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Stroke volume variability

Meher R Juttukonda, Chelsea A Lee, Niral J Patel, Larry T Davis, Spencer L Waddle, Melissa C Gindville, Sumit Pruthi, Adetola A Kassim, Michael R DeBaun, Manus J Donahue, Lori C Jordan
BACKGROUND: Blood transfusions are administered to children and adults with sickle cell anemia (SCA) for secondary stroke prevention, or as treatment for recurrent pain crises or acute anemia, but transfusion effects on cerebral hemodynamics and metabolism are not well-characterized. PURPOSE: To compare blood transfusion-induced changes in hemometabolic parameters, including oxygen extraction fraction (OEF) and cerebral blood flow (CBF), within and between adults and children with SCA...
October 15, 2018: Journal of Magnetic Resonance Imaging: JMRI
Ma XiaoHui, Wei Li, Guo Wei, Liu XiaoPing, Jia Xin, Zhang Hongpeng, Wang Lijun
Introduction Endovascular intervention involving the aortic arch, particularly in thoracic aortic dissection, remains challenging and controversial at current time when there is no commercially suitable grafts on most of the international markets. This study compared two endovascular treatments that maintain left subclavian artery perfusion using two modified techniques for type-B aortic dissection patients. Methods Consecutive cases utilizing chimney or in situ fenestration techniques to preserve left subclavian artery in type B AD from 2006 to 2015 in our single institution were retrospectively reviewed...
October 14, 2018: Vascular
Dewei Xie, Weiwei Xiang, Yiyun Weng, Jia Li, Ling Xu, Xu Zhang, Zhibo Chen
OBJECTIVE: We aimed to investigate whether platelet volume indices (PVIs) were associated with an unfavorable clinical outcome in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis (IVT). METHODS: We defined a modified Rankin Scale (mRS) score of 3-6 at 90 days as an unfavorable outcome. Logistic regression analysis was performed to find out whether mean platelet volume (MPV), platelet distribution width (PDW), MPV/platelet count (PC) ratio and PDW/PC ratio were associated with poor prognosis...
October 12, 2018: International Journal of Neuroscience
Chintan Dave, Jennifer Shen, Dipayan Chaudhuri, Brent Herritt, Shannon M Fernando, Peter M Reardon, Peter Tanuseputro, Kednapa Thavorn, David Neilipovitz, Erin Rosenberg, Dalibor Kubelik, Kwadwo Kyeremanteng
Static indices, such as the central venous pressure, have proven to be inaccurate predictors of fluid responsiveness. An emerging approach uses dynamic assessment of fluid responsiveness (FT-DYN), such as stroke volume variation (SVV) or surrogate dynamic variables, as more accurate measures of volume status. Recent work has demonstrated that goal-directed therapy guided by FT-DYN was associated with reduced intensive care unit (ICU) mortality; however, no study has specifically assessed this in surgical ICU patients...
October 11, 2018: Journal of Intensive Care Medicine
Markus D Schirmer, Mark R Etherton Md PhD, Adrian V Dalca PhD, Anne-Katrin Giese Md, Lisa Cloonan MSc, Ona Wu PhD, Polina Golland PhD, Natalia S Rost Md Mph Faan
Prediction of functional outcome after stroke based on initial presentation remains an open challenge, suggesting that an important aspect is missing from these prediction models. There exists the notion of a protective mechanism called brain reserve, which may be utilized to understand variations in disease outcome. In this work, we expand the concept of brain reserve (effective reserve) to improve prediction models of functional outcome after acute ischemic stroke (AIS). Consecutive AIS patients with acute brain magnetic resonance imaging (<48 hours) were eligible for this study...
September 27, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Suresh Vellaiyan, Arunkumar Subbiah, Prabha Chockalingam
The present study is aimed to analyze the combustion, performance, and emission characteristics of water-emulsified soybean biodiesel fueled diesel engine with alumina nanoadditive and the results compared with conventional diesel fuel (BD). Experiments were conducted in a single-cylinder, four-stroke, variable compression ratio, and natural aspirated diesel engine with an eddy current dynamometer at a constant speed of 1500 rpm. Water-soybean biodiesel emulsion fuel was prepared using a mechanical agitator, in which the water concentration was limited to 10%, whereas soybean biodiesel (SB) and surfactant concentrations were 89% and 1% by volume respectively...
September 28, 2018: Environmental Science and Pollution Research International
M Heringlake, M Sander, S Treskatsch, S Brandt, C Schmidt
Despite broad availability, extended hemodynamic monitoring is used in practice only in the minority of critical care patients. Pathophysiological reasoning suggests that systemic perfusion pressure (and thereby arterial as well as central venous pressure), cardiac stroke volume, and the systemic oxygen balance are key variables in maintaining adequate organ perfusion. In line with these assumptions, several studies support that a goal-directed optimization of these hemodynamic variables leads to a reduction in morbidity and mortality...
