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Stroke volume variability

Graeme A Deuchar, Josie C van Kralingen, Lorraine M Work, Celestine Santosh, Keith W Muir, Chris McCabe, I Mhairi Macrae
In acute stroke patients, penumbral tissue is non-functioning but potentially salvageable within a time window of variable duration and represents target tissue for rescue. Reperfusion by thrombolysis and/or thrombectomy can rescue penumbra and improve stroke outcomes, but these treatments are currently available to a minority of patients. In addition to the utility of Glasgow Oxygen Level Dependent (GOLD) as an MRI contrast capable of detecting penumbra, its constituent perfluorocarbon (PFC) oxygen carrier, combined with normobaric hyperoxia, also represents a potential acute stroke treatment through improved oxygen delivery to penumbra...
November 30, 2018: Translational Stroke Research
Ana Diaz-Artiles, Thomas Heldt, Laurence R Young
Artificial gravity (AG) has often been proposed as an integrated multi-system countermeasure to physiological deconditioning associated with extended exposure to reduced gravity levels, particularly if combined with exercise. Twelve subjects underwent short-radius centrifugation along with bicycle ergometry to quantify the short-term cardiovascular response to AG and exercise across three AG levels (0 G or no rotation, 1 G, and 1.4 G; referenced to the subject's feet and measured in the centripetal direction) and three exercise intensities (25, 50, and 100 W)...
2018: Frontiers in Physiology
Gabriel Ramirez-Garcia, Kathleen A Harrison, Juan Fernandez-Ruiz, Joseph Y Nashed, Douglas J Cook
Stroke is the second leading cause of death worldwide. Brain imaging data from experimental rodent stroke models suggest that size and location of the ischemic lesion relate to behavioral outcome. However, such a relationship between these two variables has not been established in Non-Human Primate (NHP) models. Thus, we aimed to evaluate whether size, location, and severity of stroke following controlled Middle Cerebral Artery Occlusion (MCAO) in NHP model correlated to neurological outcome. Forty cynomolgus macaques underwent MCAO, after 4 mortalities, thirty-six subjects were followed during the longitudinal study...
November 24, 2018: Neuroscience
Tobias Kammerer, Valentina Faihs, Nikolai Hulde, Andreas Bayer, Max Hübner, Florian Brettner, Walter Karlen, Julia Maria Kröpfl, Markus Rehm, Christina Spengler, Simon Thomas Schäfer
Objective: Normobaric (NH) and hypobaric hypoxia (HH) are associated with acute mountain sickness (AMS) and cognitive dysfunction. Only few variables, like heart-rate-variability, are correlated with AMS. However, prediction of AMS remains difficult. We therefore designed an expedition-study with healthy volunteers in NH/HH to investigate additional non-invasive hemodynamic variables associated with AMS. Methods: Eleven healthy subjects were examined in NH (FiO2 13...
2018: Annals of Occupational and Environmental Medicine
Alejandro M Brunser, Rodrigo Ibañez-Arenas, Martin Larico, Eloy Mansilla, Juan Almeida, Verónica V Olavarría, Paula Muñoz, Alexis Rojo, Gabriel Cavada, Pablo M Lavados
BACKGROUND: Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients. METHODS: We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017. RESULTS: A total of 696 patients were included (female, 57...
November 22, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Kangyoon Lee, Young Min Lee, Je-Min Park, Byung-Dae Lee, Eunsoo Moon, Hee-Jeong Jeong, Soo Yeon Kim, Young-In Chung, Ji-Hoon Kim
AIM: The purpose of this study was to determine whether regionally distributed medial temporal cortex thickness (or hippocampal volume) and frontal lobe volume are independently associated with the onset of Alzheimer's disease (AD) with psychosis. METHODS: We identified 26 AD patients with psychosis (AD+P) and 48 AD patients without psychosis (AD-P) from the Memory Impairment Clinic at Pusan National University Hospital in South Korea. They were matched for age, gender, duration of AD, and Clinical Dementia Rating sum of box score...
