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https://www.readbyqxmd.com/read/28434968/cardiac-contractility-correction-strategies-applied-to-telemetry-data-from-a-hesi-sponsored-consortium
#1
Emmanuel Boulay, Michael K Pugsley, Vincent Jacquemet, Alain Vinet, Michael V Accardi, Maxim Soloviev, Eric Troncy, Jennifer M Doyle, Jennifer Beck Pierson, Simon Authier
INTRODUCTION: QT has a long history of heart rate (HR) correction but limited investigations have been undertaken to assess the impact of cardiovascular parameters on left ventricular (LV) contractility in drug safety testing. Cardiac contractility is affected by preload (Cyon-Frank-Starling law), afterload (Anrep effect) and HR (Bowditch effect). We evaluated multi-parameter correction methods to help with dP/dtmax interpretation. METHODOLOGY: Modeling was undertaken using data from dogs in single or double 4×4 Latin square studies...
April 20, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#2
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28396302/development-and-testing-of-the-myhealthypregnancy-app-a-behavioral-decision-research-based-tool-for-assessing-and-communicating-pregnancy-risk
#3
Tamar Krishnamurti, Alexander L Davis, Gabrielle Wong-Parodi, Baruch Fischhoff, Yoel Sadovsky, Hyagriv N Simhan
BACKGROUND: Despite significant advances in medical interventions and health care delivery, preterm births in the United States are on the rise. Existing research has identified important, seemingly simple precautions that could significantly reduce preterm birth risk. However, it has proven difficult to communicate even these simple recommendations to women in need of them. Our objective was to draw on methods from behavioral decision research to develop a personalized smartphone app-based medical communication tool to assess and communicate pregnancy risks related to preterm birth...
April 10, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28391395/biomechanical-analysis-of-anterior-ring-fixation-of-the-ramus-in-type-c-pelvis-fractures
#4
S McLachlin, M Lesieur, D Stephen, H Kreder, C Whyne
PURPOSE: This biomechanical study compared the stability of four different ramus fracture fixation methods for Type C pelvic ring injuries in the absence of posterior fixation. METHODS: A 5-mm vertical osteotomy of the mid-superior and inferior pubic ramus was created in 12 synthetic pelvic models. Four surgical constructs were compared: (1) two-pin AIIS external fixation, (2) 3.5-mm reconstruction plating, (3) bicortical, fully threaded 3.5-mm, and (4) 6.5-mm pubic ramus screws...
April 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28374812/the-effect-of-blood-volume-and-volume-loading-on-left-ventricular-diastolic-function-in-individuals-with-spinal-cord-injury
#5
H Sharif, L Wainman, D O'Leary, D Ditor
STUDY DESIGN: Cohort Study (Prospective Observational Study). OBJECTIVES: The objectives of the study were (i) to examine left ventricular (LV) diastolic function at rest and during rapid saline infusion in those with spinal cord injury (SCI) and (ii) to determine the contribution of blood volume on the purported diastolic impairments in individuals with SCI. SETTINGS: St Catharines, ON, Canada. METHODS: Thirteen SCI (AIS:A-D; C4-T6; age: 41±8...
April 4, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28356163/a-novel-system-for-continuous-real-time-monitoring-of-heart-motion-signals
#6
Guy Dori, Jorge E Schliamser, Oscar Lichtenstein, Ilia Anshelevich, Moshe Y Flugelman
BACKGROUND: Understanding cardiac mechanics is important for developing cardiac therapies. Current modalities for assessing cardiac mechanics sample patient's heart at specific heart rate, contractility, preload, and afterload. The objective of this study was to test the feasibility of a novel system composed of intra-cardiac leads equipped with an inertial module chip (3D accelerometers and 3D gyroscopes) in monitoring continuous heart motion. METHODS: In this descriptive study, four healthy pigs were anesthetized and instrumented with motion-sensitive intra-cardiac leads; the temporal correlation between signals from motion sensors and tissue Doppler from the chest wall were studied; changes in real-time heart accelerations (ACC) and angular velocity (ANGV) were reported as percentages of change from baseline...
