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Cardiac perfusion

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https://www.readbyqxmd.com/read/27933282/myocardial-perfusion-scintigraphy-dosimetry-optimal-use-of-spect-and-spect-ct-technologies-in-stress-first-imaging-protocol
#1
REVIEW
M Lecchi, S Malaspina, C Scabbio, V Gaudieri, A Del Sole
PURPOSE: Over the past decade, nuclear medicine experts have been seeking to minimize patient exposure to radiation in myocardial perfusion scintigraphy (MPS). This review describes the latest technological innovations in MPS, particularly with regard to dose reduction. METHODS: We searched in PubMed for original clinical papers in English, published after 2008, using the following research criteria: (dose) and ((reduction) or (reducing)) and ((myocardial) or (cardiac) or (heart)) and ((nuclear medicine) or (nuclear imaging) or (radionuclide) or (scintigraphy) or (SPET) or (SPECT))...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27932051/functional-and-exercise-limitations-after-a-first-episode-of-pulmonary-embolism-results-of-the-elope-prospective-cohort-study
#2
Susan R Kahn, Andrew M Hirsch, Arash Akaberi, Paul Hernandez, David R Anderson, Philip S Wells, Marc Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Christopher Rush, William H Geerts, Shawn D Aaron, John T Granton
BACKGROUND: We aimed to determine the frequency and predictors of exercise limitation after pulmonary embolism (PE), and to assess its association with health-related quality of life (HRQOL) and dyspnea. METHODS: 100 patients with acute PE were recruited at five Canadian hospitals from 2010-2013. Cardiopulmonary exercise testing (CPET) was performed at 1 and 12 months. Quality of life, dyspnea, six-minute walk distance (6MWD), residual clot burden (perfusion (Q) scan; CT pulmonary angiography (CTPA)), cardiac function (echocardiogram) and pulmonary function tests (PFT) were measured during follow-up...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27931654/the-response-of-the-microcirculation-to-mechanical-support-of-the-heart-in-critical-illness
#3
REVIEW
Sakir Akin, Atila Kara, Corstiaan A den Uil, Can Ince
Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock, and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS does not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation (MC)...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931647/hemodynamic-coherence-in-patients-with-burns
#4
REVIEW
Sabri Soussi, Matthieu Legrand
Burn shock is characterized by profound hemodynamic alterations mainly associated with rapid loss of intravascular volume related to severe capillary leak. Thus, fluid resuscitation conventionally based on macrocirculatory targets is considered as a corner stone of initial management of patients with burns. Nonetheless, traditional markers such as blood pressure, urinary output, and cardiac output are helpful but do not sufficiently reflect the adequacy of perfusion and oxygenation at the microcirculatory level...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931565/ex%C3%A2-vivo-perfusion-characteristics-of-donation-after-cardiac-death-kidneys-predict-long-term-graft-survival
#5
M Sevinc, S Stamp, J Ling, N Carter, D Talbot, N Sheerin
BACKGROUND: Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. METHODS: All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27923692/a-hemodynamic-directed-approach-to-pediatric-cardiopulmonary-resuscitation-hd-cpr-improves-survival
#6
Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27922334/ionizing-radiation-impairs-endogenous-regeneration-of-infarcted-heart-an-in-vivo-18-f-fdg-pet-ct-and-99m-tc-tetrofosmin-spect-ct-study-in-mice
#7
Lan Luo, Kodai Nishi, Yoshishige Urata, Chen Yan, Al Shaimaa Hasan, Shinji Goto, Takashi Kudo, Zhao-Lan Li, Tao-Sheng Li
Epidemiological studies have suggested that ionizing radiation increases cardiovascular disease risk, but the relevant mechanism is poorly understood. We recently demonstrated that adult mice exposed to whole-body irradiation with 3 Gy gamma rays significantly decreases the number and quality of cardiac stem cells. To further determine if radiation impairs myocardial regenerative potency, a myocardial infarction model was established in adult C57BL/6 mice by ligating the left anterior descending artery approximately 6 h after sham- or whole-body gamma irradiation (0 or 3 Gy)...
December 6, 2016: Radiation Research
https://www.readbyqxmd.com/read/27920725/controlled-reperfusion-strategies-improve-cardiac-hemodynamic-recovery-after-warm-global-ischemia-in-an-isolated-working-rat-heart-model-of-donation-after-circulatory-death-dcd
#8
Emilie Farine, Petra Niederberger, Rahel K Wyss, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
Aims: Donation after circulatory death (DCD) could improve cardiac graft availability, which is currently insufficient to meet transplant demand. However, DCD organs undergo an inevitable period of warm ischemia and most cardioprotective approaches can only be applied at reperfusion (procurement) for ethical reasons. We investigated whether modifying physical conditions at reperfusion, using four different strategies, effectively improves hemodynamic recovery after warm ischemia. Methods and Results: Isolated hearts of male Wistar rats were perfused in working-mode for 20 min, subjected to 27 min global ischemia (37°C), and 60 min reperfusion (n = 43)...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27919740/metabolic-differences-between-cold-stored-and-machine-perfused-porcine-kidneys-a-1-h-nmr-based-study
#9
Jay Nath, Tom B Smith, Kamlesh Patel, Sam R Ebbs, Alex Hollis, Daniel A Tennant, Christian Ludwig, Andrew R Ready
Hypothermic machine perfusion (HMP) and static cold storage (SCS) are the two methods used to preserve deceased donor kidneys prior to transplant. This study seeks to characterise the metabolic profile of HMP and SCS porcine kidneys in a cardiac death donor model. Twenty kidneys were cold flushed and stored for two hours following retrieval. Paired kidneys then underwent 24 h of HMP or SCS or served as time zero controls. Metabolite quantification in both storage fluid and kidney tissue was performed using one dimensional (1)H NMR spectroscopy...
