. Regional cerebral blood flow and vasoreactivity to acetazolamide in childhood moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Hohkin, Kiyohiro; Kamiyama, Hiroyasu; Abe, Hiroshi [Hokkaido Univ., Sapporo (Japan). School of Medicine; Mitsumori, Kenji

    1995-04-01

    Using the 133-xenon inhalation method and single photon emission CT (SPECT), we measured regional cerebral blood flow (rCBF) and its reactivity to acetazolamide in 15 children with moyamoya disease (spontaneous occlusion of circle of Willis). In most of them, the mean hemispheric cerebral blood flow (mCBF) was similar to that of age-matched healthy children. However, their rCBF distribution was abnormal with low perfusion in the frontal and temporal lobes, and disturbed reactivity to acetazolamide in the frontal, temporal, and parietal lobes. After surgical revascularization of the anterior circulation with STA-MCA anastomosis and encephalo-duro-myo-anterio-sysnangiosis (EDAMS) these abnormal hemodynamics improved dramatically in the anterior circulation, including the frontal lobe. Postoperative SPECT studies revealed that cerebral vasodilatory capacity also improved in the occipital lobe and the basal ganglia. These results suggest that surgical revascularization of the anterior circulation should be carried out in order to improve cerebral hemodynamics as much as possible, especially in the frontal lobe, and it could also improve cerebral perfusion reserve in the posterior circulation. (author).

  5. Effects of axillary blockade on regional cerebral blood flow during dynamic hand contractions

    DEFF Research Database (Denmark)

    Friedman, D B; Friberg, L; Payne, G

    1992-01-01

    +9 increased much less. Axillary blockade had no effect on resting CBF, rCBF, or increases in the two during hand contractions of the opposite hand. Thus neural feedback from the contracting muscle is necessary for the increases in SM bilateral OM +5 motor sensory rCBF and the maximal increase......Regional cerebral blood flow (rCBF) was measured at orbitomeatal (OM) plane +5.0 and +9.0 cm in 10 subjects at rest and during dynamic hand contractions before and after axillary blockade. Handgrip strength was significantly reduced, and rating of perceived exertion increased after blockade. During...... hand contractions before blockade, contralateral hemispheric cerebral blood flow (CBF) at OM +9.0 increased from a resting value of 58 (49-75) to 63 (52-82) ml.100 g-1.min-1; contralateral motor sensory rCBF at OM +9 from 58 (50-77) to 71 (64-84); motor sensory rCBF at OM +5 from 67 (54-76) to 77 (64...

  6. Regional cerebral blood flow in various pediatric neurological patients using /sup 123/I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-03-01

    The recent development of a new radiopharmaceutical /sup 123/I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using /sup 123/I-IMP SPECT may reveal functional abnormalities as well as organic lesions. /sup 123/I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases.

  7. Effects of histamine and related compounds on regional cerebral blood flow in rats.

    Science.gov (United States)

    Suzuki, G; Chen, Z; Sugimoto, Y; Fujii, Y; Kamei, C

    1999-11-01

    The effects of histamine and related compounds on regional cerebral blood flow (rCBF) in the hippocampus of conscious rats were studied. Intracerebroventricular injection of histamine caused a dose-dependent increase in rCBF in the hippocampus, and similar findings were observed with not only the H1 agonist, 2-thiazolylethylamine, but also the H2 agonist, dimaprit. Intraperitoneal injection of L-histidine also resulted in an increase in rCBF in the hippocampus, in parallel with elevation of histamine content in the brain. The increase in rCBF in the hippocampus induced by L-histidine was antagonized by both H1 and H2 antagonists (diphenhydramine, pyrilamine and zolantidine). In addition, when both antagonists were injected simultaneously, an additive effect was observed in antagonism of the L-histidine-induced increase in rCBF. L-Histidine caused no marked changes in blood pressure even at a dose of 1,500 mg/kg, which showed an increase in rCBF in the hippocampus. These results indicate that histamine elicited an increase in rCBF via both H1 and H2 receptors.

  8. A study on measurement of the regional cerebral blood flow using autoradiographic method in moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Tomohiro; Kiya, Katsuzo; Yuki, Kiyoshi; Kawamoto, Hitoshi; Mizoue, Tatsuya; Kiura, Yoshihiro; Uozumi, Tohru [Hiroshima Prefectural Hospital (Japan); Ikawa, Fusao

    1997-11-01

    Development of Autoradiographic method (ARG) has provided measurement of cerebral blood flow in moyamoya disease. We evaluate a cerebral vasodilatory capacity (CVC) for moyamoya disease using ARG method. We used 5 patients with moyamoya disease as a candidate for measurement of the cerebral blood flow (CBF) who admitted to Hiroshima Prefectural Hospital during the past one year. There were 3 patients in an adult age and 2 patients in a young age. We tried to measure the regional CBF (rCBF) using ARG method which was a easy way to estimate the rCBF on SPECT. The CVC was calculated from the difference of the rCBF between resting SPECT and Diamox-loading SPECT. Results were as follows; Reactivity of cerebral vessels to CO{sub 2} loading and CVC weakened in moyamoya disease. The rCBF and CVC in the territories of anterior and middle cerebral arteries reduced in comparison with those in the area supplied by the posterior cerebral artery. The CVC at the treated side with surgical reconstruction recovered somewhat in an adult type. From these results, measurement of CBF using ARG method seems to be useful for evaluation of the CVC in moyamoya disease. (author)

  9. Atrial fibrillation and coronary bypass surgery - what can be risk factors for its' appearance?

    Science.gov (United States)

    Straus, Slavenka; Kacila, Mirsad; Omerbasic, Edin; Mujicic, Ermina

    2010-02-01

    The main goal of our study was to evaluate possible perioperative risk factors for occurrence of atrial fibrillation in the postoperative period in patients after CABG operations. The study included 140 patients after CABG, divided into two groups - Group I - 64 patients with new onset of POAF and Group II - 76 patients without postoperative atrial fibrillation occurrence. In both groups possible risk factors for atrial fibrillation onset (preoperative and postoperative) were analyzed.Results showed that we can predict new onset of atrial fibrillation after CABG if the following preoperative factors are present - low ejection fraction (less than 40%), LAd > 40mm, higher body mass index (BMI over 30), presence of COPD and older age. Important perioperative factors for onset of atrial fibrillation in our study were longer extracorporeal circulation, increased dose/number of inotropic drugs, blood transfusion and elevated WBC count postoperatively.

  10. Regional cerebral blood flow and cognitive deficits in chronic lyme disease.

    Science.gov (United States)

    Fallon, Brian A; Keilp, John; Prohovnik, Isak; Heertum, Ronald Van; Mann, J John

    2003-01-01

    This study examined brain functioning in patients with Lyme encephalopathy. Eleven patients underwent neuropsychological tests and Xenon(133)-regional cerebral blood flow (rCBF) studies, using an external detector system. Each rCBF scan was age- and sex-matched to two archival, normal controls. While few differences were noted on gray-matter flow indices (ISI, fg), Lyme patients demonstrated significant flow reductions in white matter index (k(2)) (p=.004), particularly in the posterior temporal and parietal lobes bilaterally (p=.003). Flow reductions in white matter areas were significantly associated with deficits in memory (r=.66, p=.027) and visuospatial organization (r=.62, p=.041). Results suggest that Lyme encephalopathy may be a disease primarily affecting the cerebral white matter.

  11. Regional cerebral blood flow and cognitive function in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Huirong Guo

    2014-01-01

    Full Text Available Objective: To explore the relationship between regional cerebral blood flow (CBF and cognitive function in obsessive-compulsive disorder (OCD. Method: Single-photon emission computed tomography (SPECT was performed for 139 OCD patients and 139 controls, and the radioactivity rate (RAR was calculated. Cognitive function was assessed by the Wisconsin Card Sorting Test (WCST. Results: The RARs of the prefrontal, anterior temporal, and right occipital lobes were higher in patients than controls. For the WCST, correct and classification numbers were significantly lower, and errors and persistent errors were significantly higher in OCD patients. Right prefrontal lobe RAR was negatively correlated with correct numbers, right anterior temporal lobe RAR was positively correlated with errors, and the RARs of the right prefrontal lobe and left thalamus were positively correlated with persistent errors. Conclusion: OCD patients showed higher CBF in the prefrontal and anterior temporal lobes, suggesting that these areas may be related with cognitive impairment.

  12. Atrial natriuretic peptide (ANP) as a neuropeptide: Interaction with angiotensin II on volume control and renal sodium handling

    OpenAIRE

    Unger, Th.; Badoer, E.; Gareis, C.; Girchev, R.; Kotrba, M.; Qadri, F; Rettig, R.; Rohmeiss, P

    1990-01-01

    1 Angiotensin II (ANG II) and atrial natriuretic peptide (ANP) are functionally antagonistic circulating hormones involved in blood pressure and body fluid regulation. An inappropriate atrial secretion of ANP has been implicated in the pathogenesis of hypertension, but clinical and experimental results on the role of ANP in hypertension are still conflicting.

  13. Fractal regional myocardial blood flows pattern according to metabolism, not vascular anatomy.

    Science.gov (United States)

    Yipintsoi, Tada; Kroll, Keith; Bassingthwaighte, James B

    2016-02-01

    Regional myocardial blood flows are markedly heterogeneous. Fractal analysis shows strong near-neighbor correlation. In experiments to distinguish control by vascular anatomy vs. local vasomotion, coronary flows were increased in open-chest dogs by stimulating myocardial metabolism (catecholamines + atropine) with and without adenosine. During control states mean left ventricular (LV) myocardial blood flows (microspheres) were 0.5-1 ml·g(-1)·min(-1) and increased to 2-3 ml·g(-1)·min(-1) with catecholamine infusion and to ∼4 ml·g(-1)·min(-1) with adenosine (Ado). Flow heterogeneity was similar in all states: relative dispersion (RD = SD/mean) was ∼25%, using LV pieces 0.1-0.2% of total. During catecholamine infusion local flows increased in proportion to the mean flows in 45% of the LV, "tracking" closely (increased proportionately to mean flow), while ∼40% trended toward the mean. Near-neighbor regional flows remained strongly spatially correlated, with fractal dimension D near 1.2 (Hurst coefficient 0.8). The spatial patterns remain similar at varied levels of metabolic stimulation inferring metabolic dominance. In contrast, adenosine vasodilation increased flows eightfold times control while destroying correlation with the control state. The Ado-induced spatial patterns differed from control but were self-consistent, inferring that with full vasodilation the relaxed arterial anatomy dominates the distribution. We conclude that vascular anatomy governs flow distributions during adenosine vasodilation but that metabolic vasoregulation dominates in normal physiological states.

  14. Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications.

    Science.gov (United States)

    Lau, Y-F; Yiu, K-H; Siu, C-W; Tse, H-F

    2012-10-01

    Hypertension is one of the most important risk factors associated with atrial fibrillation (AF) and increased the risk of cardiovascular events in patients with AF. However, the pathophysiological link between hypertension and AF is unclear. Nevertheless, this can be explained by the hemodynamic changes of the left atrium secondary to long standing hypertension, resulting in elevated left atrium pressure and subsequently left atrial enlargement. Moreover, the activation of renin-angiotensin-aldosterone system (RAAS) activation in patients with hypertension induces left atrial fibrosis and conduction block in the left atrium, resulting in the development of AF. Accordingly, recent studies have shown that effective blockage of RAAS by angiotensin converting enzyme inhibitors or angiotensin receptor antagonist may be effective in both primary and secondary prevention of AF in patients with hypertension, although with controversies. In addition, optimal antithrombotic therapy, blood pressure control as well as rate control for AF are key to the management of patients with AF.

  15. Biological Therapies for Atrial Fibrillation: Ready for Prime Time?

    Science.gov (United States)

    Donahue, J Kevin

    2016-01-01

    Atrial fibrillation is a prominent cause of morbidity and mortality in developed countries. Treatment strategies center on controlling atrial rhythm or ventricular rate. The need for anticoagulation is an independent decision from the rate versus rhythm control debate. This review discusses novel biological strategies that have potential utility in the management of atrial fibrillation. Rate controlling strategies predominately rely on G-protein gene transfer to enhance cholinergic or suppress adrenergic signaling pathways in the atrioventricular node. Calcium channel blocking gene therapy and fibrosis enhancing cell therapy have also been reported. Rhythm controlling strategies focus on disrupting reentry by enhancing conduction or suppressing repolarization. Efforts to suppress inflammation and apoptosis are also under study. Resistance to blood clot formation has been shown with thrombomodulin. These strategies are in various stages of preclinical development.

  16. SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY STUDY OF REGIONAL CEREBRAL BLOOD FLOW IN PATIENTS WITH HEMISPATIAL NEGLECT

    Institute of Scientific and Technical Information of China (English)

    尹雅芙; 任艳; 李亚明

    2003-01-01

    Objective.To explore the correlations between the occurrence and severity of neglect and the region,range or extent of the decrease in regional cerebral blood flow(rCBF). Methods. Nineteen dextromanual patients who were diagnosed as unilateral stroke clinically and hemispatial neglect by a neglect test battery received single photon emission computed tomography(SPECT) scans. Results. On images,the damages of patients with neglect were seen most frequently in the frontal cortex,and then in turn in the parietal cortex,occipital cortex,temporal cortex,basal ganglia and thalamus. Most patients with neglect had two or more regions damaged. The most significant region was temporal-parietal-occipi-tal(TPO)junction. The correlation coefficient between rCBF and the severity of neglect was -0.34(t=-1.5,P>0.05),and that between the decrease percentage of rCBF and the severity of neglect was 0.34(t=1.47,P>0.05). The correlation coefficients between the range,number of foci,the flow deficit size and the severity of neglect were 0.71(t=4.13,P<0.01),0.70(t=4.07,P<0.01)and 0.64(t=3.40, P<0.01),respectively. Conclusions. The severity of neglect correlates with rCBF and the decrease percentage of rCBF insignificantly,but correlates positively with the range,number of foci and the flow deficit size significantly. Hemispatial neglect is caused by the damage of multiple sites and combined damage results in more severe neglect.

  17. Relationships among arteriolar, regional, and whole organ blood flow in cremaster muscle

    Energy Technology Data Exchange (ETDEWEB)

    Proctor, K.G.; Busija, D.W.

    1985-07-01

    The relationship between microvessel and tissue blood flow (BF) was determined with two different techniques during changes in local vasomotor tone in the rat cremaster muscle. Whole organ and regional BF were measured with the radioactive microsphere technique (BFms) and compared with values calculated in individual arterioles (BFc) using the dual-slit cross-correlation technique. In the muscle prepared for microcirculatory observation (i.e., dissected, surgically divided into a flattened sheet, and covered with clear plastic), resting BFms was 43 +/- 3 ml X min-1 X 100 g-1, which was significantly higher than paired BFms in the contralateral undisturbed muscle (24 +/- 7 ml X min-1 X 100 g-1). Over a range in vasomotor tone, regional BFms to the edge of the tissue, which was exposed to the trauma of the surgery, was 56 +/- 7 ml X min-1 X 100 g-1 compared with 38 +/- 5 in the less traumatized center region, a significant difference of 79 +/- 31%. There was no linear relationship between arteriolar BFc and BFms. The correlation was not improved if the factors of vessel size, vasomotor tone, animal size, or muscle size were considered. Changes in arteriolar BFc (y) overestimated changes in total tissue BFms (x) by a factor of 2 (y = 2.01x - 0.6; r = 0.86), but changes in arteriolar BFc were proportional to changes in BFms if only the center region (x) of the tissue was considered (y = 1.08x - 0.1; r = 0.84). The general implication from these results is that factors that influence perfusion heterogeneity, such as surgical trauma, should be carefully considered when correlating macro- and microcirculatory measurements of BF.

  18. Nicotine effects on regional cerebral blood flow in awake, resting tobacco smokers.

    Science.gov (United States)

    Domino, E F; Minoshima, S; Guthrie, S; Ohl, L; Ni, L; Koeppe, R A; Zubieta, J K

    2000-12-01

    The hypothesis for this research was that regional cerebral blood flow (rCBF) would increase following nasal nicotine administration to overnight abstinent tobacco smokers in relationship to the known brain distribution of nicotinic cholinergic receptors (nAChRs). Nine male and nine female healthy adult smokers were studied. They abstained overnight from tobacco products for 10 or more hours prior to study the next morning. Nicotine nasal spray was given in doses of 1-2.5 mg total with half in each nostril while the subject was awake and resting in a supine position. Oleoresin of pepper solution in a similar volume was used as an active placebo to control for the irritating effects of nicotine. Both substances were given single blind to the subjects. Positron emission tomography (PET) with H(2)(15)O was used to measure rCBF. The data from each subject volunteer were normalized to global activity to better assess regional brain changes. Both nasal nicotine and pepper spray produced similar increases in CBF in somesthetic area II, consistent with the irritant effects of both substances. The mean rCBF effects of nasal pepper were subtracted from those of nasal nicotine to determine the actions of nicotine alone. The latter produced increases in rCBF in the thalamus, pons, Brodman area 17 of the visual cortex, and cerebellum. Some brain areas that contain a large number of nAChRs, such as the thalamus, showed an increase in CBF. Other areas that have few nAChRs, such as the cerebellum, also showed an increase in relative CBF. The hippocampal/parahippocampal areas showed greater regional decreases (left) and lesser increases (right) in CBF that correlated with the increase in plasma arterial nicotine concentrations. The results obtained indicate complex primary and secondary effects of nicotine in which only some regional brain CBF changes correlate with the known distribution of nAChR. No gender differences were noted.

  19. Regional cerebral blood flow changes associated with transcranial magnetic stimulation in refractory depressed patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, C. H.; Chung, Y. A.; Chae, J. H.; Oh, J. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    Imaging studies by repetitive transcranial magnetic stimulation (rTMS) demonstrates biological activities of the brain. The aim of this study was to investigate the patterns of regional cerebral blood flow (rCBF) after a series of therapeutic rTMS sessions. Nine patients with refractory depression who had not been responsive to appropriate pharmacotherapy over 1 year were randomly assigned to daily 1 Hz right-sided rTMS or 20 Hz left-sided rTMS sessions for over 3 weeks. Baseline and 3-week post-rTMS treatment SPECT images were obtained 40 minutes after intravenous injection of approximately 740925 MBq of Tc-99m ECD using a multi-detector scanner (ECAM plus; Siemens, Erlangen, Germany) equipped with a low-energy, fan-beam collimator. All patients showed a good clinical outcome. Statistically significant common increase in rCBF patterns was found in the fusiform gyrus of left temporal lobe, left hippocampus, left superior parietal lobule, superior frontal gyrus of right frontal lobe, right lateral globus pallidus and cingulated gyrus of both limbic lobes. And in the fusiform gyrus of left occipital lobe and middle frontal gyrus of right frontal lobe decreased uptake was seen compared to controls. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased activity in specific brain regions in patients with treatment refractory depression. Therapeutic TMS seems to influence distinct cortical regions, as well as different pathways, affecting rCBF in a homogeneous manner that is probably region dependent and illness related.

  20. Humoral Control of Regional Blood Flow in Hemorrhagic Shock in Non-Resuscitated and Resuscitated Animals.

    Science.gov (United States)

    1987-07-17

    to perfusion with autologous normal (non-shock) blood. This increased resistance could be eliminated with phentolamine . However, oxygen consumption...perfusion with normal blood of 2.1 resistance units during perfusion with shock blood (pɘ.001). In a total of 17 phentolamine treated pig limbs...mL/min for normal blood and 1.4 mL/min for shock blood. None of these differences was statistically significant. The findings show that phentolamine

  1. Improved blood culture identification by FilmArray in cultures from regional hospitals compared with teaching hospital cultures.

    Science.gov (United States)

    Inglis, Timothy J J; Bzdyl, Nicole; Chua, I-Ly Joanna; Urosevic, Nadezda M; Leung, Michael J; Geelhoed, Elizabeth

    2016-01-01

    Rapid identification of bacteria isolated from blood cultures by direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now in wide spread use in major centres but is not yet feasible in smaller hospital laboratories. A FilmArray multiplex PCR panel for blood culture isolate identification (BCID) provides an alternative approach to near point-of-care microbial identification in regional hospitals. We assessed the accuracy and time to identification of the BCID FilmArray in a consecutive series of 149 blood cultures from 143 patients in a teaching hospital and smaller regional hospitals, currently identified by direct MALDI-TOF and proprietary molecular methods. The BCID FilmArray contained 18 of 34 species and 20 of 23 species isolated from teaching and regional hospital, respectively. Overall, 85 % of the teaching hospital and 100 % of the regional hospital monomicrobial blood cultures were identified, compared with 60 and 68 %, respectively, for direct MALDI-TOF on the same cultures. There were no incorrect results from blood cultures containing Staphylococcus aureus, streptococci, Pseudomonas aeruginosa or Enterobacteriaceae. The three discrepant results were all in mixed cultures. The mean reduction in time to identification of blood culture isolates was 53 h, which did not include the time required to transport cultures from regional centres to a central laboratory. The overall performance of the BCID FilmArray is stronger in blood cultures from smaller regional hospitals that encounter a narrower range of bacterial species dominated by the commonest species. This approach is more suited to smaller clinical laboratories than the MALDI-TOF direct method.

  2. Regional cerebral blood flow abnormalities in late-life depression. Relation to refractoriness and chronification

    Energy Technology Data Exchange (ETDEWEB)

    Awata, Shuichi; Konno, Michiko; Sato, Mitsumoto [Tohoku Univ., Sendai (Japan). School of Medicine; Ito, Hiroshi; Ono, Shuichi; Kawashima, Ryuta; Fukuda, Hiroshi

    1998-02-01

    We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and {sup 99m}Tc-hexamethyl-propylenamine oxime ({sup 99m}Tc-HMPAO). Compared with 13 age-matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non-refractory subgroup. In the non-reflactory subgroup, rCBF decreased significantly in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late-life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression. (author). 60 refs.

  3. Reduced serotonin synthesis and regional cerebral blood flow after anxiolytic treatment of social anxiety disorder.

    Science.gov (United States)

    Frick, Andreas; Åhs, Fredrik; Appel, Lieuwe; Jonasson, My; Wahlstedt, Kurt; Bani, Massimo; Merlo Pich, Emilio; Bettica, Paolo; Långström, Bengt; Lubberink, Mark; Fredrikson, Mats; Furmark, Tomas

    2016-11-01

    Social anxiety disorder (SAD) is associated with increased fear-related neural activity in the amygdala and we recently found enhanced serotonin synthesis rate in the same region. Anxiolytic agents like selective serotonin re-uptake inhibitors (SSRIs) and neurokinin-1 receptor (NK1R) antagonists reduce amygdala activity and may attenuate serotonin formation according to animal studies. Here, we examined the effects of SSRI pharmacotherapy, NK1R antagonism, and placebo on serotonin synthesis rate in relation to neural activity, measured as regional cerebral blood flow (rCBF), and symptom improvement in SAD. Eighteen SAD patients were randomized to receive daily double-blind treatment for six weeks either with the SSRI citalopram (n=6; 40mg), the NK1R antagonist GR205171 (n=6; 5mg; 4 weeks following 2 weeks of placebo), or placebo (n=6). Serotonin synthesis rate at rest and rCBF during stressful public speaking were assessed, before and after treatment, using positron emission tomography with the tracers [(11)C]5-hydroxytryptophan and [(15)O]water respectively. The Liebowitz Social Anxiety Scale (LSAS-SR) indexed symptom severity. All groups exhibited attenuated amygdala serotonin synthesis rate after treatment, which was associated with reduced amygdala rCBF during public speaking and accompanied by symptom improvement. These results are consistent with the notion that serotonin in the amygdala exerts an anxiogenic influence and, conversely, that anxiolysis is achieved through decreased serotonin formation in the amygdala.

  4. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc- HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, Ra Hyeong; Suh, Tae Suk; Kwark, Chul Eun; Choe, Bo Young; Lee, Hyoung Koo; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo [College of Medicine, The Catholic Univ. of Seoul, Seoul (Korea, Republic of)

    2002-06-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of '9{sup 9m}Tc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and {sup 99m}Tc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map(SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  5. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc-HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, R. H.; Suh, T. S.; Chung, Y. A. [The Catholic Univ., of Korea, Seoul (Korea, Republic of)

    2002-07-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of 99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99mTc- HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  6. Roux-en-Y gastric bypass alleviates hypertension and is associated with an increase in mid-regional pro-atrial natriuretic peptide in morbid obese patients

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten;

    2015-01-01

    OBJECTIVE: To examine 24-h blood pressure (24BP), systemic haemodynamics and the effect of sodium intake on 24BP in obese patients before and after gastric bypass surgery [laparoscopic Roux-en-Y gastric bypass (LRYGB)], and to determine whether weight loss from LRYGB might be related to an increase...... of high versus low sodium intake on 24BP was evaluated before and 12 months after LRYGB. RESULTS: Six weeks after LRYGB, the average weight loss was 20 kg, with a further 21 kg weight loss 1 year after surgery. In hypertensive patients, 24BP was significantly reduced at 6 weeks, but not 1 year after LRYGB...... in hypertensive patients and increased by 77% 1 year after the operation. In normotensive patients, preoperative concentrations were normal and increased only by 6%. High sodium intake induced plasma volume expansion, increased stroke volume and cardiac output, but no significant change in 24BP - neither before...

  7. Regional cerebral blood flow imaging assessment of brain function reconstruction in elderly hemiplegia patients by body weight support treadmill training

    Institute of Scientific and Technical Information of China (English)

    Wenqing Wang; Yongping Liu; Diqing Wang; Yanshuang Li; Jinglai Hao; Hongwei Zhang; Sheng Bi; Changshui Weng

    2011-01-01

    The mechanism underlying body weight support treadmill training in elderly hemiplegic stroke patients is largely unknown. This study aimed to elucidate the changes of cortical blood flow in seven elderly patients with post-stroke hemiplegia before and after body weight support treadmill training by semi-quantitative analysis of regional cerebral blood flow assessed by single photon emission computed tomography. Body weight support treadmill training for 6 months was effective in improving cerebral blood flow and promoting the walking speed and balance recovery in elderly patients with post-stroke hemiplegia.

  8. Mean corpuscular volume and red cell distribution width as predictors of left atrial stasis in patients with non-valvular atrial fibrillation.

    Science.gov (United States)

    Providência, Rui; Ferreira, Maria João; Gonçalves, Lino; Faustino, Ana; Paiva, Luís; Fernandes, Andreia; Barra, Sérgio; Pimenta, Joana; Leitão-Marques, António M

    2013-01-01

    The role of erythrocyte indexes for the prediction of left atrial stasis, assessed by transesophageal echocardiography in patients with non-valvular atrial fibrillation, has not been previously clarified. Single center cross-sectional study comprising 247 consecutive patients admitted to the emergency department due to symptomatic atrial fibrillation and undergoing transesophageal echocardiogram evaluation for exclusion of left atrial appendage thrombus (LAAT) before cardioversion. All patients had a complete blood count performed up to 12 hours prior to the transesophageal echocardiogram. Markers of left atrial stasis were sought: LAAT, dense spontaneous echocardiographic contrast (DSEC) and low flow velocities (LFV) in the left atrial appendage. Erythrocyte indexes' accuracy for detecting transesophageal echocardiogram changes was evaluated through receiver operating curve analysis. Binary logistic multivariate analysis, using solely erythrocyte indexes and in combination with other variables (i.e. CHADS2, CHA2DS2VASc classifications and left ventricle ejection fraction), was used for transesophageal echocardiogram endpoints prediction. LAAT was found in 8.5%, DSEC in 26.1% and LFV in 12.1%. Mean corpuscular volume and red cell distribution width were independent predictors of LAAT and DSEC. Despite adding incremental predictive value to each other, when clinical risk factors from CHADS2 and CHA2DS2VASc classifications and left ventricle ejection fraction were added to the models, only mean corpuscular volume remained an independent predictor of LAAT and DSEC. These findings suggest that mean corpuscular volume and red cell distribution width may be linked to left atrial stasis markers.

  9. Changes in Regional Cerebral Blood Flow with Cognitive Behavioral Therapy in the Treatment of Panic Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Won, K. S.; Jun, S. K.; Kim, J. B.; Jang, E. J. [College of Medicine, Univ. of Kyemyoung, Taegu (Korea, Republic of)

    2003-07-01

    This study attempted to prospectively investigate changes in regional cerebral blood flow (rCBF) on SPECT and clinical response to cognitive behavioral therapy (CBT) in patients with panic disorder with (PDA) and without (PD) agoraphobia. Using 99mTc-ECD brain SPECT, we assessed brain perfusion in 5 out patients at rest before and after CBT. The subjects received 12 weekly sessions of CBT. Subjects were assessed by Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, Anxiety Sensitivity Index, Beck Depression Inventory-II, Panic Disorder Severity Scale (PDSS) and clinical global improvement (CGI) scale measurement were used as outcome measures. Patients were considered responders to CBT if they are much or very much improved on CGI scale and have a PDSS score at least 30% below their baseline. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The baseline scans were compared to the post-CBT scans by using the statistics option multi subject, different conditions. Of 5 subjects 4 were male, 3 diagnosed PDA, and 4 on anti-anxiety medication. All of the subjects were classified as CBT responders. Their mean pretreatment and posttreatment PDSS were 17.4 (SD=8.2) and 4.2 (SD=3.1), respectively. The results of SPM analysis showed a significant decrease in blood flow after CBT in the thalamus bilaterally and right middle frontal gyrus (Brodmann's area 6). All results were thresholded at an uncorrected p<0.001 (for voxel height) and a corrected p<0.04 (for spatial extent). These preliminary data suggest that SPM analysis of 99mTc-ECD brain SPECT can reveal the change of rCBF in patient with panic disorder before and after CBT and the CBT effect may be associated with limbic and thalamic networks. However this study was a short trial with small number of subjects. Further studies with larger patient cohorts are needed.

  10. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mukamal, KJ; Tolstrup, JS; Friberg, J;

    2005-01-01

    and incident atrial fibrillation among 16,415 women and men enrolled in the Copenhagen City Heart Study. We ascertained use of beer, wine, and spirits individually at up to 3 study visits with a structured questionnaire. We identified cases of atrial fibrillation by routine study ECGs and a validated...... not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood...

  11. Thermistor guided radiofrequency ablation of atrial insertion sites in patients with accessory pathways.

    Science.gov (United States)

    Tracy, C M; Moore, H J; Solomon, A J; Rodak, D J; Fletcher, R D

    1995-11-01

    Radiofrequency ablation has gained acceptance in the treatment of patients with symptomatic Wolff-Parkinson-White syndrome. The purpose of this study was to characterize the relation between temperature and other electroconductive parameters in patients undergoing atrial insertion accessory pathway ablation utilizing a thermistor equipped catheter. The mean temperature and power at sites of atrial insertion ablation are lower than has been previously associated with creation of radiofrequency lesions in the ventricle. While high cavitary blood flow in the atrium may result in cooling, the thinner atrial tissue may require less energy to achieve adequate heating than ventricular myocardium.

  12. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation

    DEFF Research Database (Denmark)

    Krarup, L-H; Sandset, E C; Sandset, P M

    2011-01-01

    Krarup L-H, Sandset EC, Sandset PM, Berge E. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation. Acta Neurol Scand: 2011: 124: 40-44. © 2010 John Wiley & Sons A/S. Background -  Patients with acute ischemic stroke and atrial fibrillation...... in patients with acute ischemic stroke and atrial fibrillation....... are at increased risk of stroke progression and recurrence. We sought to assess whether D-dimer and other markers of hemostatic activation could predict these adverse events in such patients. Method -  Blood samples were obtained from patients included in the Heparin in Acute Embolic Stroke Trial. Stroke...

  13. Reduced pulmonary blood flow in regions of injury 2 hours after acid aspiration in rats.

    Science.gov (United States)

    Richter, Torsten; Bergmann, Ralf; Musch, Guido; Pietzsch, Jens; Koch, Thea

    2015-01-01

    Aspiration-induced lung injury can decrease gas exchange and increase mortality. Acute lung injury following acid aspiration is characterized by elevated pulmonary blood flow (PBF) in damaged lung areas in the early inflammation stage. Knowledge of PBF patterns after acid aspiration is important for targeting intravenous treatments. We examined PBF in an experimental model at a later stage (2 hours after injury). Anesthetized Wistar-Unilever rats (n = 5) underwent unilateral endobronchial instillation of hydrochloric acid. The PBF distribution was compared between injured and uninjured sides and with that of untreated control animals (n = 6). Changes in lung density after injury were measured using computed tomography (CT). Regional PBF distribution was determined quantitatively in vivo 2 hours after acid instillation by measuring the concentration of [(68)Ga]-radiolabeled microspheres using positron emission tomography. CT scans revealed increased lung density in areas of acid aspiration. Lung injury was accompanied by impaired gas exchange. Acid aspiration decreased the arterial pressure of oxygen from 157 mmHg [139;165] to 74 mmHg [67;86] at 20 minutes and tended toward restoration to 109 mmHg [69;114] at 110 minutes (P < 0.001). The PBF ratio of the middle region of the injured versus uninjured lungs of the aspiration group (0.86 [0.7;0.9], median [25%;75%]) was significantly lower than the PBF ratio in the left versus right lung of the control group (1.02 [1.0;1.05]; P = 0.016). The PBF pattern 2 hours after aspiration-induced lung injury showed a redistribution of PBF away from injured regions that was likely responsible for the partial recovery from hypoxemia over time. Treatments given intravenously 2 hours after acid-induced lung injury may not preferentially reach the injured lung regions, contrary to what occurs during the first hour of inflammation. Please see related article: http://dx.doi.org/10.1186/s12871-015-0014-z.

  14. Atrial fibrillation and heart failure: is atrial fibrillation a disease?

    Science.gov (United States)

    Tilman, V

    2014-09-01

    Atrial fibrillation in heart failure often occur together. The relationship between atrial fibrillation and heart failure has remained a subject of research. The main manifestation of the violation of hydrodynamics in heart failure is the increased end-diastolic pressure, which is transmitted through the intercommunicated system (left ventricle-left atrium-pulmonary veins-alveolar capillaries) causing increased pulmonary wedge pressure with the danger for pulmonary edema. End-diastolic pressure is the sum of left ventricle diastolic pressure and left atrial systolic pressure. Stopping the mechanical systole of the left atrium can reduce the pressure in the system in heart failure. Atrial fibrillation stops the mechanical systole of the left atrium and decreases the intercommunicating pressure and pulmonary wedge pressure. It is possible that atrial fibrillation is a mechanism for protection from increasing end-diastolic pressure and pulmonary wedge pressure, and prevents the danger of pulmonary edema. This hypothesis may explain the relationship between heart failure and atrial fibrillation and their frequent association.

  15. Origin and pharmacological response of atrial tachyarrhythmias induced by activation of mediastinal nerves in canines.

    Science.gov (United States)

    Armour, J Andrew; Richer, Louis-Philippe; Pagé, Pierre; Vinet, Alain; Kus, Teresa; Vermeulen, Michel; Nadeau, Réginald; Cardinal, René

    2005-03-31

    We sought to determine the sites of origin of atrial tachyarrhythmias induced by activating mediastinal nerves, as well as the response of such arrhythmias to autonomic modulation. Under general anaesthesia, atrioventricular block was induced after thoracotomy in 19 canines. Brief trains of 5 electrical stimuli were delivered to right-sided mediastinal nerves during the atrial refractory period. Unipolar electrograms were recorded from 191 right and left atrial epicardial sites under several conditions, i.e. (i) with intact nervous systems and following (ii) acute decentralization of the intrathoracic nervous system or administration of (iii) atropine, (iv) timolol, (v) hexamethonium. Concomitant right atrial endocardial mapping was performed in 7 of these dogs. Mediastinal nerve stimulation consistently initiated bradycardia followed by atrial tachyarrhythmias. In the initial tachyarrhythmia beats, early epicardial breakthroughs were identified in the right atrial free wall (28/50 episodes) or Bachmann bundle region (22/50), which corresponded to endocardial sites of origin associated with the right atrial subsidiary pacemaker complex, i.e. the crista terminalis and dorsal locations including the right atrial aspect of the interatrial septum. Neuronally induced responses were eliminated by atropine, modified by timolol and unaffected by acute neuronal decentralization. After hexamethonium, responses to extra-pericardial but not intra-pericardial nerve stimulation were eliminated. It is concluded that concomitant activation of cholinergic and adrenergic efferent intrinsic cardiac neurons induced by right-sided efferent neuronal stimulation initiates atrial tachyarrhythmias that originate from foci anatomically related to the right atrial pacemaker complex and tissues underlying major atrial ganglionated plexuses.

  16. Multivariate evaluation of brain function by measuring regional cerebral blood flow and event-related potentials

    Energy Technology Data Exchange (ETDEWEB)

    Koga, Yoshihiko; Mochida, Masahiko; Shutara, Yoshikazu; Nakagawa, Kazumi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Nagata, Ken

    1998-07-01

    To measure the effect of events on human cognitive function, effects of odors by measurement regional cerebral blood flow (rCBF) and P300 were evaluated during the auditory odd-ball exercise. PET showed the increase in rCBF on the right hemisphere of the brain by coffee aroma. rCBF was measured by PET in 9 of right-handed healthy adults men, and P300 was by event-related potential (ERP) in each sex of 20 right-handed healthy adults. ERP showed the difference of the P300 amplitude between men and women, and showed the tendency, by odors except the lavender oil, that women had higher in the P300 amplitude than men. These results suggest the presence of effects on the cognitive function through emotional actions. Next, the relationship between rCBF and ERP were evaluated. The subjects were 9 of the right-handed healthy adults (average: 25.6{+-}3.4 years old). rCBF by PET and P300 amplitude by ERP were simultaneously recorded during the auditory odd-ball exercise using the tone-burst method (2 kHz of the low frequency aimed stimuli and 1 kHz of the high frequency non-aimed stimuli). The rCBF value was the highest at the transverse gyrus of Heschl and the lowest at the piriform cortex among 24 regions of interest (ROI) from both sides. The difference of P300 peak latent time among ROI was almost the same. The brain waves from Cz and Pz were similar and the average amplitude was highest at Pz. We found the high correlation in the right piriform cortex (Fz), and right (Fz, Cz) and left (Cz, Pz) transverse gyrus of Heschl between the P300 amplitude and rCBF. (K.H.)

  17. Dual role of cerebral blood flow in regional brain temperature control in the healthy newborn infant.

    Science.gov (United States)

    Iwata, Sachiko; Tachtsidis, Ilias; Takashima, Sachio; Matsuishi, Toyojiro; Robertson, Nicola J; Iwata, Osuke

    2014-10-01

    Small shifts in brain temperature after hypoxia-ischaemia affect cell viability. The main determinants of brain temperature are cerebral metabolism, which contributes to local heat production, and brain perfusion, which removes heat. However, few studies have addressed the effect of cerebral metabolism and perfusion on regional brain temperature in human neonates because of the lack of non-invasive cot-side monitors. This study aimed (i) to determine non-invasive monitoring tools of cerebral metabolism and perfusion by combining near-infrared spectroscopy and echocardiography, and (ii) to investigate the dependence of brain temperature on cerebral metabolism and perfusion in unsedated newborn infants. Thirty-two healthy newborn infants were recruited. They were studied with cerebral near-infrared spectroscopy, echocardiography, and a zero-heat flux tissue thermometer. A surrogate of cerebral blood flow (CBF) was measured using superior vena cava flow adjusted for cerebral volume (rSVC flow). The tissue oxygenation index, fractional oxygen extraction (FOE), and the cerebral metabolic rate of oxygen relative to rSVC flow (CMRO₂ index) were also estimated. A greater rSVC flow was positively associated with higher brain temperatures, particularly for superficial structures. The CMRO₂ index and rSVC flow were positively coupled. However, brain temperature was independent of FOE and the CMRO₂ index. A cooler ambient temperature was associated with a greater temperature gradient between the scalp surface and the body core. Cerebral oxygen metabolism and perfusion were monitored in newborn infants without using tracers. In these healthy newborn infants, cerebral perfusion and ambient temperature were significant independent variables of brain temperature. CBF has primarily been associated with heat removal from the brain. However, our results suggest that CBF is likely to deliver heat specifically to the superficial brain. Further studies are required to assess the

  18. Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.

    Science.gov (United States)

    Yano, Yuichiro; Vongpatanasin, Wanpen; Ayers, Colby; Turer, Aslan; Chandra, Alvin; Carnethon, Mercedes R; Greenland, Philip; de Lemos, James A; Neeland, Ian J

    2016-09-01

    Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all Pfat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both Pfat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity.

  19. [Nosology and mechanism of monomorphous atrial tachycardia].

    Science.gov (United States)

    Puech, P

    1990-12-01

    Monomorphous atrial tachycardias have been classified taking into account the ectopic rhythm rate, atrial wave morphology, the mode of activation of the atrial studied by endocavitary cartography, stimulation tests and their natural history. Atrial flutter is a right intra-atrial macroreentry of anticlockwise (common flutter) or clockwise (atypical flutter) rotation, maintained by anisotropic conduction around two pivotal zones located at the posterior and inferior part of the atrium. Tachycardia is made possible by the existence of an excitable zone on the circuit. Paroxysmal atrial tachycardias are far more often linked to localised reentry (sino-atrial or intra-atrial microreentry) than to provoked activity, stimulation tests enabling the distinction to be made. "Digitalis tachycardias" must be seen in the context of activity induced by late post-potential. Focal atrial tachycardias linked to ectopic automatism are a separate entity. They follow a chronic course in the young individual and may lead to a cardiomyopathy purely due to the rhythm abnormality.

  20. Effect of atrial natriuretic peptide on gonadotropin release in superfused rat pituitary cells.

    OpenAIRE

    Horvath, J; Ertl, T.; Schally, A V

    1986-01-01

    Cardiac atrial muscle cells produce a polypeptide hormone that plays a role in the control of water and electrolyte balance and blood pressure. The circulating form of this hormone is the atrial natriuretic peptide (ANP), which contains 28 amino acids. Various immunohistochemical studies have shown that ANP is present in many areas of the central nervous system, including the median eminence. In our studies, we investigated the effect of ANP in a superfused rat pituitary cell system. When ANP...

  1. Regional cerebral blood flow during the auditory oddball task measured by positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Mochida, Masahiko [Kyorin Univ., Mitaka, Tokyo (Japan). Graduate School of Medicine

    1997-03-01

    Regional cerebral blood flow (rCBF) was measured by employing PET in nine healthy right-handed male subjects, while they simultaneously performed the auditory oddball task using tone bursts. Results showed that the rCBF value was highest in the transverse gyrus of Heschl in both right and left hemispheres. When comparing the rCBF values between right and left hemispheres, four areas had higher rCBF values in the left hemisphere and eight areas had higher rCBF values in the right hemisphere. Of these, the anterior and posterior parts of the superior temporal gyrus, especially, showed significant differences. The hemispheric differences in the rCBF values of the auditory areas can be attributed to the performance of the oddball task which requires higher processing of non verbal auditory input. The P300 amplitude which reflects the amount of the allocated information processing resources correlated positively with rCBF in the following areas: left piriform cortex, the transverse gyrus of Heschl in both left and right hemispheres. Mean-while, P300 amplitude correlated negatively with rCBF in the nucleus accumbens septi in both right and left hemispheres. The N100 amplitude evoked by frequent stimulus did not correlate with rCBF in almost all ROIs. (K.H.)

