Science.gov

Sample records for cardiac blood pool

  1. Combined gated cardiac blood pool scintigraphy and /sup 67/Ga-citrate scintigraphy for detection of cardiac lymphoproliferative disorders

    SciTech Connect

    Winzelberg, G.G.; Rapoport, F.; Boucher, C.A.

    1981-10-01

    Two cases are reported in which combined radionuclide imaging using gated cardiac blood pool scintigraphy and /sup 67/Ga-citrate scintigraphy aided in evaluating lymphomatous involvement of the heart and distinguishing tumor involvement from other cardiac disorders.

  2. Design of an automated algorithm for labeling cardiac blood pool in gated SPECT images of radiolabeled red blood cells

    SciTech Connect

    Hebert, T.J. |; Moore, W.H.; Dhekne, R.D.; Ford, P.V.; Wendt, J.A.; Murphy, P.H.; Ting, Y.

    1996-08-01

    The design of an automated computer algorithm for labeling the cardiac blood pool within gated 3-D reconstructions of the radiolabeled red blood cells is investigated. Due to patient functional abnormalities, limited resolution, and noise, certain spatial and temporal features of the cardiac blood pool that one would anticipate finding in every study are not present in certain frames or with certain patients. The labeling of the cardiac blood pool requires an algorithm that only relies upon features present in all patients. The authors investigate the design of a fully-automated region growing algorithm for this purpose.

  3. Biplanar cardiac blood-pool tomography. [Technetium 99

    SciTech Connect

    Mirell, S.G.; Hecth, H.S.; Hopkins, J.M.; Blahd, W.H.

    1981-10-01

    Dynamic transverse axial wall tomograms of the left verticle (LV) are reconstructed by a new technique from anterior and LAO views acquired with a conventional scintillation camera imaging the distribution of in-vivo Tc-99m-labeled red blood cells. By confining reconstruction to the singular contiguous uniform concentration of activity in the LV, the requisite angular samplings for a given level of accuracy are substantially reduced in this restricted form of emission computed tomography (ECT). Static phantom studies using a series of volumes having various cross-sectional dimensions demonstrate tomographic edge reconstruction with less than or equal to 12% rms radial error. The dynamic cardiac ECT is demonstrated in a series of representative patient studies by reconstruction of wall tomograms in the end-diastolic and end-systolic phases of the 28-frame cardiac cycle. In contrast to the conventional dual multiframe projection views, the motion tomograms derived from the reconstructions clearly show the complete three-dimensional perspective of wall displacement.

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

    SciTech Connect

    Machac, J.; Vallabhajosula, S.; Goldman, M.E.; Goldsmith, S.J.; Palestro, C.; Strashun, A.; Vaquer, R.; Phillips, R.A.; Fuster, V. )

    1989-09-01

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

  5. ECG-gated emission computed tomography of the cardiac blood pool

    SciTech Connect

    Moore, M.L.; Murphy, P.H.; Burdine, J.A.

    1980-01-01

    ECG-gated cross-sectional images of the cardiac blood pool were produced using a specially constructed emission computed tomographic scanner. A pair of large-field-of-view cameras were mounted in opposition in a gantry that rotates 360/sup 0/ about the patient. The coordinates of each detected event, the output of a physiological synchronizer, and the position of the camera heads were input to a dedicated minicomputer which was used to produce the images. Display as a movie permitted evaluation of regional and global wall motion in cross section without the disadvantages of superimposed blood pools as obtained in nontomographic views.

  6. Cinematic three-dimensional surface display of cardiac blood pool tomography

    SciTech Connect

    Honda, N.; Machida, K.; Takishima, T.; Mamiya, T.; Takahashi, T.; Kamano, T.; Tamaki, S.; Ban, R. )

    1991-02-01

    A method of three-dimensional cinematic display (3D cine) of cardiac blood pool tomography is described. ECG-gated transaxial blood pool imaging was obtained from a set of projection images that were collected from 32 images with 10 ECG-gated images per projection during a 180 degrees arc of a rotating gamma camera. A surface contour of the blood pool was determined by a set of isocount lines (40-55% of the maximum pixel counts) of the transaxial images. 3D cine was made by a depth-shading method, in which brightness of a given point on the contour was set proportional to the distance between the viewing plane and the point and to the incident angle formed by the viewing line and the surface of the point. In 15 patients, 3D cine showed hypokinesia, akinesia, dyskinesia, ventricular aneurysm, and opposite motions of the atria and ventricles. Diagnoses of left ventricular motion by 3D cine agreed well with those by echocardiography and contrast left ventriculography.

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

    SciTech Connect

    Pieri, P.; Fischman, A.J.; Ahmad, M.; Moore, R.H.; Callahan, R.J.; Strauss, H.W. )

    1991-05-01

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

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2016-08-01

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

  10. A new method for Fourier analysis in ECG-gated cardiac blood pool emission computed tomography (ECT)

    SciTech Connect

    Ito, T.; Maeda, H.; Takeda, K.; Nakagawa, T.; Yamaguchi, N.; Konishi, T.; Ichikawa, T.

    1984-01-01

    An integrated technique for Fourier analysis in multigated blood pool ECT study has been developed. Following the administration of 15-20 mCi of Tc-99m RBC, ECG-gated cardiac blood pool data were acquired using an ECT system with dual opposed gamma cameras. Fundamental studies for data acquisition showed that acquisition time of 10 sec. for each projection, 14 divisions of one cardiac cycle and angular interval of 6/sup 0/ (60 projections over 360/sup 0/) were reasonable for clinical purpose. Total acquisition time was about 5 minutes under these conditions. Data were processed as follows: 1) Transaxial (TA) tomographic images in every phase of cardiac cycle were reconstructed by convolution algorithm; 2) TA images were rotated to construct sagittal (SAG) and short axial (S-A) oblique-angle tomography which are respectively parallel and perpendicular to the long axis of either of the ventricles; 3) Images covering the portion other than the purposed ventricle were eliminated from the series of SAG images in every phase of the cycle; 4) Images in the same phase were summed to construct a series of SAG and S-A planar images; and 5) Fourier analysis was made to construct phase and amplitude images. The advantages of this method are that the phase and amplitude images from arbitrary directions can be obtained, that the region of interest can be selected on a three dimensional basis, eliminating the overlapping activity of the other ventricle or neighbouring tissues, that the diseased areas can be easily and accurately localized even in small inferior wall myocardial infarction and that patient study can be finished within 5 minutes.

  11. Thallium 201 imaging and gated cardiac blood pool scans in patients with ischemic and idiopathic congestive cardiomyopathy. A clinical and pathologic study.

    PubMed

    Bulkley, B H; Hutchins, G M; Bailey, I; Strauss, H W; Pitt, B

    1977-05-01

    In ischemic cardiomyopathy (CM) fibrosis replaces large segments of myocardium, but in idiopathic congestive CM the myocardium contains only small foci of fibrosis or is morphologically normal. As coronary disease and myocardial infarction may be clinically silent, it is not always possible to distinguish ischemic from idiopathic congestive CM during life without cardiac catheterization. To determine whether noninvasive methods, thallium 201 myocardial (Tl) imaging and technetium 99m gated cardiac blood pool scans (GCBPS), could separate the entities, we evaluated radioisotope images of the heart in 13 patients with ischemic, and eight patients with idiopathic congestive CM, and 14 patients with normal hearts. Diagnosis was setablished by cardiac catherterization and/or autopsy in each of the 35 patients. The 14 normals could be readily distinguished from CM, and ischemic could be distinguished from idiopathic dilated CM in 20 of 21 patients. All patients with myocardiopathy showed hypokinetic and dilated left ventricles, but right ventricular dilatation was evident mainly in those with idiopathic CM. Tl images in the ischemic type had defects of greater than 40% of image circumference which corresponded to segmental wall motion abnormalities on GCBPS, whereas those with the idiopathic congestive form were homogeneous or had defects of less than 20% of image circumference. Autopsy studies in 7 of 35 patients correlated Tl defects of greater than 20% of circumference with transmural myocardial fibrosis. PMID:557377

  12. Hemangioma of the tongue demonstrating a perfusion blood pool mismatch

    SciTech Connect

    Front, D.; Groshar, D.; Israel, O.; Robinson, E.

    1986-02-01

    Perfusion blood pool mismatch using Tc-99m labeled red blood cells (RBCs) in a hemangioma of the tongue is described. The method is useful in the evaluation of size of the residual blood pool after irradiation of the tumor.

  13. Hemophilic bleeding evaluated by blood pool scanning.

    PubMed

    Green, D; Spies, S M; Rana, N A; Milgram, J W; Mintzer, R

    1981-06-30

    The technique of blood pool scanning was used to examine 15 hemophilic subjects. Employing an in vivo method for erythrocyte labeling with Technetium-99 m, a dynamic perfusion sequence is obtained using a scintillation camera positioned over the area to be examined. This demonstrates the vascularity of the tissue. Subsequently, equilibrium blood pool images of the area are obtained and analyzed with a densitometer to assess relative regional blood volume. In patients who were not bleeding but had chronic arthropathy, vascularity was not increased, and the blood volume of comparable joints was similar. By contrast, marked increases in vascularity and image density were observed in studies of acutely bleeding joints. Chronic hemarthroses were associated with persistent, but less marked increases in joint perfusion. Transient increases in joint vascularity were demonstrated after insertion of knee prostheses. In a patient with a thigh hematoma, the dimensions of the hemorrhage were clearly delineated. Since only a tracer dose of nuclide is infused intravenously, there are no allergic reactions or other side effects of the procedure. Blood pool scanning is a safe, non-invasive technique that augments clinical and radiographic evaluations, and provides a new dimension in the assessment of the hemophilic patient. PMID:6269248

  14. Blood transfusion practices in cardiac anaesthesia

    PubMed Central

    Mangu, Hanumantha Rao; Samantaray, Aloka; Anakapalli, Muralidhar

    2014-01-01

    The primary reasons for blood transfusion in cardiac surgery are to correct anaemia and to improve tissue oxygen delivery. However, there is a considerable debate regarding the actual transfusion trigger at which the benefits of transfusion overweight the risk. The association between extreme haemodilution, transfusion and adverse outcome after cardio pulmonary bypass (CPB) is not clear and the current available literature is not sufficient to provide a strong recommendation regarding the safe haematocrit range during CPB. There is no quality evidence to support use of fresh red blood cell except during massive transfusion or exchange transfusion in neonate. Overall concern regarding the safety of allogeneic blood transfusion resulted in the search for autologous blood transfusion and perioperative blood salvage. The aim of this review is to provide cardiac surgery specific clinically useful guidelines pertaining to transfusion triggers, optimal haemodilution during CPB, autologous blood transfusion and role of perioperative blood salvage based on available evidence. PMID:25535425

  15. Use of blood products in cardiac surgery.

    PubMed

    Renton, M C; McClelland, D B; Sinclair, C J

    1997-05-01

    The quantity of blood products used perioperatively during cardiac surgery is known to vary widely between institutions. This study looked at the amount of blood products used perioperatively in 74 consecutive elective cardiac operations in one institution. The results are compared with those from other European centres and a cost analysis carried out. On average 2.33 +/- 0.74 (95% confidence interval 1.93-2.77) units of red cell concentrate were transfused perioperatively per patient. Six (8%) patients received no blood products. In addition a number of preoperative factors were studied in an attempt to identify predictors of transfusion requirements. Age, preoperative haemoglobin, female sex and red cell mass were all found to have some predictive value. In the face of increasing demands on a limited supply of blood products we question the need for cross matching more than four units of red cell concentrate in elective cardiac surgery. PMID:9226702

  16. Nuclear cardiac blood volume detecting apparatus

    SciTech Connect

    Wagner, H.N.; Wake, R.H.

    1980-04-15

    A built up image illustrating blood volume in the heart versus time taken over many cardiac cycles is produced by continuously displaying a graph of cumulative data indicating the amount of radioactivity from a tracer in the blood detected in the heart during each of a series of intervals into which the average cardiac period is divided. The parallel lines of a raster scan display correspond respectively to the memory channels. The count stored in a particular memory channel causes the video signal for the corresponding line to be maintained at a binary level for a corresponding time interval thus generating a bar graph in which the length of each bar indicates the amount of radioactivity sensed during the corresponding interval of the cardiac cycle. As each memory channel accumulates radioactivity data with each successive cardiac cycle, each bar displayed in the bar graph lengthens to indicate the cumulative activity until an interpretable curve is obtained.

  17. /sup 99m/Tc dextran: a new blood-pool-labeling agent for radionuclide angiocardiography

    SciTech Connect

    Henze, E.; Robinson, G.D.; Kuhl, D.E.; Schelbert, H.R.

    1982-04-01

    We have explored the possibility of imaging the cardiac blood pool with dextran (Dx) labeled with /sup 99m/Tc (Tc) after Sn2+ reduction. Stannous dextran (SnDx) kits were prepared in advance and labeling was performed by adding /sup 99m/Tc. The labeling efficiency was greater than 95%. /sup 99m/Tc dextran (TcDx) was highly stable both in vivo and in vitro. In seven dogs we compared the quality of blood-pool images obtained with TcDx of different molecular weights (4 X 10(4) . Dx-40; 5 X 10(5) . Dx-500; 2 X 10(6) . Dx-2000) and with /sup 99m/Tc red blood cells (TcRBC) labeled in vitro, and determined the organ distribution of this new agent by whole-body scanning and blood sampling. TcDx provided high-quality cardiac blood-pool images up to 60 min after injection. The heart-to-lung ratios averaged 3.7 for TcDx-40, 3.9 for TcDx-500, and 5.4 for TcRBC at 60 min. Whereas TcDx-40 showed a relatively rapid initial urinary excretion and TcDx-2000 was degraded rapidly, TcDx-500 demonstrated the best kinetics for blood-pool imaging. Thus, TcDx is a new radiopharmaceutical with high labeling efficiency and stability. It overcomes a number of the limitations of currently used blood-labeling agents and may become useful for blood-pool imaging in man.

  18. Gallbladder visualization during technetium-99m RBC blood pool imaging. Case report and literature review

    SciTech Connect

    Kotlyarov, E.V.; Mattay, V.S.; Reba, R.C.

    1988-07-01

    Gallbladder visualization occurred after a Tc-99m red blood cell (RBC) cardiac gated blood pool scan. To date, seven cases of gallbladder visualization after the intravenous injection of Tc-99m RBCs have been reported. In the previous six patients the gallbladder was visualized incidentally during a search for gastrointestinal (GI) bleeding. All of the patients were anemic, six of seven had chronic renal failure, and five of seven had received multiple blood transfusions. When interpreting GI bleeding scans in patients with anemia and renal failure, awareness of the possibility of gallbladder visualization in the delayed images is important to avoid false-positive results. 3 references.

  19. Strategies for blood conservation in pediatric cardiac surgery

    PubMed Central

    Singh, Sarvesh Pal

    2016-01-01

    Cardiac surgery accounts for the majority of blood transfusions in a hospital. Blood transfusion has been associated with complications and major adverse events after cardiac surgery. Compared to adults it is more difficult to avoid blood transfusion in children after cardiac surgery. This article takes into account the challenges and emphasizes on the various strategies that could be implemented, to conserve blood during pediatric cardiac surgery. PMID:27716703

  20. Experimental radionuclide ventriculography and the baboon (Papio ursinus) model: imaging projection of the heart and blood pool labelling.

    PubMed

    Dormehl, I C; du Plessis, M; Maree, M; van Wyk, A

    1986-01-01

    The chacma baboon (Papio ursinus) presents a suitable animal model for the evaluation of interpretation problems of data from radionuclide ventriculography. However, the procedure has to be standardized: it is important to so view the heart as to ensure optimal ventricular separation and minimal ventricle-atrium overlap. Also necessary is efficient labelling of the blood pool for good cardiac images and prolonged experimentation. This report concerns an evaluation of different cardiac viewing projections and labelling procedures, and concludes with a preferred method.

  1. Trigeminal Cardiac Reflex and Cerebral Blood Flow Regulation

    PubMed Central

    Lapi, Dominga; Scuri, Rossana; Colantuoni, Antonio

    2016-01-01

    The stimulation of some facial regions is known to trigger the trigemino-cardiac reflex: the main stimulus is represented by the contact of the face with water. This phenomenon called diving reflex induces a set of reactions in the cardiovascular and respiratory systems occurring in all mammals, especially marine (whales, seals). During the immersion of the face in the water, the main responses are aimed at reducing the oxygen consumption of the organism. Accordingly reduction in heart rate, peripheral vasoconstriction, blood pooling in certain organs, especially the heart, and brain and an increase in blood pressure have been reported. Moreover, the speed and intensity of the reflex is inversely proportional to the temperature of the water: more cold the water, more reactions as described are strong. In the case of deep diving an additional effect, such as blood deviation, has been reported: the blood is sequestered within the lungs, to compensate for the increase in the external pressure, preventing them from collapsing. The trigeminal-cardiac reflex is not just confined to the diving reflex; recently it has been shown that a brief proprioceptive stimulation (10 min) by jaw extension in rats produces interesting effects both at systemic and cerebral levels, reducing the arterial blood pressure, and vasodilating the pial arterioles. The arteriolar dilation is associated with rhythmic diameter changes characterized by an increase in the endothelial activity. Fascinating the stimulation of trigeminal nerve is able to activate the nitric oxide release by vascular endothelial cells. Therefore, the aim of this review was to highlight the effects due to trigeminal cardiac reflex induced by a simple mandibular extension. Opposite effects, such as hypotension, and modulation of cerebral arteriolar tone, were observed, when these responses were compared to those elicited by the diving reflex. PMID:27812317

  2. Tc-99m dextran: a new blood-pool-labeling agent for radionuclide angiocardiography

    SciTech Connect

    Henze, E.; Robinson, G.D.; Kuhl, D.E.; Schelbert, H.R.

    1982-04-01

    We have explored the possibility of imaging the cadiac blood pool with dextran (Dx) labeled with Tc-99m (Tc) after Sn/sup 2 +/ reduction. Stannous dextrane (SnDx) kits were prepared in advance and labeling was performed by adding Tc-99m. The labeling efficiency was greater than 95%. Technetium-99m dextran (TcDx) was highly stable both in vivo and in vitro. In seven dogs we compared the quality of blood-pool images obtained with TcDx of different molecular weights ( 4 x 10/sup 4/ = Dx-40; 5 x 10/sup 5/ = Dx-500; 1 x 10/sup 6/ = Dx-2000) and with Tc-99m red blood cells (TcRBC) labeled in vitro, and determined the organ distribution of this new agent by whole-body scanning and blood sampling. TcDx provided high-quality cardiac blood-pool images up to 60 min after injection. The heart-to-lung ratios averaged 3.7 for TcDx-40, 3.9 for TcDx-500, and 5.4 for TcRBC at 60 min. Whereas TcDx-40 showed a relatively rapid initial urinary excretion and TcDx-2000 was degraded rapidly, TcDx-500 demonstrated the best kinetics for blood-pool imaging. Thus, TcDx is a new radiopharmaceutical with high labeling efficiency and stability. It overcomes a number of the limitations of currently used blood-labeling agents and may become useful for blood-pool imaging in man.

  3. Blood conservation strategies in cardiac valve replacement

    PubMed Central

    Zheng, Junnan; Chen, Liangwei; Qian, Linfeng; Jiang, Jianjie; Chen, Yinglian; Xie, Jue; Shi, Liping; Ni, Yiming; Zhao, Haige

    2016-01-01

    Abstract We aimed to evaluate whether blood conservation strategies including intraoperative autologous donation (IAD) could reduce perioperative blood transfusion for patients undergoing cardiac valve replacement including mitral valve replacement, aortic valve replacement (AVR), and double valve replacement (DVR). A total of 726 patients were studied over a 3-year period (2011–2013) after the implementation of IAD and were compared with 919 patients during the previous 36-month period (January 2008–December 2010). The method of small-volume retrograde autologous priming, strict blood transfusion standard together with IAD constituted a progressive blood-saving strategy. Baseline characteristics and preoperative information showed no statistically significant difference between IAD group and non-IAD group. Most of the postoperative morbidities are statistically the same in the 2 groups. Chest tube output (415.2 vs 1029.8 mL, P < 0.001) and postoperative respiratory failure (5.9% vs 8.6%, P = 0.039) favored the IAD group, whereas hematocrit levels were more favorable in the non-IAD group (30.3% vs 33.0% at the end of the operation, P < 0.001; 30.4% vs 31.5% at the time of discharge). The use of blood product transfusion was higher in the non-IAD group (22.6% vs 43.3%, P < 0.001). Binary multivariate logistic regression analysis showed that high age, non-IAD, DVR surgery, and absent smoking history are associated with a higher risk of intra-/postoperative blood transfusion. Blood conservation is effective and safe in cardiac valve replacement surgeries. The use of intraoperative autologous donation can lead to improved outcomes including a significantly lower rate of intra-/postoperative blood transfusion and postoperative complications. PMID:27741149

  4. Detection of varicocele by radionuclide blood-pool scanning

    SciTech Connect

    Freund, J.; Handelsman, D.J.; Bautovich, G.J.; Conway, A.J.; Morris, J.G.

    1980-10-01

    Varicocele is a common and treatable cause of male subfertility. The authors describe a new technique for varicocele detection using radionuclide blood-pool imaging of the scrotum. The results indicate that this technique detects unilateral varicoceles with high sensitivity, including some which are subclinical. There may be significant implications for treatment of infertility.

  5. Patterns of ventricular emptying by Fourier analysis of gated blood-pool studies

    SciTech Connect

    Links, J.M.; Douglass, K.H.; Wagner, H.N. Jr.

    1980-10-01

    Temporal Fourier analysis was applied to the processing of ECG-gated cardiac blood-pool studies on a pixel-by-pixel basis, to yield information about the pattern of ventricular emptying in normal hearts and in others with conduction abnormalities. The transform data at the fundamental frequency (the heart rate) were used to construct two types of display: (a) a distribution histogram of the pixel phase values, and (b) a cinematic display of the wave of emptying as it spread over the cardiac chambers. Preliminary results indicate that temporal Fourier analysis permits visualization of the pattern of ventricular emptying, which may prove useful in the study of motion abnormalities and asynergies, including those resulting from myocardial hypertrophy or conduction abnormalities, and as an aid in the optimum placement of pacemakers.

  6. Synthetic copolymer kit for radionuclide blood-pool imaging

    SciTech Connect

    Bogdanov, A.A. Jr.; Callahan, R.J.; Wilkinson, R.A.

    1994-11-01

    A synthetic blood pool imaging agent labeled with {sup 99m}Tc is reported. The agent, methoxypolyethylene glycolpoly-L-Iysyl-diethylenetriaminepentaacetate monoamide was synthesized from a covalent graft copolymer of methoxypolyethylene glycol succinate (molecular weight 5.1 kD) with subsequent modification of the product with diethylenetriamineacetyl residues. The polymer was formulated into a kit that contained Sn(II) and sodium acetate for radiolabeling with {sup 99m}Tc. Biodistribution studies were performed in rats. Blood-pool imaging and blood clearance determination was carried out in rabbits and in a rhesus monkey. The {sup 99m}Tc-labeled agent [specific activity greater than 3.7 GBq/mg; radiochemical purity more than 98% by thin-layer and high-performance liquid chromatography (HPLC)] demonstrated remarkable stability in solution (pH 5.5-6.5) with no radioactive products of degradation detectable by HPLC even at 24 hr postlabeling. The agent exhibited prolonged circulation in the blood with a half-life of 31.5 hr in rabbits. Bio-distribution in rats showed a lack of substantial accumulation of the agent in the reticuloendothelial system. Sequential acquisitions were performed in a rhesus monkey. The {sup 99m}Tc-labeled polymer kit was compared with the {sup 99m}Tc-red blood cells (RBCs) labeled in vitro. Both methods produced similar heart-to-lung ratios. The ratios remained essentially unchanged for up to 15 hr postinjection. The {sup 99m}Tc-labeled methaxypolyethylene glycol-poly-L-lysyl-diethylenetriamine pentaacetate monoamide is an attractive alternative to radiolabeled RBCs for blood pool imaging applications. 33 refs., 7 figs.

  7. Slower Lower Limb Blood Pooling Increases Orthostatic Tolerance in Women with Vasovagal Syncope

    PubMed Central

    Skoog, Johan; Zachrisson, Helene; Länne, Toste; Lindenberger, Marcus

    2016-01-01

    Background and Aim: Slower lower limb blood pooling and associated blunted sympathetic activation has been detected in healthy women prone to orthostatic syncope. Whether these findings are true also for patients with vasovagal syncope (VVS) is unknown. The aim was to investigate initial blood pooling time (poolingtime, time to 50% of total blood pooling) together with hemodynamic responses and orthostatic tolerance during lower body negative pressure (LBNP) in VVS and healthy controls. Methods and Results: Fourteen VVS women (25.7 ± 1.3 years) and 15 healthy women (22.8 ± 0.8 years) were subjected to single-step and graded LBNP to pre-syncope. Lower limb blood pooling (ml · 100 ml−1), poolingtime (s), hemodynamic responses and LBNP-tolerance were evaluated. LBNP induced comparable lower limb blood pooling in both groups (controls, 3.1 ± 0.3; VVS, 2.9 ± 0.3 ml · 100 ml−1, P = 0.70). In controls, shorter poolingtime correlated to higher LBNP-tolerance (r = –0.550, P < 0.05) as well as better maintained stroke volume (r = –0.698, P < 0.01) and cardiac output (r = –0.563, P < 0.05). In contrast, shorter poolingtime correlated to lower LBNP-tolerance in VVS (r = 0.821, P < 0.001) and larger decline in stroke volume (r = 0.611, P < 0.05). Furthermore, in controls, shorter poolingtime correlated to baroreflex-mediated hemodynamic changes during LBNP, e.g., increased vasoconstriction (P < 0.001). In VVS, poolingtime was not correlated with LBNP-induced baroreceptor unloading, but rather highly correlated to resting calf blood flow (P < 0.001). Conclusions: Shorter poolingtime seems to elicit greater sympathetic activation with a concomitant higher orthostatic tolerance in healthy women. The contrasting findings in VVS indicate a deteriorated vascular sympathetic control suggesting well-defined differences already in the initial responses during orthostatic stress. PMID:27378941

  8. Evaluation of polyethylene glycol coated liposomes labeled with Tc-99m as a blood pool agent

    SciTech Connect

    Phillips, W.T.; Klipper, R.; Goins, B.

    1994-05-01

    This investigation evaluated Tc-99m liposomes coated with polyethylene glycol (PEG) as a blood pool agent in comparison with Tc-99m liposomes carrying no surface charge (Neutral) and with Tc-99m autologous red cells. Liposomes (135 nm diameter) encapsulating glutathione were labeled with Tc-99m using the lipophilic chelator, HMPAO as previously described. Autologous red cells were labeled using an Ultratag kit. Labeling efficiencies averaged 66%, 52%, and 97% for the PEG liposomes. Neutral liposomes, and red cells, respectively. Rabbits (3-3.5 Kg) were injected IV via ear vein with 2.0 mls of PEG liposomes (2 mCi, 17 mg phospholipid/Kg body weight, n=5). Neutral liposomes (1.3 mCi, 17 mg phospholipid/Kg body weight, n=4), or red cells (2.6 mCi, n=2). Gamma camera images were acquired at 5,22, and 45 minutes, and 2,20,and 44 hours post-injection. Blood samples were obtained at each time point to determine clearance kinetics. Circulation half lives of both Tc-99m liposome formulations were longer than Tc-99m red cells (8 hrs), with the half life of PEG liposomes (35 hrs) 1.6 times longer than Neutral liposomes (22 hrs). In vivo stability of the Tc-99m label was excellent for the liposomes with only 3.5-4% bladder activity at 45 minutes compared to 12% bladder activity for the red cells. Excellent blood pool images were obtained for the PEG liposomes in the rabbit. Heart/liver ratios calculated from region of interest analysis of 45 minutes images were 1.9, 1.5, and 1.7 for PEG liposomes, Neutral liposomes and red cells. This study demonstrates the feasibility of using Tc-99m PEG liposomes to perform gated cardiac blood pool and rapid gastrointestinal bleeding studies.

  9. Spontaneous retroperitoneal hemorrhage localized by blood pool scintigraphy.

    PubMed

    Lerer, Daniel B; Rozenblit, Alla M; Cynamon, Jacob; Tubman, Gary; Freeman, Leonard M

    2004-02-01

    A healthy 17-year-old girl presented to the emergency department with a 1-day history of left upper quadrant abdominal pain associated with nausea and vomiting. Her hematocrit was 22. On physical examination, she had left upper quadrant fullness and tenderness. Initial computed tomography revealed a large, loculated, left-sided retroperitoneal hematoma. Blood pool scintigraphy with labeled red cells revealed a very large photon-deficient area with 3 areas of active bleeding in the upper margin of the cold area. An angiogram showed active extravasation from the left inferior phrenic artery. The patient was felt to have had spontaneous adrenal hemorrhage, likely within a preexisting, large adrenal cyst. Spontaneous hemorrhage into an adrenal cyst is a rare entity that can be life-threatening if not treated early in its course.

  10. Diagnostic yield of blood flow and blood pool studies of the liver

    SciTech Connect

    Azar, M.; Royal, H.D.; Parker, J.A.; Kolodny, G.M.

    1984-01-01

    The accuracy of Tc-99m RBC studies of the liver to diagnose cavernous hemangiomas has been previously reported. The authors have reviewed 82 of these studies performed in the last four years to determine the prevalence of this benign lesion when it is suspected. Studies were performed in patients with focal solid abnormalities of the liver if the patient had no known primary or if there were no definitive clinical or laboratory findings to support the diagnosis of metastatic disease. Blood flow, immediate blood pool and one hour delayed blood pool images were obtained in all patients. The combination of decreased or normal blood flow and markedly increased blood pool is pathognomonic for patients having cavernous hemangiomas. Seventeen percent (14/82) of patients were found to have cavernous hemangiomas of the liver. The remaining patients had metastatic disease (38), abscess (6), hepatomas (6), and miscellaneous diagnosis (11). All patients diagnosed as having cavernous hemangioma have been followed for at least one year. Seven of the remaining patients were lost to medical follow-up. In the series no false positive or false negative results have been obtained; however, false negative cases are anticipated for small or thrombosed hemangiomas. RBC liver studies should be encouraged since 1) the diagnostic yield is high; 2) it is the diagnostic procedure of choice; 3) biopsy of these lesions can be catastrophic; and 4) therapy and prognosis is greatly altered if the liver lesions are proven to be benign.

  11. Factors affecting postoperative blood loss in children undergoing cardiac surgery.

    PubMed

    Faraoni, David; Van der Linden, Philippe

    2014-01-01

    We hypothesized that the influence of cyanotic disease on postoperative blood loss is closely related to age in children undergoing cardiac surgery. Here, we demonstrate that the presence of a cyanotic disease is associated with increased postoperative blood loss in children aged 1 to 6 months. Children with cyanotic disease and aged<1 month who received fresh frozen plasma during cardiopulmonary bypass had less postoperative blood loss and higher maximal clot firmness on FIBTEM than cyanotic children from all other groups. Additional studies are needed to define optimal pathophysiology-based management in children undergoing cardiac surgery. PMID:24512988

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

    SciTech Connect

    Cohan, S.L.; Mun, S.K.; Petite, J.; Correia, J.; Tavelra Da Silva, A.T.; Waldhorn, R.E.

    1989-06-01

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

  13. The importance of exercise gated blood pool imaging in Chagas Disease

    SciTech Connect

    Meneguetti, J.C.; Neto, J.E.; Hironaka, F.H.; Netto, M.P.; Gomes, J.R.; Goldbaum, M.; Pileggi, F.; Camargo, E.E.

    1984-01-01

    Myocardial involvement in Chagas Disease (CD) often leads to cardiomyopathy and heart failure. Patients (pts) with the indeterminate form (IF) have positive complement fixation test as the only abnormality. Cardiac form (CF) pts have positive serology, abnormal ECG with or without clinical symptoms. To investigate the degree of cardiac involvement in IF pts, exercise (handgrip) gated blood pool (EGBP) was performed on 77 CD male workers (46 IF, 17-50 yrs; 31 CF, 24-61 yrs) and 28 male (22-46 yrs) normal volunteers (NV). Regional wall motion (RWM), ventricular volumes (VV) and percent EF variation (..delta..%) were analysed. NV group shoed ..delta..% - 3.51 +- 4.86 with normal RWM and VV. IF pts showed ..delta..% - 4.27 +- 7.46 with >-10% drop in 22% of pts; RWM and VV were abnormal in 43% and 30%, respectively; at least one parameter was abnormal in 59% of pts. CF pts showed ..delta..%-10.52 +- 7.37 with >-10% drop in 59%; RWM and VV were abnormal in 79% and 83%, respectively; at least one parameter was abnormal in 86% of pts. No ..delta..% difference was found between NV and IF groups, but there was a significant difference between these two groups and CF pts. When EGBP is considered, only 41% of IF pts are normal. Also, 14% CF pts with ECG and serologic abnormalities have no cardiac dysfunction. This suggests that EGBP study should be included as a routine procedure in CD pts and used as a basis for a new classification of the disease.

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

    PubMed Central

    Ferraris, V A; Ferraris, S P

    1995-01-01

    Analysis of blood product use after cardiac operations reveals that a few patients (< or = 20%) consume the majority of blood products (> 80%). The risk factors that predispose a minority of patients to excessive blood use include patient-related factors, transfusion practices, drug-related causes, and procedure-related factors. Multivariate studies suggest that patient age and red blood cell volume are independent patient-related variables that predict excessive blood product transfusion after cardiac procedures. Other factors include preoperative aspirin ingestion, type of operation, over- or underutilization of heparin during cardiopulmonary bypass, failure to correct hypothermia after cardiopulmonary bypass, and physician overtransfusion. A survey of the currently available blood conservation techniques reveals 5 that stand out as reliable methods: 1) high-dose aprotinin therapy, 2) preoperative erythropoietin therapy when time permits adequate dosage before operation, 3) hemodilution by harvest of whole blood immediately before cardiopulmonary bypass, 4) autologous predonation of blood, and 5) salvage of oxygenator blood after cardiopulmonary bypass. Other methods, such as the use of epsilon-aminocaproic acid or desmopressin, cell saving devices, reinfusion of shed mediastinal blood, and hemofiltration have been reported to be less reliable and may even be harmful in some high-risk patients. Consideration of the available data allows formulation of a 4-pronged plan for limiting excessive blood transfusion after surgery: 1) recognize the causes of excessive transfusion, including the importance of red blood cell volume, type of procedure being performed, preoperative aspirin ingestion, etc.; 2) establish a quality management program, including a survey of transfusion practices that emphasizes physician education and availability of real-time laboratory testing to guide transfusion therapy; 3) adopt a multimodal approach using institution-proven techniques; and

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

    NASA Astrophysics Data System (ADS)

    Rahmer, J.; Antonelli, A.; Sfara, C.; Tiemann, B.; Gleich, B.; Magnani, M.; Weizenecker, J.; Borgert, J.

    2013-06-01

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

  16. Assessment of right and left ventricular function in healthy mice by blood-pool pinhole gated SPECT.

    PubMed

    Goetz, Christian; Monassier, Laurent; Choquet, Philippe; Constantinesco, André

    2008-09-01

    The feasibility of blood-pool pinhole ECG gated SPECT was investigated in healthy mice to assess right and left ventricular function analysis. Anaesthetized (isoflurane 1-1.5%) adult CD1 mice (n=11) were analyzed after intravenous administration of 0.2 ml of 550 MBq of (99m)Tc human albumin. For blood-pool gated SPECT imaging, 48 ventral step and shoot projections with eight time bins per RR over 180 degrees with 64 x 64 word images were acquired with a small animal gamma camera equipped with a pinhole collimator of 12 cm in focal length and 1.5 mm in diameter. For appropriate segmentation of right and left ventricular volumes, a 4D Fourier analysis was performed after reconstruction and reorientation of blood-pool images with a voxel size of 0.55 x 0.55 x 0.55 mm(3). Average right and left ejection fractions were respectively 52+/-4.7% and 65+/-5.2%. Right end diastolic and end systolic volumes were significantly higher compared with the corresponding left ventricular volumes (P<0.0001 each). A linear correlation between right and left stroke volumes (r=0.9, P<0.0001) was obtained and right and left cardiac outputs were not significantly different 14.2+/-1.9 and 14.1+/-2 ml/min, respectively.

  17. When blood runs cold: cold agglutinins and cardiac surgery.

    PubMed

    Findlater, Rhonda R; Schnell-Hoehn, Karen N

    2011-01-01

    Cold agglutinins are particular cold-reactive antibodies that react with red blood cells when the blood temperature drops below normal body temperature causing increased blood viscosity and red blood cell clumping. Most individuals with cold agglutinins are not aware of their presence, as these antibodies have little effect on daily living, often necessitating no treatment. However, when those with cold agglutinins are exposed to hypothermic situations or undergo procedures such as cardiopulmonary bypass with hypothermia during cardiac surgery, lethal complications of hemolysis, microvascular occlusion and organ failure can occur. By identifying those suspected of possessing cold agglutinins through a comprehensive nursing assessment and patient history, cold agglutinin screening can be performed prior to surgery to determine a diagnosis of cold agglutinin disease. With a confirmed diagnosis of cold agglutinin disease, the plan of care can be focused on measures to maintain the patient's blood temperature above the thermal amplitude throughout their hospitalization including the use of normothermic cardiopulmonary bypass with warm myocardial preservation techniques to prevent these fatal complications. Using a case report approach, the authors review the mechanism, clinical manifestations, detection and nursing management of a patient with cold agglutinins undergoing scheduled cardiac surgery. Cold agglutinin disease is rare. However, the risk to patients warrants an increased awareness of cold agglutinins and screening for those who are suspected of carrying these antibodies. PMID:21630629

  18. Pictorial estimation of blood loss in a birthing pool--an aide memoire.

    PubMed

    Goodman, Anushia

    2015-04-01

    The aim of this article is to share some photographic images to help midwives visually estimate blood loss at water births. PubMed, CINAHL and MEDLINE databases were searched for relevant research. There is little evidence to inform the practice of visually estimating blood loss in water, as discussed further on in the article. This article outlines a simulation where varying amounts of blood were poured into a birthing pool, captured by photo images. Photo images of key amounts like 150mls, 300mls and 450mls can be useful visual markers when estimating blood loss at water births. The speed of spread across the pool may be a significant factor in assessing blood loss. The author recommends that midwives and educators embark on similar simulations to inform their skill in estimating blood loss at water births.

  19. Desiccation of a pool of blood: from fluid mechanics to forensic investigations

    NASA Astrophysics Data System (ADS)

    Nicloux, Celine; Brutin, David

    2012-11-01

    The evaporation of biological fluids (with droplet configuration) has been studied since a few years due to several applications in medical fields such as medical tests, drug screening, biostabilization... The evaporation of a drop of whole blood leads to the formation of final typical pattern of cracks. Flow motion, adhesion, gelation and fracturation all occur during the evaporation of this complex matter. During the drying, a sol-gel transition develops. The evaporation of a pool of blood is studied in order to link the pattern formation and the evaporation dynamics. We intend to transfer the knowledge acquired for drops on pool to improve the forensic investigations. In this study, we focus on both pool of blood and pure water to determine the transition region from drop to pool and then to characterize the evaporation rate in the pool configuration. The spreading of blood which can be seen as a complex fluid is strongly influenced the substrate nature. The initial contact angle of blood on different substrate nature will influence the maximum thickness of the layer and then will influence the evaporation mass flux. The authors gratefully acknowledge the help and the fruitful discussions raised with A. Boccoz.

  20. Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

    PubMed Central

    Tan, Zhaoxia; Zhou, Li; Qin, Zhen; Luo, Ming; Chen, Hao; Xiong, Jiyue; Li, Jian; Liu, Ting; Du, Lei; Zhou, Jing

    2016-01-01

    Abstract Patients undergoing cardiac surgery often experience abnormal bleeding, due primarily to cardiopulmonary bypass (CPB)-induced activation of platelets. Sevoflurane may inhibit platelet activation, raising the possibility that administering it during CPB may reduce blood loss. Patients between 18 and 65 years old who were scheduled for cardiac surgery under CPB at our hospital were prospectively enrolled and randomized to receive intravenous anesthetics alone (control group, n = 77) or together with sevoflurane (0.5–1.0 vol/%) from an oxygenator (sevoflurane group, n = 76). The primary outcome was postoperative blood loss, the secondary outcome was postoperative need for blood products. Volume of blood loss was 48% lower in the sevoflurane group than the control group at 4 hours after surgery, and 33% lower at 12 hours after surgery. Significantly fewer patients in the sevoflurane group lost >700 mL blood within 24 hours (9 of 76 vs 28 of 77, P < 0.001). As a result, the sevoflurane group received significantly smaller volumes of packed red blood cells (1.25 ± 2.36 vs 2.23 ± 3.75 units, P = 0.011) and fresh frozen plasma (97 ± 237 vs 236 ± 344 mL, P = 0.004). Thus the sevoflurane group was at significantly lower risk of requiring complex blood products after surgery (adjusted odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17–0.68, P = 0.002). Sevoflurane inhalation from an oxygenator during CPB may reduce blood loss and need for blood products after cardiac surgery. PMID:27124028

  1. ECG-gated blood-pool study of carotid arterial pulsation as a sign of stenosis: concise communication

    SciTech Connect

    Winston, M.A.; Cohen, S.N.

    1983-06-01

    The large elastic arteries, such as the carotids, pulsate (expand and contract) in synchrony with the heart beat. These pulsations should be reduced by significant stenosis. This hypothesis was studied in 15 men by obtaining sequential ECG-gated labeled blood-pool images of these vessels in anterior and lateral oblique views. These were computer processed by a functional program that displays each pixel with an intensity proportional to its change in activity level during the cardiac cycle. Blank areas indicated lack of pulsation and were correlated with angiographic studies. The blank skip areas were present when there was 50% or greater narrowing in arterial diameter (94% sensitivity) but were not seen in patients with normal or minimally diseased vessels (25% or less narrowing). They were present inconsistently in the four vessels with 25 to 50% narrowing.

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

    PubMed

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

    2012-01-01

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

  3. Cardiac risk factors: new cholesterol and blood pressure management guidelines.

    PubMed

    Anthony, David; George, Paul; Eaton, Charles B

    2014-06-01

    The 2013 American College of Cardiology/American Heart Association cholesterol guidelines depart from low-density lipoprotein (LDL) treatment targets and recommend treating four specific patient groups with statins. Statins are the only cholesterol-lowering drugs with randomized trial evidence of benefit for preventing atherosclerotic cardiovascular disease (ASCVD). The groups are patients with clinical ASCVD; patients ages 40 to 75 years with diabetes and LDL of 70 to 189 mg/dL but no clinical ASCVD; patients 21 years or older with LDL levels of 190 mg/dL or higher; and patients ages 40 to 75 years with LDL of 70 to 189 mg/dL without clinical ASCVD or diabetes but with 10-year ASCVD risk of 7.5% or higher. Ten-year ASCVD risk may be calculated using the Pooled Cohort Equations. The Eighth Joint National Committee (JNC 8) guidelines for blood pressure management recommend a blood pressure goal of less than 140/90 mm Hg for all adults except those 60 years or older. For the latter group, the JNC 8 recommends a systolic blood pressure goal of less than 150 mm Hg. In another notable change from prior guidelines, the JNC 8 recommends relaxing the systolic blood pressure goal for patients with diabetes and chronic kidney disease to less than 140 mm Hg from less than 130 mm Hg. PMID:24936717

  4. Multifunctional PEGylated multiwalled carbon nanotubes for enhanced blood pool and tumor MR imaging.

    PubMed

    Wen, Shihui; Zhao, Qinghua; An, Xiao; Zhu, Jingyi; Hou, Wenxiu; Li, Kai; Huang, Yunpeng; Shen, Mingwu; Zhu, Wei; Shi, Xiangyang

    2014-10-01

    Long-circulating multifunctional Gd(III)-loaded multiwalled carbon nanotubes (MWCNTs) modified with polyethylene glycol are designed and synthesized. The formed MWCNTs are water-dispersible, stable, and have good cytocompatibility and antifouling property. With the low r 2 /r 1 relaxivity ratio and relatively long blood circulation time, the multifunctional MWCNTs are able to be used as a platform for enhanced blood pool and tumor MR imaging.

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

    SciTech Connect

    Brash, H.M.; Wraith, P.K.; Hannan, W.J.; Dewhurst, N.G.; Muir, A.L.

    1980-04-01

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

  6. Detection of bladder hemangioma in a child by blood-pool scintigraphy.

    PubMed

    Ishikawa, Ken; Saitoh, Masahiko; Chida, Shoichi

    2003-06-01

    Bladder hemangioma is a rare cause of gross hematuria. A 5-year-old boy was investigated for recurrent episodes of asymptomatic gross hematuria, but no abnormalities were found. Blood-pool scintigraphy using (99m)technetium-human serum albumin combined with diethylene triamine penta-acetic acid (DTPA) revealed an area of increased activity in the right side of the bladder, which was confirmed by cystoscopy as a bladder hemangioma. Endoscopic laser therapy was used to remove two lesions successfully that were diagnosed histologically as cavernous hemangioma. The patient had no further episodes of hematuria in the 2-year period after this treatment. This case study indicates blood-pool scintigraphy may be a useful technique for detecting bladder hemangiomas.

  7. Diagnosis of Popliteal Venous Entrapment Syndrome by Magnetic Resonance Imaging Using Blood-Pool Contrast Agents

    SciTech Connect

    Beitzke, Dietrich Wolf, Florian; Juelg, Gregor; Lammer, Johannes; Loewe, Christian

    2011-02-15

    Popliteal vascular entrapment syndrome is caused by aberrations or hypertrophy of the gastrocnemius muscles, which compress the neurovascular structures of the popliteal fossa, leading to symptoms of vascular and degeneration as well as aneurysm formation. Imaging of popliteal vascular entrapment may be performed with ultrasound, magnetic resonance imaging (MRI), computed tomography angiography, and conventional angiography. The use of blood-pool contrast agents in MRI when popliteal vascular entrapment is suspected offers the possibility to perform vascular imaging with first-pass magnetic resonance angiographic, high-resolution, steady-state imaging and allows functional tests all within one examination with a single dose of contrast agent. We present imaging findings in a case of symptomatic popliteal vein entrapment diagnosed by the use of blood pool contrast-enhanced MRI.

  8. Effect of Vanadate on Elevated Blood Glucose and Depressed Cardiac Performance of Diabetic Rats

    NASA Astrophysics Data System (ADS)

    Heyliger, Clayton E.; Tahiliani, Arun G.; McNeill, John H.

    1985-03-01

    The trace element vanadium has an unclear biological function. Vanadate, an oxidized form of vanadium, appears to have an insulin-like action. The effect of vanadate on blood glucose and cardiac performance was assessed in female Wistar rats 6 weeks after they were made diabetic with streptozotocin. When vanadate was administered for a 4-week period to the diabetic rats, their blood glucose was not significantly different from that of nondiabetic controls despite a low serum insulin. In contrast, blood glucose was increased about threefold in the diabetic rats that were not treated with vanadate; these rats also had low insulin levels. Cardiac performance was depressed in the untreated diabetic animals, but the cardiac performance of the vanadate-treated diabetic animals was not significantly different from that of nondiabetic controls. Thus vanadate controlled the high blood glucose and prevented the decline in cardiac performance due to diabetes.

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

    PubMed

    Brøndum, E; Hasenkam, J M; Secher, N H; Bertelsen, M F; Grøndahl, C; Petersen, K K; Buhl, R; Aalkjaer, C; Baandrup, U; Nygaard, H; Smerup, M; Stegmann, F; Sloth, E; Ostergaard, K H; Nissen, P; Runge, M; Pitsillides, K; Wang, T

    2009-10-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow remained unchanged. Cardiac output was reduced by 30%, CVP decreased to -1 +/- 2 mmHg (P < 0.01), and jugular flow ceased as the jugular cross-sectional area increased to 3.2 +/- 0.6 cm(2) (P < 0.01), corresponding to accumulation of approximately 1.2 l of blood in the veins. When the head was raised, the jugular veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head is lowered, blood accumulates in the vein, affecting MAP.

  10. Management of intraoperative fluid balance and blood conservation techniques in adult cardiac surgery.

    PubMed

    Vretzakis, George; Kleitsaki, Athina; Aretha, Diamanto; Karanikolas, Menelaos

    2011-02-01

    Blood transfusions are associated with adverse physiologic effects and increased cost, and therefore reduction of blood product use during surgery is a desirable goal for all patients. Cardiac surgery is a major consumer of donor blood products, especially when cardiopulmonary bypass (CPB) is used, because hematocrit drops precipitously during CPB due to blood loss and blood cell dilution. Advanced age, low preoperative red blood cell volume (preoperative anemia or small body size), preoperative antiplatelet or antithrombotic drugs, complex or re-operative procedures or emergency operations, and patient comorbidities were identified as important transfusion risk indicators in a report recently published by the Society of Cardiovascular Anesthesiologists. This report also identified several pre- and intraoperative interventions that may help reduce blood transfusions, including off-pump procedures, preoperative autologous blood donation, normovolemic hemodilution, and routine cell saver use.A multimodal approach to blood conservation, with high-risk patients receiving all available interventions, may help preserve vital organ perfusion and reduce blood product utilization. In addition, because positive intravenous fluid balance is a significant factor affecting hemodilution during cardiac surgery, especially when CPB is used, strategies aimed at limiting intraoperative fluid balance positiveness may also lead to reduced blood product utilization.This review discusses currently available techniques that can be used intraoperatively in an attempt to avoid or minimize fluid balance positiveness, to preserve the patient's own red blood cells, and to decrease blood product utilization during cardiac surgery. PMID:21345774

  11. Evaluation of hemangiomas with technetium 99m-labeled RBCs: the perfusion-blood pool mismatch

    SciTech Connect

    Front, D.; Israel, O.; Joachims, H.; Brown, Y.; Eliachar, I.

    1983-03-18

    A case report is presented of a woman with a tumor mass in the nasopharynx. Early and delayed scintigraphy with Technetium 99m-labeled RBCs showed a large area of increased uptake which was later shown to be a hemangioma by contrast angiography. The perfusion-blood pool mismatch observed in hemangiomas is characteristic of these lesions and has not been described in any other abnormalities. The Tc-RBC using both early and delayed scintigraphy is a simple, noninvasive method for assessing the vascular characteristics of these tumors. (JMT)

  12. Three dimensional quantification of left ventricular wall motion by ECG-gated blood pool emission tomography

    SciTech Connect

    Underwood, S.R.; Walton, S.; Laming, P.J.; Jarritt, P.H.; Ell, P.J.; Emanuel, R.W.; Swanton, R.H.

    1985-05-01

    ECG-gated blood pool emission tomography is a relatively new technique, and this study establishes a simple method for displaying the three dimensional data obtained, determines a normal range for ejection fraction in all regions of the left ventricle, and compares wall motion in abnormal subjects with that determined by X-ray contrast ventriculography. The short axis sections dividing the ventricle in slices from apex to base, were used to calculate ejection fraction for all parts of the ventricle and the results were plotted on a single colour coded circular image. The apex was represented in the centre, the base around the circumference, and all other parts of the ventricle were represented in between. The image was divided into 15 segments, and normal segmental ejection fraction was defined as within two standard deviations of the mean in a group of 10 normal subjects. In 25 subjects with coronary artery disease, motion of the anterior, apical, and inferior walls agreed in every case with the right anterior oblique contrast ventriculogram, but in 12 of these, the three dimensional ejection fraction image showed abnormal septal motion, and in a further 3, abnormal lateral wall motion in addition. In the 12 subjects there was disease of the left anterior descending coronary artery, and in the further 3 there was left circumflex disease. ECG-gated blood pool emission tomography thus provides an accurate quantitative assessment of left ventricular wall motion in three dimensions, and has significant advantages over conventional planar techniques.

  13. Characteristics of the rat cardiac sphingolipid pool in two mitochondrial subpopulations.

    PubMed

    Monette, Jeffrey S; Gómez, Luis A; Moreau, Régis F; Bemer, Brett A; Taylor, Alan W; Hagen, Tory M

    2010-07-23

    Mitochondrial sphingolipids play a diverse role in normal cardiac function and diseases, yet a precise quantification of cardiac mitochondrial sphingolipids has never been performed. Therefore, rat heart interfibrillary mitochondria (IFM) and subsarcolemmal mitochondria (SSM) were isolated, lipids extracted, and sphingolipids quantified by LC-tandem mass spectrometry. Results showed that sphingomyelin (approximately 10,000 pmol/mg protein) was the predominant sphingolipid regardless of mitochondrial subpopulation, and measurable amounts of ceramide (approximately 70 pmol/mg protein) sphingosine, and sphinganine were also found in IFM and SSM. Both mitochondrial populations contained similar quantities of sphingolipids except for ceramide which was much higher in SSM. Analysis of sphingolipid isoforms revealed ten different sphingomyelins and six ceramides that differed from 16- to 24-carbon units in their acyl side chains. Sub-fractionation experiments further showed that sphingolipids are a constituent part of the inner mitochondrial membrane. Furthermore, inner membrane ceramide levels were 32% lower versus whole mitochondria (45 pmol/mg protein). Three ceramide isotypes (C20-, C22-, and C24-ceramide) accounted for the lower amounts. The concentrations of the ceramides present in the inner membranes of SSM and IFM differed greatly. Overall, mitochondrial sphingolipid content reflected levels seen in cardiac tissue, but the specific ceramide distribution distinguished IFM and SSM from each other.