November 14, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Abbas Rattani, Jaims Lim, Akshitkumar M Mistry, Marc A Prablek, Steven G Roth, Lori C Jordan, Chevis N Shannon, Robert P Naftel
INTRODUCTION: Epilepsy is a serious and often lifelong consequence of perinatal arterial ischemic stroke (PAIS). Variable incidences and risk factors for long-term epilepsy in PAIS have been reported. To determine the incidence of epilepsy in PAIS survivors and report factors associated with the risk of developing epilepsy, a meta-analysis and systematic review of prior publications was performed. METHODS: We examined studies on perinatal or neonatal patients (≤28 days of life) with arterial ischemic strokes in which the development of epilepsy was reported...
September 21, 2018: Pediatric Neurology
Eric R Miller, Elena A Kharlamov, Zeyu Hu, Edwin C Klein, Deng-Shan Shiau, Kevin M Kelly
The pathophysiological mechanisms of epileptogenesis following ischemic stroke in the aged brain are not well understood, largely due to limited developments in animal modeling of poststroke epilepsy (PSE). A recent study in our laboratory (Kelly et al., 2018) using transient (3 h) unilateral middle cerebral artery (MCA) and common carotid artery (CCA) occlusion (MCA/CCAo) in 4- and 20-month-old Fischer (F344) rats resulted in epileptic seizures in both age groups; age and infarction factors independently had effects on seizure frequency...
December 2018: Epilepsy Research
Michinari Hieda, Erin J Howden, Satyam Sarma, William Cornwell, Justin S Lawley, Takashi Tarumi, Dean Palmer, Mitchel Samels, Braden Everding, Sheryl Livingston, Qi Fu, Rong Zhang, Benjamin D Levine
KEY POINTS: Heart rate variability, a common and easily measured index of cardiovascular dynamics, is the output variable of complicated cardiovascular and respiratory control systems. Both neural and non-neural control mechanisms may contribute to changes in heart rate variability. We previously developed an innovative method using transfer function analysis to assess the effect of prolonged exercise training on integrated cardiovascular regulation. In this study, we modified and applied it to investigate the effect of 2-years of high-intensity training on circulatory components to tease out the primary effects of training...
November 1, 2018: Journal of Physiology
Alejandro Díaz, Yanina Zócalo, Edmundo Cabrera-Fischer, Daniel Bia
BACKGROUND: Echocardiographic reference intervals (RIs) for left ventricular outflow tract (LVOT) and velocity time integral (VTI) are scarce in pediatrics. AIMS: (a) to generate RIs and percentiles for LVOT, VTI, and hemodynamic variables in healthy children and adolescents from Argentina; (b) to analyze the equivalence between stroke volume (SV), cardiac output (CO), and cardiac index (CI) obtained from two-dimensional echocardiography (2D) and LVOT-VTI analysis with pulsed wave Doppler (PWD); and (c) to analyze the association between subjects' characteristics and VTI and LVOT-VTI-derived parameters...
October 30, 2018: Echocardiography
Victoria A Bennett, Hollmann D Aya, Maurizio Cecconi
Heart lung interactions can be used clinically to assist in the evaluation of cardiac function. Application of these interactions and understanding of the physiology underlying them has formed a focus of research over a number of years. The changes in preload induced by changes in intrathoracic pressure (ITP) with the respiratory cycle, have been applied to form dynamic tests of fluid responsiveness. Pulse pressure variation (PPV), stroke volume variation (SVV), end expiratory occlusion test, pleth variability index (PVI) and use of echocardiography are all clinical assessments that can be made at the bedside...