  2. Regional differences in the cerebral blood flow velocity response to hypobaric hypoxia at high altitudes.

    Science.gov (United States)

    Feddersen, Berend; Neupane, Pritam; Thanbichler, Florian; Hadolt, Irmgard; Sattelmeyer, Vera; Pfefferkorn, Thomas; Waanders, Robb; Noachtar, Soheyl; Ausserer, Harald

    2015-11-01

    Symptoms of acute mountain sickness (AMS) may appear above 2,500 m altitude, if the time allowed for acclimatization is insufficient. As the mechanisms underlying brain adaptation to the hypobaric hypoxic environment are not fully understood, a prospective study was performed investigating neurophysiological changes by means of near infrared spectroscopy, electroencephalograpy (EEG), and transcranial doppler sonography at 100, 3,440 and 5,050 m above sea level in the Khumbu Himal, Nepal. Fourteen of the 26 mountaineers reaching 5,050 m altitude developed symptoms of AMS between 3,440 and 5,050 m altitude (Lake-Louise Score ⩾3). Their EEG frontal beta activity and occipital alpha activity increased between 100 and 3,440 m altitude, i.e., before symptoms appeared. Cerebral blood flow velocity (CBFV) in the anterior and middle cerebral arteries (MCAs) increased in all mountaineers between 100 and 3,440 m altitude. During further ascent to 5,050 altitude, mountaineers with AMS developed a further increase in CBFV in the MCA, whereas in all mountaineers CBFV decreased continuously with increasing altitude in the posterior cerebral arteries. These results indicate that hypobaric hypoxia causes different regional changes in CBFV despite similar electrophysiological changes.

  3. Hepatitis B and C prevalences among blood donors in the south region of Brazil

    Directory of Open Access Journals (Sweden)

    H. C. F. F. Vasconcelos

    1994-12-01

    Full Text Available The prevalence of hepatitis B and C infection has been determined in a seroepidemiological survey among blood donors from the south of Brazil (Florianópolis, State of Santa Catarina. These markers has also been correlated with the levels of alanine aminotransferase (ALT, a surrogate marker to prevent post-transfusion hepatitis. Sera from 5000 donors were randomly collected in the period of April to November 1991. The prevalences of HBsAg, anti-HBs and anti-HBc were respectively 0.78, 7.02 and 13.98. The anti-HCV prevalence after confirmation testing with line immunoassay (LIA, was 1.14. Normal values of ALT ( = 70 U/ml in 2.48. The positivity of anti-HCV antibodies increased with the elevation of ALT levels. This correlation was not observed in relation to HBsAg. There exists a diversity in the recognition of HCV epitopes among HCV positive donors. Via the confirmation test used, we could observe that 94.7 of donors recognize the structural core antigen. Besides that, we observed that 5.26 of the HCV reactive sera recognized only epitopes located in the NS4 and/or NS5 region, indicating the importance of these epitopes for the improvement of assays.

  4. The evaluation of regional cerebral blood flow in the chronic alcohol abuse patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. A.; Kim, D. J.; Oh, J. H.; Kim, C. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The use of alcohol is increasingly prevalent in our country and remains associated with innumerable social and economic problems. In addition, brain abnormalities have been proved by means of neuroimaging techniques not only in the first days of withdrawal, but also months after the last use of the substance in the patients. The purpose of the present study was to investigate patterns of the regional cerebral blood flow (rCBF) in alcoholic dementia. Six patients (all men; 44-67 years, mean age = 57.5 years) who fulfilled DSM-IV criteria for alcoholic dementia were enrolled in the study. RCBF measurements of resting state using Tc-99m ethyl cysteinate dimmer (ECD) SPECT were performed. The SPECT image was obtained 40 minutes after intravenous injection of 1110 MBq of Tc-99m ECD using a dual-head gamma camera (ECAM plus; Siemens, Erlangen, Germany). The normalized SPECT data from the alcoholic dementia group were compared with those from 12 healthy subjects. Alcoholic dementia patients showed significant decrement of rCBF in the left thalamus, superior frontal gyrus of left frontal lobe, left insula, postcentral gyrus of left parietal lobe, parahippocapal gyrus of left limbic lobe, right caudate, and cingulate gyrus of right limbic lobe than age-matched healthy subjects. Despite the small number of patients examined, the study supports the belief that patients with alcohol induced cognitive dysfunction have the neuro pathophysiology as those with classical alcoholic dementia.

  5. Idiopathic giant right atrial aneurysm

    Science.gov (United States)

    Uppu, Santosh C; Sachdeva, Ritu; Imamura, Michiaki

    2013-01-01

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening. PMID:23626440

  6. Idiopathic giant right atrial aneurysm

    OpenAIRE

    Uppu, Santosh C; Ritu Sachdeva; Michiaki Imamura

    2013-01-01

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thicken...

  7. Idiopathic giant right atrial aneurysm

    Directory of Open Access Journals (Sweden)

    Santosh C Uppu

    2013-01-01

    Full Text Available A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening.

  8. Neovascularization in Left Atrial Myxoma

    Science.gov (United States)

    Dubey, Laxman; Chaurasia, Amit Kumar

    2012-01-01

    Abstract We report a case with a left atrial mass who underwent coronary angiography to rule out coronary artery disease. Coronary angiography revealed an anomalous tortuous vascular structure originating from the left circumflex coronary artery to the left atrial tumor suggestive of neovascularization. Preoperative coronary angiography is useful for coronary artery evaluation and also provides additional information regarding the feeding vessel supplying the mass. PMID:24757609

  9. Probucol attenuates atrial autonomic remodeling in a canine model of atrial fibrillation produced by prolonged atrial pacing

    Institute of Scientific and Technical Information of China (English)

    GONG Yong-tai; LI Wei-min; LI Yue; YANG Shu-sen; SHENG Li; YANG Ning; SHAN Hong-bo; XUE Hong-jie; LIU Wei; YANG Bao-feng; DONG De-li; LI Bao-xin

    2009-01-01

    Background We hypothesize that increased atrial oxidative stress and inflammation may play an important role in atrial nerve sprouting and heterogeneous sympathetic hyperinnervation during atrial fibrillation (AF). To test the hypothesis, we examined whether the antioxidant and anti-inflammatory treatment with probucol attenuates atrial autonomic remodeling in a canine model of AF produced by prolonged rapid right atrial pacing. Methods Twenty-one dogs were divided into a sham-operated group, a control group and a probucol group. Dogs in the control group and probucol group underwent right atrial pacing at 400 beats per minute for 6 weeks, and those in the probucol group received probucol 1 week before rapid atrial pacing until pacing stopped. After 6-week rapid atrial pacing, general properties including left atrial structure and function, atrial hemodynamics and the inducibility and duration of AF were measured in all the groups. Atrial oxidative stress markers and serum C-reactive protein (CRP) concentration were estimated. The degree of nerve sprouting and sympathetic innervation at the right atrial anterior wall (RAAW) and the left atrial anterior wall (LAAW) were quantified by immunohistochemistry, atdal norepinephrine contents were also detected. Atrial beta-nerve growth factor (beta-NGF) mRNA and protein expression at the RAAW and LAAW were assessed by real-time quantitative RT-PCR and Western blotting respectively. Results Atrial tachypacing induced significant nerve sprouting and heterogeneous sympathetic hyperinnervation, and the magnitude of nerve sprouting and hyperinnervation was higher in the RAAW than in the LAAW. Atrial beta-NGF mRNA and protein levels were significantly increased at the RAAW and LAAW, and the upregulation of beta-NGF expression was greater at the RAAW than at the LAAW in the control group. The beta-NGF protein level was positively correlated with the density of sympathetic nerves in all groups. Probucol decreased the increase of

  10. Regional cerebral blood flow during rest and skilled hand movements by xenon-133 inhalation and emission computerized tomography

    DEFF Research Database (Denmark)

    Lauritzen, M; Henriksen, L; Lassen, N A

    1981-01-01

    Regional cerebral blood flow (CBF) was studied in 16 normal adult volunteers during rest and in 10 the study was repeated during skilled hand movements. A fast-rotating ("dynamic"), single-photon emission computerized tomograph (ECT) with four detector heads was used. Xenon-133 was inhaled over a 1...

  11. Autistic Traits, ADHD Symptoms, Neurological Soft Signs and Regional Cerebral Blood Flow in Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Manouilenko, Irina; Pagani, Marco; Stone-Elander, Sharon; Odh, Richard; Brolin, Fredrik; Hatherly, Robert; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne

    2013-01-01

    The resting regional cerebral blood flow (rCBF) patterns related to co-occurring symptoms such as inattention, hyperactivity, neurological soft signs and motor problems have not yet been disclosed in autism spectrum disorders (ASD). In this study thirteen adults with ASD and ten matched neurotypical controls underwent PET. The scores of rating…

  12. Physiological activation of the human cerebral cortex during auditory perception and speech revealed by regional increases in cerebral blood flow

    DEFF Research Database (Denmark)

    Lassen, N A; Friberg, L

    1988-01-01

    by measuring regional cerebral blood flow CBF after intracarotid Xenon-133 injection are reviewed with emphasis on tests involving auditory perception and speech, and approach allowing to visualize Wernicke and Broca's areas and their contralateral homologues in vivo. The completely atraumatic tomographic CBF...

  13. Interictal "patchy" regional cerebral blood flow patterns in migraine patients. A single photon emission computerized tomographic study

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, J; Iversen, Helle Klingenberg

    1994-01-01

    In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right...

  14. Alterations in Blood Coagulation and Viscosity Among Young Male Cigarette Smokers of Al-Jouf Region in Saudi Arabia.

    Science.gov (United States)

    Almarshad, Hassan A; Hassan, Fathelrahman M

    2016-05-01

    Hemorheology, a measure of rheological properties of blood, is often correlated with cerebral blood flow and cardiac output; an increased blood viscosity may increase the risk of thrombosis or thromboembolic events. Previous studies have reported a large variation in hemorheological properties of blood among smokers. This prompted us to conduct coagulation experiments to evaluate the effect of cigarette smoking on hematological parameters, like cell counts, and coagulation parameters among young males in Al-Jouf region, Saudi Arabia. The hematological and coagulation parameters were used to relate the changes in viscosity and coagulation to smoking. A total of 321 male participants (126 nonsmokers and 195 smokers) were enrolled into the study as randomized sample. Complete blood count was measured by hematology analyzer, and coagulation tests were performed by coagulation analyzer. Thettest analysis was performed to compare the relationships of variables between the 2 groups. The results confirmed that smoking alters some hematology parameters leading to significant deterioration in blood flow properties. Smoking also increased the hematocrit (HCT), whole blood viscosity (WBV), and plasma viscosity (PV) but decreased the international normalized ratio (INR). The decrease in INR was found to be associated with the increase in WBV, PV, and HCT. Further investigations are necessary to assess the reversibility of such changes in cessation of smoking or other elements of influence.

  15. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... atrial fibrillation has more than five times the risk of stroke.” “Because high blood pressure is so frequent, affecting tens of millions of ... is a more potent risk factor.” The two risk factors are also related to each other: High blood pressure is a risk factor for atrial fibrillation. Middle- ...

  16. Vascular Steal Explains Early Paradoxical Blood Oxygen Level-Dependent Cerebrovascular Response in Brain Regions with Delayed Arterial Transit Times

    Directory of Open Access Journals (Sweden)

    Julien Poublanc

    2013-04-01

    Full Text Available Introduction: Blood oxygen level-dependent (BOLD magnetic resonance imaging (MRI during manipulation of inhaled carbon dioxide (CO2 can be used to measure cerebrovascular reactivity (CVR and map regions of exhausted cerebrovascular reserve. These regions exhibit a reduced or negative BOLD response to inhaled CO2. In this study, we sought to clarify the mechanism behind the negative BOLD response by investigating its time delay (TD. Dynamic susceptibility contrast (DSC MRI with the injection of a contrast agent was used as the gold standard in order to provide measurement of the blood arrival time to which CVR TD could be compared. We hypothesize that if negative BOLD responses are the result of a steal phenomenon, they should be synchronized with positive BOLD responses from healthy brain tissue, even though the blood arrival time would be delayed. Methods: On a 3-tesla MRI system, BOLD CVR and DSC images were collected in a group of 19 patients with steno-occlusive cerebrovascular disease. For each patient, we generated a CVR magnitude map by regressing the BOLD signal with the end-tidal partial pressure of CO2 (PETCO2, and a CVR TD map by extracting the time of maximum cross-correlation between the BOLD signal and PETCO2. In addition, a blood arrival time map was generated by fitting the DSC signal with a gamma variate function. ROI masks corresponding to varying degrees of reactivity were constructed. Within these masks, the mean CVR magnitude, CVR TD and DSC blood arrival time were extracted and averaged over the 19 patients. CVR magnitude and CVR TD were then plotted against DSC blood arrival time. Results: The results show that CVR magnitude is highly correlated to DSC blood arrival time. As expected, the most compromised tissues with the longest blood arrival time have the lowest (most negative CVR magnitude. However, CVR TD shows a noncontinuous relationship with DSC blood arrival time. CVR TD is well correlated to DSC blood arrival time

  17. Biodegradable radiopaque microspheres for the evaluation of regional pulmonary blood flow distribution using electron-beam computed tomography

    Science.gov (United States)

    Workman, Michael J.; Tajik, Jehangir K.; Robinson, Miguel T.; Hoffman, Eric A.

    1994-05-01

    Accurate measurement of regional pulmonary blood flow distribution is of interest both as a research and diagnostic tool. Measurements of regional pulmonary perfusion via x-ray CT offer the possibility of detecting perfusion deficits due to pulmonary embolus while maintaining a high degree of anatomic detail. Use of bolus injection of conventional radiopaque contrast with associated short mean transit times (5 - 7 seconds), requires a high degree of temporal resolution offered clinically only by electron beam x-ray CT (Imatron). The present study was intended to characterize biodegradable radiopaque microspheres as an alternative contrast agent which would allow for measurement of regional pulmonary blood flow with scanning times associated with conventional or spiral thin slice, volumetric x-ray CT protocols. To test this, a dog was scanned at 6 slice levels and 13 time points with image acquisition gated to the cardiac cycle. Lung volumes were maintained at functional residual capacity.

  18. Regional blood flow during exercise in humans measured by near-infrared spectroscopy and indocyanine green

    DEFF Research Database (Denmark)

    Boushel, R; Langberg, Henning; Olesen, J;

    2000-01-01

    Using near-infrared spectroscopy (NIRS) and the tracer indocyanine green (ICG), we quantified blood flow in calf muscle and around the Achilles tendon during plantar flexion (1-9 W). For comparison, blood flow in calf muscle was determined by dye dilution in combination with magnetic resonance im...

  19. Cerebral oxygen extraction, oxygen consumption, and regional cerebral blood flow during the aura phase of migraine

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, Jes; Lassen, N A

    1994-01-01

    The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism.......The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism....

  20. Late atypical atrial flutter after ablation of atrial fibrillation.

    Science.gov (United States)

    Ferreira, Raquel; Primo, João; Adão, Luís; Gonzaga, Anabela; Gonçalves, Helena; Santos, Rui; Fonseca, Paulo; Santos, José; Gama, Vasco

    2016-10-01

    Cardiac surgery for structural heart disease (often involving the left atrium) and radiofrequency catheter ablation of atrial fibrillation have led to an increased incidence of regular atrial tachycardias, often presenting as atypical flutters. This type of flutter is particularly common after pulmonary vein isolation, especially after extensive atrial ablation including linear lesions and/or defragmentation. The authors describe the case of a 51-year-old man, with no relevant medical history, referred for a cardiology consultation in 2009 for paroxysmal atrial fibrillation. After failure of antiarrhythmic therapy, he underwent catheter ablation, with criteria of acute success. Three years later he again suffered palpitations and atypical atrial flutter was documented. The electrophysiology study confirmed the diagnosis of atypical left flutter and reappearance of electrical activity in the right inferior pulmonary vein. This vein was again ablated successfully and there has been no arrhythmia recurrence to date. In an era of frequent catheter ablation it is essential to understand the mechanism of this arrhythmia and to recognize such atypical flutters.

  1. Hemovigilance survey of pathogen-reduced blood components in the Warsaw Region in the 2009 to 2013 period.

    Science.gov (United States)

    Łętowska, Magdalena; Przybylska, Zofia; Piotrowski, Dariusz; Lachert, Elżbieta; Rosiek, Aleksandra; Rzymkiewicz, Lech; Cardoso, Marcia

    2016-03-01

    In 2009 the Mirasol Pathogen Reduction Technology (PRT) was introduced to the routine blood component production of the Regional Blood Transfusion Center in Warsaw (RBTCW). The goal of this study was to investigate the safety of Mirasol-treated blood components. The accumulated passive hemovigilance data of Mirasol-treated blood components collected at the RBTCW are presented and compared to historical and contemporary data. Furthermore, active hemovigilance data collected from patients with different hematologic disorders transfused with Mirasol-treated or untreated blood components at the Institute of Hematology and Transfusion Medicine (IHTM) are presented and discussed. The adverse reaction (AR) reporting rate by hospitals to the RBTCW after the implementation of the Mirasol technology was 0.39% for Mirasol-treated platelet concentrates (M-PCs) and 0.05% for Mirasol-treated fresh-frozen plasma. When comparing contemporary rates of ARs recorded by RBTCW in the time period 2011 to 2012, no statistical difference was observed between Mirasol-treated and untreated blood components. No serious AR was attributed to Mirasol-treated components. At the IHTM a lower rate of ARs after transfusion of M-PCs was observed than with untreated PCs. Despite the fact that very large amounts of Mirasol-treated plasma have been transfused to patients with congenital or acquired thrombotic thrombocytopenic purpura, no significant increase in AR rates was observed. Treatment of blood components with the Mirasol PRT System has proven to be safe for patients and is not associated with increased rates and grades of adverse events in patients of hospitals in the Warsaw Region. © 2015 AABB.

  2. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria.

    Science.gov (United States)

    Freitas, Daniel Roberto Coradi; Duarte, Elisabeth Carmen

    2014-01-01

    To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM). This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA) Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points), 'partially adequate' (from 50 to 80 points), or 'inadequate' (<50 points). The following components were evaluated: 'donor education' (5 points), 'clinical screening' (40 points), 'laboratory screening' (40 points) and 'hemovigilance' (15 points). The overall median score was 49.8 (minimum=16; maximum=78). Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum=16; maximum=32). The median laboratory screening score was 20 (minimum=0; maximum=32). Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria. Malaria is neglected as a blood-borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with. Copyright © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

  3. Isolated Atrial Amyloidosis in Patients with Various Types of Atrial Fibrillation.

    Science.gov (United States)

    Sukhacheva, T V; Eremeeva, M V; Ibragimova, A G; Vaskovskii, V A; Serov, R A; Revishvili, A Sh

    2016-04-01

    The myocardium of the right and left atrial appendages (auricles) in patients with paroxysmal, persistent, and permanent forms of atrial fibrillation was examined by histological methods and electron microscopy. Isolated atrial amyloidosis was detected in the left (50.0-56.3% patients) and in the right (45.0-55.6% patients) atrial appendages. In all cases, immunohistochemistry revealed atrial natriuretic peptide in fibrillary amyloid deposits. Ultrastructurally, amyloid masses formed clusters of myofibrils 8-10 nm in diameter. They were chaotically located in the extracellular space along the sarcolemma as well as in membrane invaginations, dilated tubules of cardiomyocyte T-tubular system, and vascular walls. Amyloidosis was predominantly observed in women; its degree positively correlated with age of patients and duration of atrial fibrillation but negatively correlated with atrial fibrosis. The study revealed positive (in permanent atrial fibrillation) and negative (in paroxysmal atrial fibrillation) correlation of amyloidosis with myofibril content in atrial cardiomyocytes.

  4. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, Afib and Your Risk of Stroke Updated:Sep ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  5. Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET

    DEFF Research Database (Denmark)

    Iida, H; Law, I; Pakkenberg, B

    2000-01-01

    formulated four mathematical models that describe the dynamic behavior of a freely diffusible tracer (H215O) in a region of interest (ROI) incorporating estimates of regional tissue flow that are independent of PVE. The current study was intended to evaluate the feasibility of these models and to establish...... a methodology to accurately quantify regional cerebral blood flow (CBF) corrected for PVE in cortical gray matter regions. Five monkeys were studied with PET after IV H2(15)O two times (n = 3) or three times (n = 2) in a row. Two ROIs were drawn on structural magnetic resonance imaging (MRI) scans and projected...... onto the PET images in which regional CBF values and the water perfusable tissue fraction for the cortical gray matter tissue (hence the volume of gray matter) were estimated. After the PET study, the animals were killed and stereologic analysis was performed to assess the gray matter mass...

  6. Left Atrial Linear Ablation of Paroxysmal Atrial Fibrillation Guided by Three-dimensional Electroanatomical System

    DEFF Research Database (Denmark)

    Zhang, Dai-Fu; Li, Ying; Qi, Wei-Gang

    2005-01-01

    Objective To investigate the safety and efficacy of Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system. Methods 29 patients with paroxysmal atrial fibrillation in this study. A nonfluoroscopic mapping system was used to generate a 3D...... attacks unchanged. No pulmonary vein narrowing was observed. Conclusion Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system was safe and effective....

  7. Investigation of polycyclic aromatic hydrocarbon level in blood and semen quality for residents in Pearl River Delta Region in China.

    Science.gov (United States)

    Song, Xiao Fei; Chen, Zhi Yuan; Zang, Zhi Jun; Zhang, Ya Nan; Zeng, Feng; Peng, Yen Ping; Yang, Chen

    2013-10-01

    This study is the first one investigating the correlation between the concentration of polycyclic aromatic hydrocarbon (PAHs) in blood and semen qualities for residents in the Pearl River Delta (PRD) region in China. Blood samples from 53 infertile volunteers were studied for measures of semen quality and 16 PAHs. Information on the study subjects' living habits (such as smoking, drinking and preference of consumption for food) and general information (age, body-mass-index (BMI) and educational background) were also collected. Statistical results showed that age and BMI were significantly and negatively related to semen motilities. The total concentrations of PAHs (∑16 PAHs) in the blood were 12,010, 7493, 9105 and 8647ng/g for factory workers, office workers, technicians and salespersons, respectively. In addition, ∑16 PAHs in the blood of smokers, drinkers and heavy-taste food consumers were 11,950, 11,266 and 12,141ng/g, which were higher than those observed in nonsmokers (10,457ng/g), nondrinkers (10,920ng/g) and light-taste food consumers (9202ng/g), individually. Furthermore, the Pearson correlation analysis results showed significant positive correlations between BMI and ∑16 PAHs in the blood. Statistically significant correlations were observed between semen motilities and ∑16 PAHs in the blood as well. Logistic regression results showed that for each 1ng/g increase in ∑16 PAHs in blood samples, the log odds of experiencing a pregnancy decrease by 0.039 on average. However, more evidences are needed to clarify the impact of PAHs in the blood to male infertility.

  8. RELATION BETWEEN LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN DIFFERENT DISEASES

    Directory of Open Access Journals (Sweden)

    Rajith

    2014-11-01

    Full Text Available BACKGROUND: Atrial fibrillation is the most common cardiac dysrhythmia and left atrial size is an important factor in the development of atrial fibrillation. In the presence of atrial fibrillation an increase in left atrial size is associated with increased risk of stroke as well as increased morbidity and mortality. In this context, this study entitled “relation between left atrial size and atrial fibrillation in different diseases” was undertaken to study the left atrial size in different diseases causing atrial fibrillation and its relation to the atrial fibrillation. METHODS: A cross-sectional study was done from March 2004 to February 2006 in all medical units of Basaveshwar teaching and general hospital and Government general hospital Gulbarga. 70 cases of atrial fibrillation were studied in the present study. RESULTS: In the present study Atrial Fibrillation was common in >40 years age group (70%, left atrial enlargement was also more common in this age group (69.38%. Left atrial enlargement was seen in 70% of patients with Atrial Fibrillation. Rheumatic heart disease was the most common cause of Atrial Fibrillation (54.28% and left atrial enlargement was seen in 92% of these patients with mean left atrial size of 58.92 mm. Next most common cause was coronary artery disease (20% and left atrial enlargement was seen in 57.14% patients with a mean left atrial size of 39.5 mm. Left atrial size was normal in patients with thyrotoxicosis, congenital heart disease, lone Atrial Fibrillation and primary pulmonary hypertension. Left atrial enlargement was significantly associated with worsening of functional status (p<0.01, pulmonary arterial hypertension (p<0.005 and congestive cardial failure (p<0.02. 17.14% of patients with Atrial Fibrillation had embolic complications like stroke, of them left atrial enlargement was seen in 83.33% patients. 4.27% of patients with Atrial Fibrillation died during the hospital course, of them left atrial

  9. Blood lead concentrations in wild birds from a polluted mining region at Villa de La Paz, San Luis Potosi, Mexico.

    Science.gov (United States)

    Chapa-Vargas, Leonardo; Mejia-Saavedra, Jose J; Monzalvo-Santos, Karina; Puebla-Olivares, Fernando

    2010-01-01

    This investigation was undertaken to determine the concentrations of lead in bird blood samples from a mining region in central Mexico and to compare concentrations among several different feeding guilds. The study took place in the Mexican state of San Luis Potosi in a region known as "Villa de la Paz." This is one of the most intensely exploited mining regions in central Mexico and has been actively mined for over four centuries. Lead concentrations from bird blood samples taken from four polluted sites were significantly higher than those from a control, unpolluted site (F = 6.3, P birds from a highly polluted site were higher than those from a site that has intermediate pollution levels (P birds had significantly lower lead concentrations compared to granivores, frugivores-insectivores, and omnivores (F = 4.86, P = 0.004), and a large proportion of all individuals had blood lead concentrations indicative of low, sub-lethal toxic effects. Finally, in two polluted sites, remarkably small numbers of insectivore-frugivores, and granivores were trapped, and in one polluted site a large number of insectivores was trapped (X(2) = 29.9, P = 0.03), and no differences in proportions of migrants and non-migrants were found among sampling sites (X(2) = 0.6, P = 0.96). To date, it has not been determined to what extent constant exposure to these levels of pollution can influence health at the individual level, lifespan, and, therefore, population demography of birds from this region.

  10. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  11. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant

  12. Growth differentiation factor-15 (GDF-15), novel biomarker for assessing atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease.

    Science.gov (United States)

    Zhou, Yong-Ming; Li, Ming-Jiang; Zhou, Yan-Li; Ma, Le-Le; Yi, Xin

    2015-01-01

    Growth differentiation factor-15 (GDF-15) has been identified as a strong biomarker of cardiovascular diseases; however, no evidence are available concerning the relationship of GDF-15 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD). Twenty patients with rheumatic heart disease were divided into two groups, 10 cases with AF and 10 cases with sinus rhythm (SR). Clinical data and blood samples were collected; left atrial appendage was taken by the surgeon in the process of valve replacement. Masson stained sections and mRNA levels of cardiac fibrosis biomarkers were used to determine the level of cardiac fibrosis, the expression level of GDF-15 was evaluated via immunohistochemistry, enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR). Compared with SR group, more collagen deposited in the atrial tissue of AF group. The distribution of GDF-15 in the AF group was significantly higher than SR group (Pfibrosis. GDF-15 might involve in the development and maintenance of atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease, and GDF-15 could be used as a novel biomarker to evaluate myocardial fibrosis in the future.

  13. The internodal atrial myocardium.

    Science.gov (United States)

    Anderson, R H; Ho, S Y; Smith, A; Becker, A E

    1981-09-01

    The anatomical substrates of internodal conduction have long been a contentious topic. Debated first by the German Pathological Society in 1910, the consensus of established opinion for over half a century was that conduction between sinus and atrioventricular nodes occurred through plain myocardium. This was a conclusion supported by Truex in 1961. Despite his restatement of this fact in 1976, it has become fashionable to describe internodal conduction as being mediated by specialized internodal pathways. To reinvestigate this problem we studied 22 human fetal and 32 human infant hearts. In each case it was possible to cut the atrial tissues as a single block of tissue and to examine serial sections through the internodal myocardium. The sinus node, atrioventricular node, and segments of atrioventricular ring specialized tissue were recognized as specialized tissue using the light microscope in each heart. In contrast, there was nothing "special" about the myocardium between the nodes, nor was it possible to recognize tracts on the basis of either histological appearance or cellular architecture. It is concluded that, from the standpoint of light microscopy, there is no evidence whatsoever to support the purported concept of specialized anatomical substrates for internodal conduction.

  14. Epidemiological profile of hepatitis C in blood donors at the Uberaba Regional Blood Center Perfil epidemiológico para hepatite C em doadores de sangue do Hemocentro Regional de Uberaba

    Directory of Open Access Journals (Sweden)

    Fernanda Bernadelli Garcia

    2009-02-01

    Full Text Available The aim of the present study was to outline the serological profile of hepatitis C among blood donors seen at the Uberaba Regional Blood Center, Hemominas Foundation, over the last 14 years. The frequency of hepatitis C was compared between first-time and repeat donors and the epidemiological characteristics of those with positive and indeterminate ELISA anti-HCV (third and fourth generation were analyzed based on the donor histories kept in the archives of the Uberaba Regional Blood Center. The serological ineligibility rate was 0.3%, with higher prevalence in the group of first-time donors. We did not find any significant differences regarding age, skin color, marital status or place of residence between eligible and ineligible donors; however, the frequency of positive serology was higher among men. The lower (0.3% rate of ineligibility due to hepatitis C that was observed at the Uberaba Regional Blood Center, in relation to most Brazilian blood centers, is probably due to the large number of repeat donors (83.3%. This reinforces the importance of achieving donor commitment for increasing transfusion safety.O objetivo deste estudo foi traçar o perfil sorológico para a hepatite C nos doadores de sangue do Hemocentro Regional de Uberaba/Fundação Hemominas nos últimos 14 anos, comparando a sua ocorrência em doadores iniciais e de retorno e analisando as características epidemiológicas daqueles com ELISA anti-HCV (terceira e quarta geração positivo e indeterminado, a partir dos históricos dos doadores nos arquivos do Hemocentro Regional de Uberaba. A inaptidão sorológica encontrada foi de 0,3%, com maior ocorrência no grupo de doadores iniciais. Não encontramos diferenças significativas quanto à idade, cor da pele, estado civil e local de residência entre os aptos e os inaptos, porém a ocorrência de sorologia positiva foi maior nos homens. A menor prevalência de inaptidão para hepatite C (0,3% no Hemocentro Regional de

  15. Regional differences of PCB and PCQ concentrations in the blood and subcutaneous fat tissue of residents of Nagasaki.

    Science.gov (United States)

    Ohgami, T; Nonaka, S; Yamashita, K; Irifune, H; Watanabe, M; Tsukazaki, N; Tanaka, K; Yoshida, H; Rikioka, Y

    1989-05-01

    In this study, we analyzed PCB and PCQ concentrations in the subcutaneous fat tissue of residents of Nagasaki Prefecture, and compared these levels between the blood and subcutaneous fat tissue of people living in various parts of the prefecture. Seventy-one inhabitants were examined. In the blood, PCB concentrations in Tamanoura and Fukue were significantly higher than those in Nagasaki City. The CB% ratio in Tamanoura was significantly higher than that in Nagasaki and Isahaya. PCQ concentrations were below detection level except in one case. PCB concentrations in fishery areas showed higher levels than urban or agricultural areas. PCB concentration in the subcutaneous fat tissue was 100 times higher than that in the blood. PCQs could be detected in almost all of the subcutaneous tissues, but there was no regional difference in the PCQ concentration.

  16. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria

    Directory of Open Access Journals (Sweden)

    Daniel Roberto Coradi Freitas

    2014-12-01

    Full Text Available Objective:To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM.Methods:This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points, 'partially adequate' (from 50 to 80 points, or 'inadequate' (<50 points. The following components were evaluated: 'donor education' (5 points, 'clinical screening' (40 points, 'laboratory screening' (40 points and 'hemovigilance' (15 points.Results:The overall median score was 49.8 (minimum = 16; maximum = 78. Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum = 16; maximum = 32. The median laboratory screening score was 20 (minimum = 0; maximum = 32. Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria.Conclusion:Malaria is neglected as a blood–borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.

  17. Exercise increases blood flow to locomotor, vestibular, cardiorespiratory and visual regions of the brain in miniature swine

    Science.gov (United States)

    Delp, M. D.; Armstrong, R. B.; Godfrey, D. A.; Laughlin, M. H.; Ross, C. D.; Wilkerson, M. K.

    2001-01-01

    1. The purpose of these experiments was to use radiolabelled microspheres to measure blood flow distribution within the brain, and in particular to areas associated with motor function, maintenance of equilibrium, cardiorespiratory control, vision, hearing and smell, at rest and during exercise in miniature swine. Exercise consisted of steady-state treadmill running at intensities eliciting 70 and 100 % maximal oxygen consumption (V(O(2),max)). 2. Mean arterial pressure was elevated by 17 and 26 % above that at rest during exercise at 70 and 100 % V(O(2),max), respectively. 3. Mean brain blood flow increased 24 and 25 % at 70 and 100 % V(O(2),max), respectively. Blood flow was not locally elevated to cortical regions associated with motor and somatosensory functions during exercise, but was increased to several subcortical areas that are involved in the control of locomotion. 4. Exercise elevated perfusion and diminished vascular resistance in several regions of the brain related to the maintenance of equilibrium (vestibular nuclear area, cerebellar ventral vermis and floccular lobe), cardiorespiratory control (medulla and pons), and vision (dorsal occipital cortex, superior colliculi and lateral geniculate body). Conversely, blood flow to regions related to hearing (cochlear nuclei, inferior colliculi and temporal cortex) and smell (olfactory bulbs and rhinencephalon) were unaltered by exercise and associated with increases in vascular resistance. 5. The data indicate that blood flow increases as a function of exercise intensity to several areas of the brain associated with integrating sensory input and motor output (anterior and dorsal cerebellar vermis) and the maintenance of equilibrium (vestibular nuclei). Additionally, there was an intensity-dependent decrease of vascular resistance in the dorsal cerebellar vermis.

  18. Exercise increases blood flow to locomotor, vestibular, cardiorespiratory and visual regions of the brain in miniature swine

    Science.gov (United States)

    Delp, M. D.; Armstrong, R. B.; Godfrey, D. A.; Laughlin, M. H.; Ross, C. D.; Wilkerson, M. K.

    2001-01-01

    1. The purpose of these experiments was to use radiolabelled microspheres to measure blood flow distribution within the brain, and in particular to areas associated with motor function, maintenance of equilibrium, cardiorespiratory control, vision, hearing and smell, at rest and during exercise in miniature swine. Exercise consisted of steady-state treadmill running at intensities eliciting 70 and 100 % maximal oxygen consumption (V(O(2),max)). 2. Mean arterial pressure was elevated by 17 and 26 % above that at rest during exercise at 70 and 100 % V(O(2),max), respectively. 3. Mean brain blood flow increased 24 and 25 % at 70 and 100 % V(O(2),max), respectively. Blood flow was not locally elevated to cortical regions associated with motor and somatosensory functions during exercise, but was increased to several subcortical areas that are involved in the control of locomotion. 4. Exercise elevated perfusion and diminished vascular resistance in several regions of the brain related to the maintenance of equilibrium (vestibular nuclear area, cerebellar ventral vermis and floccular lobe), cardiorespiratory control (medulla and pons), and vision (dorsal occipital cortex, superior colliculi and lateral geniculate body). Conversely, blood flow to regions related to hearing (cochlear nuclei, inferior colliculi and temporal cortex) and smell (olfactory bulbs and rhinencephalon) were unaltered by exercise and associated with increases in vascular resistance. 5. The data indicate that blood flow increases as a function of exercise intensity to several areas of the brain associated with integrating sensory input and motor output (anterior and dorsal cerebellar vermis) and the maintenance of equilibrium (vestibular nuclei). Additionally, there was an intensity-dependent decrease of vascular resistance in the dorsal cerebellar vermis.

  19. The effects of epinine on arterial blood pressure and regional vascular resistances in anesthetized rats.

    Science.gov (United States)

    Martínez-Mir, I; Palop, V; Morales-Olivas, F J; Estañ, L; Rubio, E

    1998-07-01

    1. We carried out experiments in anesthetized rats to study the hemodynamic effects of intravenous injections of epinine. 2. Epinine (1-320 micrograms/kg) produced a biphasic effect on mean arterial blood pressure (n = 30). At doses lower than 40 micrograms/kg, arterial blood pressure decreased (by as much as 21.5 +/- 3.4%), though at higher doses it increased dose dependently (by as much as 73.2 +/- 14.5%). Epinine also produced bradicardia in a dose-dependent manner (by as much as 26.4 +/- 4.9%). Sulpiride (100 micrograms/kg) suppressed the hypotensive effect of epinine but did not change the hypertensive effect. In the presence of prazosin (1,000 micrograms/kg), arterial blood pressure remained significantly decreased at all doses of epinine. Neither sulpiride nor prazosin changed the bradycardic effect of epinine. 3. Prazosin produced a significant decrease in renal vascular resistance. Epinine (5 micrograms/kg) after prazosin reverted the effects of prazosin in renal vascular resistance, without any significant modification in the renal blood flows. However, 20 micrograms/kg epinine increased the renal vascular resistances and, moreover, produced a significant decrease in the blood flows of both kidneys. Neither prazosin nor epinine produced modifications in the intestinal vascular bed. 4. Although epinine possesses significant dopamine and alpha-adrenergic activities that are involved in the biphasic effect of the agent on mean arterial blood pressure in anesthetized rats, in the presence of prazosin, it is not possible to manifest dopaminergic activity involved in the increase in renal or mesenteric blood flow; this may be due to the low tone of the vascular wall induced by the alpha-adrenergic antagonist, though an alpha 2-activity cannot be discarded.

  20. Regulation of peripheral blood flow in Complex Regional Pain Syndrome: clinical implication for symptomatic relief and pain management

    OpenAIRE

    2009-01-01

    Abstract Background During the chronic stage of Complex Regional Pain Syndrome (CRPS), impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. Discussion The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropa...

  1. Relation between regional distribution of /sup 201/Tl and myocardial blood flow in normal, acutely ischemic, and infarcted myocardium

    Energy Technology Data Exchange (ETDEWEB)

    Chu, A.; Murdock, R.H. Jr.; Cobb, F.R.

    1982-11-01

    Myocardial localization of /sup 201/Tl was compared with direct measurements of myocardial perfusion in normal, acutely ischemic, and recently infarcted myocardium. Studies were performed in 6 chronically instrumented dogs that were subjected to myocardial infarction by occlusion of the proximal left circumflex coronary artery. Four days after myocardial infarction, /sup 201/Tl and 9 +/- 1 micrometer /sup 95/Nb-labelled microspheres were injected simultaneously after acute left anterior descending coronary arterial occlusion; the animals were killed 5 minutes later and the entire left ventricle was sectioned into 1 to 2 g samples. Regression analyses between /sup 201/Tl activity and regional myocardial blood flow using all myocardial samples demonstrated a very close linear relation in each dog; r values were 0.98 or greater, indicating that the initial localization of /sup 201/Tl in acutely ischemic and recently infarcted myocardium as a function of regional blood flow was essentially identical. Consequently, in each dog the regional distribution of /sup 201/Tl closely approximated myocardial perfusion over a wide range of blood flow and potentially different local metabolic conditions that may be encountered in the clinical use of the isotope.

  2. Atrial Electrogram Fractionation Distribution before and after Pulmonary Vein Isolation in Human Persistent Atrial Fibrillation—A Retrospective Multivariate Statistical Analysis

    Science.gov (United States)

    Almeida, Tiago P.; Chu, Gavin S.; Li, Xin; Dastagir, Nawshin; Tuan, Jiun H.; Stafford, Peter J.; Schlindwein, Fernando S.; Ng, G. André

    2017-01-01

    Purpose: Complex fractionated atrial electrograms (CFAE)-guided ablation after pulmonary vein isolation (PVI) has been used for persistent atrial fibrillation (persAF) therapy. This strategy has shown suboptimal outcomes due to, among other factors, undetected changes in the atrial tissue following PVI. In the present work, we investigate CFAE distribution before and after PVI in patients with persAF using a multivariate statistical model. Methods: 207 pairs of atrial electrograms (AEGs) were collected before and after PVI respectively, from corresponding LA regions in 18 persAF patients. Twelve attributes were measured from the AEGs, before and after PVI. Statistical models based on multivariate analysis of variance (MANOVA) and linear discriminant analysis (LDA) have been used to characterize the atrial regions and AEGs. Results: PVI significantly reduced CFAEs in the LA (70 vs. 40%; P PVI that remained fractionated after PVI (31% of the collected points); (ii) fractionated that converted to normal (39%); (iii) normal prior to PVI that became fractionated (9%) and; (iv) normal that remained normal (21%). Individually, the attributes failed to distinguish these LA regions, but multivariate statistical models were effective in their discrimination (P PVI, while others are affected by it. Although, traditional methods were unable to identify these different regions, the proposed multivariate statistical model discriminated LA regions resistant to PVI from those affected by it without prior ablation information. PMID:28883795

  3. Atrial fibrillation and delayed gastric emptying.

    Directory of Open Access Journals (Sweden)

    Isadora C Botwinick

    Full Text Available BACKGROUND: Atrial fibrillation and delayed gastric emptying (DGE are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7(th postoperative day. METHODS: We performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables. RESULTS: Approximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p = 0.0005. Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p = 0.03. 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p = 0.0007. This association held true when controlling for age. CONCLUSION: Patients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.

  4. Lumbar Discectomy of a Patient of Mitral Stenosis with Chronic Atrial Fibrillation Under Epidural Anaesthesia

    Directory of Open Access Journals (Sweden)

    Vinaya R Kulkarni

    2008-01-01

    Full Text Available A 60-year-old female patient posted for discectomy of lumbar region L 3 -L 4 was accidently diagnosed to have chronic atrial fibrillation of rheumatic aetiology.This is a case report of this patient of critical mitral stenosis with mild mitral regurgitation with chronic atrial fibrillation managed successfully under lower thoracic epidural anaesthesia,in prone position without any compli-cation.

  5. Effects of striatal nitric oxide production on regional cerebral blood flow and seizure development in rats exposed to extreme hyperoxia.

    Science.gov (United States)

    Gasier, Heath G; Demchenko, Ivan T; Allen, Barry W; Piantadosi, Claude A

    2015-12-01

    The endogenous vasodilator and signaling molecule nitric oxide has been implicated in cerebral hyperemia, sympathoexcitation, and seizures induced by hyperbaric oxygen (HBO2) at or above 3 atmospheres absolute (ATA). It is unknown whether these events in the onset of central nervous system oxygen toxicity originate within specific brain structures and whether blood flow is diverted to the brain from peripheral organs with high basal flow, such as the kidney. To explore these questions, total and regional cerebral blood flow (CBF) were measured in brain structures of the central autonomic network in anesthetized rats in HBO2 at 6 ATA. Electroencephalogram (EEG) recordings, cardiovascular hemodynamics, and renal blood flow (RBF) were also monitored. As expected, mean arterial blood pressure and total and regional CBF increased preceding EEG spikes while RBF was unaltered. Of the brain structures examined, the earliest rise in CBF occurred in the striatum, suggesting increased neuronal activation. Continuous unilateral or bilateral striatal infusion of the nitric oxide synthase inhibitor N(ω)-nitro-L-arginine methyl ester attenuated CBF responses in that structure, but global EEG discharges persisted and did not differ from controls. Our novel findings indicate that: 1) cerebral hyperemia in extreme HBO2 in rats does not occur at the expense of renal perfusion, highlighting the remarkable autoregulatory capability of the kidney, and 2) in spite of a sentinel increase in striatal blood flow, additional brain structure(s) likely govern the pathogenesis of HBO2-induced seizures because EEG discharge latency was unchanged by local blockade of striatal nitric oxide production and concomitant hyperemia.