  14. Characteristics of the Rat Cardiac Sphingolipid Pool in Two Mitochondrial Subpopulations

    PubMed Central

    Monette, Jeffrey S.; Gómez, Luis A.; Moreau, Régis F.; Bemer, Brett A.; Taylor, Alan W.; Hagen, Tory M.

    2010-01-01

    Mitochondrial sphingolipids play a diverse role in normal cardiac function and diseases, yet a precise quantification of cardiac mitochondrial sphingolipids has never been performed. Therefore, rat heart interfibrillary (IFM) and subsarcolemmal (SSM) mitochondria were isolated, lipids extracted, and sphingolipids quantified by LC-tandem mass spectrometry. Results showed that sphingomyelin (~10,000 pmols/mg protein) was the predominant sphingolipid regardless of mitochondrial subpopulation, and measurable amounts of ceramide (~70 pmols/mg protein) sphingosine, and sphinganine were also found in IFM and SSM. Both mitochondrial populations contained similar quantities of sphingolipids except for ceramide which was much higher in SSM. Analysis of sphingolipid isoforms revealed ten different sphingomyelins and six ceramides that differed from 16 to 24 carbon units in their acyl side-chains. Sub-fractionation experiments further showed that sphingolipids are a constituent part of the inner mitochondrial membrane. Furthermore, inner membrane ceramide levels were 32% lower versus whole mitochondria (45 pmols/mg protein). Three ceramide isotypes (C20-, C22-, and C24-ceramide) accounted for the lower amounts. The concentrations of the ceramides present in the inner membranes of SSM and IFM differed greatly. Overall, mitochondrial sphingolipid content reflected levels seen in cardiac tissue, but the specific ceramide distribution distinguished IFM and SSM from each other. PMID:20599536

  15. Characteristics of the rat cardiac sphingolipid pool in two mitochondrial subpopulations.

    PubMed

    Monette, Jeffrey S; Gómez, Luis A; Moreau, Régis F; Bemer, Brett A; Taylor, Alan W; Hagen, Tory M

    2010-07-23

    Mitochondrial sphingolipids play a diverse role in normal cardiac function and diseases, yet a precise quantification of cardiac mitochondrial sphingolipids has never been performed. Therefore, rat heart interfibrillary mitochondria (IFM) and subsarcolemmal mitochondria (SSM) were isolated, lipids extracted, and sphingolipids quantified by LC-tandem mass spectrometry. Results showed that sphingomyelin (approximately 10,000 pmol/mg protein) was the predominant sphingolipid regardless of mitochondrial subpopulation, and measurable amounts of ceramide (approximately 70 pmol/mg protein) sphingosine, and sphinganine were also found in IFM and SSM. Both mitochondrial populations contained similar quantities of sphingolipids except for ceramide which was much higher in SSM. Analysis of sphingolipid isoforms revealed ten different sphingomyelins and six ceramides that differed from 16- to 24-carbon units in their acyl side chains. Sub-fractionation experiments further showed that sphingolipids are a constituent part of the inner mitochondrial membrane. Furthermore, inner membrane ceramide levels were 32% lower versus whole mitochondria (45 pmol/mg protein). Three ceramide isotypes (C20-, C22-, and C24-ceramide) accounted for the lower amounts. The concentrations of the ceramides present in the inner membranes of SSM and IFM differed greatly. Overall, mitochondrial sphingolipid content reflected levels seen in cardiac tissue, but the specific ceramide distribution distinguished IFM and SSM from each other. PMID:20599536

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

    PubMed

    Basuli, Falguni; Li, Changhui; Xu, Biying; Williams, Mark; Wong, Karen; Coble, Vincent L; Vasalatiy, Olga; Seidel, Jurgen; Green, Michael V; Griffiths, Gary L; Choyke, Peter L; Jagoda, Elaine M

    2015-03-01

    We sought to develop a practical, reproducible and clinically translatable method of radiolabeling serum albumins with fluorine-18 for use as a PET blood pool imaging agent in animals and man. Fluorine-18 radiolabeled fluoronicotinic acid-2,3,5,6-tetrafluorophenyl ester, [(18)F]F-Py-TFP was prepared first by the reaction of its quaternary ammonium triflate precursor with [(18)F]tetrabutylammonium fluoride ([(18)F]TBAF) according to a previously published method for peptides, with minor modifications. The incubation of [(18)F]F-Py-TFP with rat serum albumin (RSA) in phosphate buffer (pH9) for 15 min at 37-40 °C produced fluorine-18-radiolabeled RSA and the product was purified using a mini-PD MiniTrap G-25 column. The overall radiochemical yield of the reaction was 18-35% (n=30, uncorrected) in a 90-min synthesis. This procedure, repeated with human serum albumin (HSA), yielded similar results. Fluorine-18-radiolabeled RSA demonstrated prolonged blood retention (biological half-life of 4.8 hours) in healthy awake rats. The distribution of major organ radioactivity remained relatively unchanged during the 4 hour observation periods either by direct tissue counting or by dynamic PET whole-body imaging except for a gradual accumulation of labeled metabolic products in the bladder. This manual method for synthesizing radiolabeled serum albumins uses fluorine-18, a widely available PET radionuclide, and natural protein available in both pure and recombinant forms which could be scaled up for widespread clinical applications. These preclinical biodistribution and PET imaging results indicate that [(18)F]RSA is an effective blood pool imaging agent in rats and might, as [(18)F]HSA, prove similarly useful as a clinical imaging agent.

  17. Synthesis of Fluorine-18 Radio-labeled Serum Albumins for PET Blood Pool Imaging

    PubMed Central

    Basuli, Falguni; Li, Changhui; Xu, Biying; Williams, Mark; Wong, Karen; Coble, Vincent L; Vasalatiy, Olga; Seidel, Jurgen; Green, Michael V.; Griffiths, Gary L.; Choyke, Peter L.; Jagoda, Elaine M.

    2015-01-01

    We sought to develop a practical, reproducible and clinically translatable method of radiolabeling serum albumins with fluorine-18 for use as a PET blood pool imaging agent in animals and man. Fluorine-18 radiolabeled fluoronicotinic acid-2,3,5,6-tetrafluorophenyl ester, [18F]F-Py-TFP was prepared first by the reaction of its quaternary ammonium triflate precursor with [18F]tetrabutylammonium fluoride ([18F]TBAF) according to a previously published method for peptides, with minor modifications. The incubation of [18F]F-Py-TFP with rat serum albumin (RSA) in phosphate buffer (pH 9) for 15 min at 37–40 °C produced fluorine-18-radiolabeled RSA and the product was purified using a mini-PD MiniTrap G-25 column. The overall radiochemical yield of the reaction was 18–35% (n = 30, uncorrected) in a 90-min synthesis. This procedure, repeated with human serum albumin (HSA), yielded similar results. Fluorine-18-radiolabeled RSA demonstrated prolonged blood retention (biological half-life of 4.8 hours) in healthy awake rats. The distribution of major organ radioactivity remained relatively unchanged during the 4 hour observation periods either by direct tissue counting or by dynamic PET whole-body imaging except for a gradual accumulation of labeled metabolic products in the bladder. This manual method for synthesizing radiolabeled serum albumins uses fluorine-18, a widely available PET radionuclide, and natural protein available in both pure and recombinant forms which could be scaled up for widespread clinical applications. These preclinical biodistribution and PET imaging results indicate that [18F]RSA is an effective blood pool imaging agent in rats and might, as [18F]HSA, prove similarly useful as a clinical imaging agent. PMID:25533724

  18. Novel approaches to expanding the lung donor pool: donation after cardiac death and ex vivo conditioning.

    PubMed

    Cypel, Marcelo; Yeung, Jonathan C; Keshavjee, Shaf

    2011-06-01

    Two novel approaches have been developed to potentially increase the availability of donor lungs for lung transplantation. In the first approach, lungs from donation after cardiac death (DCD) donors are used to increase the quantity of organ donors. In the second approach, a newly developed normothermic ex vivo lung perfusion (EVLP) technique is used as a means of reassessing the adequacy of lung function from DCD and from high-risk brain death donors prior to transplantation. This EVLP technique can also act as a platform for the delivery of novel therapies to repair injured organs ex vivo. PMID:21511086

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

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  20. Cardiopulmonary Bypass Priming Using Autologous Cord Blood in Neonatal Congenital Cardiac Surgery

    PubMed Central

    Choi, Eun Seok; Cho, Sungkyu; Jang, Woo Sung

    2016-01-01

    Background and Objectives A blood transfusion is almost inevitable in neonatal cardiac surgery. This study aimed to assess the feasibility of using autologous cord blood for a cardiopulmonary bypass (CPB) priming as an alternative to an allo-transfusion in neonatal cardiac surgery. Subjects and Methods From January 2012 to December 2014, cord blood had been collected during delivery after informed consent and was stored immediately into a blood bank. Eight neonatal patients had their own cord blood used for CPB priming during cardiac surgery. Results All patients underwent surgery for their complex congenital heart disease. The median age and body weight at surgery was 11 days (from 0 to 21 days) and 3.2 kg (from 2.2 to 3.7 kg). The median amount and hematocrit of collected cord blood was 72.5 mL (from 43 to 105 mL) and 48.7% (from 32.0 to 51.2%). The median preoperative hematocrit of neonates was 36.5% (from 31.0 to 45.0%); the median volume of CPB priming was 130 mL (From 120 to 140 mL). Seven out of eight patients did not need an allo-transfusion in CPB priming and only one neonate used 20 mL of packed red blood cells in CPB priming to obtain the target hematocrit. Conclusion Autologous cord blood can be used for CPB priming as alternative to packed red blood cells in neonatal congenital cardiac surgery in order to reduce allo-transfusion. PMID:27721864

  1. Importance of SPECT/CT in detecting multiple hemangiomas on 99mTc-labeled RBC blood pool scintigraphy.

    PubMed

    Roy, Shambo Guha; Karunanithi, Sellam; Agarwal, Krishan Kant; Bal, Chandrasekhar; Kumar, Rakesh

    2015-04-01

    Vascular malformations and hemangiomas are common in children, but gastric hemangioma is extremely rare with less than 15 reported cases in the pediatric age group. Gastric hemangioma accounts for only 0.05% of all gastrointestinal neoplasms, and intra-abdominal hemangiomas are rarely found outside of the liver. We present a unique case of gastric hemangioma, and multiple hemangiomas were detected in a single scan by 99mTc-labeled RBC blood pool imaging. This case also depicts the incremental role of SPECT/CT over planar acquisition for detecting multiple hemangiomas, especially for those lesions located adjacent to physiological blood pool activity.

  2. Cardiac cryosurgery: regional myocardial blood flow of ventricular cryolesions

    SciTech Connect

    Holman, W.L.; Ikeshita, M.; Lease, J.G.; Smith, P.K.; Ungerleider, R.M.; Cox, J.L.

    1986-11-01

    Cryosurgery is one of three methods introduced recently for the treatment of ventricular tachyarrhythmias. Cryothermic exposure ablates arrhythmogenic ventricular myocardium, and produces a dense fibrous scar with a sharp border to histologically normal tissue. Myocardial blood flow in the region of the cryolesion, however, has not been quantitated. The purpose of this study was to measure regional blood flow within and around the cryolesion in an attempt to identify ischemic zones that might become arrhythmogenic. Left ventricular cryolesions were created in eleven adult dogs. Two weeks later, the animals underwent radioactive tracer microsphere injection for quantitation of regional myocardial blood flow. The fibrotic cryolesion demonstrated a significantly depressed blood flow (0.44 +/- 0.07 ml/min/g) compared to blood flow in control tissue (1.36 +/- 0.12 ml/min/g) (P less than 0.001). A 1-mm strip of myocardium immediately adjacent to the cryolesion, as well as other myocardium surrounding and subjacent to the cryolesion, did not show a significant decrease in regional blood flow. The border between the fibrotic cryolesion and the surrounding myocardium is, therefore, sharply defined not only in terms of histology but also in regards to regional blood flow. These data lend further support to the safe clinical use of cryothermia in the treatment of refractory ventricular tachycardia.

  3. Do deficits in cardiac care influence high mortality rates in schizophrenia? A systematic review and pooled analysis

    PubMed Central

    Mitchell, Alex J; Lord, Oliver

    2010-01-01

    We have previously documented inequalities in the quality of medical care provided to those with mental ill health but the implications for mortality are unclear. We aimed to test whether disparities in medical treatment of cardiovascular conditions, specifically receipt of medical procedures and receipt of prescribed medication, are linked with elevated rates of mortality in people with schizophrenia and severe mental illness. We undertook a systematic review of studies that examined medical procedures and a pooled analysis of prescribed medication in those with and without comorbid mental illness, focusing on those which recruited individuals with schizophrenia and measured mortality as an outcome. From 17 studies of treatment adequacy in cardiovascular conditions, eight examined cardiac procedures and nine examined adequacy of prescribed cardiac medication. Six of eight studies examining the adequacy of cardiac procedures found lower than average provision of medical care and two studies found no difference. Meta-analytic pooling of nine medication studies showed lower than average rates of prescribing evident for the following individual classes of medication; angiotensin converting enzyme inhibitors (n = 6, aOR = 0.779, 95% CI = 0.638–0.950, p = 0.0137), beta-blockers (n = 9, aOR = 0.844, 95% CI = 0.690–1.03, p = 0.1036) and statins (n = 5, aOR = 0.604, 95% CI = 0.408–0.89, p = 0.0117). No inequality was evident for aspirin (n = 7, aOR = 0.986, 95% CI = 0.7955–1.02, p = 0.382). Interestingly higher than expected prescribing was found for older non-statin cholesterol-lowering agents (n = 4, aOR = 1.55, 95% CI = 1.04–2.32, p = 0.0312). A search for outcomes in this sample revealed ten studies linking poor quality of care and possible effects on mortality in specialist settings. In half of the studies there was significantly higher mortality in those with mental ill health

  4. Reduction of blood oxygen levels enhances postprandial cardiac hypertrophy in Burmese python (Python bivittatus).

    PubMed

    Slay, Christopher E; Enok, Sanne; Hicks, James W; Wang, Tobias

    2014-05-15

    Physiological cardiac hypertrophy is characterized by reversible enlargement of cardiomyocytes and changes in chamber architecture, which increase stroke volume and via augmented convective oxygen transport. Cardiac hypertrophy is known to occur in response to repeated elevations of O2 demand and/or reduced O2 supply in several species of vertebrate ectotherms, including postprandial Burmese pythons (Python bivittatus). Recent data suggest postprandial cardiac hypertrophy in P. bivittatus is a facultative rather than obligatory response to digestion, though the triggers of this response are unknown. Here, we hypothesized that an O2 supply-demand mismatch stimulates postprandial cardiac enlargement in Burmese pythons. To test this hypothesis, we rendered animals anemic prior to feeding, essentially halving blood oxygen content during the postprandial period. Fed anemic animals had heart rates 126% higher than those of fasted controls, which, coupled with a 71% increase in mean arterial pressure, suggests fed anemic animals were experiencing significantly elevated cardiac work. We found significant cardiac hypertrophy in fed anemic animals, which exhibited ventricles 39% larger than those of fasted controls and 28% larger than in fed controls. These findings support our hypothesis that those animals with a greater magnitude of O2 supply-demand mismatch exhibit the largest hearts. The 'low O2 signal' stimulating postprandial cardiac hypertrophy is likely mediated by elevated ventricular wall stress associated with postprandial hemodynamics.

  5. Nano Liposomes Labeled with (99m)Tc-HMPAO, a Novel Agent for Blood Pool Imaging.

    PubMed

    Sadri, Kayvan; Momenypoor, Salimeh; Dabbagh Kakhki, Vahid Reza; Sadeghi, Ramin; Aryana, Kamran; Johari Daha, Fariba; Zakavi, Seyed Rasoul; Jaafari, Mahmoud Reza

    2015-01-01

    In-vitro labeling of RBC with (99m)Tc is an intricate procedure and there is always a need for an alternate blood pool imaging agent. The aim of this study was to prepare an effective nano sized liposome (NLs) similar to human RBC for blood pool scintigraphy. This study formulates PEG-NLs and non-PEG-NLs using film method plus high pressure homogenization technique. Biodistribution studies were performed on BALB/C mice 1, 4 and 24 h after tail vein injection of labeled NLs with (99m)Tc hexamethylpropylene-amine-oxime ((99m)Tc-HMPAO). Planar images were acquired using a 256 × 256 matrix following(99m) Tc-HMPAO-NLs injection into ear vein of rabbits 1, 2 and 24 h later. SPECT images were obtained 15 minutes after the injection (64 slices, 30 second/projection). The mean diameter, zeta potential and polydispersity index (PDI) of the PEG-NLs and the NLs were (80.88 ± 0.594 nm, -12.5 ± 0.56 mv, 0.158 ± 0.025) and (94.14 ± 0.114 nm, -35.5 ± 0.67 mv and 0.198 ± 0.007), respectively. (99m)Tc-HMPAO-PEG-NLs showed a significant circulation tracer activity (7.74 ± 1.63%ID/g at 1 h and 4.9 ± 0.77 %ID/g at 4 h), with low liver accumulation (12.07 ± 3.66 %ID/g at 1 h and 14.85 ± 1.3 %ID/g at 4 h). Heart to liver, spleen and background ROIs (region of interests) for (99m) Tc-HMPAO-PEG-NLs were 1.25, 4 and 4.28 respectively at 2 h which changed to 1.06, 1.75 and 2.51 respectively at 24 h. The (99m)Tc-HMPAO-PEG-NLs with a prolonged blood circulation time could be an excellent RBC alternative for scintigraphy and gastrointestinal bleeding.

  6. Two-phase whole-body skeletal scintigraphy in children--revisiting the usefulness of the early blood pool phase.

    PubMed

    Kwatra, Neha; Shalaby-Rana, Eglal; Majd, Massoud

    2013-10-01

    The usefulness of whole-body blood pool imaging as part of Tc-99m methylene diphosphonate (MDP) skeletal scintigraphy in detection of marrow infiltrative processes and unexpected soft-tissue and visceral abnormalities is demonstrated via illustrative case examples. Technical aspects of this simple and fast scanning technique are also highlighted.

  7. Utility of the SPECT Tc-99m labeled RBC blood pool scan in the detection of hepatic hemangiomas

    SciTech Connect

    Guze, B.H.; Hawkins, R.A.

    1989-11-01

    The sensitivity of SPECT imaging of hepatic blood pool activity using Tc-99m labeled RBCs was contrasted with magnetic resonance and CT imaging in 22 cases. SPECT is a noninvasive technique with a high sensitivity for the diagnosis of hepatic hemangiomas. It is helpful for clarifying equivocal magnetic resonance imaging results.

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

    Low load blood flow restricted resistance exercise (LBFR) causes muscle hypertrophy that may be stimulated by the local ischemic environment created by the cuff pressure. However, local blood flow (BF) during such exercise is not well understood. PURPOSE: To characterize femoral artery BF and cardiac output (CO) during leg press exercise (LP) performed at a high load (HL) and low load (LL) with different levels of cuff pressure. METHODS: Eleven subjects (men/women 4/7, age 31.4+/-12.8 y, weight 68.9+/-13.2 kg, mean+/-SD) performed 3 sets of supine left LP to fatigue with 90 s of rest in 4 conditions: HL (%1-RM/cuff pressure: 80%/0); LL (20%/0); LBFR(sub DBP) (20%/1.3 x diastolic blood pressure, BP); LBFR(sub SBP) (20%/1.3 x supine systolic BP). The cuff remained inflated throughout the LBFR exercise sessions. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using Doppler ultrasound at rest and immediately after each set of exercise. Heart rate (HR) was monitored using a 3-lead ECG. BF was calculated as VTI x vessel cross-sectional area. CO was calculated as HR x SV. The data obtained after each set of exercise were averaged and used for analyses. Multi-level modeling was used to determine the effect of exercise condition on dependent variables. Statistical significance was set a priori at p< 0.05. RESULTS: Artery diameter did not change from baseline. BF increased (p<0.05) after exercise in each condition except LBFR(sub SBP) in the order of HL (12.73+/-1.42 cm3,mean+/-SE) > LL (9.92+/-0.82 cm3) > LBFR(sub dBP)(6.47+/-0.79 cm3) > LBFR(sub SBP) (3.51+/-0.59 cm3). Blunted exercise induced increases occurred in HR, SV, and CO after LBFR compared to HL and LL. HR increased 45% after HL and LL and 28% after LBFR (p<0.05), but SV increased (p<0.05) only after HL. Consequently, the increase (p<0.05) in CO was greater in HL and LL (approximately 3 L/min) than in LBFR (approximately 1 L/min). CONCLUSION: BF during LBFR(sub SBP) was 1/3 of

  9. Effective High-Throughput Blood Pooling Strategy before DNA Extraction for Detection of Malaria in Low-Transmission Settings

    PubMed Central

    Nyunt, Myat Htut; Kyaw, Myat Phone; Thant, Kyaw Zin; Shein, Thinzer; Han, Soe Soe; Zaw, Ni Ni; Han, Jin-Hee; Lee, Seong-Kyun; Muh, Fauzi; Kim, Jung-Yeon; Cho, Shin-Hyeong; Lee, Sang-Eun; Yang, Eun-Jeong; Chang, Chulhun L.; Han, Eun-Taek

    2016-01-01

    In the era of (pre) elimination setting, the prevalence of malaria has been decreasing in most of the previously endemic areas. Therefore, effective cost- and time-saving validated pooling strategy is needed for detection of malaria in low transmission settings. In this study, optimal pooling numbers and lowest detection limit were assessed using known density samples prepared systematically, followed by genomic DNA extraction and nested PCR. Pooling strategy that composed of 10 samples in 1 pool, 20 µl in 1 sample, was optimal, and the parasite density as low as 2 p/µl for both falciparum and vivax infection was enough for detection of malaria. This pooling method showed effectiveness for handling of a huge number of samples in low transmission settings (<9% positive rate). The results indicated that pooling of the blood samples before DNA extraction followed by usual nested PCR is useful and effective for detection of malaria in screening of hidden cases in low-transmission settings. PMID:27417078

  10. Analyses of cardiac blood cells and serum proteins with regard to cause of death in forensic autopsy cases.

    PubMed

    Quan, Li; Ishikawa, Takaki; Michiue, Tomomi; Li, Dong-Ri; Zhao, Dong; Yoshida, Chiemi; Chen, Jian-Hua; Komatsu, Ayumi; Azuma, Yoko; Sakoda, Shigeki; Zhu, Bao-Li; Maeda, Hitoshi

    2009-04-01

    To investigate hematological and serum protein profiles of cadaveric heart blood with regard to the cause of death, serial forensic autopsy cases (n=308, >18 years of age, within 48 h postmortem) were examined. Red blood cells (Rbc), hemoglobin (Hb), platelets (Plt), white blood cells (Wbc), total protein (TP) and albumin (Alb) were examined in bilateral cardiac blood. Blood cell counts, collected after turning the bodies at autopsy, approximated to the clinical values. Postmortem changes were not significant for these markers. In non-head blunt injury cases, Rbc counts, Hb, TP and Alb levels in bilateral cardiac blood were lower in subacute deaths (survival time, 1-12 h) than in acute deaths (survival time <1 h). Wbc counts of left cardiac blood were significantly higher for non-head injury than for head injury in subacute deaths. In fire fatality cases, Plt count was markedly higher with an automated hematology analyzer than by using a blood smear test, suggesting Rbc fragmentation caused by deep burns, while increases in Wbc count and decreases in Alb levels were seen for subacute deaths. For asphyxiation, Rbc count, Hb, TP and Alb levels in bilateral cardiac blood were higher than other groups, and TP and Alb levels in the right cardiac blood were higher for hanging than for strangulation. These findings suggest that analyses of blood cells and proteins are useful for investigating the cause of death.

  11. Stability of echogenic liposomes as a blood pool ultrasound contrast agent in a physiologic flow phantom.

    PubMed

    Radhakrishnan, Kirthi; Haworth, Kevin J; Huang, Shao-Ling; Klegerman, Melvin E; McPherson, David D; Holland, Christy K

    2012-11-01

     vivo investigations will be needed to evaluate the optimal usage of ELIP as blood pool contrast agents.

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

    PubMed Central

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

    2016-01-01

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

  13. The Case for a Conservative Approach to Blood Transfusion Management in Cardiac Surgery.

    PubMed

    Gunn, Tyler; Paone, Gaetano; Emery, Robert W; Ferraris, Victor A

    2016-01-01

    Limiting blood transfusion in cardiac operations is a well-meaning goal of perioperative care. Potential benefits include decreasing morbidity and limiting procedural costs. It is difficult to identify transfusion as the cause of adverse outcomes. The need for transfusion may identify a sicker patient population at greater risk for a worse outcome that may or may not be related to the transfusion. We reviewed the indications for and adverse effects of blood transfusion in patients undergoing cardiac procedures to provide a balanced approach to management of blood resources in this population. We reviewed current literature, including systematic reviews and practice guidelines, to synthesize a practice management plan in patients having cardiac operations. Several prospective randomized studies and large population cohort studies compared a postoperative restrictive transfusion policy to a more liberal policy and found very little difference in outcomes but decreased costs with a restrictive policy. Evidence-based practice guidelines and implementation standards provide robust intervention plans that can limit harmful effects of transfusion and provide safe and effective procedure outcomes. A restrictive transfusion policy seems to be safe and effective but does not necessarily provide better outcome in most patient cohorts. The implications of these findings suggest that many discretionary transfusions could be avoided. A subset of high-risk patients could undoubtedly benefit from a more liberal transfusion policy, but the definition of high risk is ill defined. PMID:27532302

  14. ECG-gated blood pool tomography in the determination of left ventricular volume, ejection fraction, and wall motion

    SciTech Connect

    Underwood, S.R.; Ell, P.J.; Jarritt, P.H.; Emanuel, R.W.; Swanton, R.H.

    1984-01-01

    ECG-gated blood pool tomography promises to provide a ''gold standard'' for noninvasive measurement of left ventricular volume, ejection fraction, and wall motion. This study compares these measurements with those from planar radionuclide imaging and contrast ventriculography. End diastolic and end systolic blood pool images were acquired tomographically using an IGE400A rotating gamma camera and Star computer, and slices were reconstructed orthogonal to the long axis of the heart. Left ventricular volume was determined by summing the areas of the slices, and wall motion was determined by comparison of end diastolic and end systolic contours. In phantom experiments this provided an accurate measurement of volume (r=0.98). In 32 subjects who were either normal or who had coronary artery disease left ventricular volume (r=0.83) and ejection fraction (r=0.89) correlated well with those using a counts based planar technique. In 16 of 18 subjects who underwent right anterior oblique X-ray contrast ventriculography, tomographic wall motion agreed for anterior, apical, and inferior walls, but abnormal septal motion which was not apparent by contrast ventriculography, was seen in 12 subjects tomographically. All 12 had disease of the left anterior descending coronary artery and might have been expected to have abnormal septal motion. ECG-gated blood pool tomography can thus determine left ventricular volume and ejection fraction accurately, and provides a global description of wall motion in a way that is not possible from any single planar image.

  15. Magnitude of Morning Surge in Blood Pressure Is Associated with Sympathetic but Not Cardiac Baroreflex Sensitivity.

    PubMed

    Johnson, Aaron W; Hissen, Sarah L; Macefield, Vaughan G; Brown, Rachael; Taylor, Chloe E

    2016-01-01

    The ability of the arterial baroreflex to regulate blood pressure may influence the magnitude of the morning surge in blood pressure (MSBP). The aim was to investigate the relationships between sympathetic and cardiac baroreflex sensitivity (BRS) and the morning surge. Twenty-four hour ambulatory blood pressure was recorded in 14 young individuals. The morning surge was defined via the pre-awakening method, which is calculated as the difference between mean blood pressure values 2 h before and 2 h after rising from sleep. The mean systolic morning surge, diastolic morning surge, and morning surge in mean arterial pressures were 15 ± 2, 13 ± 1, and 11 ± 1 mmHg, respectively. During the laboratory protocol, continuous measurements of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) were made over a 10-min period of rest. Sympathetic BRS was quantified by plotting MSNA burst incidence against diastolic pressure (sympathetic BRSinc), and by plotting total MSNA against diastolic pressure (sympathetic BRStotal). Cardiac BRS was quantified using the sequence method. The mean values for sympathetic BRSinc, sympathetic BRStotal and cardiac BRS were -1.26 ± 0.26 bursts/100 hb/mmHg, -1.60 ± 0.37 AU/beat/mmHg, and 13.1 ± 1.5 ms/mmHg respectively. Significant relationships were identified between sympathetic BRSinc and the diastolic morning surge (r = 0.62, p = 0.02) and the morning surge in mean arterial pressure (r = 0.57, p = 0.03). Low sympathetic BRS was associated with a larger morning surge in mean arterial and diastolic blood pressure. Trends for relationships were identified between sympathetic BRStotal and the diastolic morning surge (r = 0.52, p = 0.066) and the morning surge in mean arterial pressure (r = 0.48, p = 0.095) but these did not reach significance. There were no significant relationships between cardiac BRS and the morning surge. These findings indicate that the ability of the baroreflex to buffer increases in blood pressure

  16. Magnitude of Morning Surge in Blood Pressure Is Associated with Sympathetic but Not Cardiac Baroreflex Sensitivity

    PubMed Central

    Johnson, Aaron W.; Hissen, Sarah L.; Macefield, Vaughan G.; Brown, Rachael; Taylor, Chloe E.

    2016-01-01

    The ability of the arterial baroreflex to regulate blood pressure may influence the magnitude of the morning surge in blood pressure (MSBP). The aim was to investigate the relationships between sympathetic and cardiac baroreflex sensitivity (BRS) and the morning surge. Twenty-four hour ambulatory blood pressure was recorded in 14 young individuals. The morning surge was defined via the pre-awakening method, which is calculated as the difference between mean blood pressure values 2 h before and 2 h after rising from sleep. The mean systolic morning surge, diastolic morning surge, and morning surge in mean arterial pressures were 15 ± 2, 13 ± 1, and 11 ± 1 mmHg, respectively. During the laboratory protocol, continuous measurements of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) were made over a 10-min period of rest. Sympathetic BRS was quantified by plotting MSNA burst incidence against diastolic pressure (sympathetic BRSinc), and by plotting total MSNA against diastolic pressure (sympathetic BRStotal). Cardiac BRS was quantified using the sequence method. The mean values for sympathetic BRSinc, sympathetic BRStotal and cardiac BRS were −1.26 ± 0.26 bursts/100 hb/mmHg, −1.60 ± 0.37 AU/beat/mmHg, and 13.1 ± 1.5 ms/mmHg respectively. Significant relationships were identified between sympathetic BRSinc and the diastolic morning surge (r = 0.62, p = 0.02) and the morning surge in mean arterial pressure (r = 0.57, p = 0.03). Low sympathetic BRS was associated with a larger morning surge in mean arterial and diastolic blood pressure. Trends for relationships were identified between sympathetic BRStotal and the diastolic morning surge (r = 0.52, p = 0.066) and the morning surge in mean arterial pressure (r = 0.48, p = 0.095) but these did not reach significance. There were no significant relationships between cardiac BRS and the morning surge. These findings indicate that the ability of the baroreflex to buffer increases in blood

  17. Magnitude of Morning Surge in Blood Pressure Is Associated with Sympathetic but Not Cardiac Baroreflex Sensitivity

    PubMed Central

    Johnson, Aaron W.; Hissen, Sarah L.; Macefield, Vaughan G.; Brown, Rachael; Taylor, Chloe E.

    2016-01-01

    The ability of the arterial baroreflex to regulate blood pressure may influence the magnitude of the morning surge in blood pressure (MSBP). The aim was to investigate the relationships between sympathetic and cardiac baroreflex sensitivity (BRS) and the morning surge. Twenty-four hour ambulatory blood pressure was recorded in 14 young individuals. The morning surge was defined via the pre-awakening method, which is calculated as the difference between mean blood pressure values 2 h before and 2 h after rising from sleep. The mean systolic morning surge, diastolic morning surge, and morning surge in mean arterial pressures were 15 ± 2, 13 ± 1, and 11 ± 1 mmHg, respectively. During the laboratory protocol, continuous measurements of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) were made over a 10-min period of rest. Sympathetic BRS was quantified by plotting MSNA burst incidence against diastolic pressure (sympathetic BRSinc), and by plotting total MSNA against diastolic pressure (sympathetic BRStotal). Cardiac BRS was quantified using the sequence method. The mean values for sympathetic BRSinc, sympathetic BRStotal and cardiac BRS were −1.26 ± 0.26 bursts/100 hb/mmHg, −1.60 ± 0.37 AU/beat/mmHg, and 13.1 ± 1.5 ms/mmHg respectively. Significant relationships were identified between sympathetic BRSinc and the diastolic morning surge (r = 0.62, p = 0.02) and the morning surge in mean arterial pressure (r = 0.57, p = 0.03). Low sympathetic BRS was associated with a larger morning surge in mean arterial and diastolic blood pressure. Trends for relationships were identified between sympathetic BRStotal and the diastolic morning surge (r = 0.52, p = 0.066) and the morning surge in mean arterial pressure (r = 0.48, p = 0.095) but these did not reach significance. There were no significant relationships between cardiac BRS and the morning surge. These findings indicate that the ability of the baroreflex to buffer increases in blood

  18. Utilisation of Blood Components in Cardiac Surgery: A Single-Centre Retrospective Analysis with Regard to Diagnosis-Related Procedures

    PubMed Central

    Geissler, Raoul Georg; Rotering, Heinrich; Buddendick, Hubert; Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Kwiecien, Robert; Sibrowski, Walter; Scheld, Hans H.; Martens, Sven; Schlenke, Peter

    2015-01-01

    Background More blood components are required in cardiac surgery than in most other medical disciplines. The overall blood demand may increase as a function of the total number of cardiothoracic and vascular surgical interventions and their level of complexity, and also when considering the demographic ageing. Awareness has grown with respect to adverse events, such as transfusion-related immunomodulation by allogeneic blood supply, which can contribute to morbidity and mortality. Therefore, programmes of patient blood management (PBM) have been implemented to avoid unnecessary blood transfusions and to standardise the indication of blood transfusions more strictly with aim to improve patients' overall outcomes. Methods A comprehensive retrospective analysis of the utilisation of blood components in the Department of Cardiac Surgery at the University Hospital of Münster (UKM) was performed over a 4-year period. Based on a medical reporting system of all medical disciplines, which was established as part of a PBM initiative, all transfused patients in cardiac surgery and their blood components were identified in a diagnosis- and medical procedure-related system, which allows the precise allocation of blood consumption to interventional procedures in cardiac surgery, such as coronary or valve surgery. Results This retrospective single centre study included all in-patients in cardiac surgery at the UKM from 2009 to 2012, corresponding to a total of 1,405-1,644 cases per year. A blood supply was provided for 55.6-61.9% of the cardiac surgery patients, whereas approximately 9% of all in-patients at the UKM required blood transfusions. Most of the blood units were applied during cardiac valve surgery and during coronary surgery. Further surgical activities with considerable use of blood components included thoracic surgery, aortic surgery, heart transplantations and the use of artificial hearts. Under the measures of PBM in 2012 a noticeable decrease in the number of

  19. In vivo interactions between cobalt or ferric compounds and the pools of sulphide in the blood during and after H2S poisoning.

    PubMed

    Haouzi, Philippe; Sonobe, Takashi; Torsell-Tubbs, Nicole; Prokopczyk, Bogdan; Chenuel, Bruno; Klingerman, Candice M

    2014-10-01

    Hydrogen sulphide (H2S), a chemical hazard in oil and gas production, has recently become a dreadful method of suicide, posing specific risks and challenges for the first responders. Currently, there is no proven effective treatment against H2S poisoning and its severe neurological, respiratory or cardiac after-effects. We have recently described that H2S is present in various compartments, or pools, in the body during sulphide exposure, which have different levels of toxicity. The general goals of our study were to (1) determine the concentrations and kinetics of the various pools of hydrogen sulphide in the blood, i.e., gaseous (CgH2S) versus total sulphide, i.e., reacting with monobromobimane (CMBBH2S), during and following H2S exposure in a small and large mammal and (2) establish the interaction between the pools of H2S and a methemoglobin (MetHb) solution or a high dose of hydroxocobalamin (HyCo). We found that CgH2S during and following H2S infusion was similar in sedated sheep and rats at any given rate of infusion/kg and provoked symptoms, i.e., hyperpnea and apnea, at the same CgH2S. After H2S administration was stopped, CgH2S disappeared within 1 min. CMBBH2S also dropped to 2-3μM, but remained above baseline levels for at least 30 min. Infusion of a MetHb solution during H2S infusion produced an immediate reduction in the free/soluble pool of H2S only, whereas CMBBH2S increased by severalfold. HyCo (70 mg/kg) also decreased the concentrations of free/soluble H2S to almost zero; CgH2S returned to pre-HyCo levels within a maximum of 20 min, if H2S infusion is maintained. These results are discussed in the context of a relevant scenario, wherein antidotes can only be administered after H2S exposure.

  20. In Vivo Interactions Between Cobalt or Ferric Compounds and the Pools of Sulphide in the Blood During and After H2S Poisoning

    PubMed Central

    Haouzi, Philippe; Sonobe, Takashi; Torsell-Tubbs, Nicole; Prokopczyk, Bogdan; Chenuel, Bruno; Klingerman, Candice M.

    2014-01-01

    Hydrogen sulphide (H2S), a chemical hazard in oil and gas production, has recently become a dreadful method of suicide, posing specific risks and challenges for the first responders. Currently, there is no proven effective treatment against H2S poisoning and its severe neurological, respiratory or cardiac after-effects. We have recently described that H2S is present in various compartments, or pools, in the body during sulphide exposure, which have different levels of toxicity. The general goals of our study were to (1) determine the concentrations and kinetics of the various pools of hydrogen sulphide in the blood, i.e., gaseous (CgH2S) versus total sulphide, i.e., reacting with monobromobimane (CMBBH2S), during and following H2S exposure in a small and large mammal and (2) establish the interaction between the pools of H2S and a methemoglobin (MetHb) solution or a high dose of hydroxocobalamin (HyCo). We found that CgH2S during and following H2S infusion was similar in sedated sheep and rats at any given rate of infusion/kg and provoked symptoms, i.e., hyperpnea and apnea, at the same CgH2S. After H2S administration was stopped, CgH2S disappeared within 1 min. CMBBH2S also dropped to 2–3μM, but remained above baseline levels for at least 30 min. Infusion of a MetHb solution during H2S infusion produced an immediate reduction in the free/soluble pool of H2S only, whereas CMBBH2S increased by severalfold. HyCo (70 mg/kg) also decreased the concentrations of free/soluble H2S to almost zero; CgH2S returned to pre-HyCo levels within a maximum of 20 min, if H2S infusion is maintained. These results are discussed in the context of a relevant scenario, wherein antidotes can only be administered after H2S exposure. PMID:25015662

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

    PubMed Central

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

    2016-01-01

    Background Perioperative red blood cell transfusions (RBC) are associated with increased morbidity and mortality after cardiac surgery. Acute normovolemic hemodilution (ANH) is recommended to reduce perioperative transfusions; however, supporting data are limited and conflicting. We describe the relationship between ANH and RBC transfusions after cardiac surgery using a multi-center registry. Methods We analyzed 13,534 patients undergoing cardiac surgery between 2010 and 2014 at any of the 26 hospitals participating in a prospective cardiovascular perfusion database. The volume of ANH (no ANH, <400mL, 400–799mL, ≥800mL) was recorded and linked to each center’s surgical data. We report adjusted relative risks reflecting the association between the use and amount of ANH and the risk of perioperative RBC transfusion. Results were adjusted for preoperative risk factors, procedure, BSA, preoperative HCT, and center. Results ANH was used in 17% of the patients. ANH was associated with a reduction in RBC transfusions (RRadj 0.74, p <0.001). Patients having ≥800mL of ANH had the most profound reduction in RBC transfusions (RRadj 0.57, p<0.001). Platelet and plasma transfusions were also significantly lower with ANH. The ANH population had superior postoperative morbidity and mortality compared to the no ANH population. Conclusions There is a significant association between ANH and reduced perioperative RBC transfusion in cardiac surgery. Transfusion reduction is most profound with larger volumes of ANH. Our findings suggest the volume of ANH, rather than just its use, may be an important feature of a center’s blood conservation strategy. PMID:26206721

  2. Correlation-based discrimination between cardiac tissue and blood for segmentation of 3D echocardiographic images

    NASA Astrophysics Data System (ADS)

    Saris, Anne E. C. M.; Nillesen, Maartje M.; Lopata, Richard G. P.; de Korte, Chris L.

    2013-03-01

    Automated segmentation of 3D echocardiographic images in patients with congenital heart disease is challenging, because the boundary between blood and cardiac tissue is poorly defined in some regions. Cardiologists mentally incorporate movement of the heart, using temporal coherence of structures to resolve ambiguities. Therefore, we investigated the merit of temporal cross-correlation for automated segmentation over the entire cardiac cycle. Optimal settings for maximum cross-correlation (MCC) calculation, based on a 3D cross-correlation based displacement estimation algorithm, were determined to obtain the best contrast between blood and myocardial tissue over the entire cardiac cycle. Resulting envelope-based as well as RF-based MCC values were used as additional external force in a deformable model approach, to segment the left-ventricular cavity in entire systolic phase. MCC values were tested against, and combined with, adaptive filtered, demodulated RF-data. Segmentation results were compared with manually segmented volumes using a 3D Dice Similarity Index (3DSI). Results in 3D pediatric echocardiographic images sequences (n = 4) demonstrate that incorporation of temporal information improves segmentation. The use of MCC values, either alone or in combination with adaptive filtered, demodulated RF-data, resulted in an increase of the 3DSI in 75% of the cases (average 3DSI increase: 0.71 to 0.82). Results might be further improved by optimizing MCC-contrast locally, in regions with low blood-tissue contrast. Reducing underestimation of the endocardial volume due to MCC processing scheme (choice of window size) and consequential border-misalignment, could also lead to more accurate segmentations. Furthermore, increasing the frame rate will also increase MCC-contrast and thus improve segmentation.

  3. Effect of bilateral carotid body resection on cardiac baroreflex control of blood pressure during hypoglycemia.

    PubMed

    Limberg, Jacqueline K; Taylor, Jennifer L; Mozer, Michael T; Dube, Simmi; Basu, Ananda; Basu, Rita; Rizza, Robert A; Curry, Timothy B; Joyner, Michael J; Wehrwein, Erica A

    2015-06-01

    Hypoglycemia results in a reduction in cardiac baroreflex sensitivity and a shift in the baroreflex working range to higher heart rates. This effect is mediated, in part, by the carotid chemoreceptors. Therefore, we hypothesized hypoglycemia-mediated changes in baroreflex control of heart rate would be blunted in carotid body-resected patients when compared with healthy controls. Five patients with bilateral carotid body resection for glomus tumors and 10 healthy controls completed a 180-minute hyperinsulinemic, hypoglycemic (≈3.3 mmol/L) clamp. Changes in heart rate, blood pressure, and spontaneous cardiac baroreflex sensitivity were assessed. Baseline baroreflex sensitivity was not different between groups (P>0.05). Hypoglycemia resulted in a reduction in baroreflex sensitivity in both the groups (main effect of time, P<0.01) and responses were lower in resected patients when compared with controls (main effect of group, P<0.05). Hypoglycemia resulted in large reductions in systolic (-17±7 mm Hg) and mean (-14±5 mm Hg) blood pressure in resected patients that were not observed in controls (interaction of group and time, P<0.05). Despite lower blood pressures, increases in heart rate with hypoglycemia were blunted in resected patients (interaction of group and time, P<0.01). Major novel findings from this study demonstrate that intact carotid chemoreceptors are essential for increasing heart rate and maintaining arterial blood pressure during hypoglycemia in humans. These data support a contribution of the carotid chemoreceptors to blood pressure control and highlight the potential widespread effects of carotid body resection in humans.

  4. The effect of induced hypocalcaemia on the cardiac output and blood pressure of dairy cattle.

    PubMed

    Daniel, R C; Moodie, E W

    1978-05-01

    A mean reduction of plasma calcium level to 51 per cent of normal infusion of 4.7 per cent Na2EDTA solution into four cows was associated with a mean reduction of 48 per cent in cardiac output. Hypocalcaemia sufficient to produce sternal recumbency in a further four cows resulted in a highly significant fall in the mean arterial blood pressure, which returned to normal immediately after treatment with an intravenous infusion of 350 ml of 32.5 per cent calcium borogluconate.

  5. Postoperative blood transfusion is an independent predictor of acute kidney injury in cardiac surgery patients

    PubMed Central

    Freeland, Kristofer; Hamidian Jahromi, Alireza; Duvall, Lucas Maier; Mancini, Mary Catherine

    2015-01-01

    Background: Acute kidney injury (AKI) is a serious complication of cardiac surgery with cardiopulmonary bypass (CPB) which increases postoperative morbidity and mortality. Objectives: The study was designed to assess the incidence of AKI and associated risk factors in patients undergoing CPB ancillary to coronary artery bypass grafting (CABG), valve surgery, and combined CABG and valve surgery. Patients and Methods: This Intuitional Review Board (IRB) approved retrospective study included patients with normal preoperative kidney function (Serum creatinine [sCr] <2.0 mg/dl) who underwent cardiac surgery with CPB between 2012 and 2014. Patients were divided into 2 groups: group I: Patients with cardiac surgery associated AKI (CS-AKI) (postoperative sCr >2 mg/dl with a minimal doubling of baseline sCr) and group II: Patients with a normal postoperative kidney function. Demographic data, body mass index (BMI), co-morbidities, hematologic/biochemical profiles, preoperative ejection fraction (%EF), blood transfusion history, and operative data were compared between the groups. Mean arterial pressure (MAP) was recorded during the operation and in the postoperative period. Δ-MAP was defined as the difference between pre-CPB-MAP and the CPB-MAP. Results: 241 patients matched the inclusion criteria (CS-AKI incidence = 8.29%). Age, gender, BMI, %EF, and co-morbidities were not predictors of CS-AKI (P > 0.05). High preoperative sCr (P = 0.047), type of procedure (P = 0.04), clamp time (P = 0.003), pump time (P = 0.005) and history of blood transfusion within 14 days postsurgery (P = 0.0004) were associated with risk of CS-AKI. Pre-CPB-MAP, CPB-MAP, Δ-MAP, and ICU-MAP were not significantly different between the 2 groups. Male gender (OR: 5.53; P = 0.048), age>60 (OR: 4.54; P = 0.027) and blood transfusion after surgery (OR: 5.25; P = 0.0054) were independent predictors for postoperative AKI. Conclusions: Age, gender and blood transfusion were independent predictors of

  6. Ventricular Assist Devices and Increased Blood Product Utilization for Cardiac Transplantation

    PubMed Central

    Stone, Matthew L.; LaPar, Damien J.; Benrashid, Ehsan; Scalzo, David C.; Ailawadi, Gorav; Kron, Irving L.; Bergin, James D.; Blank, Randal S.; Kern, John A.

    2016-01-01

    Background and Aim of Study The purpose of this study was to examine whether blood product utilization, one-year cell-mediated rejection rates, and mid-term survival significantly differ for ventricular assist device (VAD patients compared to non-VAD (NVAD) patients following cardiac transplantation. Methods From July 2004 to August 2011, 79 patients underwent cardiac transplantation at a single institution. Following exclusion of patients bridged to transplantation with VADs other than the HeartMate II® LVAD (n = 10), patients were stratified by VAD presence at transplantation: VAD patients (n = 35, age: 54.0 [48.0–59.0] years) vs. NVAD patients (n = 34, age: 52.5 [42.8–59.3] years). The primary outcomes of interest were blood product transfusion requirements, one-year cell-mediated rejection rates, and mid-term survival post-transplantation. Results Preoperative patient characteristics were similar for VAD and NVAD patients. NVAD patients presented with higher median preoperative creatinine levels compared to VAD patients (1.3 [1.1–1.6] vs. 1.1 [0.9–1.4], p = 0.004). VAD patients accrued higher intraoperative transfusion of all blood products (all p ≤ 0.001) compared to NVAD patients. The incidence of clinically significant cell-mediated rejection within the first posttransplant year was higher in VAD compared to NVAD patients (66.7% vs. 33.3%, p = 0.02). During a median follow-up period of 3.2 (2.0, 6.3) years, VAD patients demonstrated an increased postoperative mortality that did not reach statistical significance (20.0% vs. 8.8%, p = 0.20). Conclusions During the initial era as a bridge to transplantation, the HeartMate II® LVAD significantly increased blood product utilization and one-year cell-mediated rejection rates for cardiac transplantation. Further study is warranted to optimize anticoagulation strategies and to define causal relationships between these factors for the current era of cardiac transplantation. PMID:25529999

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

    PubMed

    Hitzler, Walter E

    2014-01-01

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

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

    PubMed Central

    Chandrashekar, Shivaram

    2014-01-01

    Background and Objectives: It is well established that Nucleic acid testing (NAT) reduces window phase of transfusion transmissible infections (TTI) and helps improve blood safety. NAT testing can be done individually or in pools. The objectives of this study were to determine the utility, feasibility and cost effectiveness of an in-house minipool-NAT(MP-NAT). Materials and Methods: Blood donors were screened by history, tested by ELISA and sero-negative samples were subjected to an in-house NAT by using reverse transcriptase-polymerase chain reaction (RT-PCR). Testing was done in mini-pools of size eight (8). Positive pools were repeated with individual samples. Results: During the study period of Oct 2005-Sept 2010 (5 years) all blood donors (n=53729) were screened by ELISA. Of which 469 (0.87%) were positive for HIV-1, HBV or HCV. Sero-negative samples (n=53260) were screened by in-house MP-NAT. HIV-NAT yield was 1/53260 (n=1) and HBV NAT yield (n=2) was 1/26630. Conclusion: NAT yield was lower than other India studies possibly due to the lower sero-reactivity amongst our donors. Nevertheless it intercepted 9 lives including the components prepared. The in-house assay met our objective of improving blood safety at nominal cost and showed that it is feasible to set up small molecular biology units in medium-large sized blood banks and deliver blood within 24-48 hours. The utility of NAT (NAT yield) will vary based on the donor population, the type of serological test used, the nature of kit employed and the sensitivity of NAT test used. The limitations of our in-house MP-NAT consisted of stringent sample preparation requirements, with labor and time involved. The benefits of our MP-NAT were that it acted as a second level of check for ELISA tests, was relatively inexpensive compared to ID-NAT and did not need sophisticated equipment. PMID:24678172

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

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  10. Hemodynamic simulation of blood flow in a new type of cardiac assist device named AVICENA.

    PubMed

    Alizadeh, Mansour; Tehrani, Pedram; Rahmani, Shahrokh

    2014-08-01

    The purpose of this study is to investigate the hemodynamic parameters of blood flow in a balloon as a part of a new type of cardiac assist device named AVICENA, which is implanted into the descending aorta to improve the strength of pumping blood flow in a poor-performing left ventricle. Balloon is inflated and deflated during diastole and systole, respectively. The longitudinal velocity of blood flow during balloon inflation and deflation has been considered. Through these investigations, the result reveals that the balloon inflation causes the blood flow to accelerate through the balloon and compensates the blood flow velocity required for the normal circulation system. When the balloon deflates, a reverse flow is generated and improves the perfusion of coronary arteries. Furthermore, the inlet pressure and acting force on the aortic valve for the healthy, unhealthy, and assisted heart have been compared. Result indicates that the force acting on the aortic valve has been considerably reduced for the assisted heart compare to the unhealthy or unassisted heart.

  11. Post-extrasystolic Blood Pressure Potentiation as a Risk Predictor in Cardiac Patients

    PubMed Central

    Steger, Alexander; Sinnecker, Daniel; Barthel, Petra; Müller, Alexander; Gebhardt, Josef; Schmidt, Georg

    2016-01-01

    For more than 100 years physicians have observed that heartbeats following extrasystolic beats are characterised by augmented myocardial contractility. This phenomenon was termed post-extrasystolic potentiation (PESP). In the 1970s it was first noted that PESP measured at the blood pressure level is typically pronounced in heart failure patients. Only recently, it was shown that PESP measured non-invasively as post-extrasystolic blood pressure potentiation was a strong and independent predictor of death in survivors of myocardial infarction and in patients with chronic heart failure. A similar parameter (PESPAfib) can be also assessed in patients with atrial fibrillation. PESP and PESPAfib can be understood as non-invasive parameters that indicate myocardial dysfunction. They have the potential to improve risk stratification strategies for cardiac patients. PMID:27403290

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

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

    PubMed

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

    2014-08-01

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

  14. Human cord blood CD34+ progenitor cells acquire functional cardiac properties through a cell fusion process.

    PubMed

    Avitabile, Daniele; Crespi, Alessia; Brioschi, Chiara; Parente, Valeria; Toietta, Gabriele; Devanna, Paolo; Baruscotti, Mirko; Truffa, Silvia; Scavone, Angela; Rusconi, Francesca; Biondi, Andrea; D'Alessandra, Yuri; Vigna, Elisa; Difrancesco, Dario; Pesce, Maurizio; Capogrossi, Maurizio C; Barbuti, Andrea

    2011-05-01

    The efficacy of cardiac repair by stem cell administration relies on a successful functional integration of injected cells into the host myocardium. Safety concerns have been raised about the possibility that stem cells may induce foci of arrhythmia in the ischemic myocardium. In a previous work (36), we showed that human cord blood CD34(+) cells, when cocultured on neonatal mouse cardiomyocytes, exhibit excitation-contraction coupling features similar to those of cardiomyocytes, even though no human genes were upregulated. The aims of the present work are to investigate whether human CD34(+) cells, isolated after 1 wk of coculture with neonatal ventricular myocytes, possess molecular and functional properties of cardiomyocytes and to discriminate, using a reporter gene system, whether cardiac differentiation derives from a (trans)differentiation or a cell fusion process. Umbilical cord blood CD34(+) cells were isolated by a magnetic cell sorting method, transduced with a lentiviral vector carrying the enhanced green fluorescent protein (EGFP) gene, and seeded onto primary cultures of spontaneously beating rat neonatal cardiomyocytes. Cocultured EGFP(+)/CD34(+)-derived cells were analyzed for their electrophysiological features at different time points. After 1 wk in coculture, EGFP(+) cells, in contact with cardiomyocytes, were spontaneously contracting and had a maximum diastolic potential (MDP) of -53.1 mV, while those that remained isolated from the surrounding myocytes did not contract and had a depolarized resting potential of -11.4 mV. Cells were then resuspended and cultured at low density to identify EGFP(+) progenitor cell derivatives. Under these conditions, we observed single EGFP(+) beating cells that had acquired an hyperpolarization-activated current typical of neonatal cardiomyocytes (EGFP(+) cells, -2.24 ± 0.89 pA/pF; myocytes, -1.99 ± 0.63 pA/pF, at -125 mV). To discriminate between cell autonomous differentiation and fusion, EGFP(+)/CD34

  15. Effects of red cell transfusion on cardiac output and blood flow velocities in cerebral and gastrointestinal arteries in premature infants.