September 2018: Annals of Translational Medicine
Shilpa Tyagi, Gerald Choon-Huat Koh, Nan Luo, Kelvin Bryan Tan, Helen Hoenig, David B Matchar, Joanne Yoong, Eric A Finkelstein, Kim En Lee, N Venketasubramanian, Edward Menon, Kin Ming Chan, Deidre Anne De Silva, Philip Yap, Boon Yeow Tan, Effie Chew, Sherry H Young, Yee Sien Ng, Tian Ming Tu, Yan Hoon Ang, Keng He Kong, Rajinder Singh, Reshma A Merchant, Hui Meng Chang, Tseng Tsai Yeo, Chou Ning, Angela Cheong, Yu Li Ng, Chuen Seng Tan
BACKGROUND: Health services research aimed at understanding service use and improving resource allocation often relies on collecting subjectively reported or proxy-reported healthcare service utilization (HSU) data. It is important to know the discrepancies in such self or proxy reports, as they have significant financial and policy implications. In high-dependency populations, such as stroke survivors, with varying levels of cognitive impairment and dysphasia, caregivers are often potential sources of stroke survivors' HSU information...
October 25, 2018: BMC Health Services Research
Peter B Sporns, André Kemmling, Michael Schwake, Jens Minnerup, Jawed Nawabi, Gabriel Broocks, Moritz Wildgruber, Jens Fiehler, Walter Heindel, Uta Hanning
Background and Purpose- Besides the established spot sign (SS) in computed tomography angiography (CTA), there is growing evidence that different imaging markers in noncontrast CT offer great value for outcome prediction in patients with intracerebral hemorrhage (ICH). However, it is unclear how the concurrent presence of each sign independently contributes to the predictive power of poor outcome. We, therefore, aimed to clarify the predictive value of 5 recently published noncontrast CT parameters (blend sign, black hole sign, island sign, hematoma heterogeneity, and hypodensities) and the established SS in 1 consecutive series of patients with ICH...
October 2018: Stroke; a Journal of Cerebral Circulation
Yu Sakai, Bradley N Delman, Johanna T Fifi, Stanley Tuhrim, Danielle Wheelwright, Amish H Doshi, J Mocco, Kambiz Nael
Background and Purpose- Estimation of infarction based on computed tomographic perfusion (CTP) has been challenging, mainly because of noise associated with CTP data. The Bayesian method is a robust probabilistic method that minimizes effects of oscillation, tracer delay, and noise during residue function estimation compared with other deconvolution methods. This study compares CTP-estimated ischemic core volume calculated by the Bayesian method and by the commonly used block-circulant singular value deconvolution technique...
October 2018: Stroke; a Journal of Cerebral Circulation
Syed F Ali, Gregg Fonarow, Li Liang, Ying Xian, Eric E Smith, Deepak L Bhatt, Lee Schwamm
Background While many patients are transferred to specialized stroke centers for advanced acute ischemic stroke (AIS) care, few studies have characterized these patients. We sought to determine variation in the rates and differences in the baseline characteristics and clinical outcomes between AIS cases presenting directly to stroke centers' front door versus Transfer-Ins from another hospital. Methods and Results We analyzed 970 390 AIS cases in the Get With The Guidelines-Stroke registry from January 2010 to March 2014 to compare hospitals with high Transfer-In rates (≥15%) versus those with low Transfer-In rates (<5%) and to compare the front-door versus Transfer-In patients admitted to those hospitals with high Transfer-In rates (high Transfer-In hospitals)...
September 2018: Circulation. Cardiovascular Quality and Outcomes
Guan-Rong Zheng, Bin Chen, Jia Shen, Shen-Zhong Qiu, Huai-Ming Yin, Wei Mao, Hong-Xiang Wang, Jian-Bo Gao
BACKGROUND: Oxidative stress is related to brain injury after spontaneous intracerebral hemorrhage (ICH). Myeloperoxidase (MPO) is a potent oxidizing enzyme. We tested the hypothesis that serum MPO concentrations are increased after ICH and they correlate with stroke severity and outcome. METHODS: Serum MPO concentrations were measured in 128 ICH patients and 128 controls. Odds ratios of dependent variables, including early neurological deterioration, hematoma growth, 1-week mortality, 6-month mortality, 6-month unfavorable outcome (modified Rankin Scale score > 2) and 6-month overall survival, were calculated and adjusted for age, sex, hematoma volume, National Institutes of Health Stroke Scale (NIHSS) score and vascular risk factors...
October 19, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
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
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