  6. Molecular identification of blood source animals from black flies (Diptera: Simuliidae) collected in the alpine regions of Japan.

    Science.gov (United States)

    Imura, Takayuki; Sato, Yukita; Ejiri, Hiroko; Tamada, Asumi; Isawa, Haruhiko; Sawabe, Kyoko; Omori, Sumie; Murata, Koichi; Yukawa, Masayoshi

    2010-01-01

    One of vector-borne avian protozoa, Leucocytozoon lovati, has been found in the Japanese rock ptarmigans (Lagopus mutus japonicus), the endangered bird species distributed in the alpine regions in Japan. Vector arthropod species of L. lovati has also been estimated as Simuliidae black flies distributed in the same habitat of the host bird, however, possible blood meals of the black flies were not identified yet. To reveal host animals of black flies, we estimated the blood resources by using molecular techniques. Black flies were collected at Mt. Chogatake, one of the alpine regions of Japan in which Japanese rock ptarmigans live in June 2005. The analyzed 144 specimens were morphologically identified into five species including Simulium japonicum (n = 87), Prosimulium hirtipes (n = 48), Prosimulium yezoense (n = 3), Twinnia japonensis (n = 3), and Cnephia mutata (n = 3). Individually extracted DNA from the black flies was subjected to polymerase chain reaction (PCR) amplification targeting the partial mitochondrial cytochrome b gene of birds or mammals to identify the blood meals. Of 144 black flies examined, 34 specimens were PCR positive for avian hosts (23.6%). No mammalian-derived bloods were detected from the samples studied through. Sequences amplified from 11 black flies consist of S. japonicum, P. hirtipes, and C. mutata showed high similarity to that of the Japanese rock ptarmigan. Therefore, present results conclusively suggest that these three species of black flies might suck the bloods of Japanese rock ptarmigans and could be the vector for L. lovati infection among this endangered bird species of Japan.

  7. Slow conduction in the border zones of patchy fibrosis stabilises the drivers for atrial fibrillation: Insights from multi-scale human atrial modelling

    Directory of Open Access Journals (Sweden)

    Ross Morgan

    2016-10-01

    Full Text Available Introduction. The genesis of atrial fibrillation (AF and success of AF ablation therapy have been strongly linked with atrial fibrosis. Increasing evidence suggests that patient-specific distributions of fibrosis may determine the locations of electrical drivers (rotors sustaining AF, but the underlying mechanisms are incompletely understood. This study aims to elucidate a missing mechanistic link between patient-specific fibrosis distributions and AF drivers. Methods. 3D atrial models integrated human atrial geometry, rule-based fibre orientation, region-specific electrophysiology and AF-induced ionic remodelling. A novel detailed model for an atrial fibroblast was developed, and effects of myocyte-fibroblast (M-F coupling were explored at single-cell, 1D tissue and 3D atria levels. Left atrial LGE MRI datasets from 3 chronic AF patients were segmented to provide the patient-specific distributions of fibrosis. The data was non-linearly registered and mapped to the 3D atria model. Six distinctive fibrosis levels (0 – healthy tissue, 5 – dense fibrosis were identified based on LGE MRI intensity and modelled as progressively increasing M-F coupling and decreasing atrial tissue coupling. Uniform 3D atrial model with diffuse (level 2 fibrosis was considered for comparison.Results. In single cells and tissue, the largest effect of atrial M-F coupling was on the myocyte resting membrane potential, leading to partial inactivation of sodium current and reduction of conduction velocity (CV. In the 3D atria, further to the M-F coupling, effects of fibrosis on tissue coupling greatly reduce atrial CV. AF was initiated by fast pacing in each 3D model with either uniform or patient-specific fibrosis. High variation in fibrosis distributions between the models resulted in varying complexity of AF, with several drivers emerging. In the diffuse fibrosis models, waves randomly meandered through the atria, whereas in each the patient-specific models, rotors

  8. Pediatric blood transfusion practices at a regional referral hospital in Kenya.

    Science.gov (United States)

    Nabwera, Helen M; Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W

    2016-11-01

    Severe anemia in children is a major public health problem in sub-Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. This was an observational study where over a 2-year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6-6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4-12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2-9.1 g/dL). Ninety-four percent (186) were transfused "appropriately" while 52% (120) were transfused "inappropriately." There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p practice. © 2016 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  9. Association of gene polymorphisms in ABO blood group chromosomal regions and menstrual disorders.

    Science.gov (United States)

    Su, Yong; Kong, Gui-Lian; Su, Ya-Li; Zhou, Yan; Lv, Li-Fang; Wang, Qiong; Huang, Bao-Ping; Zheng, Rui-Zhi; Li, Quan-Zhong; Yuan, Hui-Juan; Zhao, Zhi-Gang

    2015-06-01

    This study aimed to investigate whether single nucleotide polymorphisms (SNPs) located near the gene of the ABO blood group play an important role in the genetic aetiology of menstrual disorders (MDs). Polymerase chain reaction-ligase detection reaction technology was used to detect eight SNPs near the ABO gene location on the chromosomes in 250 cases of MD and 250 cases of normal menstruation. The differences in the distribution of each genotype, as well as the allele frequency in the normal and control groups, were analysed using Pearson's χ(2) test to search for disease-associated loci. SHEsis software was used to analyse the linkage disequilibrium and haplotype frequencies and to inspect the correlation between haplotypes and the disease. Compared with the control group, the experimental group exhibited statistically significant differences in the genotype distribution frequencies of the rs657152 locus of the ABO blood group gene and the rs17250673 locus of the tumour necrosis factor cofactor 2 (TRAF2) gene, which is located downstream of the ABO gene. The allele distribution frequencies of rs657152 and rs495828 loci in the ABO blood group gene exhibited significant differences between the groups. Dominant and recessive genetic model analysis of each locus revealed that the experimental group exhibited statistically significant differences from the control group in the genotype distribution frequencies of rs657152 and rs495828 loci, respectively. These results indicate that the ABO blood group gene and TRAF2 gene may be a cause of MDs.

  10. Regional variations in nocturnal fluctuations in subcutaneous blood flow rate in the lower leg of man

    DEFF Research Database (Denmark)

    Sindrup, J H; Kastrup, J; Jørgensen, B

    1991-01-01

    aspect of the right lower leg of normal human subjects. In the present study subcutaneous adipose tissue blood flow rates were measured simultaneously in the right and left lower legs of 16 normal human subjects over 12-20 h ambulatory conditions. The 133Xe wash-out technique, portable CdTe(Cl) detectors...

  11. Delayed Treatment with Sodium Hydrosulfide Improves Regional Blood Flow and Alleviates Cecal Ligation and Puncture (CLP)-Induced Septic Shock.

    Science.gov (United States)

    Ahmad, Akbar; Druzhyna, Nadiya; Szabo, Csaba

    2016-08-01

    Cecal ligation and puncture (CLP)-induced sepsis is a serious medical condition, caused by a severe systemic infection resulting in a systemic inflammatory response. Recent studies have suggested the therapeutic potential of donors of hydrogen sulfide (H2S), a novel endogenous gasotransmitter and biological mediator in various diseases. The aim of the present study was to assess the effect of H2S supplementation in sepsis, with special reference to its effect on the modulation of regional blood flow. We infused sodium hydrosulfide (NaHS), a compound that produces H2S in aqueous solution (1, 3, or 10 mg/kg/h, for 1 h at each dose level) in control rats or rats 24 h after CLP, and measured blood flow using fluorescent microspheres. In normal control animals, NaHS induced a characteristic redistribution of blood flow, and reduced cardiac, hepatic, and renal blood flow in a dose-dependent fashion. In contrast, in rats subjected to CLP, cardiac, hepatic, and renal blood flow was significantly reduced; infusion of NaHS (1 mg/kg/h and 3 mg/kg/h) significantly increased organ blood flow. In other words, the effect of H2S on regional blood flow is dependent on the status of the animals (i.e., a decrease in blood flow in normal controls, but an increase in blood flow in CLP). We have also evaluated the effect of delayed treatment with NaHS on organ dysfunction and the inflammatory response by treating the animals with NaHS (3 mg/kg) intraperitoneally (i.p.) at 24 h after the start of the CLP procedure; plasma levels of various cytokines and tissue indicators of inflammatory cell infiltration and oxidative stress were measured 6 h later. After 24 h of CLP, glomerular function was significantly impaired, as evidenced by markedly increased (over 4-fold over baseline) blood urea nitrogen and creatinine levels; this increase was also significantly reduced by treatment with NaHS. NaHS also attenuated the CLP-induced increases in malondialdehyde levels (an index of

  12. Quantitation of the regional blood flow in the interventricular septum using positron emission tomography and nitrogen-13 ammonia

    Energy Technology Data Exchange (ETDEWEB)

    Hove, Jens D. [The Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen (Denmark); Cardiovascular PET Research Unit, Section 9201, Medical Department B, The Heart Center, Rigshospitalet, Juliane Mariesvej 24, 2100 Copenhagen (Denmark); Gambhir, Sanjiv S. [Crump Institute for Molecular Imaging, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, California (United States); Kofoed, Klaus F.; Freiberg, Jacob; Kelbaek, Henning [The Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen (Denmark)

    2003-01-01

    The purpose of the present study was to evaluate the effect of spillover of activity from the right ventricle (RV) on quantitation of the regional myocardial blood flow in the septum. Thirty-one healthy volunteers, 31 patients with ischemic heart disease, 7 patients with severe congestive heart failure, and 6 heart transplant patients underwent positron emission tomography (PET) with nitrogen-13 ammonia. Quantitation of the regional myocardial blood flow in the septum was performed using both a conventional two-compartment model and a previously validated two-compartment model taking RV spillover into account. Unaccounted RV spillover resulted in significant underestimation of the regional myocardial blood flow in the septum. The amount of underestimation was primarily dependent on the magnitude of spillover and the dispersion between the right and the left ventricular input functions. In healthy volunteers, the flow error was small but significant: on average 6% (range 5%-29%, P<0.00001), compared with 27% (range 0%-88%, P<0.002) in the group of patients with severe congestive heart failure, who had the most considerable amount of RV spillover. In the group of patients with ischemic heart disease and the group of heart transplant patients the flow errors were 10% (range 0%-55%, P<0.00001) and 6% (range 1%-19%, P<0.01), respectively. It is concluded that flow quantitation in the septum is significantly affected by RV spillover, resulting in a considerable underestimation of the septal blood flow unless correction is performed. (orig.)

  13. [New antithrombotics for atrial fibrillation].

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2011-01-01

    Cerebral infarction is the most serious complication of atrial fibrillation. Coumarin derivatives (vitamin K antagonists) counteract systemic thromboembolism and reduce the risk of stroke by more than 60%, but carry a risk of serious bleeding. Antiplatelet therapy and subcutaneous low-molecular-weig

  14. Radiofrequency ablation of atrial fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Tan, ES; Van Veldhuisen, DJ; Crijns, HJGM; Van Gelder, IC

    2004-01-01

    Twenty-five patients (16 males, mean age 46 years.) underwent radiofrequency ablation because of either paroxysmal (13 patients) or persistent atrial fibrillation (12 patients). Ablation aimed at earliest activation of spontaneous and catheter-induced repetitive ectopy in left and right atria and ap

  15. Genetic basis of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Oscar Campuzano

    2016-12-01

    Full Text Available Atrial fibrillation is the most common sustained arrhythmia and remains as one of main challenges in current clinical practice. The disease may be induced secondary to other diseases such as hypertension, valvular heart disease, and heart failure, conferring an increased risk of stroke and sudden death. Epidemiological studies have provided evidence that genetic factors play an important role and up to 30% of clinically diagnosed patients may have a family history of atrial fibrillation. To date, several rare variants have been identified in a wide range of genes associated with ionic channels, calcium handling protein, fibrosis, conduction and inflammation. Important advances in clinical, genetic and molecular basis have been performed over the last decade, improving diagnosis and treatment. However, the genetics of atrial fibrillation is complex and pathophysiological data remains still unraveling. A better understanding of the genetic basis will induce accurate risk stratification and personalized clinical treatment. In this review, we have focused on current genetics basis of atrial fibrillation.

  16. Facts about Atrial Septal Defect

    Science.gov (United States)

    ... Living With Heart Defects Data & Statistics Tracking & Research Articles & Key Findings Free Materials Multimedia and Tools Links to Other Websites Information For... Media Policy Makers Facts about Atrial Septal Defect Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  17. Personalized management of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne

    2013-01-01

    The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to de...

  18. Regional cerebral blood flow pattern in normal young and aged volunteers: a {sup 99m}Tc-HMPAO SPET study

    Energy Technology Data Exchange (ETDEWEB)

    Catafau, A.M. [Dept. of Nuclear Medicine, Hospital Clinic, Univ. of Barcelona (Spain); Lomena, J. [Dept. of Nuclear Medicine, Hospital Clinic, Univ. of Barcelona (Spain); Pavia, J. [Dept. of Nuclear Medicine, Hospital Clinic, Univ. of Barcelona (Spain); Parellada, E. [Dept. of Psychiatry, Hospital Clinic, Univ. of Barcelona (Spain); Bernardo, M. [Dept. of Psychiatry, Hospital Clinic, Univ. of Barcelona (Spain); Setoain, J. [Dept. of Nuclear Medicine, Hospital Clinic, Univ. of Barcelona (Spain); Tolosa, E. [Dept. of Neurology, Hospital Clinic, Univ. of Barcelona (Spain)

    1996-10-01

    The aim of this study was to investigate the normal pattern of regional cerebral blood flow (rCBF) distribution in normal young and aged volunteers using technetium-99m hexamethylpropylene amine oxime ({sup 99m}-Tc-HMPAO) as a tracer. The region brain perfusion of young and aged subjects was compared, especially regarding rCBF differences due to age and gender, and interhemispheric rCBF asymmetries. Sixty-eight right-handed normal volunteers - 40 young (mean age 29.5{+-}6.3 years) and 28 aged (mean age 71.2{+-}4.3 years) - were included in the study. rCBF was estimated on the basis of a semiquantitative approach by means of a left-right index and two region/reference ratios, using the cerebellum and the whole brain activity as references. A good correlation between these two region/reference ratios was found (P<0.005 in all cerebral regions). The highest rCBF ratios corresponded to the cerebellum, followed by the occipital lobe. The remaining cortical regions (temporal, parietal, frontal and basal ganglia) showed slightly lower values. The white matter showed rCBF ratios substantially lower than the grey matter. In neighter young nor aged subjects were significant rCBF differences between the genders found in any of the two region/reference indices employed. Aged sugjects showed significantly lower rCBF ratios than young subjects in the left frontal lobe and in the posterior region of the left temporal lobe. In both young and aged subjects, lower perfusion was found in the left hemisphere, except for the white matter region in both age groups and the frontal lobe in the young subjects. Aged subjects presented a slightly higher interhemispheric asymmetry in the frontal lobe. However, interhemispheric asymmetry was minimal (-1.01% to 3.14%). Consequently, a symmetrical rCBF distribution can be assumed between homologous regions, independent of age. (orig.)

  19. Plasma Vitamin E and Blood Selenium Concentrations in Norwegian Dairy Cows: Regional Differences and Relations to Feeding and Health

    Directory of Open Access Journals (Sweden)

    Sivertsen T

    2006-12-01

    Full Text Available Plasma α-tocopherol (vit E and blood selenium (Se concentrations in February were determined in samples from 314 dairy cows in Norway, selected to provide a representative subset of the Norwegian dairy cow population. Each sample was followed by a questionnaire with information about feeding of the cow at the time of sampling. The results were correlated to herd data and to calving and health data for each cow from the Norwegian Dairy Herd Recording System and the Norwegian Cattle Health Recording System. The mean concentrations were 6.9 μg vit E per ml plasma and 0.16 μg Se per g blood. Both levels were highest in mid lactation. Plasma vit E varied with the amount of silage fed to the cow, while blood Se varied with the amount of concentrates and mineral supplements, and with geographical region. No differences in vit E or Se levels were found between cows with recorded treatments for mastitis, parturient paresis or reproductive disorders in the lactation during or immediately prior to sampling, and those without such treatments. For ketosis, a small difference in blood Se was found between the groups with or without recorded treatments. It is concluded that winter-fed lactating cows in Norway had an adequate plasma level of vit E and a marginal-to-adequate level of Se.

  20. Plasma Vitamin E and Blood Selenium Concentrations in Norwegian Dairy Cows: Regional Differences and Relations to Feeding and Health

    Directory of Open Access Journals (Sweden)

    Østerås O

    2005-12-01

    Full Text Available Plasma α-tocopherol (vit E and blood selenium (Se concentrations in February were determined in samples from 314 dairy cows in Norway, selected to provide a representative subset of the Norwegian dairy cow population. Each sample was followed by a questionnaire with information about feeding of the cow at the time of sampling. The results were correlated to herd data and to calving and health data for each cow from the Norwegian Dairy Herd Recording System and the Norwegian Cattle Health Recording System. The mean concentrations were 6.9 μg vit E per ml plasma and 0.16 μg Se per g blood. Both levels were highest in mid lactation. Plasma vit E varied with the amount of silage fed to the cow, while blood Se varied with the amount of concentrates and mineral supplements, and with geographical region. No differences in vit E or Se levels were found between cows with recorded treatments for mastitis, parturient paresis or reproductive disorders in the lactation during or immediately prior to sampling, and those without such treatments. For ketosis, a small difference in blood Se was found between the groups with or without recorded treatments. It is concluded that winter-fed lactating cows in Norway had an adequate plasma level of vit E and a marginal-to-adequate level of Se.

  1. Atrial secretion of B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Goetze, Jens Peter; Friis-Hansen, Lennart; Rehfeld, Jens F

    2006-01-01

    In the normal heart, the endocrine capacity resides in the atria. Atrial myocytes express and secrete natriuretic hormones that regulate fluid homeostasis and blood pressure. But in ventricular disease, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression is also...... understanding of the endocrine atria during ventricular dysfunction is still scarce. Although ventricular disease and increased circulating concentrations are associated, it does not entail that the ventricle is the sole or even the main source in all types of heart disease. Clearly, the endocrine atria...... are also active in heart failure. Plasma measurement of cardiac natriuretic peptides and their molecular precursors can perhaps help us to discriminate when, where and how....

  2. Cluster headache: transcranial Doppler ultrasound and regional cerebral blood flow studies

    Energy Technology Data Exchange (ETDEWEB)

    Dahl, A.; Russell, D.; Nyberg-Hansen, R.; Rootwelt, K. (Rikshospitalet, Oslo (Norway))

    1990-04-01

    Transcranial Doppler and rCBF examinations were carried out in 25 cluster headache patients. Spontaneous glyceryl trinitrate (nitroglycerin) provoked attacks were accompanied by a bilateral decrease in middle cerebral artery blood flow velocities. This decrease was more pronounced on the symptomatic side, but the difference did not reach statistical significance. Mean hemispheric blood flow and rCBF were within normal limits during provoked attacks and similar to those found when patients were attack-free. During cluster periods middle cerebral artery velocities were significantly higher on the symptomatic side. Glyceryl trinitrate caused a bilateral middle cerebral artery velocity decrease which was significantly greater on the symptomatic side. Attacks provoked by glyceryl trinitrate appeared to begin when the vasodilatory effect of this substance was received. 17 refs., 2 figs., 5 tabs.

  3. Hybrid model of arm for analysis of regional blood oxygenation in non-invasive optical diagnostics

    Science.gov (United States)

    Nowocień, Sylwester; Mroczka, Janusz

    2017-06-01

    The paper presents a new comprehensive approach to modeling and analysis of processes occurring during the blood flow in the arm's small vessels as well as non-invasive measurement method of mixed venous oxygen saturation. During the work, a meta-analysis of available physiological data was performed and based on its result a hybrid model of forearm vascular tree was proposed. The model, in its structure, takes into account a classical nonlinear hydro-electric analogy in conjunction with light-tissue interaction. Several geometries of arm vascular tree obtained from magnetic resonance angiography (MRA) image were analyzed which allowed to proposed the structure of electrical analog network. Proposed model allows to simulate the behavior of forearm blood flow from the vascular tree mechanics point of view, as well as effects of the impact of cuff and vessel wall mechanics on the recorded photoplethysmographic signals. In particular, it allows to analyze the reaction and anatomical effects in small vessels and microcirculation caused by occlusive maneuver in selected techniques, what was of particular interest to authors and motivation to undertake research in this area. Preliminary studies using proposed model showed that inappropriate selection of occlusion maneuver parameters (e.g. occlusion time, cuff pressure etc.), cause dangerous turbulence of blood flow in the venous section of the vascular tree.

  4. [Atrial fibrillation and cognitive function].

    Science.gov (United States)

    Duron, Emmanuelle; Hanon, Olivier

    2010-09-01

    Atrial fibrillation (AF), which prevalence increases with age, is a growing public health problem and a well known risk factor for stroke. On the other hand, dementia is one of the most important neurological disorders in the elderly, and with aging of the population in developed countries, the number of demented patients will increase in absence of prevention. In the past decade, several vascular risk factors (hypertension, obesity and metabolic syndrome, hypercholesterolemia) have been found, with various degree of evidence, to be associated with vascular dementia but also, surprisingly, with Alzheimer's disease. This review is devoted to the links between atrial fibrillation, cognitive decline and dementia. Globally, transversal studies showed a significant association between atrial fibrillation, cognitive decline and dementia. However, these studies are particularly sensitive to various biases. In this context, recent longitudinal studies of higher level of evidence have been conducted to assess the link between AF and dementia. One study disclosed a high incidence of dementia among patients suffering from atrial fibrillation during a 4.6 years follow-up. Similarly another study showed that atrial fibrillation was significantly associated with conversion from mild cognitive impairment to dementia during a 3 years follow-up. Nevertheless two other longitudinal studies did not find any significant association between AF and dementia, but this discrepancy should be interpreted taking into account that the comparability of all these studies is moderate because they were using different methodologies (population, cognitive testing, and mean follow-up). Possible explanatory mechanisms for the association between AF and the risk of dementia are proposed, such as thrombo-embolic ischemic damage and cerebral hypo perfusion due to fluctuations in the cardiac output. Thus, there is some evidence that FA could be associated with cognitive decline and dementia but this

  5. Evaluation of New Diagnostic Biomarkers in Pediatric Sepsis: Matrix Metalloproteinase-9, Tissue Inhibitor of Metalloproteinase-1, Mid-Regional Pro-Atrial Natriuretic Peptide, and Adipocyte Fatty-Acid Binding Protein.

    Directory of Open Access Journals (Sweden)

    Mashael F Alqahtani

    Full Text Available Elevated plasma concentrations of matrix metalloproteinase-9 (MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1, mid-regional pro-atrial natriuretic peptide (mrProANP, and adipocyte fatty-acid-binding proteins (A-FaBPs have been investigated as biomarkers for sepsis or detection of acute neurological injuries in adults, but not children. We carried out a single-center, prospective observational study to determine if these measures could serve as biomarkers to identify children with sepsis. A secondary aim was to determine if these biomarkers could identify children with neurologic complications of sepsis. A total of 90 patients ≤ 18 years-old were included in this study. 30 with severe sepsis or septic shock were compared to 30 age-matched febrile and 30 age-matched healthy controls. Serial measurements of each biomarker were obtained, beginning on day 1 of ICU admission. In septic patients, MMP9-/TIMP-1 ratios (Median, IQR, n were reduced on day 1 (0.024, 0.004-0.174, 13, day 2 (0.020, 0.002-0.109, 10, and day 3 (0.018, 0.003-0.058, 23 compared with febrile (0.705, 0.187-1.778, 22 and healthy (0.7, 0.4-1.2, 29 (p< 0.05 controls. A-FaBP and mrProANP (Median, IQR ng/mL, n were elevated in septic patients compared to control groups on first 2 days after admission to the PICU (p <0.05. The area under the curve (AUC for MMP-9/TIMP-1 ratio, mrProANP, and A-FaBP to distinguish septic patients from healthy controls were 0.96, 0.99, and 0.76, respectively. MMP-9/TIMP-1 ratio was inversely and mrProANP was directly related to PIM-2, PELOD, and ICU and hospital LOS (p<0.05. A-FaBP level was associated with PELOD, hospital and ICU length of stay (p<0.05. MMP-9/TIMP-1 ratio associated with poor Glasgow Outcome Score (p<0.05. A-FaBP levels in septic patients with neurological dysfunction (29.3, 17.2-54.6, 7 were significantly increased compared to septic patients without neurological dysfunction (14.6, 13.3-20.6, 11. MMP-9/TIMP-1 ratios were

  6. Human regional cerebral blood flow during rapid-eye-movement sleep

    DEFF Research Database (Denmark)

    Madsen, P L; Holm, S; Vorstrup, S;

    1991-01-01

    Owing to the coupling between CBF and neuronal activity, regional CBF is a reflection of neural activity in different brain regions. In this study we measured regional CBF during polysomnographically well-defined rapid-eye-movement (REM) sleep by the use of single photon emission computerized...... tomography and the new tracer 99mTc-dl-hexamethylpropyleneamine. Eleven healthy volunteers aged between 22 and 27 years were studied. CBF was measured on separate nights during REM sleep and during EEG-verified wakefulness. On awakening from REM sleep, all subjects reported visual dreams. During REM sleep...

  7. Candida species distribution and fluconazole susceptibility of blood isolates at a regional hospital in Passo Fundo, RS, Brazil

    Directory of Open Access Journals (Sweden)

    Maira Giseli C. Silva

    2015-06-01

    Full Text Available ABSTRACT Introduction: Candidemia is a bloodstream infection produced by Candida genus yeasts. Objective: The purpose of this study was to characterize the epidemiology and the fluconazole susceptibility in Candida species isolated from patients at a regional hospital in Passo Fundo, RS. Methods: Records from the laboratory were used to identify patients with positive blood cultures for Candida between 2010 and 2011. The in vitro activity of fluconazole was determined using the disk diffusion method. Results: Were analyzed 24 positive blood cultures for Candida and found a 54.16% mortality rate. C. albicans was the most prevalent species, followed by C. parapsilosis and C. krusei. For susceptibility to fluconazole, C. albicans, C. parapsilosis and C. tropicalis showed 100% sensitivity. However, C. krusei was 100% resistant; and C. glabrata, 50% resistant. Conclusion: The high mortality and fluconazole resistance rates emphasize the importance of the diagnosis of candidemia in a hospital environment.

  8. Right atrial tamponade complicating cardiac operation: clinical, hemodynamic, and scintigraphic correlates

    Energy Technology Data Exchange (ETDEWEB)

    Bateman, T.; Gray, R.; Chaux, A.; Lee, M.; De Robertis, M.; Berman, D.; Matloff, J.

    1982-09-01

    Persistent bleeding into the pericardial space in the early hours after cardiac operation not uncommonly results in cardiac tamponade. Single chamber tamponade also might be expected, since in this setting the pericardium frequently contains firm blood clots localized to the area of active bleeding. However, this complication has received very little attention in the surgical literature. We are therefore providing documentation that isolated right atrial tamponade can occur as a complication of cardiac operation and that there exists a potential for misdiagnosis and hence incorrect treatment of this condition. Right atrial tamponade may be recognized by a combination of low cardiac output, low blood pressure, prominent neck veins, right atrial pressure in excess of pulmonary capillary wedge pressure and right ventricular end-diastolic pressure, and a poor response to plasma volume expansion. Findings on chest roentgenogram and gated wall motion scintigraphy may be highly suggestive. This review should serve to increase awareness of this complication and to provide some helpful diagnostic clues.

  9. Study on the non-linear metrics contribution to estimate atrial fibrillation organization from the surface electrocardiogram

    OpenAIRE

    JULIÁN SEGUÍ, MATILDE

    2016-01-01

    [EN] Atrial fibrillation (AF) is the most frequently diagnosed arrhythmia, characterized by an uncoordinated atrial electrical activation, thus causing the atria to be unable to pump blood effectively. The prevalence of AF is expected to increase significantly in the next decades as the population ages. However, both the knowledge and the treatment of this arrhythmia still have to experiment a significant progress. Previous studies have reported that AF organization, which can be defined as t...

  10. Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gijs E. De Maat

    2015-01-01

    Full Text Available Background. In order to reduce stroke risk, left atrial appendage amputation (LAAA is widely adopted in recent years. The effect of LAAA on left atrial (LA function remains unknown. The objective of present study was to assess the effect of LAAA on LA function. Methods. Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group, and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group. To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up. Results. Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p=0.005. In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups. Conclusions. In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.

  11. Atrial Electrogram Fractionation Distribution before and after Pulmonary Vein Isolation in Human Persistent Atrial Fibrillation-A Retrospective Multivariate Statistical Analysis.

    Science.gov (United States)

    Almeida, Tiago P; Chu, Gavin S; Li, Xin; Dastagir, Nawshin; Tuan, Jiun H; Stafford, Peter J; Schlindwein, Fernando S; Ng, G André

    2017-01-01

    Purpose: Complex fractionated atrial electrograms (CFAE)-guided ablation after pulmonary vein isolation (PVI) has been used for persistent atrial fibrillation (persAF) therapy. This strategy has shown suboptimal outcomes due to, among other factors, undetected changes in the atrial tissue following PVI. In the present work, we investigate CFAE distribution before and after PVI in patients with persAF using a multivariate statistical model. Methods: 207 pairs of atrial electrograms (AEGs) were collected before and after PVI respectively, from corresponding LA regions in 18 persAF patients. Twelve attributes were measured from the AEGs, before and after PVI. Statistical models based on multivariate analysis of variance (MANOVA) and linear discriminant analysis (LDA) have been used to characterize the atrial regions and AEGs. Results: PVI significantly reduced CFAEs in the LA (70 vs. 40%; P multivariate statistical models were effective in their discrimination (P multivariate statistical model discriminated LA regions resistant to PVI from those affected by it without prior ablation information.

  12. A comparison of blood lead levels in bald eagles from two regions on the great plains of North America.

    Science.gov (United States)

    Miller, M J; Restani, M; Harmata, A R; Bortolotti, G R; Wayland, M E

    1998-10-01

    The connection between bald eagles (Haliaeetus leucocephalus) and the consumption of waterfowl, lead shotshell pellet ingestion, and subsequent lead exposure is well documented in the United States and is presumed also to be widespread in Canada. We compared blood lead concentrations in samples from bald eagles ranging in age from 0.5- to 1.5-yr-old at Galloway Bay, Saskatchewan, Canada (n = 97) during October-November, 1992-95 and Hauser Lake, Montana, USA (n = 81) during October-December, 1990-94, within the Great Plains region of North America. Abundant prey are available in the form of hunter-injured waterfowl in Saskatchewan and spawning salmon in Montana; both areas attract large numbers of mid-continent bald eagles during fall migration. Blood lead concentrations suggestive of recent lead exposure (> 0.201 microgram/ml) were found in 32% and 8% of eagles at Hauser Lake and Galloway Bay, respectively, when samples from each study area were analyzed independently at two laboratories. To determine if this difference was an artifact of interlaboratory variation, we determined a correction factor by reanalyzing 14 Saskatchewan blood samples at each laboratory and predicted blood lead concentrations from Hauser Lake had the samples been analyzed at the Canadian laboratory. Adjusted blood lead concentrations of samples from Hauser Lake indicated that 21% of eagles were recently exposed to lead, a proportion not significantly different from the proportion of the same exposure category at Galloway Bay. Our data do not support the supposition that a large proportion of bald eagles feeding on waterfowl in areas of high hunting pressure will be exposed to lead via consumption of lead shotshell pellets in waterfowl.

  13. Atrioverter : An implantable device for the treatment of atrial fibrillation

    NARCIS (Netherlands)

    Wellens, HJJ; Lau, CP; Luderitz, B; Akhtar, M; Waldo, AL; Camm, AJ; Timmermans, C; Tse, HF; Jung, W; Jordaens, L; Ayers, G

    1998-01-01

    Background-During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows pr

  14. Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. A regional cerebral blood flow study

    DEFF Research Database (Denmark)

    Friberg, L; Olsen, T S; Roland, P E

    1987-01-01

    During the course of hemiplegic migraine in 3 patients, changes in regional cerebral blood flow (rCBF) were recorded by the intracarotid 133Xe method and a 254 multidetector camera covering one hemisphere. The rCBF measurements were performed in conjunction with cerebral angiography. During...... was probably the cause of the neurological deficits. On the basis of these observations and previous work from our laboratory we conclude that instability of cerebrovascular tone may cause focal ischaemia during the course of attacks of classical and hemiplegic migraine....

  15. Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Kenichi Hashimoto, MD

    2005-01-01

    Full Text Available Left atrial tachycardia (AT has been reported to occur after pulmonary vein isolation (PVI for the treatment of atrial fibrillation (AF. We treated 3 patients who developed AT of different mechanisms following PVI. In case 1, focal AT originating at the ostium of the left superior PV was demonstrated and focal radiofrequency ablation was performed at the breakthrough point at the ostium of the left superior PV terminated the AT. In case 2, AT was shown to be counterclockwise macroreentrant AT around the left inferior PV through the conduction gap of the left sided posterior wall for which linear ablation was performed between left superior and inferior PVs. Focal ablation at the conduction gap terminated the AT. In case 3, a macroreentrant AT propagating around the mitral annulus was demonstrated and linear ablation between left inferior pulmonary vein and mitral annulus (mitral isthmus terminated the AT.

  16. Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region.

    Science.gov (United States)

    Vijayaraghavan, Maya; He, Guozhong; Stoddard, Pamela; Schillinger, Dean

    2010-09-01

    To determine prevalence of blood pressure control, hypertension, hypertension awareness, and antihypertensive treatment among adults (> 18 years old) with diabetes living in the border region between the United States of America and Mexico, and to explore variation in those variables between all adults on the Mexican side of the border ("Mexicans") and three groups on the U.S. side of the border ("all U.S. adults," "U.S.-born Hispanics," and "Mexican immigrants"). Using data from Phase I (February 2001-October 2002) of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, age-adjusted prevalence of hypertension-related variables was calculated for the sample (n = 682) and differences between the border groups were examined through logistic regression. Less than one-third of the sample had controlled blood pressure (hypertension (≥140/90 mm Hg), and hypertension awareness and treatment were inadequate. After adjusting for demographics, body mass index, and access to health care, there were no differences in blood pressure control, hypertension, hypertension awareness, or treatment between Mexicans and both U.S. adults and Mexican immigrants. However, compared to Mexicans and Mexican immigrants, U.S.-born Hispanics, particularly younger individuals, had the lowest rates of blood pressure control (17.3%) and the highest rates of coexisting hypertension (54.8%). Compared to Mexicans, U.S.-born Hispanics had lower odds of controlled blood pressure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.09-0.95) and greater odds of hypertension (OR 3.75, 95% CI 1.51-9.29) and hypertension awareness (OR 6.19, 95% CI 1.46-26.15). Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives should aggressively target blood

  17. Mapping techniques for atrial fibrillation ablation.

    Science.gov (United States)

    Sra, Jasbir; Akhtar, Masood

    2007-12-01

    Atrial fibrillation (AF) is a common arrhythmia. Although significant work still needs to be done, recent advances in understanding the mechanism of AF have led to the development of elegant catheter mapping techniques for ablation of AF. These improved mapping techniques are complemented by an evolution in various imaging and navigational technologies, several of which can now be combined in a process called registration, so that the physician no longer needs to rely solely on a mental image of the anatomy of the left atrium and the pulmonary vein while attempting to ablate the region. Ongoing advances in mapping technique will increase safety and efficacy and it is likely that AF ablation will become the first-line therapy in most patients with this complicated arrhythmia.

  18. Multi-regional investigation of the relationship between functional MRI blood oxygenation level dependent (BOLD activation and GABA concentration.

    Directory of Open Access Journals (Sweden)

    Ashley D Harris

    Full Text Available Several recent studies have reported an inter-individual correlation between regional GABA concentration, as measured by MRS, and the amplitude of the functional blood oxygenation level dependent (BOLD response in the same region. In this study, we set out to investigate whether this coupling generalizes across cortex. In 18 healthy participants, we performed edited MRS measurements of GABA and BOLD-fMRI experiments using regionally related activation paradigms. Regions and tasks were the: occipital cortex with a visual grating stimulus; auditory cortex with a white noise stimulus; sensorimotor cortex with a finger-tapping task; frontal eye field with a saccade task; and dorsolateral prefrontal cortex with a working memory task. In contrast to the prior literature, no correlation between GABA concentration and BOLD activation was detected in any region. The origin of this discrepancy is not clear. Subtle differences in study design or insufficient power may cause differing results; these and other potential reasons for the discrepant results are discussed. This negative result, although it should be interpreted with caution, has a larger sample size than prior positive results, and suggests that the relationship between GABA and the BOLD response may be more complex than previously thought.

  19. Alterations of Regional Cerebral Blood Flow in Tinnitus Patients as Assessed Using Single-Photon Emission Computed Tomography.

    Directory of Open Access Journals (Sweden)

    Takashi Ueyama

    Full Text Available Tinnitus is the perception of phantom sound without an external auditory stimulus. Using neuroimaging techniques, such as positron emission tomography, electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI, many studies have demonstrated that abnormal functions of the central nervous system are closely associated with tinnitus. In our previous research, we reported using resting-state fMRI that several brain regions, including the rectus gyrus, cingulate gyrus, thalamus, hippocampus, caudate, inferior temporal gyrus, cerebellar hemisphere, and medial superior frontal gyrus, were associated with tinnitus distress and loudness. To reconfirm these results and probe target regions for repetitive transcranial magnetic stimulation (rTMS, we investigated the regional cerebral blood flow (rCBF between younger tinnitus patients (<60 years old and the age-matched controls using single-photon emission computed tomography and easy Z-score imaging system. Compared with that of controls, the rCBF of tinnitus patients was significantly lower in the bilateral medial superior frontal gyri, left middle occipital gyrus and significantly higher in the bilateral cerebellar hemispheres and vermis, bilateral middle temporal gyri, right fusiform gyrus. No clear differences were observed between tinnitus patients with normal and impaired hearing. Regardless of the assessment modality, similar brain regions were identified as characteristic in tinnitus patients. These regions are potentially involved in the pathophysiology of chronic subjective tinnitus.

  20. Atrial septal stenting - How I do it?

    Directory of Open Access Journals (Sweden)

    Kothandam Sivakumar

    2015-01-01

    Full Text Available A wide atrial communication is important to maintain hemodynamics in certain forms of congenital and acquired heart defects. In comparison to balloon septostomy or blade septostomy, atrial septal stenting provides a controlled, predictable, and long-lasting atrial communication. It often needs a prior Brockenbrough needle septal puncture to obtain a stable stent position. A stent deployed across a previously dilated and stretched oval foramen or tunnel form of oval foramen carries higher risk of embolization. This review provides technical tips to achieve a safe atrial septal stenting. Even though this is a "How to do it article," an initial discussion about the indications for atrial septal stenting is vital as the resultant size of the atrial septal communication should be tailored for each indication.

  1. Risk of atrial fibrillation in diabetes mellitus

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik L.; Schjerning, Anne-Marie; Lindhardt, Tommi B.

    2016-01-01

    AIM: Diabetes has been associated with atrial fibrillation but the current evidence is conflicting. In particular knowledge regarding young diabetes patients and the risk of developing atrial fibrillation is sparse. The aim of our study was to investigate the risk of atrial fibrillation in patients...... with diabetes compared to the background population in Denmark. METHODS AND RESULTS: Through Danish nationwide registries we included persons above 18 years of age and without prior atrial fibrillation and/or diabetes from 1996 to 2012. The study cohort was divided into a background population without diabetes...... and a diabetes group. The absolute risk of developing atrial fibrillation was calculated and Poisson regression models adjusted for sex, age and comorbidities were used to calculate incidence rate ratios of atrial fibrillation. The total study cohort included 5,081,087 persons, 4,827,713 (95%) in the background...

  2. Atrial – Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    T Panagiotopoulos

    2009-05-01

    Full Text Available Atrial and ventricular septal defect constitute the most common congenital heart disease.Aim: Τhe aim of the present retrospective study was to record data and factors that affect atrial and ventricular septal defect.Method and material: The sample study included patients of both sexes who were hospitalized with diagnosis atrial and ventricular septal defect in a Cardiac Surgery hospital of Athens. A specially constructed printed form was used for data collection, where were recorded the demographic and personal variables, the pathological, surgical, cardiology and obstetric history, the habits of adults, as well as the personal characteristics of mothers. Analysis of data was performed by descriptive statistical analysis.Results: The sample study consisted of 101 individuals with diagnosis atrial or ventricular Septal Defect, of which 40% were boys and 60% girls. The 70% of the sample study suffered from atrial Septal Defect and the 30% suffered from ventricular Septal Defect. Regarding age, 12% of the sample study was 0-1 years old, 35% was >1 years old, 8% was >12-18 years old and 45% over than 18 years old. Regarding educational status of the adult participants, 9% was of 0-6 years education, 22%>6 -12 years, 13%>12 years. 14% of the adult paticipants smoked, 4% consumed alcohol and 5% smoked in conjunction with alcohol. In terms of the obstetric history of the sample studied, 32% of the cases had normal birth, 4% had a twin birth and 1% had a triplet one. According to the variables related to mothers, the mean age of the mother was 30 years and 3 months, 10% were smokers at pregnancy and 3% used chemical substance and mainly hair color. Also, the results of the present study showed that individuals of 12-18 and >18 years old did not suffer from ventricular Septal Defect, whereas the infants 0-1 years old did not suffer from Atrial Septal Defect. The mean value of age at the admission in intensive care unit was 7 months (12% for the infants

  3. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, J. J.; Im, K. C.; Moon, D. H. [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)

    2003-07-01

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p<0.0001, extent threshold>100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF.