    PubMed Central

    Nelle, M; Höcker, C; Zilow, E P; Linderkamp, O

    1994-01-01

    Anaemia may increase the risk of tissue hypoxia in preterm infants. The effect of transfusion on circulation was studied in 33 preterm infants with a mean (SD) gestational age of 29 (5) weeks (range 26-34), birth weight 1153 (390) g (range 520-1840), and postnatal age of 48 (21) days (range 19-100). Packed cell volume, blood viscosity (capillary viscometer), cardiac output, and cerebral blood flow velocities in the internal carotid artery, anterior cerebral artery, and coeliac trunk (Doppler ultrasound) were determined before and after transfusion of 10 ml/kg of packed red blood cells. Transfusion increased packed cell volume from a mean (SD) 0.27 (0.45) to 0.37 (0.48). Mean arterial blood pressure did not change while heart rate decreased significantly from 161 (14) l/min to 149 (12). Cardiac output decreased from 367 (93) ml/kg/min to 311 (74) due to decrease in stroke volume from 2.28 (0.57) ml/kg to 2.14 (0.46) and in heart rate. There was a significant increase in systemic red cell transport (cardiac output times packed cell volume) by 17%, systemic flow resistance (blood pressure to cardiac output ratio) by 23%, and blood viscosity by 33%. Vascular hindrance (flow resistance to blood viscosity ratio) did not change significantly, thereby suggesting that neither vasoconstriction nor vasodilation occurred with transfusion. After transfusion blood flow velocities decreased significantly in the anterior cerebral artery by 23%, in the internal carotid artery by 8%, and in the coeliac trunk by 12%. Red cell transport estimated as products of blood flow velocities times packed cell volume increased significantly by 25% in the internal carotid artery and by 21% in the coeliac trunk. These results indicate that red cell transfusion improved systemic oxygen transport as well as oxygen transport in the internal carotid artery and coeliac trunk. PMID:8092871

  16. Enhancing Predictive Accuracy of Cardiac Autonomic Neuropathy Using Blood Biochemistry Features and Iterative Multitier Ensembles.

    PubMed

    Abawajy, Jemal; Kelarev, Andrei; Chowdhury, Morshed U; Jelinek, Herbert F

    2016-01-01

    Blood biochemistry attributes form an important class of tests, routinely collected several times per year for many patients with diabetes. The objective of this study is to investigate the role of blood biochemistry for improving the predictive accuracy of the diagnosis of cardiac autonomic neuropathy (CAN) progression. Blood biochemistry contributes to CAN, and so it is a causative factor that can provide additional power for the diagnosis of CAN especially in the absence of a complete set of Ewing tests. We introduce automated iterative multitier ensembles (AIME) and investigate their performance in comparison to base classifiers and standard ensemble classifiers for blood biochemistry attributes. AIME incorporate diverse ensembles into several tiers simultaneously and combine them into one automatically generated integrated system so that one ensemble acts as an integral part of another ensemble. We carried out extensive experimental analysis using large datasets from the diabetes screening research initiative (DiScRi) project. The results of our experiments show that several blood biochemistry attributes can be used to supplement the Ewing battery for the detection of CAN in situations where one or more of the Ewing tests cannot be completed because of the individual difficulties faced by each patient in performing the tests. The results show that AIME provide higher accuracy as a multitier CAN classification paradigm. The best predictive accuracy of 99.57% has been obtained by the AIME combining decorate on top tier with bagging on middle tier based on random forest. Practitioners can use these findings to increase the accuracy of CAN diagnosis.

  17. Imaging the cardiac blood flow during CPR with EBCT in an animal model

    NASA Astrophysics Data System (ADS)

    Recheis, Wolfgang A.; Schuster, Antonius H.; Pallwein-Prettner, Leo; Kleinsasser, Axel; Loeckinger, Alexander; Hoermann, Christoph; zur Nedden, Dieter

    2002-04-01

    There are open questions concerning the hemodynamics during cardiopulmonary resuscitation (CPR). The purpose was to evaluate a model of the blood flow during CPR in specified anatomic regions. After cardiac arrest, one intubated swine under full intensive care supervision was scanned during CPR using an automated resuscitation device. CT scans were performed with an EBCT in the 50ms modus at eight levels, therefore covering most of the heart and pulmonary vessels. 50ml contrast agent was administered with 10ml/sec and a delay of five seconds to visualize the contrast agent passage through the heart and pulmonary circulation. The gray-value changes in previously specified ROIs were directly correlated with the resuscitation device position in respect to the thorax. The effects of CPR on the blood flow could be visualized dynamically by quantifying the contrast enhancement. The increase of gray values could be estimated with different delays, depending on the anatomical situation. The inflow and outflow dependent on thumper dynamics could be estimated. At the onset of contrast medium inflow, turbulence could be visualized in the right ventricle, which are caused by the inhomogeneous contrast medium distribution. Triggered EBCT during CPR offers the opportunity to study regional blood flow depending on chest compression.

  18. Measurement of cardiac output in small laboratory animals using recordings of blood conductivity.

    PubMed

    Vogel, J

    1997-11-01

    No method exists which enables easy, frequent, and, at the same time, reliable cardiac output (CO) measurements in mice. To validate a simple indicator-dilution method suitable for frequent measurements of CO in small laboratory animals, a 5% glucose solution was injected as a bolus into femoral veins of mice and rats. The corresponding blood conductivity was measured continuously between an intra-aortic and a rectal electrode. The resulting conductivity-dilution curves were used to calculate CO in mice during hypervolemia and hypovolemia and in conscious as well as halothane-anesthetized mice and rats. In rats, conductivity-dilution curves and time courses of plasma glucose concentration were recorded simultaneously. Compared with CO in awake animals, CO in both species was slightly, but not significantly, reduced during halothane anesthesia. CO was significantly and gradually reduced in hypovolemic mice (up to 58 ml blood/kg body wt), whereas hypervolemia (23 ml saline/kg body wt) had no significant effect. Simultaneous recordings of conductivity-dilution curves and time courses of plasma glucose concentration yielded corresponding values of CO (P < 0.001). Measurement of blood conductivity appears to be a reliable, simple, and convenient method for quantification of CO in small animals. PMID:9374792

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

    SciTech Connect

    Williams, L.R.

    1994-09-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  1. Hemodynamic and regional blood flow distribution responses to dextran, hydralazine, isoproterenol and amrinone during experimental cardiac tamponade

    SciTech Connect

    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.

  2. Acute hemodynamic effects and blood pool kinetics of polystyrene microspheres following intravenous administration

    SciTech Connect

    Slack, J.D.; Kanke, M.; Simmons, G.H.; DeLuca, P.P.

    1981-06-01

    The acute hemodynamic effect of intravenous administration of polystyrene microspheres was investigated and correlated with their distribution pattern and kinetics. Microspheres of three diameters (3.4, 7.4, and 11.6 micrometer) were administered. The 7.4- and 11.6-micrometer diameter microspheres were filtered by the pulmonary capillary network following intravenous administration, the majority during the first pass. There was no significant hemodynamic effect following administrations of the 7.4- and 11.6-micrometer diameter microspheres in doses as high as 3.0 X 10(9) and 6.1 X 10(8) respectively (total cross-sectional area of 1.3 X 10(11) and 6.4 X 10(10) micrometer2, respectively). Intravenous administration of 3.4-micrometer diameter microspheres produced significant dose-dependent systemic hypotension and depression of myocardial performance at dosages as slow as 1.0 X 10(10) (cross-sectional area of 9.1 X 10(10) micrometer2). These differences in acute hemodynamic effect from the 7.4- and 11.6-micrometer diameter microspheres may be due to the differences in distribution kinetics and fate of the 3.4-micrometer diameter microspheres, which readily pass through the lungs to the spleen. Although elimination of the smaller spheres from the blood during the first 6-8 min was rapid, i.e., t 1/2 . 1.62 and 1.72 min from the venous and arterial blood circulation, respectively, levels of 10(3) spheres/g of blood were present in the circulation for greater than 1 hr. These findings must be considered in the planning of intravenous administration of microspheres as a drug delivery system to target organs.

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

    PubMed

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

    2016-05-30

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

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

    PubMed Central

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

    2016-01-01

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

  5. Measurement of the Red Blood Cell Distribution Width Improves the Risk Prediction in Cardiac Resynchronization Therapy

    PubMed Central

    Boros, András Mihály; Perge, Péter; Jenei, Zsigmond; Karády, Júlia; Zima, Endre; Molnár, Levente; Becker, Dávid; Gellér, László; Prohászka, Zoltán; Merkely, Béla; Széplaki, Gábor

    2016-01-01

    Objectives. Increases in red blood cell distribution width (RDW) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) predict the mortality of chronic heart failure patients undergoing cardiac resynchronization therapy (CRT). It was hypothesized that RDW is independent of and possibly even superior to NT-proBNP from the aspect of long-term mortality prediction. Design. The blood counts and serum NT-proBNP levels of 134 patients undergoing CRT were measured. Multivariable Cox regression models were applied and reclassification analyses were performed. Results. After separate adjustment to the basic model of left bundle branch block, beta blocker therapy, and serum creatinine, both the RDW > 13.35% and NT-proBNP > 1975 pg/mL predicted the 5-year mortality (n = 57). In the final model including all variables, the RDW [HR = 2.49 (1.27–4.86); p = 0.008] remained a significant predictor, whereas the NT-proBNP [HR = 1.18 (0.93–3.51); p = 0.07] lost its predictive value. On addition of the RDW measurement, a 64% net reclassification improvement and a 3% integrated discrimination improvement were achieved over the NT-proBNP-adjusted basic model. Conclusions. Increased RDW levels accurately predict the long-term mortality of CRT patients independently of NT-proBNP. Reclassification analysis revealed that the RDW improves the risk stratification and could enhance the optimal patient selection for CRT. PMID:26903690

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

    PubMed

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

    2006-10-01

    Cardiac output is a determinant of systemic blood flow and its measurement may therefore be a useful indicator of abnormal hemodynamics and tissue oxygen delivery. The purpose of this study was to investigate in very premature newborn infants the relationships between cardiac output (left and right ventricular outputs), systemic blood pressure, peripheral blood flow (PBF) and two indicators of cerebral oxygen delivery (cerebral electrical activity and cerebral fractional oxygen extraction (CFOE)). This was a prospective observational study performed on 40 infants of less than 30 wk gestation. Digital electroencephalograms (EEGs) were recorded for one hour every day during the first four days after birth and subjected to qualitative and quantitative analysis. Left and right ventricular outputs, mean blood pressure (MBP), CFOE, PBF and arterial blood gases were measured at the same time. Within the ranges studied, there was no apparent relationship between left or right ventricular output (RVO), PBF and indicators of cerebral perfusion (cerebral electrical activity and CFOE). The EEG was normal in infants with low left and right ventricular outputs (<150 mL/kg/min) and MBP > 30 mm Hg. Infants with low cardiac output and normal MBP seem able to maintain cerebral perfusion, possibly through vasodilatation of the cerebral microvasculature. PMID:16940235

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

    SciTech Connect

    Lalonde, Michel Wassenaar, Richard; Wells, R. Glenn; Birnie, David; Ruddy, Terrence D.

    2014-07-15

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

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

    SciTech Connect

    Alazraki, N.; Lawrence, P.F.; Syverud, J.B.

    1984-01-01

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

  9. Scintigraphic diagnosis of gastrointestinal bleeding with /sup 99/. mu. Tc-labeled blood-pool agents

    SciTech Connect

    Miskowiak, J.; Nielsen, S.; Munck, O.

    1981-11-01

    Abdominal scintigraphy with /sup 99/..mu..Tc-labeled albumin or red blood cells was used in 68 patients to localize gastrointestinal bleeding or confirm that it had stopped. Acute, active bleeding was identified in 33 patients; characteristic patterns of bleeding from the stomach, biliary passages, small intestine, and colon are shown. Sensitivity was 0.86 (95% confidence limits, 0.57-0.98) and specificity was 1.0 (95% confidence limits, 0.82-1.0) in 33 patients who had scintigraphy and endoscopy performed in succession. Abdominal scintigraphy appears to be a valuable supplement to conventional diagnostic methods. In upper gastrointestinal bleeding, scintigraphy should be considered when endoscopy fails. In lower intestinal bleeding, scintigraphy should be the method of choice.

  10. Echocardiographic evaluation of pulmonary venous blood flow and cardiac function changes during one-lung ventilation

    PubMed Central

    Lee, Su Hyun; Kim, Namo; Kim, Hyun IL; Oh, Young Jun

    2015-01-01

    Objectives: The intra-pulmonary shunt induced by one-lung ventilation (OLV), is alleviated by increased pulmonary blood flow by gravitational redistribution and hypoxic pulmonary vasoconstriction. We investigated the changes of pulmonary venous blood flow (PVBF) and biventricular function during OLV with echocardiography. And the correlation between PVBF and intra-pulmonary shunt fraction (Qs/Qt) was evaluated. Methods: PVBF of the left upper pulmonary vein and cardiac function were measured with echocardiography in twenty-five patients who underwent elective thoracic surgery in left lateral decubitus. Qs/Qt and PaO2 were measured with blood gas analysis. Data was obtained at 10 min after two-lung ventilation in supine (TLV-S) and lateral decubitus position (TLV-L), and at 10, 20 and 30 min after OLV in lateral decubitus position (OLV-10, -20 and -30). Results: There were significant changes in PVBF among TLV-S, TLV-L and OLV-10 (959.5±280.8, 1416.9±489.7 and 1999.9±670.5 ml/min; P<0.05, respectively). There were not differences in PVBF, Qs/Qt and PaO2 among OLV-10, -20 and -30. There were an inverse correlation between percent change of PVBF and change of Qs/Qt (r2 = 0.5; P<0.0001) and positive correlations between the percent change of PVBF and change of PaO2 (r2 = 0.4; P<0.0001) during OLV over TLV-L. No significant changes in biventricular systolic and diastolic function were observed during positional change and OLV. Conclusions: A remarkable change of PVBF relevant to gravitational distribution and hypoxic pulmonary vasoconstriction was proved by echocardiography. And PVBF changes could represent the changes of Qs/Qt and PaO2 during OLV. However, biventricular function was not impaired during OLV. PMID:26550232

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

    PubMed Central

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

    2008-01-01

    Background and objectives: Optimal hemoglobin targets for chronic kidney disease patients receiving erythropoiesis-stimulating agents remain controversial. The effects of different hemoglobin targets on blood transfusion requirements have not been well characterized, despite their relevance to clinical decision-making. Design, setting, participants, & measurements: Five hundred ninety-six incident hemodialysis patients without symptomatic cardiac disease were randomly assigned to hemoglobin targets of 9.5 to 11.5 g/dl or 13.5 to 14.5 g/dl for 96 wk using epoetin alfa as primary therapy and changes in left ventricular structure as the primary outcome (previously reported). Patients were masked to treatment assignment. Blood transfusion data were prospectively collected at 4-wk intervals. Results: The mean age and prior duration of dialysis therapy of the study population were 50.8 and 0.8 yr, respectively. Previously reported mortality was similar in low and high-target subjects, at 4.7 (95% confidence interval 3.0, 7.3) and 3.1 (1.8, 5.4) per hundred patient years, respectively. Transfusion rates were 0.66 (0.59, 0.74) units of blood per year in low and 0.26 (0.22, 0.32) in high-target subjects (P < 0.0001). Hemoglobin level at transfusion (7.7 [7.5, 7.9]) versus 8.1 [7.6, 8.5] g/dl) were similar with both groups. High hemoglobin target was a significant predictor of time to first transfusion independent of baseline associations (hazard ratio = 0.42; 95% confidence interval = 0.26 − 0.67). Conclusions: In hemodialysis patients with comparatively low mortality risks, normal hemoglobin targets may reduce the need for transfusions. PMID:18922988

  12. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients

    PubMed Central

    Kim, Youn-Jung; Lee, You Jin; Ryoo, Seung Mok; Sohn, Chang Hwan; Ahn, Shin; Seo, Dong-Woo; Lim, Kyoung Soo; Kim, Won Young

    2016-01-01

    Abstract To determine the relationship between acid–base findings, such as pH, pCO2, and serum lactate levels, obtained immediately after starting cardiopulmonary resuscitation and the return of spontaneous circulation (ROSC). A prospective observational study of adult, nontraumatic out-of-hospital cardiac arrest (OHCA) patients was conducted at an urban academic teaching institution between April 1, 2013 and March 31, 2015. Arterial blood sample for acid–base data was taken from all OHCA patients on arrival to the emergency department. Of 224 OHCA patients, 88 patients with unavailable blood samples or delayed blood sampling or ROSC within 4 minutes were excluded, leaving 136 patients for analysis. The pH in the ROSC group was significantly higher than in the non-ROSC group (6.96 vs. 6.85; P = 0.009). pCO2 and lactate levels in the ROSC group were significantly lower than those in the non-ROSC group (74.0 vs. 89.5 mmHg, P < 0.009; 11.6 vs. 13.6 mmol/L, P = 0.044, respectively). In a multivariate regression analysis, pCO2 was the only independent biochemical predictor for sustained ROSC (OR 0.979; 95% CI 0.960–0.997; P = 0.025) and pCO2 of <75 mmHg was 3.3 times more likely to achieve ROSC (OR 0.302; 95% CI 0.146–0.627; P = 0.001). pCO2 levels obtained during cardiopulmonary resuscitation on ER arrival was associated with ROSC in OHCA patients. It might be a potentially marker for reflecting the status of the ischemic insult. These preliminary results need to be confirmed in a larger population. PMID:27336894

  13. Therapeutic options to minimize allogeneic blood transfusions and their adverse effects in cardiac surgery: A systematic review

    PubMed Central

    dos Santos, Antônio Alceu; da Silva, José Pedro; da Silva, Luciana da Fonseca; de Sousa, Alexandre Gonçalves; Piotto, Raquel Ferrari; Baumgratz, José Francisco

    2014-01-01

    Introdution Allogeneic blood is an exhaustible therapeutic resource. New evidence indicates that blood consumption is excessive and that donations have decreased, resulting in reduced blood supplies worldwide. Blood transfusions are associated with increased morbidity and mortality, as well as higher hospital costs. This makes it necessary to seek out new treatment options. Such options exist but are still virtually unknown and are rarely utilized. Objective To gather and describe in a systematic, objective, and practical way all clinical and surgical strategies as effective therapeutic options to minimize or avoid allogeneic blood transfusions and their adverse effects in surgical cardiac patients. Methods A bibliographic search was conducted using the MeSH term “Blood Transfusion” and the terms “Cardiac Surgery” and “Blood Management.” Studies with titles not directly related to this research or that did not contain information related to it in their abstracts as well as older studies reporting on the same strategies were not included. Results Treating anemia and thrombocytopenia, suspending anticoagulants and antiplatelet agents, reducing routine phlebotomies, utilizing less traumatic surgical techniques with moderate hypothermia and hypotension, meticulous hemostasis, use of topical and systemic hemostatic agents, acute normovolemic hemodilution, cell salvage, anemia tolerance (supplementary oxygen and normothermia), as well as various other therapeutic options have proved to be effective strategies for reducing allogeneic blood transfusions. Conclusion There are a number of clinical and surgical strategies that can be used to optimize erythrocyte mass and coagulation status, minimize blood loss, and improve anemia tolerance. In order to decrease the consumption of blood components, diminish morbidity and mortality, and reduce hospital costs, these treatment strategies should be incorporated into medical practice worldwide. PMID:25714216

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

    PubMed

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

    2014-08-22

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

  15. Blood pressure lowering, vasodilator and cardiac-modulatory potential of Carum roxburghianum seed extract.

    PubMed

    Khan, Munasib; Khan, Arif-ullah; Najeeb-ur-Rehman; Gilani, Anwarul-Hassan

    2015-01-01

    In current study, we describe blood pressure (BP)-lowering, endothelium-dependent, and independent vasodilator and cardio-modulatory actions of Carum roxburghianum seed. The crude extract of C. roxburghianum seed (Cr.Cr) induced dose-dependent (10-100 mg/kg) fall in arterial BP of anaesthetized rats. In isolated rabbit aorta, Cr.Cr (0.3-10 mg/mL) inhibited high K+ (80 mM) and phenylephrine (PE, 1 µM)-induced contractions, like verapamil and papaverine. In endothelium-intact rat aortic preparations, Nω-nitro-L-arginine methyl ester hydrochloride-sensitive vasodilator activity was observed with Cr.Cr, which also relaxed endothelium-denuded aorta tissues. In guinea-pig atria, Cr.Cr initially caused mild cardiac stimulation, followed by inhibition, as shown by papaverine. These results reveal that cardiovascular effects of C. roxburghianum seed extract are mediated possibly through combination of Ca++ antagonist, nitric oxide modulating and phosphodiesterase inhibitory mechanisms, though further in-depth studies are required for elucidating precise mode of action.

  16. Blood pressure lowering, vasodilator and cardiac-modulatory potential of Carum roxburghianum seed extract.

    PubMed

    Khan, Munasib; Khan, Arif-ullah; Najeeb-ur-Rehman; Gilani, Anwarul-Hassan

    2015-01-01

    In current study, we describe blood pressure (BP)-lowering, endothelium-dependent, and independent vasodilator and cardio-modulatory actions of Carum roxburghianum seed. The crude extract of C. roxburghianum seed (Cr.Cr) induced dose-dependent (10-100 mg/kg) fall in arterial BP of anaesthetized rats. In isolated rabbit aorta, Cr.Cr (0.3-10 mg/mL) inhibited high K+ (80 mM) and phenylephrine (PE, 1 µM)-induced contractions, like verapamil and papaverine. In endothelium-intact rat aortic preparations, Nω-nitro-L-arginine methyl ester hydrochloride-sensitive vasodilator activity was observed with Cr.Cr, which also relaxed endothelium-denuded aorta tissues. In guinea-pig atria, Cr.Cr initially caused mild cardiac stimulation, followed by inhibition, as shown by papaverine. These results reveal that cardiovascular effects of C. roxburghianum seed extract are mediated possibly through combination of Ca++ antagonist, nitric oxide modulating and phosphodiesterase inhibitory mechanisms, though further in-depth studies are required for elucidating precise mode of action. PMID:24785464

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

    PubMed

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

    2015-09-01

    The current study examined the degree of blood pressure (BP) control and incidence of myocardial ischemia in hypertensive patients (n=2039) referred for cardiac stress test. Patients were categorized into well-controlled (<140/90 mm Hg), poorly controlled (140-160/90-100 mm Hg), and very poorly controlled (>160/100 mm Hg) groups according to their resting BP. The mean age[±standard error of the mean] of the patients was 68±13 years, and 885 (43.4%) were men. The prevalence of well-controlled hypertension (HTN) was 47.2%, poorly controlled HTN was 29.5%, and very poorly controlled HTN was 23.3%. Evidence of ischemia was seen in 19.8% and 19.3% of the well-controlled and poorly controlled groups, respectively. The very poorly controlled group had the lowest incidence of ischemia (14.3%) (P<.05) compared with the other two groups. Symptoms that mimic ischemic heart disease in hypertensive patients may be partly explained by poorly controlled BP. Quality of care might be improved by optimally controlling BP in patients with angina symptoms prior to ordering diagnostic testing associated with radiation exposure and cost. PMID:26011137

  18. Myocardial function after polarizing versus depolarizing cardiac arrest with blood cardioplegia in a porcine model of cardiopulmonary bypass†

    PubMed Central

    Aass, Terje; Stangeland, Lodve; Moen, Christian Arvei; Salminen, Pirjo-Riitta; Dahle, Geir Olav; Chambers, David J.; Markou, Thomais; Eliassen, Finn; Urban, Malte; Haaverstad, Rune; Matre, Knut; Grong, Ketil

    2016-01-01

    OBJECTIVES Potassium-based depolarizing St Thomas' Hospital cardioplegic solution No 2 administered as intermittent, oxygenated blood is considered as a gold standard for myocardial protection during cardiac surgery. However, the alternative concept of polarizing arrest may have beneficial protective effects. We hypothesize that polarized arrest with esmolol/adenosine/magnesium (St Thomas' Hospital Polarizing cardioplegic solution) in cold, intermittent oxygenated blood offers comparable myocardial protection in a clinically relevant animal model. METHODS Twenty anaesthetized young pigs, 42 ± 2 (standard deviation) kg on standardized tepid cardiopulmonary bypass (CPB) were randomized (10 per group) to depolarizing or polarizing cardiac arrest for 60 min with cardioplegia administered in the aortic root every 20 min as freshly mixed cold, intermittent, oxygenated blood. Global and local baseline and postoperative cardiac function 60, 120 and 180 min after myocardial reperfusion was evaluated with pressure–conductance catheter and strain by Tissue Doppler Imaging. Regional tissue blood flow, cleaved caspase-3 activity, GRK2 phosphorylation and mitochondrial function and ultrastructure were evaluated in myocardial tissue samples. RESULTS Left ventricular function and general haemodynamics did not differ between groups before CPB. Cardiac asystole was obtained and maintained during aortic cross-clamping. Compared with baseline, heart rate was increased and left ventricular end-systolic and end-diastolic pressures decreased in both groups after weaning. Cardiac index, systolic pressure and radial peak systolic strain did not differ between groups. Contractility, evaluated as dP/dtmax, gradually increased from 120 to 180 min after declamping in animals with polarizing cardioplegia and was significantly higher, 1871 ± 160 (standard error) mmHg/s, compared with standard potassium-based cardioplegic arrest, 1351 ± 70 mmHg/s, after 180 min of reperfusion (P = 0

  19. Lack of association between blood-based detection of Trypanosoma cruzi DNA and cardiac involvement in a non-endemic area

    PubMed Central

    Norman, F F; Pérez-Ayala, A; Pérez-Molina, J A; Flores-Chavez, M; Cañavate, C; López-Vélez, R

    2011-01-01

    Cases of chronic Chagas disease have been increasing in non-endemic areas due to the growth in immigration. This study examined the association between positive Trypanosoma cruzi-DNA detection in blood by PCR and presence of chagasic cardiac involvement in a cohort of immigrants in a European city. No association was found in this study between the positive T. cruzi blood PCR and cardiac involvement. PMID:22117851

  20. delta-Storage pool disease: a pitfall in the forensic investigation of sudden anal blood loss in children: a case report.

    PubMed

    De Munnynck, K; Van Geet, C; De Vos, R; Van de Voorde, W

    2007-01-01

    We present the case of a 3.5-year-old boy with sudden anal blood loss at school. Sexual abuse was suspected, and, apart from anal fissures seen on sigmoidoscopy, no other clinical signs of any sort of disorder were present. As no medical explanation for the blood loss could be given, penetrating anal trauma was suggested. During follow-up consultations, there were complaints of occasional blood loss. Platelet aggregation tests and electron microscopy finally helped diagnose a delta-storage pool disease which is a rare haemostatic disorder involving the dense granules of the platelets. Although exclusion of well-known blood diseases through routine laboratory testing is a common practice in children with sudden blood loss, this case illustrates the value of more specialised investigation both from a diagnostic and forensic point of view. PMID:16283350

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

    PubMed

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

    2015-10-01

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

  2. Comparison of estimates of left ventricular ejection fraction obtained from gated blood pool imaging, different software packages and cameras

    PubMed Central

    Steyn, Rachelle; Boniaszczuk, John; Geldenhuys, Theodore

    2014-01-01

    Summary Objective To determine how two software packages, supplied by Siemens and Hermes, for processing gated blood pool (GBP) studies should be used in our department and whether the use of different cameras for the acquisition of raw data influences the results. Methods The study had two components. For the first component, 200 studies were acquired on a General Electric (GE) camera and processed three times by three operators using the Siemens and Hermes software packages. For the second part, 200 studies were acquired on two different cameras (GE and Siemens). The matched pairs of raw data were processed by one operator using the Siemens and Hermes software packages. Results The Siemens method consistently gave estimates that were 4.3% higher than the Hermes method (p < 0.001). The differences were not associated with any particular level of left ventricular ejection fraction (LVEF). There was no difference in the estimates of LVEF obtained by the three operators (p = 0.1794). The reproducibility of estimates was good. In 95% of patients, using the Siemens method, the SD of the three estimates of LVEF by operator 1 was ≤ 1.7, operator 2 was ≤ 2.1 and operator 3 was ≤ 1.3. The corresponding values for the Hermes method were ≤ 2.5, ≤ 2.0 and ≤ 2.1. There was no difference in the results of matched pairs of data acquired on different cameras (p = 0.4933) Conclusion Software packages for processing GBP studies are not interchangeable. The report should include the name and version of the software package used. Wherever possible, the same package should be used for serial studies. If this is not possible, the report should include the limits of agreement of the different packages. Data acquisition on different cameras did not influence the results. PMID:24844547

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

    PubMed

    Knuttinen, Martha-Grace; Karow, Jillian; Mar, Winnie; Golden, Margaret; Xie, Karen L

    2014-01-01

    Magnetic resonance angiography (MRA) provides noninvasive visualization of the vascular supply of soft tissue masses and vascular pathology, without harmful radiation. This is important for planning an endovascular intervention, and helps to evaluate the efficiency and effectiveness of the treatment. MRA with conventional extracellular contrast agents relies on accurate contrast bolus timing, limiting the imaging window to first-pass arterial phase. The recently introduced blood pool contrast agent (BPCA), gadofosveset trisodium, reversibly binds to human serum albumin, resulting in increased T1 relaxivity and prolonged intravascular retention time, permitting both first-pass and steady-state phase high-resolution imaging. In our practice, high-quality MRA serves as a detailed "roadmap" for the needed endovascular intervention. Cases of aortoiliac occlusive disease, inferior vena cava thrombus, pelvic congestion syndrome, and lower extremity arteriovenous malformation are discussed in this article. MRA was acquired at 1.5 T with an 8-channel phased array coil after intravenous administration of gadofosveset (0.03 mmol/kg body weight), at the first-pass phase. In the steady-state, serial T1-weighted 3D spoiled gradient echo images were obtained with high resolution. All patients underwent digital subtraction angiography (DSA) and endovascular treatment. MRA and DSA findings of vascular anatomy and pathology are discussed and correlated. BPCA-enhanced MRA provides high-quality first-pass and steady-state vascular imaging. This could increase the diagnostic accuracy and create a detailed map for pre-intervention planning. Understanding the pharmacokinetics of BPCA and being familiar with the indications and technique of MRA are important for diagnosis and endovascular intervention. PMID:25558430

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

    PubMed Central

    SAENGKLUB, Nakkawee; YOUNGBLOOD, Brad; DEL RIO, Carlos; SAWANGKOON, Suwanakiet; HAMLIN, Robert L.; KIJTAWORNRAT, Anusak

    2016-01-01

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

  5. Effects of far infrared rays irradiated from ceramic material (BIOCERAMIC) on psychological stress-conditioned elevated heart rate, blood pressure, and oxidative stress-suppressed cardiac contractility.

    PubMed

    Leung, Ting-Kai; Chen, Chien-Ho; Tsai, Shih-Ying; Hsiao, George; Lee, Chi-Ming

    2012-10-31

    The present study examined the effects of BIOCERAMIC on psychological stress-conditioned elevated heart rate, blood pressure and oxidative stress-suppressed cardiac contractility using in vivo and in vitro animal models. We investigated the effects of BIOCERAMIC on the in vivo cardiovascular hemodynamic parameters of rats by monitoring their heart rates, systolic blood pressure, mean blood pressure and diastolic blood pressure. Thereafter, we assayed its effects on the heart rate in an isolated frog heart with and without adrenaline stimulation, and on cardiac contractility under oxidative stress. BIOCERAMIC caused significant decreases in heart rates and systolic and mean blood pressure in the stress-conditioned heart rate rat models (P < 0.05), as well as in the experimental models of an isolated frog heart with and without adrenaline stimulation (P < 0.05), and normalized cardiac contractility under oxidative stress (P < 0.05). BIOCERAMIC may, therefore, normalize the effects of psychological stress and oxidative stress conditions.

  6. Association of blood products administration during cardiopulmonary bypass and excessive post-operative bleeding in pediatric cardiac surgery.

    PubMed

    Agarwal, Hemant S; Barrett, Sarah S; Barry, Kristen; Xu, Meng; Saville, Benjamin R; Donahue, Brian S; Harris, Zena L; Bichell, David P

    2015-03-01

    Our objectives were to study risk factors and post-operative outcomes associated with excessive post-operative bleeding in pediatric cardiac surgeries performed using cardiopulmonary bypass (CPB) support. A retrospective observational study was undertaken, and all consecutive pediatric heart surgeries over 1 year period were studied. Excessive post-operative bleeding was defined as 10 ml/kg/h of chest tube output for 1 h or 5 ml/kg/h for three consecutive hours in the first 12 h of pediatric cardiac intensive care unit (PCICU) stay. Risk factors including demographics, complexity of cardiac defect, CPB parameters, hematological studies, and post-operative morbidity and mortality were evaluated for excessive bleeding. 253 patients were studied, and 107 (42 %) met the criteria for excessive bleeding. Bayesian model averaging revealed that greater volume of blood products transfusion during CPB was significantly associated with excessive bleeding. Multiple logistic regression analysis of blood products transfusion revealed that increased volume of packed red blood cells (PRBCs) administration for CPB prime and during CPB was significantly associated with excessive bleeding (p = 0.028 and p = 0.0012, respectively). Proportional odds logistic regression revealed that excessive bleeding was associated with greater time to achieve negative fluid balance, prolonged mechanical ventilation, and duration of PCICU stay (p < 0.001) after adjusting for multiple parameters. A greater volume of blood products administration, especially PRBCs transfusion for CPB prime, and during the CPB period is associated with excessive post-operative bleeding. Excessive bleeding is associated with worse post-operative outcomes.

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

    PubMed

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

    2011-01-01

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

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

    SciTech Connect

    Weishaupt, Dominik; Hilfiker, Paul R.; Schmidt, Michaela; Debatin, Joerg F.

    1999-07-15

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Plavnik, F L; Ajzen, S; Kohlmann, O; Tavares, A; Zanella, M T; Ribeiro, A B; Ramos, O L

    2000-01-01

    The aim of this study was to analyze the thickness of the intima-media complex (IMC) using a noninvasive method. The carotid and femoral common arteries were evaluated by noninvasive B-mode ultrasound in 63 normotensive and in 52 hypertensive subjects and the thickness of the IMC was tested for correlation with blood pressure, cardiac structures and several clinical and biological parameters. The IMC was thicker in hypertensive than in normotensive subjects (0.67 +/- 0.13 and 0.62 +/- 0.16 vs 0.54 +/- 0.09 and 0.52 +/- 0.11 mm, respectively, P<0.0001). In normotensive patients, the simple linear regression showed significant correlations between IMC and age, body mass index and 24-h systolic blood pressure for both the carotid and femoral arteries. In hypertensives the carotid IMC was correlated with age and 24-h systolic blood pressure while femoral IMC was correlated only with 24-h diastolic blood pressure. Forward stepwise regression showed that age, body mass index and 24-h systolic blood pressure influenced the carotid IMC relationship (r2 = 0.39) in normotensives. On the other hand, the femoral IMC relationship was influenced by 24-h systolic blood pressure and age (r2 = 0.40). In hypertensives, age and 24-h systolic blood pressure were the most important determinants of carotid IMC (r2 = 0.37), while femoral IMC was influenced only by 24-h diastolic blood pressure (r2 = 0.10). There was an association between carotid IMC and echocardiographic findings in normotensives, while in hypertensives only the left posterior wall and interventricular septum were associated with femoral IMC. We conclude that age and blood pressure influence the intima-media thickness, while echocardiographic changes are associated with the IMC. PMID:10625875

  13. Correlation-based discrimination between cardiac tissue and blood for segmentation of the left ventricle in 3-D echocardiographic images.

    PubMed

    Saris, Anne E C M; Nillesen, Maartje M; Lopata, Richard G P; de Korte, Chris L

    2014-03-01

    For automated segmentation of 3-D echocardiographic images, incorporation of temporal information may be helpful. In this study, optimal settings for calculation of temporal cross-correlations between subsequent time frames were determined, to obtain the maximum cross-correlation (MCC) values that provided the best contrast between blood and cardiac tissue over the entire cardiac cycle. Both contrast and boundary gradient quality measures were assessed to optimize MCC values with respect to signal choice (radiofrequency or envelope data) and axial window size. Optimal MCC values were incorporated into a deformable model to automatically segment the left ventricular cavity. MCC values were tested against, and combined with, filtered, demodulated radiofrequency data. Results reveal that using envelope data in combination with a relatively small axial window (0.7-1.25 mm) at fine scale results in optimal contrast and boundary gradient between the two tissues over the entire cardiac cycle. Preliminary segmentation results indicate that incorporation of MCC values has additional value for automated segmentation of the left ventricle. PMID:24412178

  14. Swimming Pools.

    ERIC Educational Resources Information Center

    Ministry of Housing and Local Government, London (England).

    Technical and engineering data are set forth on the design and construction of swimming pools. Consideration is given to site selection, pool construction, the comparative merits of combining open air and enclosed pools, and alternative uses of the pool. Guidelines are presented regarding--(1) pool size and use, (2) locker and changing rooms, (3)…

  15. Myocardial Blood Flow Quantification for Evaluation of Coronary Artery Disease by Positron Emission Tomography, Cardiac Magnetic Resonance Imaging, and Computed Tomography

    PubMed Central

    Waller, Alfonso H.; Blankstein, Ron; Kwong, Raymond Y.; Di Carli, Marcelo F.

    2014-01-01

    The noninvasive detection of the presence and functional significance of coronary artery stenosis is important in the diagnosis, risk assessment, and management of patients with known or suspected coronary artery disease. Quantitative assessment of myocardial perfusion can provide an objective and reproducible estimate of myocardial ischemia and risk prediction. Positron emission tomography, cardiac magnetic resonance, and cardiac computed tomography perfusion are modalities capable of measuring myocardial blood flow and coronary flow reserve. In this review, we will discuss the technical aspects of quantitative myocardial perfusion imaging with positron emission tomography, cardiac magnetic resonance imaging and computed tomography, and its emerging clinical applications. PMID:24718671

  16. Feasibility of measuring superior mesenteric artery blood flow during cardiac surgery under hypothermic cardiopulmonary bypass using transesophageal echocardiography: An observational study

    PubMed Central

    Singh, Naveen G.; Nagaraja, P. S.; Gopal, Divya; Manjunath, V.; Nagesh, K. S.; Manjunatha, N.; Patel, Guru Police; Mishra, Satish Kumar

    2016-01-01

    Background: Abdominal complications being rare but results in high mortality, commonly due to splanchnic organ hypoperfusion during the perioperative period of cardiac surgery. There are no feasible methods to monitor intraoperative superior mesenteric artery blood flow (SMABF). Hence, the aim of this study was to evaluate the feasibility and to measure SMABF using transesophageal echocardiography (TEE) during cardiac surgery under hypothermic cardiopulmonary bypass (CPB). Methodology: Thirty-five patients undergoing elective cardiac surgery under CPB were enrolled. Heart rate, mean arterial pressure (MAP), cardiac output (CO), SMABF, superior mesenteric artery (SMA) diameter, superior mesentric artery blood flow over cardiac output (SMA/CO) ratio and arterial blood lactates were recorded at three time intervals. T0: before sternotomy, T1: 30 min after initiation of CPB and T2: after sternal closure. Results: SMA was demonstrated in 32 patients. SMABF, SMA diameter, SMA/CO, MAP and CO decreased significantly (P < 0.0001) between T0 and T1, increased significantly (P ≤ 0.001) between T0 and T2. Lactates increased progressively from T0 to T2. Conclusion: Study shows that there is decrease in SMABF during CPB and returns to baseline after CPB. Hence, it is feasible to measure SMABF using TEE in patients undergoing cardiac surgery under hypothermic CPB. TEE can be a promising tool in detecting and preventing splanchnic hypoperfusion during perioperative period. PMID:27397442

  17. Polyphosphoric acid capping radioactive/upconverting NaLuF4:Yb,Tm,153Sm nanoparticles for blood pool imaging in vivo.

    PubMed

    Peng, Juanjuan; Sun, Yun; Zhao, Lingzhi; Wu, Yongquan; Feng, Wei; Gao, Yanhong; Li, Fuyou

    2013-12-01

    Nanoparticles that circulate in the bloodstream for a prolonged period of time have important biomedicine applications. However, no example of lanthanide-based nanoparticles having a long-term circulation bloodstream has been reported to date. Herein, we report on difunctional radioactive and upconversion nanoparticles (UCNP) coated with polyphosphoric acid ligand, that is ethylenediamine tetramethylenephosphonic acid (EDTMP), for an application in single-photon emission computed tomography (SPECT) blood pool imaging. The structure, size and zeta-potential of the EDTMP-coated nanoparticles (EDTMP-UCNP) are verified using transmission electron microscopy and dynamic light scattering. Injection of radioisotope samarium-153-labeled EDTMP-UCNP (EDTMP-UCNP:(153)Sm) into mice reveal superior circulation time compared to control nanoparticles coated with citric acid (cit-UCNP:(153)Sm) and (153)Sm complex of EDTMP (EDTMP-(153)Sm). The mechanism for the extended circulation time may be attributed to the adhesion of EDTMP-UCNP on the membrane of red blood cells (RBCs). In vivo toxicity results show no toxicity of EDTMP-UCNP at the dose of 100 mg/kg, validating its safety as an agent for blood pool imaging. Our results provide a new strategy of nanoprobe for a long-term circulation bloodstream by introducing polyphosphoric acid as surface ligand.

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

    PubMed

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

    2016-09-01

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

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

    PubMed Central

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

    2016-01-01

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

  20. Dynamic T1 functional MRI examinations with use of blood pool contrast agent--an approach to optimization of the technique.

    PubMed

    Majos, Agata; Wolak, Tomasz; Sapieha, Michał; Olszycki, Marek; Bogorodzki, Piotr; Stefańczyk, Ludomir

    2011-01-01

    The goal was to optimize dynamic T1 imaging for functional MRI (fMRI) examinations. For each of the 10 healthy subjects T1 3D gradient echo sequence (GRE) sequences were provided immediately after administration of blood pool contrast agent then every 2 h when subjects performed block finger tapings. Dynamic T1 fMRI is sensitive to detect cortical activations up to 6 h after BPCA administration. fMRI should be conducted within 2 h of CA administration, which is enough time for a typical fMRI experiment procedure.

  1. Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery†‡

    PubMed Central

    Hirsch, J.; DePalma, G.; Tsai, T. T.; Sands, L. P.; Leung, J. M.

    2015-01-01

    Introduction Postoperative delirium is common in older patients. Despite its prognostic significance, the pathophysiology is incompletely understood. Although many risk factors have been identified, no reversible factors, particularly ones potentially modifiable by anaesthetic management, have been identified. The goal of this prospective cohort study was to investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing major non-cardiac surgery. Methods Study subjects were patients >65 years of age, undergoing major non-cardiac surgery, who were enrolled in an ongoing prospective observational study of the pathophysiology of postoperative delirium. Intraoperative blood pressure was measured and predefined criteria were used to define hypotension. Delirium was measured by the Confusion Assessment Method on the first two postoperative days. Data were analysed using t-tests, two-sample proportion tests and ordered logistic regression multivariable models, including correction for multiple comparisons. Results Data from 594 patients with a mean age of 73.6 years (sd 6.2) were studied. Of these 178 (30%) developed delirium on day 1 and 176 (30%) on day 2. Patients developing delirium were older, more often female, had lower preoperative cognitive scores, and underwent longer operations. Relative hypotension (decreases by 20, 30, or 40%) or absolute hypotension [mean arterial pressure (MAP)<50 mm Hg] were not significantly associated with postoperative delirium, nor was the duration of hypotension (MAP<50 mm Hg). Conversely, intraoperative blood pressure variance was significantly associated with postoperative delirium. Discussion These results showed that increased blood pressure fluctuation, not absolute or relative hypotension, was predictive of postoperative delirium. PMID:25616677

  2. Heart rate and blood pressure variability in cardiac diseases: pharmacological implications.

    PubMed

    Cloarec-Blanchard, L

    1997-01-01

    Even at rest, blood pressure and heart fluctuate continuously around their mean values. Considerable interest has recently focused on the assessment of spontaneous in fluctuations in heart rate and blood pressure, i.e., heart rate and blood pressure variability, using time or frequency domain indexes. Heart rate variability has been extensively studied in cardiovascular disease and has emerged as a valuable parameter for detecting abnormalities in autonomic cardiovascular control, evaluating the prognosis and assessing the impact of drug therapy on the autonomic nervous system in patients with myocardial infarction, congestive heart failure or a heart transplant. In contrast, until the recent development of noninvasive methods for continuous blood pressure recording, blood pressure variability received little attention, and this parameter remains to be evaluated in cardiovascular disease.

  3. Comparative and scaling aspects of heart and body weights with reference to blood supply of cardiac fibers.

    PubMed

    Poupa, O; Lindström, L

    1983-01-01

    Relative heart weight (RHW) differs in vertebrates with the ratio 1:20 between extremes (bottom bound fishes--Pleuronectidae--and birds). When plotting heart weight (HW) against body weight (BW) one obtains channels which contain not only vertebrates of the same classes (poikilotherms, small and big mammals and birds) but also animals belonging to different classes: tuna fish data are located in the "small mammalian channel" together with data of large tropical snakes while large mammals (upwards 4000 g) belong to the "bird channel". Reasons for such groupings are not clear and physical activity seems not to be the only reason. When comparing active and non active vertebrates one finds that the RHW is as a rule greater in physically more active poikilotherms and homoiotherms. The RHW is also higher in wild than in domesticated forms the differences appearing after weaning (wild vs laboratory rat). In spongy type of myocardium the growth of cardiac fibers results in restriction of the blood flow through lacunae and the contact between endothelial cells lining growing strands of musculature probably provokes formation of capillaries. The appearance of mixed type of myocardium (outer compact and inner spongy compartments) is not bound to the water to land transition since it occurs also in some fishes; it does not occur or is rare in amphibia and is frequent in reptiles. The compact outer layer comprises a different proportion of the cardiac wall volume (5-73%). Metabolic differences were described between cardiac cells in compact and spongy compartments.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Gd-AAZTA-MADEC, an improved blood pool agent for DCE-MRI studies on mice on 1 T scanners.

    PubMed

    Longo, Dario Livio; Arena, Francesca; Consolino, Lorena; Minazzi, Paolo; Geninatti-Crich, Simonetta; Giovenzana, Giovanni Battista; Aime, Silvio

    2016-01-01

    A novel MRI blood-pool contrast agent (Gd-AAZTA-MADEC) has been compared with established blood pool agents for tumor contrast enhanced images and angiography. Synthesis, relaxometric properties, albumin binding affinity and pharmacokinetic profiles are reported. For in vivo studies, angiographic images and tumor contrast enhanced images were acquired on mice with benchtop 1T-MRI scanners and compared with MS-325, B22956/1 and B25716/1. The design of this contrast agent involved the elongation of the spacer between the targeting deoxycholic acid moiety and the Gd-AAZTA imaging reporting unit that drastically changed either the binding affinity to albumin (KA(HSA) = 8.3 × 10(5) M(-1)) and the hydration state of the Gd ion (q = 2) in comparison to the recently reported B25716/1. The very markedly high binding affinity towards mouse and human serum albumins resulted in peculiar pharmacokinetics and relaxometric properties. The NMRD profiles clearly indicated that maximum efficiency is attainable at magnetic field strength of 1 T. In vivo studies showed high enhancement of the vasculature and a prolonged accumulation inside tumor. The herein reported pre-clinical imaging studies show that a great benefit arises from the combination of a benchtop MRI scanner operating at 1 T and the albumin-binding Gd-AAZTA-MADEC complex, for pursuing enhanced angiography and improved characterization of tumor vascular microenvironment.

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

    PubMed Central

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

    2015-01-01

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

  6. Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm.

    PubMed

    Achar, Suraj; Rostamian, Armand; Narayan, Sanjiv M

    2010-09-15

    Recent surveys and reports suggest that many athletes and bodybuilders abuse anabolic-androgenic steroids (AAS). However, scientific data on the cardiac and metabolic complications of AAS abuse are divergent and often conflicting. A total of 49 studies describing 1,467 athletes were reviewed to investigate the cardiovascular effects of the abuse of AAS. Although studies were typically small and retrospective, some associated AAS abuse with unfavorable effects. Otherwise healthy young athletes abusing AAS may show elevated levels of low-density lipoprotein and low levels of high-density lipoprotein. Although data are conflicting, AAS have also been linked with elevated systolic and diastolic blood pressure and with left ventricular hypertrophy that may persist after AAS cessation. Finally, in small case studies, AAS abuse has been linked with acute myocardial infarction and fatal ventricular arrhythmias. In conclusion, recognition of these adverse effects may improve the education of athletes and increase vigilance when evaluating young athletes with cardiovascular abnormalities.

  7. Olmesartan Inhibits Cardiac Hypertrophy in Mice Overexpressing Renin Independently of Blood Pressure: Its Beneficial Effects on ACE2/Ang(1-7)/Mas Axis and NADPH Oxidase Expression.

    PubMed

    Tanno, Tomohiro; Tomita, Hirofumi; Narita, Ikuyo; Kinjo, Takahiko; Nishizaki, Kimitaka; Ichikawa, Hiroaki; Kimura, Yoshihiro; Tanaka, Makoto; Osanai, Tomohiro; Okumura, Ken

    2016-06-01

    Enhanced renin-angiotensin activity causes hypertension and cardiac hypertrophy. The angiotensin (Ang)-converting enzyme (ACE)2/Ang(1-7)/Mas axis pathway functions against Ang II type 1 receptor (AT1R) signaling. We investigated whether olmesartan (Olm), an AT1R blocker, inhibits cardiac hypertrophy independently of blood pressure, and evaluated the potential mechanisms. The 3- to 4-month-old male mice overexpressing renin in the liver (Ren-Tg) were given Olm (5 mg/kg/d) and hydralazine (Hyd) (3.5 mg/kg/d) orally for 2 months. Systolic blood pressure was higher in the Ren-Tg mice than in wild-type littermates. Olm and Hyd treatments lowered systolic blood pressure to the same degree. However, cardiac hypertrophy, evaluated by echocardiography, heart weight, cross-sectional area of cardiomyocytes, and gene expression, was inhibited by only Olm treatment, but not by Hyd. Olm treatment reversed decreased gene expressions of ACE2 and Mas receptor of Ren-Tg mice and inhibited enhanced NADPH oxidase (Nox)4 expression and reactive oxygen species, whereas Hyd treatment had no influence on them. These findings indicate that Olm treatment inhibits cardiac hypertrophy independently of blood pressure, not only through its original AT1R blockade but partly through enhancement of ACE2/Ang(1-7)/Mas axis and suppression of Nox4 expression. PMID:26886190

  8. [Experimental evaluation of the reliance of coronary sinus blood flow (CSF) and great cardiac vein blood flow (GCVF) measured by local thermodilution method].

    PubMed

    Obata, H; Nishijima, H; Yasuda, H

    1991-03-01

    A closed circuit was made to evaluate the reliance of coronary sinus blood flow (CSF) and great cardiac vein blood flow (GCVF) measured by local thermodilution method using multi-thermister catheter. The circuit consists of four parts: a constant-temperature water bath, a reservoir, a rotary pump and a polyethylene tube with a cock. Using this circuit and thermodilution catheters, flow rate was measured under various conditions. Measurements were repeated in changing injection rate of indicator, thermister interval of the catheter, diameter of the polyethylene tube and temperature difference between the room and the water bath. Indicator injection rate and thermister interval were important factors in flow rate measurement. Measured data and real flow were well correlated until 300 ml/min in injection rate of 40-50 ml/min. Other factors did not significantly influence the flow measurement. These results indicate that local thermodilution method is reliable if only injection rate of indicator and thermister interval are suitably settled.