October 2018: Der Anaesthesist
Karin H Wodack, Michael F Graessler, Sarah A Nishimoto, Christoph R Behem, Hans O Pinnschmidt, Mark A Punke, M Ignacio Monge-García, Constantin J C Trepte, Daniel A Reuter
Phenylephrine is an α1-adrenergic receptor agonist widely used to treat perioperative hypotension. Its other hemodynamic effects, in particular on preload and contractility, remain controversial. We, therefore, investigated the effect of continuously applied phenylephrine on central hemodynamics in eight mechanically ventilated domestic pigs. Mean arterial pressure (MAP) was increased in steps by 50%, and 100% using phenylephrine. Besides stroke volume (SV), cardiac output (CO), and MAP, mean systemic vascular resistance (SVR) and dynamic arterial elastance (Eadyn ) were assessed for characterization of afterload...
September 27, 2018: Journal of Clinical Monitoring and Computing
Dong-Eog Kim, Jong-Ho Park, Dawid Schellingerhout, Wi-Sun Ryu, Su-Kyoung Lee, Min Uk Jang, Sang-Wuk Jeong, Jeong-Yong Na, Jung E Park, Eun Ja Lee, Ki-Hyun Cho, Joon-Tae Kim, Beom Joon Kim, Moon-Ku Han, Jun Lee, Jae-Kwan Cha, Dae-Hyun Kim, Soo Joo Lee, Youngchai Ko, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Keun-Sik Hong, Yong-Jin Cho, Jong-Moo Park, Kyusik Kang, Tai Hwan Park, Kyung Bok Lee, Kyoung-Jong Park, Heung-Kook Choi, Juneyoung Lee, Hee-Joon Bae
Importance: Cerebral vascular territories are of key clinical importance in patients with stroke, but available maps are highly variable and based on prior studies with small sample sizes. Objective: To update and improve the state of knowledge on the supratentorial vascular supply to the brain by using the natural experiment of large artery infarcts and to map out the variable anatomy of the anterior, middle, and posterior cerebral artery (ACA, MCA, and PCA) territories...
September 24, 2018: JAMA Neurology
Matthew D Howe, Liang Zhu, Lauren H Sansing, Nicole R Gonzales, Louise D McCullough, Nancy J Edwards
Background: Intracerebral hemorrhage (ICH) is a stroke subtype associated with high disability and mortality. There is a clinical need for blood-based biomarkers that can aid in diagnosis, risk stratification, and prognostication. Given their role in the pathophysiology of ICH, we hypothesized markers of blood-brain barrier disruption and fibrosis would associate with neurologic deterioration and/or long-term functional outcomes. We also hypothesized these markers may be unique in patients with ICH due to cerebral amyloid angiopathy (CAA) vs...
2018: Frontiers in Neurology
Inga-Catalina Cruz-Benedetti, Isabelle Bublot, Thibault Ribas, Isabelle Fourel, Claus Vogl, Claire Dubois, Mathilde Milani, Keila Kazue Ida, Karine Portier
The pharmacokinetics and the effects of a single intramuscular (IM) dose of alfaxalone on sedation and cardiopulmonary and echocardiographic variables was studied in dogs. Twelve healthy adult Beagles (3 females, 9 males) were used in this prospective controlled cross-over trial. Echocardiography was performed with and without 4 mg kg-1 alfaxalone IM with a week wash-out interval. Sedation (19-point scale; 0 = no sedation), cardiopulmonary parameters, blood gas analysis and plasma concentration of alfaxalone were assessed every 5 minutes following the injection (T0)...
2018: PloS One
Hua Zen Ling, Gavin Guy, Alesandra Bisquera, Liona C Poon, Kypros Nicolaides, Nikos A Kametas
OBJECTIVE: To compare maternal hemodynamics and perinatal outcomes in women identified at 11-13 weeks' gestation as being screen positive (N=170) or negative (N=926) for preterm preeclampsia (PE) by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor and pregnancy associated plasma protein-A. METHODS: This was a prospective, longitudinal cohort study of maternal cardiovascular function, assessed by a bioreactance method, in women undergoing first trimester screening for PE...