  4. Obesity, metabolic syndrome and risk of atrial fibrillation: a Swedish, prospective cohort study.

    Science.gov (United States)

    Nyström, Petter K; Carlsson, Axel C; Leander, Karin; de Faire, Ulf; Hellenius, Mai-Lis; Gigante, Bruna

    2015-01-01

    We aimed to investigate whether different measures of obesity could similarly predict atrial fibrillation, and whether the atrial fibrillation risk associated with obesity is dependent on presence of metabolic syndrome. We performed our study in a population-based longitudinal cardiovascular study, comprising 1 924 men and 2 097 women, aged 60 years, from Stockholm. Body mass index, waist circumference, sagittal abdominal diameter and components of metabolic syndrome (systolic- and diastolic blood pressure, fasting glucose, triglycerides, high-density lipoprotein-cholesterol) were recorded at baseline. Participants were classified by their body mass index (normal weight, overweight or obese), waist circumference (normal, semi-elevated or elevated), and according to presence of metabolic syndrome. Atrial fibrillation risk was estimated by Cox proportional hazards regression models, adjusted for common atrial fibrillation risk factors, expressed as HR and 95% CI. During a mean follow-up of 13.6 years, 285 incident atrial fibrillation cases were recorded. One standard deviation increment of each obesity measure was associated with increased atrial fibrillation risk as: body mass index 1.25 (1.12 - 1.40), waist circumference 1.35 (1.19 - 1.54) and sagittal abdominal diameter 1.28 (1.14 - 1.44). Compared to normal weight subjects without metabolic syndrome, increased atrial fibrillation risk was noted for overweight subjects with metabolic syndrome, 1.67 (1.16 - 2.41), obese subjects without metabolic syndrome, 1.75 (1.11 - 2.74) and obese subjects with metabolic syndrome, 1.92 (1.34 - 2.74). Compared to subjects with normal waist circumference without metabolic syndrome, subjects with elevated waist circumference and metabolic syndrome suffered increased atrial fibrillation risk, 2.03 (1.44 - 2.87). Body mass index, waist circumference and sagittal abdominal diameter could similarly predict atrial fibrillation. Obesity was associated with an increased atrial

  5. ANALYSIS OF RANDOMNESS OF ATRIAL AND VENTRICULAR RHYTHM IN ATRIAL-FIBRILLATION

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; HAAKSMA, J; BEL, KJ; CRIJNS, HJGM; DIJK, WA; LIE, KI

    1995-01-01

    The aim of the present study was top examine the relationship between randomness of atrial and ventricular rhythm during atrial fibrillation. Atrial fibrillation was induced in 10 open-chest pigs by application of metacholine on the surface of the right atrium followed by incremental pacing. Local a

  6. Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed Tomography

    NARCIS (Netherlands)

    Hof, Irene; Arbab-Zadeh, Armin; Scherr, Daniel; Chilukuri, Karuna; Dalal, Darshan; Abraham, Theodore; Lima, Joao; Calkins, Hugh

    2009-01-01

    Computed Tomography. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echoca

  7. The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash; Safi, Sanam; Nielsen, Emil E

    2017-01-01

    BACKGROUND: Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation...... as healthcare systems and healthcare economy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016051433....

  8. Congenital left atrial appendage aneurysm: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Mehdi Bamous

    2017-01-01

    Full Text Available Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.

  9. Capillary blood gas analysis in complex regional pain syndrome: a pilot study.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Keijzer, M.H. de; Goris, R.J.A.

    2003-01-01

    BACKGROUND: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1) is still a matter of debate. An inflammatory reaction may cause the syndrome. Increasing evidence points to a role for impairment of oxygen metabolism in the affected limb. METHODS: In this pilot study (16 patients) we

  10. Intima-Media Thickness and Regional Cerebral Blood Flow in Older Adults

    Science.gov (United States)

    Sojkova, Jitka; Najjar, Samer S.; Beason-Held, Lori L.; Metter, E. Jeffrey; Davatzikos, Christos; Kraut, Michael A; Zonderman, Alan B.; Resnick, Susan M.

    2010-01-01

    Background and Purpose The relationship between the thickness of the carotid intima (IMT) and brain function remains unclear in those without clinical manifestations of cerebrovascular disease. Understanding the neural correlates of this vascular measure is important in view of emerging evidence linking poorer cognitive performance with increased IMT in individuals without clinical cerebrovascular disease. Methods 73 participants in the Baltimore Longitudinal Study of Aging (70.9(SD 7.3) years) were evaluated with carotid artery ultrasound and resting [15O]H2O-PET. Results After adjusting for age, sex, and grey and white matter volumes in the regions where IMT is related to rCBF, we found that higher IMT was associated with lower rCBF in lingual, inferior occipital, and superior temporal regions. Higher IMT was also associated with higher rCBF in medial frontal gyrus, putamen, and hippocampal-uncal regions (p=0.001). While women had lower IMT (p=0.01) and mean arterial pressure (MAP;p=0.05) than men, they showed more robust associations between IMT and rCBF. The relationship between IMT and rCBF was only minimally affected by additional adjustment for MAP. Conclusions IMT is related to patterns of resting rCBF in older adults without clinical manifestations of cerebrovascular disease, suggesting that there are regional differences in CBF that are associated with subclinical vascular disease. PMID:20044526

  11. [Evaluation of regional cortical blood flow by thermal diffusion using a Peltier stack].

    Science.gov (United States)

    Yamagata, S; Kikuchi, H; Hashimoto, K; Minamikawa, J

    1987-08-01

    The possibility of quantitative evaluation of cerebral blood flow (CBF) by thermal diffusion has been reported, when the thermal gradient was created by a Peltier stack. We already described the linear relationship between the CBF and the inverse of thermal gradient elsewhere when the CBF measured by hydrogen clearance (Hydrogen CBF) was compared to the values estimated by thermal diffusion. In this paper, the correlation of linear relationship between the thermal CBF and hydrogen CBF in each animal was first investigated. Secondary, the possibility of in vitro calibration for quantitative evaluation was discussed. Two kinds of probes were manufactured. One was treated not to leak the heat from the Peltier stack except the sensors for the experimental or intraoperative use, and the other was not treated to minimize the size of probe for the long-term use by implantation into the subdural space. When the thermal CBF was compared to hydrogen CBF in each of 3 cats, a linear relationship was obtained in each and the values showing gradient and constant of the regression line were similar in each cat. Moreover, a good linear relationship was also observed when all measurements in 3 cats were included. These results suggested that there is no difference between each animal in the relationship of thermal and hydrogen CBF when the same probe is employed. In addition, the probe can be characterized with two values, and these are gradient and constant of the linear relationship. The fact that the blood flow is proportional to the heat conductivity indicates that the heat conductivity of some material is equivalent to some CBF value in the brain tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Effect of hindlimb suspension on VO2 max and regional blood flow responses to exercise.

    Science.gov (United States)

    Overton, J M; Woodman, C R; Tipton, C M

    1989-02-01

    Male rodents were studied before and after undergoing one of three treatment conditions for 9 days: 1) cage control (n = 15, CON), 2) horizontal suspension (n = 15, HOZ), and 3) head-down suspension (n = 18, HDT). Testing included measurements of maximal O2 uptake (VO2 max) and select cardiovascular responses to graded treadmill exercise. VO2 max expressed on an absolute basis (ml/min) was significantly decreased after HOZ (-14.1 +/- 2.5%) and HDT (-14.3 +/- 2.0%), while being essentially unchanged in CON (-1.0 +/- 3.3%). Significant reductions in body weight were observed after both HOZ (-10.1 +/- 4.2 g) and HDT (-22.5 +/- 3.3 g), whereas CON animals exhibited a significant increase in weight (10.4 +/- 3.8 g). As a result, when VO2 max was normalized for body weight, all groups exhibited similar significant reductions of 6-7%. Although no differences in heart rate and blood pressure response to graded exercise were observed, the HDT group exhibited greater increases in mesenteric resistance at the same absolute exercise intensity. Furthermore, both suspended groups had higher iliac resistance values during exercise at similar relative exercise conditions, suggesting that muscle blood flow during treadmill running may have been reduced after suspension. In general, the decrements associated with the HOZ and HDT conditions were similar. It was concluded that reduction in exercise capacity and altered cardiovascular responses to exercise observed after 6-9 days of suspension were attributable to a combination of hypokinesia, lack of hindlimb weight bearing, or restraint, rather than to hydrostatic influences associated with HDT.

  13. Positron emission tomography study of regional cerebral blood flow and flow-metabolism coupling during general anaesthesia with xenon in humans

    National Research Council Canada - National Science Library

    Rex, S; Meyer, P. T; Baumert, J.-H; Rossaint, R; Fries, M; Büll, U; Schaefer, W. M

    2008-01-01

    Background The effects of xenon on regional cerebral blood flow (rCBF) are controversial. Moreover, the precise sites of action at which xenon exerts its effects in the human brain remain to be established...

  14. A Morphological Hessian Based Approach for Retinal Blood Vessels Segmentation and Denoising Using Region Based Otsu Thresholding.

    Directory of Open Access Journals (Sweden)

    Khan BahadarKhan

    Full Text Available Diabetic Retinopathy (DR harm retinal blood vessels in the eye causing visual deficiency. The appearance and structure of blood vessels in retinal images play an essential part in the diagnoses of an eye sicknesses. We proposed a less computational unsupervised automated technique with promising results for detection of retinal vasculature by using morphological hessian based approach and region based Otsu thresholding. Contrast Limited Adaptive Histogram Equalization (CLAHE and morphological filters have been used for enhancement and to remove low frequency noise or geometrical objects, respectively. The hessian matrix and eigenvalues approach used has been in a modified form at two different scales to extract wide and thin vessel enhanced images separately. Otsu thresholding has been further applied in a novel way to classify vessel and non-vessel pixels from both enhanced images. Finally, postprocessing steps has been used to eliminate the unwanted region/segment, non-vessel pixels, disease abnormalities and noise, to obtain a final segmented image. The proposed technique has been analyzed on the openly accessible DRIVE (Digital Retinal Images for Vessel Extraction and STARE (STructured Analysis of the REtina databases along with the ground truth data that has been precisely marked by the experts.

  15. Reproductive biology of blood cockle Anadara granosa (Bivalvia: Arcidae) in the northern region of the Strait of Malacca

    Science.gov (United States)

    Khalil, Munawar; Yasin, Zulfigar; Hwai, Tan Shau

    2017-02-01

    A study on the reproductive cycle of the blood cockle Anadara granosa (Bivalvia: Arcidae) was conducted at three different areas in the northern region of the Strait of Malacca. A total of 1,920 samples of adult A. granosa (38-71 mm length) were collected from June 2009 until September 2010. Qualitative techniques (gonadal microscopic fresh smear test and histology analysis) as well as quantitative techniques (analysis of condition index and gonadal index) were used to predict monthly gonadal development stages of A. granosa. The gonadal index of A. granosa from Banda Aceh (Indonesia) (r = 0.469, P > 0.05) and Pulau Pinang (Malaysia) (r = 0.123, P > 0.05) did not show any correlation to their condition index, whereas the gonadal index of A. granosa from Lhokseumawe (Indonesia) (r = 0.609, P management and to improve the sustainability practices of the fisheries industry. These findings will provide basic information on the biology of the blood cockle A. granosa for stock management in the region.

  16. Reproductive biology of blood cockle Anadara granosa (Bivalvia: Arcidae) in the northern region of the Strait of Malacca

    Science.gov (United States)

    Khalil, Munawar; Yasin, Zulfigar; Hwai, Tan Shau

    2017-03-01

    A study on the reproductive cycle of the blood cockle Anadara granosa (Bivalvia: Arcidae) was conducted at three different areas in the northern region of the Strait of Malacca. A total of 1,920 samples of adult A. granosa (38-71 mm length) were collected from June 2009 until September 2010. Qualitative techniques (gonadal microscopic fresh smear test and histology analysis) as well as quantitative techniques (analysis of condition index and gonadal index) were used to predict monthly gonadal development stages of A. granosa. The gonadal index of A. granosa from Banda Aceh (Indonesia) ( r = 0.469, P > 0.05) and Pulau Pinang (Malaysia) ( r = 0.123, P > 0.05) did not show any correlation to their condition index, whereas the gonadal index of A. granosa from Lhokseumawe (Indonesia) ( r = 0.609, P principle component analysis (PCA) indicated that A. granosa reproduction was affected by interaction between internal physiological factors and indigenous environmental factors. In all sampling areas, phytoplankton density played a key role in the reproductive cycle in A. granosa. Information on the reproductive biology of this species is essential for species management and to improve the sustainability practices of the fisheries industry. These findings will provide basic information on the biology of the blood cockle A. granosa for stock management in the region.

  17. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roger Kerzner; Michael W. Rich

    2005-01-01

    Atrial fibrillation (AF) is an extremely common condition in the elderly, with increasing prevalence around the world as the population ages. AF may be associated with serious health consequences, including stroke, heart failure, and decreased quality of life, so that careful management of AF by geriatric health care providers is required. With careful attention to anticoagulation therapy, and prudent use of medications and invasive procedures to minimize symptoms, many of the adverse health consequences of AF can be prevented.

  18. [Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia - a randomized study].

    Science.gov (United States)

    Kosel, Juliusz; Rusak, Małgorzata; Gołembiewski, Łukasz; Dąbrowska, Milena; Siemiątkowski, Andrzej

    2016-01-01

    Among the many changes caused by a surgical insult one of the least studied is postoperative immunosuppression. This phenomenon is an important cause of infectious complications of surgery such as surgical site infection or hospital acquired pneumonia. One of the mechanisms leading to postoperative immunosuppression is the apoptosis of immunological cells. Anesthesia during surgery is intended to minimize harmful changes and maintain perioperative homeostasis. The aim of the study was evaluation the effect of the anesthetic technique used for total knee replacement on postoperative peripheral blood lymphocyte apoptosis. 34 patients undergoing primary total knee replacement were randomly assigned to two regional anesthetic protocols: spinal anesthesia and combined spinal-epidural anesthesia. 11 patients undergoing total knee replacement under general anesthesia served as control group. Before surgery, immediately after surgery, during first postoperative day and seven days after the surgery venous blood samples were taken and the immunological status of the patient was assessed with the use of flow cysts 87 m, along with lymphocyte apoptosis using fluorescent microscopy. Peripheral blood lymphocyte apoptosis was seen immediately in the postoperative period and was accompanied by a decrease of the number of T cells and B cells. There were no significant differences in the number of apoptotic lymphocytes according to the anesthetic protocol. Changes in the number of T CD3/8 cells and the number of apoptotic lymphocytes were seen on the seventh day after surgery. Peripheral blood lymphocyte apoptosis is an early event in the postoperative period lasts up to seven days and is not affected by the choice of the anesthetic technique. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  19. Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia - a randomized study.

    Science.gov (United States)

    Kosel, Juliusz; Rusak, Małgorzata; Gołembiewski, Łukasz; Dąbrowska, Milena; Siemiątkowski, Andrzej

    2016-01-01

    Among the many changes caused by a surgical insult one of the least studied is postoperative immunosuppression. This phenomenon is an important cause of infectious complications of surgery such as surgical site infection or hospital acquired pneumonia. One of the mechanisms leading to postoperative immunosuppression is the apoptosis of immunological cells. Anesthesia during surgery is intended to minimize harmful changes and maintain perioperative homeostasis. The aim of the study was evaluation of the effect of the anesthetic technique used for total knee replacement on postoperative peripheral blood lymphocyte apoptosis. 34 patients undergoing primary total knee replacement were randomly assigned to two regional anesthetic protocols: spinal anesthesia and combined spinal-epidural anesthesia. 11 patients undergoing total knee replacement under general anesthesia served as control group. Before surgery, immediately after surgery, during first postoperative day and seven days after the surgery venous blood samples were taken and the immunological status of the patient was assessed with the use of flow cytometry, along with lymphocyte apoptosis using fluorescent microscopy. Peripheral blood lymphocyte apoptosis was seen immediately in the postoperative period and was accompanied by a decrease of the number of T cells and B cells. There were no significant differences in the number of apoptotic lymphocytes according to the anesthetic protocol. Changes in the number of T CD3/8 cells and the number of apoptotic lymphocytes were seen on the seventh day after surgery. Peripheral blood lymphocyte apoptosis is an early event in the postoperative period that lasts up to seven days and is not affected by the choice of the anesthetic technique. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. CORRELATION OF LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN RHD WITH MITRAL VALVE DISEASE

    Directory of Open Access Journals (Sweden)

    Raghavendra

    2016-03-01

    Full Text Available BACKGROUND Atrial fibrillation (AF, the most common sustained cardiac rhythm disturbance, commonly occurs with rheumatic heart disease, particularly mitral stenosis. Hemodynamic impairment and thromboembolic events result in significant morbidity& mortality. Left atrial (LA enlargement is one of the elements that evolve in the natural history of mitral stenosis. The objective of this study is to study the relation between echo cardio graphically determined left atrial size and atrial fibrillation in mitral valve disease (MVD. METHODOLOGY 50 Patients with rheumatic heart disease with mitral valve disease were studied using ECG and ECHO, excluding patients with congenital heart diseases, non-rheumatic mitral valve disease, essential hypertension, patients undergone PTMC or valvuloplasty or valve replacement, coronary artery diseases, patients on antiarrhythmic drugs, pregnant women. Left atrial dimensions measured by ECHO in patients of MVD and AF on ECG were compared with the left atrial dimension of patients in sinus rhythm. RESULTS In this study 42 patients had left atrial size >40 mm, 29(93.55% of them were in atrial fibrillation and only 13(68.42% were in sinus rhythm. Among 8 patients with left atrial size <40 mm, 2(6.45% were in atrial fibrillation and 06(31.58% were in sinus rhythm with p<0.02 which is significant. CONCLUSION Atrial fibrillation incidence was common when left atrial dimension was above 40 mm. There is a quantitative relation between left atrial size measured echocardiographically and the presence or absence of atrial fibrillation. These results may have therapeutic implication in that it may be possible with echocardiography, to identify patients in sinus rhythm, who are at high risk of developing atrial fibrillation. Prophylactic anticoagulation, antiarrhythmic therapy or both might be considered in management to prevent embolism.

  1. Percutaneous closure of congenital aortocaval fistula with a coexisting secundum atrial septal defect

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Jensen, Tim; Søndergaard, Lars

    2012-01-01

    Congenital aortocaval fistula is a very rare anomaly. Clinically, it resembles conditions that cause left-to-right shunt of blood. We report a case of such anomaly in combination with a secundum atrial septal defect in a 13-month-old girl who presented with failure to thrive and exertional respir...

  2. Minimally invasive ventriculo-atrial shunt for hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    李江山; 江勇豪; 程成; 张世凯

    2005-01-01

    Objective: To study the therapeutic effect of mini-traumatic ventriculo-atrial shunt on hydrocephalus. Methods: Seventeen patients were treated with right internal jugular venepuncture intubation to finish minimally invasive ventriculo-atrial shunt for hydrocephalus. The patients were evaluated by CT/MRI. The catheters were deployed at the proper position in the right atrium under X-ray fluoroscopy.Results: The hydrocephalus in all the 17 patients eliminated with this surgical procedure with a 100% success rate technically. The operational duration ranged from 0.75 to 1.5 h (average: 1 h). Mistaken puncture into the internal carotid artery as a complication occurred on 1 case.Conclusions: The mini-traumatic ventriculo-atrial shunt, as a novel minimal invasion technique, has the advantages of small trauma, no influence on local blood circulation, short time and simplicity at operation, rapid healing, and good short-term effect. Moreover, it is suitable for those patients with organic dysfunction.

  3. Regional cerebral blood flow in various types of brain tumor. Effect of the space-occupying lesion on blood flow in brain tissue close to and remote from tumor site

    DEFF Research Database (Denmark)

    Kuroda, K; Skyhøj Olsen, T; Lassen, N A

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured in 23 patients with brain tumors using the 133Xe intra-carotid injection method and a 254 channel gamma camera. The glioblastomas (4) and astrocytomas (4) all showed hyperemia in the tumor and tumor-near region. This was also seen in several mening...

  4. Case with stenosis of internal carotid artery detected as a region of decreased blood flow by Tc-99m HMPAO cerebral blood flow scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, K.; Nishimura, T.; Uehara, T.; Imakita, S.; Yokota, I.; Ogura, H.; Oka, H.; Hayashi, M.; Kikuchi, H.

    1987-04-01

    Tc-99m hexamethylpropyleneamine oxime (= HMPAO) is expected to be an excellent agent as blood flow tracer of brain because it passes through blood brain barrier and is retained in brain parenchyma for several hours. Tc-99m HMPAO scintigraphy was applied to a patient complaining of transient ischemic attack without neurological findings. Left hemispheric hypoperfusion was detected by Tc-99m HMPAO cerebral blood flow scintigraphy. Although it was normal in CT and MRI, it was proved to be a 99 % stenosis of left internal carotid artery by digital subtraction angiography. Tc-99m HMPAO cerebral blood flow scintigraphy is useful for detecting abnormality of cerebral blood flow.

  5. Auto-validation of complete blood counts in an outpatient's regional laboratory.

    Science.gov (United States)

    Froom, Paul; Barak, Mira

    2015-02-01

    The rate of auto-validation is dependent on the ability of the laboratory information system (LIS) to integrate historical data, on the frequency and methods for identifying analyzer errors, and on the criteria for reflex testing, including the need for peripheral smear review. The rate of auto-validation in outpatient laboratories, however, is unclear. We examined 45,925 consecutive complete blood count (CBC) test results (1 January, 2014-31 January, 2014) from patients aged 50±24 years. The LIS auto-validates all samples according to set criteria. Technicians validated test results when previous CBC test results were required to determine: 1) the need for peripheral slide review and/or sample rerun or 2) the need for reflex testing to detect autoimmune hemolytic anemia or β-thalassemia minor. The auto-validation rates were 97.6% after rejecting results requiring validation to determine the need for a peripheral smear review and/or sample rerun. This decreased to 92.9% after including reflex testing to determine the reasons for normocytic and microcytic anemia. We estimated that auto-validation decreased the workload by 7.7-11.6 h per 3000 test results. We conclude that very high auto-validation rates are possible in outpatient general laboratories, leading to conformity in the validation process and a considerable estimated savings in technician time. Further studies are needed in other settings.

  6. Optimisation of Ionic Models to Fit Tissue Action Potentials: Application to 3D Atrial Modelling

    Directory of Open Access Journals (Sweden)

    Amr Al Abed

    2013-01-01

    Full Text Available A 3D model of atrial electrical activity has been developed with spatially heterogeneous electrophysiological properties. The atrial geometry, reconstructed from the male Visible Human dataset, included gross anatomical features such as the central and peripheral sinoatrial node (SAN, intra-atrial connections, pulmonary veins, inferior and superior vena cava, and the coronary sinus. Membrane potentials of myocytes from spontaneously active or electrically paced in vitro rabbit cardiac tissue preparations were recorded using intracellular glass microelectrodes. Action potentials of central and peripheral SAN, right and left atrial, and pulmonary vein myocytes were each fitted using a generic ionic model having three phenomenological ionic current components: one time-dependent inward, one time-dependent outward, and one leakage current. To bridge the gap between the single-cell ionic models and the gross electrical behaviour of the 3D whole-atrial model, a simplified 2D tissue disc with heterogeneous regions was optimised to arrive at parameters for each cell type under electrotonic load. Parameters were then incorporated into the 3D atrial model, which as a result exhibited a spontaneously active SAN able to rhythmically excite the atria. The tissue-based optimisation of ionic models and the modelling process outlined are generic and applicable to image-based computer reconstruction and simulation of excitable tissue.

  7. Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging

    Directory of Open Access Journals (Sweden)

    Hala Mahfouz Badran

    2012-12-01

    Full Text Available Objectives: Hypertrophic cardiomyopathy (HCM represents a generalized myopathic process affecting both ventricular and atrial myocardium. We assessed the global and regional left atrial (LA function and its relation to left ventricular (LV mechanics and clinical status in patients with HCM using Vector Velocity Imaging (VVI. Methods: VVI of the LA and LV was acquired from apical four- and two-chamber views of 108 HCM patients (age 40±19years, 56.5% men and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ɛ/strain rate (SR measurements. Results: Left atrial reservoir (ɛsys,SRsys and conduit (early diastolic SRe function were significantly reduced in HCM compared to controls (P-1.8s-1 was 81% sensitive and 30% specific, SRa>-1.5s-1 was 73% sensitive and 40% specific. By multivariate analysis global LVɛsys and LV septal thickness are independent predictors for LAɛsys, while end systolic diameter is the only independent predictor for SRsys, P<.001. Conclusion: Left atrial reservoir and conduit function as measured by VVI were significantly impaired while contractile function was preserved among HCM patients. Left atrial deformation was greatly influenced by LV mechanics and correlated to severity of phenotype.

  8. Basal and hyperaemic myocardial blood flow in regionally denervated canine hearts: an in vivo study with positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Rimoldi, Ornella E.; Camici, Paolo G. [Hammersmith Hospital, MRC Clinical Sciences Centre, London (United Kingdom); Imperial College, National Heart and Lung Institute, London (United Kingdom); Drake-Holland, Angela J. [Robert Gordon University, School of Pharmacy, Aberdeen (United Kingdom); Noble, Mark I.M. [University of Aberdeen, Department of Cardiology, Aberdeen (United Kingdom)

    2007-02-15

    Positron emission tomography (PET) studies in patients with diabetic autonomic neuropathy (DAN) have demonstrated the impact of this disease on cardiac sympathetic innervation and myocardial blood flow (MBF). To investigate the effects of selective partial sympathetic denervation of the left ventricle (LV) on baseline and hyperaemic MBF, we measured myocardial presynaptic catecholamine re-uptake (uptake-1), {beta}-adrenoceptor ({beta}-AR) density and MBF non-invasively by means of PET in a canine model of regional sympathetic denervation. In 11 anaesthetised dogs, the sympathetic nerves of the free wall and septum of the LV were removed by means of dissection and phenol painting. Three weeks later, the animals were studied with PET. MBF was measured at baseline and following i.v. adenosine (140 {mu}g kg{sup -1} min{sup -1}) and dobutamine (20 {mu}g kg{sup -1} min{sup -1}) using{sup 15}O-labelled water. Sympathetic denervation was confirmed by an 80{+-}12% decrease in the volume of distribution (V{sub d}) of [{sup 11}C]hydroxyephedrine (HED) compared with innervated regions. Myocardial {beta}-AR density was measured using [{sup 11}C]CGP12177. Innervated and denervated regions showed no differences in MBF at baseline and during adenosine or dobutamine. [{sup 11}C]HED V{sub d}was inversely correlated with MBF in both regions at baseline, and the correlation was lost during hyperaemia in denervated regions. However, for any given value of MBF, [{sup 11}C]HED V{sub d}was significantly lower in the denervated regions. {beta}-AR density was comparable in denervated and innervated regions (17.9{+-}4.2 vs 18.4{+-}3.3 pmol g{sup -1};p=NS). In this experimental model, selective, regional sympathetic denervation of the LV, which results in a profound reduction in [{sup 11}C]HED V{sub d}, did not affect baseline or hyperaemic MBF. In addition, we demonstrated that, under baseline conditions, there was a significant inverse correlation between [{sup 11}C]HED V{sub d}and MBF in

  9. Early thyroid gland dysfunction and biorhythmic activity disturbance in patients with cardiovascular pathology and atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Shvarts Yu.G.

    2012-12-01

    Full Text Available The review deals with the problem of combined pathology of the thyroid gland and cardiovascular system, the state of thyroid homeostasis in atrial fibrillation. The main mechanisms of action of thyroid hormones on the heart and blood vessels, particularly changes in the cardiovascular system with hypo-or hyperthyroidism; the possibility of substitution therapy in subclinical disease have been presented in the article. Characteristics of daily rhythmic activity of thyroid gland in normal and various pathological conditions with persistent and paroxysmal atrial fibrillation have been considered.

  10. Dynamics of AV coupling during human atrial fibrillation: role of atrial rate.

    Science.gov (United States)

    Masè, M; Marini, M; Disertori, M; Ravelli, F

    2015-07-01

    The causal relationship between atrial and ventricular activities during human atrial fibrillation (AF) is poorly understood. This study analyzed the effects of an increase in atrial rate on the link between atrial and ventricular activities during AF. Atrial and ventricular time series were determined in 14 patients during the spontaneous acceleration of the atrial rhythm at AF onset. The dynamic relationship between atrial and ventricular activities was quantified in terms of atrioventricular (AV) coupling by AV synchrogram analysis. The technique identified n:m coupling patterns (n atrial beats in m ventricular cycles), quantifying their percentage, maximal length, and conduction ratio (= m/n). Simulations with a difference-equation AV model were performed to correlate the observed dynamics to specific atrial/nodal properties. The atrial rate increase significantly affected AV coupling and ventricular response during AF. The shortening of atrial intervals from 185 ± 32 to 165 ± 24 ms (P AV patterns with progressively decreasing m/n ratios (from conduction ratio = 0.34 ± 0.09 to 0.29 ± 0.08, P AV block and coupling instability at higher atrial rates were associated with increased ventricular interval variability (from 123 ± 52 to 133 ± 55 ms, P AV pattern transitions and coupling instability in patients were predicted, assuming the filtering of high-rate irregular atrial beats by the slow recovery of nodal excitability. These results support the role of atrial rate in determining AV coupling and ventricular response and may have implications for rate control in AF. Copyright © 2015 the American Physiological Society.

  11. Acute effects of electroconvulsive therapy on regional cerebral blood flow (rCBF) in psychiatric disorders

    Energy Technology Data Exchange (ETDEWEB)

    Prohovnik, I.; Alderson, P.O.; Sackheim, H.A.; Decina, P.; Kahn, D.

    1984-01-01

    Electroconvulsive therapy (ECT) is frequently used in the treatment of major depression and other psychiatric disorders; its mechanism of action is not established, but previous evidence suggests that it is associated with postictal metabolic suppression. The authors have used measurements of rCBF as an index of cortical metabolic activity to study the acute effects of ECT. Measurements of rCBF were made in 32 cortical regions in 10 patients (pts) following one minute breathing of Xe-133 (5mCi/L); the measurements were performed 30min before and 50min after ECT. Bilateral ECT was administered to six pts (five diagnosed as major depressives and one schizophrenic) and unilateral ECT to four (all diagnosed as unipolar or bipolar affective disorder). The total rCBF material consists of 52 measurements in these pts, made before and after 16 bilateral and 10 unilateral treatments. ECT was found to cause significant reduction of rCBF. Mean hemispheric flows (using the Initial Slope Index to measure grey-matter flow) were reduced by about 5% in both hemispheres following bilateral treatment. Unilateral treatment caused a 9% reduction of flow in the treated hemisphere, but only 2% contralaterally. Regional patterns of flow decreases also differed between the two treatment modes: bilateral frontal reductions were found after bilateral treatment, whereas unilateral ECT caused a widespread flow reduction in the treated hemisphere, and almost no effect contralaterally. These results suggest that rCBF studies are useful for assessing ECT, and indicate that the acute cerebral effects of ECT vary with the mode of treatment.

  12. miRNAs as biomarkers of atrial fibrillation.

    Science.gov (United States)

    Gomes da Silva, Ananília Medeiros; Silbiger, Vivian Nogueira

    2014-12-01

    Atrial fibrillation (AF) is a highly prevalent arrhythmia with pronounced morbidity and mortality. Genetics analysis has established electrophysiological substrates, which determine individual vulnerability to AF occurrence and maintenance. MicroRNAs (miRNAs) found in virtually all organisms function as negative regulators of protein-coding genes. Several studies have suggested a role for miRNAs in the regulation of cardiac excitability and arrhythmogenesis. This review is based on 18 studies conducted between 2009 and 2013 to investigate the association of miRNAs with AF. miRNAs are discussed here as candidate biomarkers for AF in blood and cardiac tissues and as potential targets for AF therapy.

  13. Ionic basis of the different action potential configurations of single guinea-pig atrial and ventricular myocytes.

    Science.gov (United States)

    Hume, J R; Uehara, A

    1985-11-01

    Single myocardial cells were enzymatically dispersed from guinea-pig atria and ventricles. At 25 degrees C, atrial cell action potentials differed significantly from ventricular cell action potentials in duration (atrial = 141 ms, ventricular = 497 ms) and over-shoot (atrial = +36 mV, ventricular = +42 mV). Action potentials of atrial and ventricular cells responded differently to changes in external K+ concentration ([K+]o). Elevation of [K+]o from 6 to 11 mM depolarized atrial cells but produced no significant change in action potential duration; similar changes in [K+]o depolarized ventricular cells and produced a significant shortening of the action potential duration. Voltage-clamp experiments were performed to investigate the ionic basis underlying the different action potential configurations of single atrial and ventricular myocytes. A single-micropipette voltage-clamp technique was used, employing either extremely small-tip diameter pipettes, without internal cell dialysis (Hume & Giles, 1983), or larger tip diameter pipettes, with internal dialysis (Hamill, Marty, Neher, Sakmann & Sigworth, 1981). Two significant differences in background K+ conductance in single atrial and ventricular myocytes were observed: (i) the isochronal (5 s) current-voltage relationship of single ventricular myocytes exhibited a region of prominent negative slope conductance and elevation of [K+]o produced cross-over; a negative slope conductance region was absent in atrial cells and elevation of [K+]o produced very little cross-over of isochronal current-voltage relationships, and (ii) hyperpolarizing voltage pulses applied from holding potentials of -50 mV elicited inward current in ventricular cells which decayed with time; similar voltage-clamp pulses in atrial cells elicited inward currents which fail to decay. Single K+ channel current measurements confirmed the existence of different resting K+ channel properties in single atrial and ventricular myocytes. Resting K

  14. Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine

    Science.gov (United States)

    Hodkinson, Duncan J.; Veggeberg, Rosanna; Wilcox, Sophie L.; Scrivani, Steven; Burstein, Rami; Becerra, Lino; Borsook, David

    2015-01-01

    The regulation of cerebral blood flow (CBF) is a complex integrated process that is critical for supporting healthy brain function. Studies have demonstrated a high incidence of alterations in CBF in patients suffering from migraine with and without aura during different phases of attacks. However, the CBF data collected interictally has failed to show any distinguishing features or clues as to the underlying pathophysiology of the disease. In this study we used the magnetic resonance imaging (MRI) technique—arterial spin labeling (ASL)—to non-invasively and quantitatively measure regional CBF (rCBF) in a case-controlled study of interictal migraine. We examined both the regional and global CBF differences between the groups, and found a significant increase in rCBF in the primary somatosensory cortex (S1) of migraine patients. The CBF values in S1 were positively correlated with the headache attack frequency, but were unrelated to the duration of illness or age of the patients. Additionally, 82% of patients reported skin hypersensitivity (cutaneous allodynia) during migraine, suggesting atypical processing of somatosensory stimuli. Our results demonstrate the presence of a disease-specific functional deficit in a known region of the trigemino-cortical pathway, which may be driven by adaptive or maladaptive functional plasticity. These findings may in part explain the altered sensory experiences reported between migraine attacks. PMID:26372461

  15. Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine.

    Directory of Open Access Journals (Sweden)

    Duncan J Hodkinson

    Full Text Available The regulation of cerebral blood flow (CBF is a complex integrated process that is critical for supporting healthy brain function. Studies have demonstrated a high incidence of alterations in CBF in patients suffering from migraine with and without aura during different phases of attacks. However, the CBF data collected interictally has failed to show any distinguishing features or clues as to the underlying pathophysiology of the disease. In this study we used the magnetic resonance imaging (MRI technique-arterial spin labeling (ASL-to non-invasively and quantitatively measure regional CBF (rCBF in a case-controlled study of interictal migraine. We examined both the regional and global CBF differences between the groups, and found a significant increase in rCBF in the primary somatosensory cortex (S1 of migraine patients. The CBF values in S1 were positively correlated with the headache attack frequency, but were unrelated to the duration of illness or age of the patients. Additionally, 82% of patients reported skin hypersensitivity (cutaneous allodynia during migraine, suggesting atypical processing of somatosensory stimuli. Our results demonstrate the presence of a disease-specific functional deficit in a known region of the trigemino-cortical pathway, which may be driven by adaptive or maladaptive functional plasticity. These findings may in part explain the altered sensory experiences reported between migraine attacks.

  16. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2007-01-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  17. A novel and simple atrial retractor.

    Science.gov (United States)

    Kofidis, Theo; Lee, Chuen Neng

    2011-05-01

    Minimally invasive cardiac operations require specialized equipment. Atrial retractors are a frequently used tool to expose heart valves for minimally invasive and open procedures. The models currently available in the market are efficient; however, they may be complex, bulky, or expensive. We introduce a novel, very simple atrial retractor we designed using ubiquitously available materials.

  18. Atrial Arrhythmia Summit: Post Summit Report

    Science.gov (United States)

    Barr, Yael

    2010-01-01

    The Atrial Arrhythmia Summit brought together nationally and internationally recognized experts in cardiology, electrophysiology, exercise physiology, and space medicine in an effort to elucidate the mechanisms, risk factors, and management of atrial arrhythmias in the unique occupational cohort of the U.S. astronaut corps.

  19. Corticosteroids and the risk of atrial fibrillation

    NARCIS (Netherlands)

    van der Hooft, CS; Heeringa, J; Brusselle, GG; Hofman, A; Witteman, JCM; Kingma, JH; Sturkenboom, MCJM; Stricker, BHC

    2006-01-01

    Background: High-dose ( pulse) corticosteroid therapy has been associated with the development of atrial fibrillation. This association, however, is mainly based on case reports. Methods: To test the hypothesis that high-dose corticosteroid exposure increases the risk of new-onset atrial fibrillatio

  20. Atrial Electrogram Fractionation Distribution before and after Pulmonary Vein Isolation in Human Persistent Atrial Fibrillation—A Retrospective Multivariate Statistical Analysis

    Directory of Open Access Journals (Sweden)

    Tiago P. Almeida

    2017-08-01

    Full Text Available Purpose: Complex fractionated atrial electrograms (CFAE-guided ablation after pulmonary vein isolation (PVI has been used for persistent atrial fibrillation (persAF therapy. This strategy has shown suboptimal outcomes due to, among other factors, undetected changes in the atrial tissue following PVI. In the present work, we investigate CFAE distribution before and after PVI in patients with persAF using a multivariate statistical model.Methods: 207 pairs of atrial electrograms (AEGs were collected before and after PVI respectively, from corresponding LA regions in 18 persAF patients. Twelve attributes were measured from the AEGs, before and after PVI. Statistical models based on multivariate analysis of variance (MANOVA and linear discriminant analysis (LDA have been used to characterize the atrial regions and AEGs.Results: PVI significantly reduced CFAEs in the LA (70 vs. 40%; P < 0.0001. Four types of LA regions were identified, based on the AEGs characteristics: (i fractionated before PVI that remained fractionated after PVI (31% of the collected points; (ii fractionated that converted to normal (39%; (iii normal prior to PVI that became fractionated (9% and; (iv normal that remained normal (21%. Individually, the attributes failed to distinguish these LA regions, but multivariate statistical models were effective in their discrimination (P < 0.0001.Conclusion: Our results have unveiled that there are LA regions resistant to PVI, while others are affected by it. Although, traditional methods were unable to identify these different regions, the proposed multivariate statistical model discriminated LA regions resistant to PVI from those affected by it without prior ablation information.

  1. Atrial Remodeling And Atrial Fibrillation: Mechanistic Interactions And Clinical Implications

    OpenAIRE

    2009-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The prevalence of AF increases dramatically with age and is seen in as high as 9% of individuals by the age of 80 years. In high-risk patients, the thromboembolic stroke risk can be as high as 9% per year and is associated with a 2-fold increase in mortality. Although the pathophysiological mechanism underlying the genesis of AF has been the focus of many studies, it remains only partially understood. Conventional th...

  2. The Blood Pressure Circadian Rhythm of Atrial Fibrillation in Patients with Essential Hypertension%原发性高血压并发心房颤动患者血压的昼夜节律及心率变异性变化

    Institute of Scientific and Technical Information of China (English)

    李坚; 詹伟跃

    2015-01-01

    [Abstract ]Objective to explore the circadian rhythm change of blood pressure in essontial hypertension patients with atrial fibrillation.Methods 128 cases of hypertensive patients in our hospital from August 2012 to August 2014. were divided into concurrent group and the normal group with afrial fibritlation or without afrial fibritlation. 64 cases in each group. Concurrent group of were composed of hypertanzine patients with of. The normal group of patients with normal heart function,giving ambulatory blood pressure and Holter monitoring. To Compare the changes of ECG within 24 hours as well as circadian(Including daytime mean systolic and diastolic blood pressure, mean systolic and diastolic blood pressure at night and 24-hour mean systolic and diastolic blood pressure, etc.) between the two groups.Results Compared with the normal group, the 24h average diastolic blood pressure, mean daytime diastolic blood pressure, diastolic blood pressure and daytime minimum minimum daytime systolic blood pressure were lower than the normal group, the difference was statistically significant (P 0.05);The largest nighttime systolic diastolic blood pressure, and the anti-dipper patients between two groups increased, significantly compered with normel group (P<0.05).Conclusions Primary hypertension patients with atrial fibrillation, day can lead to decreased blood pressure and night hypertension, and alsoced cause the decrease of HRV.%目的:探讨原发性高血压并发心房颤动患者血压的昼夜节律变化情况。方法选取我院收治的原发性高血压128例资料,根据心功能情况,分为并发组和正常组,每组各64例。并发组为原发性高血压并发心房颤动的患者,正常组为原发性高血压不伴房颤且心功能正常的患者,对患者采取动态血压和动态心电图24 h同步监测,比较两组患者的24 h内心率变异性情况以及昼夜血压(包括白昼平均收缩压和舒张压、夜间平

  3. Platelet Reactivity Is Independent of Left Atrial Wall Deformation in Patients with Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Nathan Procter

    2016-01-01

    Full Text Available It has been documented recently that left atrial (LA deformation in AF patients (while in AF is predictive of subsequent stroke risk. Additionally, diminished LA deformation during AF correlates with the presence of LA blood stasis. Given that endothelial function is dependent on laminar blood flow, the present study sought to investigate the effect of diminished LA deformation (during AF on platelet reactivity and inflammation in AF patients. Patients (n=17 hospitalised with AF underwent echocardiography (while in AF for determination of peak positive LA strain (LASp. Whole blood impedance aggregometry was used to measure extent of ADP-induced aggregation and subsequent inhibitory response to the nitric oxide (NO donor, sodium nitroprusside. Platelet thioredoxin-interacting protein (Txnip content was determined by immunohistochemistry. LASp tended (p=0.078 to vary inversely with CHA2DS2VASc scores. However, mediators of inflammation (C-reactive protein, Txnip did not correlate significantly with LASp nor did extent of ADP-induced platelet aggregation or platelet NO response. These results suggest that the thrombogenic risk associated with LA stasis is independent of secondary effects on platelet aggregability or inflammation.

  4. Regional cerebral blood flow in schizophrenic patients. Headtome xenon 133 inhalation technique

    Energy Technology Data Exchange (ETDEWEB)

    Sagawa, Katsuo

    1989-01-01

    Seventy-six schizophrenic patients met criterias of DSM-III for schizophrenia. The rCBF was determined by the Xe-133 inhalation technique (HEADTOMA: ring type SPECT). There was no significant difference in age between the patients (32.5+-6.6, mean +-SD) and controls (32.5+-6.6). The rCBF was corrected by end-tidal CO/sub 2/ concentration. Mean hemispheric rCBF did not differ significantly between the patients and controls. The patients showed significantly less rCBF than controls (p<0.05) in the frontal regions and the sensorimotor area. There was a significant correlation between frontal rCBF and the Scale for the Assessment of Negative Symptoms (SANS) in patients (i.e. between right dorsal frontal rCBF and SANS total score, r=-0.32, p<0.05) and also a significant negative correlation between numbers of perseverative errors of the Wisconsin card sorting test (WCST) and left orbitofrontal rCBF (r=-0.56, p<0.01).