  9. Cardiac output and leg and arm blood flow during incremental exercise to exhaustion on the cycle ergometer.

    PubMed

    Calbet, Jose A L; Gonzalez-Alonso, Jose; Helge, Jörn W; Søndergaard, Hans; Munch-Andersen, Thor; Boushel, Robert; Saltin, Bengt

    2007-09-01

    To determine central and peripheral hemodynamic responses to upright leg cycling exercise, nine physically active men underwent measurements of arterial blood pressure and gases, as well as femoral and subclavian vein blood flows and gases during incremental exercise to exhaustion (Wmax). Cardiac output (CO) and leg blood flow (BF) increased in parallel with exercise intensity. In contrast, arm BF remained at 0.8 l/min during submaximal exercise, increasing to 1.2 +/- 0.2 l/min at maximal exercise (P < 0.05) when arm O(2) extraction reached 73 +/- 3%. The leg received a greater percentage of the CO with exercise intensity, reaching a value close to 70% at 64% of Wmax, which was maintained until exhaustion. The percentage of CO perfusing the trunk decreased with exercise intensity to 21% at Wmax, i.e., to approximately 5.5 l/min. For a given local Vo(2), leg vascular conductance (VC) was five- to sixfold higher than arm VC, despite marked hemoglobin deoxygenation in the subclavian vein. At peak exercise, arm VC was not significantly different than at rest. Leg Vo(2) represented approximately 84% of the whole body Vo(2) at intensities ranging from 38 to 100% of Wmax. Arm Vo(2) contributed between 7 and 10% to the whole body Vo(2). From 20 to 100% of Wmax, the trunk Vo(2) (including the gluteus muscles) represented between 14 and 15% of the whole body Vo(2). In summary, vasoconstrictor signals efficiently oppose the vasodilatory metabolites in the arms, suggesting that during whole body exercise in the upright position blood flow is differentially regulated in the upper and lower extremities.

  10. Cardiac Reactivity and Elevated Blood Pressure Levels among Young African Americans: The Importance of Stress.

    ERIC Educational Resources Information Center

    Livingston, Ivor Lensworth; Marshall, Ronald J.

    1990-01-01

    Explores the racial differences in elevated arterial blood pressure between African American youth, especially adolescents, and their White counterparts. Argues that African American adolescents' perception of day-to-day stress is an important contributor to this condition. Considers a conceptual model of the sociopsychophysiological stress…

  11. In utero intra-cardiac tomato-lectin injections on mouse embryos to gauge renal blood flow.

    PubMed

    Rymer, Christopher C; Sims-Lucas, Sunder

    2015-01-01

    The formation and perfusion of developing renal blood vessels (apart from glomeruli) are greatly understudied. As vasculature develops via angiogenesis (which is the branching off of major vessels) and vasculogenesis (de novo vessel formation), perfusion mapping techniques such as resin casts, in vivo ultrasound imaging, and micro-dissection have been limited in demonstrating the intimate relationships between these two processes and developing renal structures within the embryo. Here, we describe the procedure of in utero intra-cardiac ultrasound-guided FITC-labeled tomato lectin microinjections on mouse embryos to gauge the ontogeny of renal perfusion. Tomato lectin (TL) was perfused throughout the embryo and kidneys harvested. Tissues were co-stained for various kidney structures including: nephron progenitors, nephron structures, ureteric epithelium, and vasculature. Starting at E13.5 large caliber vessels were perfused, however peripheral vessels remained unperfused. By E15.5 and E17.5, small peripheral vessels as well as glomeruli started to become perfused. This experimental technique is critical for studying the role of vasculature and blood flow during embryonic development. PMID:25741893

  12. Weighted Least-Squares Finite Element Method for Cardiac Blood Flow Simulation with Echocardiographic Data

    PubMed Central

    Wei, Fei; Westerdale, John; McMahon, Eileen M.; Belohlavek, Marek; Heys, Jeffrey J.

    2012-01-01

    As both fluid flow measurement techniques and computer simulation methods continue to improve, there is a growing need for numerical simulation approaches that can assimilate experimental data into the simulation in a flexible and mathematically consistent manner. The problem of interest here is the simulation of blood flow in the left ventricle with the assimilation of experimental data provided by ultrasound imaging of microbubbles in the blood. The weighted least-squares finite element method is used because it allows data to be assimilated in a very flexible manner so that accurate measurements are more closely matched with the numerical solution than less accurate data. This approach is applied to two different test problems: a flexible flap that is displaced by a jet of fluid and blood flow in the porcine left ventricle. By adjusting how closely the simulation matches the experimental data, one can observe potential inaccuracies in the model because the simulation without experimental data differs significantly from the simulation with the data. Additionally, the assimilation of experimental data can help the simulation capture certain small effects that are present in the experiment, but not modeled directly in the simulation. PMID:22312412

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

    PubMed Central

    Hindel, Stefan; Sauerbrey, Anika; Maaß, Marc; Maderwald, Stefan; Schlamann, Marc; Lüdemann, Lutz

    2015-01-01

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

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

    PubMed

    Hindel, Stefan; Sauerbrey, Anika; Maaß, Marc; Maderwald, Stefan; Schlamann, Marc; Lüdemann, Lutz

    2015-01-01

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

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

    PubMed

    Hindel, Stefan; Sauerbrey, Anika; Maaß, Marc; Maderwald, Stefan; Schlamann, Marc; Lüdemann, Lutz

    2015-01-01

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

  16. Low toxicity and long circulation time of Polyampholyte-coated magnetic nanoparticles for blood pool contrast agents

    PubMed Central

    Wang, Qi; Shen, Ming; Zhao, Tao; Xu, Yuanyuan; Lin, Jiang; Duan, Yourong; Gu, Hongchen

    2015-01-01

    Polyampholyte-coated (poly(acrylic acid) (PAA)-co-3-(diethylamino)-propylamine (DEAPA)) magnetite nanoparticles (PAMNPs) have been prepared as contrasting agent used in magnetic resonance imaging (MRI). Excellent biocompatibility is required for contrasting agents used in high-resolution magnetic resonance angiography. To evaluate the biocompatibility of PAMNPs, some experiments have been conducted. The hemolysis, plasma recalcification, dynamic blood clotting, prothrombin time, inflammatory cytokine release and complement system activation assays were carried out to investigate the hemocompatibility. To evaluate the toxicity to vessel, MTT test and vascular irritation tests were conducted. Tissue toxicity test was also performed to investigate the biocompability in vivo. We also looked into the biodistribution. The results showed that PAMNPs at the working concentration (0.138 mM) present similar hemocompatibility with negative control, thus have no significant effect to vessels. PAMNPs were mainly distributed in the liver and the blood. The circulation time in blood was considerably long, with the half-time of 3.77 h in plasma. This property is advantageous for PAMNPs' use in angiography. PAMNPs could be metabolized rapidly in mice and were not observed to cause any toxic or adverse effect. In short, these results suggest that the PAMNPs have great potential to serve as safe contrast agents in magnetic resonance imaging (MRI). PMID:25585607

  17. Low toxicity and long circulation time of Polyampholyte-coated magnetic nanoparticles for blood pool contrast agents

    NASA Astrophysics Data System (ADS)

    Wang, Qi; Shen, Ming; Zhao, Tao; Xu, Yuanyuan; Lin, Jiang; Duan, Yourong; Gu, Hongchen

    2015-01-01

    Polyampholyte-coated (poly(acrylic acid) (PAA)-co-3-(diethylamino)-propylamine (DEAPA)) magnetite nanoparticles (PAMNPs) have been prepared as contrasting agent used in magnetic resonance imaging (MRI). Excellent biocompatibility is required for contrasting agents used in high-resolution magnetic resonance angiography. To evaluate the biocompatibility of PAMNPs, some experiments have been conducted. The hemolysis, plasma recalcification, dynamic blood clotting, prothrombin time, inflammatory cytokine release and complement system activation assays were carried out to investigate the hemocompatibility. To evaluate the toxicity to vessel, MTT test and vascular irritation tests were conducted. Tissue toxicity test was also performed to investigate the biocompability in vivo. We also looked into the biodistribution. The results showed that PAMNPs at the working concentration (0.138 mM) present similar hemocompatibility with negative control, thus have no significant effect to vessels. PAMNPs were mainly distributed in the liver and the blood. The circulation time in blood was considerably long, with the half-time of 3.77 h in plasma. This property is advantageous for PAMNPs' use in angiography. PAMNPs could be metabolized rapidly in mice and were not observed to cause any toxic or adverse effect. In short, these results suggest that the PAMNPs have great potential to serve as safe contrast agents in magnetic resonance imaging (MRI).

  18. Synthesis and evaluation of a polydisulfide with Gd-DOTA monoamide side chains as a biodegradable macromolecular contrast agent for MR blood pool imaging.

    PubMed

    Ye, Zhen; Wu, Xueming; Tan, Mingqian; Jesberger, Jack; Grisworld, Mark; Lu, Zheng-Rong

    2013-01-01

    Macromolecular Gd(III)-based contrast agents are effective for contrast-enhanced blood pool and cancer MRI in preclinical studies. However, their clinical applications are impeded by potential safety concerns associated with slow excretion and prolonged retention of these agents in the body. To minimize the safety concerns of macromolecular Gd contrast agents, we have developed biodegradable macromolecular Gd contrast agents based on polydisulfide Gd(III) complexes. In this study, we designed and synthesized a new generation of the polydisulfide Gd(III) complexes containing a macrocyclic Gd(III) chelate, Gd-DOTA monoamide, to improve the in vivo kinetic inertness of the Gd(III) chelates. (N6-Lysyl)lysine-(Gd-DOTA) monoamide and 3-(2-carboxyethyldisulfanyl)propanoic acid copolymers (GODC) were synthesized by copolymerization of (N6-lysyl)lysine DOTA monoamide and dithiobis(succinimidylpropionate), followed by complexation with Gd(OAc)3. The GODC had an apparent molecular weight of 26.4 kDa and T1 relaxivity of 8.25 mM(-1) s(-1) per Gd at 1.5 T. The polymer chains of GODC were readily cleaved by L-cysteine and the chelates had high kinetic stability against transmetallation in the presence of an endogenous metal ion Zn(2+). In vivo MRI study showed that GODC produced strong and prolonged contrast enhancement in the vasculature and tumor periphery of mice with breast tumor xenografts. GODC is a promising biodegradable macromolecular MRI contrast agent with high kinetic stability for MR blood pool imaging.

  19. Synthesis and evaluation of a polydisulfide with Gd-DOTA monoamide side chains as a biodegradable macromolecular contrast agent for MR blood pool imaging

    PubMed Central

    Ye, Zhen; Wu, Xueming; Tan, Mingqian; Jesberger, Jack; Griswold, Mark; Lu, Zheng-Rong

    2014-01-01

    Macromolecular Gd(III) based contrast agents are effective for contrast enhanced blood pool and cancer MRI in preclinical studies. However, their clinical applications are impeded by potential safety concerns associated with slow excretion and prolonged retention of these agents in the body. To minimize the safety concerns of macromolecular Gd contrast agents, we have recently designed and developed biodegradable macromolecular Gd contrast agents based on polydisulfide Gd(III) complexes. In this study, we designed and synthesized a new generation of the polydisulfide Gd(III) complexes containing macrocyclic Gd(III) chelate, Gd-DOTA monoamide, to further improve the in vivo kinetic stability of the Gd(III) chelates of the contrast agents. (N6-Lysyl)lysine Gd-DOTA monoamide and 3-(2-carboxyethyldisulfanyl)propanoic acid copolymers (GODC) was synthesized by copolymerization of (N6-lysyl)lysine DOTA monoamide and dithiobis (succinimidylpropionate), followed by complexation with Gd(OAc)3. The GODC had an apparent molecular weight of 26.4 kDa and T1 relaxivity of 8.25 mM−1s−1 per Gd at 1.5 T. The polymer chains of GODC were readily cleaved by L-cysteine and the chelates had high kinetic stability against transmetallation in the presence of an endogenous metal ion Zn2+. In vivo MR study showed that GODC produced strong and prolonged contrast enhancement in the vasculature and tumor periphery of mice with breast tumor xenografts. GODC is a promising biodegradable macromolecular MRI contrast agent with high kinetic stability for MR blood pool imaging. PMID:23606425

  20. Cardiac catheterization

    MedlinePlus

    Catheterization - cardiac; Heart catheterization; Angina - cardiac catheterization; CAD - cardiac catheterization; Coronary artery disease - cardiac catheterization; Heart valve - cardiac catheterization; Heart failure - ...

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

    SciTech Connect

    Roberts, D.; Bake, B.; William-Olsson, G.

    1985-01-01

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

  2. Maternal prepregnancy body mass index and their children's blood pressure and resting cardiac autonomic balance at age 5 to 6 years.

    PubMed

    Gademan, Maaike G J; van Eijsden, Manon; Roseboom, Tessa J; van der Post, Joris A M; Stronks, Karien; Vrijkotte, Tanja G M

    2013-09-01

    Adverse intrauterine conditions can program hypertension. Because one of the underlying mechanisms is thought to be cardiac autonomic balance, we investigated the association between prepregnancy body mass index (BMI) and blood pressure and indicators of the autonomic balance in the child at age 5 to 6 years. Also investigated was whether these associations were mediated by standardized birth weight and child BMI. Pregnant women (n=3074) participating in the Amsterdam Born Children and their Development study completed a questionnaire at gestational week 14. At age 5 to 6 years, offspring's sympathetic drive (pre-ejection period), parasympathetic drive (respiratory sinus arrhythmia), and heart rate were measured by electrocardiography and impedance cardiography at rest. Blood pressure was assessed simultaneously. After adjusting for possible maternal/offspring confounders, prepregnancy BMI was positively linearly associated with diastolic blood pressure (β=0.11 mm Hg; 95% confidence interval, 0.05-0.17), systolic blood pressure (β=0.14 mm Hg; 95% confidence interval, 0.07-0.21), but not with heart rate, sympathetic or parasympathetic drive. After adding birth weight and child BMI to the model, the independent effect size of prepregnancy body mass index on systolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.00-0.14) and diastolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.01-0.13) decreased by ≈50%. Birth weight did not mediate these relationships, but was independently and negatively associated with blood pressure. Child BMI was positively associated with blood pressure and partly mediated the association between prepregnancy BMI and blood pressure. In conclusion, higher prepregnancy BMI is associated with higher blood pressure in the child (aged 5-6 years) but does not seem to be attributable to early alterations in resting cardiac autonomic balance. Child BMI, but not birth weight, mediated the association between prepregnancy

  3. Tight control of effectiveness of cardiac massage with invasive blood pressure monitoring during cardiopulmonary resuscitation.

    PubMed

    Prause, Gerhard; Archan, Sylvia; Gemes, Geza; Kaltenböck, Friedrich; Smolnikov, Ilja; Schuchlenz, Herwig; Wildner, Gernot

    2010-07-01

    The continuity of chest compression is the main challenge in prehospital cardiopulmonary resuscitation in the field as well as during transport. Invasive blood pressure monitoring with visible pulse waves by means of an arterial line set prehospitally allows for tight control of the effectiveness of chest compressions as well as of the impact of the administered epinephrine and also captures beginning fatigue of the rescuers. In this case, maintaining uninterrupted circulation through manual as well as mechanical chest compressions continued until the successful percutaneous coronary intervention saved the patients life without neurologic damage. PMID:20637398

  4. Red blood cell distribution width and 3-year outcome in patients undergoing cardiac catheterization.

    PubMed

    Arbel, Yaron; Birati, Edo Y; Finkelstein, Ariel; Halkin, Amir; Berliner, Shlomo; Katz, Ben-Zion; Revivo, Miri; Saranga, Hila; Herz, Itzhak; Keren, Gad; Banai, Shmuel

    2014-05-01

    Red blood cell distribution width (RDW), which is routinely reported in complete blood counts, is a measure of the variability in size of circulating erythrocytes. RDW is a novel, independent predictor of prognosis in patients with cardiovascular diseases. The aim of the present study was to evaluate the significance of this biomarker in a relatively large cohort of patients, and to assess its association with a more severe underlying cardiovascular disease. A cohort of 3,222 consecutive patients undergoing coronary angiography was divided according RDW median. The association between RDW and 3-year outcome in the context of other predictors was assessed using Cox's proportional hazards analysis. Patients with elevated RDWs were older, had higher body mass indices, and had more cardiovascular risk factors and more cardiovascular diseases. The total rate of mortality, MI and stroke (MACE) was 7.7% (120 events) in the lower RDW group, and 18.2% (303 events) in the higher RDW group, p < 0.001. Following adjustment for multiple background risk factors, medications, and laboratory results, the RDW value was independently associated with worse outcome (HR = 1.12, 95% CI 1.07-1.18, p < 0.001, for each 1% increase in RDW). Elevated RDW values are independently associated with adverse 3-year outcome in patients undergoing coronary angiography. PMID:23836454

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

    PubMed

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

    2016-08-01

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

  6. Cardiac-Gated En Face Doppler Measurement of Retinal Blood Flow Using Swept-Source Optical Coherence Tomography at 100,000 Axial Scans per Second

    PubMed Central

    Lee, ByungKun; Choi, WooJhon; Liu, Jonathan J.; Lu, Chen D.; Schuman, Joel S.; Wollstein, Gadi; Duker, Jay S.; Waheed, Nadia K.; Fujimoto, James G.

    2015-01-01

    Purpose. To develop and demonstrate a cardiac gating method for repeatable in vivo measurement of total retinal blood flow (TRBF) in humans using en face Doppler optical coherence tomography (OCT) at commercially available imaging speeds. Methods. A prototype swept-source OCT system operating at 100-kHz axial scan rate was developed and interfaced with a pulse oximeter. Using the plethysmogram measured from the earlobe, Doppler OCT imaging of a 1.5- × 2-mm area at the optic disc at 1.8 volumes/s was synchronized to cardiac cycle to improve sampling of pulsatile blood flow. Postprocessing algorithms were developed to achieve fully automatic calculation of TRBF. We evaluated the repeatability of en face Doppler OCT measurement of TRBF in 10 healthy young subjects using three methods: measurement at 100 kHz with asynchronous acquisition, measurement at 100 kHz with cardiac-gated acquisition, and a control measurement using a 400-kHz instrument with asynchronous acquisition. Results. The median intrasubject coefficients of variation (COV) of the three methods were 8.0%, 4.9%, and 6.1%, respectively. All three methods correlated well, without a significant bias. Mean TRBF measured at 100 kHz with cardiac-gated acquisition was 40.5 ± 8.2 μL/min, and the range was from 26.6 to 55.8 μL/min. Conclusions. Cardiac-gated en face Doppler OCT can achieve smaller measurement variability than previously reported methods. Although further validation in older subjects and diseased subjects is required, precise measurement of TRBF using cardiac-gated en face Doppler OCT at commercially available imaging speeds should be feasible. PMID:25744974

  7. Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients

    SciTech Connect

    Applefeld, M.M.; Wiernik, P.H.

    1983-06-01

    Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable.

  8. [The multiple organ failure syndrome after cardiac surgery with artificial blood circulation].

    PubMed

    Babaev, M A; Eremenko, A A; Minbolatova, N M; Dzemeshkevich, S L

    2013-01-01

    The 10-year study of etiology, pathogenesis, diagnostic, treatment and prevention of the multiple organ failure syndrome (MOFS) after cardiovascular operations with artificial blood circulation was conducted in the SCS. 4383 patients, aged 16-75 years, were observed. Of them, MOFS was diagnosed in 206 (4.7%) patients. Extracorporal detoxication was used in 385 patients. When used in patients with complicated postoperative period, the extracorporal detoxication prevents MOFS and decreases lethality in 3 times (from 59.3 to 19.2%). The method is indicated to patients with MOFS severity estimated of 13.5 points and damage of 5-6 organ systems. Herewith the duration of veno-venous ultrahemodiafiltration should not exceed 80 hours and the number of sessions should not be more then 3.

  9. Relationships between baroreceptor cardiac reflex sensitivity and cognitive performance: modulations by gender and blood pressure.

    PubMed

    Paso, Gustavo A Reyes Del; Mata, José Luis; Martín-Vázquez, María

    2012-01-01

    This study aimed at replicating and extending previous results on the association between baroreceptor reflex sensitivity (BRS) and cognitive performance. Thirty men and 31 women performed an arithmetic task. After adjusting for numerical aptitude and effort, no predictors of performance were found in men. In women, the relationships between BRS and parameters related to correct responses were modulated by blood pressure (BP). BRS was inversely associated with these parameters for participants with BP>1 SD above the mean, whereas the associations were positive in participants with BP<1 SD below the mean. Also for women, BRS was positively associated with number of errors during the task. These results suggest that the relation between BRS and performance varies as a function of the type of cognitive processes assessed and that the central nervous system effects of the baroreceptors on cognitive functioning are modulated by gender and BP.

  10. Increased All-Cause, Liver, and Cardiac Mortality among Hepatitis C Virus-seropositive Blood Donors

    PubMed Central

    Guiltinan, Anne M.; Kaidarova, Zhanna; Custer, Brian; Orland, Jennie; Strollo, Angela; Cyrus, Sherri; Busch, Michael P.; Murphy, Edward L.

    2010-01-01

    Hospital-based studies suggest that hepatitis C virus (HCV) infection causes frequent cirrhosis, hepatocellular carcinoma, and mortality, but epidemiologic studies have shown less morbidity and mortality. The authors performed a retrospective cohort study of 10,259 recombinant immunoblot assay-confirmed, HCV antibody-positive (HCV+), allogeneic blood donors from 1991 to 2002 and 10,259 HCV antibody-negative (HCV−) donors matched for year of donation, age, gender, and Zone Improvement Plan Code (ZIP Code). Vital status through 2003 was obtained from the US National Death Index, and hazard ratios with 95% confidence intervals were calculated by survival analysis. After a mean follow-up of 7.7 years, there were 601 (2.92%) deaths: 453 HCV+ and 148 HCV− (hazard ratio (HR) = 3.13, 95% confidence interval (CI): 2.60, 3.76). Excess mortality in the HCV+ group was greatest in liver-related (HR = 45.99, 95% CI: 11.32, 186.74), drug- or alcohol-related (HR = 10.81, 95% CI: 4.68, 24.96), and trauma/suicide (HR = 2.99, 95% CI: 2.05, 4.36) causes. There was also an unexpected increase in cardiovascular mortality among the HCV+ donors (HR = 2.21, 95% CI: 1.41, 3.46). HCV infection is associated with a significant, threefold increase in overall mortality among former blood donors, including significantly increased mortality from liver and cardiovascular causes. High rates of mortality from drug/alcohol and trauma/suicide causes are likely due to lifestyle factors and may be at least partially preventable. PMID:18203734

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

    SciTech Connect

    Wagner, Marlies; Kyriakou, Yiannis; Mesnil de Rochemont, Richard du; Singer, Oliver C.; Berkefeld, Joachim

    2013-08-01

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

  12. A strategic approach for cardiac MR left ventricle segmentation.

    PubMed

    Dakua, Sarada Prasad; Sahambi, J S

    2010-09-01

    Quantitative evaluation of cardiac function from cardiac magnetic resonance (CMR) images requires the identification of the myocardial walls. This generally requires the clinician to view the image and interactively trace the contours. Especially, detection of myocardial walls of left ventricle is a difficult task in CMR images that are obtained from subjects having serious diseases. An approach to automated outlining the left ventricular contour is proposed. In order to segment the left ventricle, in this paper, a combination of two approaches is suggested. Difference of Gaussian weighting function (DoG) is newly introduced in random walk approach for blood pool (inner contour) extraction. The myocardial wall (outer contour) is segmented out by a modified active contour method that takes blood pool boundary as the initial contour. Promising experimental results in CMR images demonstrate the potentials of our approach.

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

    PubMed

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

    1989-04-01

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

  14. Comparison of two noninvasive devices for measurement of central systolic blood pressure with invasive measurement during cardiac catheterization.

    PubMed

    Ott, Christian; Haetinger, Siegberto; Schneider, Markus P; Pauschinger, Matthias; Schmieder, Roland E

    2012-09-01

    Recently, a new device for noninvasive assessment of central systolic blood pressure (cSBP) (BPro device with A-Pulse) was approved by the US Food and Drug Administration, but available data are limited. In 52 patients undergoing invasive elective cardiac evaluation, central hemodynamics were measured invasively. Immediately thereafter, radial artery waveforms were sampled by two noninvasive techniques, the BPro and, as a comparator, the SphygmoCor System. Then, central hemodynamics were measured invasively for a second time. The invasively recorded cSBP (137 ± 27 mm Hg) did not differ with both noninvasively assessed cSBP by BPro (136 ± 21 mm Hg, P = .627 vs invasive cSBP) and by SphygmoCor (136 ± 23 mm Hg, P=.694 vs invasive cSBP) and correlated highly between invasively recorded and both noninvasively assessed cSBP. However, using Bland-Altman plots, spreading of compared data of both devices can be found (BPro: 0.87 ± 13 mm Hg vs invasive cSBP; SphygmoCor: 0.77 ± 14 mm Hg vs invasive cSBP). There was an excellent correlation of both noninvasive devices for the calculation of cSBP (r=0.961, P<.001). cSBP differed by only 0.1 ± 6 mm Hg (P=.913) between the two noninvasive devices. Therefore, both noninvasive devices showed an accurate agreement in cSBP compared with invasively measured cSBP. PMID:22947354

  15. Thoracic epidural anesthesia during coronary artery bypass surgery: effects on cardiac sympathetic activity, myocardial blood flow and metabolism, and central hemodynamics.

    PubMed

    Kirnö, K; Friberg, P; Grzegorczyk, A; Milocco, I; Ricksten, S E; Lundin, S

    1994-12-01

    The effects of high thoracic epidural anesthesia (TEA) on cardiac sympathetic nerve activity, myocardial blood flow and metabolism, and central hemodynamics were studied in 20 patients undergoing coronary artery bypass grafting (CABG). In 10 of the patients, TEA (T1-5 block) was used as an adjunct to a standardized fentanyl-nitrous oxide anesthesia. Hemodynamic measurements and blood sampling were performed after induction of anesthesia but prior to skin incision and after sternotomy. Assessment of total and cardiac sympathetic activity was performed by means of the norepinephrine kinetic approach. Prior to surgery, mean arterial pressure (MAP), great cardiac vein flow (GCVF), and regional myocardial oxygen consumption (Reg-MVO2) were lower in the TEA group compared to the control group. During sternotomy there was a pronounced increase in cardiac norepinephrine spillover, MAP, systemic vascular resistance index (SVRI), pulmonary capillary wedge pressure (PCWP), GCVF, and Reg-MVO2 in the control group. These changes were clearly attenuated in the TEA group. None of the patients in the TEA group had metabolic (lactate) or electrocardiographic signs of myocardial ischemia. Three patients in the control group had indices of myocardial ischemia prior to and/or during surgery. We conclude that TEA attenuates the surgically mediated sympathetic stress response to sternotomy, thereby preventing the increase in myocardial oxygen demand in the pre-bypass period without jeopardizing myocardial perfusion. PMID:7978429

  16. Pool Purification

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Caribbean Clear, Inc. used NASA's silver ion technology as a basis for its automatic pool purifier. System offers alternative approach to conventional purification chemicals. Caribbean Clear's principal markets are swimming pool owners who want to eliminate chlorine and bromine. Purifiers in Caribbean Clear System are same silver ions used in Apollo System to kill bacteria, plus copper ions to kill algae. They produce spa or pool water that exceeds EPA Standards for drinking water.

  17. Blood

    MedlinePlus

    ... solid part of your blood contains red blood cells, white blood cells, and platelets. Red blood cells (RBC) deliver oxygen from your lungs to your tissues and organs. White blood cells (WBC) fight infection and are part of your ...

  18. Ultra High-Resolution In vivo Computed Tomography Imaging of Mouse Cerebrovasculature Using a Long Circulating Blood Pool Contrast Agent

    PubMed Central

    Starosolski, Zbigniew; Villamizar, Carlos A.; Rendon, David; Paldino, Michael J.; Milewicz, Dianna M.; Ghaghada, Ketan B.; Annapragada, Ananth V.

    2015-01-01

    Abnormalities in the cerebrovascular system play a central role in many neurologic diseases. The on-going expansion of rodent models of human cerebrovascular diseases and the need to use these models to understand disease progression and treatment has amplified the need for reproducible non-invasive imaging methods for high-resolution visualization of the complete cerebral vasculature. In this study, we present methods for in vivo high-resolution (19 μm isotropic) computed tomography imaging of complete mouse brain vasculature. This technique enabled 3D visualization of large cerebrovascular networks, including the Circle of Willis. Blood vessels as small as 40 μm were clearly delineated. ACTA2 mutations in humans cause cerebrovascular defects, including abnormally straightened arteries and a moyamoya-like arteriopathy characterized by bilateral narrowing of the internal carotid artery and stenosis of many large arteries. In vivo imaging studies performed in a mouse model of Acta2 mutations demonstrated the utility of this method for studying vascular morphometric changes that are practically impossible to identify using current histological methods. Specifically, the technique demonstrated changes in the width of the Circle of Willis, straightening of cerebral arteries and arterial stenoses. We believe the use of imaging methods described here will contribute substantially to the study of rodent cerebrovasculature. PMID:25985192

  19. Influence of menstrual cycle phase on muscle metaboreflex control of cardiac baroreflex sensitivity, heart rate and blood pressure in humans.

    PubMed

    Hartwich, Doreen; Aldred, Sarah; Fisher, James P

    2013-01-01

    We sought to determine whether menstrual cycle phase influences muscle metaboreflex control of spontaneous cardiac baroreflex sensitivity (cBRS), blood pressure (BP) and heart rate (HR). Twenty-three young women not taking oral contraceptives were studied during the early (EF; low oestrogen, low progesterone) and late follicular menstrual phases (LF; high oestrogen, low progesterone). Protocol 1 consisted of leg cycling at low (21 ± 2 W) and moderate workloads (71 ± 3 W) in free-flow conditions and with partial flow restriction (bilateral thigh-cuff inflation at 100 mmHg) to activate the muscle metaboreflex. Protocol 2 consisted of rhythmic hand-grip exercise with incremental upper arm-cuff inflation (0, 80, 100 and 120 mmHg) to elicit graded metaboreflex activation. Both protocols were followed by post-exercise ischaemia. Leg cycling decreased cBRS (EF, 20 ± 5, 6 ± 1 and 1 ± 0.1 ms mmHg(-1); and LF, 19 ± 3, 6 ± 0.4, 1 ± 0.1 ms mmHg(-1) during rest, low- and moderate-intensity leg cycling, respectively) and increased HR in an intensity-dependent manner, while BP remained unchanged. Partial flow restriction during leg cycling decreased cBRS, and increased HR and BP. During post-exercise ischaemia, HR and BP remained elevated, while cBRS remained suppressed (EF, 4.2 ± 0.6 ms mmHg(-1); and LF, 4.7 ± 0.5 ms mmHg(-1); P < 0.05 versus rest). Cardiac baroreflex sensitivity was unchanged during hand-grip with and without partial flow restriction and post-exercise ischaemia. No differences in cBRS, HR or BP responses were observed between EF and LF at any time during either protocol. These data indicate that endogenous fluctuations in oestrogen between the EF and LF phases of the menstrual cycle do not influence muscle metaboreflex control of cBRS, BP or HR in young women.

  20. Respiratory compensation in cardiac PET using doubly-gated acquisitions

    SciTech Connect

    Huesman, R.H.; Klein, G.J.; Reutter, B.W.

    1997-05-01

    We present results of respiratory compensation in cardiac PET data via doubly-gated acquisitions on a human subject. The extent of cardiac motion due to respiration has now been documented by numerous researchers. To correct for the blurring effects of this motion, we have modified the CTI/Siemens ECAT EXACT HR scanner to support acquisitions gated for different stages of both the cardiac and respiratory cycles. A human subject was injected with 11.0 mCi 18-FDG. After allowing time for the isotope to clear the blood pool, emission data were acquired for 30 minutes. The respiratory cycle was divided into five gates, the cardiac cycle into three gates for a total of fifteen 47-plane emission datasets. An ungated transmission dataset was acquired to correct for the effects of attenuation. Each gate was separately reconstructed using standard filtered backprojection techniques. Data resulting from the five respiratory gates obtained during diastole will be discussed in this paper.

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

    PubMed

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

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) <12h. After 12h postmortem, these markers were also higher in fatal drug abuse, spontaneous cerebral/subarachnoid bleeding, electrocution and pulmonary embolism. In addition, most other causes of death, including ischemic heart disease, showed substantial elevations, while these markers remained low in acute hemorrhagic death from sharp instrument injury, hypothermia (cold exposure) and sea-/freshwater drowning during PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  2. Are lower levels of red blood cell transfusion more cost-effective than liberal levels after cardiac surgery? Findings from the TITRe2 randomised controlled trial

    PubMed Central

    Stokes, E A; Wordsworth, S; Bargo, D; Pike, K; Rogers, C A; Brierley, R C M; Angelini, G D; Murphy, G J; Reeves, B C

    2016-01-01

    Objective To assess the incremental cost and cost-effectiveness of a restrictive versus a liberal red blood cell transfusion threshold after cardiac surgery. Design A within-trial cost-effectiveness analysis with a 3-month time horizon, based on a multicentre superiority randomised controlled trial from the perspective of the National Health Service (NHS) and personal social services in the UK. Setting 17 specialist cardiac surgery centres in UK NHS hospitals. Participants 2003 patients aged >16 years undergoing non-emergency cardiac surgery with a postoperative haemoglobin of <9 g/dL. Interventions Restrictive (transfuse if haemoglobin <7.5 g/dL) or liberal (transfuse if haemoglobin <9 g/dL) threshold during hospitalisation after surgery. Main outcome measures Health-related quality of life measured using the EQ-5D-3L to calculate quality-adjusted life years (QALYs). Results The total costs from surgery up to 3 months were £17 945 and £18 127 in the restrictive and liberal groups (mean difference is −£182, 95% CI −£1108 to £744). The cost difference was largely attributable to the difference in the cost of red blood cells. Mean QALYs to 3 months were 0.18 in both groups (restrictive minus liberal difference is 0.0004, 95% CI −0.0037 to 0.0045). The point estimate for the base-case cost-effectiveness analysis suggested that the restrictive group was slightly more effective and slightly less costly than the liberal group and, therefore, cost-effective. However, there is great uncertainty around these results partly due to the negligible differences in QALYs gained. Conclusions We conclude that there is no clear difference in the cost-effectiveness of restrictive and liberal thresholds for red blood cell transfusion after cardiac surgery. Trial registration number ISRCTN70923932; Results. PMID:27481621

  3. Monoclonal antibody for the demonstration by ELISA of antibodies to protein p24 of enzootic bovine leukosis virus in individual and pooled blood serum and milk samples.

    PubMed

    Rodák, L; Granátová, M; Veselý, T; Nevoránková, Z

    1997-09-01

    A sensitive and specific ELISA for the demonstration of antibodies to the protein p24 of enzootic bovine leukosis virus (EBVL) using a 'capture' monoclonal antibody to this protein (MAb p24) was developed. The method is sensitive enough to detect the international reference serum E4/10 in pooled blood serum samples collected from up to 50 cows, or, if a 10-fold concentrate of milk whey is tested, in samples of bulk milk collected from up to 400 cows. The application of MAb p24 has considerably increased not only the sensitivity, but also the specificity of ELISA. Moreover it is possible to differentiate reliably between positive and 'false positive' reagents by testing a suspicious sample in a pair of wells of which one is coated with MAb p24 alone and the other with the complex MAb p24 + EBLV antigen and the subsequent calculation of 'specific absorbance'. This method, showing the highest sensitivity of detection of antibodies to EBLV p24 described so far, can become an effective tool on the sanitation of infected herds as well as in checks of the EBL-free status. A diagnostic kit suitable for commercial manufacture has been devised.

  4. Detection of Type II Endoleak After Endovascular Aortic Repair: Comparison Between Magnetic Resonance Angiography and Blood-Pool Contrast Agent and Dual-Phase Computed Tomography Angiography

    SciTech Connect

    Wieners, Gero; Meyer, Frank; Halloul, Zuhir; Peters, Nils; Ruehl, Ricarda; Dudeck, Oliver; Tautenhahn, Joerg; Ricke, Jens; Pech, Maciej

    2010-12-15

    PurposeThis prospective study was designed to assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR).MethodsThirty-two patients with aortic aneurysms who had undergone EVAR were included in this study. All patients were examined by dual-phase computed tomography angiography (CTA) as well as MRA with gadofosveset in the first-pass and steady-state phases. Two independent readers evaluated the images of CTA and MRA in terms of endoleak type II, feeding vessel, and image quality.ResultsMedian follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type II was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations.ConclusionMRA with gadofosveset appeared superior to CTA, and has higher diagnostic accuracy, in the detection of endoleak after EVAR.

  5. Regulation of central blood volume and cardiac filling in endurance athletes: the Frank-Starling mechanism as a determinant of orthostatic tolerance.

    PubMed

    Levine, B D

    1993-06-01

    Orthostatic intolerance may result from either an abnormally large postural decrease in central blood volume, cardiac filling pressures, and stroke volume, or inadequate neurohumoral responses to orthostasis. Endurance athletes have been reported as having a high incidence of orthostatic intolerance, which has been attributed primarily to abnormalities in baroreflex regulation of heart rate and peripheral resistance. In this review, we present evidence that athletes also have structural changes in the cardiovascular system that although beneficial during exercise, lead to an excessively large decrease in stroke volume during orthostasis and contribute to orthostatic intolerance. A unifying hypothesis based on cardiac mechanics that may explain the divergence of findings in conditions such as bed rest or spaceflight, and short- and long-term endurance training is presented. PMID:8321111

  6. Regulation of central blood volume and cardiac filling in endurance athletes: the Frank-Starling mechanism as a determinant of orthostatic tolerance

    NASA Technical Reports Server (NTRS)

    Levine, B. D.; Blomqvist, C. G. (Principal Investigator)

    1993-01-01

    Orthostatic intolerance may result from either an abnormally large postural decrease in central blood volume, cardiac filling pressures, and stroke volume, or inadequate neurohumoral responses to orthostasis. Endurance athletes have been reported as having a high incidence of orthostatic intolerance, which has been attributed primarily to abnormalities in baroreflex regulation of heart rate and peripheral resistance. In this review, we present evidence that athletes also have structural changes in the cardiovascular system that although beneficial during exercise, lead to an excessively large decrease in stroke volume during orthostasis and contribute to orthostatic intolerance. A unifying hypothesis based on cardiac mechanics that may explain the divergence of findings in conditions such as bed rest or spaceflight, and short- and long-term endurance training is presented.

  7. Postmortem cardiac troponin T levels in the blood and pericardial fluid. Part 1. Analysis with special regard to traumatic causes of death.

    PubMed

    Zhu, Bao-Li; Ishikawa, Takaki; Michiue, Tomomi; Li, Dong-Ri; Zhao, Dong; Oritani, Shigeki; Kamikodai, Yasunobu; Tsuda, Kohei; Okazaki, Shuji; Maeda, Hitoshi

    2006-03-01

    In forensic pathology, previous studies have suggested the possible application of cardiac troponins in the diagnosis of myocardial infarction. However, there appears to be insufficient practical data on other causes of death. The present study was a comprehensive analysis of the cardiac, peripheral blood and pericardial levels of cardiac troponin T (cTnT) in serial medicolegal autopsy cases (n = 405) with a survival time <24 h and within 48 h postmortem to assess the validity of investigating myocardial damage with special regard to traumatic causes of death. These included blunt and sharp instrument injury (n = 122 and 21, respectively), asphyxiation (n = 35), drowning (n = 27), fire fatalities (n = 94), hyperthermia (n = 13), hypothermia (n = 6), fatal methamphetamine (MA) abuse (n = 12) and carbon monoxide (CO) poisoning (n = 5) in comparison with myocardial infarction (MI, n = 57) and cerebrovascular diseases (n = 13). Cases within 12h postmortem usually showed lower cardiac and pericardial cTnT levels than did those of longer postmortem time of 12-48 h. In the early postmortem period of <12 h, significantly elevated serum cTnT levels were observed for hyperthermia. Thereafter, fatal MA abuse, CO poisoning and MI cases also showed higher levels. However, cTnT remained at lower levels for hypothermia and drowning. The elevation of cTnT was associated with the pathology of advanced myocardial damage involving swelling and liquefactive necrosis. The above-mentioned differences were the smallest for peripheral blood. These findings suggest that elevations in postmortem serum and pericardial cTnT levels depend on the severity of myocardial damage at the time of death and are related to the pathological findings, although postmortem interference should be taken into consideration.

  8. Bone Scintigraphy in the Diagnosis of Rheumatoid Arthritis: Is There Additional Value of Bone Scintigraphy with Blood Pool Phase over Conventional Bone Scintigraphy?

    PubMed Central

    2016-01-01

    We aimed to investigate the value of bone scintigraphy with additional blood pool phase (BSBP), compared with conventional bone scintigraphy (CBS), in the assessment of rheumatoid arthritis (RA). A total of 242 patients (43 males, 199 females; 14–78 years) with arthralgia, and underwent BSBP were retrospectively analyzed. On the first physical examination, active arthritis was found in 128 of the 242 patients. Clinical diagnosis was made by a rheumatologist on the basis of the 1987 American College of Rheumatology (ACR) criteria, which are considered to be the gold standard. The diagnostic performances and prognostic value of BSBP and CBS were analyzed in the total patients with arthralgia and in the patients with arthritis. The sensitivity of BSBP (84.2%, 80/95) were significantly higher than that of CBS (74.8%, 72/95) in the patients with arthralgia (P = 0.039). When BSBP was interpreted with the results of elevated/positive anti-CCP antibody, its accuracy over CBS also became significantly higher (86.0%, 208/242 vs. 83.1%, 201/242 respectively, P = 0.021). The diagnostic odds ratio of BSBP positivity was higher than CBS positivity in the patients with arthralgia (26.0, 12.9-52.4 vs. 21.1, 10.8-41.3) and with arthritis (12.0, 4.9-29.4 vs. 10.0, 4.2-23.4). Both BSBP and CBS appear to provide acceptable accuracy and comparable diagnostic performance for diagnosis of RA. However, in the patients with arthralgia, BSBP was found to be more sensitive than CBS and more accurate when interpreted with the result of anti-CCP antibody. This could help physicians diagnose RA in daily clinical practice. PMID:27051232

  9. Reductions in systolic blood pressure with liraglutide in patients with type 2 diabetes: Insights from a patient-level pooled analysis of six randomized clinical trials☆

    PubMed Central

    Fonseca, Vivian A.; DeVries, J. Hans; Henry, Robert R.; Donsmark, Morten; Thomsen, Henrik F.; Plutzky, Jorge

    2014-01-01

    Aims To quantify the effect of liraglutide on systolic blood pressure (SBP) and pulse in patients with type 2 diabetes (T2D), and assess the influence of covariates on observed SBP reductions. Methods A patient-level pooled analysis of six phase 3, randomized trials was conducted. Results The analysis included 2792 randomized patients. In the intention-to-treat population (n = 2783), mean [±SE] SBP reductions from baseline with liraglutide 1.2 mg (2.7 [0.8] mmHg) and 1.8 mg (2.9 [0.7] mmHg) once daily were significantly greater than with placebo (0.5 [0.9] mmHg; P = 0.0029 and P = 0.0004, respectively) after 26 weeks, and were evident after 2 weeks. Liraglutide was also associated with significantly greater SBP reductions than glimepiride and, at a dose of 1.8 mg, insulin glargine and rosiglitazone. SBP reductions with liraglutide weakly correlated with weight loss (Pearson’s correlation coefficient: 0.08–0.12; P ≤ 0.0148). No dependence of these reductions on concomitant antihypertensive medications was detected (P = 0.1304). Liraglutide 1.2 and 1.8 mg were associated with mean increases in pulse of 3 beats per minute (bpm), versus a 1 bpm increase with placebo (P < 0.0001 for each dose versus placebo). Conclusions Liraglutide reduces SBP in patients with T2D, including those receiving concomitant antihypertensive medication. PMID:24561125

  10. Intravenous and intramyocardial injection of apoptotic white blood cell suspensions prevents ventricular remodelling by increasing elastin expression in cardiac scar tissue after myocardial infarction.

    PubMed

    Lichtenauer, Michael; Mildner, Michael; Baumgartner, Andrea; Hasun, Matthias; Werba, Gregor; Beer, Lucian; Altmann, Patrick; Roth, Georg; Gyöngyösi, Mariann; Podesser, Bruno Karl; Ankersmit, Hendrik Jan

    2011-06-01

    Congestive heart failure developing after acute myocardial infarction (AMI) is a major cause of morbidity and mortality. Clinical trials of cell-based therapy after AMI evidenced only a moderate benefit. We could show previously that suspensions of apoptotic peripheral blood mononuclear cells (PBMC) are able to reduce myocardial damage in a rat model of AMI. Here we experimentally examined the biochemical mechanisms involved in preventing ventricular remodelling and preserving cardiac function after AMI. Cell suspensions of apoptotic cells were injected intravenously or intramyocardially after experimental AMI induced by coronary artery ligation in rats. Administration of cell culture medium or viable PBMC served as controls. Immunohistological analysis was performed to analyse the cellular infiltrate in the ischaemic myocardium. Cardiac function was quantified by echocardiography. Planimetry of the infarcted hearts showed a significant reduction of infarction size and an improvement of post AMI remodelling in rats treated with suspensions of apoptotic PBMC (injected either intravenously or intramoycardially). Moreover, these hearts evidenced enhanced homing of macrophages and cells staining positive for c-kit, FLK-1, IGF-I and FGF-2 as compared to controls. A major finding in this study further was that the ratio of elastic and collagenous fibres within the scar tissue was altered in a favourable fashion in rats injected with apoptotic cells. Intravenous or intramyocardial injection of apoptotic cell suspensions results in attenuation of myocardial remodelling after experimental AMI, preserves left ventricular function, increases homing of regenerative cells and alters the composition of cardiac scar tissue. The higher expression of elastic fibres provides passive energy to the cardiac scar tissue and results in prevention of ventricular remodelling.

  11. Human umbilical cord blood derived mesenchymal stem cells improve cardiac function in cTnT(R141W) transgenic mouse of dilated cardiomyopathy.

    PubMed

    Gong, Xuhe; Wang, Pengbo; Wu, Qingqing; Wang, Sijia; Yu, Litian; Wang, Guogan

    2016-01-01

    Cell transplantation is a promising strategy in regenerative medicine. Beneficial effects of bone marrow mesenchymal stem cells (BM-MSCs) on heart disease have been widely reported. However, the MSCs in these studies have been mainly derived from autologous animals, and data on MSCs from human umbilical cord blood (UCB-MSCs) are still scarce. We investigated whether intramyocardial xenogeneic administration of UCB-MSCs is beneficial for preserving heart function in a cTnT(R141W) transgenic mouse of dilated cardiomyopathy (DCM). Cultured UCB-MSCs, which were identified by there morphology, differentiation and cell surface markers, were transplanted into cTnT(R141W) transgenic mice to examine apoptosis, fibrosis, vasculogenesis and the associated Akt pathway. Moreover, we measured the expression levels of VEGF and IGF-1, which are growth factors required for differentiation into cardiomyocytes, and are also involved in cardiac regeneration and improving heart function. One month after transplantation, MSCs significantly decreased chamber dilation and contractile dysfunction in the cTnT(R141W) mice. MSCs transplanted hearts showed a significant decrease in cardiac apoptosis and its regulation by the Akt pathway. Cardiac fibrosis and cytoplasmic vacuolisation were significantly attenuated in the MSCs group. Importantly, the levels of VEGF and IGF-1 were increased in the MSCs transplanted hearts. In vitro, the MSC-conditioned medium displayed anti-apoptotic activity in h9c2 cardiomyocytes subjected to hypoxia. These results further confirm the paracrine effects of MSCs. In conclusion, UCB-MSCs preserve cardiac function after intramyocardial transplantation in a DCM mouse, and this effect may be associated with reductions in cellular apoptosis, inflammation, hypertrophy and myocardial fibrosis; in addition to; up-regulation of Akt, VEGF and IGF-1; and enhanced angiogenesis. PMID:26655348

  12. Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study

    PubMed Central

    Côté, Claudia L.; Yip, Alexandra M.; MacLeod, Jeffrey B.; O’Reilly, Bill; Murray, Joshua; Ouzounian, Maral; Brown, Craig D.; Forgie, Rand; Pelletier, Marc P.; Hassan, Ansar

    2016-01-01

    Background Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery. Methods We conducted a retrospective analysis of patients who underwent nonemergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS. Perioperative transfusion rates, postoperative bleeding, clinical and hematological outcomes, and overall cost were examined. We used multivariable logistic regression modelling to determine the risk-adjusted effect of ICS on likelihood of perioperative transfusion. Results A total of 389 patients formed the final study population (186 undergoing ICS and 203 controls). Patients undergoing ICS had significantly lower perioperative transfusion rates of packed red blood cells (pRBCs; 33.9% v. 45.3% p = 0.021), coagulation products (16.7% v. 32.5% p < 0.001) and any blood product (38.2% v. 52.7%, p = 0.004). Patients receiving ICS had decreased mediastinal drainage at 12 h (mean 320 [range 230–550] mL v. mean 400 [range 260–690] mL, p = 0.011) and increased postoperative hemoglobin (mean 104.7 ± 13.2 g/L v. 95.0 ± 11.9 g/L, p < 0.001). Following adjustment for other baseline and intraoperative covariates, ICS emerged as an independent predictor of lower perioperative transfusion rates of pRBCs (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.31–0.87), coagulation products (OR 0.41, 95% CI 0.24–0.71) and any blood product (OR 0.47, 95% CI 0.29–0.77). Additionally, ICS was associated with a cost benefit of $116 per patient. Conclusion Intraoperative cell salvage could represent a clinically cost-effective way of reducing transfusion rates in patients undergoing cardiac surgery. Further research on systematic ICS is required before recommending it for routine use. PMID:27668331

  13. Effect of increased cardiac output on liver blood flow, oxygen exchange and metabolic rate during longterm endotoxin-induced shock in pigs

    PubMed Central

    Šantak, Borislav; Radermacher, Peter; Adler, Jens; Iber, Thomas; Rieger, Karen M; Wachter, Ulrich; Vogt, Josef; Georgieff, Michael; Träger, Karl

    1998-01-01

    We investigated hepatic blood flow, O2 exchange and metabolism in porcine endotoxic shock (Control, n=8; Endotoxin, n=10) with administration of hydroxyethylstarch to maintain arterial pressure (MAP)>60 mmHg. Before and 12, 18 and 24 h after starting continuous i.v. endotoxin we measured portal venous and hepatic arterial blood flow, intracapillary haemoglobin O2 saturation (Hb-O2%) of the liver surface and arterial, portal and hepatic venous lactate, pyruvate, glyercol and alanine concentrations. Glucose production rate was derived from the plasma isotope enrichment during infusion of [6,6-2H2]-glucose. Despite a sustained 50% increase in cardiac output endotoxin caused a progressive, significant fall in MAP. Liver blood flow significantly increased, but endotoxin affected neither hepatic O2 delivery and uptake nor mean intracapillary Hb-O2% and Hb-O2% frequency distributions. Endotoxin nearly doubled endogenous glucose production rate while hepatic lactate, alanine and glycerol uptake rates progressively decreased significantly. The lactate uptake rate even became negative (P<0.05 vs Control). Endotoxin caused portal and hepatic venous pH to fall significantly concomitant with significantly increased arterial, portal and hepatic venous lactate/pyruvate ratios. During endotoxic shock increased cardiac output achieved by colloid infusion maintained elevated liver blood flow and thereby macro- and microcirculatory O2 supply. Glucose production rate nearly doubled with complete dissociation of hepatic uptake of glucogenic precursors and glucose release. Despite well-preserved capillary oxygenation increased lactate/pyruvate ratios reflecting impaired cytosolic redox state suggested deranged liver energy balance, possibly due to the O2 requirements of gluconeogenesis. PMID:9756385

  14. Urinary Proteome and Systolic Blood Pressure as Predictors of 5-Year Cardiovascular and Cardiac Outcomes in a General Population.

    PubMed

    Zhang, Zhen-Yu; Thijs, Lutgarde; Petit, Thibault; Gu, Yu-Mei; Jacobs, Lotte; Yang, Wen-Yi; Liu, Yan-Ping; Koeck, Thomas; Zürbig, Petra; Jin, Yu; Verhamme, Peter; Voigt, Jens-Uwe; Kuznetsova, Tatiana; Mischak, Harald; Staessen, Jan A

    2015-07-01

    In a previous cross-sectional study, we identified a multidimensional urinary classifier (HF1), which was associated with left ventricular dysfunction. We investigated whether HF1 predicts cardiovascular end points over and beyond traditional risk factors. In 791 randomly recruited Flemish (mean age, 51.2 years; 50.6% women), we quantified HF1 by capillary electrophoresis coupled with mass spectrometry. In addition, we measured cardiovascular risk factors. HF1 averaged -0.97 U (range, -3.26 to 2.60). Over 6.1 years (median), 35 participants died and 63, 45, and 22 experienced fatal or nonfatal cardiovascular, cardiac, or coronary events, respectively. The incidence of fatal combined with nonfatal cardiovascular and cardiac end points, standardized for sex and age, increased across thirds of the HF1 distribution (P≤0.014), whereas trends for all-cause mortality and coronary events were nonsignificant (P≥0.10). The multivariable-adjusted hazard ratios (+1-SD) were 1.30 (95% confidence interval, 1.03-1.65; P=0.029) and 1.39 (1.06-1.84; P=0.018) for cardiovascular and cardiac events in relation to HF1. For systolic pressure, the corresponding estimates were 0.97 (0.74-1.28; P=0.85) and 0.93 (0.67-1.29; P=0.66), respectively. The HF1 upper thresholds optimized by maximizing Younden's index were -0.50 and -0.36 U for cardiovascular and cardiac end points, respectively. Prognostic accuracy significantly (P≤0.006) improved by adding HF1 to Cox models already including the other baseline predictors. Sensitivity analyses, from which we excluded 71 participants with previous cardiovascular disease, were confirmatory. In conclusion, over a 6-year period, the urinary proteome, but not systolic pressure, predicted cardiovascular and cardiac disease. PMID:26063667

  15. Cardiac gated ventilation

    SciTech Connect

    Hanson, C.W. III; Hoffman, E.A.