March 29, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28340895/post-operative-consequences-of-hemodynamic-optimization
#7
A Lazkani, G Lebuffe
Hemodynamic optimization begins with a medical assessment to identify the high-risk patients. This stratification is needed to customize the choice of hemodynamic support that is best adapted to the patient's level of risk, integrating the use of the least invasive procedures. The macro-circulatory hemodynamic approach aims to maintain a balance between oxygen supply (DO2) and oxygen demand (VO2). Volume replacement plays a crucial role based on the titration of fluid boluses according to their effect on measured stroke volume or indices of preload dependency...
December 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28325672/new-parameter-derived-from-three-dimensional-speckle-tracking-echocardiography-for-the-estimation-of-left-ventricular-filling-pressure-in-nondilated-hearts
#8
Daisuke Sakurai, Toshihiko Asanuma, Kasumi Masuda, Hikaru Koriyama, Satoshi Nakatani
BACKGROUND: E/e' is clinically useful for the noninvasive assessment of left ventricular (LV) filling pressure. However, its use in some conditions is controversial, and angle dependence of the Doppler measurement and preload dependence of mitral e' in nondilated hearts represent major problems. The ratio of early filling rate derived from the time derivative of LV volume to early diastolic strain rate (FRe/SRe), similar to E/e', by three-dimensional (3D) speckle-tracking echocardiography has the potential to address such limitations...
March 18, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28281172/needle-based-confocal-laser-endomicroscopy-for-evaluation-of-cystic-neoplasms-of-the-pancreas
#9
Abdurrahman Kadayifci, Mustafa Atar, Omer Basar, David G Forcione, William R Brugge
BACKGROUND: The accurate diagnosis of cystic neoplasms of the pancreas (CNP) with current diagnostic methods is limited. Endoscopic ultrasound (EUS)-guided needle-based confocal laser endomicroscopy (nCLE) is a new technique which can obtain images from the cyst wall during EUS-fine needle aspiration (EUS-FNA). The aim of this study was to assess the safety, feasibility, and diagnostic value of nCLE for CNP. METHODS: Patients who underwent EUS-FNA to evaluate a CNP larger than 2 cm were enrolled...
May 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28260125/pull-out-strength-of-patient-specific-template-guided-vs-free-hand-fluoroscopically-controlled-thoracolumbar-pedicle-screws-a-biomechanical-analysis-of-a-randomized-cadaveric-study
#10
A Aichmair, M Moser, M R Bauer, E Bachmann, J G Snedeker, M Betz, M Farshad
PURPOSE: To assess the pull-out strength of thoracolumbar pedicle screws implanted via either a patient-specific template-guided or conventional free-hand fluoroscopically controlled technique in a randomized cadaveric study, and to evaluate the influence of local vertebral bone density, quantified by Hounsfield units (HU), on pedicle screw pull-out strength. METHODS: Thoracolumbar pedicles of three spine cadavers were instrumented using either a free-hand fluoroscopically controlled or a patient-specific template-guided technique...
March 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28253850/pulmonary-hypertension-attenuates-the-dynamic-preload-indicators-increase-during-experimental-hypovolemia
#11
Juan P Bouchacourt, Juan Riva, Juan C Grignola
BACKGROUND: Pulse pressure (PPV) and stroke volume (SVV) variations may not be reliable in the setting of pulmonary hypertension and/or right ventricular (RV) failure. We hypothesized that RV afterload increase attenuates SVV and PPV during hypovolemia in a rabbit model of pulmonary embolism (PE) secondary to RV dysfunction. METHODS: Seven anesthetized and mechanically ventilated rabbits were studied during four experimental conditions: normovolemia, blood withdrawal, pulmonary embolism and fluid loading of a colloidal solution...