  5. Atrial fibrillation in patients with ischemic stroke

    DEFF Research Database (Denmark)

    Thygesen, Sandra Kruchov; Frost, Lars; Eagle, Kim A;

    2009-01-01

    BACKGROUND: Atrial fibrillation is a major risk factor for ischemic stroke. However, the prognostic impact of atrial fibrillation among patients with stroke is not fully clarified. We compared patient characteristics, including severity of stroke and comorbidity, quality of in-hospital care...... and outcomes in a cohort of first-time ischemic stroke patients with and without atrial fibrillation. METHODS: Based on linkage of public medical databases, we did a population-based follow-up study among 3,849 stroke patients from the County of Aarhus, Denmark admitted in the period of 2003......-2007 and prospectively registered in the Danish National Indicator Project. RESULTS: Atrial fibrillation was associated with an adverse prognostic profile but not with an overall poorer quality of in-hospital care. Patients with atrial fibrillation had a longer total length of stay (median: 15 vs 9 days), and were...

  6. [Serum lipids and blood pressure levels in the +Mapuche population living in the Chilean region of Araucanía].

    Science.gov (United States)

    Stockins, B; Larenas, G; Charles, M; Standen, D; Espinoza, O; Illesca, M; Opazo, J A; Carrasco, B; Lanas, F; Davis, M

    1998-11-01

    Chilean aboriginal populations (Mapuche) predominantly live in the region of Araucanía, in the southern part of the country. Their cardiovascular risk factors have not been systematically assessed. To study the prevalence of cardiovascular risk factors in the Mapuche population. Blood pressure, weight, height, dietary habits, fasting serum total cholesterol, HDL cholesterol and triglycerides were measured in 1.948 adults living in 28 Mapuche communities. Thirteen percent of males and 16% of females had high blood pressure. Body mass index was 25.5 kg/m2 in males and 28.1 kg/m2 in females. Forty five percent of women and 24% of men were classified as obese. Mean serum total cholesterol was 186.7 +/- 9.6 mg/dl, HDL cholesterol was 58.7 +/- 30.7 mg/dl, total cholesterol/HDL cholesterol was 3.4 +/- 2 and triglycerides were 155.2 +/- 91.2 mg/dl. Twenty eight percent of males and 9.6% of females smoked. Mapuche individuals have higher levels of HDL cholesterol a better total cholesterol/HDL cholesterol ratio and lower frequency of smoking than non aboriginal Chileans subjects.

  7. Reproducibility of regional cerebral blood flow measurement at rest with autoradiography method using {sup 123}I-IMP and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Kyoko; Murata, Hajime; Maruno, Hirotaka; Mori, Kazuaki; Tsuchida, Shoichi [Toranomon Hospital, Tokyo (Japan)

    1997-05-01

    Reproducibility of regional cerebral blood flow (rCBF) values obtained by the autoradiography (ARG) method with one SPECT scan and one point arterial blood sampling at 10 min after {sup 123}I-N-isopropyl-p-iodoamphetamine (IMP) infusion was evaluated. The variation in the cross calibration factor between SPECT counts and well-type scintillation counts remained 2.2% for 13 months. The error in rCBF by sampling time difference was less than 3% when sampling time was within 10 min{+-}30 sec after infusion. There was a favorable correlation between the rCBF values in two separate resting scans measured by the ARG method in 10 patients (r=0.907). And the mean ratio of rCBF values by the second study to those by the first study in the cerebellum and cerebral lobes in 10 patients was 0.989{+-}0.056 (mean{+-}SD). There was no significant difference in rCBF values between two separate studies. Reproducibility of rCBF with the ARG method was proved to be good. The ARG method was thought to be useful for the assessment of treatment effects and clinical courses. (author)

  8. QUANTITATIVE CHANGES IN REGIONAL CEREBRAL BLOOD FLOW INDUCED BY COLD, HEAT AND ISCHEMIC PAIN: A CONTINUOUS ARTERIAL SPIN LABELING STUDY

    Science.gov (United States)

    Frölich, Michael A.; Deshpande, Hrishikesh; Ness, Timothy; Deutsch, Georg

    2012-01-01

    Background The development of arterial spin labeling methods, has allowed measuring regional cerebral blood flow (rCBF) quantitatively and to show the pattern of cerebral activity associated with any state such as a sustained pain state or changes due to a neurotropic drug. Methods We studied the differential effects of three pain conditions in ten healthy subjects on a 3T scanner during resting baseline, heat, cold and ischemic pain using continuous arterial spin labeling. Results Cold pain showed the greatest absolute rCBF increases in left anterior cingulate cortex, left amygdala, left angular gyrus, and Brodmann Area 6, and a significant rCBF decrease in the cerebellum. Changes in rCBF were characteristic of the type of pain condition: cold and heat pain showed increases, while the ischemic condition showed a reduction in mean absolute gray matter flow compared to rest. An association of subjects’ pain tolerance and cerebral blood flow was noted. Conclusions The observation that quantitative rCBF changes are characteristic of the pain task employed and that there is a consistent rCBF change in Brodman area 6, an area responsible for the integration of a motor response to pain, should provide extremely useful information in the quest to develop an imaging biomarker of pain. Conceivably, response in BA6 may serve as an objective measure of analgesic efficacy. PMID:22913924

  9. Regional cerebral blood flow during light sleep--a H(2)(15)O-PET study

    DEFF Research Database (Denmark)

    Kjaer, Troels W; Law, Ian; Wiltschiøtz, Gordon

    2002-01-01

    This is the first report on the distribution of regional cerebral blood flow (rCBF) changes during stage-1 sleep or somnolence. Two hypotheses were tested: (A) that rCBF differed between the awake relaxed state and stage-1 sleep, (B) that hypnagogic hallucinations frequently experienced at sleep...... onset would be accompanied by measurable changes in rCBF using positron emission tomography (PET). Eight subjects were PET-scanned with (15)O-labeled water injection in three conditions: awake, stage-1 sleep with reportable experiences and stage-1 sleep without reportable experiences....... Electroencephalography (EEG) was performed continuously during the experiment. Sleep interviews were performed after each scan. The EEG was scored blindly to determine sleep stage. The sleep interviews revealed a substantial increase in how unrealistic and how leaping the thoughts were during stage-1 sleep. During sleep...

  10. Effects of W-CDMA 1950 MHz EMF emitted by mobile phones on regional cerebral blood flow in humans.

    Science.gov (United States)

    Mizuno, Yoko; Moriguchi, Yoshiya; Hikage, Takashi; Terao, Yasuo; Ohnishi, Takashi; Nojima, Toshio; Ugawa, Yoshikazu

    2009-10-01

    Use of the third generation mobile phone system is increasing worldwide. This is the first study to investigate the effects of the third generation system on regional cerebral blood flow (rCBF) in humans. We compared effects of the electromagnetic field (EMF) emitted from the Wideband Code Division Multiple Access (W-CDMA) cellular system versus sham control exposure on rCBF in humans. Nine healthy male volunteers participated in this study. Positron emission tomography (PET) scans were obtained before, during, and after unilateral 30 min EMF exposure. The subtraction analysis revealed no significant rCBF changes caused by the EMF conditions compared with the sham exposure, suggesting that EMF emitted by a third generation mobile phone does not affect rCBF in humans.

  11. Bioptic Study of Left and Right Atrial Interstitium in Cardiac Patients with and without Atrial Fibrillation: Interatrial but Not Rhythm-Based Differences.

    Science.gov (United States)

    Smorodinova, Natalia; Lantová, Lucie; Bláha, Martin; Melenovský, Vojtěch; Hanzelka, Jan; Pirk, Jan; Kautzner, Josef; Kučera, Tomáš

    2015-01-01

    One of the generally recognized factors contributing to the initiation and maintenance of atrial fibrillation (AF) is structural remodeling of the myocardium that affects both atrial cardiomyocytes as well as interstitium. The goal of this study was to characterize morphologically and functionally interstitium of atria in patients with AF or in sinus rhythm (SR) who were indicated to heart surgery. Patient population consisted of 46 subjects (19 with long-term persistent AF, and 27 in SR) undergoing coronary bypass or valve surgery. Peroperative bioptic samples of the left and the right atria were examined using immunohistochemistry to visualize and quantify collagen I, collagen III, elastin, desmin, smooth muscle actin, endothelium and Vascular Endothelial Growth Factor (VEGF). The content of interstitial elastin, collagen I, and collagen III in atrial tissue was similar in AF and SR groups. However, the right atrium was more than twofold more abundant in elastin as compared with the left atrium and similar difference was found for collagen I and III. The right atrium showed also higher VEGF expression and lower microvascular density as compared to the left atrium. No significant changes in atrial extracellular matrix fiber content, microvascular density and angiogenic signaling, attributable to AF, were found in this cohort of patients with structural heart disease. This finding suggests that interstitial fibrosis and other morphological changes in atrial tissue are rather linked to structural heart disease than to AF per se. Significant regional differences in interstitial structure between right and left atrium is a novel observation that deserves further investigation.

  12. Artificial atrial fibrillation in the dog. An artifact?

    NARCIS (Netherlands)

    Strackee, J.; Hoelen, A.J.; Zimmerman, A.N.E.; Meijler, F.L.

    1971-01-01

    R-R interval sequences during artificial atrial fibrillation in dogs were studied in the same way as in patients in a previous study and compared with results obtained in dogs with spontaneous atrial fibrillation. Artificial atrial fibrillation was effected by right atrial stimulation in three close

  13. Galectin-3 in patients undergoing ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Nicolas Clementy

    2014-11-01

    Conclusions: Persistent type of atrial fibrillation is an independent predictor of higher Galectin-3 concentration. This biomarker of fibrosis may be implied in the mechanisms of atrial remodeling and maintenance of atrial fibrillation, and thus be helpful for the design of therapeutic strategy in patients with atrial fibrillation.

  14. Influence of social activity on regional cerebral blood flow and mental function in the normal aged volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Shotai; Yamaguchi, Shuhei; Katsube, Tomoko; Kitani, Kohaku; Okada, Masanori (Shimane Medical University (Japan))

    1983-12-01

    The infuence of social activity on regional cerebral blood flow (rCBF) and mental function was studied by Xe133 inhalation method in normal aged volunteers. Subjects: The first group consisted of 33 aged volunteers living in nursing home and exposed to little social stimuli. There were 15 males (mean age of 77 years) and 18 females (77 years). The second group consisted of 49 aged community volunteers who were confirmed socially active. There were 25 males (76 years) and 24 females (72 years). All subjects were healthy persons without a past history of cerebral diseases and lung diseases. There were no difference in blood pressure and hematocrit between the two groups. The rCBF was measured by 16-ch-Novo-cerebrograph. Verbal intelligence was evaluated by the Hasegawa Simple Intelligence Scale for Aged. Performance intelligence was evaluated with the Kohs' Block Design Test. The mean rCBF in group I showed significantly lower value than that of group II, especially in the frontotemporal region. The performance intelligence was decreased in group I. However, there were no significant difference in the verbal intelligence between the two groups. 2) The aging effect on rCBF and intelligences was more prominent in group II. 3) In males, hemispheric rCBF of group I decreased bilaterally associated with the decrease of both intelligences. While the left hemispheric rCBF in females was relatively preserved as well as the preservation of verbal intelligence. These results indicate that the social environmental factors may have significant influence to aging of the brain especially in the males.

  15. Stimulus rate dependence of regional cerebral blood flow in human striate cortex, demonstrated by positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fox, P.T.; Raichle, M.E.

    1984-05-01

    The purpose of this investigation was to determine the relationship between the repetition rate of a simple sensory stimulus and regional cerebral blood flow (rCBF) in the human brain. Positron emission tomography (PET), using intravenously administered H/sub 2/(/sup 15/)O as the diffusible blood-flow tracer, was employed for all CBF measurements. The use of H/sub 2/(/sup 15/)O with PET allowed eight CBF measurements to be made in rapid sequence under multiple stimulation conditions without removing the subject from the tomograph. Nine normal volunteers each underwent a series of eight H2(/sup 15/)O PET measurements of CBF. Initial and final scans were made during visual deprivation. The six intervening scans were made during visual activation with patterned-flash stimuli given in random order at 1.0-, 3.9-, 7.8-, 15.5-, 33.1-, and 61-Hz repetition rates. The region of greatest rCBF increase was determined. Within this region the rCBF was determined for every test condition and then expressed as the percentage change from the value of the initial unstimulated scan (rCBF% delta). In every subject, striate cortex rCBF% delta varied systematically with stimulus rate. Between 0 and 7.8 Hz, rCBF% delta was a linear function of stimulus repetition rate. The rCBF response peaked at 7.8 Hz and then declined. The rCBF% delta during visual stimulation was significantly greater than that during visual deprivation for every stimulus rate except 1.0 Hz. The anatomical localization of the region of peak rCBF response was determined for every subject to be the mesial occipital lobes along the calcarine fissure, primary visual cortex. Stimulus rate is a significant determinant of rCBF response in the visual cortex. Investigators of brain responses to selective activation procedures should be aware of the potential effects of stimulus rate on rCBF and other measurements of cerebral metabolism.

  16. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mukamal, Kenneth J; Tolstrup, Janne S; Friberg, Jens

    2005-01-01

    BACKGROUND: The relationship of the full range of alcohol consumption with risk of incident atrial fibrillation has been inconsistent in previous, mainly case-control studies. METHODS AND RESULTS: In a prospective cohort study, we studied the association between self-reported alcohol use...... not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood...... nationwide registry of all hospitalizations. A total of 1071 cases occurred during follow-up. Among both women and men, alcohol consumption throughout the moderate range was not associated with risk of atrial fibrillation. However, consumption of 35 or more drinks per week among men was associated...

  17. Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry.

    Science.gov (United States)

    Cosio, F G; Palacios, J; Vidal, J M; Cocina, E G; Gómez-Sánchez, M A; Tamargo, L

    1983-01-01

    Extrastimulus-induced intraatrial conduction delays were measured in 12 patients with documented episodes of atrial fibrillation (AF) by recording atrial electrograms at the high right atrium, His bundle region, and coronary sinus. Seventeen patients with and without heart disease, but without atrial arrhythmias served as the control group. During baseline-paced atrial rhythms, a conduction delay zone could be delineated, near the atrial effective refractory period, during which all extrastimuli produced conduction delays. When compared at the same paced cycle lengths (500 to 650 ms), the patients with AF had shorter atrial effective refractory periods (mean +/- standard deviation 206 +/- 24.1 versus 233 +/- 28.2 in control patients, p less than 0.02), wider conduction delay zones (79 +/- 21.7 ms versus 52 +/- 21 in control patients, p less than 0.01), and longer conduction delays both to the His bundle region (64 +/- 18.3 ms versus 35 +/- 21.7 in control patients, p less than 0.005) and the coronary sinus (76 +/- 18.9 ms versus 35 +/- 16.1 in control patients, p less than 0.001). Repetitive atrial responses were recorded in 6 patients with AF and in 9 control subjects. Sinus nodal function abnormalities were detected in 6 of the patients with fibrillation. Patients with AF had a higher tendency than control subjects to develop slow intraatrial conduction, as well as shorter effective refractory periods. Since both features would favor reentry, they may be the electrophysiologic manifestations of the abnormalities making these patients prone to atrial reentrant arrhythmias. Repetitive atrial responses were of no predictive value. Sinus nodal dysfunction was frequently found, but was not essential for the occurrence of AF.

  18. Atrial Natriuretic Peptide and Renal Dopaminergic System: A Positive Friendly Relationship?

    Directory of Open Access Journals (Sweden)

    Marcelo Roberto Choi

    2014-01-01

    Full Text Available Sodium metabolism by the kidney is accomplished by an intricate interaction between signals from extrarenal and intrarenal sources and between antinatriuretic and natriuretic factors. Renal dopamine plays a central role in this interactive network. The natriuretic hormones, such as the atrial natriuretic peptide, mediate some of their effects by affecting the renal dopaminergic system. Renal dopaminergic tonus can be modulated at different steps of dopamine metabolism (synthesis, uptake, release, catabolism, and receptor sensitization which can be regulated by the atrial natriuretic peptide. At tubular level, dopamine and atrial natriuretic peptide act together in a concerted manner to promote sodium excretion, especially through the overinhibition of Na+, K+-ATPase activity. In this way, different pathological scenarios where renal sodium excretion is dysregulated, as in nephrotic syndrome or hypertension, are associated with impaired action of renal dopamine and/or atrial natriuretic peptide, or as a result of impaired interaction between these two natriuretic systems. The aim of this review is to update and comment on the most recent evidences demonstrating how the renal dopaminergic system interacts with atrial natriuretic peptide to control renal physiology and blood pressure through different regulatory pathways.

  19. A possible role of atrial natriuretic peptide in ethanol-induced acute diuresis

    Energy Technology Data Exchange (ETDEWEB)

    Colantonio, D.; Casale, R.; Mammarella, M.; Pasqualetti, P. (Univ. of L' Aquila (Italy)); Desiati, P.; De Michele, G. (General Hospital of Coppito, L' Aquila (Italy))

    1991-01-01

    The acute effects of ethanol on plasma atrial natriuretic peptide levels were investigated in 4 clinically healthy males, aged 24-26 years, consumed either 750 ml of water as a control study, or the same beverage with 1 ml/kg alcohol added, which increased the plasma alcohol concentration to 99.12{plus minus}15.10 mg/dl at 60 min. Plasma atrial natriuretic peptide levels were significantly higher in the alcohol study compared to the control study at each time point, and with a peak at 10 min. Atrial natriuretic peptide levels showed a positive significant correlation with plasma antidiuretic hormone in the control group, while no relationship was found between the two peptides in the alcohol study. Moreover, a significant correlation exists between plasma atrial natriuretic peptide levels and systolic arterial blood pressure, and heart rate, and between the variations in atrial natriuretic peptide values and the variations in plasma sodium, serum ethanol, and plasma osmolality in the alcohol study. Acute ethanol intake causes an increase in urinary volume, and a decrease in urinary potassium excretion and urinary osmolality, and no change in urinary sodium excretion.

  20. Left Atrial Structure and Function in Heart Failure with Preserved Ejection Fraction: A RELAX Substudy

    Science.gov (United States)

    McNulty, Steven E.; Hernandez, Adrian F.; Semigran, Marc J.; Lewis, Gregory D.; Jerosch-Herold, Michael; Kim, Raymond J.; Redfield, Margaret M.; Kwong, Raymond Y.

    2016-01-01

    Given the emerging recognition of left atrial structure and function as an important marker of disease in heart failure with preserved ejection fraction (HF-pEF), we investigated the association between left atrial volume and function with markers of disease severity and cardiac structure in HF-pEF. We studied 100 patients enrolled in the PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and EXercise Capacity in Diastolic Heart Failure (RELAX) trial who underwent cardiac magnetic resonance (CMR), cardiopulmonary exercise testing, and blood collection before randomization. Maximal left atrial volume index (LAVi; N = 100), left atrial emptying fraction (LAEF; N = 99; including passive and active components (LAEFP, LAEFA; N = 80, 79, respectively) were quantified by CMR. After adjustment for multiple testing, maximal LAVi was only associated with age (ρ = 0.39), transmitral filling patterns (medial E/e’ ρ = 0.43), and N-terminal pro-BNP (NT-proBNP; ρ = 0.65; all pHFpEF. Further research to explore the relevance of left atrial structure and function in HF-pEF is warranted. PMID:27812147

  1. Mathematical modeling of epicardial RF ablation of atrial tissue with overlying epicardial fat.

    Science.gov (United States)

    Suárez, Ana González; Hornero, Fernando; Berjano, Enrique J

    2010-02-04

    The efficacy of treating atrial fibrillation by RF ablation on the epicardial surface is currently under question due to the presence of epicardial adipose tissue interposed between the ablation electrode and target site (atrial wall). The problem is probably caused by the electrical conductivity of the fat (0.02 S/m) being lower than that of the atrial tissue (0.4-0.6 S/m). Since our objective is to improve epicardial RF ablation techniques, we planned a study based on a two-dimensional mathematical model including an active electrode, a fragment of epicardial fat over a fragment of atrial tissue, and a section of atrium with circulating blood. Different procedures for applying RF power were studied, such as varying the frequency, using a cooled instead of a dry electrode, and different modes of controlling RF power (constant current, temperature and voltage) for different values of epicardial fat thickness. In general, the results showed that the epicardial fat layer seriously impedes the passage of RF current, thus reducing the effectiveness of atrial wall RF ablation.

  2. Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

    Directory of Open Access Journals (Sweden)

    Claudia Loardi

    2015-01-01

    Full Text Available Background. Maze procedure aims at restoring sinus rhythm (SR and atrial contractility (AC. This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation. Methods. 122 mitral and fibrillating patients underwent radiofrequency Maze. Rhythm check and echocardiographic control of biatrial contractility were performed at 3, 6, 12, and 24 months postoperatively. A multivariate Cox analysis of risk factors for absence of AC recuperation was applied. Results. At 2-years follow-up, SR was achieved in 79% of patients. SR-AC coexistence increased from 76% until 98%, while biatrial contraction detection augmented from 84 to 98% at late stage. Shorter preoperative arrhythmia duration was the only common predictor of SR-AC restoring, while pulmonary artery pressure (PAP negatively influenced AC recuperation. Early AC restoration favored future freedom from arrhythmia recurrence. Minor LA dimensions correlated with improved future A/E value and vice versa. Right atrial (RA contractility restoring favored better left ventricular (LV performance and volumes. Conclusions. SR and left AC are two interrelated Maze objectives. Factors associated with arrhythmia “chronic state” (PAP and arrhythmia duration are negative predictors of procedural success. Our results suggest an association between postoperative LA dimensions and “kick” restoring and an influence of RA contraction onto LV function.

  3. Left atrial ball valve thrombus

    Directory of Open Access Journals (Sweden)

    R. Balaji

    2013-10-01

    Full Text Available "Ball valve thrombus" which is a spherical free floating clot in left atrium is an often quoted, but uncommonly encountered complication in patients with severe mitral stenosis of rheumatic origin, who are in atrial fibrillation. We describe the case of a 31-year-old lady with rheumatic heart disease, severe mitral stenosis and moderately severe aortic stenosis who had undergone closed mitral valvotomy 13 years ago. The patient presented with an episode of non-exertional syncope and breathlessness on exertion of 6 months duration and was in normal sinus rhythm. Echocardiography facilitated ante-mortem diagnosis and prompt institution of surgery was life saving.

  4. Differential gene expression during atrial structural remodeling in human left and right atrial appendages in atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Hui Zhu; Wei Zhang; Ming Zhong; Gong Zhang; Yun Zhang

    2011-01-01

    Extracellular matrix (ECM) remodeling increases the vulnerability to atrial fibrillation (AF). Some gene expressions are crucial for the metabolism of ECM. The left atrium plays an important role in maintaining AF.However, most studies investigated only the right atrial tissue. We therefore chose human tissue samples from both the left and right atrial to detect the different gene expressions during structural remodeling in AF. The atrial appendages tissue samples from 24 patients with chronic AF and 12 patients with sinus rhythm were obtained when they were undergoing mitral/aortic valve replacement operation. The mRNA levels of matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), disintegrin, metalloproteases-15, and integrins β1 were determined by reverse transcriptionpolymerase chain reaction (RT-PCR). in AF group, the level of MMP-9 in left atrial appendage (LAA) was increased (P<0.001), while integrin β1 level was decreased (P< 0.05) compared with those expressed in right atrial appendage (RAA) tissue. The levels of disintegrin, metalloproteinases-15, and TIMP-1 genes in the LAA and RAA had no significant differences. The results demonstrated that the gene expressions in the LAA and RAA are different during AF, which implied that the mechanism of atrial structural remodeling in AF is due to multiple sources and is complicated.

  5. Atrial and ventricular volume and function in persistent and permanent atrial fibrillation, a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Therkelsen, Susette Krohn; Groenning, Bjoern Aaris; Svendsen, Jesper Hastrup

    2005-01-01

    Left atrial size is independently related to cardiovascular morbidity and mortality, and atrial fibrillation (AF) is strongly associated with atrial size. Our aims were to report atrial and ventricular dimensions in patients with AF evaluated with magnetic resonance imaging (MRI), and to assess t...

  6. Fully automated quantification of regional cerebral blood flow with three-dimensional stereotaxic region of interest template. Validation using magnetic resonance imaging. Technical note

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Ryo; Katayama, Shigenori; Takeda, Naoya; Fujita, Katsuzo [Nishi-Kobe Medical Center (Japan); Yonekura, Yoshiharu [Fukui Medical Univ., Matsuoka (Japan); Konishi, Junji [Kyoto Univ. (Japan). Graduate School of Medicine

    2003-03-01

    The previously reported three-dimensional stereotaxic region of interest (ROI) template (3DSRT-t) for the analysis of anatomically standardized technetium-99m-L,L-ethyl cysteinate dimer ({sup 99m}Tc-ECD) single photon emission computed tomography (SPECT) images was modified for use in a fully automated regional cerebral blood flow (rCBF) quantification software, 3DSRT, incorporating an anatomical standardization engine transplanted from statistical parametric mapping 99 and ROIs for quantification based on 3DSRT-t. Three-dimensional T{sub 2}-weighted magnetic resonance images of 10 patients with localized infarcted areas were compared with the ROI contour of 3DSRT, and the positions of the central sulcus in the primary sensorimotor area were also estimated. All positions of the 20 lesions were in strict accordance with the ROI delineation of 3DSRT. The central sulcus was identified on at least one side of 210 paired ROIs and in the middle of 192 (91.4%) of these 210 paired ROIs among the 273 paired ROIs of the primary sensorimotor area. The central sulcus was recognized in the middle of more than 71.4% of the ROIs in which the central sulcus was identifiable in the respective 28 slices of the primary sensorimotor area. Fully automated accurate ROI delineation on anatomically standardized images is possible with 3DSRT, which enables objective quantification of rCBF and vascular reserve in only a few minutes using {sup 99m}Tc-ECD SPECT images obtained by the resting and vascular reserve (RVR) method. (author)

  7. Mapping strategy for multiple atrial tachyarrhythmias in a transplant heart

    DEFF Research Database (Denmark)

    Jin, Qi; Pehrson, Steen; Jacobsen, Peter Karl;

    2015-01-01

    BACKGROUND: Different atrial arrhythmias can coexist in the recipient and donor atria after heart transplantation. CASE PRESENTATION: We report an unusual case of a patient with three different types of atrial arrhythmia after heart transplantation: an atrial fibrillation in the recipient atria....... CONCLUSIONS: It is critical to understand the surgical anatomy of a bi-atrial anastomosis and its relevant electrical activation pattern before ablation. Appropriate electroanatomical mapping strategy with RMN can facilitate the successful ablation of post-transplant atrial arrhythmias....

  8. Exclusion of linkage between alcoholism and the MNS blood group region on chromosome 4q in multiplex families

    Energy Technology Data Exchange (ETDEWEB)

    Neiswanger, K.; Kaplan, B.; Hill, S.Y. [Univ. of Pittsburgh School of Medicine, PA (United States)

    1995-02-27

    Polymorphic DNA markers on the long arm of chromosome 4 were used to examine linkage to alcoholism in 20 multiplex pedigrees. Fifteen loci were determined for 124 individuals. Lod scores were calculated assuming both dominant and recessive disease modes of inheritance, utilizing incidence data by age and gender that allow for correction for variable age of onset and frequency of the disorder by gender. Under the assumption that alcoholism is homogeneous in this set of pedigrees, and that a recessive mode with age and gender correction is the most appropriate, the total lod scores for all families combined were uniformly lower than -2.0. This suggests an absence of linkage between the putative alcoholism susceptibility gene and markers in the region of the MNS blood group (4q28-31), a region for which we had previously found suggestive evidence of linkage to alcoholism. The 100 cM span of chromosome 4 studied includes the class I alcohol dehydrogenase (ADH) loci. Using the recessive mode, no evidence for linkage to alcoholism was found for the markers tested, which spanned almost the entire long arm of chromosome 4. Under the dominant mode, no evidence for linkage could be found for several of the markers. 36 refs., 1 fig., 3 tabs.

  9. Atrial and ventricular function in thalassemic patients with supraventricular arrhythmias

    Directory of Open Access Journals (Sweden)

    Vitantonio Di Bello

    2009-04-01

    Full Text Available The aims of this study were to evaluate through Color Doppler Myocardial Imaging (CDMI echocardiography if atrial or ventricular myocardial alterations could be detectable in patients with thalassemia major (THAL and if these alterations could be considered as predictive elements for supra-ventricular arrhythmic events. Twenty-three patients with THAL underwent clinical and electrocardiographic evaluation; patients were grouped in THAL1 (9 with supra-ventricular arrhythmias and THAL2 (14 without arrhythmias; 12 healthy subjects were considered as control group (C. We examined through conventional 2D Color Doppler echocardiography some morphological and functional parameters regarding left ventricular (LV systolic and diastolic function, and through CDMI the velocities at mitral annulus level, the regional LV and left atrial (LA strain and strain rate. All THAL patients had LV dimension (pless than 0.05, LA area (p less than 0.01 and E/Em ratio (pless than 0.001 to be significantly higher than controls. The mitral annulus longitudinal velocities were significantly lower in THAL1 than in THAL2 (pless than 0.001; the E/Em ratio was higher in THAL1 than THAL2 (pless than 0.001. The THAL1 showed a lower systolic strain rate of atrial wall than THAL2 and C (pless than 0.05. The multiple regression highlighted a significantly inverse correlation among E/Em and atrial strain (pless than 0.02. CDMI showed both THAL subgroups had subtle systolic and diastolic left ventricular myocardial alterations, which could represent the onset of developing “iron cardiomyopathy” and are related to supra-ventricular arrhythmia. Monitoring these parameters in the THAL patients could contribute to decisions about follow-up and therapy.

  10. Novel Computational Analysis of Left Atrial Anatomy Improves Prediction of Atrial Fibrillation Recurrence after Ablation

    Science.gov (United States)

    Varela, Marta; Bisbal, Felipe; Zacur, Ernesto; Berruezo, Antonio; Aslanidi, Oleg V.; Mont, Lluis; Lamata, Pablo

    2017-01-01

    The left atrium (LA) can change in size and shape due to atrial fibrillation (AF)-induced remodeling. These alterations can be linked to poorer outcomes of AF ablation. In this study, we propose a novel comprehensive computational analysis of LA anatomy to identify what features of LA shape can optimally predict post-ablation AF recurrence. To this end, we construct smooth 3D geometrical models from the segmentation of the LA blood pool captured in pre-procedural MR images. We first apply this methodology to characterize the LA anatomy of 144 AF patients and build a statistical shape model that includes the most salient variations in shape across this cohort. We then perform a discriminant analysis to optimally distinguish between recurrent and non-recurrent patients. From this analysis, we propose a new shape metric called vertical asymmetry, which measures the imbalance of size along the anterior to posterior direction between the superior and inferior left atrial hemispheres. Vertical asymmetry was found, in combination with LA sphericity, to be the best predictor of post-ablation recurrence at both 12 and 24 months (area under the ROC curve: 0.71 and 0.68, respectively) outperforming other shape markers and any of their combinations. We also found that model-derived shape metrics, such as the anterior-posterior radius, were better predictors than equivalent metrics taken directly from MRI or echocardiography, suggesting that the proposed approach leads to a reduction of the impact of data artifacts and noise. This novel methodology contributes to an improved characterization of LA organ remodeling and the reported findings have the potential to improve patient selection and risk stratification for catheter ablations in AF.

  11. Novel Computational Analysis of Left Atrial Anatomy Improves Prediction of Atrial Fibrillation Recurrence after Ablation.

    Science.gov (United States)

    Varela, Marta; Bisbal, Felipe; Zacur, Ernesto; Berruezo, Antonio; Aslanidi, Oleg V; Mont, Lluis; Lamata, Pablo

    2017-01-01

    The left atrium (LA) can change in size and shape due to atrial fibrillation (AF)-induced remodeling. These alterations can be linked to poorer outcomes of AF ablation. In this study, we propose a novel comprehensive computational analysis of LA anatomy to identify what features of LA shape can optimally predict post-ablation AF recurrence. To this end, we construct smooth 3D geometrical models from the segmentation of the LA blood pool captured in pre-procedural MR images. We first apply this methodology to characterize the LA anatomy of 144 AF patients and build a statistical shape model that includes the most salient variations in shape across this cohort. We then perform a discriminant analysis to optimally distinguish between recurrent and non-recurrent patients. From this analysis, we propose a new shape metric called vertical asymmetry, which measures the imbalance of size along the anterior to posterior direction between the superior and inferior left atrial hemispheres. Vertical asymmetry was found, in combination with LA sphericity, to be the best predictor of post-ablation recurrence at both 12 and 24 months (area under the ROC curve: 0.71 and 0.68, respectively) outperforming other shape markers and any of their combinations. We also found that model-derived shape metrics, such as the anterior-posterior radius, were better predictors than equivalent metrics taken directly from MRI or echocardiography, suggesting that the proposed approach leads to a reduction of the impact of data artifacts and noise. This novel methodology contributes to an improved characterization of LA organ remodeling and the reported findings have the potential to improve patient selection and risk stratification for catheter ablations in AF.

  12. How can we best detect atrial fibrillation?

    Science.gov (United States)

    Harris, K; Edwards, D; Mant, J

    2012-01-01

    Atrial fibrillation (AF) is an arrhythmia of increasing prevalence associated with a reducible risk of stroke. We conducted a systematic review to address five questions relating to how we can best detect AF: 1. Are there useful screening tests to determine who should have a 12-lead electrocardiogram (ECG)? Potential screening tests, all with acceptable sensitivity, include pulse palpation, single-lead ECG and newer technologies such as modified sphygmomanometers or a finger probe device. Pulse palpation has a high number of false positives, but is the cheapest method. 2. Is it more effective to offer 12-lead ECGs to the whole population (or specific sub-groups) or only to those who screen positive for AF? The cost-effectiveness of new devices, such as a modified blood pressure monitor, needs to be assessed. It is more cost-effective to opportunistically screen people rather than to offer a 12-lead ECG to everybody. 3. How accurate are different healthcare professionals and interpretative software at diagnosing AF on ECG? Definitive diagnosis of AF should be by 12-lead ECG, interpreted by someone with appropriate expertise. Computer software is not currently sensitive enough to be used alone to diagnose AF on ECG. Primary care practitioners may not accurately detect AF on ECG, but consistently high accuracy can be achieved by healthcare professionals with adequate training. 4. How best can we diagnose paroxysmal atrial fibrillation (PAF)? In patients in whom PAF is suspected, longer periods of monitoring will detect more cases of PAF. 5. What is the impact of the use of different ECG monitoring strategies (e.g. Holter monitoring, serial ECGs, continuous ECG) on AF detection rates post-stroke? In patients post-stroke, a single ECG will miss cases of PAF which can be detected by longer duration monitoring such as Holter monitoring, cardiac event recorders and serial ECGs. Further research into the cost-effectiveness of these methods, the duration of monitoring

  13. Atrial fibrillation and survival in colorectal cancer

    Directory of Open Access Journals (Sweden)

    Justin Timothy A

    2004-11-01

    Full Text Available Abstract Background Survival in colorectal cancer may correlate with the degree of systemic inflammatory response to the tumour. Atrial fibrillation may be regarded as an inflammatory complication. We aimed to determine if atrial fibrillation is a prognostic factor in colorectal cancer. Patients and methods A prospective colorectal cancer patient database was cross-referenced with the hospital clinical-coding database to identify patients who had underwent colorectal cancer surgery and were in atrial fibrillation pre- or postoperatively. Results A total of 175 patients underwent surgery for colorectal cancer over a two-year period. Of these, 13 patients had atrial fibrillation pre- or postoperatively. Atrial fibrillation correlated with worse two-year survival (p = 0.04; log-rank test. However, in a Cox regression analysis, atrial fibrillation was not significantly associated with survival. Conclusion The presence or development of atrial fibrillation in patients undergoing surgery for colorectal cancer is associated with worse overall survival, however it was not found to be an independent factor in multivariate analysis.

  14. Improvement of regional cerebral blood flow after oral intake of branched-chain amino acids in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Mika Yamamoto; Motoh Iwasa; Kaname Matsumura; Yuri Nakagawa; Naoki Fujita; Yoshinao Kobayashi; Masahiko Kaito; Kan Takeda; Yukihiko Adachi

    2005-01-01

    AIM: To evaluate the effect of oral intake of branchedchain amino acids (BCAA) on brain perfusion in patients with liver cirrhosis.METHODS: Single photon emission computed tomography scans were performed in 43 patients with cirrhosis and in 15 age-matched healthy subjects.Twenty-nine out of forty-three patients were randomly treated with either BCAA granules or placebo, and single photon emission computed tomography was performed before and after the treatment. We measured the regional cerebral blood flow values using a threedimensional stereotaxic region of interest template.RESULTS: Cirrhotic patients had regions of significant hypoperfusion in the bilateral central (right P=0.039,P<0.05; left P = 0.006 P<0.01), parietal (right P=0.018, P<0.05;left P=0.009, P<0.01), angular (right P=0.039, P<0.05;left P = 0.008, P<0.01), and left pericallosal segments (P= 0.038 P<0.05) as compared with healthy subjects. A significant increase in cerebral perfusion was observed 70 min after the oral intake of BCAA in the angular (right P=0.012,P<0.05;left P=0.049, P<0.05), temporal (right P=0.012, P<0.05; left P=0.038, P<0.05), pericallosal segments (right P = 0.025,P<0.05; left P = 0.049, P<0.05) and left precentral (P=0.044, P<0.05), parietal (P=0.040, P<0.05) and thalamus (P=0.033, P<0.05). No significant change in perfusion was observed in the placebo group.CONCLUSION: Administration of BCAA rapidly improves cerebral perfusion.

  15. Anticoagulation therapy for atrial fibrillation.

    Science.gov (United States)

    Hylek, Elaine M

    2013-03-01

    Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder, and its prevalence is increasing worldwide. Atrial fibrillation confers a fivefold increased risk of stroke, and these strokes are associated with significant mortality and disability. The vitamin K antagonist, warfarin, has been the mainstay of anticoagulant therapy for patients with AF, reducing the risk of stroke by 65%. Despite its efficacy, warfarin remains underused in clinical practice because of its variable dose response, diet and medication interactions, and need for frequent monitoring. Stroke prevention in AF has entered an exciting therapeutic era with new classes of targeted anticoagulants that avoid the many pitfalls of the vitamin K antagonists. Dabigatran, an oral thrombin inhibitor, and the factor Xa inhibitors, rivaroxaban and apixaban, have demonstrated efficacy for stroke prevention and a reduced risk of intracranial hemorrhage relative to warfarin. Translating the efficacy of clinical trials into effective use of these novel agents in clinical practice will require an understanding of their pharmacokinetic profiles, dose selection, and management in select clinical situations.

  16. Incidence and clinical predictors of subsequent atrial fibrillation requiring additional ablation after cavotricuspid isthmus ablation for typical atrial flutter.

    Science.gov (United States)

    De Bortoli, Alessandro; Shi, Li-Bin; Ohm, Ole-Jørgen; Hoff, Per Ivar; Schuster, Peter; Solheim, Eivind; Chen, Jian

    2017-06-01

    We sought to investigate the incidence of atrial fibrillation after catheter ablation for typical atrial flutter and to determine the predictors for symptomatic atrial fibrillation that required a further additional dedicated ablation procedure. 127 patients underwent elective cavotricuspid isthmus ablation with the indication of symptomatic, typical atrial flutter. The occurrence of atrial flutter, atrial fibrillation, cerebrovascular events and the need for additional ablation procedures for symptomatic atrial fibrillation was assessed during long-term follow-up. The majority of patients (70%) manifested atrial fibrillation during a follow-up period of 68 ± 24 months, and a significant proportion (42%) underwent one or multiple atrial fibrillation ablation procedures after an average of 26 months from the index procedure. Recurrence of typical atrial flutter was rare. Ten patients (8%) suffered cerebrovascular events. Earlier documentation of atrial fibrillation (OR 3.53), previous use of flecainide (OR 3.33) and left atrial diameter (OR 2.96) independently predicted occurrence of atrial fibrillation during the follow-up. A combination of pre- and intra-procedural documentation of atrial fibrillation (OR 3.81) and previous use of flecainide (OR 2.43) independently predicted additional atrial fibrillation ablation. Atrial fibrillation occurred in the majority of patients after ablation for typical atrial flutter and 42% of them required an additional dedicated ablation procedure. Pre- and intraprocedural documentation of atrial fibrillation together with previous use of flecainide independently predicted atrial fibrillation occurrence and a need for additional ablation. Anticoagulation treatment should be continued in high-risk patients in spite of clinical disappearance of atrial flutter.

  17. Impact of pulmonary vein isolation on atrial vagal activity and atrial electrical remodeling

    Institute of Scientific and Technical Information of China (English)

    Yingxue Dong; Shulong Zhang; Lianjun Gao; Hongwei Zhao; Donghui Yang; Yunlong Xia; Yanzong Yang

    2008-01-01

    Objective Mechanisms of pulmonary vein isolation (PVI) for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling (AER) was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period (ERP),vulnerability window (VW) of atrial fibrillation,and sinus rhythm cycle length (SCL) were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage (RAA),left atrial appendage (LAA),distal coronary sinus (CSd) and proximal coronary sinus (CSp).Results (1) Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A (P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI (P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI (P<0.05).(2) Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A (P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B (P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.(J Geriatr Cardiol 2008;5:28-32)

  18. Response of atrial flutter to overdrive atrial pacing and intravenous disopyramide phosphate, singly and in combination.