    1995-12-31

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart.

  16. Cardiac gated ventilation

    NASA Astrophysics Data System (ADS)

    Hanson, C. William, III; Hoffman, Eric A.

    1995-05-01

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. We evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50msec scan aperture. Multislice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. We observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a nonfailing model of the heart.

  17. Cardiac dilatation index as an indicator of terminal central congestion evaluated using postmortem CT and forensic autopsy data.

    PubMed

    Michiue, Tomomi; Sogawa, Nozomi; Ishikawa, Takaki; Maeda, Hitoshi

    2016-06-01

    Previous studies demonstrated possible application of postmortem quantitative CT data analysis of the heart and lung in situ to investigate terminal cardiopulmonary pathophysiology. The present study analyzed virtual CT morphometric and autopsy data of the heart to investigate terminal central congestion in forensic autopsy cases (n=113, within 3 days postmortem); the virtual total heart weight in situ was estimated using CT morphometry, and the difference from and ratio to the measured weight at autopsy were calculated as indicators of heart blood pooling and the cardiac dilatation index (CDI) before dissection, respectively. There were substantial differences between the estimated heart blood pooling in situ and volume recovered at autopsy, including a characteristic decrease in drowning, alcohol/sedative-hypnotic intoxication and sudden cardiac death (SCD), possibly due to blood redistribution after thoracic dissection. The estimated in situ heart blood pool and CDI values were higher in SCD but lower in fatal hemorrhage and hemopericardium, as well as in acute mechanical asphyxiation and hyperthermia (heatstroke). In addition, there was a significant difference in heart blood pooling between mechanical asphyxiation or drowning and SCD. The CDI was significantly lower in fatal hyperthermia (heatstroke) than in drowning, fatal methamphetamine abuse, alcohol/sedative-hypnotic intoxication and SCD. These findings suggest the usefulness of applying the CDI and postmortem heart blood volume in situ as supplementary indicators of terminal central congestion, especially for investigating deaths from hemorrhage, hemopericardium, hyperthermia (heatstroke) and SCD.

  18. [Cardiac amyloidosis].

    PubMed

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

    2008-03-15

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

  19. Blood neutrophil bactericidal activity against methicillin-resistant and methicillin-sensitive Staphylococcus aureus during cardiac surgery.

    PubMed

    Mekontso-Dessap, Armand; Honoré, Stéphanie; Kirsch, Matthias; Plonquet, Anne; Fernandez, Eric; Touqui, Lhousseine; Farcet, Jean-Pierre; Soussy, Claude-James; Loisance, Daniel; Delclaux, Christophe

    2005-08-01

    Whether methicillin-resistant Staphylococcus aureus (MRSA) constitutes per se an independent risk factor for morbidity and mortality after surgery as compared with methicillin-sensitive Staphylococcus aureus (MSSA) remains a subject of debate. The aim of this study was to assess whether innate defenses against MRSA and MSSA strains are similarly impaired after cardiac surgery. Both intracellular (isolated neutrophil functions) and extracellular (plasma) defenses of 12 patients undergoing scheduled cardiac surgery were evaluated preoperatively (day 0) and postoperatively (day 3) against two MSSA strains with a low level of catalase secretion and two MRSA strains with a high level of catalase secretion, inasmuch as SA killing by neutrophils relies on oxygen-dependent mechanisms. After surgery, an increase in plasma concentration of IL-10, an anti-inflammatory cytokine able to inhibit reactive oxygen species secretion and bactericidal activity of neutrophils, was evidenced. Despite the fact that univariate analysis suggested a specific impairment of neutrophil functions against MRSA strains, two-way repeated-measures ANOVA failed to demonstrate that the effect of S. aureus phenotype was significant. On the other hand, an increase in type-II secretory phospholipase A2 activity, a circulating enzyme involved in SA lysis, was evidenced and was associated with an enhancement of extracellular defenses (bactericidal activity of plasma) against MRSA. Overall, cardiac surgery and S. aureus phenotype had a significant effect on plasma bactericidal activity. Cardiac surgery was characterized by enhanced antibacterial defenses of plasma, whereas neutrophil killing properties were reduced. The overall effect of S. aureus phenotype on neutrophil functions did not seem significant.

  20. The effect of the perioperative blood transfusion and blood conservation in cardiac surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon clinical practices.

    PubMed

    Likosky, Donald S; FitzGerald, Daniel C; Groom, Robert C; Jones, Dwayne K; Baker, Robert A; Shann, Kenneth G; Mazer, C David; Spiess, Bruce D; Body, Simon C

    2010-06-01

    The 2007 Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Clinical Practice Guideline for Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery was recently promulgated and has received much attention. Using a survey of cardiac anesthesiologists and perfusionists' clinical practice, we assessed the current practices of perfusion, anesthesia, and surgery, as recommended by the Guidelines and also determined the role the Guidelines had in changing these practices. Nontrainee members of the Society of Cardiovascular Anesthesiologists, the American Academy of Cardiovascular Perfusion, the Canadian Society of Clinical Perfusion, and the American Society of ExtraCorporeal Technology were surveyed using a standardized survey instrument that examined clinical practices and responses to the Guidelines. One thousand four hundred and two surveys from 1,061 institutions principally in the United States (677 institutions) and Canada (34 institutions) were returned, with a 32% response rate. There was wide distribution of the Guidelines with 78% of anesthesiologists and 67% of perfusionists reporting having read all, part, or a summary of the Guidelines. However, only 20% of respondents reported that an institutional discussion had taken place as a result of the Guidelines, and only 14% of respondents reported that an institutional monitoring group had been formed. There was wide variability in current preoperative testing, perfusion, surgical, and pharmacological practices reported by respondents. Twenty-six percent of respondents reported one or more practice changes in response to the Guidelines.The changes made were reported to be highly (9%) or somewhat effective (31%) in reducing overall transfusion rates. Only four of 38 Guideline recommendations were reported by more than 5% of respondents to have been changed in response to the Guidelines. Wide variation in clinical practices of cardiac surgery was reported. Little

  1. Selectively engaging β-arrestins at the angiotensin II type 1 receptor reduces blood pressure and increases cardiac performance.

    PubMed

    Violin, Jonathan D; DeWire, Scott M; Yamashita, Dennis; Rominger, David H; Nguyen, Lisa; Schiller, Kevin; Whalen, Erin J; Gowen, Maxine; Lark, Michael W

    2010-12-01

    Biased G protein-coupled receptor ligands engage subsets of the receptor signals normally stimulated by unbiased agonists. However, it is unclear whether ligand bias can elicit differentiated pharmacology in vivo. Here, we describe the discovery of a potent, selective β-arrestin biased ligand of the angiotensin II type 1 receptor. TRV120027 (Sar-Arg-Val-Tyr-Ile-His-Pro-D-Ala-OH) competitively antagonizes angiotensin II-stimulated G protein signaling, but stimulates β-arrestin recruitment and activates several kinase pathways, including p42/44 mitogen-activated protein kinase, Src, and endothelial nitric-oxide synthase phosphorylation via β-arrestin coupling. Consistent with β-arrestin efficacy, and unlike unbiased antagonists, TRV120027 increased cardiomyocyte contractility in vitro. In rats, TRV120027 reduced mean arterial pressure, as did the unbiased antagonists losartan and telmisartan. However, unlike the unbiased antagonists, which decreased cardiac performance, TRV120027 increased cardiac performance and preserved cardiac stroke volume. These striking differences in vivo between unbiased and β-arrestin biased ligands validate the use of biased ligands to selectively target specific receptor functions in drug discovery.

  2. Cardiac Rehabilitation

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Cardiac Rehabilitation? Cardiac rehabilitation (rehab) is a medically supervised program ... be designed to meet your needs. The Cardiac Rehabilitation Team Cardiac rehab involves a long-term commitment ...

  3. 20-Hydroxyeicosatetraenoic Acid Inhibition by HET0016 Offers Neuroprotection, Decreases Edema, and Increases Cortical Cerebral Blood Flow in a Pediatric Asphyxial Cardiac Arrest Model in Rats

    PubMed Central

    Shaik, Jafar Sadik B; Poloyac, Samuel M; Kochanek, Patrick M; Alexander, Henry; Tudorascu, Dana L; Clark, Robert SB; Manole, Mioara D

    2015-01-01

    Vasoconstrictive and vasodilatory eicosanoids generated after cardiac arrest (CA) may contribute to cerebral vasomotor disturbances and neurodegeneration. We evaluated the balance of vasodilator/vasoconstrictor eicosanoids produced by cytochrome P450 (CYP) metabolism, and determined their role on cortical perfusion, functional outcome, and neurodegeneration after pediatric asphyxial CA. Cardiac arrest of 9 and 12 minutes was induced in 16- to 18-day-old rats. At 5 and 120 minutes after CA, we quantified the concentration of CYP eicosanoids in the cortex and subcortical areas. In separate rats, we inhibited 20-hydroxyeicosatetraenoic acid (20-HETE) synthesis after CA and assessed cortical cerebral blood flow (CBF), neurologic deficit score, neurodegeneration, and edema. After 9 minutes of CA, vasodilator eicosanoids markedly increased versus sham. Conversely, after 12 minutes of CA, vasoconstrictor eicosanoid 20-HETE increased versus sham, without compensatory increases in vasodilator eicosanoids. Inhibition of 20-HETE synthesis after 12 minutes of CA decreased cortical 20-HETE levels, increased CBF, reduced neurologic deficits at 3 hours, and reduced neurodegeneration and edema at 48 hours versus vehicle-treated rats. In conclusion, cerebral vasoconstrictor eicosanoids increased after a pediatric CA of 12 minutes. Inhibition of 20-HETE synthesis improved cortical perfusion and short-term neurologic outcome. These results suggest that alterations in CYP eicosanoids have a role in cerebral hypoperfusion and neurodegeneration after CA and may represent important therapeutic targets. PMID:26058691

  4. Brain hyperperfusion during cardiac operations. Cerebral blood flow measured in man by intra-arterial injection of xenon 133: evidence suggestive of intraoperative microembolism

    SciTech Connect

    Henriksen, L.; Hjelms, E.; Lindeburgh, T.

    1983-08-01

    Cerebral blood flow (CBF) was measured by intra-arterial injection of xenon 133 in 29 patients during cardiac operations. Marked changes occurred in all patients. A normal and significant correlation with temperature and plasma pCO/sub 2/ (p less than 0.01) support the reliability of the method. Mean CBF measured between sternotomy and the onset of extracorporeal circulation (ECC) was 38 ml/100 gm . min. The first minute of ECC was associated with a decrease in CBF in nine of 12 patients (p less than 0.02). During steady-state hypothermic ECC (temperature 29 degrees C), CBF increased unexpectedly to 64 ml/100 gm . min (p less than 0.01). Following rewarming steady-state normothermic ECC, mean CBF decreased to 42 ml/100 gm . min with signs of impairment of cerebral autoregulation. Ten and 20 minutes after termination of ECC, mean CBF was 40 and 41 ml/100 gm . min, respectively. Arterial PCO2 was found to be important in regulating CBF. The cerebral autoregulation maintained CBF down to arterial pressures of around 55 mm Hg. Below this level, CBF was significantly correlated with perfusion pressure (p less than 0.01). Multiple small emboli with a hyperemic border zone could cause a brain hyperperfusion, as seen in our patients during bypass. Measurements of CBF during ECC hold promise as a guide toward safer cardiac operations.

  5. Short-Term Effects and Safety Analysis of Retrograde Autologous Blood Priming for Cardiopulmonary Bypass in Patients with Cardiac Valve Replacement Surgery.

    PubMed

    Cheng, Ming; Li, Jun-Quan; Wu, Tian-Chi; Tian, Wei-Chen

    2015-11-01

    This randomized, double-blind study evaluated the short-term effects and safety of perioperative retrograde autologous priming (RAP) for cardiopulmonary bypass (CPB) in patients with cardiac replacement surgery to determine if this approach is a better substitute for crystal liquids priming in patients with valvular heart disease. We observed that RAP significantly decreased the actual priming volume, preserved the hematocrit and hemoglobin level during CPB to a certain degree, and decreased lactate accumulation in CPB period. Moreover, RAP lowered the volume of transfusion and dosage blood products. Thus, our results showed that RAP approach effectively improved tissue perfusion and lowered intraoperative Lac levels, by reducing the hemodilution, which safely and reliably improve the microcirculation perfusion. PMID:27352335

  6. Electromagnetic Interference in a Private Swimming Pool

    PubMed Central

    Iskandar, Sandia; Lavu, Madhav; Atoui, Moustapha; Lakkireddy, Dhanunjaya

    2016-01-01

    Although current lead design and filtering capabilities have greatly improved, Electromagnetic Interference (EMI) from environmental sources has been increasingly reported in patients with Cardiac Implantable Electronic Device (CIED) [1]. Few cases of inappropriate intracardiac Cardioverter Defibrillator (ICD) associated with swimming pool has been described [2]. Here we present a case of 64 year old male who presented with an interesting EMI signal that was subsequently identified to be related to AC current leak in his swimming pool. PMID:27479205

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

    PubMed

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

    2014-03-01

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

  8. End-expiration Respiratory Gating for a High Resolution Stationary Cardiac SPECT system

    PubMed Central

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

    2014-01-01

    Respiratory and cardiac motions can degrade myocardial perfusion SPECT (MPS) image quality and reduce defect detection and quantitative accuracy. In this study, we developed a dual-respiratory and cardiac gating system for a high resolution fully stationary cardiac SPECT scanner in order to improve the image quality and defect detection. Respiratory motion was monitored using a compressive sensor pillow connected to a dual respiratory-cardiac gating box, which sends cardiac triggers only during end-expiration phases to the single cardiac trigger input on the SPECT scanners. The listmode data were rebinned retrospectively into end-expiration frames for respiratory motion reduction or 8 cardiac gates only during end-expiration phases to compensate for both respiratory and cardiac motions. The proposed method was first validated on a motion phantom in the presence and absence of multiple perfusion defects, and then applied on 11 patient studies with and without perfusion defects. In the normal phantom studies, the end-expiration gated SPECT (EXG-SPECT) reduced respiratory motion blur and increased myocardium to blood pool contrast by 51.2% as compared to the ungated images. The proposed method also yielded an average of 11.2% increase in myocardium to defect contrast as compared to the ungated images in the phantom studies with perfusion defects. In the patient studies, EXG-SPECT significantly improved the myocardium to blood pool contrast (p<0.005) by 24% on average as compared to the ungated images, and led to improved perfusion uniformity across segments on polar maps for normal patients. For a patient with defect, EXG-SPECT improved the defect contrast and definition. The dual respiratory-cardiac gating further reduced the blurring effect, increased the myocardium to blood pool contrast significantly by 36% (p<0.05) compared to EXG SPECT, and further improved defect characteristics and visualization of fine structures at the expense of increased noise on the

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

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

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

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

    PubMed

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

    2014-10-21

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

  11. Functional imaging as an indicator of diagnostic information in cardiac magnetic-resonance images

    NASA Astrophysics Data System (ADS)

    Klingler, Joseph W.; Andrews, Lee T.; Begeman, Michael S.; Zeiss, Jacob; Leighton, Richard F.

    1990-08-01

    Magnetic Resonance (MR) images of the human heart provide three dimensional geometric information about the location of cardiac structures throughout the cardiac cycle. Analysis of this four dimensional data set allows detection of abnormal cardiac function related to the presence of coronary artery disease. To assist in this analysis, quantitative measurements of cardiac performance are made from the MR data including ejection fractions, regional wall motion and myocardial wall thickening. Analysis of cardiac performance provided by quantitative analysis of MR data can be aided by computer graphics presentation techniques. Two and three dimensional functional images are computed to indicate regions of abnormality based on the previous methods. The two dimensional images are created using color graphics overlays on the original MR image to represent performance. Polygon surface modeling techniques are used to represent data which is three dimensional, such as blood pool volumes. The surface of these images are color encoded by regional ejection fraction, wall motion or wall thickening. A functional image sequence is constructed at each phase of the cardiac cycle and displayed as a movie loop for review by the physician. Selection of a region on the functional image allows visual interpretation of the original MR images, graphical plots of cardiac function and tabular results. Color encoding is based on absolute measurements and comparison to standard normal templates of cardiac performance.

  12. Changes in cerebral blood flow in patients with severe congestive cardiac failure before and after captopril treatment

    SciTech Connect

    Rajagopalan, B.; Raine, A.E.; Cooper, R.; Ledingham, J.G.

    1984-05-31

    The intravenous /sup 133/xenon injection method was used to estimate global cerebral blood flow before and after treatment with captopril in nine patients with severe heart failure. The pretreatment mean blood pressure was 94.9 mm Hg (S.D. 13.9) and fell to 85.1 mm Hg (S.D. 18.1) after treatment with captopril for between four and 15 days. The cerebral blood flow before captopril was 61.1 ml/100 g per minute (S.D. 6.9), which was less than the value of 75.8 ml/100 g per minute found in control subjects. After treatment with captopril the cerebral blood flow increased to 73.8 ml/100 g per minute (S.D. 11.8, p less than 0.01). The fraction of carbon dioxide in the expired air was not significantly different in the two studies (4.1 +/- 0.88 versus 3.97 +/- 0.65). It is concluded that cerebral blood flow is reduced in severe heart failure and can be restored by treatment with captopril, but the reasons for the reduced flow and its improvement after converting enzyme inhibition are not known.

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

    SciTech Connect

    Ziemer, B; Hubbard, L; Lipinski, J; Molloi, S

    2014-06-15

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

  14. Mechanisms of cardiac arrhythmias

    PubMed Central

    Tse, Gary

    2015-01-01

    Blood circulation is the result of the beating of the heart, which provides the mechanical force to pump oxygenated blood to, and deoxygenated blood away from, the peripheral tissues. This depends critically on the preceding electrical activation. Disruptions in the orderly pattern of this propagating cardiac excitation wave can lead to arrhythmias. Understanding of the mechanisms underlying their generation and maintenance requires knowledge of the ionic contributions to the cardiac action potential, which is discussed in the first part of this review. A brief outline of the different classification systems for arrhythmogenesis is then provided, followed by a detailed discussion for each mechanism in turn, highlighting recent advances in this area. PMID:27092186

  15. Relation of blood pressure and all-cause mortality in 180,000 Japanese participants: pooled analysis of 13 cohort studies.

    PubMed

    Murakami, Yoshitaka; Hozawa, Atsushi; Okamura, Tomonori; Ueshima, Hirotsugu

    2008-06-01

    Hypertension is a leading cause of death because of cardiovascular disease and predominantly affects total mortality. To reduce avoidable deaths from hypertension, we need to collect blood pressure data and assess their impact on total mortality. To examine this issue, a meta-analysis of 13 cohort studies was conducted in Japan. Poisson regression was used for estimating all-cause mortality rates and ratios. In the model, blood pressure data were treated as continuous (10-mm Hg increase) and categorical (every 10 mm Hg) according to recommendations of the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hypertension. Potential confounders included body mass index, smoking, drinking, and cohort. The impact of hypertension was measured by the population-attributable fraction. After excluding participants with cardiovascular disease history, 176 389 participants were examined in the analysis. Adjusted mortality rates became larger as the blood pressure increased, and these were more distinct in younger men and women. Hazard ratios also showed the same trends, and these trends were more apparent in younger men (hazard ratio [unit: 10-mm Hg increase] aged 40 to 49 years: systolic blood pressure 1.37 (range: 1.15 to 1.62); diastolic blood pressure 1.46 [range: 1.05 to 2.03]) than older ones (hazard ratio: aged 80 to 89 years: systolic blood pressure 1.09 [range: 1.05 to 1.13]and diastolic blood pressure 1.12 [range: 1.03 to 1.22]). Population-attributable fraction of hypertension was approximately 20% when the normal category was used as a reference level and was 10% when we included the prehypertension group in the reference level. In conclusion, high blood pressure raised the risk of total mortality, and this trend was higher in the younger Japanese population.

  16. Cardiac rehabilitation

    MedlinePlus

    ... Coronary artery disease - cardiac rehab; Angina - cardiac rehab; Heart failure - cardiac rehab ... have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery ...

  17. The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: the Framingham Heart Study.

    PubMed

    Kaess, Bernhard M; Harris, William S; Lacey, Sean; Larson, Martin G; Hamburg, Naomi M; Vita, Joseph A; Robins, Sander J; Benjamin, Emelia J; Mitchell, Gary F; Vasan, Ramachandran S

    2015-02-01

    Polyunsaturated fatty acids have been associated with beneficial influences on cardiovascular health. However, the underlying mechanisms are not clear, and data on the relations of polyunsaturated fatty acids to subclinical disease measures such as vascular stiffness and cardiac function are sparse and inconclusive. In a large community-based cohort, we examined the relations of omega-3 and other fatty acids to a comprehensive panel of vascular function measures (assessing microvascular function and large artery stiffness), cardiac structure and left ventricular function. Red blood cell (RBC) membrane fatty acid composition, a measure of long-term fatty acid intake, was assessed in participants of the Framingham Offspring Study and Omni cohorts and related to tonometry-derived measures of vascular stiffness and to a panel of echocardiographic traits using partial correlations. Up to n=3055 individuals (56% women, mean age 66 years) were available for analyses. In age- and sex-adjusted models, higher RBC omega-3 content was moderately associated (p≤0.002) with several measures of vascular stiffness and function in a protective direction. However, after multivariable adjustment, only an association of higher RBC omega-3 content with lower carotid-femoral pulse wave velocity (a measure of aortic stiffness) remained significant (r = -0.06, p=0.002). In secondary analyses, higher linoleic acid, the major nutritional omega-6 fatty acid, was associated with smaller left atrial size, even after multivariable adjustment (r = -0.064, p<0.001). In conclusion, in our cross-sectional community-based study, we found several associations consistent with the notion of protective effects of omega-3 and linoleic acid. The clinical significance of these modest associations remains to be elucidated.

  18. Obesity-Related Alterations in Cardiac Lipid Profile and Nondipping Blood Pressure Pattern during Transition to Diastolic Dysfunction in Male db/db Mice

    PubMed Central

    Ford, David A.; Henriksen, Erik J.; Aroor, Annayya R.; Johnson, Megan S.; Habibi, Javad; Ma, Lixin; Yang, Ming; Albert, Carolyn J.; Lally, John W.; Ford, Caleb A.; Prasannarong, Mujalin; Hayden, Melvin R.; Whaley-Connell, Adam T.; Sowers, James R.

    2013-01-01

    Obesity and a nondipping circadian blood pressure (BP) pattern are associated with diastolic dysfunction. Ectopic lipid accumulation is increasingly recognized as an important metabolic abnormality contributing to diastolic dysfunction. However, little is known about the contribution of different lipids and the composition of lipid analytes to diastolic dysfunction. We have performed functional and structural studies and analyzed cardiac lipid profile at two time points during progression to diastolic dysfunction in a genetic model of obesity. Serial cardiac magnetic resonance imaging and telemetric measures of BP between 12 and 15 wk of age in obese male db/db mice indicated a nondipping circadian BP pattern and normal diastolic function at 12 wk that progressed to a deteriorating nondipping pattern and onset of diastolic dysfunction at 15 wk of age. Lipidomic analysis demonstrated elevated fatty acids and ceramides in db/db at 12 wk, but their levels were decreased at 15 wk, and this was accompanied by persistent mitochondrial ultrastructural abnormalities in concert with evidence of increased fatty acid oxidation and enhanced production of reactive oxygen species. Triacylglyceride and diacylglyceride levels were elevated at both 12 and 15 wk, but their composition changed to consist of more saturated and less unsaturated fatty acyl at 15 wk. An increase in the lipid droplets was apparent at both time points, and this was associated with increases in phosphatidycholine. In conclusion, a distinct pattern of myocardial lipid remodeling, accompanied by oxidative stress, is associated with the onset of diastolic dysfunction in obese, insulin-resistant db/db mice. PMID:23142808

  19. Cardiac phase: Amplitude analysis using macro programming

    SciTech Connect

    Logan, K.W.; Hickey, K.A.

    1981-11-01

    The analysis of EKG gated radionuclide cardiac imaging data with Fourier amplitude and phase images is becoming a valuable clinical technique, demonstrating location, size, and severity of regional ventricular abnormalities. Not all commercially available nuclear medicine computer systems offer software for phase and amplitude analysis; however, many systems do have the capability of linear image arithmetic using simple macro commands which can easily be sequenced into stored macro-strings or programs. Using simple but accurate series approximations for the Fourier operations, macro programs have been written for a Digital Equipment Corporation Gamma-11 system to obtain phase and amplitude images from routine gated cardiac studies. In addition, dynamic cine-mode presentation of the onset of mechanical systole is generated from the phase data, using only a second set of macro programs. This approach is easily adapted to different data acquisition protocols, and can be used on any system with macro commands for image arithmetic. Key words: Fourier analysis, cardiac cycle, gated blood pool imaging, amplitude image, phase image

  20. Isolated and combined effects of aerobic and strength exercise on post-exercise blood pressure and cardiac vagal reactivation in normotensive men.

    PubMed

    Ruiz, Roberto José; Simão, Roberto; Saccomani, Milene Granja; Casonatto, Juliano; Alexander, Jeffrey L; Rhea, Matthew; Polito, Marcos Doederlein

    2011-03-01

    The purpose of this study was to examine blood pressure (BP), heart rate (HR), and cardiac vagal reactivation (VR) after an aerobic training session (ATS), a strength training session (STS), and a combined aerobic and strength training session (ASTS) in normotensive men. Eleven healthy men (age 26.8 ± 2.9 years, body mass index 24.3 ± 1.6 kg·m) with at least 6 months of strength and aerobic training experience performed an STS, an ATS, and an ASTS in a counterbalanced crossover design. Blood pressure and HR were measured at rest and at 15-minute intervals post-training for 1 hour. Vagal reactivation was measured during the first minute immediately post-exercise. After STS and ASTS, systolic BP (SBP) and mean arterial BP (MAP) remained significantly lower than at rest at all time intervals (p < 0.05). After ATS, SBP was significantly lower than at rest at 30 minutes and beyond (p < 0.01); however, no significant differences were observed for MAP. Post-training HR remained high after STS and ASTS at all intervals (p < 0.01). However, after ATS, the HR remained high only at the 15-minute post-exercise interval (p < 0.01). Vagal reactivation was significantly less pronounced after the first 30 seconds post-exercise (p < 0.01) in ASTS (531.3 ± 329.6 seconds) than in ATS (220.7 ± 88.5 seconds) and in STS (317.6 ± 158.5 seconds). The delta of the HR decrease at 60 seconds post-exercise was greater (p < 0.00) in ATS (33.4 ± 12.7 b·min) than in STS (14.1 ± 7.2 b·min) and in ASTS (11.4 ± 7.1 b·min). In conclusion, post-exercise BP reduction was independent of the type of exercise; however, HR remained significantly greater after combination of strength and aerobic exercise, implying a reduction in cardiac VR after this type of training. Therefore, strength and conditioning professionals may prescribe aerobic, strength, or a combination of aerobic and strength exercise to assist individuals concerned with BP control, thus allowing for variety in training while

  1. Swimming Pool Safety

    MedlinePlus

    ... insist that the following rules are followed: Keep toys away from the pool when the pool is ... after each use. No tricycles or other riding toys at poolside. No electrical appliances near the pool. ...

  2. THE OUTDOOR POOL

    PubMed Central

    Craster, Charles V.

    1919-01-01

    That almost any bit of water will serve for a wading pool seems to be the idea in practice. Dr. Craster has tested such pools and finds that they need to be as well constructed as bathing pools and as well cared for. Chlorination is necessary when they can not otherwise be controlled. ImagesPOOL I.POOL II.POOL III.p826-a PMID:18010192

  3. Effects of feeding and hypoxia on cardiac performance and gastrointestinal blood flow during critical speed swimming in the sea bass Dicentrarchus labrax.

    PubMed

    Dupont-Prinet, A; Claireaux, G; McKenzie, D J

    2009-10-01

    Previous studies have shown that if European sea bass are exercised after feeding, they can achieve a significantly higher maximum metabolic rate (MMR) than when fasted. They can meet combined metabolic demands of digestion (specific dynamic action, SDA) and maximal aerobic exercise, with no decline in swimming performance. If, however, exposed to mild hypoxia (50% saturation), bass no longer achieve higher MMR after feeding but they swim as well fed as fasted, due to an apparent ability to defer the SDA response. This study explored patterns of cardiac output (Q(A)) and blood flow to the gastrointestinal tract (Q(GI)) associated with the higher MMR after feeding, and with the ability to prioritise swimming in hypoxia. Sea bass (mean mass approximately 325 g, forklength approximately 27 cm) were instrumented with flow probes to measure Q(A) and Q(GI) during an incremental critical swimming speed (U(crit)) protocol in a tunnel respirometer, to compare each animal either fasted or 6h after a meal of fish fillet equal to 3% body mass. Feeding raised oxygen uptake (M(O2)) prior to exercise, an SDA response associated with increased Q(A) (+30%) and Q(GI) (+100%) compared to fasted values. As expected, when exercised the fed bass maintained the SDA load throughout the protocol and achieved 14% higher MMR than when fasted, and the same U(crit) (approximately 100 cm s(-1)). Both fed and fasted bass showed pronounced increases in Q(A) and decreases in Q(GI) during exercise and the higher MMR of fed bass was not associated with higher maximum Q(A) relative to when fasted, or to any differences in Q(GI) at maximum Q(A). In hypoxia prior to exercise, metabolic and cardiac responses to feeding were similar compared to normoxia. Hypoxia caused an almost 60% reduction to MMR and 30% reduction to U(crit), but neither of these traits differed between fed or fasted bass. Despite hypoxic limitations to MMR and U(crit), maximum Q(A) and patterns of Q(GI) during exercise in fasted and

  4. Evaluation of blood pressure reduction response and responder characteristics to fixed-dose combination treatment of amlodipine and losartan: a post hoc analysis of pooled clinical trials.

    PubMed

    Unniachan, Sreevalsa; Wu, David; Rajagopalan, Srinivasan; Hanson, Mary E; Fujita, Kenji P

    2014-09-01

    Data from four clinical trials compared reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) among patients treated with amlodipine/losartan 5/50 mg vs 5/100 mg and amlodipine/losartan 5/50 mg vs amlodipine 5 mg and 10 mg. Response rate was assessed as reduction in SBP or DBP (>20/10 mm Hg) and proportion of patients achieving SBP <140 mm Hg or DBP <90 mm Hg. Patients were grouped into quartiles based on baseline SBP and DBP. Mean SBP and DBP were reduced in amlodipine/losartan 5/50 mg (n=182) and amlodipine/losartan 5/100 mg (n=95) users across all baseline quartiles. Patients using amlodipine/losartan 5/50 mg had significantly greater SBP and DBP reductions vs amlodipine 5 mg (P=.001 and P=.02, respectively). Amlodipine/losartan 5/50 mg users had significantly greater SBP reduction vs amlodipine 10 mg (SBP P=.02; DBP P=not significant). The odds of responding to therapy were significantly greater with amlodipine/losartan 5/50 mg vs amlodipine 5 mg (odds ratio, 5.33; 95% confidence interval, 1.42-25.5) and were similar vs amlodipine 10 mg (odds ratio, 0.67; 95% confidence interval, 0.017-9.51). These results support the use of combination therapy early in the treatment of hypertension.

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

    PubMed Central

    Winklewski, Pawel J.; Tkachenko, Yurii; Mazur, Kamila; Kot, Jacek; Gruszecki, Marcin; Guminski, Wojciech; Czuszynski, Krzysztof; Wtorek, Jerzy; Frydrychowski, Andrzej F.

    2015-01-01

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

  6. Cardiac arrest

    MedlinePlus

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

  7. Analytical validation of a high-sensitivity cardiac troponin T assay in horses.

    PubMed

    Van Der Vekens, Nicky; van Dievoet, Marie-Astrid; De Puydt, Hendrik; Decloedt, Annelies; Ven, Sofie; De Clercq, Dominique; Deprez, Piet; van Loon, Gunther

    2015-07-01

    Although cardiac troponin T (cTnT) assays have been used to detect myocardial damage in horses, a cTnT assay has not been analytically validated, to our knowledge. The aims of this study were to estimate the precision of a high-sensitivity cTnT assay in horses and determine the effect of hemolysis on the measured cTnT concentration. Serum samples from horses were mixed in 3 different pools. Pool 1 consisted of samples from 3 healthy horses, pool 2 from 6 horses with heart failure or atypical myopathy, and pool 3 from 10 horses with atypical myopathy. The within- and between-run coefficients of variation were determined for each pool. Pools 2 and 3 were diluted to estimate linearity. To study the influence of sample hemolysis, serum was collected from 4 horses with a high cTnT concentration, in which hemolysis was mechanically induced. In addition, ethylenediamine tetra-acetic acid blood tubes were collected from 3 other horses, from which hemolysate was prepared and added to plasma at different concentrations. The within- and between-run coefficients of variation of all pools were <10%, and a good linearity was found. Three out of 4 hemolyzed serum samples had a decreased serum cTnT concentration. Plasma samples with a high hemolysis index showed a negative interference, resulting in a lower cTnT concentration. Results of the high-sensitivity cTnT assay were highly reproducible. Because samples from horses with musculoskeletal damage were included, further studies should test the possible cross-reactivity between troponin T of musculoskeletal and cardiac origin before the assay can be used in equine clinical practice.

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

    PubMed Central

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

    2016-01-01

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

  9. The science of pooling

    SciTech Connect

    Gilbert, E.

    1995-10-01

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

  10. Umbilical Cord Blood Levels of Maternal Antibodies Reactive with p200 and Full Length Ro52 in the Assessment of Risk for Cardiac Manifestations of Neonatal Lupus

    PubMed Central

    Reed, Joanne H.; Clancy, Robert M.; Lee, Kristen H.; Saxena, Amit; Izmirly, Peter M.; Buyon, Jill P.

    2012-01-01

    Objective Maternal anti-Ro autoantibodies associate with cardiac manifestations of neonatal lupus (cardiac NL), yet only 2% of women with this reactivity have an affected child. Identification of a more specific marker would channel intense monitoring to fetuses at greater risk. This study aims to determine whether autoantibodies against Ro52 amino acids 200–239 (p200) confer added risk over autoantibodies to full length Ro52, Ro60 or La. Methods/Results Anti-Ro-exposed pregnancies resulting in cardiac NL or no cardiac manifestations were identified from the Research Registry for Neonatal Lupus and PR Interval and Dexamethasone Evaluation. Umbilical cord (n=123) and maternal (n=115) samples were evaluated by ELISA. The frequencies of p200, Ro52, Ro60 and La autoantibodies were not significantly different between affected and unaffected children. However, neonatal anti-Ro52 and Ro60 titers were highest in cardiac NL and their unaffected siblings compared to unaffected neonates without a cardiac NL sibling. Although both maternal anti-Ro52 and p200 autoantibodies were less than 50% specific for cardiac NL, anti-p200 was the least likely of the Ro autoantibodies to be false positive in mothers who have never had an affected child. Titers of anti-Ro52 and p200 did not differ during a cardiac NL or unaffected pregnancy from the same mother. Conclusion Maternal reactivity to p200 does not confer an added risk to fetal conduction defects over full length Ro52 or Ro60 autoantibodies. Mothers who may never be at risk for having an affected child have lower anti-Ro60 titers and may require less stringent echocardiographic monitoring compared to women with high titer autoantibodies. PMID:22511615

  11. Measurement of photon attenuation from different cardiac chambers

    SciTech Connect

    Keller, A.M.; Simon, T.R.; Malloy, C.R.; Dehmer, G.J.; Smitherman, T.C.

    1985-05-01

    Accounting for the attenuation (AT) of photons within cardiac chambers is crucial to accurate non-geometric volume determinations from gated blood pool scintigraphy. Previous techniques to determine AT for each patient have assumed an attenuation factor of 0.15/cm for Tc-99m, the value of water. To verify this, the authors determined the AT at various tissue distances (TD) in vivo. As a point source they used the balloon of a 5 French Swan-Ganz catheter which could reproducibly be filled with a constant amount of Tc-99m and could be placed within the left or right cardiac chambers. The exact location of the balloon, once inflated, and the TD from the balloon to the collimator of a small field-of-view Anger camera was determined using biplane orthogonal fluoroscopy. AT was determined by counting the inflated Tc-99m filled balloon in air and dividing that value by the counts of the same balloon within the heart. The authors positioned the balloon in the apex of the right and left ventricle, the ascending aorta and at the junction of the right atrium and inferior vena cava to give a total of 36 simultaneous observations of AT and TD. For our data the slope of the regression of the natural log of AT versus TD, when forced through zero, was 0.102, the calculated attenuation factor. The authors conclude that the attenuation factor that should be used for determining cardiac volumes with gated blood pool scans is 0.102/cm, not the value for water.

  12. Red blood cell distribution width independently predicts medium-term mortality and major adverse cardiac events after an acute coronary syndrome

    PubMed Central

    Turcato, Gianni; Serafini, Valentina; Dilda, Alice; Bovo, Chiara; Caruso, Beatrice; Ricci, Giorgio

    2016-01-01

    Background The value of red blood cell distribution width (RDW), a simple and inexpensive measure of anisocytosis, has been associated with the outcome of many human chronic disorders. Therefore, this retrospective study was aimed to investigate whether RDW may be associated with medium-term mortality and major adverse cardiac events (MACE) after an acute coronary syndrome (ACS). Methods A total number of 979 patients diagnosed with ACS were enrolled from June 2014 to November 2014, and followed-up until June 2015. Results The RDW value in patients with 3-month MACE and in those who died was significantly higher than that of patients without 3-month MACE (13.3% vs. 14.0%; P<0.001) and those who were still alive at the end of follow-up (13.4% vs. 14.4%; P<0.001). In univariate analysis, RDW was found to be associated with 3-month MACE [odds ratio (OR), 1.70; 95% CI, 1.44–2.00, P<0.001]. In multivariate analysis, RDW remained independently associated with 3-month MACE (adjusted OR, 1.36; 95% CI, 1.19–1.55; P<0.001) and death (adjusted OR, 1.34; 95% CI, 1.05–1.71; P=0.020). The accuracy of RDW for predicting 3-month MACE was 0.67 (95% CI, 0.66–0.72; P<0.001). The most efficient discriminatory RDW value was 14.8%, which was associated with 3.8 (95% CI, 2.6–5.7; P<0.001) higher risk of 3-month MACE. Patients with RDW >14.8% exhibited a significantly short survival than those with RDW ≤14.8% (331 vs. 465 days; P<0.001). Conclusions The results of this study confirm that RDW may be a valuable, easy and inexpensive parameter for stratifying the medium-term risk in patients with ACS. PMID:27500155

  13. 13 CFR 120.611 - Pools backing Pool Certificates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Pools backing Pool Certificates... Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set forth in the Program Guide, each Pool must have: (1) A minimum number of guaranteed portions of...

  14. 13 CFR 120.611 - Pools backing Pool Certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Pools backing Pool Certificates... Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set forth in the Program Guide, each Pool must have: (1) A minimum number of guaranteed portions of...

  15. 13 CFR 120.611 - Pools backing Pool Certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Pools backing Pool Certificates... Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set forth in the Program Guide, each Pool must have: (1) A minimum number of guaranteed portions of...

  16. 13 CFR 120.611 - Pools backing Pool Certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Pools backing Pool Certificates... Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set forth in the Program Guide, each Pool must have: (1) A minimum number of guaranteed portions of...

  17. 13 CFR 120.611 - Pools backing Pool Certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pools backing Pool Certificates... Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set forth in the Program Guide, each Pool must have: (1) A minimum number of guaranteed portions of...

  18. Cardiac Sarcoidosis.

    PubMed

    Birnie, David; Ha, Andrew C T; Gula, Lorne J; Chakrabarti, Santabhanu; Beanlands, Rob S B; Nery, Pablo

    2015-12-01

    Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

  19. The impact of juvenile coxsackievirus infection on cardiac progenitor cells and postnatal heart development.

    PubMed

    Sin, Jon; Puccini, Jenna M; Huang, Chengqun; Konstandin, Mathias H; Gilbert, Paul E; Sussman, Mark A; Gottlieb, Roberta A; Feuer, Ralph

    2014-07-01

    Coxsackievirus B (CVB) is an enterovirus that most commonly causes a self-limited febrile illness in infants, but cases of severe infection can manifest in acute myocarditis. Chronic consequences of mild CVB infection are unknown, though there is an epidemiologic association between early subclinical infections and late heart failure, raising the possibility of subtle damage leading to late-onset dysfunction, or chronic ongoing injury due to inflammatory reactions during latent infection. Here we describe a mouse model of juvenile infection with a subclinical dose of coxsackievirus B3 (CVB3) which showed no evident symptoms, either immediately following infection or in adult mice. However following physiological or pharmacologically-induced cardiac stress, juvenile-infected adult mice underwent cardiac hypertrophy and dilation indicative of progression to heart failure. Evaluation of the vasculature in the hearts of adult mice subjected to cardiac stress showed a compensatory increase in CD31+ blood vessel formation, although this effect was suppressed in juvenile-infected mice. Moreover, CVB3 efficiently infected juvenile c-kit+ cells, and cardiac progenitor cell numbers were reduced in the hearts of juvenile-infected adult mice. These results suggest that the exhausted cardiac progenitor cell pool following juvenile CVB3 infection may impair the heart's ability to increase capillary density to adapt to increased load.

  20. Cold pool dissipation

    NASA Astrophysics Data System (ADS)

    Grant, Leah D.; Heever, Susan C.

    2016-02-01

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

  1. Cardiac transplantation.

    PubMed

    Shanewise, Jack

    2004-12-01

    Cardiac transplantation is a proven, accepted mode of therapy for selected patients with end-stage heart failure, but the inadequate number of suitable donor hearts available ultimately limits its application. This chapter reviews adult cardiac transplantation, with an emphasis on the anesthetic considerations of the heart transplant operation itself.

  2. Bioactive scaffolds for engineering vascularized cardiac tissues

    PubMed Central

    Chiu, Loraine; Radisic, Milica; Vunjak-Novakovic, Gordana

    2013-01-01

    Functional vascularization is a key requirement for the development and function of most tissues, and most critically cardiac muscle. Rapid and irreversible loss of cardiomyocytes during cardiac infarction directly results from the lack of blood supply. Contractile cardiac grafts, engineered using cardiovascular cells in conjunction with biomaterial scaffolds, are an actively studied method for cardiac repair. In this article, we focus on biomaterial scaffolds designed to mediate the development and maturation of vascular networks, by immobilized growth factors. The interactive effects of multiple vasculogenic factors are discussed in the context of cardiac tissue engineering. PMID:20857391

  3. Platelet lysate from whole blood-derived pooled platelet concentrates and apheresis-derived platelet concentrates for the isolation and expansion of human bone marrow mesenchymal stromal cells: production process, content and identification of active components

    PubMed Central

    Fekete, Natalie; Gadelorge, Mélanie; Fürst, Daniel; Maurer, Caroline; Dausend, Julia; Fleury-Cappellesso, Sandrine; Mailänder, Volker; Lotfi, Ramin; Ignatius, Anita; Sensebé, Luc; Bourin, Philippe; Schrezenmeier, Hubert; Rojewski, Markus Thomas

    2012-01-01

    Background aims The clinical use of human mesenchymal stromal cells (MSC) requires ex vivo expansion in media containing supplements such as fetal bovine serum or, alternatively, human platelet lysate (PL). Methods Platelet concentrates were frozen, quarantine stored, thawed and sterile filtered to obtain PL. PL content and its effect on fibroblast-colony-forming unit (CFU-F) formation, MSC proliferation and large-scale expansion were studied. Results PL contained high levels of basic fibroblast growth factor (bFGF), soluble CD40L (sCD40L), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), platelet-derived growth factor AA (PDGF-AA), platelet-derived growth factor AB/BB (PDGF-AB/BB), chemokine (C-C) ligand 5 (CCL5; RANTES) transforming growth factor-β1 (TGF-β1) and chemokine (C-X-C) ligand 1/2/3 (GRO), with low batch-to-batch variability, and most were stable for up to 14 days. Inhibition of PDGF-BB and bFGF decreased MSC proliferation by about 20% and 50%, respectively. The strongest inhibition (about 75%) was observed with a combination of anti-bFGF + anti-PDGF-BB and anti-bFGF + anti-TGF-β1 + anti-PDGF-BB. Interestingly, various combinations of recombinant PDGF-BB, bFGF and TGF-β1 were not sufficient to promote cell proliferation. PL from whole blood-derived pooled platelet concentrates and apheresis platelet concentrates did not differ significantly in their growth-promoting activity on MSC. Conclusions PL enhances MSC proliferation and can be regarded as a safe tool for MSC expansion for clinical purposes. \\in particular, PDGF-BB and bFGF are essential components for the growth-promoting effect of PL, but are not sufficient for MSC proliferation. PMID:22296115

  4. Cardiac metastases

    PubMed Central

    Bussani, R; De‐Giorgio, F; Abbate, A; Silvestri, F

    2007-01-01

    Tumours metastatic to the heart (cardiac metastases) are among the least known and highly debated issues in oncology, and few systematic studies are devoted to this topic. Although primary cardiac tumours are extremely uncommon (various postmortem studies report rates between 0.001% and 0.28%), secondary tumours are not, and at least in theory, the heart can be metastasised by any malignant neoplasm able to spread to distant sites. In general, cardiac metastases are considered to be rare; however, when sought for, the incidence seems to be not as low as expected, ranging from 2.3% and 18.3%. Although no malignant tumours are known that diffuse preferentially to the heart, some do involve the heart more often than others—for example, melanoma and mediastinal primary tumours. This paper attempts to review the pathophysiology of cardiac metastatic disease, epidemiology and clinical presentation of cardiac metastases, and pathological characterisation of the lesions. PMID:17098886

  5. Swimming pool. View of aisle between swimming pool and seating ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Swimming pool. View of aisle between swimming pool and seating area. Non-original spa pool is partially visible on right. - Jewish Community Center of San Francisco, 3200 California Street, San Francisco, San Francisco County, CA

  6. 13 CFR 120.1704 - Pool Loans eligible for Pooling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., construction or renovation of an aquarium, zoo, golf course, or swimming pool; or (iv) To a business covered by... zoos—712130 (“Zoos and Botanical Gardens”). (b) SBA review of a Pool Loan prior to pool formation....

  7. 13 CFR 120.1704 - Pool Loans eligible for Pooling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., construction or renovation of an aquarium, zoo, golf course, or swimming pool; or (iv) To a business covered by... zoos—712130 (“Zoos and Botanical Gardens”). (b) SBA review of a Pool Loan prior to pool formation....

  8. 13 CFR 120.1704 - Pool Loans eligible for Pooling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., construction or renovation of an aquarium, zoo, golf course, or swimming pool; or (iv) To a business covered by... zoos—712130 (“Zoos and Botanical Gardens”). (b) SBA review of a Pool Loan prior to pool formation....

  9. 13 CFR 120.1704 - Pool Loans eligible for Pooling.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., construction or renovation of an aquarium, zoo, golf course, or swimming pool; or (iv) To a business covered by... zoos—712130 (“Zoos and Botanical Gardens”). (b) SBA review of a Pool Loan prior to pool formation....

  10. 13 CFR 120.1704 - Pool Loans eligible for Pooling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., construction or renovation of an aquarium, zoo, golf course, or swimming pool; or (iv) To a business covered by... zoos—712130 (“Zoos and Botanical Gardens”). (b) SBA review of a Pool Loan prior to pool formation....

  11. Diagnosis of enzootic bovine leucosis in single and pooled samples.

    PubMed

    Hoff-Jørgensen, R

    1990-12-01

    Diagnosis of enzootic bovine leucosis is based on detection of antibodies against bovine leukemia virus, BLV. Some ELISA modifications have proved sensitive enough for use in the examination of pooled blood samples from slaughterhouses, milk and pooled milk samples. Suggestions for the standardisation of different ELISA modifications using a common reference serum are presented. PMID:1966753

  12. Cardiac amyloidosis

    MedlinePlus

    ... the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats ( arrhythmias ) ... due to medicine) Sick sinus syndrome Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of ...

  13. Cardiac Sarcoidosis

    MedlinePlus

    ... is Cardiac Sarcoidosis? Sarcoidosis is a poorly understood disease that commonly affects the lungs. It can also involve the lymph nodes, liver, spleen, eyes, skin, bones, salivary glands and heart. ...

  14. Pools for the Handicapped.

    ERIC Educational Resources Information Center

    American School and University, 1979

    1979-01-01

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

  15. Vitamin D Pooling Project

    Cancer.gov

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

  16. Weld pool phenomena

    SciTech Connect

    David, S.A.; Vitek, J.M.; Zacharia, T.; DebRoy, T.

    1994-09-01

    During welding, the composition, structure and properties of the welded structure are affected by the interaction of the heat source with the metal. The interaction affects the fluid flow, heat transfer and mass transfer in the weld pool, and the solidification behavior of the weld metal. In recent years, there has been a growing recognition of the importance of the weld pool transport processes and the solid state transformation reactions in determining the composition, structure and properties of the welded structure. The relation between the weld pool transport processes and the composition and structure is reviewed. Recent applications of various solidification theories to welding are examined to understand the special problems of weld metal solidification. The discussion is focussed on the important problems and issues related to weld pool transport phenomena and solidification. Resolution of these problems would be an important step towards a science based control of composition, structure and properties of the weld metal.

  17. Swimming pool granuloma

    MedlinePlus

    Aquarium granuloma; Fish tank granuloma ... Risks include exposure to swimming pools, salt water aquariums, or ocean fish. ... Wash hands and arms thoroughly after cleaning aquariums. Or, wear rubber gloves when cleaning.

  18. Dietary long-chain n-3 fatty acids modify blood and cardiac phospholipids and reduce protein kinase-C-delta and protein kinase-C-epsilon translocation.

    PubMed

    Judé, Sébastien; Martel, Eric; Vincent, Fanny; Besson, Pierre; Couet, Charles; Ogilvie, Gregory K; Pinault, Michelle; De Chalendar, Catherine; Bougnoux, Philippe; Richard, Serge; Champeroux, Pascal; Crozatier, Bertrand; Le Guennec, Jean-Yves

    2007-12-01

    The effects of an n-3 PUFA-enriched diet on cardiac cell membrane phospholipid fraction compositions and associated protein kinase-C (PKC) translocation modification have never been studied in higher mammals. This is of importance since membrane fatty acid composition has been shown to influence PKC signalling pathways. In the present study, we have tested whether the incorporation of n-3 PUFA in cardiac membrane phospholipids correlated with changes in the fatty acid composition of diacylglycerols (DAG) and led to a differential translocation of PKC isoforms. Two groups of five dogs were fed the standard diet supplemented with palm oil or fish oil for 8 weeks. Dogs fed a fish oil-enriched diet showed a preferential incorporation of EPA and, to a lesser extent, of DHA, at the expense of arachidonic acid, in the circulating TAG, plasma phospholipids, erythrocyte phospholipids and cardiomyocyte phospholipid fractions. Analysis of 1,2-DAG fatty acid composition also indicated a preferential enrichment of EPA compared with DHA. Associated with these results, a reduction in the expression of PKC-delta and PKC-epsilon isoforms in the particulate fractions was observed whereas no effect was seen for PKC-alpha and PKC-zeta. We conclude that a fish oil-enriched diet induces a modification in fatty acid composition of cardiac membrane phospholipids, associated with a differential translocation of PKC isoforms. These results can be explained by the production of structurally different DAG that may participate in some of the protective effects of n-3 PUFA against various chronic diseases.

  19. To pool or not to pool

    SciTech Connect

    Powell, J.

    1998-07-01

    In world electricity markets, third party access to transmission and distribution networks on non-discriminatory terms is available to generators and retail suppliers. Some market participants may believe that they are able to negotiate better terms and more market share through bilateral contracts than they would be able to obtain in a pool. Hence such companies will either argue against the development of a pool or seek to make membership of it optional. These companies are therefore seeking to ensure their continued ability to exercise their market power. Inevitably, those companies who would suffer in this form of market will advocate a more transparent arrangement where the market power of other organizations is curbed. The physical nature of the country and plant is also an important factor. Hydro-electric plant can, within water limitations, react very quickly to changing demand. These plant do not therefore require elaborate operating schedules hence market prices can be set ignoring physical plant characteristics. The ability of fossil fuel plant to respond is highly dependent on the operating condition of the plant. These generators need to plan their operations well in advance hence prices cannot be set in complete disregard of the generating plants' ability to meet the resulting schedule. The development of competitive markets is not, however, solely driven by commercial issues. Political and economic considerations such as stranded assets and the protection of indigenous industries, such as coal mines, can greatly influence the nature of the markets. Most countries have accepted the wisdom of having some form of pool. The choice of market mechanism will therefore be driven by: Physical constraints of the country infrastructure and plant; Market power of participants; and Political pressures on the Government. Of these factors political pressures tend to carry the greatest influence.