March 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28251932/inhibition-of-sweet-chemosensory-receptors-alters-insulin-responses-during-glucose-ingestion-in-healthy-adults-a-randomized-crossover-interventional-study
#12
Elnaz Karimian Azari, Kathleen R Smith, Fanchao Yi, Timothy F Osborne, Roberto Bizzotto, Andrea Mari, Richard E Pratley, George A Kyriazis
Background: Glucose is a natural ligand for sweet taste receptors (STRs) that are expressed on the tongue and in the gastrointestinal tract. Whether STRs directly contribute to the regulation of glucose homeostasis in response to glucose ingestion is unclear.Objective: We sought to determine the metabolic effects of the pharmacologic inhibition of STRs in response to an oral glucose load in healthy lean participants.Design: Ten healthy lean participants with a body mass index (in kg/m(2)) of 22.4 ± 0.8 were subjected to an oral-glucose-tolerance test (OGTT) on 4 separate days with the use of a randomized crossover design...
April 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28246005/incremental-prognostic-value-of-ventricular-arterial-coupling-over-ejection-fraction-in-patients-with-maintenance-hemodialysis
#13
Masaru Obokata, Koji Kurosawa, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Yoshitaka Ando, Masahiko Kurabayashi, Kazuaki Negishi
BACKGROUND: Left ventricular ejection fraction (LVEF) is a predictor of adverse outcomes in hemodialysis patients. LVEF is, however, an integral parameter determined by contractility, loading condition, and coupling. We sought to determine whether these components would better predict adverse outcomes and have incremental prognostic value over a validated clinical score and EF. METHODS: Two hundred thirty-four hemodialysis patients were prospectively followed up for primary composite endpoint: all-cause death, nonfatal myocardial infarction, and hospitalization due to worsening heart failure (HF)...
February 25, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28213737/associations-among-left-ventricular-systolic-function-tachycardia-and-cardiac-preload-in-septic-patients
#14
Michael J Lanspa, Sajid Shahul, Andrew Hersh, Emily L Wilson, Troy D Olsen, Eliotte L Hirshberg, Colin K Grissom, Samuel M Brown
BACKGROUND: In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload. METHODS: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28212401/preload-based-starling-like-control-of-rotary-blood-pumps-an-in-vitro-evaluation
#15
Mahdi Mansouri, Shaun D Gregory, Robert F Salamonsen, Nigel H Lovell, Michael C Stevens, Jo P Pauls, Rini Akmeliawati, Einly Lim
Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow ([Formula: see text]) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC)...
2017: PloS One
https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#16
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28202132/comparison-of-platelet-reactivity-in-black-versus-white-patients-with-acute-coronary-syndromes-after-treatment-with-ticagrelor
#17
Michael A Gaglia, Michael J Lipinski, Thibault Lhermusier, Arie Steinvil, Sarkis Kiramijyan, Shreejana Pokharel, Rebecca Torguson, Dominick J Angiolillo, Lars Wallentin, Robert F Storey, Ron Waksman
Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28195341/left-ventricular-systolic-function-is-associated-to-sympathetic-nervous-activity-and-markers-of-inflammation-in-cirrhosis
#18
Raquel Yotti, Cristina Ripoll, Yolanda Benito, Maria Vega Catalina, Jaime Elízaga, Diego Rincón, Francisco Fernández-Avilés, Javier Bermejo, Rafael Bañares
An accurate evaluation of cardiac function in patients with cirrhosis remains a challenge. We used robust echocardiographic indices to characterize LV systolic function and its relationship to activation of the sympathetic nervous system (SNS) and inflammation in 59 patients cirrhosis and 59 age-matched controls. Aditionally, in eleven patients we withdrew betablockers and diuretics and used phenylephrine and albumin infusion to evaluate the response to acute afterload and preload changes (interventional substudy)...
February 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#19
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28171797/efficacy-of-repair-techniques-of-the-achilles-tendon-a-meta-analysis-of-human-cadaveric-biomechanical-studies
#20
REVIEW
Kaissar Yammine, Chahine Assi
PURPOSE: Achilles injuries are very common, mainly among young athletes. When indicated, the surgical treatment aims for strong repairs that can resist distraction and consequently ruptures. The majority of the published clinical meta-analyses reported comparisons between broad treatment modalities such as conservative treatment, open, and minimally invasive surgery. METHODS: A meta-analysis has been conducted to assess further clinical and biomechanical variables on human cadavers related to the efficacy of Achilles repair...
March 2017: Foot
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