    Science.gov (United States)

    Camm, J; Ward, D; Spurrell, R

    1980-01-01

    Ten patients who suffered spontaneous paroxysms of atrial flutter were investigated by electrophysiological techniques. Two had overt Wolff-Parkinson-White syndrome; three Lown-Ganong-Levine syndrome; and one a concealed accessory atrioventricular connection. Atrial flutter was initiated, at study, by right atrial pacing and electrograms from the right atrium and coronary sinus were observed for at least five minutes to ensure stable flutter in both atria. Atrial flutter was terminated by 2.5 s or 5 s bursts of atrial pacing at rates 10, 50, or 100 beats/min faster than the intrinsic flutter rate in only two patients. Atrial flutter, which was reinitiated in two patients, was then treated with intravenous disopyramide phosphate, 2 mg/kg body weight, infused over five minutes. In all 10 patients the atrial rate slowed from a mean of 310 +/- 39 beats/min to 217 +/- 27 beats/min and atrial flutter terminated in one case. Though the mean ventricular rate fell from 161 +/- 52 beats/min to 156 +/- 45 beats/min the atrioventricular conduction ratio fell from 2.17 +/- 0.86 to 1.55 +/- 0.59 and four patients were left with symptomatically significant increases of ventricular rate. In seven of nine patients overdrive atrial pacing, repeated after disopryamide, resulted in the conversion of atrial flutter to sinus rhythm. In this study, overdrive atrial pacing and intravenous disopyramide, singly and in combination, terminated atrial flutter in nine of the 10 patients and it is suggested that this method may provide an effective alternative to direct current cardioversion. PMID:7426181

  19. Validation of transit-time flowmetry for chronic measurements of regional blood flow in resting and exercising rats

    Directory of Open Access Journals (Sweden)

    S.L. Amaral

    1997-07-01

    Full Text Available The objective of the present study was to validate the transit-time technique for long-term measurements of iliac and renal blood flow in rats. Flow measured with ultrasonic probes was confirmed ex vivo using excised arteries perfused at varying flow rates. An implanted 1-mm probe reproduced with accuracy different patterns of flow relative to pressure in freely moving rats and accurately quantitated the resting iliac flow value (on average 10.43 ± 0.99 ml/min or 2.78 ± 0.3 ml min-1 100 g body weight-1. The measurements were stable over an experimental period of one week but were affected by probe size (resting flows were underestimated by 57% with a 2-mm probe when compared with a 1-mm probe and by anesthesia (in the same rats, iliac flow was reduced by 50-60% when compared to the conscious state. Instantaneous changes of iliac and renal flow during exercise and recovery were accurately measured by the transit-time technique. Iliac flow increased instantaneously at the beginning of mild exercise (from 12.03 ± 1.06 to 25.55 ± 3.89 ml/min at 15 s and showed a smaller increase when exercise intensity increased further, reaching a plateau of 38.43 ± 1.92 ml/min at the 4th min of moderate exercise intensity. In contrast, exercise-induced reduction of renal flow was smaller and slower, with 18% and 25% decreases at mild and moderate exercise intensities. Our data indicate that transit-time flowmetry is a reliable method for long-term and continuous measurements of regional blood flow at rest and can be used to quantitate the dynamic flow changes that characterize exercise and recovery

  20. Pharmacologic Atrial Natriuretic Peptide Reduces Human Leg Capillary Filtration

    Science.gov (United States)

    Watenpaugh, Donald E.; Vissing, Susanne F.; Lane, Lynda D.; Buckey, Jay C.; Firth, Brian G.; Erdman, William; Hargens, Alan R.; Blomqvist, C. Gunnar

    1995-01-01

    Atrial natriuretic peptide (ANP) is produced and secreted by atrial cells. We measured calf capillary filtration rate with prolonged venous-occlusion plethys-mography of supine health male subjects during pharmacologic infusion of ANP (48 pmol/kg/min for 15 min; n equals 6) and during placebo infusion (n equals 7). Results during infusions were compared to prior control measurements. ANP infusion increased plasma (ANP) from 30 plus or minus 4 to 2,568 plus or minus 595 pmol/L. Systemic hemoconcentration occurred during ANP infusion; mean hematocrit and plasma colloid osmotic pressure increased 4.6 and 11.3 percent respectively, relative to pre-infusion baseline values (p is less than 0.05). Mean calf filtration, however was significantly reduced from 0.15 to 0.08 ml/100 ml/min with ANP. Heart rate increased 20 percent with ANP infusion, wheras blood pressure was unchanged. Calf conductance (blood flow/arterial pressure) and venous compliance were unaffected by ANP infusion. Placebo infusion had no effect relative to prior baseline control measurements. Although ANP induced systemic capillary filtration, in the calf, filtration was reduced with ANP. Therefore, phamacologic ANP infusion enhances capillary filtration from the systemic circulation, perhaps at upper body or splanchic sites or both, while having the opposite effect in the leg.

  1. The circadian variation of premature atrial contractions

    DEFF Research Database (Denmark)

    Larsen, Bjørn Strøier; Kumarathurai, Preman; Nielsen, Olav W

    2016-01-01

    AIMS: The aim of the study was to assess a possible circadian variation of premature atrial contractions (PACs) in a community-based population and to determine if the daily variation could be used to assess a more vulnerable period of PACs in predicting later incidence of atrial fibrillation (AF...... variation in heart rate. After adjusting for relevant risk factors, the risk of AF was equal in all time intervals throughout the day. CONCLUSION: Premature atrial contractions showed a circadian variation in subjects with frequent PACs. No specific time interval of the day was more predictive of AF than...

  2. Strategies for the transfusion of subjects with complex red cell immunisation: the Bank of rare blood donors of the Region of Lombardy

    Science.gov (United States)

    Morelati, Fernanda; Arnaboldi, Piera; Barocci, Fiorella; Bodini, Umberto; Boiani, Elisa; Bresciani, Susanna; Cambiè, Giuseppe; Cazzaniga, Giovanni; Cocco, Ernesto; Copeta, Alessandro; Crotti, Massimo; D’Agostino, Francesco; D’Agostino, Marco; Focchiatti, Valeria; Fonti, Elena; Galassi, Luigi; Gazzola, Giambattista; Gelpi, Luigi; Greppi, Noemi; Inghilleri, Giovanni Battista; Isernia, Paola; Manera, Maria Cristina; Marini, Mirella; Monti, Rosalia; Morales, Rino; Moroni, Gianalessandro; Morra, Enrica; Pau, Maria Paola; Paccapelo, Cinzia; Pagliaro, Pasqualepaolo; Prati, Daniele; Revelli, Nicoletta; Rinaldini, Claudia; Rossi, Davide; Rossi, Fabio; Salvaneschi, Laura; Sciariada, Luca; Sergiacomo, Pierluigi; Tiburzi, Alessandra; Trotti, Roberta; Turdo, Rosalia; Velati, Claudio; Villa, Maria Antonietta; Vismara, Giuseppina; Vitali, Elisabetta; Marconi, Maurizio

    2007-01-01

    Introduction Selecting units of rare blood for transfusion to patients with complex immunisation is one of the most critical processes of a Transfusion Centre. In January 2005 the ‘Rare Blood Components Bank – Reference Centre of the Region of Lombardy’ w as established with the following goals: 1) identifying regional rare blood donors; 2) creating a regional registry of rare donors; 3) organising a regional bank of liquid and frozen rare blood units; 4) setting up a regional Immunohaematology Reference Laboratory (IRL) to type donors and resolve complex cases. Methods The key elements in establishing the Bank were periodic meetings organised by the directors and representatives of the regional Departments of Transfusion Medicine and Haematology (DTMH) and the institution of three working groups (informatics, regulations, finance). Results The regional IRL was set up, the relevant operating procedures were distributed region-wide, software features were defined and later validated upon activation, and the funds assigned were allocated to various cost items. The number and characteristics of the donors to be typed were identified and 14 regional DTMHs started to send samples. Overall, 20,714 donors were typed, for a total of 258,003 typings, and 2,880 rare donors were identified. Of these, 97% were rare donors because of combinations of antigens (2,139 negative for the S antigen and 659 negative for the s antigen) and 3% (n=82) because they were negative for high-frequency antigens. In the first 2 years of activity, the IRL carried out investigations of 140 complex cases referred from other Centres and distributed 2,024 units with rare phenotypes to 142 patients. Conclusions The main goal achieved in the first 24 months from the start of the project was to set up a regional network able to meet the transfusion needs of patients with complex immunisation. PMID:19204778

  3. High-intensity interval training improves cardiovascular health, exercise capacity, and quality of life in permanent atrial fibrillation: a case study.

    Science.gov (United States)

    Reed, Jennifer L; Nery, Pablo B; Birnie, David H; Tulloch, Heather E; Pipe, Andrew L

    2015-12-01

    Persons with permanent atrial fibrillation experience reduced exercise tolerance, weight gain, and an associated decline in overall health. We report on a 74-year-old man with permanent atrial fibrillation who underwent a 10-week high-intensity interval training program. Substantial improvements in heart rate, blood pressure, aerobic and functional capacity, and quality of life were observed. These are desirable as these patients are not candidates for other treatment options and more effective therapies for the treatment of atrial fibrillation are needed.

  4. Navx-guided Cryoablation of Atrial Tachycardia Inside the Left Atrial Appendage

    Science.gov (United States)

    Pandozi, Claudio; Galeazzi, Marco; Lavalle, Carlo; Ficili, Sabina; Russo, Maurizio; Santini, Massimo

    2010-01-01

    Radiofrequency ablation procedures inside the left atrial appendage (LAA) are likely to involve dangerous complications because of a high thrombogenic effect. Cryoablation procedures are supposed to be safer. We describe two cases of successful cryoablation procedures. Two NavX-guided cryoablations of permanent focal atrial arrhythmias arising from the LAA were performed. Left atrial reconstruction and mapping allowed the zone of the earliest atrial potential to be recorded; the entire course of the ablation catheter was monitored. The arrhythmias were successfully ablated; no thrombotic complications were observed. PMID:21346824

  5. Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease.

    Science.gov (United States)

    Labombarda, Fabien; Hamilton, Robert; Shohoudi, Azadeh; Aboulhosn, Jamil; Broberg, Craig S; Chaix, Marie A; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Macle, Laurent; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Khairy, Paul

    2017-08-15

    Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers. Qualifying arrhythmias were classified by a blinded adjudicating committee. The most common presenting arrhythmia was intra-atrial re-entrant tachycardia (IART) (61.6%), followed by atrial fibrillation (28.8%), and focal atrial tachycardia (9.5%). The proportion of arrhythmias due to IART increased with congenital heart disease complexity from 47.2% to 62.1% to 67.0% in patients with simple, moderate, and complex defects, respectively (p = 0.0013). Atrial fibrillation increased with age to surpass IART as the most common arrhythmia in those ≥50 years of age (51.2% vs. 44.2%; p heart disease, with a predominantly paroxysmal pattern. However, atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. A new algorithm to diagnose atrial ectopic origin from multi lead ECG systems--insights from 3D virtual human atria and torso.

    Science.gov (United States)

    Alday, Erick A Perez; Colman, Michael A; Langley, Philip; Butters, Timothy D; Higham, Jonathan; Workman, Antony J; Hancox, Jules C; Zhang, Henggui

    2015-01-01

    Rapid atrial arrhythmias such as atrial fibrillation (AF) predispose to ventricular arrhythmias, sudden cardiac death and stroke. Identifying the origin of atrial ectopic activity from the electrocardiogram (ECG) can help to diagnose the early onset of AF in a cost-effective manner. The complex and rapid atrial electrical activity during AF makes it difficult to obtain detailed information on atrial activation using the standard 12-lead ECG alone. Compared to conventional 12-lead ECG, more detailed ECG lead configurations may provide further information about spatio-temporal dynamics of the body surface potential (BSP) during atrial excitation. We apply a recently developed 3D human atrial model to simulate electrical activity during normal sinus rhythm and ectopic pacing. The atrial model is placed into a newly developed torso model which considers the presence of the lungs, liver and spinal cord. A boundary element method is used to compute the BSP resulting from atrial excitation. Elements of the torso mesh corresponding to the locations of the placement of the electrodes in the standard 12-lead and a more detailed 64-lead ECG configuration were selected. The ectopic focal activity was simulated at various origins across all the different regions of the atria. Simulated BSP maps during normal atrial excitation (i.e. sinoatrial node excitation) were compared to those observed experimentally (obtained from the 64-lead ECG system), showing a strong agreement between the evolution in time of the simulated and experimental data in the P-wave morphology of the ECG and dipole evolution. An algorithm to obtain the location of the stimulus from a 64-lead ECG system was developed. The algorithm presented had a success rate of 93%, meaning that it correctly identified the origin of atrial focus in 75/80 simulations, and involved a general approach relevant to any multi-lead ECG system. This represents a significant improvement over previously developed algorithms.

  7. The atrial myocardial cells of mouse heart: a structural and stereological study.

    Science.gov (United States)

    Forbes, M S; Van Niel, E E; Purdy-Ramos, S I

    1990-05-01

    Structural and stereological studies of mouse atrial myocardial cells, carried out in the same fashion as our previous investigations on mouse ventricle, demonstrate an extremely well-developed sarcoplasmic reticulum (SR) in atrial cells. The volume fraction (Vv) of the SR exceeds 12% in mouse atrial cells; perimyofibrillar network SR constitutes the major portion. We have confirmed the findings of Bossen et al. (1981, Tissue Cell 13, 71-77) of a difference between atria in terms of coupling density, the right atrium having a significantly lower incidence of interior junctional SR than the left. The SR of mouse atrium comprises a rich variety of specialized segments, including the IJSR, peripheral junctional SR, corbular SR, cisternal SR (including regions similar to fenestrated collars of striated skeletal muscle SR), as well as a peculiar form of extended junctional SR (EJSR). Although less frequent in occurrence than corbular SR, the EJSR seems closely related, since it occurs in multiple clusters at or near the Z-line regions, contains internal granular densities, and bears surface-connected structures resembling junctional processes. Seen in thin sections, mouse atrial EJSR elements are more complex than corbular SR, being larger in diameter and frequently circular in profile. Thick-section and serial-section analyses reveal that bodies of EJSR are in fact hollow spheroids. The transverse-axial tubular system of mouse atrium is rather poorly developed in comparison to its ventricular counterpart. The Golgi apparatus and associated specific atrial granules are prominent cell components. "Focal ellipsoidal deposits" (FEDs) previously described by Page and co-workers (1986, Amer. J. Physiol.) are consistently located adjacent to the Golgi region, but immunocytochemical staining for two different segments of atrial natriuretic peptide reveals no specific reaction in FEDs, whereas the SAGs are densely labeled for both antibodies.

  8. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  9. Diagnosis of suspected Alzheimer's disease is improved by automated analysis of regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Bich-Ngoc-Thanh [UCL-Universite Catholique de Louvain, Department of Nuclear Medicine, Mont-Godinne University Hospital, Yvoir (Belgium); Free University of Brussels, Department of Nuclear Medicine, Erasme Hospital, Brussels (Belgium); Minoshima, Satoshi [University of Washington, Department of Radiology, Seattle (United States); George, Jean; Borght, Thierry Vander [UCL-Universite Catholique de Louvain, Department of Nuclear Medicine, Mont-Godinne University Hospital, Yvoir (Belgium); Robert, Annie [UCL-Universite Catholique de Louvain, Departments of PHS Epidemiology and Biostatistics, Mont-Godinne University Hospital, Yvoir (Belgium); Swine, Christian [UCL-Universite Catholique de Louvain, Department of Geriatrics, Mont-Godinne University Hospital, Yvoir (Belgium); Laloux, Patrice [UCL-Universite Catholique de Louvain, Department of Neurology, Mont-Godinne University Hospital, Yvoir (Belgium)

    2004-11-01

    Accurate diagnosis of Alzheimer's disease (AD), the most common form of dementia, remains difficult. In order to assess whether fully automated stereotactic surface projection (3D-SSP) presentation contributes to the diagnosis of AD by single-photon emission computed tomography (SPECT), we investigated the diagnostic accuracy of transaxial display with and without 3D-SSP analysis as well as the correlation between cerebral perfusion in different cortical areas and the mini mental score (MMS). Seventy-two patients referred because of cognitive impairment were included in the study. According to the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's disease and Related Disorders Association (ADRDA) criteria, 27 patients were diagnosed as having probable AD while 45 were classified as non-AD patients. 3D-SSP was used to quantify the regional cerebral blood flow (rCBF) acquired from SPECT imaging. Compared with the transaxial section presentation alone, 3D-SSP presentation improved the area under the receiver operating curve (p<0.05) as well as intra-observer (k=0.73 vs 0.88) and inter-observer (k=0.50 vs 0.84) reproducibility. Upon normalisation of regional to thalamic activity, multiple regression analysis revealed a strong correlation between the MMS and rCBF in the right parietal cortex (p=0.002). Addition of 3D-SSP to the transaxial section display of ECD-SPECT studies improves the reproducibility and the diagnostic performance in respect of AD in patients with cognitive impairment and provides a valid tool for assessment of the severity of cortical perfusion abnormalities in such patients. (orig.)

  10. Changes in regional cerebral blood flow in nondominant hemisphere during speech task in aphasics. A PET activation study

    Energy Technology Data Exchange (ETDEWEB)

    Ohyama, Masashi; Kitamura, Shin; Mishina, Masahiro; Terashi, Akiro [Nippon Medical School, Tokyo (Japan); Senda, Michio; Ishii, Kenji

    1995-08-01

    To investigate the patients with language disorder and to detect the activated areas in language processing, we measured the changes in the regional cerebral blood flow (CBF) during speech task (`counting` task) using O-15 water PET activation technique in six normal subjects (age 58.3 {+-}8.1, mean{+-}SD), ten fluent aphasics (age 60.3{+-}12.5) and six nonfluent aphasics (age 50.5{+-}8.3). In `counting` task, the subjects were instructed to count the number aloud from 1 to 10 and repeat the sequence over and over in the native language (Japanese) at the rate of one number per 2.5 sec. The data were analyzed with stereotactic intersubject averaging analysis for the normal subjects. Apart from it, the regions of interest (ROI) analysis (a circular ROI of 12 mm diameter) was performed in the language-related area for each subject. In the normal subjects, the language-related areas: posteroinferofrontal areas (PIF), posterosuperotemporal area (PST), and Rolandic areas (related to the mouth and lips) were significantly activated bilaterally in the `counting` task. PIF were activated with a dominance in the left side. In the resting state, rCBF in the left PIF and left PST was reduced in both fluent and nonfluent aphasics. In nonfluent aphasics, the magnitude of activation in the right PIF by `counting` task was significantly greater than normal subjects and patients with fluent aphasia (ANOVA). It suggests the importance of the right PIF in the simple language processing in the nonfluent aphasia. In the sixteen aphasic patients, the increase in rCBF in the right PST during the `counting` task was negatively correlated with the score of comprehension (WAB) in the Spearman ranked correlation (p<0.05). It suggests that, while the activity of the right PST is minimal for the `counting` in normal subjects, it plays an important and compensatory role in aphasic patients. (author).

  11. Regional cerebral blood flow in acute stage ischemic cerebrovascular disease by xenon-133 inhalation and single photon emission computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hiroyuki (Akita Univ. (Japan). School of Medicine)

    1989-03-01

    During the period from February 1984 through June 1985, single photon emission computerized tomography (SPECT) with xenon-133 inhalation method has been performed for the measurement of regional cerebral blood flow (rCBF) during the first 48 hours of onset of cerebral infarction (n=71) and transient ischemic attack (n=21). X-ray CT (CT) and carotid arteriography were concurrently performed in all the patients. In repeated studies performed for 15 normal volunteers, rCBF measurement by SPECT was found reproducible. Mean values of rCBF for the right and left cerebral hemispheres were 60.3{plus minus}6.52 and 61.8{plus minus}6.91 ml/100 g/min, respectively. For cerebral infarction, ischemic foci corresponding to clinical symptoms were detected more frequently on SPECT than on CT (93% vs 63%). In all of the evaluable 35 patients with cerebral infarction, rCBF within the first 8 hours of onset was decreased: 31.0 ml/100 g/min for the internal carotid artery (ICA) occlusion and 36.0 ml/100 g/min for the middle cerebral artery (MCA) occlusion. Crossed cerebellar diaschisis was observed in 50% (9/18) for ICA occlusion and 37% (14/38) for MCA occlusion. For transient ischemic attack, there was no significant difference in the detection of ischemic foci between SPECT and CT (38% vs 43%). In detecting small foci especially in the deep regions such as the basal ganglia, SPECT was inferior to CT. Mean rCBF for transient ischemic attack tended to be lower than the normal rCBF (50.7 ml/100 g/min for the right cerebral hemisphere and 50.6 ml/100 g/min for the left cerebral hemisphere). SPECT may aid in predicting prognosis and chosing treatment strategy, as well as in determining cerebral hemodynamics. (N.K.).

  12. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipsett, Mark; Hamilton, Douglas; Lemery, Jay; Polk, James

    2011-01-01

    This slide presentation reviews a possible scenario of an astronaut having Atrial Fibrillation during a Mars Mission. In the case review the presentation asks several questions about the alternatives for treatment, medications and the ramifications of the decisions.

  13. POSTOPERATIVE ATRIAL FIBRILLATION – AN UPDATE

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2015-12-01

    Full Text Available Atrial fibrillation is the most common perioperative cardiac arrhythmia. Sympathetic overactivity, inflammatory state and oxidative stress are important contributors to the genesis of postoperative atrial fibrillation. Advancing age and mitral valve disease along with left atrial size are important parameters in noted in multivariate prediction model. Genetic predisposition has also been noted. Preventive strategies tried include beta blockers, statins, posterior pericardiotomy, carperitide infusion and thoracic epidural analgesia. Treatment options include rate and rhythm control along with anticoagulation if it persists more than 48 hours with high CHADS2 score. Some of the therapeutic modalities which have been found to be NOT useful in preventing post operative atrial fibrillation are dexamethasone, magnesium infusion and concomitant pulmonary vein isolation.

  14. Atrial Fibrillation and Stroke in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Geetanjali Dang

    2016-11-01

    Full Text Available The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although anticoagulation decreases the risk of thromboembolism, management in the elderly remains complex due to major concerns about bleeding. New anticoagulants and nonpharmacologic strategies are helpful to reduce the risk of bleeding, particularly in older-elderly patients. Herein, we review the pathogenesis and management of select issues of thromboembolism in the elderly with atrial fibrillation.

  15. [Cardiac rehabilitation in patients with atrial fibrillation].

    Science.gov (United States)

    Schlitt, Axel; Kamke, Wolfram; Guha, Manju; Haberecht, Olaf; Völler, Heinz

    2015-06-01

    The course of cardiac rehabilitation is often altered due to episodes of paroxysmal, predominantly postoperative atrial fibrillation. In symptomatic patients, a TEE-guided cardioversion - preferential DC shock - is indicated. In patients with persistent / permanent atrial fibrillation, a heart rate up to 110 / min and 170 / min at rest and during physical activity should, respectively, be tolerated. Therefore, training should not be quitted by heart rate but rather by load. The antithrombotic management is in addition a great task in treating patients with atrial fibrillation. With the exception of patients with a CHA2DS2-VASc-Score < 1, oral anticoagulation is indicated. Atrial fibrillation has little impact on social aspects, whereas the underlying heart disease and drug treatment (oral anticoagulation) has an important impact.

  16. Alcohol consumption and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Tolstrup, Janne Schurmann; Wium-Andersen, Marie Kim; Ørsted, David Dynnes

    2016-01-01

    BACKGROUND: The aim of this study was to test the hypothesis that alcohol consumption, both observational (self-reported) and estimated by genetic instruments, is associated with a risk of atrial fibrillation and to determine whether people with high cardiovascular risk are more sensitive towards...... register. As a measure of alcohol exposure, both self-reported consumption and genetic variations in alcohol metabolizing genes (ADH1B/ADH1C) were used as instrumental variables. The endpoint was admission to hospital for atrial fibrillation as recorded in a validated hospital register. RESULTS: A total...... of 3493 cases of atrial fibrillation occurred during follow-up. High alcohol consumption was associated with a risk of atrial fibrillation among men, but not among women. Among the men who drank 28-35 and 35+ drinks/week, the hazards ratios were 1.40 (95% confidence interval 1.09-1.80) and 1.62 (95...

  17. Suppression of verbal hallucinations and changes in regional cerebral blood flow after intravenous lidocaine: a case report.

    Science.gov (United States)

    Plewnia, Christian; Bischof, Felix; Reimold, Matthias

    2007-01-30

    Simple and complex auditory phantom-perceptions such as tinnitus and musical hallucinations occur predominantly in elderly subjects and are often associated with hearing impairment. Isolated verbal hallucinations without other psychotic features are rare. It has been shown that an intravenous (i.v.) injection of lidocaine can transiently suppress tinnitus. Here we present the case of a 74 year old left-handed women with severely distressing, continuous verbal auditory hallucinations without other psychotic features. I.v. injections of 100 mg lidocaine but not saline resulted in substantial transient suppressions of the hallucinations for several hours. Using [(15)O]H(2)O positron-emission tomography (PET) decreased regional cerebral blood flow associated with reduced perception of voices was found in the right angular and supramarginal gyrus, right inferior frontal gyrus, orbitofronal cortex and in major parts of the cingulate cortex. These data suggest to further investigate the clinical relevance of i.v. lidocaine in patients with therapy-resistant verbal hallucinations, support the notion of common pathophysiological mechanisms in different forms of auditory phantom-perception and demonstrate the feasibility of a new strategy for imaging studies on auditory hallucinations.

  18. The effect of black tea and caffeine on regional cerebral blood flow measured with arterial spin labeling

    Science.gov (United States)

    Vidyasagar, Rishma; Greyling, Arno; Draijer, Richard; Corfield, Douglas R; Parkes, Laura M

    2013-01-01

    Black tea consumption has been shown to improve peripheral vascular function. Its effect on brain vasculature is unknown, though tea contains small amounts of caffeine, a psychoactive substance known to influence cerebral blood flow (CBF). We investigated the effects on CBF due to the intake of tea components in 20 healthy men in a double-blinded, randomized, placebo-controlled study. On separate days, subjects received a single dose of 184 mg caffeine (equivalent to one strong espresso coffee), 2,820 mg black tea solids containing 184 mg caffeine (equivalent to 6 cups of tea), 2,820 mg decaffeinated black tea solids, or placebo. The CBF and cerebrovascular reactivity (CVR) to hypercapnia were measured with arterial spin labeled magnetic resonance imaging (MRI) before and 2 hours after administration. We found a significant global reduction with caffeine (20%) and tea (21%) in gray matter CBF, with no effect of decaffeinated tea, suggesting that only caffeine influences CBF acutely. Voxelwise analysis revealed the effect of caffeine to be regionally specific. None of the interventions had an effect on CVR. Additional research is required to conclude on the physiologic relevance of these findings and the chronic effects of caffeine and tea intake on CBF. PMID:23486295

  19. The effect of black tea and caffeine on regional cerebral blood flow measured with arterial spin labeling.

    Science.gov (United States)

    Vidyasagar, Rishma; Greyling, Arno; Draijer, Richard; Corfield, Douglas R; Parkes, Laura M

    2013-06-01

    Black tea consumption has been shown to improve peripheral vascular function. Its effect on brain vasculature is unknown, though tea contains small amounts of caffeine, a psychoactive substance known to influence cerebral blood flow (CBF). We investigated the effects on CBF due to the intake of tea components in 20 healthy men in a double-blinded, randomized, placebo-controlled study. On separate days, subjects received a single dose of 184 mg caffeine (equivalent to one strong espresso coffee), 2,820 mg black tea solids containing 184 mg caffeine (equivalent to 6 cups of tea), 2,820 mg decaffeinated black tea solids, or placebo. The CBF and cerebrovascular reactivity (CVR) to hypercapnia were measured with arterial spin labeled magnetic resonance imaging (MRI) before and 2 hours after administration. We found a significant global reduction with caffeine (20%) and tea (21%) in gray matter CBF, with no effect of decaffeinated tea, suggesting that only caffeine influences CBF acutely. Voxelwise analysis revealed the effect of caffeine to be regionally specific. None of the interventions had an effect on CVR. Additional research is required to conclude on the physiologic relevance of these findings and the chronic effects of caffeine and tea intake on CBF.

  20. Atrial conduction delay predicts atrial fibrillation in paroxysmal supraventricular tachycardia patients after radiofrequency catheter ablation.

    Science.gov (United States)

    Xu, Zhen-Xing; Zhong, Jing-Quan; Zhang, Wei; Yue, Xin; Rong, Bing; Zhu, Qing; Zheng, Zhaotong; Zhang, Yun

    2014-06-01

    This study aimed to assess whether intra- and inter-atrial conduction delay could predict atrial fibrillation (AF) for paroxysmal supraventricular tachycardia (PSVT) patients after successful treatment by radiofrequency catheter ablation (RFCA). Echocardiography examination was performed on 524 consecutive PSVT patients (15 patients were excluded). Left atrial dimension, right atrial diameter and intra- and inter-atrial conduction delay were measured before ablation. Patients were divided into group A (n = 32): occurrence of AF after the ablation and group B (n = 477): remained in sinus rhythm during follow-up. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive value of intra- and inter-atrial conduction delay. Both intra- and inter-atrial conduction delay were higher in group A than in group B (4.79 ± 0.30 msec vs. 4.56 ± 0.32 msec; 21.98 ± 1.32 msec vs. 20.01 ± 1.33; p < 0.05). Binary logistic regression analysis showed that intra- and inter-atrial conduction were significant influential factors for the occurrence of AF (odds ratio [OR] = 13.577, 95% confidence interval [CI], 3.469-48.914; OR = 2.569, 95% CI, 1.909-3.459, p < 0.05). The ROC cure analysis revealed that intra-atrial conduction delay ≥ 4.45 msec and inter-atrial conduction delay ≥ 20.65 were the most optimal cut-off value for predicting AF in PSVT patients after RFCA. In conclusion, this is the first study to show that the intra- and inter-atrial conduction delay could effectively predict AF in post-ablation PSVT patients.

  1. Calpain I Inhibition prevents atrial structural remodeling in a canine model with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    XUE Hong-jie; SHAN Hong-bo; LIU Jie; LI Wei-min; LI Yue; GONG Yong-tai; YANG Bao-feng; JIN Cheng-luo; SHENG Li; CHU Shan; ZHANG Li

    2008-01-01

    Background Atrial fibrillation (AF) is accompanied by atrial structural remodeling. Calpain activity is induced during AR To lest a causal relationship between calpain activation and atrial structural changes, N-acetyl-Leu-Leu-Met (ALLM), a calpain inhibitor, was utilized in a canine AF model.Methods Fifteen dogs were randomly divided into 3 groups: sham-operated group, control group and calpain inhibitor group; each with 5 dogs. Sustained AF was induced by rapid right atrium pacing at 600 beats per minute for 3 weeks. ALLM was administered at a dosage of 1.0 mg-kg-1·d-1 in the calpain inhibitor group. Three weeks later, the proteolysis, protein expression of TnT and myosin, calpain l localization and expression and structural changes were examined in left atrial free walls, right atrial free walls and the interatrial septum respectively. Atrial size and contractile function were also measured by echocardiography.Results Long-term rapid atrial pacing induced marked structural changes such as enlarged atrial volume, myolysis, degradation of TnT and myosin, accumulation of glycogen and changes in mitochondrial shape and size, which were paralleled by an increase in calpain activity. The positive correlation between calpain activity and the degree of myolysis (rs=0.90 961, P<0.0001) was demonstrated. In addition to structural abnormalities, pacing-induced atrial contractile dysfunction was observed in this study. The pacing-induced atrial structural alterations and loss of contractility were partially prevented by the calpain inhibitor ALLM.Conclusions Activation of calpain represents key features in the progression towards overt structural remodeling. Calpain inhibitor, ALLM, suppressed the increased calpain activity and reversed structural remodeling caused by sustained atrial fibrillation in the present model. Calpain Inhibition may therefore provide a possibility for therapeutic Intervention in AF.

  2. Presence of accessory left atrial appendage/diverticula in a population with atrial fibrillation compared with those in sinus rhythm: a retrospective review.

    Science.gov (United States)

    Troupis, John; Crossett, Marcus; Scneider-Kolsky, Michal; Nandurkar, Dee

    2012-02-01

    Accessory left atrial appendages and atrial diverticula have an incidence of 10-27%. Their association with atrial fibrillation needs to be confirmed. This study determined the prevalence, number, size, location and morphology of accessory left atrial appendages/atrial diverticula in patients with atrial fibrillation compared with those in sinus rhythm. A retrospective analysis of 47 consecutive patients with atrial fibrillation who underwent 320 multidetector Coronary CT angiography (CCTA) was performed. A random group of 47 CCTA patients with sinus rhythm formed the control group. The presence, number, size, location and morphology of accessory left atrial appendages and atrial diverticula in each group were analysed. Twenty one patients had a total of 25 accessory left atrial appendages and atrial diverticula in the atrial fibrillation group and 22 patients had a total of 24 accessory left atrial appendages and atrial diverticula in the sinus rhythm group. Twenty-one atrial diverticula were identified in 19 patients in the atrial fibrillation group and 19 atrial diverticula in 17 patients in the sinus rhythm group. The mean length and width of accessory left atrial appendage was 6.9 and 4.7 mm, respectively in the atrial fibrillation group and 12 and 4.6 mm, respectively, in the sinus rhythm group, P = ns (not significant). The mean length and width of atrial diverticulum was 4.7 and 3.6 mm, respectively in the atrial fibrillation group and 6.2 and 5 mm, respectively in the sinus rhythm group (P = ns). Eighty-four % and 96% of the accessory left atrial appendages/atrial diverticula in the atrial fibrillation and sinus rhythm groups were located along the right anterosuperior left atrial wall. Accessory left atrial appendages and atrial diverticula are common structures with similar prevalence in patients with atrial fibrillation and sinus rhythm.

  3. [Anticoagulation in atrial fibrillation - an update].

    Science.gov (United States)

    Antz, Matthias; Hullmann, Bettina; Neufert, Christian; Vocke, Wolfgang

    2008-12-01

    The correct anticoagulation regimen for prevention of thromboembolic events is essential in patients with atrial fibrillation. However, only a minority of patients receives anticoagulation according to the guidelines. The current guidelines are intended to make the indication for anticoagulation more simple and are summarized in the present article. This includes recommendations for chronic anticoagulation, prevention of thromboembolic events after cardioversion and in ablation of atrial fibrillation.

  4. Complex fractionated electrogram distribution and temporal stability in patients undergoing atrial fibrillation ablation.

    Science.gov (United States)

    Roux, Jean-François; Gojraty, Sattar; Bala, Rupa; Liu, Christopher F; Hutchinson, Mathew D; Dixit, Sanjay; Callans, David J; Marchlinski, Francis; Gerstenfeld, Edward P

    2008-08-01

    Targeting of complex fractionated electrograms (CFEs) has been described as an approach for catheter ablation of atrial fibrillation (AF); however, the distribution and temporal stability of CFE regions remain poorly defined. In patients with persistent AF referred for ablation, we performed two consecutive left atrial (LA) CFE maps prior to AF ablation. Bipolar electrograms were acquired during AF, and the mean AF cycle length and electrogram voltage were automatically determined at each point. Sites with mean CL CFE positive. The two maps were then compared qualitatively and quantitatively. A total of 15 patients (93% male, age 56.1 +/- 9.0 years) undergoing AF ablation were studied. The two maps were separated in time by 31 +/- 10 minutes. There was no significant difference in the number of CFE-positive regions (12.3 +/- 5.2 vs 11.3 +/- 4.7; P = 0.06) between the maps. While CFEs were widely distributed within the LA, the PV/left atrial junction (73%) and left atrial appendage (77%) were most often CFE positive. The presence of CFEs at each region was concordant 78% of the time. There was a significant correlation between the two maps (r = 0.35 +/- 0.21, range 0.1-0.84; P CFE regions are found in the vicinity of the PVs. There is a significant correlation between two CFE maps constructed 31 minutes apart, with 78% concordance of CFE sites.

  5. Effects of Aminoguanidine on Pre- and Post-Irradiation Regional Cerebral Blood Flow, Systemic Blood Pressure and Plasma Histamine Levels in the Primate,

    Science.gov (United States)

    1991-01-01

    respiration rate, blood pH, and pie, one group (using a method with less sensitivity peripheral reflexes. A femoral arterial catheter was to HA than the one...and *,vidas.. st’te during acute intestinal in hernia in pigs. dopg% antihistamine. Experientia 33. 1047 1048 (1977). and rabbits: Evidencee fo~r a

  6. Sick sinus syndrome and atrial fibrillation in older persons - A view from the sinoatrial nodal myocyte.

    Science.gov (United States)

    Monfredi, O; Boyett, M R

    2015-06-01

    Sick sinus syndrome remains a highly relevant clinical entity, being responsible for the implantation of the majority of electronic pacemakers worldwide. It is an infinitely more complex disease than it was believed when first described in the mid part of the 20th century. It not only involves the innate leading pacemaker region of the heart, the sinoatrial node, but also the atrial myocardium, predisposing to atrial tachydysrhythmias. It remains controversial as to whether the dysfunction of the sinoatrial node directly causes the dysfunction of the atrial myocardium, or vice versa, or indeed whether these two aspects of the condition arise through some related underlying pathological mechanism, such as extracellular matrix remodeling, i.e., fibrosis. This review aims to shed new light on the myriad possible contributing factors in the development of sick sinus syndrome, with a particular focus on the sinoatrial nodal myocyte. This article is part of a Special Issue entitled CV Aging.

  7. RR-Interval variance of electrocardiogram for atrial fibrillation detection

    Science.gov (United States)

    Nuryani, N.; Solikhah, M.; Nugoho, A. S.; Afdala, A.; Anzihory, E.

    2016-11-01

    Atrial fibrillation is a serious heart problem originated from the upper chamber of the heart. The common indication of atrial fibrillation is irregularity of R peak-to-R-peak time interval, which is shortly called RR interval. The irregularity could be represented using variance or spread of RR interval. This article presents a system to detect atrial fibrillation using variances. Using clinical data of patients with atrial fibrillation attack, it is shown that the variance of electrocardiographic RR interval are higher during atrial fibrillation, compared to the normal one. Utilizing a simple detection technique and variances of RR intervals, we find a good performance of atrial fibrillation detection.

  8. Long-term effects of simvastatin on protection against atrial fibrillation in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the impact of simvastatin on blood lipid and the incidence of atrial fibrillation and ischemic-related events in patients with acute myocardial infarction accompanied by paroxysmal atrial fibrillation. Methods One hundred and three patients with acute myocardial infarction and paroxysmal atrial fibrillation were selected as subjects, and were divided into a simvastatin group and a control group. Forty-five patients were in the simvastatin group, who took simvastatin 20mg/d orally for 18 months; fifty-eight patients were in the control group, and received conventional therapy except for statins. All patients were followed up for 18months. The level of blood lipid, recurrence rate of paroxysmal atrial fibrillation, incidence rate of persistent or permanent atrial lipids did not change significantly in the control group (P>0.05); concentrations of total cholesterol (TC) and low density lipoprotein five patients during 18 months follow-up in the simvastatin group (11.1%), whereas it occurred in 14 patients of the control group(24.1%, P<0.05); the occurrence rate of persistent or permanent atrial fibrillation in the simvastatin group was 4.4%, which was lower than (6.6%), two rehospitalizations for deterioration of coronary heart diseases (4.4%), three cardiac deaths (6.6%), and one cerebral stroke (2.2%), which was lower evidently than in the control group (41.4%, P<0.05). Conclusions Simvastatin can not only decrease the levels of serum TC and LDL-C but also prevent the occurrence of atrial fibrillation and ischemic-related events.

  9. Response to post-donation counseling is still a challenge in outdoor voluntary blood donation camps: A survey from a tertiary care regional blood center in Eastern India

    Directory of Open Access Journals (Sweden)

    Somnath Mukherjee

    2014-01-01

    Full Text Available Background: Blood transfusion carries the risk of transmission of several infectious agents. The latest method for blood screening, nucleic acid testing is not affordable in developing countries. Aim: The study was aimed to find response to post-donation counseling for reactive markers among the voluntary blood donors donating in blood donation camps. Material and Methods: This 1 year study was conducted in 2011. Transfusion transmitted infections testing was performed by routine enzyme linked immunosorbent assay method. The initial human immunodeficiency virus (HIV reactive donors who returned back to the blood bank were confidentially counseled and referred to the Integrated Counseling Cum Testing Center (ICTC. The hepatitis B surface antigen (HBsAg and anti-hepatitis C virus (HCV reactive donors were referred to the gastroenterology department for confirmation by qualitative polymerase chain reaction (PCR, Roche Diagnostics, Germany and followed-up. Results: Twenty seven thousand two hundred forty six 27,246 units were collected during the survey. One hundred twenty nine129 units were reactive for HIV 1 and 2, 99 were reactive for HCV, 206 for hepatitis B virus (HBV. Of these reactive donors, 138 could be personally communicated. Out of 47, 27 donors who returned for counseling were initially reactive for HIV 1 and 2, 8 for HBsAg and 12 for anti-HCV. Two were positive for HBV deoxyribonucleic acid and one was positive for HCV ribonucleic acid. The HIV positivity was detected in 1 of 27 donors at ICTC. Conclusion: The response to the post-donation counseling appears in this study to be only 34% (47/138, which is still a challenge.

  10. Detection of African Swine Fever Virus DNA in Blood Samples Stored on FTA Cards from Asymptomatic Pigs in Mbeya Region, Tanzania

    DEFF Research Database (Denmark)

    Braae, U. C.; Johansen, M. V.; Ngowi, H. A.;

    2015-01-01

    The aim of the study was to assess whether blood samples collected onto FTA® cards could be used in combination with real-time PCR for the detection of African swine fever virus (ASFV) DNA in samples from resource-poor settings under the assumption that asymptomatically (sub-clinically) infected...... pigs may be present. Blood samples were collected from clinically healthy pigs from Mbeya Region, Tanzania. The blood samples were stored on FTA® cards and analysed by real-time PCR assays in duplicate; three pigs had high levels of viral DNA (Ct values of 27-29), and three pigs had a low level...... of viral DNA (Ct 36-45). Four pigs were positive in one of the duplicate samples only, but clear products of the expected size were obtained when the reactions were analysed by gel electrophoresis. For comparison, blood samples from pigs experimentally infected with either a pathogenic (OURT T88...

  11. SPECT with [99mTc]-d,l-hexamethyl-propylene amine oxime (HM-PAO) compared with regional cerebral blood flow measured by PET

    DEFF Research Database (Denmark)

    Yonekura, Y; Nishizawa, S; Mukai, Thomas Søgaard;

    1988-01-01

    In order to validate the use of technetium-99m-d,l-hexamethylpropyleneamine oxime (HM-PAO) as a flow tracer, a total of 21 cases were studied with single photon emission computerized tomography (SPECT), and compared to regional cerebral blood flow (rCBF) measured by position emission tomography (...

  12. Species composition, activity patterns and blood meal analysis of sand fly populations (Diptera: Psychodidae) in the metropolitan region of Thessaloniki, an endemic focus of canine leishmaniasis

    Science.gov (United States)

    Species composition, activity patterns and blood meal analysis of sand fly populations were investigated in the metropolitan region of Thessaloniki, North Greece from May to October 2011. Sampling was conducted weekly in 3 different environments (animal facilities, open fields, residential areas) al...

  13. Blood pressure and atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930082 Clinical administration of atrial natri-uretic factor in reno-vascular hypertension.ZHANG Weiguo(张卫国),et al.Cardiovasc In-stit & Fuwai Hosp,CAMS,Beijing.Chin Cir J1992;7(5):450-452.In order to evaluate the effects of atrial natri-uretic factor(ANF)on patients with reno-vas-cular hypertension,α-hANF(0.025μg/kg/min×60min)was administered to 7 patients byi.v.drip..The renin-angiotensin-aldosteronesystem,plasma catecholamine and arginine va-sopressin were suppressed with diuresis and na-triuresis and lowering of blood pressure.The

  14. Predictors of left atrial appendage stunning after electrical cardioversion of non-valvular atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    杨沙宁; 黄从新; 胡晓军; 金立军; 李凤翥; 彭水先

    2003-01-01

    Objective To identify predictors of left atrial appendage stunning after the use of electrical cardioversion to restore sinus rhythm in patients with non-valvular atrial fibrillation.Methods A total of 68 consecutive patients (45 men, 23 women, 60.5±8.7 years of age) with non-valvular atrial fibrillation undergoing electrical cardioversion were enlisted in this study. Clinical and echocardiographic variables were analyzed by univariate regression and multivariate logistic regression to investigate the relationship between occurrences of left atrial appendage stunning and these factors. Results Univariate analysis revealed that, in comparing patients without and with left atrial appendage stunning, there were significant differences in the duration of atrial fibrillation > 8 weeks (32.3% vs 75.5%, P 50 mm (29.0% vs 54.1%, P 8 weeks (OR=7.249, 95%CI=1.998-26.304, P 50 mm (OR=3.896, 95%CI=1.105-13.734, P8 weeks, left atrial diameter >50 mm, left ventricular ejection fraction <50%, and cumulative energy of electrical cardioversion are independent predictors of left atrial appendage stunning. Anticoagulation treatment should be individualized for patients undergoing electrical cardioversion to reduce the risk of both cardioversion-related thromboembolic events and hemorrhagic complications caused by warfarin treatment.