  20. Biomechanics of Cardiac Function

    PubMed Central

    Voorhees, Andrew P.; Han, Hai-Chao

    2015-01-01

    The heart pumps blood to maintain circulation and ensure the delivery of oxygenated blood to all the organs of the body. Mechanics play a critical role in governing and regulating heart function under both normal and pathological conditions. Biological processes and mechanical stress are coupled together in regulating myocyte function and extracellular matrix structure thus controlling heart function. Here we offer a brief introduction to the biomechanics of left ventricular function and then summarize recent progress in the study of the effects of mechanical stress on ventricular wall remodeling and cardiac function as well as the effects of wall mechanical properties on cardiac function in normal and dysfunctional hearts. Various mechanical models to determine wall stress and cardiac function in normal and diseased hearts with both systolic and diastolic dysfunction are discussed. The results of these studies have enhanced our understanding of the biomechanical mechanism in the development and remodeling of normal and dysfunctional hearts. Biomechanics provide a tool to understand the mechanism of left ventricular remodeling in diastolic and systolic dysfunction and guidance in designing and developing new treatments. PMID:26426462

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

    MedlinePlus

    ... High Blood Pressure Tools & Resources Stroke More Cardiac Computed Tomography (Multidetector CT, or MDCT) Updated:Sep 3,2015 ... facts MDCT is a very fast type of computed tomography (CT) scan. MDCT creates pictures of the healthy ...

  2. Cardiac Pressure-Volume Loop Analysis Using Conductance Catheters in Mice

    PubMed Central

    Abraham, Dennis; Mao, Lan

    2016-01-01

    Cardiac pressure-volume loop analysis is the “gold-standard” in the assessment of load-dependent and load-independent measures of ventricular systolic and diastolic function. Measures of ventricular contractility and compliance are obtained through examination of cardiac response to changes in afterload and preload. These techniques were originally developed nearly three decades ago to measure cardiac function in large mammals and humans. The application of these analyses to small mammals, such as mice, has been accomplished through the optimization of microsurgical techniques and creation of conductance catheters. Conductance catheters allow for estimation of the blood pool by exploiting the relationship between electrical conductance and volume. When properly performed, these techniques allow for testing of cardiac function in genetic mutant mouse models or in drug treatment studies. The accuracy and precision of these studies are dependent on careful attention to the calibration of instruments, systematic conduct of hemodynamic measurements and data analyses. We will review the methods of conducting pressure-volume loop experiments using a conductance catheter in mice. PMID:26436838

  3. [Risk management in cardiac anesthesia].

    PubMed

    Inada, Eiichi

    2008-05-01

    Cardiac anesthesia carries high risk because of the patient's cardiac and coexisting diseases and rapid and complex hemodynamic changes during surgery. We should be ready to treat hemodynamic changes which may rapidly deteriorate into a vicious cycle. Many potent drugs and life-support devices are used. The drugs should be properly labeled to avoid drug error. Prefilled drug syringes and ready-to-use bags are helpful to avoid mixture error. Syringe and infusion pumps should be properly set. All the infusion systems should be checked in a systematical way. Blood management including blood transfusion and coagulation is important. Heparin-induced thrombocytopenia (HIT) may cause thrombosis. Heparin and heparin-coated catheter should be avoided in patients with HIT. Causes of bleeding tendency should be sort out and treated accordingly. Protamine reactions including hypotension and pulmonary hypertension can be catastrophic. Lastly, intimate communication between surgeons, anesthesiologists, medical engineers, and nurses is essential to perform cardiac surgery safely.

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

    NASA Astrophysics Data System (ADS)

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

    2015-09-01

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

  5. Anatomical-based Partial Volume Correction for Low-dose Dedicated Cardiac SPECT/CT

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-09-01

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

  7. Vernal Pool Lessons and Activities.

    ERIC Educational Resources Information Center

    Childs, Nancy; Colburn, Betsy

    This curriculum guide accompanies Certified: A Citizen's Step-by-Step Guide to Protecting Vernal Pools which is designed to train volunteers in the process of identifying vernal pool habitat so that as many of these pools as possible can be certified by the Massachusetts Natural Heritage and Endangered Species Program. Vernal pools are a kind of…

  8. Extracorporeal Cardiac Shock Wave Therapy Ameliorates Clinical Symptoms and Improves Regional Myocardial Blood Flow in a Patient with Severe Coronary Artery Disease and Refractory Angina

    PubMed Central

    Prinz, Christian; Lindner, Oliver; Bitter, Thomas; Hering, Detlef; Burchert, Wolfgang; Horstkotte, Dieter; Faber, Lothar

    2009-01-01

    Different therapeutic options are being used for chronic coronary artery disease (CAD). We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The patient received cardiac shock wave therapy (CSWT) over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium. PMID:19724656

  9. Thread Pool Interface (TPI)

    2008-04-01

    Thread Pool Interface (TpI) provides a simple interface for running functions written in C or C++ in a thread-parallel mode. Application or library codes may need to perform operations thread-parallel on machines with multicore processors. the TPI library provides a simple mechanism for managing thread activation, deactivation, and thread-parallel execution of application-provided subprograms.

  10. The Future of Pooling.

    ERIC Educational Resources Information Center

    Young, Peter C.; Fone, Martin

    1997-01-01

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

  11. Effect of marginal dietary zinc on blood fractions of rats

    SciTech Connect

    Brenckle, L.B.; Rasmussen, A.I.

    1986-03-05

    Use of blood components as indices of zinc (Zn) status has been proposed. This study evaluated changes in whole blood counts and Zn concentration of blood fractions in rats fed marginal dietary Zn. Rats (175-199 gm) were divided into 2 groups after 1 wk acclimation on a 6 ppm soybean-based Zn ration: a low Zn group (n=72) fed the 6 ppm Zn ration ad lib, and a pair-fed Zn-adequate group (n=72) fed the same ration supplemented to 30 ppm Zn. RBC Zn, WBC/platelet Zn, RBC count. WBC count, hemoglobin (Hb), and hematocrit (Hct) were determined at 0, 2, 4, 6, and 8 wks on blood obtained by cardiac puncture. Samples from 2 rats were pooled for Zn determinations. Low Zn rats decreased food intake, failed to gain weight, and 29% exhibited hair loss and/or scaly paws. RBC count, Hb, and Hct increased with time in both groups: the increase in RBC count preceeded that of Hb. Despite this different rate of change, RBC Zn results were the same regardless of basis of expression. WBC count decreased with time in both groups. Differences in pooled RBC Zn values between or within groups were not significant. The greatest difference between groups occurred at wk 2 when pooled WBC/platelet Zn was low in both groups, body weight differences became significant, and hair loss was first seen in low Zn rats. However, convincing evidence for changes in blood fractions due to marginal dietary Zn intake is not apparent despite other evidence of Zn deficiency in the low Zn group.

  12. Cardiac Surgery

    PubMed Central

    Weisse, Allen B.

    2011-01-01

    Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121

  13. Allergic to Pool Water

    PubMed Central

    2012-01-01

    To identify the allergy problem of a 36-year old swimming instructor, who experiences heavy itching and rashes whenever she comes in contact with pool water. Patch tests were performed with European standard series and materials from the work floor. A positive patch test to aluminum chloride and flocculant was observed. Occupational dermatitis is, based on a contact allergy to aluminum chloride in the flocculant. PMID:22993713

  14. Cardiac Medications

    MedlinePlus

    ... Diovan) What the Medication Does Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising. Reason for Medication Used to treat or improve ...

  15. Swimming Pools and Molluscum Contagiosum

    MedlinePlus

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

  16. Detection of occult pericardial hemorrhage early after open-heart surgery using technetium-99m red blood cell radionuclide ventriculography

    SciTech Connect

    Bateman, T.M.; Czer, L.S.; Gray, R.J.; Kass, R.M.; Raymond, M.J.; Garcia, E.V.; Chaux, A.; Matloff, J.M.; Berman, D.S.

    1984-11-01

    Pericardial or mediastinal hemorrhage requiring reoperation occurs in 2% to 5% of patients, usually early (0 to 48 hours), after open-heart surgery. This hemorrhage may be occult, and resulting cardiac tamponade may easily be misinterpreted as ventricular dysfunction, common early postoperatively. In such cases, appropriate and timely intervention may not occur. Of 50 patients evaluated by technetium-99m red blood cell gated equilibrium radionuclide ventriculography (RNV) because of early postoperative cardiogenic shock of uncertain etiology, 17 had unique scintigraphic images suggestive of intrathoracic hemorrhage. Of these 17, 5 had a generalized halo of abnormal radioactivity surrounding small hyperdynamic right and left ventricles, 11 had localized regions of intense blood pool activity outside the cardiac chambers (two with compression of single chambers), and one demonstrated marked radionuclide activity in the right hemithorax (2000 ml of blood at reoperation). Twelve patients had exploratory reoperation for control of hemorrhage as a direct result of the scintigraphic findings, three were successfully treated with fresh frozen plasma and platelet infusions along with medical interventions to optimize cardiac performance, and two patients died in cardiogenic shock (presumed tamponade) without reoperation. In the 12 reoperated patients, all were confirmed to have active pericardial bleeding. Scintigraphic localization of abnormal blood pools within the pericardium corresponded to the sites at which active bleeding was witnessed at reoperation. The abnormal bleeding was etiologically related to the tamponade state, with marked improvement in hemodynamics after reoperation. Nine additional patients were reoperated for presumed tamponade after RNV revealed an exaggerated halo of photon deficiency surrounding the cardiac chambers.

  17. Visit-to-Visit Variability and Reduction in Blood Pressure After a 3-Month Cardiac Rehabilitation Program in Patients With Cardiovascular Disease.

    PubMed

    Ishida, Toshihisa; Miura, Shin-Ichiro; Fujimi, Kanta; Ueda, Takashi; Ueda, Yoko; Matsuda, Takuro; Sakamoto, Maaya; Arimura, Tadaaki; Shiga, Yuhei; Kitajima, Ken; Saku, Keijiro

    2016-09-28

    Visit-to-visit variability (VVV) in blood pressure (BP) has been shown to be a predictor of cardiovascular events. It is unknown whether CR can improve VVV in BP as well as reducing BP. We enrolled 84 patients who had cardiovascular disease (CVD) and participated in a 3-month CR program. We measured systolic and diastolic BP (SBP and DBP), pulse pressure (PP), and heart rate (HR) before exercise training at each visit and determined VVV in BP or HR expressed as the standard deviation of the average BP or HR. Patients who had uncontrolled BP at baseline and who did not change their antihypertensive drugs throughout the study period showed a significant reduction of both SBP and DBP with a decrease in PP after 3 months. Patients who did not change their antihypertensive drugs were divided into larger (L-) and smaller (S-) VVV in the SBP groups and L- and S-VVV in the DBP groups according to the average value of VVV in SBP or DBP. In the L-VVV in the SBP and DBP groups, VVV in SBP and DBP in the 1st month was significantly decreased after the 3rd month in both groups. HR at baseline was significantly decreased after 3 months. In addition, CR induced a significant increase in the level of high-density lipoprotein cholesterol (HDL-C) in blood. In conclusion, CR improved VVV in BP in patients with L-VVV in BP and evoked a significant reduction in HR and an increase in HDL-C. These effects due to the CR program may be cardioprotective.

  18. Cardiac conduction system

    MedlinePlus

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  20. Cardiac Amyloidosis

    MedlinePlus

    ... abbreviation AL stands for Amyloidosis formed from Light chains, and it is a disease of the bone ... proteins that make up antibodies, known as light chains. These light chains circulate in the blood and ...

  1. Cardiac Na Channels: Structure to Function.

    PubMed

    DeMarco, K R; Clancy, C E

    2016-01-01

    Heart rhythms arise from electrical activity generated by precisely timed opening and closing of ion channels in individual cardiac myocytes. Opening of the primary cardiac voltage-gated sodium (NaV1.5) channel initiates cellular depolarization and the propagation of an electrical action potential that promotes coordinated contraction of the heart. The regularity of these contractile waves is critically important since it drives the primary function of the heart: to act as a pump that delivers blood to the brain and vital organs. When electrical activity goes awry during a cardiac arrhythmia, the pump does not function, the brain does not receive oxygenated blood, and death ensues. Perturbations to NaV1.5 may alter the structure, and hence the function, of the ion channel and are associated downstream with a wide variety of cardiac conduction pathologies, such as arrhythmias. PMID:27586288

  2. Cardiac complications in thalassemia major.

    PubMed

    Auger, Dominique; Pennell, Dudley J

    2016-03-01

    The myocardium is particularly susceptible to complications from iron loading in thalassemia major. In the first years of life, severe anemia leads to high-output cardiac failure and death if not treated. The necessary supportive blood transfusions create loading of iron that cannot be naturally excreted, and this iron accumulates within tissues, including the heart. Free unbound iron catalyzes the formation of toxic hydroxyl radicals, which damage cells and cause cardiac dysfunction. Significant cardiac siderosis may present by the age of 10 and may lead to acute clinical heart failure, which must be treated urgently. Atrial fibrillation is the most frequently encountered iron-related arrhythmia. Iron chelation is effective at removing iron from the myocardium, at the expense of side effects that hamper compliance to therapy. Monitoring of myocardial iron content is mandatory for clinical management of cardiac risk. T2* cardiac magnetic resonance measures myocardial iron and is the strongest biomarker for prediction of heart failure and arrhythmic events. It has been calibrated to human myocardial tissue iron concentration and is highly reproducible across all magnetic resonance scanner vendors. As survival and patient age increases, endothelial dysfunction and diabetes may become new factors in the cardiovascular health of thalassemia patients. Promising new imaging technology and therapies could ameliorate the long-term prognosis.

  3. Fully automated segmentation of left ventricle using dual dynamic programming in cardiac cine MR images

    NASA Astrophysics Data System (ADS)

    Jiang, Luan; Ling, Shan; Li, Qiang

    2016-03-01

    Cardiovascular diseases are becoming a leading cause of death all over the world. The cardiac function could be evaluated by global and regional parameters of left ventricle (LV) of the heart. The purpose of this study is to develop and evaluate a fully automated scheme for segmentation of LV in short axis cardiac cine MR images. Our fully automated method consists of three major steps, i.e., LV localization, LV segmentation at end-diastolic phase, and LV segmentation propagation to the other phases. First, the maximum intensity projection image along the time phases of the midventricular slice, located at the center of the image, was calculated to locate the region of interest of LV. Based on the mean intensity of the roughly segmented blood pool in the midventricular slice at each phase, end-diastolic (ED) and end-systolic (ES) phases were determined. Second, the endocardial and epicardial boundaries of LV of each slice at ED phase were synchronously delineated by use of a dual dynamic programming technique. The external costs of the endocardial and epicardial boundaries were defined with the gradient values obtained from the original and enhanced images, respectively. Finally, with the advantages of the continuity of the boundaries of LV across adjacent phases, we propagated the LV segmentation from the ED phase to the other phases by use of dual dynamic programming technique. The preliminary results on 9 clinical cardiac cine MR cases show that the proposed method can obtain accurate segmentation of LV based on subjective evaluation.

  4. Gated in vivo examination of cardiac metabolites with /sup 31/P nuclear magnetic resonance

    SciTech Connect

    Kantor, H.L.; Briggs, R.W.; Metz, K.R.; Balaban, R.S.

    1986-07-01

    Phosphorus-31 nuclear magnetic resonance (/sup 31/P NMR) spectroscopy was used to study the temporal aspects of metabolism of canine heart in vivo. An NMR catheter coil was passed through the jugular vein of a dog into the apex of the right ventricle and spectra were recorded at four points in the cardiac cycle by triggering from the blood pressure trace of the animal. The /sup 31/P spin-lattice relaxation times of phosphocreatine (PC) and the ..gamma../sup -/,..cap alpha../sup -/, and ..beta..-phosphates of ATP at 1.89 Tesla are 4.4, 1.8, 1.7, and 1.6 s, respectively. The ratio of PC to ATP is 2.0. No changes in PC/ATP were noted in any of the four portions of the cardiac cycle examined, and difference spectra exhibited no observable signals, in contrast to previously reported results for glucose-perfused rat hearts. On the assumption that intracellular pH and the total creatine pool were constant, the expression for the creatine kinase reaction was used to deduce that free ADP concentrations were invariant throughout the cardiac cycle. This is in apparent disagreement with the proposed regulatory role for ADP in heart oxidative phosphorylation.

  5. Cardiac CT for myocardial ischaemia detection and characterization—comparative analysis

    PubMed Central

    Bucher, A M; De Cecco, C N; Wang, R; Meinel, F G; Binukrishnan, S R; Spearman, J V; Vogl, T J; Ruzsics, B

    2014-01-01

    The assessment of patients presenting with symptoms of myocardial ischaemia remains one of the most common and challenging clinical scenarios faced by physicians. Current imaging modalities are capable of three-dimensional, functional and anatomical views of the heart and as such offer a unique contribution to understanding and managing the pathology involved. Evidence has accumulated that visual anatomical coronary evaluation does not adequately predict haemodynamic relevance and should be complemented by physiological evaluation, highlighting the importance of functional assessment. Technical advances in CT technology over the past decade have progressively moved cardiac CT imaging into the clinical workflow. In addition to anatomical evaluation, cardiac CT is capable of providing myocardial perfusion parameters. A variety of CT techniques can be used to assess the myocardial perfusion. The single energy first-pass CT and dual energy first-pass CT allow static assessment of myocardial blood pool. Dynamic cardiac CT imaging allows quantification of myocardial perfusion through time-resolved attenuation data. CT-based myocardial perfusion imaging (MPI) is showing promising diagnostic accuracy compared with the current reference modalities. The aim of this review is to present currently available myocardial perfusion techniques with a focus on CT imaging in light of recent clinical investigations. This article provides a comprehensive overview of currently available CT approaches of static and dynamic MPI and presents the results of corresponding clinical trials. PMID:25135617

  6. Tag removal in cardiac tagged MRI images using coupled dictionary learning.

    PubMed

    Makram, Abram W; Rushdi, Muhammad A; Khalifa, Ayman M; El-Wakad, Mohamed T

    2015-01-01

    Tagged Magnetic Resonance Imaging (tMRI) is considered to be the gold standard for quantitative assessment of the cardiac local functions. However, the tagging patterns and low myocardium-to-blood-pool contrast of tagged images bring great challenges to cardiac image processing and analysis tasks such as myocardium segmentation and tracking. Hence, there has been growing interest in techniques for removing tagging lines. In this work, a method for removing tagging patterns in tagged MR images using a coupled dictionary learning (CDL) model is proposed. In this model, identical sparse representations are assumed for image patches in the tagged MRI and corresponding cine MRI image spaces. First, we learn a dictionary for the tagged MRI image space. Then, we compute a dictionary for the cine MRI image space so that corresponding tagged and cine patches have the same sparse codes in terms of their respective dictionaries. Finally, in order to produce the de-tagged (cine version) of a test tagged image, the sparse codes of the tagged patches and the trained cine dictionary are used together to construct the de-tagged patches. We have tested this tag removal method on a dataset of tagged cardiac MR images. Our experimental results compared favorably with a recently proposed tag removal method that removes tags in the frequency domain using an optimal band-stop filter of harmonic peaks.

  7. Secondary pool boiling effects

    NASA Astrophysics Data System (ADS)

    Kruse, C.; Tsubaki, A.; Zuhlke, C.; Anderson, T.; Alexander, D.; Gogos, G.; Ndao, S.

    2016-02-01

    A pool boiling phenomenon referred to as secondary boiling effects is discussed. Based on the experimental trends, a mechanism is proposed that identifies the parameters that lead to this phenomenon. Secondary boiling effects refer to a distinct decrease in the wall superheat temperature near the critical heat flux due to a significant increase in the heat transfer coefficient. Recent pool boiling heat transfer experiments using femtosecond laser processed Inconel, stainless steel, and copper multiscale surfaces consistently displayed secondary boiling effects, which were found to be a result of both temperature drop along the microstructures and nucleation characteristic length scales. The temperature drop is a function of microstructure height and thermal conductivity. An increased microstructure height and a decreased thermal conductivity result in a significant temperature drop along the microstructures. This temperature drop becomes more pronounced at higher heat fluxes and along with the right nucleation characteristic length scales results in a change of the boiling dynamics. Nucleation spreads from the bottom of the microstructure valleys to the top of the microstructures, resulting in a decreased surface superheat with an increasing heat flux. This decrease in the wall superheat at higher heat fluxes is reflected by a "hook back" of the traditional boiling curve and is thus referred to as secondary boiling effects. In addition, a boiling hysteresis during increasing and decreasing heat flux develops due to the secondary boiling effects. This hysteresis further validates the existence of secondary boiling effects.

  8. Whole and Particle-Free Diesel Exhausts Differentially Affect Cardiac Electrophysiology, Blood Pressure, and Autonomic Balance in Heart Failure–Prone Rats

    PubMed Central

    Farraj, Aimen K.

    2012-01-01

    Epidemiological studies strongly link short-term exposures to vehicular traffic and particulate matter (PM) air pollution with adverse cardiovascular (CV) events, especially in those with preexisting CV disease. Diesel engine exhaust is a key contributor to urban ambient PM and gaseous pollutants. To determine the role of gaseous and particulate components in diesel exhaust (DE) cardiotoxicity, we examined the effects of a 4-h inhalation of whole DE (wDE) (target PM concentration: 500 µg/m3) or particle-free filtered DE (fDE) on CV physiology and a range of markers of cardiopulmonary injury in hypertensive heart failure–prone rats. Arterial blood pressure (BP), electrocardiography, and heart rate variability (HRV), an index of autonomic balance, were monitored. Both fDE and wDE decreased BP and prolonged PR interval during exposure, with more effects from fDE, which additionally increased HRV triangular index and decreased T-wave amplitude. fDE increased QTc interval immediately after exposure, increased atrioventricular (AV) block Mobitz II arrhythmias shortly thereafter, and increased serum high-density lipoprotein 1 day later. wDE increased BP and decreased HRV root mean square of successive differences immediately postexposure. fDE and wDE decreased heart rate during the 4th hour of postexposure. Thus, DE gases slowed AV conduction and ventricular repolarization, decreased BP, increased HRV, and subsequently provoked arrhythmias, collectively suggesting parasympathetic activation; conversely, brief BP and HRV changes after exposure to particle-containing DE indicated a transient sympathetic excitation. Our findings suggest that whole- and particle-free DE differentially alter CV and autonomic physiology and may potentially increase risk through divergent pathways. PMID:22543275

  9. G0/G1 Switch Gene 2 Regulates Cardiac Lipolysis*

    PubMed Central

    Heier, Christoph; Radner, Franz P. W.; Moustafa, Tarek; Schreiber, Renate; Grond, Susanne; Eichmann, Thomas O.; Schweiger, Martina; Schmidt, Albrecht; Cerk, Ines K.; Oberer, Monika; Theussl, H.-Christian; Wojciechowski, Jacek; Penninger, Josef M.; Zimmermann, Robert; Zechner, Rudolf

    2015-01-01

    The anabolism and catabolism of myocardial triacylglycerol (TAG) stores are important processes for normal cardiac function. TAG synthesis detoxifies and stockpiles fatty acids to prevent lipotoxicity, whereas TAG hydrolysis (lipolysis) remobilizes fatty acids from endogenous storage pools as energy substrates, signaling molecules, or precursors for complex lipids. This study focused on the role of G0/G1 switch 2 (G0S2) protein, which was previously shown to inhibit the principal TAG hydrolase adipose triglyceride lipase (ATGL), in the regulation of cardiac lipolysis. Using wild-type and mutant mice, we show the following: (i) G0S2 is expressed in the heart and regulated by the nutritional status with highest expression levels after re-feeding. (ii) Cardiac-specific overexpression of G0S2 inhibits cardiac lipolysis by direct protein-protein interaction with ATGL. This leads to severe cardiac steatosis. The steatotic hearts caused by G0S2 overexpression are less prone to fibrotic remodeling or cardiac dysfunction than hearts with a lipolytic defect due to ATGL deficiency. (iii) Conversely to the phenotype of transgenic mice, G0S2 deficiency results in a de-repression of cardiac lipolysis and decreased cardiac TAG content. We conclude that G0S2 acts as a potent ATGL inhibitor in the heart modulating cardiac substrate utilization by regulating cardiac lipolysis. PMID:26350455

  10. Prospective-gated cardiac micro-CT imaging of free-breathing mice using carbon nanotube field emission x-ray

    SciTech Connect

    Cao Guohua; Burk, Laurel M.; Lee, Yueh Z.; Calderon-Colon, Xiomara; Sultana, Shabana; Lu Jianping; Zhou, Otto

    2010-10-15

    Purpose: Carbon nanotube (CNT) based field emission x-ray source technology has recently been investigated for diagnostic imaging applications because of its attractive characteristics including electronic programmability, fast switching, distributed source, and multiplexing. The purpose of this article is to demonstrate the potential of this technology for high-resolution prospective-gated cardiac micro-CT imaging. Methods: A dynamic cone-beam micro-CT scanner was constructed using a rotating gantry, a stationary mouse bed, a flat-panel detector, and a sealed CNT based microfocus x-ray source. The compact single-beam CNT x-ray source was operated at 50 KVp and 2 mA anode current with 100 {mu}mx100 {mu}m effective focal spot size. Using an intravenously administered iodinated blood-pool contrast agent, prospective cardiac and respiratory-gated micro-CT images of beating mouse hearts were obtained from ten anesthetized free-breathing mice in their natural position. Four-dimensional cardiac images were also obtained by gating the image acquisition to different phases in the cardiac cycle. Results: High-resolution CT images of beating mouse hearts were obtained at 15 ms temporal resolution and 6.2 lp/mm spatial resolution at 10% of system MTF. The images were reconstructed at 76 {mu}m isotropic voxel size. The data acquisition time for two cardiac phases was 44{+-}9 min. The CT values observed within the ventricles and the ventricle wall were 455{+-}49 and 120{+-}48 HU, respectively. The entrance dose for the acquisition of a single phase of the cardiac cycle was 0.10 Gy. Conclusions: A high-resolution dynamic micro-CT scanner was developed from a compact CNT microfocus x-ray source and its feasibility for prospective-gated cardiac micro-CT imaging of free-breathing mice under their natural position was demonstrated.

  11. Synaptic vesicle pools: an update.

    PubMed

    Denker, Annette; Rizzoli, Silvio O

    2010-01-01

    During the last few decades synaptic vesicles have been assigned to a variety of functional and morphological classes or "pools". We have argued in the past (Rizzoli and Betz, 2005) that synaptic activity in several preparations is accounted for by the function of three vesicle pools: the readily releasable pool (docked at active zones and ready to go upon stimulation), the recycling pool (scattered throughout the nerve terminals and recycling upon moderate stimulation), and finally the reserve pool (occupying most of the vesicle clusters and only recycling upon strong stimulation). We discuss here the advancements in the vesicle pool field which took place in the ensuing years, focusing on the behavior of different pools under both strong stimulation and physiological activity. Several new findings have enhanced the three-pool model, with, for example, the disparity between recycling and reserve vesicles being underlined by the observation that the former are mobile, while the latter are "fixed". Finally, a number of altogether new concepts have also evolved such as the current controversy on the identity of the spontaneously recycling vesicle pool. PMID:21423521

  12. Left atrial volume change throughout the cardiac cycle in children with congenital heart disease associated with increased pulmonary blood flow: evaluation using a novel left atrium-tracking method.

    PubMed

    Sakata, Miho; Hayabuchi, Yasunobu; Inoue, Miki; Onishi, Tatsuya; Kagami, Shoji

    2013-01-01

    There is a paucity of data regarding the significance of left atrial (LA) volume and its changes throughout the cardiac cycle in pediatric patients with heart disease. The recently developed LA volume-tracking (LAVT) method can automatically construct the LA volume curve. The study group consisted of 48 pediatric patients with ventricular septal defect (n = 34) or patent ductus arteriosus (n = 14) and age-matched healthy controls. Maximum and minimum LA volumes (LAVmax and LAVmin, respectively) were measured. The total LA emptying volume (LAVtotal) was defined as LAVmax--LAVmin. Volume parameters were standardized by dividing by body surface area (BSA). The total LA emptying fraction (%LAVtotal) was defined as the ratio of LAVtotal to LAVmax. In the patient group, there was a positive correlation between the ratio of pulmonary to systemic blood flow (Qp/Qs) and LAVmax/BSA, LAVmin/BSA, and LAVtotal/BSA (r = 0.42, 0.44, and 0.34, respectively). LAVmin/BSA was positively correlated with the ratio of early mitral inflow velocity to early mitral annular diastolic tissue Doppler velocity (E/E') (r = 0.32). The %LAVtotal had a negative correlation with left-ventricular (LV) end-diastolic pressure (r = -0.32). There were significant correlations between serum B-type natriuretic peptide level and LAVmax/BSA, LAVmin/BSA, and %LAVtotal (r = 0.38, 0.49, and -0.35, respectively). The LAVT method is useful in the evaluation of LV diastolic function in pediatric patients with chronic LV volume overload.

  13. Imaging of cardiac sarcoidosis.

    PubMed

    Erthal, Fernanda; Juneau, Daniel; Lim, Siok P; Dwivedi, Girish; Nery, Pablo B; Birnie, David; Beanlands, Rob S

    2016-09-01

    Sarcoidosis is a multisystem inflammatory disease. Cardiac involvement is described in up to 50% of the cases. The disease spectrum is wide and cardiac manifestations ranges from being asymptomatic to heart failure, arrhythmias and sudden cardiac death. The diagnosis of cardiac sarcoidosis can be challenging due to its non-specific nature and the focal involvement of the heart. In this review, we discuss the utility of a stepwise approach with multimodality cardiac imaging in the diagnosis and management of CS. PMID:27225318

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

    PubMed

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

    1990-04-01

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

  15. Cardiac torsion and electromagnetic fields: the cardiac bioinformation hypothesis.

    PubMed

    Burleson, Katharine O; Schwartz, Gary E

    2005-01-01

    Although in physiology the heart is often referred to as a simple piston pump, there are in fact two additional features that are integral to cardiac physiology and function. First, the heart as it contracts in systole, also rotates and produces torsion due to the structure of the myocardium. Second, the heart produces a significant electromagnetic field with each contraction due to the coordinated depolarization of myocytes producing a current flow. Unlike the electrocardiogram, the magnetic field is not limited to volume conduction and extends outside the body. The therapeutic potential for interaction of this cardioelectromagnetic field both within and outside the body is largely unexplored. It is our hypothesis that the heart functions as a generator of bioinformation that is central to normative functioning of body. The source of this bioinformation is based on: (1) vortex blood flow in the left ventricle; (2) a cardiac electromagnetic field and both; (3) heart sounds; and (4) pulse pressure which produce frequency and amplitude information. Thus, there is a multidimensional role for the heart in physiology and biopsychosocial dynamics. Recognition of these cardiac properties may result in significant implications for new therapies for cardiovascular disease based on increasing cardiac energy efficiency (coherence) and bioinformation from the cardioelectromagnetic field. Research studies to test this hypothesis are suggested.

  16. CARDIAC MUSCLE

    PubMed Central

    Sommer, Joachim R.; Johnson, Edward A.

    1968-01-01

    With light and electron microscopy a comparison has been made of the morphology of ventricular (V) and Purkinje (P) fibers of the hearts of guinea pig, rabbit, cat, dog, goat, and sheep. The criteria, previously established for the rabbit heart, that V fibers are distinguished from P fibers by the respective presence and absence of transverse tubules is shown to be true for all animals studied. No evidence was found of a permanent connection between the sarcoplasmic reticulum and the extracellular space. The sarcoplasmic reticulum (SR) of V fibers formed couplings with the sarcolemma of a transverse tubule (interior coupling) and with the peripheral sarcolemma (peripheral coupling), whereas in P fibers the SR formed only peripheral couplings. The forms of the couplings were identical. The significance, with respect to excitation-contraction coupling, of the difference in the form of the couplings in cardiac versus skeletal muscle is discussed together with the electrophysiological implications of the differing geometries of bundles of P fibers from different animals. PMID:5645545

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

    PubMed

    Hogan, T S

    2012-10-01

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

  18. Tidal Pools--Miniature Oceans

    ERIC Educational Resources Information Center

    Plake, Linda Perry

    1977-01-01

    A comprehensive discussion of the biological activity in tidal pools is provided. The importance of environmental factors such as oxygen supply, temperature, salinity, and light is detailed. Plants and animals that might be found in a tidal pool are identified and described. (BT)

  19. Human parvovirus PARV4 in plasma pools of Chinese origin.

    PubMed

    Ma, Y-Y; Guo, Y; Zhao, X; Wang, Z; Lv, M-M; Yan, Q-P; Zhang, J-G

    2012-10-01

    Human parvovirus 4 (PARV4) is present in blood and blood products. As the presence and levels of PARV4 in Chinese source plasma pools have never been determined, we implemented real-time quantitative PCR to investigate the presence of PARV4 in source plasma pools in China. Results showed that 26·15% (51/195) of lots tested positive for PARV4. The amounts of DNA ranged from 2·83 × 10(3) copies/ml to 2·35×10(7) copies/ml plasma. The high level of PARV4 in plasma pools may pose a potential risk to recipients. Further studies on the pathogenesis of PARV4 are urgently required.

  20. Design of hydrotherapy exercise pools.

    PubMed

    Edlich, R F; Abidin, M R; Becker, D G; Pavlovich, L J; Dang, M T

    1988-01-01

    Several hydrotherapy pools have been designed specifically for a variety of aquatic exercise. Aqua-Ark positions the exerciser in the center of the pool for deep-water exercise. Aqua-Trex is a shallow underwater treadmill system for water walking or jogging. Swim-Ex generates an adjustable laminar flow that permits swimming without turning. Musculoskeletal conditioning can be accomplished in the above-ground Arjo shallow-water exercise pool. A hydrotherapy pool also can be custom designed for musculoskeletal conditioning in its shallow part and cardiovascular conditioning in a deeper portion of the pool. Regardless of the type of exercise, there is general agreement that the specific exercise conducted in water requires significantly more energy expenditure than when the same exercise is performed on land. PMID:3192611

  1. Alpha-syntrophin deletion removes the perivascular but not endothelial pool of aquaporin-4 at the blood-brain barrier and delays the development of brain edema in an experimental model of acute hyponatremia.

    PubMed

    Amiry-Moghaddam, Mahmood; Xue, Rong; Haug, Finn-Mogens; Neely, John D; Bhardwaj, Anish; Agre, Peter; Adams, Marvin E; Froehner, Stanley C; Mori, Susumu; Ottersen, Ole P

    2004-03-01

    The formation of brain edema, commonly occurring as a potentially lethal complication of acute hyponatremia, is delayed following knockout of the water channel aquaporin-4 (AQP4). Here we show by high-resolution immunogold analysis of the blood-brain-barrier that AQP4 is expressed in brain endothelial cells as well as in the perivascular membranes of astrocyte endfeet. A selective removal of perivascular AQP4 by alpha-syntrophin deletion delays the buildup of brain edema (assessed by Diffusion-weighted MRI) following water intoxication, despite the presence of a normal complement of endothelial AQP4. This indicates that the perivascular membrane domain, which is peripheral to the endothelial blood-brain barrier, may control the rate of osmotically driven water entry. This study is also the first to demonstrate that the time course of edema development differs among brain regions, probably reflecting differences in aquaporin-4 distribution. The resolution of the molecular basis and subcellular site of osmotically driven brain water uptake should help design new therapies for acute brain edema.

  2. Comparison of 4D-microSPECT and microCT for murine cardiac function

    PubMed Central

    Befera, Nicholas T.; Badea, Cristian T.; Johnson, G. Allan

    2014-01-01

    Purpose The objective of this study was to compare a new generation of four-dimensional (4D) microSPECT with microCT for quantitative in vivo assessment of murine cardiac function. Procedures 4D isotropic cardiac images were acquired from normal C57BL/6 mice with either microSPECT at 350-micron resolution (n=6) or microCT at 88-micron resolution (n=6). One additional mouse with myocardial infarction (MI) was scanned with both modalities. Prior to imaging, mice were injected with either 99mTc -tetrofosmin for microSPECT, or a liposomal blood pool contrast agent for microCT. Segmentation of the left ventricle (LV) was performed using Vitrea (Vital Images) software, to derive global and regional function. Results Measures of global LV function between microSPECT and microCT groups were comparable (e.g. ejection fraction=71±6%-microSPECT and 68±4%-microCT). Regional functional indices (wall motion, wall thickening, regional ejection fraction) were also similar for the two modalities. In the mouse with MI, microSPECT identified a large perfusion defect that was not evident with microCT. Conclusions Despite lower spatial resolution, microSPECT was comparable to microCT in the quantitative evaluation of cardiac function. MicroSPECT offers an advantage over microCT in the ability to evaluate myocardial perfusion radiotracer distribution and function simultaneously. MicroSPECT should be considered as an alternative to microCT and MR for preclinical cardiac imaging in the mouse. PMID:24037175

  3. Cardiac Monitor

    NASA Technical Reports Server (NTRS)

    1996-01-01

    Under contract to Johnson Space Center, the University of Minnesota developed the concept of impedance cardiography as an alternative to thermodilution to access astronaut heart function in flight. NASA then contracted Space Labs, Inc. to construct miniature space units based on this technology. Several companies then launched their own impedance cardiography, including Renaissance Technologies, which manufactures the IQ System. The IQ System is 5 to 17 times cheaper than thermodilution, and features the signal processing technology called TFD (Time Frequency Distribution). TFD provides three- dimensional distribution of the blood circulation force signals, allowing visualization of changes in power, frequency and time.

  4. Optimization of a Model Corrected Blood Input Function from Dynamic FDG-PET Images of Small Animal Heart In Vivo

    PubMed Central

    Zhong, Min; Kundu, Bijoy K.

    2013-01-01

    Quantitative evaluation of dynamic Positron Emission Tomography (PET) of mouse heart in vivo is challenging due to the small size of the heart and limited intrinsic spatial resolution of the PET scanner. Here, we optimized a compartment model which can simultaneously correct for spill over and partial volume effects for both blood pool and the myocardium, compute kinetic rate parameters and generate model corrected blood input function (MCBIF) from ordered subset expectation maximization – maximum a posteriori (OSEM-MAP) cardiac and respiratory gated 18F-FDG PET images of mouse heart with attenuation correction in vivo, without any invasive blood sampling. Arterial blood samples were collected from a single mouse to indicate the feasibility of the proposed method. In order to establish statistical significance, venous blood samples from n=6 mice were obtained at 2 late time points, when SP contamination from the tissue to the blood is maximum. We observed that correct bounds and initial guesses for the PV and SP coefficients accurately model the wash-in and wash-out dynamics of the tracer from mouse blood. The residual plot indicated an average difference of about 1.7% between the blood samples and MCBIF. The downstream rate of myocardial FDG influx constant, Ki (0.15±0.03 min−1), compared well with Ki obtained from arterial blood samples (P=0.716). In conclusion, the proposed methodology is not only quantitative but also reproducible. PMID:24741130

  5. Cardiac Rehabilitation: Improving Function and Reducing Risk.

    PubMed

    Servey, Jessica T; Stephens, Mark

    2016-07-01

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

  6. Mathematical Models of Cardiac Pacemaking Function

    NASA Astrophysics Data System (ADS)

    Li, Pan; Lines, Glenn T.; Maleckar, Mary M.; Tveito, Aslak

    2013-10-01

    Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  7. 13 CFR 120.1708 - Pool Certificates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Pool Certificates. 120.1708... of SBA Secondary Market Guarantee Program for First Lien Position 504 Loan Pools § 120.1708 Pool Certificates. (a) SBA Guarantee of Pool Certificates. SBA guarantees to a Pool Investor the timely payment...

  8. 13 CFR 120.1708 - Pool Certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Pool Certificates. 120.1708... of SBA Secondary Market Guarantee Program for First Lien Position 504 Loan Pools § 120.1708 Pool Certificates. (a) SBA Guarantee of Pool Certificates. SBA guarantees to a Pool Investor the timely payment...

  9. 13 CFR 120.1708 - Pool Certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Pool Certificates. 120.1708... of SBA Secondary Market Guarantee Program for First Lien Position 504 Loan Pools § 120.1708 Pool Certificates. (a) SBA Guarantee of Pool Certificates. SBA guarantees to a Pool Investor the timely payment...

  10. 13 CFR 120.1708 - Pool Certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Pool Certificates. 120.1708... of SBA Secondary Market Guarantee Program for First Lien Position 504 Loan Pools § 120.1708 Pool Certificates. (a) SBA Guarantee of Pool Certificates. SBA guarantees to a Pool Investor the timely payment...

  11. 13 CFR 120.1708 - Pool Certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pool Certificates. 120.1708... of SBA Secondary Market Guarantee Program for First Lien Position 504 Loan Pools § 120.1708 Pool Certificates. (a) SBA Guarantee of Pool Certificates. SBA guarantees to a Pool Investor the timely payment...

  12. Acute effects of firefighting on cardiac performance.

    PubMed

    Fernhall, Bo; Fahs, Christopher A; Horn, Gavin; Rowland, Thomas; Smith, Denise

    2012-02-01

    This study examined standard echocardiographic measures of cardiac size and performance in response to a 3-h firefighting training exercise. Forty experienced male personnel completed a standardized 3 h live firefighting exercise. Before and after the firefighting activities, participants were weighed, height, heart rate, blood pressure and blood samples were obtained, and echocardiographic measurements were made. Firefighting produced significant decreases in left ventricular diastolic dimension, stroke volume, fractional shortening, and mitral E velocity, tachycardia, a rise in core temperature, and a reduction in calculated plasma volume. On tissue Doppler imaging, there were no changes in systolic contractile function, but a decreased lateral wall diastolic velocity was observed. These findings show that 3 h of live firefighting produced cardiac changes consistent with cardiac fatigue, coupled with a decrease in systemic arterial compliance. These data show that live firefighting produces significant cardiovascular changes and future work is needed to evaluate if these changes are related to the increase in cardiovascular risk during live firefighting.

  13. What Is Cardiac Rehabilitation?

    MedlinePlus

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

  14. Methods and apparatus for determining cardiac output

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  15. 13 CFR 120.1706 - Pool Originator's retained interest in Pool.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Pool Originator's retained interest in Pool. 120.1706 Section 120.1706 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... Pools § 120.1706 Pool Originator's retained interest in Pool. The Pool Originator must retain...

  16. 13 CFR 120.1706 - Pool Originator's retained interest in Pool.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Pool Originator's retained interest in Pool. 120.1706 Section 120.1706 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... Pools § 120.1706 Pool Originator's retained interest in Pool. The Pool Originator must retain...

  17. 13 CFR 120.1706 - Pool Originator's retained interest in Pool.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Pool Originator's retained interest in Pool. 120.1706 Section 120.1706 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... Pools § 120.1706 Pool Originator's retained interest in Pool. The Pool Originator must retain...

  18. 13 CFR 120.1706 - Pool Originator's retained interest in Pool.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Pool Originator's retained interest in Pool. 120.1706 Section 120.1706 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... Pools § 120.1706 Pool Originator's retained interest in Pool. The Pool Originator must retain...

  19. 13 CFR 120.1706 - Pool Originator's retained interest in Pool.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pool Originator's retained interest in Pool. 120.1706 Section 120.1706 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... Pools § 120.1706 Pool Originator's retained interest in Pool. The Pool Originator must retain...

  20. Pool impacts of Leidenfrost drop

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  1. Cardiac ion channels

    PubMed Central

    Priest, Birgit T; McDermott, Jeff S

    2015-01-01

    Ion channels are critical for all aspects of cardiac function, including rhythmicity and contractility. Consequently, ion channels are key targets for therapeutics aimed at cardiac pathophysiologies such as atrial fibrillation or angina. At the same time, off-target interactions of drugs with cardiac ion channels can be the cause of unwanted side effects. This manuscript aims to review the physiology and pharmacology of key cardiac ion channels. The intent is to highlight recent developments for therapeutic development, as well as elucidate potential mechanisms for drug-induced cardiac side effects, rather than present an in-depth review of each channel subtype. PMID:26556552

  2. CARDIAC OPERATIONS WITH EXTRACORPOREAL CIRCULATION

    PubMed Central

    Kay, Jerome Harold; Anderson, Robert M.; Lewis, Reuben R.; Meihaus, John; Magidson, Oscar; Snyder, Edward N.; Bennett, Louis C.; Bernstein, Sol; Amsden, Neal

    1959-01-01

    In a series of 50 patients for whom a heart-lung machine was used for periods as long as 70 minutes during operations to correct structural defects of the heart, there were no deaths attributable to the machine. Seven patients died. Two of them had high pressure ventricular septal defects with bidirectional shunts; a third patient with the same lesion recovered after repair. One patient died of cardiac tamponade when a large blood clot formed about the entire heart in a loosely closed pericardial sac. Others died of various causes. The development of subacute bacterial endocarditis in one patient led to a change in sterilization of apparatus. PMID:13662856

  3. Galectin-3 blockade inhibits cardiac inflammation and fibrosis in experimental hyperaldosteronism and hypertension.

    PubMed

    Martínez-Martínez, Ernesto; Calvier, Laurent; Fernández-Celis, Amaya; Rousseau, Elodie; Jurado-López, Raquel; Rossoni, Luciana V; Jaisser, Frederic; Zannad, Faiez; Rossignol, Patrick; Cachofeiro, Victoria; López-Andrés, Natalia

    2015-10-01

    Hypertensive cardiac remodeling is accompanied by molecular inflammation and fibrosis, 2 mechanisms that finally affect cardiac function. At cardiac level, aldosterone promotes inflammation and fibrosis, although the precise mechanisms are still unclear. Galectin-3 (Gal-3), a β-galactoside-binding lectin, is associated with inflammation and fibrosis in the cardiovascular system. We herein investigated whether Gal-3 inhibition could block aldosterone-induced cardiac inflammation and fibrosis and its potential role in cardiac damage associated with hypertension. Aldosterone-salt-treated rats presented hypertension, cardiac inflammation, and fibrosis that were prevented by the pharmacological inhibition of Gal-3 with modified citrus pectin. Cardiac inflammation and fibrosis presented in spontaneously hypertensive rats were prevented by modified citrus pectin treatment, whereas Gal-3 blockade did not modify blood pressure levels. In the absence of blood pressure modifications, Gal-3 knockout mice were resistant to aldosterone-induced cardiac inflammation. In human cardiac fibroblasts, aldosterone increased Gal-3 expression via its mineralocorticoid receptor. Gal-3 and aldosterone enhanced proinflammatory and profibrotic markers, as well as metalloproteinase activities in human cardiac fibroblasts, effects that were not observed in Gal-3-silenced cells treated with aldosterone. In experimental hyperaldosteronism, the increase in Gal-3 expression was associated with cardiac inflammation and fibrosis, alterations that were prevented by Gal-3 blockade independently of blood pressure levels. These data suggest that Gal-3 could be a new molecular mechanism linking cardiac inflammation and fibrosis in situations with high-aldosterone levels, such as hypertension.

  4. Diastolic abnormalities in systemic sclerosis: evidence for associated defective cardiac functional reserve.

    PubMed Central

    Valentini, G; Vitale, D F; Giunta, A; Maione, S; Gerundo, G; Arnese, M; Tirri, E; Pelaggi, N; Giacummo, A; Tirri, G; Condorelli, M

    1996-01-01

    OBJECTIVE: To investigate the pattern of diastolic abnormalities in patients with systemic sclerosis (SSc) and the relationship between impaired ventricular filling and systolic function. METHODS: Twenty four patients with SSc underwent M-mode and two dimensional echocardiography using echo-Doppler and gated blood pool cardiac angiography, both at rest and after exercise. RESULTS: An impaired diastolic relaxation of the left ventricle was detected in 10 of the 24 patients with SSc. Left ventricular ejection fraction at rest in these 10 patients with impaired ventricular filling did not differ from that in the remaining 14 patients, but eight of the 10 failed to increase their ejection fraction during exercise, compared with two of the 14 with normal ventricular filling (p = 0.003). CONCLUSION: Impaired relaxation of the left ventricle is a recently described feature of scleroderma heart disease. Diastolic dysfunction in SSc could depend on myocardial fibrosis or myocardial ischaemia, or both. It was found to be associated with a defective cardiac functional reserve. However, its prognostic significance remains to be clarified. PMID:8774164

  5. A framework of whole heart extracellular volume fraction estimation for low dose cardiac CT images

    NASA Astrophysics Data System (ADS)

    Chen, Xinjian; Summers, Ronald M.; Nacif, Marcelo Souto; Liu, Songtao; Bluemke, David A.; Yao, Jianhua

    2012-02-01

    Cardiac magnetic resonance imaging (CMRI) has been well validated and allows quantification of myocardial fibrosis in comparison to overall mass of the myocardium. Unfortunately, CMRI is relatively expensive and is contraindicated in patients with intracardiac devices. Cardiac CT (CCT) is widely available and has been validated for detection of scar and myocardial stress/rest perfusion. In this paper, we sought to evaluate the potential of low dose CCT for the measurement of myocardial whole heart extracellular volume (ECV) fraction. A novel framework was proposed for CCT whole heart ECV estimation, which consists of three main steps. First, a shape constrained graph cut (GC) method was proposed for myocardium and blood pool segmentation for post-contrast image. Second, the symmetric Demons deformable registrations method was applied to register pre-contrast to post-contrast images. Finally, the whole heart ECV value was computed. The proposed method was tested on 7 clinical low dose CCT datasets with pre-contrast and post-contrast images. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

  6. CARDIAC MICRO-CT FOR MORPHOLOGICAL AND FUNCTIONAL PHENOTYPING OF MLP NULL MICE

    PubMed Central

    Badea, Cristian T; Hedlund, Laurence W.; Boslego Mackel, Julie F.; Mao, Lan; Rockman, Howard A.; Johnson, G. Allan

    2009-01-01

    PURPOSE Investigate the use of micro-CT for morphological and functional phenotyping of MLP null mice and compare micro-CT with M-mode echocardiography. MATERIAL AND METHODS MLP null mice and controls were imaged using both micro-CT and M-mode echocardiography. For Micro-CT imaging, we used a custom built scanner. Following a single intravenous injection of a blood pool contrast agent (Fenestra™ VC) and using a cardio-respiratory gating, we acquired eight phases of the cardiac cycle (every 15 ms) and reconstructed 3D datasets with 94 micron isotropic resolution. Wall thickness and volumetric measurements of left ventricle were performed and cardiac function was estimated. RESULTS Micro-CT and M mode echocardiography showed both morphological and functional aspects that separate MLP null mice from controls. End Diastolic and Systolic Volumes were increased significantly 3 and 5 fold respectively in the MLP null versus controls. Ejection Fraction was reduced by an average of 32% in MLP null mice. The data analysis shows that two imaging modalities provided different results partly due to the difference in anesthesia regimes. Other sources of errors for micro-CT are also analyzed. CONCLUSION Micro-CT can provide the 4D data (3D isotropic volumes over time) required for morphological and functional phenotyping in mice. PMID:17711781

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

    SciTech Connect

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

    1986-03-05

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

  8. The history of cardiac catheterization.

    PubMed

    Bourassa, Martial G

    2005-10-01

    The evolution of cardiac catheterization has occurred over at least four centuries. One of the first major steps was the description of the circulation of the blood by William Harvey in 1628. The next milestone was the measurement of arterial pressure by Stephen Hales, one century later. However, the 19th century represented the golden age of cardiovascular physiology, highlighted by the achievements of Carl Ludwig, Etienne-Jules Marey and Claude Bernard, among others. Human cardiac catheterization developed during the 20th century. The first right heart catheterization in a human was performed by Werner Forssmann on himself in 1929. Diagnostic cardiac catheterization was introduced by André Cournand and Dickinson Richards in the early 1940s, and selective coronary angiography was described by Mason Sones in the early 1960s. More recently, with the advent of catheter-based interventions, pioneered by Andreas Gruentzig in the late 1970s, there has been considerable progress in the refinement and expansion of these techniques. Currently, the Sones technique is used only infrequently, and coronary angiography and percutaneous coronary intervention rely mainly on percutaneous femoral and percutaneous radial artery approaches. On the occasion of the 50th anniversary of the Montreal Heart Institute, it seems appropriate to highlight the contribution of this institution in these two areas. PMID:16234881

  9. Laser speckle analysis synchronised with cardiac cycle

    NASA Astrophysics Data System (ADS)

    Zakharov, Pavel; Scheffold, Frank; Weber, Bruno

    2015-07-01

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

  10. The LIM Protein Ajuba Restricts the Second Heart Field Progenitor Pool by Regulating Isl1 Activity

    PubMed Central

    Witzel, Hagen R.; Jungblut, Benno; Choe, Chong Pyo; Crump, J. Gage; Braun, Thomas; Dobreva, Gergana

    2013-01-01

    SUMMARY Morphogenesis of the heart requires tight control of cardiac progenitor cell specification, expansion, and differentiation. Retinoic acid (RA) signaling restricts expansion of the second heart field (SHF), serving as an important morphogen in heart development. Here, we identify the LIM domain protein Ajuba as a crucial regulator of the SHF progenitor cell specification and expansion. Ajuba-deficient zebra-fish embryos show an increased pool of Isl1+ cardiac progenitors and, subsequently, dramatically increased numbers of cardiomyocytes at the arterial and venous poles. Furthermore, we show that Ajuba binds Isl1, represses its transcriptional activity, and is also required for autorepression of Isl1 expression in an RA-dependent manner. Lack of Ajuba abrogates the RA-dependent restriction of Isl1+ cardiac cells. We conclude that Ajuba plays a central role in regulating the SHF during heart development by linking RA signaling to the function of Isl1, a key transcription factor in cardiac progenitor cells. PMID:22771034

  11. Carbon concentrations and transformations in peatland pools

    NASA Astrophysics Data System (ADS)

    Chapman, Pippa; Holden, Joseph; Baird, Andrew; Turner, Edward; Dooling, Gemma; Billett, Mike; McKenzie, Rebecca; Leith, Fraser; Dinsmore, Kerry

    2016-04-01

    Peatland pools may act as important features for aquatic and gaseous carbon production, transformation and release. Peatland restoration often results in new pools being created. Here we compare aquatic carbon concentrations in nearby natural and artificial pool systems monitored at three sites in northern Scotland over a three-year period. We found significant differences in pool water carbon concentrations between pool types with larger dissolved organic carbon (DOC) and dissolved carbon dioxide (CO2) in artificial pools. The differences were strong for all sites and occurred in all seasons. Importantly, the DOC outflows from natural pools were markedly lower than the DOC flowing into natural pools showing that processes in these pools were transforming and removing the DOC. These effects were not found in the artificial pools. Data on the composition of the DOC (absorbance ratios, specific ultraviolet absorbance) suggested that natural pools tended to have DOC that had been processed, and was older (radiocarbon dating) while the DOC in artificial pools was young and had not undergone much biochemical processing. Slope position was an important factor influencing pool DOC with those pools with a longer upslope contributing area and collecting water with a longer hillslope residence time having larger DOC concentrations. Dissolved methane (CH4) concentrations were not significantly different between pool types but the concentrations were always above atmospheric levels with values ˜ 200 times atmospheric concentrations not uncommon. Dissolved CO2 concentrations in the artificial pools were extremely large; typically ˜20 times atmospheric levels while those in natural pools were typically only just above atmospheric levels. The pools were strong sources of CH4 and CO2 evasion from the peat system. The smaller size of the artificial pools means that more of their CO2 is stored in the water until it reaches the stream system, while the larger natural pools have

  12. 47 CFR 97.523 - Question pools.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Question pools. 97.523 Section 97.523... SERVICE Qualifying Examination Systems § 97.523 Question pools. All VECs must cooperate in maintaining one question pool for each written examination element. Each question pool must contain at least 10 times...