September 23, 2018: Ultrasound in Obstetrics & Gynecology
Greggory R DeVore, Berthold Klas, Gary Satou, Mark Sklansky
OBJECTIVES: This study was conducted to evaluate left ventricular (LV) size and function in healthy fetuses and to test a cohort of fetuses at risk for abnormal function using speckle-tracking software. METHODS: Two hundred control fetuses were examined between 20 and 40 weeks' gestation. With the use of offline speckle-tracking software, the end-diastolic and end-systolic volumes were measured and the following computed: stroke volume (SV), SV per kilogram, cardiac output (CO), CO per kilogram, and ejection fraction...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sang Hun Lee, Keun-Sik Hong, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu, Sun U Kwon
OBJECTIVES: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. PATIENTS AND METHODS: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors...
September 9, 2018: Clinical Neurology and Neurosurgery
Michael R Williamson, Cassandra M Wilkinson, Kristen Dietrich, Frederick Colbourne
Increased intracranial pressure (ICP) after stroke can lead to poor outcome and death. Novel treatments to combat ICP rises are needed. The carbonic anhydrase inhibitor acetazolamide diminishes cerebrospinal fluid (CSF) production, reduces ICP in healthy animals, and is beneficial for idiopathic intracranial hypertension patients. We tested whether acetazolamide mitigates ICP elevations by presumably decreasing CSF volume after collagenase-induced striatal hemorrhage in rats. We confirmed that acetazolamide did not adversely affect hematoma formation in this model or physiological variables, such as temperature...
September 17, 2018: Translational Stroke Research
Fabijan Lulić, Zdravko Virag, Marko Jakopović, Ivan Korade
A reliable noninvasive method for the estimation of pulmonary function in healthy and diseased subjects should be of great importance in the prognosis, diagnosis, and treatment of pulmonary hypertension. Here we propose such a method, which is based on the parameter identification of the five-element Windkessel model of pulmonary circulation. The method requires the following input variables: the heart rate, the stroke volume, the Doppler echocardiographic measurements of the tricuspid regurgitation and the pulmonary valve velocity profiles, and estimations of the right atrium and the pulmonary vein pressure...
November 2018: Medical Hypotheses
Jason Weatherald, Athénaïs Boucly, David Launay, Vincent Cottin, Grégoire Prévot, Delphine Bourlier, Claire Dauphin, Ari Chaouat, Laurent Savale, Xavier Jaïs, Mitja Jevnikar, Julie Traclet, Pascal De Groote, Gérald Simonneau, Eric Hachulla, Luc Mouthon, David Montani, Marc Humbert, Olivier Sitbon
The prognostic importance of follow-up haemodynamics and the validity of multidimensional risk assessment are not well established for systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH).We assessed incident SSc-PAH patients to determine the association between clinical and haemodynamic variables at baseline and first follow-up right heart catheterization (RHC) with transplant-free survival. RHC variables included cardiac index (CI), stroke volume index (SVI), pulmonary arterial compliance (PCa) and pulmonary vascular resistance (PVR)...
September 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Hasthi U Dissanayake, Rowena L McMullan, Yang Kong, Ian D Caterson, David S Celermajer, Melinda Phang, Camille Raynes-Greenow, Jaimie W Polson, Adrienne Gordon, Michael R Skilton
Birth weight is associated with cardiovascular disease, with those at both ends of the spectrum at increased risk. However, birth weight is a crude surrogate of fetal growth. Measures of body composition may more accurately identify high risk infants. We aimed to determine whether aortic wall thickening, cardiac autonomic control, and cardiac structure/function differ in newborns with high or low body fatness compared to those with average body fatness. 189 healthy singleton term born neonates were recruited and stratified by body fat percentiles (sex and gestation-specific)...
September 11, 2018: Journal of Clinical Medicine
Nilay Kumar, Ambarish Pandey, Neetika Garg, Emmanuel Sampene, Carl J Lavie
OBJECTIVE: To ascertain whether temporal and geographic interest in seeking cardiovascular disease (CVD) information online follows seasonal and geographic patterns similar to those observed in real-world data. METHODS: We searched Google Trends for popular search terms relating to CVD. Relative search volumes (RSVs) were obtained for the period January 4, 2004, to April 19, 2014, for the United States and Australia. We compared average RSVs by month and season and used cosinor analysis to test for seasonal variation in RSVs...
September 2018: Mayo Clinic Proceedings
Rajat Dhar, Yasheng Chen, Hongyu An, Jin-Moo Lee
Cerebral edema contributes to neurological deterioration and death after hemispheric stroke but there remains no effective means of preventing or accurately predicting its occurrence. Big data approaches may provide insights into the biologic variability and genetic contributions to severity and time course of cerebral edema. These methods require quantitative analyses of edema severity across large cohorts of stroke patients. We have proposed that changes in cerebrospinal fluid (CSF) volume over time may represent a sensitive and dynamic marker of edema progression that can be measured from routinely available CT scans...
2018: Frontiers in Neurology
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