  15. Efficacy and safety of intravenous dofetilide for rapid termination of atrial fibrillation and atrial flutter

    NARCIS (Netherlands)

    Kingma, JH; Crijns, HJGM; Dunselman, PHJM

    2000-01-01

    Dofetilide may be advantageous in terminating atrial fibrillation/atrial flutter (AFl) when there are contraindications for class I drugs (left ventricular dysfunction and/or manifest myocardial ischemia) and beta blockers. In particular, its successful outcome in usually drug-resistant AFl is promi

  16. Prednisone prevents atrial fibrillation promotion by atrial tachycardia remodeling in dogs

    NARCIS (Netherlands)

    Shiroshita-Takeshita, A; Brundel, BJJM; Lavoie, J; Nattel, S

    2006-01-01

    Background: There is evidence suggesting involvement of oxidative stress, inflammation, and calcineurin/nuclear factor of activated T cell pathways in atrial fibrillation. This study evaluated the efficacy of anti-inflammatory and calcineurin-inhibitory drugs on promotion of atrial fibrillation by a

  17. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators

    DEFF Research Database (Denmark)

    van Walraven, Carl; Hart, Robert G; Connolly, Stuart

    2009-01-01

    on the relative efficacy of oral anticoagulants (OAC) and antiplatelet (AP) therapy (including acetylsalicylic acid and triflusal) on ischemic stroke, serious bleeding, and vascular events in patients with atrial fibrillation. METHODS: This is an analysis of the Atrial Fibrillation Investigators database, which...

  18. Limited posterior left atrial linear radiofrequency ablation for patients with chronic atrial fibrillation undergoing rheumatic valvular heart surgery

    Institute of Scientific and Technical Information of China (English)

    王均志; 杜日映; 丁会霞; 柏本健; 王刚; 崔国方; 钟志欢

    2004-01-01

    @@ Since 1996, we have begun to successfully treat atrial fibrillation (AF) with the maze procedure, replacing surgical incisions with radiofrequency (RF) ablation.1,2 Recent data show that the posterior wall of the left atrium seems to be a critical area for the occurrence and the maintenance of AF in patients with valvular heart disease. The objective of this study was to evaluate whether limited surgical RF ablation of the posterior region of the left atrium is safe and effective in curing chronic AF in patients also suffering from valvular heart disease.

  19. A Pilot Clinical Study to Investigate the Human Whole Blood Spectrum Characteristics in the Sub-THz Region

    CERN Document Server

    Tseng, Tzu-Fang; Gao, Hao-Cheng; Wang, Tzung-Dau; Sun, Chi-Kuang

    2014-01-01

    We have conducted a pilot clinical study to not only investigate the THz spectra of ex-vivo fresh human whole blood of 28 patients following 8-hours fasting guideline, but also to find out the critical blood ingredients of which the concentration dominantly affects those THz spectra. A great difference between the THz absorption properties of human blood among different people was observed, while the difference can be up to ~15% of the averaged absorption coefficient of the 28 samples. Our pilot clinical study indicates that triglyceride and red blood cell were two dominant factors to have significant clinically defined negative correlation to the sub-THz absorption coefficients.

  20. A quantitative index of regional blood flow in canine myocardium derived noninvasively with N-13 ammonia and dynamic positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nienaber, C.A.; Ratib, O.; Gambhir, S.S.; Krivokapich, J.; Huang, S.C.; Phelps, M.E.; Schelbert, H.R. (Univ. of California, Los Angeles School of Medicine (USA))

    1991-01-01

    To derive a quantitative index of regional myocardial blood flow, the arterial input function of the flow tracer N-13 ammonia and the regional myocardial N-13 activity concentrations were noninvasively determined in 29 experiments in eight dogs. N-13 ammonia was administered intravenously and cross-sectional images were acquired dynamically using an ECAT III positron emission tomograph with an effective in-plane resolution of 13.46 mm full-width half-maximum. Time-activity curves were derived from the serial images by assigning regions of interest to the left ventricular myocardium and left ventricular blood pool. Tracer net extractions were estimated from the myocardial time-activity concentrations at various times after tracer injection and the integral of the arterial input function. Myocardial blood flow was altered by intravenous dipyridamole, morphine, propranolol and partial or complete occlusion of the left anterior descending coronary artery, and ranged from 9 to 860 ml/min per 100 g. Estimates of tracer net extractions were most accurate when determined from the myocardial N-13 activity concentrations at 60 s divided by the integral of the arterial input function to that time. These estimates correlated with regional myocardial blood flows determined independently by the microsphere technique by y = x (1 - 0.64(e-114/x); SEE = 22.9; r = 0.94). First pass extraction fractions of N-13 ammonia determined noninvasively with this approach declined with higher flows in a nonlinear fashion and were similar to those determined invasively by direct intracoronary N-13 ammonia injections. The findings indicate that an accurate index of regional myocardial blood flow can be obtained noninvasively by high temporal sampling of arterial and myocardial tracer activity concentrations with positron emission tomography.

  1. Determinants of Left Atrial Volume in Patients with Atrial Fibrillation

    Science.gov (United States)

    Hochgruber, Thomas; Krisai, Philipp; Zimmermann, Andreas J.; Aeschbacher, Stefanie; Pumpol, Katrin; Kessel-Schaefer, Arnheid; Stephan, Frank-Peter; Handschin, Nadja; Sticherling, Christian; Osswald, Stefan; Kaufmann, Beat A.; Paré, Guillaume; Kühne, Michael; Conen, David

    2016-01-01

    Introduction Left atrial (LA) enlargement is an important risk factor for incident stroke and a key determinant for the success of rhythm control strategies in patients with atrial fibrillation (AF). However, factors associated with LA volume in AF patients remain poorly understood. Methods Patients with paroxysmal or persistent AF were enrolled in this study. Real time 3-D echocardiography was performed in all participants and analyzed offline in a standardized manner. We performed stepwise backward linear regression analyses using a broad set of clinical parameters to determine independent correlates for 3-D LA volume. Results We included 210 patients (70.9% male, mean age 61±11years). Paroxysmal and persistent AF were present in 95 (45%) and 115 (55%) patients, respectively. Overall, 115 (55%) had hypertension, 11 (5%) had diabetes, and 18 (9%) had ischemic heart disease. Mean indexed LA volume was 36±12ml/m2. In multivariable models, significant associations were found for female sex (β coefficient -10.51 (95% confidence interval (CI) -17.85;-3.16), p = 0.0053), undergoing cardioversion (β 11.95 (CI 5.15; 18.74), p = 0.0006), diabetes (β 14.23 (CI 2.36; 26.10), p = 0.019), body surface area (BSA) (β 34.21 (CI 19.30; 49.12), pglomerular filtration rate (β -0.21 (CI -0.36; -0.06), p = 0.0064) and plasma levels of NT-pro brain natriuretic peptide (NT-proBNP) (β 6.79 (CI 4.05; 9.52), p<0.0001), but not age (p = 0.59) or hypertension (p = 0.42). Our final model explained 52% of the LA volume variability. Conclusions In patients with AF, the most important correlates with LA volume are sex, BSA, diabetes, renal function and NT-proBNP, but not age or hypertension. These results may help to refine rhythm control strategies in AF patients. PMID:27701468

  2. Left atrial strain assessed by three-dimensional speckle tracking echocardiography predicts atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation.

    Science.gov (United States)

    Mochizuki, Atsushi; Yuda, Satoshi; Fujito, Takefumi; Kawamukai, Mina; Muranaka, Atsuko; Nagahara, Daigo; Shimoshige, Shinya; Hashimoto, Akiyoshi; Miura, Tetsuji

    2017-06-01

    Several studies have shown the utility of left atrial (LA) function determined by two-dimensional or three-dimensional speckle tracking echocardiography (2D- or 3D-STE) for identifying patients with paroxysmal atrial fibrillation (AF). However, whether 3D-STE is applicable for prediction of the recurrence of AF after catheter ablation (CA) remains unknown. We examined whether any 3D-STE parameters are better than 2D-STE parameters for the prediction of AF recurrence. Forty-two patients with paroxysmal AF (58 ± 10 years old, 69% male) underwent 2D- and 3D-STE within 3 days before first-time CA. The global peak LA longitudinal, circumferential, and area strains during systole (3D-GLSs, -GCSs, and -GASs, respectively) and those just before atrial contraction (3D-GLSa, -GCSa, and -GASa, respectively) were determined by 3D-STE and standard deviations of times to peaks of regional LA strains were calculated as indices of LA dyssynchrony. In 2D-STE, global LA longitudinal strains during systole and just before atrial contraction (2D-GLSs and -GLSa) were determined. During follow-up of 441 ± 221 days, 12 patients (29%) had AF recurrence. In the univariate Cox proportional hazard analysis, age [hazard ratio (HR): 1.08, p = 0.04], 3D-GCSs (HR: 0.91, p = 0.03), and 3D-GASs (HR: 0.95, p = 0.01) were predictors of AF recurrence, though associations of recurrence with 2D-STE parameters, indices of LA synchrony, and LA volume were not significant. Multivariable analysis showed that 3D-GASs was an independent predictor of AF recurrence (HR: 0.96, p = 0.048). LA strain determined by 3D-STE is a novel and better predictor of AF recurrence after CA than that determined by 2D-STE or other known predictors.

  3. Regional cerebral blood flow during light sleep--a H(2)(15)O-PET study.

    Science.gov (United States)

    Kjaer, Troels W; Law, Ian; Wiltschiøtz, Gordon; Paulson, Olaf B; Madsen, Peter L

    2002-09-01

    This is the first report on the distribution of regional cerebral blood flow (rCBF) changes during stage-1 sleep or somnolence. Two hypotheses were tested: (A) that rCBF differed between the awake relaxed state and stage-1 sleep, (B) that hypnagogic hallucinations frequently experienced at sleep onset would be accompanied by measurable changes in rCBF using positron emission tomography (PET). Eight subjects were PET-scanned with (15)O-labeled water injection in three conditions: awake, stage-1 sleep with reportable experiences and stage-1 sleep without reportable experiences. Electroencephalography (EEG) was performed continuously during the experiment. Sleep interviews were performed after each scan. The EEG was scored blindly to determine sleep stage. The sleep interviews revealed a substantial increase in how unrealistic and how leaping the thoughts were during stage-1 sleep. During sleep there was a relative flow increase in the occipital lobes and a relative flow decrease in the bilateral cerebellum, the bilateral posterior parietal cortex, the right premotor cortex and the left thalamus. Hypnagogic experiences seemed not to be associated with any relative flow changes. The topography of the occipital activation during stage-1 sleep supports a hypothesis of this state being a state of imagery. The rCBF decreases in premotor cortex, thalamus and cerebellum could be indicative of a general decline in preparedness for goal directed action during stage-1 sleep. Stage-1 sleep seems more similar to other forms of altered awareness, for example, relaxation meditation than to deeper sleep stages. We are of the opinion that stage-1 sleep represents the dreaming state of wakefulness, while rapid eye movement (REM) sleep reflects the dreaming state of the unaware, sleeping brain.

  4. The changes of regional cerebral blood flow: successful pain relief of intractable CRPS type II patients by motor cortex stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Jung, J. A.; Son, H. S.; Kim, S. H.; Jung, S. G [The Catholic University of Korea, Seoul (Korea, Republic of)

    2004-07-01

    Authors report the effectiveness of MCS in extraordinarily extended pain due to intractable CRPS type II and rCBF study result for mechanism of pain control by MCS. A 43-year-old male presented severe spontaneous burning pain in his left hand and forearm and allodynia over the left arm and left hemibody. Authors planned MCS as a neuromodulation therapy for this intractable peripheral neuropathic pain patient because further neurodestructive procedure did not work anymore and have a potential risk of further aggrevation of neuopathic pain. We performed baseline and stimulation brain perfusion SPECT using 20 mCi of Tc-99m ECD. The baseline CBD studies were done with stimulator 'off' state and stimulation studies were done after stimulator 'on' with satisfactory pain relief. For the stimulation study, the radioisotope was injected immediately after pain-relief and the images were taken about 50 minutes after injection of radioisotope. In resting rCBF in the patient was compared with normal control datas, we found significant increase in rCBF in the bilateral prefrontal cortex, right dorsolateral prefrontal cortex, right superior temporal gyrus, left temporooccipital area. When rCBF datas obtained after alleviation of pain with stimulator 'on' . there were significant increase in rCBF in bilateral prefrontal cortex and left temporoocipital area. After subtraction of ECD SPECT, we found significant increase in rCBF in the right premotor and supplementary motor cortex left sensorimotor cortex, right cingulated cortex, right posterior insular cortex, right anterior limb of internal capsule. left orbitofrontal cortex and right pyramidal tract in cerebral peduncle. Authors report exellent pain control by MCS in a case of severe CRPS type II with hemibody involvement and regional cerebral blood flow changes according to successful pain control.

  5. Archetypal and rearranged sequences of human polyomavirus JC transcription control region in peripheral blood leukocytes and in cerebrospinal fluid.

    Science.gov (United States)

    Ciappi, S; Azzi, A; De Santis, R; Leoncini, F; Sterrantino, G; Mazzotta, F; Mecocci, L

    1999-04-01

    Two forms of human polyomavirus JC (JCV) genome are known based upon the structure of the transcriptional control region (TCR) of the virus: the archetypal form, which is commonly detected in urine, and the rearranged form, which was first detected in brain tissue from progressive multifocal leukoencephalopathy (PML) patients. The latter actually includes a group of TCR variants that, relative to the former, are characterized by various deletions and/or duplications. The aim of this study was to establish whether or not a correlation exists among the TCR type, the spreading of the virus within the host and its ability to cause PML. JCV TCR sequences from peripheral blood leukocytes (PBL) and cerebrospinal fluid (CSF) obtained from various groups of patients were compared. JCV with archetypal TCR was detected in CSF and PBL specimens from patients without neurological disorders or who eventually received a diagnosis of a non-PML neurological disorder. Rearranged TCR sequences were detected in all the CSF and PBL specimens from PML patients. The high similarity observed between the TCR structure detected in PBL and CSF specimens from individual patients could strengthen the hypothesis that PBL has a role in spreading JCV to the brain. Moreover, heterogeneous TCR patterns have been shown in individual PBL specimens from PML patients. This supports the hypothesis that, in PBL, JCV may replicate and undergo rearrangements of the TCR. The detection of JCV DNA by PCR in CSF independently from PML, although rare, could suggest that this assay is not sufficient for a virological diagnosis of PML. Further studies are required to assess the usefulness of quantitative assays or TCR typing in combination with PCR for diagnostic purposes.

  6. Effects of regional cerebral blood flow perfusion on learning and memory function and its molecular mechanism in rats

    Institute of Scientific and Technical Information of China (English)

    Cunli Xu; Wenhua Wu; Lingbin Kong

    2016-01-01

    Objective:To study the effects of regional cerebral blood flow (rCBF) perfusion on learning and memory function in special brain areas and its molecular mechanism in rat. Methods: Sixty-four adult male healthy Sprague-Dawley (SD) rats were randomly divided into two groups: Afalse operation group and an operation group. The false operation group was randomly divided into four subgroups (A0, B0, C0, and D0) and the operation group was randomly divided into four subgroups (A, B, C, and D), with eight rats in each subgroup. The operation group underwent bilateral common carotid artery permanent ligation, while the other group only underwent a skin incision without the bilateral common carotid artery permanent ligation. Learning memory function of rats in each subgroup was measured using a Y-maze at 4 h, 8 h, 24 h, and 3 days after surgery. The rCBF in the right frontal lobe and hippocampus was detected using the Periflux PF model laser Doppler flowmetry and c-fos, c-jun, Bcl-2, and Bax protein expression in the right frontal lobe and hippocampus was measured using immunohistochemistry. Results: The rCBF in the right frontal lobule division and right hippocampus division was significantly lower in the operation group than in the false operation group (P Conclusions:rCBF decrease can impair learning and memory function in rats, which may be related to the increased expression of c-fos, c-jun, Bcl-2, and Bax proteins in the frontal cortex and hippocampus.

  7. Association of EEG, MRI, and regional blood flow biomarkers is predictive of prodromal Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Moretti DV

    2015-10-01

    Full Text Available Davide Vito Moretti IRCCS S Giovanni di Dio Fatebenefratelli, Brescia, Italy Background: Thinning in the temporoparietal cortex, hippocampal atrophy, and a lower regional blood perfusion is connected with prodromal stage of Alzheimer’s disease (AD. Of note, an increase of electroencephalography (EEG upper/low alpha frequency power ratio has also been associated with these major landmarks of prodromal AD.Methods: Clinical and neuropsychological assessment, EEG recording, and high-resolution three-dimensional magnetic resonance imaging were done in 74 grown up subjects with mild cognitive impairment. This information was gathered and has been assessed 3 years postliminary. EEG recording and perfusion single-photon emission computed tomography assessment was done in 27 subjects. Alpha3/alpha2 frequency power ratio, including cortical thickness, was figured for every subject. Contrasts in cortical thickness among the groups were assessed. Pearson’s r relationship coefficient was utilized to evaluate the quality of the relationship between cortical thinning, brain perfusion, and EEG markers.Results: The higher alpha3/alpha2 frequency power ratio group corresponded with more prominent cortical decay and a lower perfusional rate in the temporoparietal cortex. In a subsequent meetup after 3 years, these patients had AD.Conclusion: High EEG upper/low alpha power ratio was connected with cortical diminishing and lower perfusion in the temporoparietal brain area. The increase in EEG upper/low alpha frequency power ratio could be helpful in recognizing people in danger of conversion to AD dementia and this may be quality information in connection with clinical assessment. Keywords: electroencephalography, mild cognitive impairment, hippocampal volume, brain rhythms, biomarkers

  8. Magnetic Resonance Imaging Quantification of Regional Cerebral Blood Flow and Cerebrovascular Reactivity to Carbon Dioxide in Normotensive and Hypertensive Rats

    Science.gov (United States)

    Leoni, Renata F.; Paiva, Fernando F.; Henning, Erica C.; Nascimento, George C.; Tannús, Alberto; de Araujo, Draulio B.; Silva, Afonso C.

    2011-01-01

    Hypertension afflicts 25% of the general population and over 50% of the elderly. In the present work, arterial spin labeling MRI was used to non-invasively quantify regional cerebral blood flow (CBF), cerebrovascular resistance and CO2 reactivity in spontaneously hypertensive rats (SHR) and in normotensive Wistar Kyoto rats (WKY), at two different ages (3 months and 10 months) and under the effects of two anesthetics, α-chloralose and 2% isoflurane (1.5 MAC). Repeated CBF measurements were highly consistent, differing by less than 10% and 18% within and across animals, respectively. Under α-chloralose, whole brain CBF at normocapnia did not differ between groups (young WKY: 61±3ml/100g/min; adult WKY: 62±4ml/100g/min; young SHR: 70±9ml/100g/min; adult SHR: 69±8ml/100g/min), indicating normal cerebral autoregulation in SHR. At hypercapnia, CBF values increased significantly, and a linear relationship between CBF and PaCO2 levels was observed. In contrast, 2% isoflurane impaired cerebral autoregulation. Whole brain CBF in SHR was significantly higher than in WKY rats at normocapnia (young SHR: 139±25ml/100g/min; adult SHR: 104±23ml/100g/min; young WKY: 55±9ml/100g/min; adult WKY: 71±19ml/100g/min). CBF values increased significantly with increasing CO2; however, there was a clear saturation of CBF at PaCO2 levels greater than 70 mmHg in both young and adult rats, regardless of absolute CBF values, suggesting that isoflurane interferes with the vasodilatory mechanisms of CO2. This behavior was observed for both cortical and subcortical structures. Under either anesthetic, CO2 reactivity values in adult SHR were decreased, confirming that hypertension, when combined with age, increases cerebrovascular resistance and reduces cerebrovascular compliance. PMID:21708273

  9. Outcomes after ablation for typical atrial flutter (from the Loire Valley Atrial Fibrillation Project).

    Science.gov (United States)

    Clementy, Nicolas; Desprets, Laurent; Pierre, Bertrand; Lallemand, Bénédicte; Simeon, Edouard; Brunet-Bernard, Anne; Babuty, Dominique; Fauchier, Laurent

    2014-11-01

    Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.

  10. Atrial strain rate is a sensitive measure of alterations in atrial phasic function in healthy ageing.

    Science.gov (United States)

    Boyd, Anita C; Richards, David A B; Marwick, Thomas; Thomas, Liza

    2011-09-01

    Strain and strain rate measure local deformation of the myocardium and have been used to evaluate phasic atrial function in various disease states. The aim of this study was to define normal values for tissue Doppler-derived atrial strain measurements and examine age-related changes by decade in healthy individuals. Transthoracic echocardiograms were performed on 188 healthy subjects. Tissue Doppler-derived strain and strain rate were measured from the apical four and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate, early and late diastolic strain rate. Phasic left atrial volumes and fractions were calculated. Mitral inflow and tissue Doppler imaging were employed to estimate left ventricular diastolic function. A significant reduction in global systolic strain was observed from decade 6. Alterations in atrial strain rate were apparent from decade 5; systolic strain rate and early diastolic strain rate decreased, while late diastolic strain rate increased significantly. Changes in phasic atrial volume and function occurred in conjunction with age-related changes in left ventricular diastolic function. Importantly, age-related changes in global atrial systolic strain rate and early diastolic strain rate occurred a decade before corresponding changes in atrial phasic volume parameters. Atrial strain and strain rate can be used to quantify atrial phasic function and appear to be altered before traditional parameters with ageing. Strain analysis may therefore be more sensitive in detecting subclinical atrial dysfunction with alterations in strain rate parameters observed before traditional parameters.

  11. Pre-surgical regional blocks in orthognathic surgery: prospective study evaluating their influence on the intraoperative use of anaesthetics and blood pressure control.

    Science.gov (United States)

    Chen, Y A; Rivera-Serrano, C M; Chen, C; Chen, Y R

    2016-06-01

    In orthognathic surgery, maxillary (CNV2) and mandibular (CNV3) divisions of the trigeminal nerve can be blocked successfully prior to surgery. In this study, it was hypothesized that regional blocks (nerve block over a particular region: bilateral CNV2 and CNV3 divisions of the trigeminal nerve) would decrease the total requirement for intraoperative anaesthetic agents and facilitate the process of hypotensive anaesthesia. Local anaesthesia containing 1/100,000 epinephrine and 10ml 0.5% levobupivacaine was injected into the planned incisions in 50 patients. Twenty-five patients (group A) underwent orthognathic surgery without regional blocks and another 25 patients (group B) underwent surgery with regional blocks. The anaesthetic protocol was the same in both groups and administered by a single anaesthesiologist. The mean arterial pressure was recorded at several points throughout the operation, as well as all the medications used. The blood loss and the amounts of medications administered were lower in group B than in group A. In patients receiving regional blocks, the amounts of fentanyl and nicardipine required were significantly lower. The use of pre-emptive anaesthesia in orthognathic surgery may reduce the overall amounts of medications required for hypotensive anaesthesia, facilitate the intraoperative control of blood pressure, and decrease intraoperative blood loss.

  12. The phosphodiesterase 3 inhibitor cilostazol dilates large cerebral arteries in humans without affecting regional cerebral blood flow

    DEFF Research Database (Denmark)

    Birk, Steffen; Kruuse, Christina Rostrup; Petersen, Kenneth A;

    2004-01-01

    in the middle cerebral arteries (VMCA) was measured with transcranial Doppler, and the superficial temporal and radial arteries diameters were measured with ultrasonography. During the 4-hour observation period, there was no effect on systolic blood pressure (P = 0.28), but diastolic blood pressure decreased...

  13. Blood pressure patterns in rural, semi-urban and urban children in the Ashanti region of Ghana, West Africa.

    NARCIS (Netherlands)

    C.O. Agyemang (Charles); W.K. Redekop (Ken); E. Owusu-Dabo (Ellis); M.A. Bruijnzeels (Marc)

    2005-01-01

    textabstractBACKGROUND: High blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan/Africa. It is unclear whether this is reflected in children. The main purpose of this study was to assess blood pressure patterns among rural, semi-urban, and urban children and to

  14. Blood pressure patterns in rural, semi-urban and urban children in the Ashanti region of Ghana, West Africa.

    NARCIS (Netherlands)

    C.O. Agyemang (Charles); W.K. Redekop (Ken); E. Owusu-Dabo (Ellis); M.A. Bruijnzeels (Marc)

    2005-01-01

    textabstractBACKGROUND: High blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan/Africa. It is unclear whether this is reflected in children. The main purpose of this study was to assess blood pressure patterns among rural, semi-urban, and urban children and to

  15. Changes in the loco-regional cerebral blood flow (r.C.B.F.) during a simulation of weightlessness

    Science.gov (United States)

    Guell, A.; Dupui, Ph.; Barrere, M.; Fanjaud, G.; Bes, A.; Kotowskaia, A.

    Experiments of prolonged bedrest in antiorthostatic position are conducted in order to simulate cardio-circulatory modifications observed in weightlessness. Until now, no studies of r.C.B.F. have been effected in these conditions. Six young, healthy volunteers (average age 23.8) were placed in strict bedrest and in antiorthostatic position -4° for 7 days. The r.C.B.F. measurements were studied by 133Xe inhalation method using a 32 detectors system. Studies were made first in basal conditions, then between the 6th and 12th hr, and finally between the 72nd and the 78th hr after the beginning of the experiment. Three of the subjects received 0.450 mg of Clonidine daily during the experiment. In the subjects having taken no Clonidine, we observed a constant increase in r.C.B.F. (12, 17 and 16% respectively) in the first 12 hr; at the 72nd hour, all values had returned to basal state. This findings agrees with the well known notion of a rapid correction of hemodynamic disturbances observed in the first days of weightlessness. In the subjects treated with Clonidine, the increase of r.C.B.F. did not occur. Several mechanicsms of action are possible; the Clonidine affecting either the heart by inhibiting volemic atrial receptors, or the brain by direct vasoconstriction.

  16. Non-detection of human herpesvirus 8 (HHV-8) DNA in HHV-8-seropositive blood donors from three Brazilian regions.

    Science.gov (United States)

    Levi, José Eduardo; Nascimento, Maria Claudia; Sumita, Laura Masami; de Souza, Vanda Akico Ueda Fick; Freire, Wilton S; Mayaud, Philippe; Pannuti, Claudio S

    2011-01-01

    Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is the etiologic agent of all forms of Kaposi's sarcoma, primary effusion lymphoma and the plasmablastic cell variant of multicentric Castleman disease. In endemic areas of sub-Saharan Africa, blood transfusions have been associated with a substantial risk of HHV-8 transmission. By contrast, several studies among healthy blood donors from North America have failed to detect HHV-8 DNA in samples of seropositive individuals. In this study, using a real-time PCR assay, we investigated the presence of HHV-8 DNA in whole-blood samples of 803 HHV-8 blood donors from three Brazilian states (São Paulo, Amazon, Bahia) who tested positive for HHV-8 antibodies, in a previous multicenter study. HHV-8 DNA was not detected in any sample. Our findings do not support the introduction of routine HHV-8 screening among healthy blood donors in Brazil. (WC = 140).

  17. Mechanism for Triggered Waves in Atrial Myocytes.

    Science.gov (United States)

    Shiferaw, Yohannes; Aistrup, Gary L; Wasserstrom, J Andrew

    2017-08-08

    Excitation-contraction coupling in atrial cells is mediated by calcium (Ca) signaling between L-type Ca channels and Ryanodine receptors that occurs mainly at the cell boundary. This unique architecture dictates essential aspects of Ca signaling under both normal and diseased conditions. In this study we apply laser scanning confocal microscopy, along with an experimentally based computational model, to understand the Ca cycling dynamics of an atrial cell subjected to rapid pacing. Our main finding is that when an atrial cell is paced under Ca overload conditions, Ca waves can then nucleate on the cell boundary and propagate to the cell interior. These propagating Ca waves are referred to as "triggered waves" because they are initiated by L-type Ca channel openings during the action potential. These excitations are distinct from spontaneous Ca waves originating from random fluctuations of Ryanodine receptor channels, and which occur after much longer waiting times. Furthermore, we argue that the onset of these triggered waves is a highly nonlinear function of the sarcoplasmic reticulum Ca load. This strong nonlinearity leads to aperiodic response of Ca at rapid pacing rates that is caused by the complex interplay between paced Ca release and triggered waves. We argue further that this feature of atrial cells leads to dynamic instabilities that may underlie atrial arrhythmias. These studies will serve as a starting point to explore the nonlinear dynamics of atrial cells and will yield insights into the trigger and maintenance of atrial fibrillation. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  18. Emergency bypass post percutaneous atrial ablation: a case report.

    LENUS (Irish Health Repository)

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  19. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar;

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  20. Management and prognosis of atrial fibrillation in the diabetic patient

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring

    2015-01-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation. I...... and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients.......The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation...

  1. The renal effects of atrial natriuretic peptide in man are not attenuated by (+)-sulpiride.

    OpenAIRE

    1989-01-01

    1. Human alpha atrial natriuretic peptide (ANP) was infused intravenously for 1 h in eight healthy salt-replete men on two occasions, with and without pretreatment with (+)-sulpiride. 2. ANP increased sodium excretion and urine flow rate but did not alter blood pressure or plasma renin activity. 3. (+)-sulpiride had no significant effect on baseline creatinine clearance, sodium excretion or urine flow rate and did not alter the increases in these parameters with ANP. 4. It is unlikely that th...

  2. Early thyroid gland dysfunction and biorhythmic activity disturbance in patients with cardiovascular pathology and atrial fibrillation

    OpenAIRE

    Shvarts Yu.G.; Mayskova Е.А.; Baurina Yu.O.

    2012-01-01

    The review deals with the problem of combined pathology of the thyroid gland and cardiovascular system, the state of thyroid homeostasis in atrial fibrillation. The main mechanisms of action of thyroid hormones on the heart and blood vessels, particularly changes in the cardiovascular system with hypo-or hyperthyroidism; the possibility of substitution therapy in subclinical disease have been presented in the article. Characteristics of daily rhythmic activity of thyroid gland in normal and v...

  3. Mixoma gigante de átrio esquerdo Giant left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Juan Francisco Muñoz Cruz

    1998-11-01

    Full Text Available Homem de 65 anos, portador de miocardiopatia dilatada e hipertensão arterial de longa data, com antecedentes de acidente vascular cerebral e que, ao ecocardiograma, apresentou mixoma gigante de átrio esquerdo.A 65 year-old man with dilated cardiomiopathy and long history of high blood pressure and a previous cerebral vascular accident had a giant left atrial myxoma as an echocardiographic finding.

  4. Giant right atrial myxoma: characterization with cardiac magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    A 53-year-old woman presented to the emergency department with a 2-week history of dyspnoea and chest pain. Computed tomography pulmonary angiography was performed to exclude acute pulmonary embolism (PE). This demonstrated a large right atrial mass and no evidence of PE. Transthoracic echocardiography followed by cardiac magnetic resonance imaging confirmed a mobile right atrial mass. Surgical resection was then performed confirming a giant right atrial myxoma. We describe the typical clinical, radiologic, and pathologic features of right atrial myxoma.

  5. Blood-brain barrier to peptides: (/sup 3/H)gonadotropin-releasing hormone accumulation by eighteen regions of the rat brain and by anterior pituitary

    Energy Technology Data Exchange (ETDEWEB)

    Ermisch, A.; Ruehle, H.J. (Karl-Marx-Universitaet, Leipzig (German Democratic Republic). Sektion Biowissenschaften); Klauschenz, E.; Kretzschmar, R. (Akademie der Wissenschaften der DDR, Berlin. Inst. fuer Wirkstofforschung)

    1984-01-01

    After intracarotid injection of (/sup 3/H)gonadotropin-releasing hormone ((/sup 3/H)GnRH) the mean accumulation of radioactivity per unit wet weight of 18 brain samples investigated and the anterior pituitary was 0.38 +- 0.11% g/sup -1/ of the injected tracer dose. This indicates a low but measurable brain uptake of the peptide. The brain uptake of (/sup 3/H)GnRH in blood-brain barrier (BBB)-protected regions is 5% of that of separately investigated (/sup 3/H)OH. In BBB-free regions the accumulation of radioactivity was more than 25-fold higher than in BBB-protected regions. The accumulation of (/sup 3/H)GnRH among regions with BBB varies less than among regions with leaky endothelia. The data presented for (/sup 3/H)GnRH are similar to those for other peptides so far investigated.

  6. Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET: I. Theory, error analysis, and stereologic comparison

    DEFF Research Database (Denmark)

    Lida, H; Law, I; Pakkenberg, B

    2000-01-01

    formulated four mathematical models that describe the dynamic behavior of a freely diffusible tracer (H215O) in a region of interest (ROI) incorporating estimates of regional tissue flow that are independent of PVE. The current study was intended to evaluate the feasibility of these models and to establish...... a methodology to accurately quantify regional cerebral blood flow (CBF) corrected for PVE in cortical gray matter regions. Five monkeys were studied with PET after IV H2(15)O two times (n = 3) or three times (n = 2) in a row. Two ROIs were drawn on structural magnetic resonance imaging (MRI) scans and projected...... onto the PET images in which regional CBF values and the water perfusable tissue fraction for the cortical gray matter tissue (hence the volume of gray matter) were estimated. After the PET study, the animals were killed and stereologic analysis was performed to assess the gray matter mass...

  7. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: a new in vivo model.

    Science.gov (United States)

    Haugan, Ketil; Lam, Henrik Rye; Knudsen, Carsten Boye; Petersen, Jørgen Søberg

    2004-07-01

    Non-pharmacological in vivo models of atrial fibrillation (AF) have been developed in large animals only. We aimed to develop and characterize a new small animal non-pharmacological in vivo model of AF. AF was induced by transesophageal atrial burst pacing during 35 seconds periods of asphyxia in anesthetized male Sprague-Dawley rats. AF was reproducibly induced in 81% of the rats. The presence of AF was associated with an increased heart rate, and a decreased blood pressure. Treatment with amiodarone, D,L-sotalol, flecainide, and propranolol all reduced duration of AF, whereas verapamil treatment was associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP10 did not affect AF duration. Basal plasma level of epinephrine and norepinephrine were increased 5- to 20-fold relative to values reported by others, but unchanged following 35 seconds of asphyxia. The results from our study demonstrate that the rat model shares several clinical key characteristics with human AF: (1) hemodynamic response to AF; (2) increased autonomic tone; (3) antiarrhythmic effects of clinically used drugs; (4) profibrillatory effect of verapamil. Relative to existing models of AF in larger animals, this model offers rapid, predictive, and inexpensive testing of antiarrhythmic/profibrillatory effects of new drugs.

  8. Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Tuinenburg, AE; Brundel, BJJM; Van Gelder, IC; Henning, RH; Van den Berg, MP; Driessen, C; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    1999-01-01

    Natriuretic Peptide System in AF. Introduction: Circulating cardiac natriuretic peptides play an important role in maintaining volume homeostasis, especially during conditions affecting hemodynamics. During atrial fibrillation (AF), levels of plasma atrial natriuretic peptide (ANP) becomes elevated.

  9. Plasma pro-atrial natriuretic peptide to estimate fluid balance during open and robot-assisted esophagectomy

    DEFF Research Database (Denmark)

    Strandby, Rune Broni; Ambrus, Rikard; Secher, Niels H

    2017-01-01

    BACKGROUND: It remains debated how much fluid should be administered during surgery. The atrial natriuretic peptide precursor proANP is released by atrial distension and deviations in plasma proANP are reported associated with perioperative fluid balance. We hypothesized that plasma proANP would...... decrease when the central blood volume is compromised during the abdominal part of robot-assisted hybrid (RE) esophagectomy and that a positive fluid balance would be required to maintain plasma proANP. METHODS: Patients undergoing RE (n = 25) or open (OE; n = 25) esophagectomy for gastroesophageal cancer...

  10. Thermoregulatory responses and blood parameters of locally adapted ewes under natural weather conditions of Brazilian semiarid region

    Directory of Open Access Journals (Sweden)

    Wirton Peixoto Costa

    2015-12-01

    Full Text Available The effect of the natural weather conditions on respiratory rate, rectal temperature and hematologic parameters such as glucose, total cholesterol, triacylglycerol, total protein, albumin, globulin, red blood cells, microhematocrit, mean corpuscular volume, serum triiodothyronine (T3 and thyroxine (T4 levels was evaluated in red (RMN and white (WMN coat colored Morada Nova ewes, of different class of body condition score (CBCS, during the dry (from july to december and wet (from january to june seasons, which exhibited different (P<0.05 air temperature, relative humidity and radiant thermal load averages. Tukey’s test was used and the difference considered was to P<0.05. Significant greater averages of respiratory rate were observed in the dry period compared to the rainy period (42.26±8.96 and 36.89±8.20 breaths min-1, respectively, mainly in the RMN (45.54±8.23 breaths min-1 compared with the WMN (39.27±8.57 breaths min-1. No differences were observed in rectal temperature measurements between the dry and the wet periods (38.59±0.58 and 38.60±0.56 oC, respectively, but the WMN had higher values than the RMN (38.77±0.54 and 38.40±0.54 oC, respectively. The glucose and total cholesterol were higher in the wet season, with no variation due to breed variety and CBCS. The triacylglycerol did not change between breed varieties and seasons. The albumin was similar between varieties and in different seasons, being different in CBCS. Total protein and globulin serum were higher during the wet season, but total protein was higher and globulin was lower in better CBCS. T3 and T4 levels were higher in the rainy season (0.25±0.07 and 6.74±11.37 ?g dL-1, for T3 and T4, respectively than in the dry season (0.18±0.08 and 6.31±1.64 ?g dL-1, for T3 and T4, respectively. The red blood cells showed no difference, but microhematocrit was higher in WMN and in the better CBCS and mean corpuscular volume was higher in the dry season. The concentration

  11. Interobserver variation in interpretation of electrocardiographic signs of atrial infarction

    DEFF Research Database (Denmark)

    Christensen, J H; Nielsen, F E; Falstie-Jensen, N

    1993-01-01

    The electrocardiogram (ECG) is the only means of diagnosing atrial infarction antemortem. Certain ECG changes (PR-segment displacements) have been taken earlier as signs of atrial infarction. The purpose of this study was to assess the interobserver variation on suggested ECG signs of atrial infa...

  12. Autonomic and surgical substrate modulation of atrial fibrillation

    NARCIS (Netherlands)

    Krul, S.P.J.

    2016-01-01

    This thesis focuses on the effects of fibrosis and the autonomic nervous system on conduction in patients with atrial fibrillation and the surgical ablation of the atria and autonomic nervous system as treatment of atrial fibrillation. Atrial fibrillation is the most common arrhythmia and results fr

  13. Atrial electromechanical delay in patients undergoing heart transplantation

    Directory of Open Access Journals (Sweden)

    Mustafa Bulut, MD

    2017-04-01

    Conclusion: Inter-AEMD and intra-AEMD were prolonged in patients who underwent heart transplantation as compared to a control population. This may explain the increased atrial fibrillation and other atrial arrhythmia incidences associated with the biatrial anastomosis heart transplantation technique and may contribute to the treatment of atrial fibrillation in this special patient group.

  14. Echocardiographic evaluation of patent foramen ovale and atrial septal defect.

    Science.gov (United States)

    Hari, Pawan; Pai, Ramdas G; Varadarajan, Padmini

    2015-01-01

    Patent foramen ovale (PFO) is a common variant present in up to 25% of the population. Atrial septal defect (ASD) is a direct communication between the 2 atrial chambers, of which the ostium secundum variety is the most common. This manuscript is an in depth review of the complex atrial septation, the diagnosis of PFO and ASD and its clinical and therapeutic implications.

  15. Surgical Treatment of Atrial Fibrillation: A Review

    Directory of Open Access Journals (Sweden)

    Nadine Hiari

    2011-01-01

    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  16. The evaluation of cerebral hemodynamics in patients with intracranial tumors by stable xenon CT; The effect of glycerol administration on regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Shimoda, Masami; Kawamata, Fumio; Yamamoto, Masahiro; Ohsuga, Hitoshi; Hidaka, Mitsuru; Oda, Shinri; Shibuya, Naoki; Yamamoto, Isao; Sato, Osamu (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1989-04-01

    In evaluating cerebral regional blood flow (rCBF), stable xenon-enhanced tomography (XeCT) study associated with simultaneous blood sampling was applied in 15 cases of intracranial neoplasms. The effect of intravenous glycerol infusion on rCBF was also investigated. The results indicated that intratumoral rCBF values were not only variable and unrelated to their histological types and grades, but also were not correlated with the vascularity of the lesion as demonstrated by angiography. When a tumor mass was enhanced after the injection of iodinated contrast media, it proved to be useful in distinguishing tumor mass and its associated edema that the rCBF of the peritumoral edematous region was predominantly low (10{plus minus}5 ml/100 g/min). The regional cerebral blood flow in remote areas, both ipsilateral and contralateral to the lesion, was low in value, and there was no statistical significance between affected and sound sides. Following glycerol administration, rCBF was increased in the whole intracranial region, but not inside of the neoplasm, particularly when the intracranial pressure (ICP) was increased. It was assumed that the elevated rCBF after glycerol administration was due to the increase in the cerebral perfusion pressure resulting from the ICP reduction, the hemodilution effect, cerebral vessel dilatation after metabolic acidosis, and/or mechanically rectified microcirculation after edema reduction. (author).

  17. GENETIC PREDICTORS OF ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    A. V. Kuskaeva

    2016-01-01

    Full Text Available Atrial fibrillation (AF is the most common heart rhythm disturbance. It is believed that the primary form of AF is genetically determined in most cases, but the genetic component cannot be excluded in the secondary form of AF. AF is a heterogeneous disease and many authors proved its relationship with other genetic heart disease. In most cases, certain combinations of polymorphisms of different genes promote the development of AF. The study of genes of renin-angiotensin-aldosterone system (RAAS is especially important, because the role of this system in AF pathogenesis is currently studding most intensively. These studies are of great practical interest, as associative effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists in the prevention of AF is revealed. RAAS blockers are able not only to reduce the risk of new-onset AF in hypertensive and normotensive patients but also prevent recurrence of AF. Furthermore, experimental studies showed that RAAS blockers prevent not only the remodeling of the left ventricle, and also the left atrium, pointing to the pathogenesis of AF. So, screening for susceptibility genes and the study of their polymorphism is currently an important focus in the study of AF.

  18. The effect of atrial preference pacing on atrial fibrillation electrophysiological substrate in Myotonic Dystrophy type 1 population

    OpenAIRE

    Russo, Vincenzo; NIGRO, GERARDO; DI MEO, FEDERICA; PAPA, ANDREA ANTONIO; CIOPPA, NADIA DELLA; PROIETTI, RICCARDO; Russo, Maria Giovanna; Calabrò, Raffaele; Politano, Luisa

    2014-01-01

    P-wave dispersion is a non invasive indicator of intra-atrial conduction heterogeneity producing substrate for reentry, which is a pathophysiological mechanism of atrial fibrillation. The relationship between P-wave dispersion (PD) and atrial fibrillation (AF) in Myotonic dystrophy type 1 (DM1) patients is still unclear. Atrial Preference Pacing (APP) is an efficient algorithm to prevent paroxysmal AF in patients implanted with dual-chamber pacemaker. Aim of our study was to evaluate the poss...