  13. 47 CFR 97.523 - Question pools.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Question pools. 97.523 Section 97.523... SERVICE Qualifying Examination Systems § 97.523 Question pools. All VECs must cooperate in maintaining one question pool for each written examination element. Each question pool must contain at least 10 times...

  14. 47 CFR 13.215 - Question pools.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Question pools. 13.215 Section 13.215... Question pools. The question pool for each written examination element will be composed of questions acceptable to the FCC. Each question pool must contain at least five (5) times the number of...

  15. 47 CFR 97.523 - Question pools.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Question pools. 97.523 Section 97.523... SERVICE Qualifying Examination Systems § 97.523 Question pools. All VECs must cooperate in maintaining one question pool for each written examination element. Each question pool must contain at least 10 times...

  16. 47 CFR 13.215 - Question pools.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Question pools. 13.215 Section 13.215... Question pools. The question pool for each written examination element will be composed of questions acceptable to the FCC. Each question pool must contain at least five (5) times the number of...

  17. 47 CFR 13.215 - Question pools.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Question pools. 13.215 Section 13.215... Question pools. The question pool for each written examination element will be composed of questions acceptable to the FCC. Each question pool must contain at least five (5) times the number of...

  18. 47 CFR 97.523 - Question pools.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Question pools. 97.523 Section 97.523... SERVICE Qualifying Examination Systems § 97.523 Question pools. All VECs must cooperate in maintaining one question pool for each written examination element. Each question pool must contain at least 10 times...

  19. 47 CFR 13.215 - Question pools.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Question pools. 13.215 Section 13.215... Question pools. The question pool for each written examination element will be composed of questions acceptable to the FCC. Each question pool must contain at least five (5) times the number of...

  20. 47 CFR 13.215 - Question pools.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Question pools. 13.215 Section 13.215... Question pools. The question pool for each written examination element will be composed of questions acceptable to the FCC. Each question pool must contain at least five (5) times the number of...

  1. 47 CFR 97.523 - Question pools.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Question pools. 97.523 Section 97.523... SERVICE Qualifying Examination Systems § 97.523 Question pools. All VECs must cooperate in maintaining one question pool for each written examination element. Each question pool must contain at least 10 times...

  2. HYDROLOGY AND LANDSCAPE CONNECTIVITY OF VERNAL POOLS

    EPA Science Inventory

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

  3. Swimming Pools. Managing School Facilities, Guide 2.

    ERIC Educational Resources Information Center

    Department for Education and Employment, London (England). Architects and Building Branch.

    This guide for schools with swimming pools offers advice concerning appropriate training for pool managers, the importance of water quality and testing, safety in the handling of chemicals, maintenance and cleaning requirements, pool security, and health concerns. The guide covers both indoor and outdoor pools, explains some technical terms,…

  4. 21 CFR 1250.89 - Swimming pools.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  5. Cardiac Innervation and Sudden Cardiac Death

    PubMed Central

    Fukuda, Keiichi; Kanazawa, Hideaki; Aizawa, Yoshiyasu; Ardell, Jeffrey L.; Shivkumar, Kalyanam

    2015-01-01

    Afferent and efferent cardiac neurotransmission via the cardiac nerves intricately modulates nearly all physiological functions of the heart (chronotropy, dromotropy, lusitropy and inotropy). Afferent information from the heart is transmitted to higher levels of the nervous system for processing (intrinsic cardiac nervous system, extracardiac-intrathoracic ganglia, spinal cord, brain stem and higher centers) which ultimately results in efferent cardiomotor neural impulses (via the sympathetic and parasympathetic nerves). This system forms interacting feedback loops that provide physiological stability for maintaining normal rhythm and life-sustaining circulation. This system also ensures that there is fine-tuned regulation of sympathetic-parasympathetic balance in the heart under normal and stressed states in the short (beat to beat), intermediate (minutes-hours) and long term (days-years). This important neurovisceral /autonomic nervous system also plays a major role in the pathophysiology and progression of heart disease, including heart failure and arrhythmias leading to sudden cardiac death (SCD). Transdifferentiation of neurons in heart failure, functional denervation, cardiac and extra-cardiac neural remodeling have also been identified and characterized during the progression of disease. Recent advances in understanding the cellular and molecular processes governing innervation and the functional control of the myocardium in health and disease provides a rational mechanistic basis for development of neuraxial therapies for preventing SCD and other arrhythmias. Advances in cellular, molecular, and bioengineering realms have underscored the emergence of this area as an important avenue of scientific inquiry and therapeutic intervention. PMID:26044253

  6. Systems approaches in integrative cardiac biology: illustrations from cardiac heterocellular signalling studies.

    PubMed

    Nim, Hieu T; Boyd, Sarah E; Rosenthal, Nadia A

    2015-01-01

    Understanding the complexity of cardiac physiology requires system-level studies of multiple cardiac cell types. Frequently, however, the end result of published research lacks the detail of the collaborative and integrative experimental design process, and the underlying conceptual framework. We review the recent progress in systems modelling and omics analysis of the heterocellular heart environment through complementary forward and inverse approaches, illustrating these conceptual and experimental frameworks with case studies from our own research program. The forward approach begins by collecting curated information from the niche cardiac biology literature, and connecting the dots to form mechanistic network models that generate testable system-level predictions. The inverse approach starts from the vast pool of public omics data in recent cardiac biological research, and applies bioinformatics analysis to produce novel candidates for further investigation. We also discuss the possibility of combining these two approaches into a hybrid framework, together with the benefits and challenges. These interdisciplinary research frameworks illustrate the interplay between computational models, omics analysis, and wet lab experiments, which holds the key to making real progress in improving human cardiac wellbeing. PMID:25499442

  7. Method of measuring a liquid pool volume

    DOEpatents

    Garcia, Gabe V.; Carlson, Nancy M.; Donaldson, Alan D.

    1991-01-01

    A method of measuring a molten metal liquid pool volume and in particular molten titanium liquid pools, including the steps of (a) generating an ultrasonic wave at the surface of the molten metal liquid pool, (b) shining a light on the surface of a molten metal liquid pool, (c) detecting a change in the frequency of light, (d) detecting an ultrasonic wave echo at the surface of the molten metal liquid pool, and (e) computing the volume of the molten metal liquid.

  8. Marketing cardiac CT programs.

    PubMed

    Scott, Jason

    2010-01-01

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

  9. Flame spread across liquid pools

    NASA Technical Reports Server (NTRS)

    Ross, Howard; Miller, Fletcher; Schiller, David; Sirignano, William A.

    1993-01-01

    For flame spread over liquid fuel pools, the existing literature suggests three gravitational influences: (1) liquid phase buoyant convection, delaying ignition and assisting flame spread; (2) hydrostatic pressure variation, due to variation in the liquid pool height caused by thermocapillary-induced convection; and (3) gas-phase buoyant convection in the opposite direction to the liquid phase motion. No current model accounts for all three influences. In fact, prior to this work, there was no ability to determine whether ignition delay times and flame spread rates would be greater or lesser in low gravity. Flame spread over liquid fuel pools is most commonly characterized by the relationship of the initial pool temperature to the fuel's idealized flash point temperature, with four or five separate characteristic regimes having been identified. In the uniform spread regime, control has been attributed to: (1) gas-phase conduction and radiation; (2) gas-phase conduction only; (3) gas-phase convection and liquid conduction, and most recently (4) liquid convection ahead of the flame. Suggestions were made that the liquid convection was owed to both vuoyancy and thermocapillarity. Of special interest to this work is the determination of whether, and under what conditions, pulsating spread can and will occur in microgravity in the absence of buoyant flows in both phases. The approach we have taken to resolving the importance of buoyancy for these flames is: (1) normal gravity experiments and advanced diagnostics; (2) microgravity experiments; and (3) numerical modelling at arbitrary gravitational level.

  10. William Harvey, Peter Lauremberg and cardiac output.

    PubMed

    Teichmann, G

    1992-11-01

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

  11. Numerical Investigation of Macroscopic Cardiac Mechanics.

    NASA Astrophysics Data System (ADS)

    Buxton, Gavin; Balazs, Anna

    2003-03-01

    In order to gain insight into the complex interactions between electrical excitation of the myocardial tissue, the mechanical contraction of the heart muscles and cardiac fluid dynamics, three computational techniques are successfully coupled. A Gerhardt-Schuster-Tyson Cellular Automata algorithm enables the excitation kinetics of myocardial tissue to be simulated in a computationally efficient manner. The cardiac excitation spreading is then coupled with a dynamic Born Lattice Spring Model which enables the contraction of the heart muscles and their subsequent relaxation to be modelled. The velocities at the inner surfaces of the heart can then be transferred to a Lattice Boltzmann simulation of blood flow within the cardiac chambers. The interactions (and complex feedback mechanisms) between electrical excitation, mechanical deformation, and fluid flow in the heart are explored through these three-dimensional models and the regular functionality of the whole heart is visualised.

  12. Diminazene Aceturate Improves Cardiac Fibrosis and Diastolic Dysfunction in Rats with Kidney Disease

    PubMed Central

    Velkoska, Elena; Patel, Sheila K.; Griggs, Karen

    2016-01-01

    Angiotensin converting enzyme (ACE) 2 is a negative regulator of the renin angiotensin system (RAS) through its role to degrade angiotensin II. In rats with subtotal nephrectomy (STNx), adverse cardiac remodelling occurs despite elevated cardiac ACE2 activity. We hypothesised that diminazene aceturate (DIZE), which has been described as having an off-target effect to activate ACE2, would have beneficial cardiac effects in STNx rats. STNx led to hypertension, diastolic dysfunction, left ventricular hypertrophy, cardiac fibrosis, and increased cardiac ACE, ACE2, Ang II and Ang 1–7 levels. Cardiac gene expression of ADAM17 was also increased. In STNx, two-weeks of subcutaneous DIZE (15mg/kg/d) had no effect on blood pressure but improved diastolic dysfunction and cardiac fibrosis, reduced ADAM17 mRNA and shifted the cardiac RAS balance to a cardioprotective profile with reduced ACE and Ang II. There was no change in cardiac ACE2 activity or in cardiac Ang 1–7 levels with DIZE. In conclusion, our results suggest that DIZE exerts a protective effect on the heart under the pathological condition of kidney injury. This effect was not due to improved kidney function, a fall in blood pressure or a reduction in LVH but was associated with a reduction in cardiac ACE and cardiac Ang II levels. As in vitro studies showed no direct effect of DIZE on ACE2 or ACE activity, the precise mechanism of action of DIZE remains to be determined. PMID:27571511

  13. Diminazene Aceturate Improves Cardiac Fibrosis and Diastolic Dysfunction in Rats with Kidney Disease.

    PubMed

    Velkoska, Elena; Patel, Sheila K; Griggs, Karen; Burrell, Louise M

    2016-01-01

    Angiotensin converting enzyme (ACE) 2 is a negative regulator of the renin angiotensin system (RAS) through its role to degrade angiotensin II. In rats with subtotal nephrectomy (STNx), adverse cardiac remodelling occurs despite elevated cardiac ACE2 activity. We hypothesised that diminazene aceturate (DIZE), which has been described as having an off-target effect to activate ACE2, would have beneficial cardiac effects in STNx rats. STNx led to hypertension, diastolic dysfunction, left ventricular hypertrophy, cardiac fibrosis, and increased cardiac ACE, ACE2, Ang II and Ang 1-7 levels. Cardiac gene expression of ADAM17 was also increased. In STNx, two-weeks of subcutaneous DIZE (15mg/kg/d) had no effect on blood pressure but improved diastolic dysfunction and cardiac fibrosis, reduced ADAM17 mRNA and shifted the cardiac RAS balance to a cardioprotective profile with reduced ACE and Ang II. There was no change in cardiac ACE2 activity or in cardiac Ang 1-7 levels with DIZE. In conclusion, our results suggest that DIZE exerts a protective effect on the heart under the pathological condition of kidney injury. This effect was not due to improved kidney function, a fall in blood pressure or a reduction in LVH but was associated with a reduction in cardiac ACE and cardiac Ang II levels. As in vitro studies showed no direct effect of DIZE on ACE2 or ACE activity, the precise mechanism of action of DIZE remains to be determined. PMID:27571511

  14. Cardiac contractility in Antarctic teleost is modulated by nitrite through xanthine oxidase and cytochrome p-450 nitrite reductase.

    PubMed

    Garofalo, Filippo; Amelio, Daniela; Gattuso, Alfonsina; Cerra, Maria Carmela; Pellegrino, Daniela

    2015-09-15

    In mammalian and non-mammalian vertebrates, nitrite anion, the largest pool of intravascular and tissue nitric oxide storage, represents a key player of many biological processes, including cardiac modulation. As shown by our studies on Antarctic teleosts, nitrite-dependent cardiac regulation is of great relevance also in cold-blooded vertebrates. This study analysed the influence elicited by nitrite on the performance of the perfused beating heart of two Antarctic stenotherm teleosts, the haemoglobinless Chionodraco hamatus (icefish) and the red-blooded Trematomus bernacchii. Since haemoglobin is crucial in nitric oxide homeostasis, the icefish, a naturally occurring genetic knockout for this protein, provides exclusive opportunities to investigate nitric oxide/nitrite signaling. In vivo, nitrite conversion to nitric oxide requires the nitrite reductase activity of xanthine oxidase and cytochrome P-450, thus the involvement of these enzymes was also evaluated. We showed that, in C. hamatus and T. bernacchii, nitrite influenced cardiac performance by inducing a concentration-dependent positive inotropic effect which was unaffected by nitric oxide scavenging by PTIO in C. hamatus, while it was abolished in T. bernacchii. Specific inhibition of xanthine oxidase and cytochrome P-450 revealed, in the two teleosts, that the nitrite-dependent inotropism required the nitrite reductase activity of both enzymes. We also found that xanthine oxidase is more expressed in C. hamatus than in T. bernacchii, while the opposite was observed concerning cytochrome P-450. Results suggested that in the heart of C. hamatus and T. bernacchii, nitrite is an integral physiological source of nitric oxide with important signaling properties, which require the nitrite reductase activity of xanthine oxidase and cytochrome P-450. PMID:26045289

  15. Cardiac contractility in Antarctic teleost is modulated by nitrite through xanthine oxidase and cytochrome p-450 nitrite reductase.

    PubMed

    Garofalo, Filippo; Amelio, Daniela; Gattuso, Alfonsina; Cerra, Maria Carmela; Pellegrino, Daniela

    2015-09-15

    In mammalian and non-mammalian vertebrates, nitrite anion, the largest pool of intravascular and tissue nitric oxide storage, represents a key player of many biological processes, including cardiac modulation. As shown by our studies on Antarctic teleosts, nitrite-dependent cardiac regulation is of great relevance also in cold-blooded vertebrates. This study analysed the influence elicited by nitrite on the performance of the perfused beating heart of two Antarctic stenotherm teleosts, the haemoglobinless Chionodraco hamatus (icefish) and the red-blooded Trematomus bernacchii. Since haemoglobin is crucial in nitric oxide homeostasis, the icefish, a naturally occurring genetic knockout for this protein, provides exclusive opportunities to investigate nitric oxide/nitrite signaling. In vivo, nitrite conversion to nitric oxide requires the nitrite reductase activity of xanthine oxidase and cytochrome P-450, thus the involvement of these enzymes was also evaluated. We showed that, in C. hamatus and T. bernacchii, nitrite influenced cardiac performance by inducing a concentration-dependent positive inotropic effect which was unaffected by nitric oxide scavenging by PTIO in C. hamatus, while it was abolished in T. bernacchii. Specific inhibition of xanthine oxidase and cytochrome P-450 revealed, in the two teleosts, that the nitrite-dependent inotropism required the nitrite reductase activity of both enzymes. We also found that xanthine oxidase is more expressed in C. hamatus than in T. bernacchii, while the opposite was observed concerning cytochrome P-450. Results suggested that in the heart of C. hamatus and T. bernacchii, nitrite is an integral physiological source of nitric oxide with important signaling properties, which require the nitrite reductase activity of xanthine oxidase and cytochrome P-450.

  16. Interactions between pool geometry and hydraulics

    USGS Publications Warehouse

    Thompson, D.M.; Nelson, J.M.; Wohl, E.E.

    1998-01-01

    An experimental and computational research approach was used to determine interactions between pool geometry and hydraulics. A 20-m-long, 1.8-m-wide flume was used to investigate the effect of four different geometric aspects of pool shape on flow velocity. Plywood sections were used to systematically alter constriction width, pool depth, pool length, and pool exit-slope gradient, each at two separate levels. Using the resulting 16 unique geometries with measured pool velocities in four-way factorial analyses produced an empirical assessment of the role of the four geometric aspects on the pool flow patterns and hence the stability of the pool. To complement the conclusions of these analyses, a two-dimensional computational flow model was used to investigate the relationships between pool geometry and flow patterns over a wider range of conditions. Both experimental and computational results show that constriction and depth effects dominate in the jet section of the pool and that pool length exhibits an increasing effect within the recirculating-eddy system. The pool exit slope appears to force flow reattachment. Pool length controls recirculating-eddy length and vena contracta strength. In turn, the vena contracta and recirculating eddy control velocities throughout the pool.

  17. Diminishing the impact of the partial volume effect in cardiac SPECT perfusion imaging.

    PubMed

    Pretorius, P Hendrik; King, Michael A

    2009-01-01

    The partial volume effect (PVE) significantly restricts the absolute quantification of regional myocardial uptake and thereby limits the accuracy of absolute measurement of blood flow and coronary flow reserve by SPECT. The template-projection-reconstruction method has been previously developed for PVE compensation. This method assumes the availability of coregistered high-spatial resolution anatomical information as is now becoming available with commercial dual-modality imaging systems such as SPECT/CTs. The objective of this investigation was to determine the extent to which the impact of the PVE on cardiac perfusion SPECT imaging can be diminished if coregistered high-spatial resolution anatomical information is available. For this investigation the authors introduced an additional parameter into the template-projection-reconstruction compensation equation called the voxel filling fraction (F). This parameter specifies the extent to which structure edge voxels in the emission reconstruction are filled by the structure in question as determined by the higher spatial-resolution imaging modality and the fractional presence of the structure at different states of physiological motion as in combining phases of cardiac motion. During correction the removal of spillover to the cardiac region from the surrounding structures is performed first by using reconstructed templates of neighboring structures (liver, blood pool, lungs) to calculate spillover fractions. This is followed by determining recovery coefficients for all voxels within the heart wall from the reconstruction of the template projections of the left and right ventricles (LV and RV). The emission data are subsequently divided by these recovery coefficients taking into account the filling fraction F. The mathematical cardiac torso phantom was used for investigation correction of PVE for a normal LV distribution, a defect in the inferior wall, and a defect in the anterior wall. PVE correction resulted in a

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

    PubMed

    Magder, S

    2016-01-01

    Volume infusions are one of the commonest clinical interventions in critically ill patients yet the relationship of volume to cardiac output is not well understood. Blood volume has a stressed and unstressed component but only the stressed component determines flow. It is usually about 30 % of total volume. Stressed volume is relatively constant under steady state conditions. It creates an elastic recoil pressure that is an important factor in the generation of blood flow. The heart creates circulatory flow by lowering the right atrial pressure and allowing the recoil pressure in veins and venules to drain blood back to the heart. The heart then puts the volume back into the systemic circulation so that stroke return equals stroke volume. The heart cannot pump out more volume than comes back. Changes in cardiac output without changes in stressed volume occur because of changes in arterial and venous resistances which redistribute blood volume and change pressure gradients throughout the vasculature. Stressed volume also can be increased by decreasing vascular capacitance, which means recruiting unstressed volume into stressed volume. This is the equivalent of an auto-transfusion. It is worth noting that during exercise in normal young males, cardiac output can increase five-fold with only small changes in stressed blood volume. The mechanical characteristics of the cardiac chambers and the circulation thus ultimately determine the relationship between volume and cardiac output and are the subject of this review. PMID:27613307

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

    PubMed

    Magder, S

    2016-09-10

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

  20. Cardiac surgery-associated acute kidney injury.

    PubMed

    Mao, Huijuan; Katz, Nevin; Ariyanon, Wassawon; Blanca-Martos, Lourdes; Adýbelli, Zelal; Giuliani, Anna; Danesi, Tommaso Hinna; Kim, Jeong Chul; Nayak, Akash; Neri, Mauro; Virzi, Grazia Maria; Brocca, Alessandra; Scalzotto, Elisa; Salvador, Loris; Ronco, Claudio

    2013-10-01

    Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy. PMID:24454314

  1. Cardiac, respiratory, and locomotor coordination during walking in humans.

    PubMed

    Niizeki, K; Kawahara, K; Miyamoto, Y

    1996-01-01

    Interactions between locomotor, respiratory, and cardiac rhythms were investigated in human subjects (n = 11) walking on a treadmill. Investigation of the phase relationship between heart rate and gait signals revealed that cardiac rhythms were entrained to locomotor rhythms when both frequencies were close to an integer ratio. Coherence spectra were estimated between heartbeat fluctuation, respiratory, and gait signals, and their magnitudes were evaluated. The results suggest that the respiratory-induced fluctuation in heartbeat would vary depending on the strength of the cardiolocomotor coupling. The synchronization tends to occur for one or two specific phases in an individual subject, but there was some variation among subjects. When the subjects voluntarily synchronized their cadence with the cardiac rhythm, the heart rate and blood pressure varied depending on the phase lag within a cardiac cycle. The coordination of locomotor and cardiac rhythms is discussed.

  2. Cardiac fluid dynamics anticipates heart adaptation.

    PubMed

    Pedrizzetti, Gianni; Martiniello, Alfonso R; Bianchi, Valter; D'Onofrio, Antonio; Caso, Pio; Tonti, Giovanni

    2015-01-21

    Hemodynamic forces represent an epigenetic factor during heart development and are supposed to influence the pathology of the grown heart. Cardiac blood motion is characterized by a vortical dynamics, and it is common belief that the cardiac vortex has a role in disease progressions or regression. Here we provide a preliminary demonstration about the relevance of maladaptive intra-cardiac vortex dynamics in the geometrical adaptation of the dysfunctional heart. We employed an in vivo model of patients who present a stable normal heart function in virtue of the cardiac resynchronization therapy (CRT, bi-ventricular pace-maker) and who are expected to develop left ventricle remodeling if pace-maker was switched off. Intra-ventricular fluid dynamics is analyzed by echocardiography (Echo-PIV). Under normal conditions, the flow presents a longitudinal alignment of the intraventricular hemodynamic forces. When pacing is temporarily switched off, flow forces develop a misalignment hammering onto lateral walls, despite no other electro-mechanical change is noticed. Hemodynamic forces result to be the first event that evokes a physiological activity anticipating cardiac changes and could help in the prediction of longer term heart adaptations.

  3. Long-term follow-up of cardiac function in patients with Hodgkin's disease treated with mediastinal irradiation and combination chemotherapy including doxorubicin

    SciTech Connect

    LaMonte, C.S.; Yeh, S.D.; Straus, D.J.

    1986-04-01

    Among 41 evaluable patients whose first treatment for advanced Hodgkin's disease had consisted of alternating cycles of mechlorethamine, vincristine, prednisone, and procarbazine (MOPP), and doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), in addition to low-dose mediastinal irradiation, 19 underwent retrospective cardiac evaluation by routine posteroanterior and lateral chest x-ray, 12-lead ECG, M-mode echocardiogram, and ECG-gated left ventricular blood pool scan at rest and during exercise. Fifteen patients had unequivocally normal left ventricular function by all these parameters. Two patients had minimally reduced left ventricular ejection fraction (LVEF) at rest with a normal increment with exercise. In two other patients with high normal resting LVEF and subnormal increment with exercise, the elevated resting values implied initial measurement in a nonbasal state. A twentieth patient (the oldest; one of two with active Hodgkin's disease at the time of evaluation and the stimulus for this study) had markedly reduced LVEF as determined by radionuclide cardiac angiography and had developed clinical congestive heart failure shortly before evaluation. Despite this patient, the study indicates that treatment with MOPP/ABVD and low-dose mediastinal irradiation entails low risk for cardiac complications.

  4. Measurement of cardiac troponins.

    PubMed

    Collinson, P O; Boa, F G; Gaze, D C

    2001-09-01

    The cardiac troponins form part of the regulatory mechanism for muscle contraction. Specific cardiac isoforms of cardiac troponin T and cardiac troponin I exist and commercially available immunoassay systems have been developed for their measurement. A large number of clinical and analytical studies have been performed and the measurement of cardiac troponins is now considered the 'gold standard' biochemical test for diagnosis of myocardial damage. There have been advances in understanding the development and structure of troponins and their degradation following myocardial cell necrosis. This has contributed to the understanding of the problems with current assays. Greater clinical use has also highlighted areas of analytical and clinical confusion. The assays are reviewed based on manufacturers' information, current published material as well as the authors' in-house experience.

  5. Functional cardiac tissue engineering

    PubMed Central

    Liau, Brian; Zhang, Donghui; Bursac, Nenad

    2013-01-01

    Heart attack remains the leading cause of death in both men and women worldwide. Stem cell-based therapies, including the use of engineered cardiac tissues, have the potential to treat the massive cell loss and pathological remodeling resulting from heart attack. Specifically, embryonic and induced pluripotent stem cells are a promising source for generation of therapeutically relevant numbers of functional cardiomyocytes and engineering of cardiac tissues in vitro. This review will describe methodologies for successful differentiation of pluripotent stem cells towards the cardiovascular cell lineages as they pertain to the field of cardiac tissue engineering. The emphasis will be placed on comparing the functional maturation in engineered cardiac tissues and developing heart and on methods to quantify cardiac electrical and mechanical function at different spatial scales. PMID:22397609

  6. Cardiac Hegemony of Senescence

    PubMed Central

    Siddiqi, Sailay; Sussman, Mark A.

    2013-01-01

    Cardiac senescence and age-related disease development have gained general attention and recognition in the past decades due to increased accessibility and quality of health care. The advancement in global civilization is complementary to concerns regarding population aging and development of chronic degenerative diseases. Cardiac degeneration has been rigorously studied. The molecular mechanisms of cardiac senescence are on multiple cellular levels and hold a multilayer complexity level, thereby hampering development of unambiguous treatment protocols. In particular, the synergistic exchange of the senescence phenotype through a senescence secretome between myocytes and stem cells appears complicated and is of great future therapeutic value. The current review article will highlight hallmarks of senescence, cardiac myocyte and stem cell senescence, and the mutual exchange of senescent secretome. Future cardiac cell therapy approaches require a comprehensive understanding of myocardial senescence to improve therapeutic efficiency as well as efficacy. PMID:24349878

  7. Vomiting blood

    MedlinePlus

    ... first part of the small intestine, or esophagus Blood clotting disorders Defects in the blood vessels of the ... as a complete blood count (CBC), blood chemistries, blood clotting tests, and liver function tests Esophagogastroduodenoscopy (EGD) (placing ...

  8. Blood Disorders

    MedlinePlus

    ... liquid part, called plasma, is made of water, salts and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells and platelets. Blood disorders affect ...

  9. [Infections transmitted in swimming pools].

    PubMed

    von Suzani, C; Hazeghi, P

    1976-01-01

    Public swimmingpools can be the source of infections due to micro-organism such as mycobacterium balnei, adeno and enteroviruses, the virus of plantar warts and molluscum contagiosum, the TRIC-Agent of swimmingpool-conjonctivitis and pathogenic fungi. The transmission of trichomonas vaginalis is considered unlikely-Water of pools, supposed to present satisfactory qualities by standard controls, was found to contain pathogenic staphylococci and pseudomonas aeruginosa. Effective preventive measures include the continuous recording of the redox-potential of the water, limiting the number of visitors to pool design specifications, better desinfection of sanitary installations, regular maintenance of technical equipment including frequent backwashing of filters and exclusion of visitors with communicable disease.

  10. [Role of antithrombin iii in cardiac surgery].

    PubMed

    Muedra, V; Barettino, D; D'Ocón, P

    2013-11-01

    Coagulation of blood is of multidisciplinary interest. Cardiac surgery produces major changes in the delicate balance between pro-and anti-coagulant serum factors. The role of antithrombin iii has been analysed after finding evidence that associated decreased levels of protein activity to postoperative morbidity and mortality. Supplementing exogenous antithrombin is considered with the aim of optimising outcomes. Its intrinsic anticoagulant and anti-inflammatory properties have stimulated a growing interest, and suggests new lines of research. PMID:23228672

  11. [Role of antithrombin iii in cardiac surgery].

    PubMed

    Muedra, V; Barettino, D; D'Ocón, P

    2013-11-01

    Coagulation of blood is of multidisciplinary interest. Cardiac surgery produces major changes in the delicate balance between pro-and anti-coagulant serum factors. The role of antithrombin iii has been analysed after finding evidence that associated decreased levels of protein activity to postoperative morbidity and mortality. Supplementing exogenous antithrombin is considered with the aim of optimising outcomes. Its intrinsic anticoagulant and anti-inflammatory properties have stimulated a growing interest, and suggests new lines of research.

  12. Cardiac cavernous hemangioma and multiple pulmonary cavernous hemangiomas.

    PubMed

    Yang, Lili; Dai, Jun; Xiao, Ying; Cheng, Henghui; Ruan, Qiurong

    2014-02-01

    We describe for the first time a rare coexistence of a cardiac cavernous hemangioma with multiple pulmonary cavernous hemangiomas. Computed tomography revealed bilateral pulmonary nodules, left pleural effusion, and pericardial effusion. Positron emission tomography showed a pericardial neoplasm. Pathologically, multiple large dilated vascular spaces, lined by a single layer of endothelial cells and filled with blood, were revealed in both the cardiac tumor and the pulmonary nodules. Immunohistochemical examination of the lining cells showed positivity for CD31, FLI1, FVIII, and CD34. Taken together, these findings led to the diagnosis of cardiac cavernous hemangioma and multiple pulmonary cavernous hemangiomas.

  13. Computational approaches to understand cardiac electrophysiology and arrhythmias

    PubMed Central

    Roberts, Byron N.; Yang, Pei-Chi; Behrens, Steven B.; Moreno, Jonathan D.

    2012-01-01

    Cardiac rhythms arise from electrical activity generated by precisely timed opening and closing of ion channels in individual cardiac myocytes. These impulses spread throughout the cardiac muscle to manifest as electrical waves in the whole heart. Regularity of electrical waves is critically important since they signal the heart muscle to contract, driving the primary function of the heart to act as a pump and deliver blood to the brain and vital organs. When electrical activity goes awry during a cardiac arrhythmia, the pump does not function, the brain does not receive oxygenated blood, and death ensues. For more than 50 years, mathematically based models of cardiac electrical activity have been used to improve understanding of basic mechanisms of normal and abnormal cardiac electrical function. Computer-based modeling approaches to understand cardiac activity are uniquely helpful because they allow for distillation of complex emergent behaviors into the key contributing components underlying them. Here we review the latest advances and novel concepts in the field as they relate to understanding the complex interplay between electrical, mechanical, structural, and genetic mechanisms during arrhythmia development at the level of ion channels, cells, and tissues. We also discuss the latest computational approaches to guiding arrhythmia therapy. PMID:22886409

  14. Pool power control in remelting systems

    DOEpatents

    Williamson, Rodney L.; Melgaard, David K.; Beaman, Joseph J.

    2011-12-13

    An apparatus for and method of controlling a remelting furnace comprising adjusting current supplied to an electrode based upon a predetermined pool power reference value and adjusting the electrode drive speed based upon the predetermined pool power reference value.

  15. Pool Safety: A Few Simple Rules.

    ERIC Educational Resources Information Center

    PTA Today, 1993

    1993-01-01

    Presents suggestions by the National Swimming Pool Safety Committee on how to keep children safe while swimming. Ideas include maintaining strict adult supervision, pool and spa barriers, and knowledge of cardiopulmonary resuscitation. (SM)

  16. Cold Pools in the Columbia Basin

    SciTech Connect

    Whiteman, Charles D.; Zhong, Shiyuan; Shaw, William J.; Hubbe, John M.; Bian, Xindi; Mittelstadt, J.

    2001-01-01

    Persistent midwinter cold air pools produce multi-day periods of cold, dreary weather in valleys and basins. Persistent stable stratification leads to the buildup of pollutants and moisture in the pool. Because the pool sometimes has temperatures below freezing while the air above is warmer, freezing precipitation often occurs with consequent effects on transportation and safety. Forecasting the buildup and breakdown of these cold pools is difficult because the physical mechanisms leading to their formation, maintenance, and destruction have received little study. This paper provides a succinct meteorological definition of a cold pool, develops a climatology of Columbia Basin cold pools, and analyzes remote and in situ temperature and wind sounding data for two winter cold pool episodes that were accompanied by fog and stratus, illustrating many of the physical mechanisms affecting cold pool evolution.

  17. CDC Study Finds Fecal Contamination in Pools

    MedlinePlus

    ... Communication (404) 639-3286 CDC study finds fecal contamination in pools A study of public pools done ... The E. coli is a marker for fecal contamination. Finding a high percentage of E. coli-positive ...

  18. Drowning in disinfection byproducts? Assessing swimming pool water.

    PubMed

    Zwiener, Christian; Richardson, Susan D; DeMarini, David M; De Marini, David M; Grummt, Tamara; Glauner, Thomas; Frimmel, Fritz H

    2007-01-15

    Disinfection is mandatory for swimming pools: public pools are usually disinfected by gaseous chlorine or sodium hypochlorite and cartridge filters; home pools typically use stabilized chlorine. These methods produce a variety of disinfection byproducts (DBPs), such as trihalomethanes (THMs), which are regulated carcinogenic DBPs in drinking water that have been detected in the blood and breath of swimmers and of nonswimmers at indoor pools. Also produced are halogenated acetic acids (HAAs) and haloketones, which irritate the eyes, skin, and mucous membranes; trichloramine, which is linked with swimming-pool-associated asthma; and halogenated derivatives of UV sun screens, some of which show endocrine effects. Precursors of DBPs include human body substances, chemicals used in cosmetics and sun screens, and natural organic matter. Analytical research has focused also on the identification of an additional portion of unknown DBPs using gas chromatography (GC)/mass spectrometry (MS) and liquid chromatography (LC)/MS/MS with derivatization. Children swimmers have an increased risk of developing asthma and infections of the respiratory tract and ear. A 1.6-2.0-fold increased risk for bladder cancer has been associated with swimming or showering/bathing with chlorinated water. Bladder cancer risk from THM exposure (all routes combined) was greatest among those with the GSTT1-1 gene. This suggests a mechanism involving distribution of THMs to the bladder by dermal/inhalation exposure and activation there by GSTT1-1 to mutagens. DBPs may be reduced by engineering and behavioral means, such as applying new oxidation and filtration methods, reducing bromide and iodide in the source water, increasing air circulation in indoor pools, and assuring the cleanliness of swimmers. The positive health effects gained by swimming can be increased by reducing the potential adverse health risks. PMID:17310693

  19. Swimming pools soak up the sun

    SciTech Connect

    Cuoghi, D.; Hesse, P.; Schiller, T.

    1996-05-01

    Solar pool heaters survived the boom and bust solar years of the 1970s and 1980s. Today they are even popular and cost-effective in parts of the country where many people think solar is impractical. This article discusses the following topics: how solar pool heaters work; types of solar pool heater collectors; collector and pump sizing; collector siting and mounting; systems costs and economics; pool covers. 3 figs.

  20. Query cardiac pain.

    PubMed

    Todd, J W

    1983-08-01

    Query cardiac pain is a common problem, and immense efforts are made to solve it. No test can prove that a patient has not had a cardiac infarct, though in the recent past eminent authorities wrongly stated that a normal ECG supplied this proof. This history is by far the most important means of interpreting recurrent pain. Coronary arteriography is only useful in diagnosis when the pain is certainly due to myocardial ischaemia but it is uncertain whether this is caused by coronary artery disease or some other cardiac lesion. In practice, much pain is not diagnosed. This need be no cause for concern, and patients who in fact have had a small cardiac infarct gain rather than lose if wrongly reassured of its non-existence. The history of cardiology is a depressing catalogue of error. Bogus cardiac diseases have been diagnosed on an enormous scale, mainly because attention has been concentrated on the cardiac manifestations, while the patient was ignored. Much "excluding" is fatuous. Because treatment was derived from theory, treatment for patients who had had cardiac infarcts was disastrous. The great error at present is to overvalue technology.

  1. Apparatus for heating a swimming pool

    SciTech Connect

    Kremen, R.D.

    1983-09-06

    This disclosure relates to a solar heater apparatus for a swimming pool which incorporates a submersible suspendible black body sheet to serve as a device to absorb solar radiation and transfer the collected energy to the pool water so that the pool water can be efficiently heated.

  2. 24 CFR 320.9 - Pool administration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Pool administration. 320.9 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.9 Pool administration. The Association will only... prescribed by the Association. Pool administration requirements are set forth in such agreements or...

  3. 28 CFR 540.64 - Press pools.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Press pools. 540.64 Section 540.64... PERSONS IN THE COMMUNITY Contact With News Media § 540.64 Press pools. (a) The Warden may establish a press pool whenever he or she determines that the frequency of requests for interviews and...

  4. 10 CFR 429.24 - Pool heaters.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Pool heaters. 429.24 Section 429.24 Energy DEPARTMENT OF... COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.24 Pool heaters. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to pool heaters; and (2) For...

  5. 10 CFR 429.24 - Pool heaters.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Pool heaters. 429.24 Section 429.24 Energy DEPARTMENT OF... COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.24 Pool heaters. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to pool heaters; and (2) For...

  6. 10 CFR 36.33 - Irradiator pools.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Irradiator pools. 36.33 Section 36.33 Energy NUCLEAR... Requirements for Irradiators § 36.33 Irradiator pools. (a) For licenses initially issued after July 1, 1993, irradiator pools must either: (1) Have a water-tight stainless steel liner or a liner...

  7. 10 CFR 36.33 - Irradiator pools.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Irradiator pools. 36.33 Section 36.33 Energy NUCLEAR... Requirements for Irradiators § 36.33 Irradiator pools. (a) For licenses initially issued after July 1, 1993, irradiator pools must either: (1) Have a water-tight stainless steel liner or a liner...

  8. 10 CFR 36.33 - Irradiator pools.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Irradiator pools. 36.33 Section 36.33 Energy NUCLEAR... Requirements for Irradiators § 36.33 Irradiator pools. (a) For licenses initially issued after July 1, 1993, irradiator pools must either: (1) Have a water-tight stainless steel liner or a liner...

  9. 10 CFR 429.24 - Pool heaters.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Pool heaters. 429.24 Section 429.24 Energy DEPARTMENT OF... COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.24 Pool heaters. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to pool heaters; and (2) For...

  10. 24 CFR 320.9 - Pool administration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Pool administration. 320.9 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.9 Pool administration. The Association will only... prescribed by the Association. Pool administration requirements are set forth in such agreements or...

  11. 28 CFR 540.64 - Press pools.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Press pools. 540.64 Section 540.64... PERSONS IN THE COMMUNITY Contact With News Media § 540.64 Press pools. (a) The Warden may establish a press pool whenever he or she determines that the frequency of requests for interviews and...

  12. 28 CFR 540.64 - Press pools.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Press pools. 540.64 Section 540.64... PERSONS IN THE COMMUNITY Contact With News Media § 540.64 Press pools. (a) The Warden may establish a press pool whenever he or she determines that the frequency of requests for interviews and...

  13. 24 CFR 320.9 - Pool administration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Pool administration. 320.9 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.9 Pool administration. The Association will only... prescribed by the Association. Pool administration requirements are set forth in such agreements or...

  14. 24 CFR 320.9 - Pool administration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Pool administration. 320.9 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.9 Pool administration. The Association will only... prescribed by the Association. Pool administration requirements are set forth in such agreements or...

  15. 28 CFR 540.64 - Press pools.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Press pools. 540.64 Section 540.64... PERSONS IN THE COMMUNITY Contact With News Media § 540.64 Press pools. (a) The Warden may establish a press pool whenever he or she determines that the frequency of requests for interviews and...

  16. 7 CFR 1005.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1005.7 Section 1005.7 Agriculture... Handling Definitions § 1005.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  17. 7 CFR 1006.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1006.7 Section 1006.7 Agriculture... Handling Definitions § 1006.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  18. 7 CFR 1001.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1001.7 Section 1001.7 Agriculture... Handling Definitions § 1001.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, but excluding a plant described in paragraph (h)...

  19. 7 CFR 1005.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1005.7 Section 1005.7 Agriculture... Handling Definitions § 1005.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  20. 7 CFR 1124.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1124.7 Section 1124.7 Agriculture... Regulating Handling Definitions § 1124.7 Pool plant. Pool plant means a plant, unit of plants, or a system of plants as specified in paragraphs (a) through (f) of this section, but excluding a plant specified...

  1. 7 CFR 1030.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1030.7 Section 1030.7 Agriculture... Handling Definitions § 1030.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, but excluding a plant specified in paragraph (h)...

  2. 7 CFR 1001.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1001.7 Section 1001.7 Agriculture... Handling Definitions § 1001.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, but excluding a plant described in paragraph (h)...

  3. 7 CFR 1033.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1033.7 Section 1033.7 Agriculture... Handling Definitions § 1033.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, or a plant specified in paragraph (j) of...

  4. 7 CFR 1033.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1033.7 Section 1033.7 Agriculture... Handling Definitions § 1033.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, or a plant specified in paragraph (j) of...

  5. 7 CFR 1131.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1131.7 Section 1131.7 Agriculture... Handling Definitions § 1131.7 Pool plant. Pool Plant means a plant or unit of plants specified in paragraphs (a) through (e) of this section, but excluding a plant specified in paragraph (g) of this...

  6. 7 CFR 1007.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1007.7 Section 1007.7 Agriculture... Handling Definitions § 1007.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  7. 7 CFR 1126.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1126.7 Section 1126.7 Agriculture... Handling Definitions § 1126.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  8. 7 CFR 1131.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1131.7 Section 1131.7 Agriculture... Handling Definitions § 1131.7 Pool plant. Pool Plant means a plant or unit of plants specified in paragraphs (a) through (e) of this section, but excluding a plant specified in paragraph (g) of this...

  9. 7 CFR 1032.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1032.7 Section 1032.7 Agriculture... Handling Definitions § 1032.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, or a plant specified in paragraph (i) of...

  10. 7 CFR 1032.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1032.7 Section 1032.7 Agriculture... Handling Definitions § 1032.7 Pool plant. Pool plant means a plant, unit of plants, or system of plants as specified in paragraphs (a) through (f) of this section, or a plant specified in paragraph (i) of...

  11. 7 CFR 1007.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1007.7 Section 1007.7 Agriculture... Handling Definitions § 1007.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  12. 7 CFR 1006.7 - Pool plant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Pool plant. 1006.7 Section 1006.7 Agriculture... Handling Definitions § 1006.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  13. 7 CFR 1126.7 - Pool plant.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Pool plant. 1126.7 Section 1126.7 Agriculture... Handling Definitions § 1126.7 Pool plant. Pool plant means a plant specified in paragraphs (a) through (d) of this section, a unit of plants as specified in paragraph (e) of this section, or a plant...

  14. 28 CFR 540.64 - Press pools.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Press pools. 540.64 Section 540.64... PERSONS IN THE COMMUNITY Contact With News Media § 540.64 Press pools. (a) The Warden may establish a press pool whenever he or she determines that the frequency of requests for interviews and...

  15. 24 CFR 320.9 - Pool administration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Pool administration. 320.9 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.9 Pool administration. The Association will only... prescribed by the Association. Pool administration requirements are set forth in such agreements or...

  16. 1968 Listing of Swimming Pool Equipment.

    ERIC Educational Resources Information Center

    National Sanitation Foundation, Ann Arbor, MI. Testing Lab.

    An up-to-date listing of swimming pool equipment including--(1) companies authorized to display the National Sanitation Foundation seal of approval, (2) equipment listed as meeting NSF swimming pool equipment standards relating to diatomite type filters, (3) equipment listed as meeting NSF swimming pool equipment standard relating to sand type…

  17. Home-based versus centre-based cardiac rehabilitation

    PubMed Central

    Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

    2014-01-01

    as in modifiable risk factors (systolic blood pressure; diastolic blood pressure; total cholesterol; HDL-cholesterol; LDL-cholesterol) or proportion of smokers at follow up or health-related quality of life. There was no consistent difference in the healthcare costs of the two forms of cardiac rehabilitation. Authors’ conclusions Home- and centre-based cardiac rehabilitation appear to be equally effective in improving the clinical and health-related quality of life outcomes in acute MI and revascularisation patients. This finding, together with an absence of evidence of difference in healthcare costs between the two approaches, would support the extension of home-based cardiac rehabilitation programmes such as the Heart Manual to give patients a choice in line with their preferences, which may have an impact on uptake of cardiac rehabilitation in the individual case. PMID:20091618

  18. Cardiac Arrest Resuscitation.

    PubMed

    Guyette, Francis X; Reynolds, Joshua C; Frisch, Adam

    2015-08-01

    Cardiac arrest is a dynamic disease that tests the multitasking and leadership abilities of emergency physicians. Providers must simultaneously manage the logistics of resuscitation while searching for the cause of cardiac arrest. The astute clinician will also realize that he or she is orchestrating only one portion of a larger series of events, each of which directly affects patient outcomes. Resuscitation science is rapidly evolving, and emergency providers must be familiar with the latest evidence and controversies surrounding resuscitative techniques. This article reviews evidence, discusses controversies, and offers strategies to provide quality cardiac arrest resuscitation.

  19. [Cardiac Rehabilitation 2015].

    PubMed

    Hoffmann, Andreas

    2015-11-25

    The goals of cardiac rehabilitation are (re-)conditioning and secondary prevention in patients with heart disease or an elevated cardiovascular risk profile. Rehabilitation is based on motivation through education, on adapted physical activity, instruction of relaxation techniques, psychological support and optimized medication. It is performed preferably in groups either in outpatient or inpatient settings. The Swiss working group on cardiac rehabilitation provides a network of institutions with regular quality auditing. Positive effects of rehabilitation programs on mortality and morbidity have been established by numerous studies. Although a majority of patients after cardiac surgery are being referred to rehabilitation, these services are notoriously underused after catheter procedures. PMID:26602848

  20. Predictive Modeling of Cardiac Ischemia

    NASA Technical Reports Server (NTRS)

    Anderson, Gary T.

    1996-01-01

    The goal of the Contextual Alarms Management System (CALMS) project is to develop sophisticated models to predict the onset of clinical cardiac ischemia before it occurs. The system will continuously monitor cardiac patients and set off an alarm when they appear about to suffer an ischemic episode. The models take as inputs information from patient history and combine it with continuously updated information extracted from blood pressure, oxygen saturation and ECG lines. Expert system, statistical, neural network and rough set methodologies are then used to forecast the onset of clinical ischemia before it transpires, thus allowing early intervention aimed at preventing morbid complications from occurring. The models will differ from previous attempts by including combinations of continuous and discrete inputs. A commercial medical instrumentation and software company has invested funds in the project with a goal of commercialization of the technology. The end product will be a system that analyzes physiologic parameters and produces an alarm when myocardial ischemia is present. If proven feasible, a CALMS-based system will be added to existing heart monitoring hardware.

  1. Hemodynamics driven cardiac valve morphogenesis.

    PubMed

    Steed, Emily; Boselli, Francesco; Vermot, Julien

    2016-07-01

    Mechanical forces are instrumental to cardiovascular development and physiology. The heart beats approximately 2.6 billion times in a human lifetime and heart valves ensure that these contractions result in an efficient, unidirectional flow of the blood. Composed of endocardial cells (EdCs) and extracellular matrix (ECM), cardiac valves are among the most mechanically challenged structures of the body both during and after their development. Understanding how hemodynamic forces modulate cardiovascular function and morphogenesis is key to unraveling the relationship between normal and pathological cardiovascular development and physiology. Most valve diseases have their origins in embryogenesis, either as signs of abnormal developmental processes or the aberrant re-expression of fetal gene programs normally quiescent in adulthood. Here we review recent discoveries in the mechanobiology of cardiac valve development and introduce the latest technologies being developed in the zebrafish, including live cell imaging and optical technologies, as well as modeling approaches that are currently transforming this field. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  2. Neurologic complications of cardiac tumors.

    PubMed

    Roeltgen, David; Kidwell, Chelsea S

    2014-01-01

    Cardiac tumors are an uncommon cause for neurologic disease, but if undiagnosed can be associated with devastating neurologic consequences. Primary cardiac tumors, both benign and neoplastic, and metastatic tumors occur. Primary cardiac tumors are more likely to be associated with neurologic embolic complications. Metastatic cardiac tumors are more likely to be associated with valvular distraction, arrhythmia, diminished cardiac output and indirect neurological dysfunction. Primary and metastatic cardiac tumors may result in cerebral metastatic disease. Atrial myxoma, a benign primary cardiac tumor, is the most common cardiac tumor associated with neurologic disease, and most commonly causes cerebral embolization and stroke. The use of thrombolytic therapy for these strokes is controversial. Additionally, delayed manifestations, including aneurysm formation and intracranial hemorrhage, are possible. Aneurysm formation has been described as occurring after removal of the primary tumor. The availability of noninvasive cardiac imaging has significantly helped decrease the neurologic morbidity of cardiac tumors and has led to frequent successful intervention. PMID:24365298

  3. Molecular Basis of Cardiac Myxomas

    PubMed Central

    Singhal, Pooja; Luk, Adriana; Rao, Vivek; Butany, Jagdish

    2014-01-01

    Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis. PMID:24447924

  4. Patent Pools: Intellectual Property Rights and Competition

    PubMed Central

    Rodriguez, Victor

    2010-01-01

    Patent pools do not correct all problems associated with patent thickets. In this respect, patent pools might not stop the outsider problem from striking pools. Moreover, patent pools can be expensive to negotiate, can exclude patent holders with smaller numbers of patents or enable a group of major players to form a cartel that excludes new competitors. For all the above reasons, patent pools are subject to regulatory clearance because they could result in a monopoly. The aim of this article is to present the relationship between patents and competition in a broad context. PMID:20200607

  5. Method of measuring a liquid pool volume

    DOEpatents

    Garcia, G.V.; Carlson, N.M.; Donaldson, A.D.

    1991-03-19

    A method of measuring a molten metal liquid pool volume and in particular molten titanium liquid pools is disclosed, including the steps of (a) generating an ultrasonic wave at the surface of the molten metal liquid pool, (b) shining a light on the surface of a molten metal liquid pool, (c) detecting a change in the frequency of light, (d) detecting an ultrasonic wave echo at the surface of the molten metal liquid pool, and (e) computing the volume of the molten metal liquid. 3 figures.

  6. Cardiac glycoside overdose

    MedlinePlus

    ... found in the leaves of the digitalis (foxglove) plant. This plant is the original source of this medicine. People ... Digitoxin (Crystodigin) Digoxin (Lanoxicaps, Lanoxin) Besides the foxglove plant, cardiac glycosides also occur naturally in plants such ...

  7. Pooled platelet concentrates: an alternative to single donor apheresis platelets?

    PubMed

    Pietersz, R N I

    2009-10-01

    Three types of platelet concentrates (PC) are compared: PC either processed with the platelet-rich plasma (PRP) or the Buffy coat (BC) method from whole blood units and PC obtained by apheresis. Leuko-reduction (LR) pre-storage is advocated to improve quality of the PC during storage and reduce adverse reactions in recipients. Standardization of methods allow preparation of PC with comparable yields of approximately 400 x 10(9) platelets in pooled non-LR-PRP, approximately 370 x 10(9) in pooled LR-BC-PC and in LR apheresis PC the number of platelets can be targeted on 350 x 10(9) or more with devices of various manufacturers. While viral transmission can be prevented by outstanding laboratory tests, the risk of bacterial contamination should be reduced by improved arm disinfection, deviation of the first 20-30 ml of blood and culture or rapid detection assays of the PC pre-issue. In a large prospective multicenter trial no significant difference was observed between cultures of apheresis PC (n = 15,198): 0.09% confirmed positive units versus 0.06% in pooled BC-PC (n = 37,045), respectively. Though platelet activation as measured by CD62 expression may differ in vitro in PC obtained with various apheresis equipment, and also between PC processed with the two whole blood methods there is scarce literature about the clinical impact of these findings. In conclusion the final products of LR-PC derived from whole blood or obtained by apheresis can be comparable, provided the critical steps of the processing method are identified and covered and the process is in control.