  19. Fibrosis and electrophysiological characteristics of the atrial appendage in patients with atrial fibrillation and structural heart disease

    NARCIS (Netherlands)

    Brakel, T.J. van; Krieken, T. van der; Westra, S.W.; Laak, J.A.W.M. van der; Smeets, J.L.R.M.; Swieten, H.A. van

    2013-01-01

    PURPOSE: This study was conducted to investigate the degree of fibrosis in atrial appendages of patients with and without atrial fibrillation (AF) undergoing cardiac surgery. In addition, we hypothesized that areas of atrial fibrosis can be identified by electrogram fractionation and low voltage for

  20. Atrial tachycardia originating from the atrial septum in a patient with dextrocardia and complex structural heart disease.

    Science.gov (United States)

    Niu, Ya-Lei; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Lee, Pi-Chang; Chen, Shih-Ann

    2012-10-01

    We report a case with dextrocardia, corrected transposition of the great arteries. He also had an atrial septum defect (ASD) with patch repair. Activation map showed a centrifugal activation from a focal origin on the systemic lower left atrial ASD patch. Ablation of the origin can terminate the atrial tachycardia.

  1. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许端敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    @@ Atrial fibrillation (AF) is a kind of common arrhythmia, which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus.The incidence of left atrial thrombosis (LAT)could reach 25%-30%(1), the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more(2,3). To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  2. Bi-focal atrial tachycardia mimicking atrial fibrillation: fusion and interference between two distinct tachycardias.

    Science.gov (United States)

    Ejima, Koichiro; Shoda, Morio; Tanizaki, Kohei; Kasanuki, Hiroshi

    2007-11-01

    Irregular tachycardias mimicking atrial fibrillation (AF) have previously been described. We report a case of a 60-year-old man with an antiarrhythmic drug-resistant atrial tachycardia (AT) mimicking AF. The tachycardia consisted of two distinct ATs with interference of one repetitive AT with another sustained AT. Radiofrequency (RF) ablation of two distinct right atrial foci eliminated the irregular tachycardia. Although catheter-based pulmonary vein isolation has become a popular therapeutic approach for patients with symptomatic AF, careful evaluation of the intracardiac recordings in the patients undergoing RF ablation for AF is important.

  3. Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash; Safi, Sanam; Feinberg, Joshua

    2017-01-01

    BACKGROUND: Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation...... and secondary outcomes, we will create a 'Summary of Findings' table based on GRADE assessments of the quality of the evidence. DISCUSSION: The results of this systematic review have the potential to benefit millions of patients worldwide as well as healthcare economy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO...

  4. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment.

    Science.gov (United States)

    Danaei, Goodarz; Lawes, Carlene M M; Vander Hoorn, Stephen; Murray, Christopher J L; Ezzati, Majid

    2006-11-11

    Cardiovascular mortality risk increases continuously with blood glucose, from concentrations well below conventional thresholds used to define diabetes. We aimed to quantify population-level effects of all higher-than-optimum concentrations of blood glucose on mortality from ischaemic heart disease and stroke worldwide. We used population distribution of fasting plasma glucose to measure exposure to higher-than-optimum blood glucose. We collated exposure data in 52 countries from individual-level records in population health surveys, systematic reviews, and data provided by investigators. Relative risks for ischaemic heart disease and stroke mortality were from a meta-analysis of more than 200,000 participants in the Asia-Pacific region, with adjustment for other cardiovascular risk factors. In addition to 959,000 deaths directly assigned to diabetes, 1 490,000 deaths from ischaemic heart disease and 709,000 from stroke were attributable to high blood glucose, accounting for 21% and 13% of all deaths from these conditions. 1.8 million of these 2.2 million cardiovascular deaths (84%) were in low-and-middle-income countries (1,224,000 for ischaemic heart disease, 623,000 for stroke). 792,000 (53%) of deaths from ischaemic heart disease and 345,000 (49%) from stroke that were attributable to high blood glucose were in men. Largest numbers of deaths attributable to this risk factor from ischaemic heart disease were in low-and-middle-income countries of South Asia (548,000) and Europe and Central Asia (313,000), and from stroke in South Asia (215,000) and East Asia and Pacific (190,000). Higher-than-optimum blood glucose is a leading cause of cardiovascular mortality in most world regions. Programmes for cardiovascular risk and diabetes management and control at the population level need to be more closely integrated.

  5. Atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. We present a case of atrial fibrillation associated with subclinical hyperthyroidism, in a 78-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  6. Effects of irbesartan on atrial cell electrophysiology

    Institute of Scientific and Technical Information of China (English)

    HUANG Cong-xin; CAO Feng; JIANG Hong; WANG Teng; LI Xia

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice.1 Its incidence increases with age and the presence of structural heart disease. It is a major cause of stroke, especially in the elderly. It has been shown that angiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardial infarction.2 Several studies have shown that activation of the rennin-angiotensin system is associated with the mechanisms of AF. Irbesartan is a long-acting angiotensin Ⅱ type 1 receptor antagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstrated that patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.4 These findings suggest that the inhibition of angiotensin Ⅱ may prevent AF, but its underlying electrophysiological mechanisms are obscure. The purpose of this study is to investigate the effects of irbesartan on atrial cell electrophysiology.

  7. Antihypertensive treatment and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Nielsen, Sune F; Benn, Marianne

    2014-01-01

    AIMS: To examine the associations between antihypertensive treatment with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs), β-blockers, diuretics, or calcium-antagonists, and risk of atrial fibrillation. We examined these associations using the entire Danish...... population from 1995 through 2010. METHODS AND RESULTS: Excluding medication used in atrial fibrillation, we matched individuals on ACEi monotherapy 1:1 with individuals on β-blocker (n = 48 658), diuretic (n = 69 630), calcium-antagonist (n = 57 646), and ARB monotherapy (n = 20 158). Likewise, individuals...... on ARB monotherapy were matched 1:1 with individuals on β-blocker (n = 20 566), diuretic (n = 20 832), calcium-antagonist (n = 20 232), and ACEi monotherapy (n = 20 158). All were free of atrial fibrillation and of predisposing diseases like heart failure, ischaemic heart disease, diabetes mellitus...

  8. Bioptic Study of Left and Right Atrial Interstitium in Cardiac Patients with and without Atrial Fibrillation: Interatrial but Not Rhythm-Based Differences.

    Directory of Open Access Journals (Sweden)

    Natalia Smorodinova

    Full Text Available One of the generally recognized factors contributing to the initiation and maintenance of atrial fibrillation (AF is structural remodeling of the myocardium that affects both atrial cardiomyocytes as well as interstitium. The goal of this study was to characterize morphologically and functionally interstitium of atria in patients with AF or in sinus rhythm (SR who were indicated to heart surgery. Patient population consisted of 46 subjects (19 with long-term persistent AF, and 27 in SR undergoing coronary bypass or valve surgery. Peroperative bioptic samples of the left and the right atria were examined using immunohistochemistry to visualize and quantify collagen I, collagen III, elastin, desmin, smooth muscle actin, endothelium and Vascular Endothelial Growth Factor (VEGF. The content of interstitial elastin, collagen I, and collagen III in atrial tissue was similar in AF and SR groups. However, the right atrium was more than twofold more abundant in elastin as compared with the left atrium and similar difference was found for collagen I and III. The right atrium showed also higher VEGF expression and lower microvascular density as compared to the left atrium. No significant changes in atrial extracellular matrix fiber content, microvascular density and angiogenic signaling, attributable to AF, were found in this cohort of patients with structural heart disease. This finding suggests that interstitial fibrosis and other morphological changes in atrial tissue are rather linked to structural heart disease than to AF per se. Significant regional differences in interstitial structure between right and left atrium is a novel observation that deserves further investigation.

  9. Atrial Fibrillation associated chromosome 4q25 variants are not associated with PITX2c expression in human adult left atrial appendages.

    Directory of Open Access Journals (Sweden)

    Shamone R Gore-Panter

    Full Text Available Atrial Fibrillation (AF, the most common sustained arrhythmia, has a strong genetic component, but the mechanism by which common genetic variants lead to increased AF susceptibility is unknown. Genome-wide association studies (GWAS have identified that the single nucleotide polymorphisms (SNPs most strongly associated with AF are located on chromosome 4q25 in an intergenic region distal to the PITX2 gene. Our objective was to determine whether the AF-associated SNPs on chromosome 4q25 were associated with PITX2c expression in adult human left atrial appendages. Analysis of a lone AF GWAS identified four independent AF risk SNPs at chromosome 4q25. Human adult left atrial appendage tissue was obtained from 239 subjects of European Ancestry and used for SNP analysis of genomic DNA and determination of PITX2c RNA expression levels by quantitative PCR. Subjects were divided into three groups based on their history of AF and pre-operative rhythm. AF rhythm subjects had higher PITX2c expression than those with history of AF but in sinus rhythm. PITX2c expression was not associated with the AF risk SNPs in human adult left atrial appendages in all subjects combined or in each of the three subgroups. However, we identified seven SNPs modestly associated with PITX2c expression located in the introns of the ENPEP gene, ∼54 kb proximal to PITX2. PITX2c expression in human adult left atrial appendages is not associated with the chromosome 4q25 AF risk SNPs; thus, the mechanism by which these SNPs are associated with AF remains enigmatic.

  10. Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines

    Directory of Open Access Journals (Sweden)

    Luciana Armaganijan

    2012-04-01

    Full Text Available Atrial Fibrillation (AF is the most common sustained arrhythmia and 1/6 strokes is attributed to AF. The cornerstone of treatment remains maintaining sinus rhythm or appropriate ventricular rate control in addition to prevention of stroke. Oral anticoagulation therapy (OAC with vitamin K antagonists (VKAs has been the gold standard for almost 50 years and a significant reduction in the risk of stroke in patients with AF has been demonstrated. Nonetheless, only 50% of patients with guideline recommendations for OAC treatment actually receive VKAs and half of these will discontinue therapy within 3 to 5 years with only another half achieving therapeutic ranges more than 50% of the time. The aforementioned limitations in addition with frequent blood monitoring have prompted the development of a series of new OAC therapies. The present review focuses on the current pharmacological management for stroke prevention in patients with AF based on current and emerging evidence.

  11. Atrial Fibrillation in a Diarrheic Holstein Dairy Calf

    Directory of Open Access Journals (Sweden)

    Aliasghar CHALMEH

    2015-01-01

    Full Text Available Cardiac auscultation of a 10-day-old diarrheic female Holstein dairy calf revealed irregularities in rhythm and absence of 4th heart sound. Electrocardiogram (ECG and blood sample were obtained before and after the treatment. Based on ECG and cardiac auscultation findings, atrial fibrillation (AF was diagnosed. Serum sodium, calcium and magnesium before treatment were significantly lower than their reference ranges and potassium was significantly higher. One day after treating this patient, serum electrolytes were reached to reference ranges and AF was changed to normal sinus rhythm. Based on resolving the AF after treating the patient and correcting the electrolyte imbalances, it can be suggested that electrolyte imbalances were the main cause of the occurrence of AF in the present case.

  12. Detecting phase singularities and rotor center trajectories based on the Hilbert transform of intraatrial electrograms in an atrial voxel model

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    Unger Laura Anna

    2015-09-01

    Full Text Available This work aimed at the detection of rotor centers within the atrial cavity during atrial fibrillation on the basis of phase singularities. A voxel based method was established which employs the Hilbert transform and the phase of unipolar electrograms. The method provides a 3D overview of phase singularities at the endocardial surface and within the blood volume. Mapping those phase singularities from the inside of the atria at the endocardium yielded rotor center trajectories. We discuss the results for an unstable and a more stable rotor. The side length of the areas covered by the trajectories varied from 1.5 mm to 10 mm. These results are important for cardiologists who target rotors with RF ablation in order to cure atrial fibrillation.

  13. Detection of HTLV-IIa in blood donors in an urban area of the Amazon Region of Brazil (Belém, PA

    Directory of Open Access Journals (Sweden)

    Ishak R.

    1998-01-01

    Full Text Available The human lymphotropic viruses type I (HTLV-I and type II (HTLV-II are members of a group of mammalian retroviruses with similar biological properties, and blood transfusion is an important route of transmission. HTLV-I is endemic in a number of different geographical areas and is associated with several clinical disorders. HTLV-II is endemic in several Indian groups of the Americas and intravenous drug abusers in North and South America, Europe and Southeast Asia. During the year of 1995, all blood donors tested positive to HTLV-I/II in the State Blood Bank (HEMOPA, were directed to a physician and to the Virus Laboratory at the Universidade Federal do Pará for counselling and laboratory diagnosis confirmation. Thirty-five sera were tested by an enzyme immune assay, and a Western blot that discriminates HTLV-I and HTLV-II infection. Two HTLV-II positive samples were submitted to PCR analysis of pX and env genomic region, and confirmed to be of subtype IIa. This is the first detection in Belém of the presence of HTLV-IIa infection among blood donors. This result emphasizes that HTLV-II is also present in urban areas of the Amazon region of Brazil and highlights the need to include screening tests that are capable to detect antibodies for both types of HTLV.

  14. Semiquantitative regional cerebral blood flow evaluation using sup 123 I-IMP SPECT in a case showing transient ischemic attack caused by putaminal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Y.; Ayada, Y.; Takahashi, T.; Toyama, Y.; Matsuo, H. (Second Department of Internal Medicine, Kagawa Medical School (Japan)); Katsuragawa, M.; Tanabe, M. (Department of Radiology, Kagawa Medical School (Japan))

    1991-01-01

    A 69-year-old woman presented a transient cerebral ischemic attack, showing left arm weakness and slurred speech which recovered within 4 h of onset, while computed tomography indicated a putaminal hemorrhage. The regional cerebral blood flow distribution, measured semiquantitatively by use of {sup 123}I amphetamine emission tomography, was disturbed, which persisted more than one month up to a maximum of 4.5 months from the onset of symptoms. the case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and provides and example in which the regional cerebral blood flow disturbances might persist for more than one month up to 4.5 months after the occurrence of a transient ischemic attack caused by a putaminal hemorrhage. (author).

  15. Hemodynamic and regional blood flow distribution responses to dextran, hydralazine, isoproterenol and amrinone during experimental cardiac tamponade

    Energy Technology Data Exchange (ETDEWEB)

    Millard, R.W.; Fowler, N.O.; Gabel, M.

    1983-06-01

    Four different interventions were examined in dogs with cardiac tamponade. Infusion of 216 to 288 ml saline solution into the pericardium reduced cardiac output from 3.5 +/- 0.3 to 1.7 +/- 0.2 liters/min as systemic vascular resistance increased from 4,110 +/- 281 to 6,370 +/- 424 dynes . s . cm-5. Left ventricular epicardial and endocardial blood flows were 178 +/- 13 and 220 +/- 12 ml/min per 100 g, respectively, and decreased to 72 +/- 14 and 78 +/- 11 ml/min per 100 g with tamponade. Reductions of 25 to 65% occurred in visceral and brain blood flows and in a composite brain sample. Cardiac output during tamponade was significantly increased by isoproterenol, 0.5 microgram/kg per min intravenously; hydralazine, 40 mg intravenously; dextran infusion or combined hydralazine and dextran, but not by amrinone. Total systemic vascular resistance was reduced by all interventions. Left ventricular epicardial flow was increased by isoproterenol, hydralazine and the hydralazine-dextran combination. Endocardial flow was increased by amrinone and the combination of hydralazine and dextran. Right ventricular myocardial blood flow increased with all interventions except dextran. Kidney cortical and composite brain blood flows were increased by both dextran alone and by the hydralazine-dextran combinations. Blood flow to small intestine was increased by all interventions as was that to large intestine by all except amrinone and hydralazine. Liver blood flow response was variable. The most pronounced hemodynamic and tissue perfusion improvements during cardiac tamponade were effected by combined vasodilation-blood volume expansion with a hydralazine-dextran combination. Isoproterenol had as dramatic an effect but it was short-lived. Amrinone was the least effective intervention.

  16. Selective α1-adrenergic blockade disturbs the regional distribution of cerebral blood flow during static handgrip exercise.

    Science.gov (United States)

    Fernandes, Igor A; Mattos, João D; Campos, Monique O; Machado, Alessandro C; Rocha, Marcos P; Rocha, Natalia G; Vianna, Lauro C; Nobrega, Antonio C L

    2016-06-01

    Handgrip-induced increases in blood flow through the contralateral artery that supplies the cortical representation of the arm have been hypothesized as a consequence of neurovascular coupling and a resultant metabolic attenuation of sympathetic cerebral vasoconstriction. In contrast, sympathetic restraint, in theory, inhibits changes in perfusion of the cerebral ipsilateral blood vessels. To confirm whether sympathetic nerve activity modulates cerebral blood flow distribution during static handgrip (SHG) exercise, beat-to-beat contra- and ipsilateral internal carotid artery blood flow (ICA; Doppler) and mean arterial pressure (MAP; Finometer) were simultaneously assessed in nine healthy men (27 ± 5 yr), both at rest and during a 2-min SHG bout (30% maximal voluntary contraction), under two experimental conditions: 1) control and 2) α1-adrenergic receptor blockade. End-tidal carbon dioxide (rebreathing system) was clamped throughout the study. SHG induced increases in MAP (+31.4 ± 10.7 mmHg, P blood flow (+80.9 ± 62.5 ml/min, P 0.05). The reduction in ipsilateral ICA vascular conductance (VC) was greater compared with contralateral ICA (contralateral: -0.8 ± 0.8 vs. ipsilateral: -2.6 ± 1.3 ml·min(-1)·mmHg(-1), P blood flow (contralateral: +58.4 ± 21.5 vs. ipsilateral: +54.3 ± 46.2 ml/min, P > 0.05) and decreases in VC (contralateral: -0.4 ± 0.7 vs. ipsilateral: -0.4 ± 1.0 ml·min(-1)·mmHg(-1), P > 0.05). These findings indicate a role of sympathetic nerve activity in the regulation of cerebral blood flow distribution during SHG.

  17. Distinct patterns of constitutive phosphodiesterase activity in mouse sinoatrial node and atrial myocardium.

    Directory of Open Access Journals (Sweden)

    Rui Hua

    Full Text Available Phosphodiesterases (PDEs are critical regulators of cyclic nucleotides in the heart. In ventricular myocytes, the L-type Ca(2+ current (I(Ca,L is a major target of regulation by PDEs, particularly members of the PDE2, PDE3 and PDE4 families. Conversely, much less is known about the roles of PDE2, PDE3 and PDE4 in the regulation of action potential (AP properties and I(Ca,L in the sinoatrial node (SAN and the atrial myocardium, especially in mice. Thus, the purpose of our study was to measure the effects of global PDE inhibition with Isobutyl-1-methylxanthine (IBMX and selective inhibitors of PDE2, PDE3 and PDE4 on AP properties in isolated mouse SAN and right atrial myocytes. We also measured the effects of these inhibitors on I(Ca,L in SAN and atrial myocytes in comparison to ventricular myocytes. Our data demonstrate that IBMX markedly increases spontaneous AP frequency in SAN myocytes and AP duration in atrial myocytes. Spontaneous AP firing in SAN myocytes was also increased by the PDE2 inhibitor erythro-9-[2-hydroxy-3-nonyl] adenine (EHNA, the PDE3 inhibitor milrinone (Mil and the PDE4 inhibitor rolipram (Rol. In contrast, atrial AP duration was increased by EHNA and Rol, but not by Mil. IBMX also potently, and similarly, increased I(Ca,L in SAN, atrial and ventricular myocytes; however, important differences emerged in terms of which inhibitors could modulate I(Ca,L in each myocyte type. Consistent with our AP measurements, EHNA, Mil and Rol each increased I(Ca,L in SAN myocytes. Also, EHNA and Rol, but not Mil, increased atrial I(Ca,L. In complete contrast, no selective PDE inhibitors increased I(Ca,L in ventricular myocytes when given alone. Thus, our data show that the effects of selective PDE2, PDE3 and PDE4 inhibitors are distinct in the different regions of the myocardium indicating important differences in how each PDE family constitutively regulates ion channel function in the SAN, atrial and ventricular myocardium.

  18. Detection of African swine fever virus DNA in blood samples stored on FTA cards from asymptomatic pigs in Mbeya region, Tanzania.

    Science.gov (United States)

    Braae, U C; Johansen, M V; Ngowi, H A; Rasmussen, T B; Nielsen, J; Uttenthal, Å

    2015-02-01

    The aim of the study was to assess whether blood samples collected onto FTA(®) cards could be used in combination with real-time PCR for the detection of African swine fever virus (ASFV) DNA in samples from resource-poor settings under the assumption that asymptomatically (sub-clinically) infected pigs may be present. Blood samples were collected from clinically healthy pigs from Mbeya Region, Tanzania. The blood samples were stored on FTA(®) cards and analysed by real-time PCR assays in duplicate; three pigs had high levels of viral DNA (Ct values of 27-29), and three pigs had a low level of viral DNA (Ct 36-45). Four pigs were positive in one of the duplicate samples only, but clear products of the expected size were obtained when the reactions were analysed by gel electrophoresis. For comparison, blood samples from pigs experimentally infected with either a pathogenic (OURT T88/1) or a non-pathogenic (OURT T88/3) isolate of ASFV were collected, stored on FTA(®) cards and analysed in the same way. The blood from pigs infected with the OURT T88/1 isolate showed high levels of viral DNA (Ct 22-33), whereas infection with non-pathogenic OURT T88/3 isolate resulted in only low levels of viral DNA (Ct 39) in samples collected at 10-14 days after inoculation.

  19. Increase in oxytocin and vasopressin concentration in the blood outflowing from sella turcica region after superior cervical ganglion stimulation in rat

    Energy Technology Data Exchange (ETDEWEB)

    Lipinska, S.; Orlowska-Majdak, M.; Traczyk, W.Z. [Akademia Medyczna, Lodz (Poland). Katedra Fizjologii

    1996-12-31

    The aim of the study was to investigate whether the stimulation of the superior cervical ganglion influences the oxytocin and vasopressin release into the blood in condition of the of the sella turcica integrity. The experiments were performed on male rats under urethane-chloralose anaesthesia. Four 0.7 ml samples of the blood from the sella turcica region flowing through a tube inserted in the maxillary interna vein were collected in the 30, 35, 60 and 90 min of the experiments. The animals were divided into three groups: 1) control, 2) after the exposition of superior cervical ganglion. 3) after the collection of the 1-st sample of the blood the superior cervical ganglion was electrically stimulated for 30 min with trains of pulses. Vasopressin (AVP) and oxytocin (OXY) were determined in the blood plasma by radioimmunoassay. Stimulation of the superior cervical ganglion evoked an significant increase of AVP and OXY release into the blood. The increase of AVP release occurred after 30 min longer latency than the increase of OXY release. (author). 32 refs, 2 figs.

  20. Red Blood Cell Immune Complex Binding Capacity in Children with Sickle Cell Trait (HbAS) Living in P. falciparum Malaria Holoendemic Region of Western Kenya

    Science.gov (United States)

    2012-12-08

    Children with Sickle Cell Trait (HbAS) Living in P. falciparum Malaria Holoendemic Region of Western Kenya Walter Otieno1,2, Benson BA Estambale1...anemia. Children with sickle cell trait (HbAS) are less predisposed to getting severe manifestations of malaria. We carried out a study to determine the...2012 to 00-00-2012 4. TITLE AND SUBTITLE Red Blood Cell Immune Complex Binding Capacity in Children with Sickle Cell Trait (HbAS) Living in P

  1. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  2. The atrial fibrillation ablation pilot study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard

    2014-01-01

    AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analyse...... tachycardia, and 4 patients died (1 haemorrhagic stroke, 1 ventricular fibrillation in a patient with ischaemic heart disease, 1 cancer, and 1 of unknown cause). CONCLUSION: The AFib Ablation Pilot Study provided crucial information on the epidemiology, management, and outcomes of catheter ablation of AFib...

  3. Non-detection of human herpesvirus 8 (HHV-8 DNA in HHV-8-seropositive blood donors from three Brazilian regions.

    Directory of Open Access Journals (Sweden)

    José Eduardo Levi

    Full Text Available Human herpesvirus 8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus (KSHV, is the etiologic agent of all forms of Kaposi's sarcoma, primary effusion lymphoma and the plasmablastic cell variant of multicentric Castleman disease. In endemic areas of sub-Saharan Africa, blood transfusions have been associated with a substantial risk of HHV-8 transmission. By contrast, several studies among healthy blood donors from North America have failed to detect HHV-8 DNA in samples of seropositive individuals. In this study, using a real-time PCR assay, we investigated the presence of HHV-8 DNA in whole-blood samples of 803 HHV-8 blood donors from three Brazilian states (São Paulo, Amazon, Bahia who tested positive for HHV-8 antibodies, in a previous multicenter study. HHV-8 DNA was not detected in any sample. Our findings do not support the introduction of routine HHV-8 screening among healthy blood donors in Brazil. (WC = 140.

  4. Time-course changes of regional cerebral blood flow by SPECT with N-isopropyl-p-( sup 123 I)-iodoamphetamine in childhood partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Michihiro, Narumi; Ariizumi, Motomizu; Shiihara, Hiroaki; Egami, Yuriko; Saga, Takeshi (Dokkyo Univ. School of Medicine, Koshigaya, Saitama (Japan). Koshigaya Hospital)

    1992-07-01

    Single photon emission computed tomography (SPECT) with N-isopropyl-p-({sup 123}I)-iodoamphetamine was performed twice at different times in 18 children suffering from partial seizures to evaluate the time-course changes of the hemodynamics in the focal region. Comparison of the 2 SPECT images revealed that a decreased regional cerebral blood flow (CBF) in the first was normalized in 4 cases (22.2%) and contracted in 7 cases (38.9%). The region of decreased blood flow in the second was contralateral to that in the first in 1 case (5.6%) and unchanged in 6 cases (33.3%). Most of the normalized and contracted cases were those in which clinical seizures disappeared and the EEG findings were normalized. In these cases which responded to treatment, the decreased regional CBF was also found to be improved. Repeated SPECT appears to be useful for evaluating the therapeutic efficacy. On the other hand, most of the underchanged cases were those in which clinical seizures were frequent or uncontrolled, or which persistently showed the abnormalities in their EG. SPECT was considered to reflect well the conditions of the epileptic foci. These results indicate that repeated SPECT for observing the time-course changes of the regional CBF represents a useful technique which can be applied in evaluating the therapeutic efficacy or deciding the time to discontinue treatment and for pathogenetic elucidation of the epileptic foci. (author).

  5. Establishment of a model of renal impairment with mild renal insufficiency associated with atrial fibrillation in canines.

    Directory of Open Access Journals (Sweden)

    Zhuo Liang

    Full Text Available Chronic kidney disease and occurrence of atrial fibrillation (AF are closely related. No studies have examined whether renal impairment (RI without severe renal dysfunction is associated with the occurrence of AF.Unilateral RI with mild renal insufficiency was induced in beagles by embolization of small branches of the renal artery in the left kidney for 2 weeks using gelatin sponge granules in the model group (n = 5. The sham group (n = 5 underwent the same procedure, except for embolization. Parameters associated with RI and renal function were tested, cardiac electrophysiological parameters, blood pressure, left ventricular pressure, and AF vulnerability were investigated. The activity of the sympathetic nervous system, renin-angiotensin-aldosterone system, inflammation, and oxidative stress were measured. Histological studies associated with atrial interstitial fibrosis were performed.Embolization of small branches of the renal artery in the left kidney led to ischemic RI with mild renal insufficiency. The following changes occurred after embolization. Heart rate and P wave duration were increased. Blood pressure and left ventricular systolic pressure were elevated. The atrial effective refractory period and antegrade Wenckebach point were shortened. Episodes and duration of AF, as well as atrial and ventricular rate during AF were increased in the model group. Plasma levels of norepinephrine, renin, and aldosterone were increased, angiotensin II and aldosterone levels in atrial tissue were elevated, and atrial interstitial fibrosis was enhanced after 2 weeks of embolization in the model group.We successfully established a model of RI with mild renal insufficiency in a large animal. We found that RI with mild renal insufficiency was associated with AF in this model.

  6. Effects of the non-selective phosphodiesterase inhibitor pentoxifylline on regional cerebral blood flow and large arteries in healthy subjects

    DEFF Research Database (Denmark)

    Kruuse, Christina; Jacobsen, T B; Thomsen, Lars Lykke

    2000-01-01

    -inhalation SPECT. High-frequency ultrasound was used for measurements of temporal and radial artery diameter. Cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP) concentrations were assessed in plasma. Except for increased heart rate (P blood pressure (P ... or to other mechanisms is not clear. In the present double-blind crossover study, 10 healthy subjects received pentoxifylline 300 mg or placebo intravenously on separate days. Blood flow velocity in the middle cerebral artery (V(mca)) was recorded by transcranial Doppler and rCBF was measured using (133)Xenon......The vasodilating properties of the non-selective phosphodiesterase (PDE) inhibitor pentoxifylline were evaluated. Pentoxifylline has been reported to increase cerebral blood flow (CBF) and improve recovery rate of stroke patients. Whether these results are due to a dilating effect on arteries...

  7. Regional disturbances in blood flow and metabolism in equine limb wound healing with formation of exuberant granulation tissue

    DEFF Research Database (Denmark)

    Sørensen, Mette A.; Petersen, Lars; Bundgaard, Louise

    2014-01-01

    As in other fibroproliferative disorders, hypoxia has been suggested to play a key role in the pathogenesis of exuberant granulation tissue (EGT). The purpose of this study was to investigate metabolism and blood flow locally in full-thickness wounds healing with (limb wounds) and without (body...... a significant difference between body and limb wounds. In conclusion, the metabolic disturbances may suggest an inadequate oxygen supply during the wound healing process in equine limb wounds healing with EGT. This may be related to the inherently decreased perfusion in the wound bed of limb wounds....... wounds) formation of EGT. Microdialysis was used to recover endogenous metabolites from the wounds, and laser Doppler flowmetry was used to measure blood flow. Measurements were performed before wounding and 1-28 days after wounding. Blood flow was consistently lower in limb wounds than in body wounds...

  8. Inactivation of neuronal function in the amygdaloid region reduces tail artery blood flow alerting responses in conscious rats.

    Science.gov (United States)

    Mohammed, M; Kulasekara, K; De Menezes, R C; Ootsuka, Y; Blessing, W W

    2013-01-03

    Few studies have investigated whether neuronal function in the amygdaloid complex is necessary for the occurrence of the cardiovascular response to natural (unconditioned) environmental threats. In the present investigation in conscious unrestrained Sprague-Dawley rats we inactivated neuronal function in the amygdaloid complex acutely (bilateral muscimol injections) or chronically (unilateral or bilateral ibotenic acid injections) and measured the effect on sudden falls in tail artery blood flow elicited by non-noxious salient stimuli (sympathetic cutaneous vasomotor alerting responses, SCVARs). After acute bilateral injection of vehicle (200nl Ringer's solution) the SCVAR index was 81 ± 2%, indicating that tail blood flow was reduced by 81% in response to the salient stimuli. After acute bilateral injection of muscimol (1 nmol in 200 nl of Ringer's solution) into the amygdaloid complex the SCVAR index was 49 ± 5%, indicating that tail blood flow was reduced by 49% in response to the salient stimuli (pbody with more immediate metabolic requirements.

  9. Investigation of Yangzhou Region Blood Donors' ABO and Rh Blood Types Distribution and Correlation%扬州地区献血者ABO及Rh血型人群分布及其相关性调查

    Institute of Scientific and Technical Information of China (English)

    焦玉东; 范恩勇

    2012-01-01

    Objective To Explore Yangzhou blood donors' ABO and Rh blood groups distribution and correlation.Methods From January 2010 to June 2011,63925 samples collected by Yangzhou blood bank from unpaid blood donors on streets,were enrolled in this study.Positive and negative stereotypes of ABO blood specimens,identification and genotyping of Rh blood group were tested by U-shaped micro-plate methods.Rh negative confirmatory tests were recognized by anti-globulin method using three kinds IgG anti-D reagents from different manufacturers.Samples gene frequencies,haplotype frequencies and expected values were calculated.The phenotypic observed and expected value were compared by the X2 test,to test the Hardy-Weinberg goodness of fit.Results The gene frequencies of ABO blood group were r>p>q,phenotype distribution characteristics were O>A>B>AB; Rh phenotypes population distribution were CCDee>CcDEe>CcDee>ccDEE>ccDEe>CCDEe>ccDee,ccdee>Ccdee>CCdee>ccdEe>CcdEe>ccdEE,haplotype frequencies were CDe>cDe>cDE>CDE,cde>Cde>cdE>CdE,and gene frequencies characteristics were D>d,C>c,e>E.The difference between the expected and observed values of the ABO blood group and Rh blood group were no statistical significance (P>0.05).Hardy-Weinberg,the goodness of fit test results were good.Conclusions The distributions of ABO and Rh blood typing population in this region were in line with the Hardy-Weinberg population-based genetic equilibrium in population genetics.Through the survey of the ABO and Rh blood group distributions in Yangzhou region,we could accurately grasp the law of Yangzhou region blood donors' blood types distribution,which were contribute for unpaid blood donors recruitment,reasonable blood collection plan development,blood reserves and rare blood types establishment library.%目的 探讨扬州地区献血者ABO,Rh血型人群分布状况,并对其相关性进行调查研究.方法 选择2010年1月至2011年6月本市中心

  10. A Simple Model for Identifying Critical Structures in Atrial Fibrillation

    CERN Document Server

    Christensen, Kim; Peters, Nicholas S

    2014-01-01

    Atrial fibrillation (AF) is the most common abnormal heart rhythm and the single biggest cause of stroke. Ablation, destroying regions of the atria, is applied largely empirically and can be curative but with a disappointing clinical success rate. We design a simple model of activation wavefront propagation on a structure mimicking the branching network architecture of heart muscle and show how AF emerges spontaneously as age-related parameters change. We identify regions responsible for the initiation and maintenance of AF, the ablation of which terminates AF. The simplicity of the model allows us to calculate analytically the risk of arrhythmia. This analytical result allows us to locate the transition in parameter space and highlights that the transition from regular to fibrillatory behaviour is a finite-size effect present in systems of any size. These clinically testable predictions might inform ablation therapies and arrhythmic risk assessment.

  11. Novel MRI Technique Enables Non-Invasive Measurement of Atrial Wall Thickness.

    Science.gov (United States)

    Varela, Marta; Morgan, Ross; Theron, Adeline; Dillon-Murphy, Desmond; Chubb, Henry; Whitaker, John; Henningsson, Markus; Aljabar, Paul; Schaeffter, Tobias; Kolbitsch, Christoph; Aslanidi, Oleg V

    2017-08-01

    Knowledge of atrial wall thickness (AWT) has the potential to provide important information for patient stratification and the planning of interventions in atrial arrhythmias. To date, information about AWT has only been acquired in post-mortem or poor-contrast computed tomography (CT) studies, providing limited coverage and highly variable estimates of AWT. We present a novel contrast agent-free MRI sequence for imaging AWT and use it to create personalized AWT maps and a biatrial atlas. A novel black-blood phase-sensitive inversion recovery protocol was used to image ten volunteers and, as proof of concept, two atrial fibrillation patients. Both atria were manually segmented to create subject-specific AWT maps using an average of nearest neighbors approach. These were then registered non-linearly to generate an AWT atlas. AWT was 2.4 ± 0.7 and 2.7 ± 0.7 mm in the left and right atria, respectively, in good agreement with post-mortem and CT data, where available. AWT was 2.6 ± 0.7 mm in the left atrium of a patient without structural heart disease, similar to that of volunteers. In a patient with structural heart disease, the AWT was increased to 3.1 ± 1.3 mm. We successfully designed an MRI protocol to non-invasively measure AWT and create the first whole-atria AWT atlas. The atlas can be used as a reference to study alterations in thickness caused by atrial pathology. The protocol can be used to acquire personalized AWT maps in a clinical setting and assist in the treatment of atrial arrhythmias.

  12. [Obesity as a risk factor for atrial fibrillation].

    Science.gov (United States)

    Duraj, Iwona; Broncel, Marlena

    2016-01-01

    Atrial fibrillation (AF) and obesity is a growing problem of public health both in Poland and in the whole world. AF risk factors may be summarized as elderliness, male sex, smoking, hypertension, diabetes, obesity, coronary heart disease, heart failure, valvular heart disease, cardiac surgery. Once obesity is an independent, potentially modifiable risk factor for AF. The connection between obesity and atrial fibrillation is very up-to-date because of incremental prevalence, almost epidemic of obesity in the whole world. The probability of AF among obese patients increases with concomitant obstructive sleep apnea. Regardless many researches it hasn't been assessed yet how obesity itself predisposes to AF. It could be an effect of change in the atrial anatomy, the rise of atrial pressure, mechanical stretch, interstitial atrial fibrosis and disruption of atrial electric integrity. A great role is ascribed to inflammation, especially proinflammatory cytokines increased by adipocites of left atrial epicardial adiposity.

  13. A rare large right atrial myxoma with rapid growth rate.

    Science.gov (United States)

    Kelly, Shawn C; Steffen, Kelly; Stys, Adam T

    2014-10-01

    Atrial myxomas are the most common benign intracavitary cardiac neoplasms. They most frequently occur in the left atrium. Right atrial tumors are rare, comprising 20 percent of myxomas achieving an incidence of 0.02 percent. Due to their rarity, right atrial tumor development and associated clinical symptoms has not been well described. The classical clinical triad for the presentation of left atrial myxomas--heart failure, embolic events, and constitutional symptoms--may not be applicable to right sided tumors. Also, natural development of myxoma is not well described, as surgical resection is the common practice. Previously ascribed growth rates of myxomas refer mostly to left atrial ones, as right atrial tumors are rare. We present a case of right atrial myxoma with growth rates exceeding those previously described.

  14. New risk factors for atrial fibrillation : causes of 'not-so-lone atrial fibrillation'

    NARCIS (Netherlands)

    Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.

    Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying

  15. Left atrial size in patients with cryptogenic stroke as a predictor of occurrence of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Antonio Cruz Culebras

    2017-04-01

    Full Text Available Objective: To determine whether the left atrial size can predict the development of atrial fibrillation (AF in patients with embolic stroke of undetermined source (ESUS. Methods: Patients with ischemic stroke were included prospectively (January 2015-July 2015 when ESUS was suspected. Clinical and cardiac imaging data were recorded. Patients with cardiac failure were excluded. Results: a total of 55 patients were included. Medium age was 71 years. The proportion of patients who developed AF during the follow-up (1 year was 23, 63%. 10 % of patients did not have any vascular risk factor. Basal ECG was normal in 98% of cases. The left atrial size volume was 36, 08 ml in patients who developed AF and 27, 14 ml in patients who did not. Conclusions: In patients with ESUS, left atrial size dimensions do not predict the occurrence of AF.

  16. New risk factors for atrial fibrillation : causes of 'not-so-lone atrial fibrillation'

    NARCIS (Netherlands)

    Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.

    2008-01-01

    Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying (cardiovascular

  17. Asymptomatic atrial fibrillation and stroke evaluation in pacemaker patients and the atrial fibrillation reduction atrial pacing trial (ASSERT)

    NARCIS (Netherlands)

    Holnloser, Stefan H.; Capucci, Alessandro; Fain, Eric; Gold, Michael R.; van Gelder, Isabelle C.; Healey, Jeff; Israel, Carsten W.; Lau, Chu P.; Morillo, Carlos; Connolly, Stuart J.

    Asymptomatic atrial fibrillation (AF) is common and may have the same prognostic implications as symptomatic AF. Among patients receiving dual-chamber pacemakers, it is now possible to quantify asymptomatic AF accurately. Most of these episodes are of short duration, often lasting only seconds to

  18. Non-invasive localization of atrial ectopic beats by using simulated body surface P-wave integral maps

    Science.gov (United States)

    Godoy, Eduardo J.; Lozano, Miguel; Martínez-Mateu, Laura; Atienza, Felipe; Saiz, Javier; Sebastian, Rafael

    2017-01-01

    Non-invasive localization of continuous atrial ectopic beats remains a cornerstone for the treatment of atrial arrhythmias. The lack of accurate tools to guide electrophysiologists leads to an increase in the recurrence rate of ablation procedures. Existing approaches are based on the analysis of the P-waves main characteristics and the forward body surface potential maps (BSPMs) or on the inverse estimation of the electric activity of the heart from those BSPMs. These methods have not provided an efficient and systematic tool to localize ectopic triggers. In this work, we propose the use of machine learning techniques to spatially cluster and classify ectopic atrial foci into clearly differentiated atrial regions by using the body surface P-wave integral map (BSPiM) as a biomarker. Our simulated results show that ectopic foci with similar BSPiM naturally cluster into differentiated non-intersected atrial regions and that new patterns could be correctly classified with an accuracy of 97% when considering 2 clusters and 96% for 4 clusters. Our results also suggest that an increase in the number of clusters is feasible at the cost of decreasing accuracy. PMID:28704537

  19. Left atrial appendage occlusion for stroke prevention in atrial fibrillation in Europe

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Dagres, Nikolaos; Proclemer, Alessandro;

    2013-01-01

    The purpose of this EP wire survey was to assess clinical practice in relation to the use of left atrial appendage occlusion (LAAO) devices for stroke prevention in atrial fibrillation (AF) among members of the European Heart Rhythm Association research network. The average number of performed LA...... are most often performed by interventional cardiologists. Experience varied widely, and this was reflected in the wide range of thromboembolic and procedural (tamponade, bleeding) complications reported by the respondents to this EP wire survey....

  20. ORIGINAL ARTICLE: Blood Donor’s Status of HIV, HBV, HCV and Syphilis in this Region of Marathwada, India

    Directory of Open Access Journals (Sweden)

    Rangrao H. Deshpande

    2012-07-01

    Full Text Available Aims & Objectives: Blood transfusion can cause the transmission of infections to recipients. This is an important mode of infection. The aim of study was to assess the prevalence of such type of infections among blood donors and to compare the seroprevalence of transfusion transmitted diseases in voluntary donors and replacement donors. Retrospective study of five years from Jan. 2007 to Dec. 2011 was done. This study was conducted at Blood bank, MIMSR Medical College Latur, Govt. Medical College, Latur and Bhalchandra Blood bank, Latur. Material & Methods: Total 10, 4925 donors were tested. Donors were screened for seroprevalence of HIV, HBC, HCV and Syphilis. Screening of HIV, HBV & HCV was done by ELISA method & Syphilis was screened by RPR type. Results: The comparison of seroprevalence of HIV, HBV, HCV & Syphilis in voluntary donors and replacement donors showed significant difference only for HIV in the years 2007, 2010, and 2011. Conclusion: The seroprevalence of transfusion transmitted diseases in the study is very low or negligible in voluntary donors as compared to replacement donors. There was a declining trend of seroprevalence for all the disease screened. But in our study the difference is not significant, which indicates that the selection of donors is of low quality. The selection of high quality voluntary donors should be achieved by creation of awareness by education of the prospective donor populations.