  8. Neuroprotection during cardiac surgery.

    PubMed

    Grocott, Hilary P; Yoshitani, Kenji

    2007-01-01

    Cerebral injury following cardiac surgery continues to be a significant source of morbidity and mortality after cardiac surgery. A spectrum of injuries ranging from subtle neurocognitive dysfunction to fatal strokes are caused by a complex series of multifactorial mechanisms. Protecting the brain from these injuries has focused on intervening on each of the various etiologic factors. Although numerous studies have focused on a pharmacologic solution, more success has been found with nonpharmacologic strategies, including optimal temperature management and reducing emboli generation. PMID:17680190

  9. Ranolazine in Cardiac Arrhythmia.

    PubMed

    Saad, Marwan; Mahmoud, Ahmed; Elgendy, Islam Y; Richard Conti, C

    2016-03-01

    Ranolazine utilization in the management of refractory angina has been established by multiple randomized clinical studies. However, there is growing evidence showing an evolving role in the field of cardiac arrhythmias. Multiple experimental and clinical studies have evaluated the role of ranolazine in prevention and management of atrial fibrillation, with ongoing studies on its role in ventricular arrhythmias. In this review, we will discuss the pharmacological, experimental, and clinical evidence behind ranolazine use in the management of various cardiac arrhythmias.

  10. Cardiac rehabilitation in Germany.

    PubMed

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  11. Ranolazine in Cardiac Arrhythmia.

    PubMed

    Saad, Marwan; Mahmoud, Ahmed; Elgendy, Islam Y; Richard Conti, C

    2016-03-01

    Ranolazine utilization in the management of refractory angina has been established by multiple randomized clinical studies. However, there is growing evidence showing an evolving role in the field of cardiac arrhythmias. Multiple experimental and clinical studies have evaluated the role of ranolazine in prevention and management of atrial fibrillation, with ongoing studies on its role in ventricular arrhythmias. In this review, we will discuss the pharmacological, experimental, and clinical evidence behind ranolazine use in the management of various cardiac arrhythmias. PMID:26459200

  12. Cardiac Munchausen's syndrome.

    PubMed Central

    Dickinson, E J; Evans, T R

    1987-01-01

    Ten years' experience of cardiac Munchausen's syndrome in the Cardiac Care Unit of an Inner London teaching hospital is reported. Thirty-six admissions in this category were identified and analysed, and 4 typical cases are described. The common presenting complaints, recurring features and the relationship with other forms of Munchausen's syndrome are discussed, as are possible strategies available to deal with this clinical entity. PMID:3694601

  13. Cardiac imaging in adults

    SciTech Connect

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  14. Laser Doppler flowmetry and cardiac output in critically ill surgical patients.

    PubMed

    Eyer, S; Borgos, J; Strate, R G

    1987-08-01

    Laser Doppler flowmetry (LDF) accurately measures cutaneous microcirculatory blood flow. We compared change in LDF flow to change in thermodilution cardiac output in ten critically ill surgical patients. A subset analysis of three patients with low cardiac output (cardiac index less than 2 L/min X m2) showed no correlation. We conclude that, under these study conditions, LDF microcirculatory flow did not reflect macrocirculatory flow. We conjecture that overcoming cutaneous vasoregulation with thermal vasodilation may obviate these results.

  15. Cardiac Applications of Optogenetics

    PubMed Central

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

    2014-01-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics. PMID:25035999

  16. Trends in cardiac metastasis.

    PubMed

    Karwinski, B; Svendsen, E

    1989-11-01

    A review of 8571 autopsies disclosed 2833 patients with malignant tumours from 1975 to 1984 at the Department of Pathology, The Gade Institute. Cardiac metastases were found in 130 cases. An increase of cardiac involvement was shown in the autopsy material from 1.2% in 1975-1979 to 1.8% in 1980-1984. The same trend was seen if cardiac metastases were related to malignant tumours. Numerically, lung cancer accounted for most of the metastases seen, but the increase was made up by other tumours than lung cancer. especially malignant melanoma, mesothelioma, breast cancer and sarcomas. These tumours have a high frequency of heart metastases and the increased incidence of these cancers in the material explains the rise of cardiac metastases. Cardiac metastases increased with rising number of distant metastases. This study shows that mesotheliomas have the highest percentage of cardiac spread. The importance of autopsy for detecting metastatic spread in sites that are difficult to detect clinically is emphasized.

  17. Cardiac applications of optogenetics.

    PubMed

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

    2014-08-01

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

  18. Blood clotting

    MedlinePlus Videos and Cool Tools

    ... the external bleeding stops. Clotting factors in the blood cause strands of blood-borne material, called fibrin, to stick together and ... the inside of the wound. Eventually, the cut blood vessel heals, and the blood clot dissolves after ...

  19. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    PubMed Central

    Chen, Olivia; Qian, Li

    2015-01-01

    Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming. PMID:26176012

  20. The Transportable Auxin Pool 1

    PubMed Central

    de la Fuente, R. K.; Leopold, A. C.

    1970-01-01

    Evidences from experiments with stem sections of sunflower seedlings suggest that the transport of auxin may be limited by a restricted pool size of transportable auxin and restrictions in the availability of transport sites. A steady state of transport is observed over a range of lengths of stem sections, and over a wide range of auxin contents. The capacity of the sections to transport a pulse of auxin declines with aging after cutting, 50% decline occurring at about 10+ hours; the transportability of a pulse of auxin declines rapidly after the completion of uptake, 50% decline occurring at about 1 hour. A chase treatment with unlabeled auxin does not alter transport, but a pretreatment with auxin depressed subsequent transport for about 1 hour. In depleted tissues such pretreatment is not inhibitory but rather is promotive of transport. The interpretation offered is that transport is limited by the pool size and transport sites, and roles for these factors are suggested in relation to the auxin transport gradient and the tropistic responses. PMID:16657273

  1. 1. OBLIQUE VIEW OF THE POOL BUILDING 307 AND THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. OBLIQUE VIEW OF THE POOL BUILDING 307 AND THE POOL 308, LOOKING WEST. - Mill Valley Air Force Station, Pool Building & Swimming Pool, East Ridgecrest Boulevard, Mount Tamalpais, Mill Valley, Marin County, CA

  2. The influence of motor activity on the development of cardiac arrhythmias during experimental emotional stress

    NASA Technical Reports Server (NTRS)

    Ulyaninskiy, L. S.; Urmancheyeva, T. G.; Stepanyan, Y. P.; Fufacheva, A. A.; Gritsak, A. V.; Kuznetsova, B. A.; Kvitka, A. A.

    1982-01-01

    Experimental emotional stress which can produce various disorders of cardiac rhythm: sinus tachycardia, atrial fibrillation, ventricular, extrasystoles and paroxysmal ventricular tachysystoles was studied. In these conditions the adrenalin content in the blood and myocardium is increased 3 to 4 times. It is found that moderate motor activity leads to a relative decrease of adrenalin in the myocardium and arrest of cardiac arrhythmias.

  3. Neurohumoral indicators of efficacy radiofrequency cardiac denervation

    NASA Astrophysics Data System (ADS)

    Evtushenko, A. V.; Evtushenko, V. V.; Saushkina, Yu. V.; Lishmanov, Yu. B.; Pokushalov, E. A.; Sergeevichev, D. S.; Gusakova, A. M.; Suslova, T. E.; Dymbrylova, O. N.; Bykov, A. N.; Syryamkin, V. I.; Kistenev, Yu. V.; Anfinogenova, Ya. D.; Smyshlyaev, K. A.; Lotkov, A. I.; Kurlov, I. O.

    2015-11-01

    In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using 123I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

  4. Neurohumoral indicators of efficacy radiofrequency cardiac denervation

    SciTech Connect

    Evtushenko, A. V. Evtushenko, V. V.; Saushkina, Yu. V.; Gusakova, A. M.; Suslova, T. E.; Dymbrylova, O. N.; Smyshlyaev, K. A.; Kurlov, I. O.; Lishmanov, Yu. B.; Anfinogenova, Ya. D.; Sergeevichev, D. S.; Bykov, A. N.; Syryamkin, V. I.; Kistenev, Yu. V.; Lotkov, A. I.; Pokushalov, E. A.

    2015-11-17

    In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using {sup 123}I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

  5. Translational aspects of cardiac cell therapy

    PubMed Central

    Chen, Cheng-Han; Sereti, Konstantina-Ioanna; Wu, Benjamin M; Ardehali, Reza

    2015-01-01

    Cell therapy has been intensely studied for over a decade as a potential treatment for ischaemic heart disease. While initial trials using skeletal myoblasts, bone marrow cells and peripheral blood stem cells showed promise in improving cardiac function, benefits were found to be short-lived likely related to limited survival and engraftment of the delivered cells. The discovery of putative cardiac ‘progenitor’ cells as well as the creation of induced pluripotent stem cells has led to the delivery of cells potentially capable of electromechanical integration into existing tissue. An alternative strategy involving either direct reprogramming of endogenous cardiac fibroblasts or stimulation of resident cardiomyocytes to regenerate new myocytes can potentially overcome the limitations of exogenous cell delivery. Complimentary approaches utilizing combination cell therapy and bioengineering techniques may be necessary to provide the proper milieu for clinically significant regeneration. Clinical trials employing bone marrow cells, mesenchymal stem cells and cardiac progenitor cells have demonstrated safety of catheter based cell delivery, with suggestion of limited improvement in ventricular function and reduction in infarct size. Ongoing trials are investigating potential benefits to outcome such as morbidity and mortality. These and future trials will clarify the optimal cell types and delivery conditions for therapeutic effect. PMID:26119413

  6. [Psychosomatic aspects of cardiac arrhythmias].

    PubMed

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  7. Altered mechanical state in the embryonic heart results in time-dependent decreases in cardiac function.

    PubMed

    Johnson, Brennan; Bark, David; Van Herck, Ilse; Garrity, Deborah; Dasi, Lakshmi Prasad

    2015-11-01

    Proper blood flow patterns are critical for normal cardiac morphogenesis, a process that occurs rapidly in order to support further development of all tissue and organs. Previously, intracardiac fluid forces have been shown to play a critical role in cardiac morphogenesis. Altered blood flow in early development can result in an array of cardiac defects including ventricular septal defects, valve malformations, and impaired cardiac looping. However, given the dynamic and highly transient nature of cardiac morphogenesis, time dependency of the mechanical environment as an epigenetic factor in relation to intracardiac forces must be significant. Here, we show that abnormal cardiac loading adversely influences cardiac morphology only during certain time windows, thus confirming that mechanical factors are a time-dependent epigenetic factor. To illustrate this, groups of zebrafish embryos were spaced at 6-h increments from 24 to 48 h post-fertilization (hpf) in which embryos were centrifuged to generate a noninvasive alteration of cardiac preload in addition to an overall hypergravity environment. We found that earlier and later treatment groups responded with altered morphology and function, while the group with altered preload from 30 to 36 hpf had no effect. These results demonstrate the inherently time-dependent nature of epigenetic factors as pertaining to intracardiac forces and external mechanical factors. Further, it underscores the highly coupled nature of programmed biology and mechanical forces during cardiac morphogenesis. Future studies with respect to surgical correction during cardiac morphogenesis must consider timing to optimize therapeutic impact. PMID:25976479

  8. Centrifugal pump and roller pump in adult cardiac surgery: a meta-analysis of randomized controlled trials.

    PubMed

    Saczkowski, Richard; Maklin, Michelle; Mesana, Thierry; Boodhwani, Munir; Ruel, Marc

    2012-08-01

    Centrifugal pump (CP) and roller pump (RP) designs are the dominant main arterial pumps used in cardiopulmonary bypass (CPB). Trials reporting clinical outcome measures comparing CP and RP are controversial. Therefore, a meta-analysis was undertaken to evaluate clinical variables from randomized controlled trials (RCTs). Keyword searches were performed on Medline (1966-2011), EmBase (1980-2011), and CINAHL (1981-2011) for studies comparing RP and CP as the main arterial pump in adult CPB. Pooled fixed-effects estimates for dichotomous and continuous data were calculated as an odds ratio and weighted-mean difference, respectively. The P value was utilized to assess statistical significance (P < 0.05) between CP and RP groups. Eighteen RCTs met inclusion criteria, which represented 1868 patients (CP = 961, RP = 907). The prevailing operation was isolated coronary artery bypass graft surgery (CP = 88%, RP = 87%). Fixed-effects pooled estimates were performed for end-of-CPB (ECP) and postoperative day one (PDO) for platelet count (ECP: P = 0.51, PDO: P = 0.16), plasma free hemoglobin (ECP: P = 0.36, PDO: P = 0.24), white blood cell count (ECP: P = 0.21, PDO: P = 0.66), and hematocrit (ECP: P = 0.06, PDO: P = 0.51). No difference was demonstrated for postoperative blood loss (P = 0.65) or red blood cell transfusion (P = 0.71). Intensive care unit length of stay (P = 0.30), hospital length of stay (P = 0.33), and mortality (P = 0.91) were similar between the CP and RP groups. Neurologic outcomes were not amenable to pooled analysis; nevertheless, the results were inconclusive. There was no reported pump-related malfunction or mishap. The meta-analysis of RCTs comparing CP and RP in adult cardiac surgery suggests no significant difference for hematological variables, postoperative blood loss, transfusions, neurological outcomes, or mortality.

  9. 13 CFR 120.1709 - Transfers of Pool Certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... transfer. The Pool Investor must supply the following information in the letter: (1) Pool number; (2) Pool... recovery. At the same time a Pool Investor submits a letter of transmittal for a Pool Certificate pursuant... will supply the transfer information to the Pool Investor....

  10. Platelet adhesiveness after blood donation.

    PubMed

    Pegrum, G D; Harrison, K M; Shaw, S

    1971-03-13

    Platelet adhesiveness to glass was measured in healthy blood donors at the time of and eight days after donating 500 ml of blood. By a whole blood method a highly significant increase was found whereas by a method using platelet-rich plasma with added adenosine diphosphate there was only a slightly significant increase. The discrepancy suggested that changes in the red cell population might influence the results. Packed red cells from 19 blood donors obtained at the time of donation and eight days later were mixed with fresh pooled platelets from the same independent persons on each occasion. The whole blood platelet adhesiveness on this mixture showed an increase in every case after blood donation. It is postulated that the increased adhesiveness is influenced by the presence of young red cells.

  11. Cardiac applications of PET.

    PubMed

    Sarikaya, Ismet

    2015-10-01

    Routine use of cardiac positron emission tomography (PET) applications has been increasing but has not replaced cardiac single-photon emission computerized tomography (SPECT) studies yet. The majority of cardiac PET tracers, with the exception of fluorine-18 fluorodeoxyglucose (18F-FDG), are not widely available, as they require either an onsite cyclotron or a costly generator for their production. 18F-FDG PET imaging has high sensitivity for the detection of hibernating/viable myocardium and has replaced Tl-201 SPECT imaging in centers equipped with a PET/CT camera. PET myocardial perfusion imaging with various tracers such as Rb-82, N-13 ammonia, and O-15 H2O has higher sensitivity and specificity than myocardial perfusion SPECT for the detection of coronary artery disease (CAD). In particular, quantitative PET measurements of myocardial perfusion help identify subclinical coronary stenosis, better define the extent and severity of CAD, and detect ischemia when there is balanced reduction in myocardial perfusion due to three-vessel or main stem CAD. Fusion images of PET perfusion and CT coronary artery calcium scoring or CT coronary angiography provide additional complementary information and improve the detection of CAD. PET studies with novel 18F-labeled perfusion tracers such as 18F-flurpiridaz and 18F-FBnTP have yielded high sensitivity and specificity in the diagnosis of CAD. These tracers are still being tested in humans, and, if approved for clinical use, they will be commercially and widely available. In addition to viability studies, 18F-FDG PET can also be utilized to detect inflammation/infection in various conditions such as endocarditis, sarcoidosis, and atherosclerosis. Some recent series have obtained encouraging results for the detection of endocarditis in patients with intracardiac devices and prosthetic valves. PET tracers for cardiac neuronal imaging, such as C-11 HED, help assess the severity of heart failure and post-transplant cardiac

  12. Radioisotope Power System Pool Concept

    NASA Technical Reports Server (NTRS)

    Rusick, Jeffrey J.; Bolotin, Gary S.

    2015-01-01

    Advanced Radioisotope Power Systems (RPS) for NASA deep space science missions have historically used static thermoelectric-based designs because they are highly reliable, and their radioisotope heat sources can be passively cooled throughout the mission life cycle. Recently, a significant effort to develop a dynamic RPS, the Advanced Stirling Radioisotope Generator (ASRG), was conducted by NASA and the Department of Energy, because Stirling based designs offer energy conversion efficiencies four times higher than heritage thermoelectric designs; and the efficiency would proportionately reduce the amount of radioisotope fuel needed for the same power output. However, the long term reliability of a Stirling based design is a concern compared to thermoelectric designs, because for certain Stirling system architectures the radioisotope heat sources must be actively cooled via the dynamic operation of Stirling converters throughout the mission life cycle. To address this reliability concern, a new dynamic Stirling cycle RPS architecture is proposed called the RPS Pool Concept.

  13. Microwave Treatment for Cardiac Arrhythmias

    NASA Technical Reports Server (NTRS)

    Arndt, G. Dickey (Inventor); Carl, James R. (Inventor); Raffoul, George W. (Inventor); Pacifico, Antonio (Inventor)

    1999-01-01

    Method and apparatus are provided for propagating microwave energy into heart tissues to produce a desired temperature profile therein at tissue depths sufficient for thermally ablating arrhythmogenic cardiac tissue to treat ventricular tachycardia and other arrhythmias while preventing excessive heating of surrounding tissues, organs, and blood. A wide bandwidth double-disk antenna is effective for this purpose over a bandwidth of about six gigahertz. A computer simulation provides initial screening capabilities for an antenna such as antenna, frequency, power level, and power application duration. The simulation also allows optimization of techniques for specific patients or conditions. In operation, microwave energy between about 1 Gigahertz and 12 Gigahertz is applied to monopole microwave radiator having a surface wave limiter. A test setup provides physical testing of microwave radiators to determine the temperature profile created in actual heart tissue or ersatz heart tissue. Saline solution pumped over the heart tissue with a peristaltic pump simulates blood flow. Optical temperature sensors disposed at various tissue depths within the heart tissue detect the temperature profile without creating any electromagnetic interference. The method may be used to produce a desired temperature profile in other body tissues reachable by catheter such as tumors and the like.

  14. Cardiac involvement in hemochromatosis.

    PubMed

    Gulati, Vinay; Harikrishnan, Prakash; Palaniswamy, Chandrasekar; Aronow, Wilbert S; Jain, Diwakar; Frishman, William H

    2014-01-01

    Cardiac hemochromatosis or primary iron-overload cardiomyopathy is an important and potentially preventable cause of heart failure. This is initially characterized by diastolic dysfunction and arrhythmias and in later stages by dilated cardiomyopathy. Diagnosis of iron overload is established by elevated transferrin saturation (>55%) and elevated serum ferritin (>300 ng/mL). Genetic testing for mutations in the HFE (high iron) gene and other proteins, such as hemojuvelin, transferrin receptor, and ferroportin, should be performed if secondary causes of iron overload are ruled out. Patients should undergo comprehensive 2D and Doppler echocardiography to evaluate their systolic and diastolic function. Newer modalities like strain imaging and speckle-tracking echocardiography hold promise for earlier detection of cardiac involvement. Cardiac magnetic resonance imaging with measurement of T2* relaxation times can help quantify myocardial iron overload. In addition to its value in diagnosis of cardiac iron overload, response to iron reduction therapy can be assessed by serial imaging. Therapeutic phlebotomy and iron chelation are the cornerstones of therapy. The average survival is less than a year in untreated patients with severe cardiac impairment. However, if treated early and aggressively, the survival rate approaches that of the regular heart failure population.

  15. Heat transfer from internally heated hemispherical pools

    SciTech Connect

    Gabor, J.D.; Ellsion, P.G.; Cassulo, J.C.

    1980-01-01

    Experiments were conducted on heat transfer from internally heated ZnSO/sub 4/-H/sub 2/O pools to the walls of hemispherical containers. This experimental technique provides data for a heat transfer system that has to date been only theoretically treated. Three different sizes of copper hemispherical containers were used: 240, 280, 320 mm in diameter. The pool container served both as a heat transfer surface and as an electrode. The opposing electrode was a copper disk, 50 mm in diameter located at the top of the pool in the center. The top surface of the pool was open to the atmosphere.

  16. [The third wave of cardiac surgery].

    PubMed

    Riera-Kinkel, Carlos

    2016-01-01

    A review of the history of cardiac surgery around the world is made divided into three stages, the first since the beginning of humanity until 300 years BC; the second moment shows how comes the platform that would give the anatomical and functional bases of the cardiovascular system. This historic moment includes: 1. the description and analysis of the function of blood and its components; 2. the description of the normal and abnormal Anatomy of the human heart and its vessels; 3. the anatomic and functional correlation: Foundation of the deductive thinking, and 4. the anatomic and functional integration with the clinic. Finally, the third wave, which is living today, is the stage of the technological explosion that begins with procedures as thoracoscopic surgery with the concept of reducing surgical trauma through minimum approach surgery. Also the use of robotics to solve some of the alterations in the CC, another is hybrid procedures and finally the use of fetal cardiac surgery. PMID:27428342

  17. [The third wave of cardiac surgery].

    PubMed

    Riera-Kinkel, Carlos

    2016-01-01

    A review of the history of cardiac surgery around the world is made divided into three stages, the first since the beginning of humanity until 300 years BC; the second moment shows how comes the platform that would give the anatomical and functional bases of the cardiovascular system. This historic moment includes: 1. the description and analysis of the function of blood and its components; 2. the description of the normal and abnormal Anatomy of the human heart and its vessels; 3. the anatomic and functional correlation: Foundation of the deductive thinking, and 4. the anatomic and functional integration with the clinic. Finally, the third wave, which is living today, is the stage of the technological explosion that begins with procedures as thoracoscopic surgery with the concept of reducing surgical trauma through minimum approach surgery. Also the use of robotics to solve some of the alterations in the CC, another is hybrid procedures and finally the use of fetal cardiac surgery.

  18. Perspectives on the value of biomarkers in acute cardiac care and implications for strategic management.

    PubMed

    Kossaify, Antoine; Garcia, Annie; Succar, Sami; Ibrahim, Antoine; Moussallem, Nicolas; Kossaify, Mikhael; Grollier, Gilles

    2013-01-01

    Biomarkers in acute cardiac care are gaining increasing interest given their clinical benefits. This study is a review of the major conditions in acute cardiac care, with a focus on biomarkers for diagnostic and prognostic assessment. Through a PubMed search, 110 relevant articles were selected. The most commonly used cardiac biomarkers (cardiac troponin, natriuretic peptides, and C-reactive protein) are presented first, followed by a description of variable acute cardiac conditions with their relevant biomarkers. In addition to the conventional use of natriuretic peptides, cardiac troponin, and C-reactive protein, other biomarkers are outlined in variable critical conditions that may be related to acute cardiac illness. These include ST2 and chromogranin A in acute dyspnea and acute heart failure, matrix metalloproteinase in acute chest pain, heart-type fatty acid binding protein in acute coronary syndrome, CD40 ligand and interleukin-6 in acute myocardial infarction, blood ammonia and lactate in cardiac arrest, as well as tumor necrosis factor-alpha in atrial fibrillation. Endothelial dysfunction, oxidative stress and inflammation are involved in the physiopathology of most cardiac diseases, whether acute or chronic. In summary, natriuretic peptides, cardiac troponin, C-reactive protein are currently the most relevant biomarkers in acute cardiac care. Point-of-care testing and multi-markers use are essential for prompt diagnostic approach and tailored strategic management.

  19. [Preoperative cardiac assessment before non-cardiac surgery: cardiac risk stratification].

    PubMed

    Iglesias, J F; Sierro, C; Aebischer, N; Vogt, P; Eeckhout, E

    2010-06-01

    Perioperative cardiac events occurring in patients undergoing non-cardiac surgery are a common cause of morbidity and mortality. Current guidelines recommend an individualized approach to preoperative cardiac risk stratification prior to non-cardiac surgery, integrating risk factors both for the patient (active cardiac conditions, clinical risk factors, functional capacity) and for the planned surgery. Preoperative cardiac investigations are currently limited to high-risk patients in whom they may contribute to modify the perioperative management. A multidisciplinary approach to such patients, integrating the general practitioner, is recommended in order to define an individualized peri-operative strategy.

  20. Cardiac Magnetic Resonance Myocardial Perfusion Reserve Index Is Reduced in Women With Coronary Microvascular Dysfunction: A National Heart, Lung and Blood Institute-Sponsored Study From the Women's Ischemia Syndrome Evaluation (WISE)

    PubMed Central

    Thomson, Louise E.J.; Wei, Janet; Agarwal, Megha; Haft-Baradaran, Afsaneh; Shufelt, Chrisandra; Mehta, Puja K.; Gill, Edward; Johnson, B. Delia; Kenkre, Tanya; Handberg, Eileen; Li, Debiao; Sharif, Behzad; Berman, Daniel S.; Petersen, John; Pepine, Carl J.; Bairey Merz, C. Noel

    2015-01-01

    Background Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD), diagnosed by invasive coronary reactivity testing (CRT). While traditional noninvasive stress imaging is often normal in CMD, cardiac magnetic resonance imaging (CMRI) may be able to detect CMD in this population. Methods and Results Vasodilator stress CMRI was performed in 118 women with suspected CMD who had undergone CRT and 21 asymptomatic reference subjects. Semi quantitative evaluation of the first-pass perfusion images was completed to determine myocardial perfusion reserve index (MPRI). The relationship between CRT findings and MPRI was examined by Pearson correlations, logistic regression and sensitivity/specificity. Symptomatic women had lower mean pharmacologic stress MPRI compared to reference subjects (1.71±0.43 vs. 2.23±0.37, p<0.0001). Lower MPRI was predictive of one or more abnormal CRT variables (OR = 0.78 [0.70, 0.88], p<0.0001, c-statistic 0.78 [0.68, 0.88]). An MPRI threshold of 1.84 predicted CRT abnormality with sensitivity 73% and specificity 74%. Conclusions Noninvasive CMRI MPRI can detect CMD defined by invasive CRT. Further work is aimed to optimize the non-invasive identification and management of CMD patients. PMID:25801710

  1. Cardiac Imaging In Athletes.

    PubMed

    Khan, Asaad A; Safi, Lucy; Wood, Malissa

    2016-01-01

    Athletic heart syndrome refers to the physiological and morphological changes that occur in a human heart after repetitive strenuous physical exercise. Examples of exercise-induced changes in the heart include increases in heart cavity dimensions, augmentation of cardiac output, and increases in heart muscle mass. These cardiac adaptations vary based on the type of exercise performed and are often referred to as sport-specific cardiac remodeling. The hemodynamic effects of endurance and strength training exercise lead to these adaptations. Any abnormalities in chamber dilatation and left ventricular function usually normalize with cessation of exercise. Athletic heart syndrome is rare and should be differentiated from pathologic conditions such as hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia when assessing a patient for athletic heart syndrome. This paper describes specific adaptations that occur in athletic heart syndrome and tools to distinguish between healthy alterations versus underlying pathology. PMID:27486490

  2. Cardiac Imaging In Athletes

    PubMed Central

    Khan, Asaad A.; Safi, Lucy; Wood, Malissa

    2016-01-01

    Athletic heart syndrome refers to the physiological and morphological changes that occur in a human heart after repetitive strenuous physical exercise. Examples of exercise-induced changes in the heart include increases in heart cavity dimensions, augmentation of cardiac output, and increases in heart muscle mass. These cardiac adaptations vary based on the type of exercise performed and are often referred to as sport-specific cardiac remodeling. The hemodynamic effects of endurance and strength training exercise lead to these adaptations. Any abnormalities in chamber dilatation and left ventricular function usually normalize with cessation of exercise. Athletic heart syndrome is rare and should be differentiated from pathologic conditions such as hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia when assessing a patient for athletic heart syndrome. This paper describes specific adaptations that occur in athletic heart syndrome and tools to distinguish between healthy alterations versus underlying pathology. PMID:27486490

  3. Cardiac arrest in the skies.

    PubMed

    Charles, R A

    2011-08-01

    Cardiac arrest occurring on board aeroplanes is rare, but remains a common cause of inflight incidents. This review examines some of the management problems unique to inflight cardiac arrests, and emphasises the use of cardiopulmonary resuscitation and automated external defibrillators.

  4. [Cardiac failure in endocrine diseases].

    PubMed

    Hashizume, K

    1993-05-01

    Several endocrine diseases show the symptoms of cardiac failure. Among them, patients with acromegaly show a specific cardiomyopathy which results in a severe left-sided cardiac failure. Hypoparathyroidism also induces cardiac failure, which is resulted from hypocalcemia and low levels of serum parathyroid hormone. In the cases of hypothyroidism, the patients with myxedemal coma show a severe cardiac failure, which is characterized by disturbance of central nervous system, renal function, and cardiac function. In the patients with thyroid crisis (storm), the cardiac failure comes from the great reduction of cardiac output with dehydration. The reduction of circulation volume, observed in the patients with pheochromocytoma easily induces cardiac failure (shock) just after the removal of adrenal tumor. In patients with malignant carcinoid syndrome, right-sided ventricular failure which may be occurred through the actions of biogenic amines is observed. PMID:8331806

  5. Method and apparatus for characterizing blood flow through the heart

    SciTech Connect

    Dam, N.G.; Gray, R.I.; Kramer, H.H.; Picunko, T.

    1981-10-13

    An automated method and improved device provide a measurement of blood flow through the heart by the detection and analysis of radioactivity emitted by a radioactive tracer introduced into a patient's bloodstream. Real time, cardiac cycle by cardiac cycle information is processed and displayed to provide diagnostically useful information on an essentially ongoing basis as the patient is being tested.

  6. Calcium binding to cardiac myocytes protected from proteolytic enzyme activity.

    PubMed

    Bailey, L E; Fawzi, A B

    1985-04-17

    Excitation-contraction coupling in cardiac muscle is dependent on extracellular calcium and calcium bound to the surface of the myocardial cell. In this study, we examined the physical characteristics of calcium binding to adult guinea pig ventricular myocytes disaggregated mechanically in oxygenated tissue culture medium containing a proteinase inhibitor (aprotinin), and separated from cellular debris by Cytodex beads. Cells prepared in this manner excluded Trypan blue and showed no evidence of spontaneous contraction or contracture. Scatchard plots of calcium binding determined by continuous flow equilibrium dialysis revealed a high-affinity, low-capacity pool, Ka = 65 X 10(3) M-1 and Bt = 1.3 nmol X mg-1 and a low-affinity, high-capacity pool, Ka = 141 M-1 and Bt = 138 nmol X mg-1. The low-affinity pool was not detectable after lanthanum, trypsin or collagenase treatment or in cells prepared without aprotinin in the isolation medium. Both neuraminidase and phospholipase C reduced Bt of the low-affinity pool by one half, but only neuraminidase affected the affinity constant of this pool. Ka was increased to 516.7 M-1, similar to the apparent affinity constant for calcium binding estimated from dP/dtmax measured at several extracellular calcium concentrations (470 M-1). The results suggest that calcium bound to sarcolemmal phospholipids represents the superficial calcium involved in excitation-contraction coupling in the heart.

  7. Cell salvage for minimising perioperative allogeneic blood transfusion

    PubMed Central

    Carless, Paul A; Henry, David A; Moxey, Annette J; O’Connell, Dianne; Brown, Tamara; Fergusson, Dean A

    2014-01-01

    Background Concerns regarding the safety of transfused blood have prompted reconsideration of the use of allogeneic (from an unrelated donor) red blood cell (RBC) transfusion, and a range of techniques to minimise transfusion requirements. Objectives To examine the evidence for the efficacy of cell salvage in reducing allogeneic blood transfusion and the evidence for any effect on clinical outcomes. Search methods We identified studies by searching CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to June 2009), EMBASE (1980 to June 2009), the internet (to August 2009) and bibliographies of published articles. Selection criteria Randomised controlled trials with a concurrent control group in which adult patients, scheduled for non-urgent surgery, were randomised to cell salvage (autotransfusion) or to a control group who did not receive the intervention. Data collection and analysis Data were independently extracted and the risk of bias assessed. Relative risks (RR) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated. Data were pooled using a random-effects model. The primary outcomes were the number of patients exposed to allogeneic red cell transfusion and the amount of blood transfused. Other clinical outcomes are detailed in the review. Main results A total of 75 trials were included. Overall, the use of cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 38% (RR 0.62; 95% CI 0.55 to 0.70). The absolute reduction in risk (ARR) of receiving an allogeneic RBC transfusion was 21% (95% CI 15% to 26%). In orthopaedic procedures the RR of exposure to RBC transfusion was 0.46 (95% CI 0.37 to 0.57) compared to 0.77 (95% CI 0.69 to 0.86) for cardiac procedures. The use of cell salvage resulted in an average saving of 0.68 units of allogeneic RBC per patient (WMD −0.68; 95% CI −0.88 to −0.49). Cell salvage did not appear to impact adversely on clinical outcomes. Authors’ conclusions

  8. Perioperative management of cardiac disease.

    PubMed

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

    2014-01-01

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

  9. Penetrating Cardiac Injury: A Review

    PubMed Central

    Lateef Wani, Mohd; Ahangar, Ab Gani; Wani, Shadab Nabi; Irshad, Ifat; Ul-Hassan, Nayeem

    2012-01-01

    Cardiac injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent death. Sometimes serious cardiac injury may manifest only subtle or occult symptoms or signs. As there is an epidemic of cardiac injuries in Kashmir valley due to problems of law and order, we herein present a review on management of such injuries. PMID:24829887

  10. Data analysis in cardiac arrhythmias.

    PubMed

    Rodrigo, Miguel; Pedrón-Torecilla, Jorge; Hernández, Ismael; Liberos, Alejandro; Climent, Andreu M; Guillem, María S

    2015-01-01

    Cardiac arrhythmias are an increasingly present in developed countries and represent a major health and economic burden. The occurrence of cardiac arrhythmias is closely linked to the electrical function of the heart. Consequently, the analysis of the electrical signal generated by the heart tissue, either recorded invasively or noninvasively, provides valuable information for the study of cardiac arrhythmias. In this chapter, novel cardiac signal analysis techniques that allow the study and diagnosis of cardiac arrhythmias are described, with emphasis on cardiac mapping which allows for spatiotemporal analysis of cardiac signals.Cardiac mapping can serve as a diagnostic tool by recording cardiac signals either in close contact to the heart tissue or noninvasively from the body surface, and allows the identification of cardiac sites responsible of the development or maintenance of arrhythmias. Cardiac mapping can also be used for research in cardiac arrhythmias in order to understand their mechanisms. For this purpose, both synthetic signals generated by computer simulations and animal experimental models allow for more controlled physiological conditions and complete access to the organ.

  11. Blood pressure

    MedlinePlus Videos and Cool Tools

    ... called diastole. Normal blood pressure is considered to be a systolic blood pressure of 115 millimeters of ... pressure reading of 140 over 90, he would be evaluated for having high blood pressure. If left ...

  12. Blood Sugar

    MedlinePlus

    Blood sugar, or glucose, is the main sugar found in your blood. It comes from the food you eat, and is your body's main source of energy. Your blood carries glucose to all of your body's cells to use ...

  13. 10 CFR 36.33 - Irradiator pools.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... purification system designed to be capable of maintaining the water during normal operation at a conductivity..., irradiator pools must either: (1) Have a water-tight stainless steel liner or a liner metallurgically... water level that could allow water to drain out of the pool. Pipes that have intakes more than 0.5...

  14. A Training Program for Swimming Pool Operators.

    ERIC Educational Resources Information Center

    Pope, James R., Jr.; Mihalik, Brian J.

    1985-01-01

    In the United States today, there is a dramatic shortage of qualified public swimming pool operators. This article describes a training program initiated in South Carolina to serve the needs of everyone responsible for and involved in the safe operation and management of a public swimming pool. (MT)

  15. 21 CFR 1250.89 - Swimming pools.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... types of salt water pools shall be so operated that complete circulation and replacement of the water in... equipped so as to provide complete circulation, replacement, and filtration of the water in the pool every six hours or less. Suitable means of chlorination and, if necessary, other treatment of the...

  16. 10 CFR 36.33 - Irradiator pools.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... purification system designed to be capable of maintaining the water during normal operation at a conductivity..., irradiator pools must either: (1) Have a water-tight stainless steel liner or a liner metallurgically... water level that could allow water to drain out of the pool. Pipes that have intakes more than 0.5...

  17. 21 CFR 1250.89 - Swimming pools.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... types of salt water pools shall be so operated that complete circulation and replacement of the water in... equipped so as to provide complete circulation, replacement, and filtration of the water in the pool every six hours or less. Suitable means of chlorination and, if necessary, other treatment of the...

  18. 21 CFR 1250.89 - Swimming pools.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... types of salt water pools shall be so operated that complete circulation and replacement of the water in... equipped so as to provide complete circulation, replacement, and filtration of the water in the pool every six hours or less. Suitable means of chlorination and, if necessary, other treatment of the...

  19. 21 CFR 1250.89 - Swimming pools.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... types of salt water pools shall be so operated that complete circulation and replacement of the water in... equipped so as to provide complete circulation, replacement, and filtration of the water in the pool every six hours or less. Suitable means of chlorination and, if necessary, other treatment of the...

  20. The Chemistry of Swimming Pool Maintenance

    ERIC Educational Resources Information Center

    Salter, Carl; Langhus, David L.

    2007-01-01

    The study of chemistry involved in the maintenance of a swimming pool provides a lot of chemical education to the students, including the demonstration of the importance of pH in water chemistry. The various chemical aspects hidden in the maintenance of the pool are being described.

  1. LinguisticBelief and PoolEvidence

    SciTech Connect

    DARBY, JOHN

    2008-03-11

    LinguisticBelief allows the creation and analysis of combinations of linguistic variables with epistemic uncertainty for decision making. The model is solved using approximate reasoning to implement the belief/plausibility measure of uncertainty for combinations of variables expressed as purely linguistic fuzzy sets. PoolEvidence pools evidence for linguistic variables from many experts for input into LinguisticBelief.

  2. Multiple Antioxidants Improve Cardiac Complications and Inhibit Cardiac Cell Death in Streptozotocin-Induced Diabetic Rats

    PubMed Central

    Kumar, Santosh; Prasad, Sahdeo; Sitasawad, Sandhya L.

    2013-01-01

    Diabetic cardiomyopathy, a disorder of the heart muscle in diabetic patients, is one of the major causes of heart failure. Since diabetic cardiomyopathy is now known to have a high prevalence in the asymptomatic diabetic patient, prevention at the earliest stage of development by existing molecules would be appropriate in order to prevent the progression of heart failure. In this study, we investigated the protective role of multiple antioxidants (MA), on cardiac dysfunction and cardiac cell apoptosis in streptozotocin (STZ)-induced diabetic rat. Diabetic cardiomyopathy in STZ-treated animals was characterized by declined systolic, diastolic myocardial performance, oxidative stress and apoptosis in cardiac cells. Diabetic rats on supplementation with MA showed decreased oxidative stress evaluated by the content of reduced levels of lipid per-oxidation and decreased activity of catalase with down-regulation of heme-oxygenase-1 mRNA. Supplementation with MA also resulted in a normalized lipid profile and decreased levels of pro-inflammatory transcription factor NF-kappaB as well as cytokines such as TNF-α, IFN-γ, TGF-β, and IL-10. MA was found to decrease the expression of ROS-generating enzymes like xanthine oxidase, monoamine oxidase-A along with 5-Lipoxygenase mRNA and/or protein expression. Further, left ventricular function, measured by a microtip pressure transducer, was re-established as evidenced by increase in ±dp/dtmax, heart rate, decreased blood pressure, systolic and diastolic pressure as well as decrease in the TUNEL positive cardiac cells with increased Bcl-2/Bax ratio. In addition, MA supplementation decreased cell death and activation of NF-kappaB in cardiac H9c2 cells. Based on our results, we conclude that MA supplementation significantly attenuated cardiac dysfunction in diabetic rats; hence MA supplementation may have important clinical implications in terms of prevention and management of diabetic cardiomyopathy. PMID:23843977

  3. Cardiac Physiology of Pregnancy.

    PubMed

    May, Linda

    2015-07-01

    Although the physiology of the heart and vascular system has not changed, there are many things we have learned and are still learning today. Research related to heart adaptations during pregnancy has been performed since the 1930s. Since the mid-1950s, researchers began to look at changes in the maternal cardiovascular system during exercise while pregnant. Research related to exercise during pregnancy and offspring heart development began and has continued since the 1970s. We will review the normal female cardiovascular system adaptations to pregnancy in general. Additionally, topics related to maternal cardiac adaptations to pregnancy during acute exercise, as well as the chronic conditioning response from exercise training will be explored. Since physical activity during pregnancy influences fetal development, the fetal cardiac development will be discussed in regards to acute and chronic maternal exercise. Similarly, the influence of various types of maternal exercise on acute and chronic fetal heart responses will be described. Briefly, the topics related to how and if there is maternal-fetal synchrony will be explained. Lastly, the developmental changes of the fetal cardiovascular system that persist after birth will be explored. Overall, the article will discuss maternal cardiac physiology related to changes with normal pregnancy, and exercise during pregnancy, as well as fetal cardiac physiology related to changes with normal development, and exercise during pregnancy as well as developmental changes in offspring after birth.

  4. The cardiac malpositions.

    PubMed

    Perloff, Joseph K

    2011-11-01

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

  5. Advanced Cardiac Life Support.

    ERIC Educational Resources Information Center

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  6. Comparative cardiac imaging

    SciTech Connect

    Brundage, B.H.

    1990-01-01

    This book is designed to compare all major cardiac imaging techniques. All major imaging techniques - including conventional angiography, digital angiography, echocardiography and Doppler imaging, conventional radioisotope techniques, computed tomography, and magnetic resonance imaging - are covered in this text as they apply to the major cardiovascular disorders. There is brief coverage of positron emission tomography and an extensive presentation of ultrafast computed tomography.

  7. Immunoelectrophoresis - blood

    MedlinePlus

    IEP - serum; Immunoglobulin electrophoresis - blood; Gamma globulin electrophoresis; Serum immunoglobulin electrophoresis ... A blood sample is needed. For information on how this is done, see: Venipuncture

  8. Microfluidic partitioning of the extracellular space around single cardiac myocytes.

    PubMed

    Klauke, Norbert; Smith, Godfrey L; Cooper, Jonathan M

    2007-02-01

    This paper describes the partitioning of the extracellular space around an electrically activated single cardiac myocyte, constrained within a microfluidic device. Central to this new method is the production of a hydrophobic gap-structure, which divides the extracellular space into two distinct microfluidic pools. The content of these pools was controlled using a pair of concentric automated pipets (subsequently called "dual superfusion pipet"), each providing the ability to dispense (i.e., the source, inner pipet) and aspirate (the sink, outer pipet) a buffer solution (perfusate) into each of the two pools. For rapid solution switching around the cell, additional dual superfusion pipets were inserted into the microchannel for defined time periods using a piezostepper, enabling us to add a test solution, such as a drug. Three distinct areas of the cell were manipulated, namely, the microfluidic environment, the cellular membrane, and the intracellular space. Planar integrated microelectrodes enabled the electrical stimulation of the cardiomyocyte and the recording of the evoked action potential. The device was mounted on an inverted microscope to allow simultaneous sarcomere length and epifluorescence measurements during evoked electrical activity, including, for example, the response of the stimulated end of the cardiac myocyte in comparison with the untreated cell end.

  9. Ethical Issues in Cardiac Surgery

    PubMed Central

    Kavarana, Minoo N.; Sade, Robert M.

    2012-01-01

    While ethical behavior has always been part of cardiac surgical practice, ethical deliberation has only recently become an important component of cardiac surgical practice. Issues such as informed consent, conflict of interest, and professional self-regulation, among many others, have increasingly attracted the attention of cardiac surgeons. This review covers several broad topics of interest to cardiac surgeons and cardiologists, and treats several other topics more briefly. There is much uncertainty about what the future holds for cardiac surgical practice, research, and culture, and we discuss the background of ethical issues to serve as a platform for envisioning what is to come. PMID:22642634

  10. Biomechanics of Early Cardiac Development

    PubMed Central

    Goenezen, Sevan; Rennie, Monique Y.

    2012-01-01

    Biomechanics affect early cardiac development, from looping to the development of chambers and valves. Hemodynamic forces are essential for proper cardiac development, and their disruption leads to congenital heart defects. A wealth of information already exists on early cardiac adaptations to hemodynamic loading, and new technologies, including high resolution imaging modalities and computational modeling, are enabling a more thorough understanding of relationships between hemodynamics and cardiac development. Imaging and modeling approaches, used in combination with biological data on cell behavior and adaptation, are paving the road for new discoveries on links between biomechanics and biology and their effect on cardiac development and fetal programming. PMID:22760547

  11. Symmetry of cardiac function assessment.

    PubMed

    Bai, Xu-Fang; Ma, Amy X

    2016-09-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function.

  12. Symmetry of cardiac function assessment.

    PubMed

    Bai, Xu-Fang; Ma, Amy X

    2016-09-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function. PMID:27582768

  13. Symmetry of cardiac function assessment

    PubMed Central

    Bai, Xu-Fang; Ma, Amy X

    2016-01-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function. PMID:27582768

  14. Viral metagenomics and blood safety.

    PubMed

    Sauvage, V; Eloit, M

    2016-02-01

    The characterization of the human blood-associated viral community (also called blood virome) is essential for epidemiological surveillance and to anticipate new potential threats for blood transfusion safety. Currently, the risk of blood-borne agent transmission of well-known viruses (HBV, HCV, HIV and HTLV) can be considered as under control in high-resource countries. However, other viruses unknown or unsuspected may be transmitted to recipients by blood-derived products. This is particularly relevant considering that a significant proportion of transfused patients are immunocompromised and more frequently subjected to fatal outcomes. Several measures to prevent transfusion transmission of unknown viruses have been implemented including the exclusion of at-risk donors, leukocyte reduction of donor blood, and physicochemical treatment of the different blood components. However, up to now there is no universal method for pathogen inactivation, which would be applicable for all types of blood components and, equally effective for all viral families. In addition, among available inactivation procedures of viral genomes, some of them are recognized to be less effective on non-enveloped viruses, and inadequate to inactivate higher viral titers in plasma pools or derivatives. Given this, there is the need to implement new methodologies for the discovery of unknown viruses that may affect blood transfusion. Viral metagenomics combined with High Throughput Sequencing appears as a promising approach for the identification and global surveillance of new and/or unexpected viruses that could impair blood transfusion safety. PMID:26778104

  15. poolMC: Smart pooling of mRNA samples in microarray experiments

    PubMed Central

    2010-01-01

    Background Typically, pooling of mRNA samples in microarray experiments implies mixing mRNA from several biological-replicate samples before hybridization onto a microarray chip. Here we describe an alternative smart pooling strategy in which different samples, not necessarily biological replicates, are pooled in an information theoretic efficient way. Further, each sample is tested on multiple chips, but always in pools made up of different samples. The end goal is to exploit the compressibility of microarray data to reduce the number of chips used and increase the robustness to noise in measurements. Results A theoretical framework to perform smart pooling of mRNA samples in microarray experiments was established and the software implementation of the pooling and decoding algorithms was developed in MATLAB. A proof-of-concept smart pooled experiment was performed using validated biological samples on commercially available gene chips. Differential-expression analysis of the smart pooled data was performed and compared against the unpooled control experiment. Conclusions The theoretical developments and experimental demonstration in this paper provide a useful starting point to investigate smart pooling of mRNA samples in microarray experiments. Although the smart pooled experiment did not compare favorably with the control, the experiment highlighted important conditions for the successful implementation of smart pooling - linearity of measurements, sparsity in data, and large experiment size. PMID:20525223

  16. Apparatus for draining lower drywell pool water into suppresion pool in boiling water reactor

    DOEpatents

    Gluntz, Douglas M.

    1996-01-01

    An apparatus which mitigates temperature stratification in the suppression pool water caused by hot water drained into the suppression pool from the lower drywell pool. The outlet of a spillover hole formed in the inner bounding wall of the suppression pool is connected to and in flow communication with one end of piping. The inlet end of the piping is above the water level in the suppression pool. The piping is routed down the vertical downcomer duct and through a hole formed in the thin wall separating the downcomer duct from the suppression pool water. The piping discharge end preferably has an elevation at or near the bottom of the suppression pool and has a location in the horizontal plane which is removed from the point where the piping first emerges on the suppression pool side of the inner bounding wall of the suppression pool. This enables water at the surface of the lower drywell pool to flow into and be discharged at the bottom of the suppression pool.

  17. A blood circulation model for reference man

    SciTech Connect

    Leggett, R.W.; Eckerman, K.F.; Williams, L.R.

    1999-01-01

    This paper describes a dynamic blood circulation model that predicts the movement and gradual dispersal of a bolus of material in the circulation after its intravascular injection into an adult human. The main purpose of the model is to improve the dosimetry of internally deposited radionuclides that decay in the circulation to a significant extent. The total blood volume is partitioned into the blood contents of 24 separate organs or tissues, right heart chambers, left heart chambers, pulmonary circulation, arterial outflow to the systemic tissues (aorta and large arteries), and venous return from the systemic tissues (large veins). As a compromise between physical reality and computational simplicity, the circulation of blood is viewed as a system of first-order transfers between blood pools, with the delay time depending on the mean transit time across the pool. The model allows consideration of incomplete, tissue-dependent extraction of material during passage through the circulation and return of material from tissues to plasma.

  18. 4D micro-CT for cardiac and perfusion applications with view under sampling

    NASA Astrophysics Data System (ADS)

    Badea, Cristian T.; Johnston, Samuel M.; Qi, Yi; Johnson, G. Allan

    2011-06-01

    Micro-CT is commonly used in preclinical studies to provide anatomical information. There is growing interest in obtaining functional measurements from 4D micro-CT. We report here strategies for 4D micro-CT with a focus on two applications: (i) cardiac imaging based on retrospective gating and (ii) pulmonary perfusion using multiple contrast injections/rotations paradigm. A dual source micro-CT system is used for image acquisition with a sampling rate of 20 projections per second. The cardiac micro-CT protocol involves the use of a liposomal blood pool contrast agent. Fast scanning of free breathing mice is achieved using retrospective gating. The ECG and respiratory signals are used to sort projections into ten cardiac phases. The pulmonary perfusion protocol uses a conventional contrast agent (Isovue 370) delivered by a micro-injector in four injections separated by 2 min intervals to allow for clearance. Each injection is synchronized with the rotation of the animal, and each of the four rotations is started with an angular offset of 22.5 from the starting angle of the previous rotation. Both cardiac and perfusion protocols result in an irregular angular distribution of projections that causes significant streaking artifacts in reconstructions when using traditional filtered backprojection (FBP) algorithms. The reconstruction involves the use of the point spread function of the micro-CT system for each time point, and the analysis of the distribution of the reconstructed data in the Fourier domain. This enables us to correct for angular inconsistencies via deconvolution and identify regions where data is missing. The missing regions are filled with data from a high quality but temporally averaged prior image reconstructed with all available projections. Simulations indicate that deconvolution successfully removes the streaking artifacts while preserving temporal information. 4D cardiac micro-CT in a mouse was performed with adequate image quality at isotropic

  19. A new paradigm for post-cardiac event resistance exercise guidelines.

    PubMed

    Adams, Jenny; Cline, Matthew J; Hubbard, Matt; McCullough, Tiffany; Hartman, Julie

    2006-01-15

    Existing guidelines for resistance exercise in cardiac rehabilitation are vague and/or overly restrictive, limiting the ability of cardiac rehabilitation programs to help patients achieve their desired levels of daily activity in a timely manner after cardiac events. This study examines the illogical nature of the existing guidelines in relation to the activities of daily living patients are expected or required to carry out during the period of cardiac rehabilitation and the existing recommendations for dynamic exercise in cardiac rehabilitation. An improved method is proposed for prescribing resistance exercise in cardiac rehabilitation. A tool is presented that stratifies the risk associated with each of 13 common resistance exercises for 3 cardiac rehabilitation diagnosis groups (myocardial infarction [MI], pacemaker or implantable cardioverter defibrillator implantation, and coronary artery bypass graft surgery) that, if used in conjunction with blood pressure and heart rate measurements, will safely facilitate more efficacious resistance training in cardiac rehabilitation patients. In conclusion, changing the approach to resistance exercise in cardiac rehabilitation will accelerate patients' return to their desired levels of daily activity, improving patient satisfaction and decreasing cardiac rehabilitation program attrition.

  20. 10 CFR 36.63 - Pool water purity.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Pool water purity. 36.63 Section 36.63 Energy NUCLEAR... § 36.63 Pool water purity. (a) Pool water purification system must be run sufficiently to maintain the conductivity of the pool water below 20 microsiemens per centimeter under normal circumstances. If pool...