December 2, 2016: Cryobiology
https://www.readbyqxmd.com/read/27918847/left-ventricular-compressions-improve-hemodynamics-in-a-swine-model-of-out-of-hospital-cardiac-arrest
#10
Kenton L Anderson, Maria G Castaneda, Susan M Boudreau, Danny J Sharon, Vikhyat S Bebarta
INTRODUCTION: We hypothesized that chest compressions located directly over the left ventricle (LV) would improve hemodynamics, including coronary perfusion pressure (CPP), and return of spontaneous circulation (ROSC) in a swine model of cardiac arrest. METHODS: Transthoracic echocardiography (echo) was used to mark the location of the aortic root and the center of the left ventricle on animals (n = 26) which were randomized to receive chest compressions in one of the two locations...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#11
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916039/-the-development-of-ex-vivo-lung-perfusion-in-lung-transplantation
#12
X F Pan, R Wang, S J Fu, Y H Yang, J Yang, H Zhao
The shortage of donor lung remains one of the major problem for lung transplantation. With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re-assessed and finally utilized for transplantation. The ex vivo lung perfusion technique (EVLP) was designed and has been developed for evaluation and repair of the lung. Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications. The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover-Madrid technique...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#13
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#14
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27909230/the-protective-role-of-sex-hormones-in-females-and-exercise-prehabilitation-in-males-on-sternotomy-induced-cranial-hypoperfusion-in-aortic-banded-mini-swine
#15
T Dylan Olver, Jessica A Hiemstra, Jenna C Edwards, Brian S Ferguson, Harold Laughlin, Craig A Emter
During cardiac surgery, specifically sternotomy, cranial hypoperfusion is linked to cerebral ischemia, increased risk of perioperative watershed stroke and other neurocognitive complications. The purpose of this study was to retrospectively examine the effect of sex hormones in females and exercise prehabilitation in males on median sternotomy-induced changes in cranial perfusion in a large animal model of heart failure. Cranial blood flow (CBF) before, 10- and 60 min post-sternotomy was analyzed in eight groups of Yucatan mini-swine: female-control, aortic-banded, ovariectomized, and ovariectomized+aortic-banded; male-control, aortic-banded, aortic-banded+continuous exercise trained, and aortic-banded+interval exercise trained...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27908971/13n-ammonia-pet-ct-detection-of-myocardial-perfusion-abnormalities-in-beagle-dogs-after-local-heart-irradiation
#16
Jianbo Song, Rui Yan, Zhifang Wu, Jianguo Li, Min Yan, Xinzhong Hao, Jianzhong Liu, Sijin Li
: To determine the potential value of (13)N-ammonia positron emission tomography (PET)/computed tomography (CT) myocardial perfusion imaging (MPI) for detection of myocardial perfusion changes at early stage induced by radiation damage. METHODS: Thirty-six Beagle dogs were randomly divided into the control (n = 18) or the irradiation groups (n = 18). The irradiation group underwent local irradiation to the left ventricular anterior cardiac wall with a single dose of 20 Gy, whereas the control group received sham irradiation...
December 1, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#17
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907931/koronararterienanomalien-diagnostik-und-klassifikation-auf-basis-der-ct-und-mrt-des-herzens-von-alcapa-bis-terminationsanomaliecoronary-artery-anomalies-diagnosis-and-classification-based-on-cardiac-ct-and-mri-cmr-from-alcapa-to-anomalies-of-termination
#18
Philipp Heermann, Walter Heindel, Christoph Schülke
Background Coronary artery anomalies encompass a clinically and anatomically variable spectrum including physiological variants and pathophysiologically relevant anomalies. The majority of the variants has no hemodynamic relevance and is often detected accidentally. The recognition of the rare and relevant anomalies that cause either relevant shunt volumes leading to myocardial ischemia or ventricular tachyarrhythmias with the risk of sudden cardiac death is of major importance. Methods This review is based on a literature search in PubMed conducted using the key words "coronary artery" and/or "anomaly" and/or "anomalous origin" and/or "myocardial bridging" and/or "coronary artery fistula" and/or "Bland-White-Garland" and/or "ALCAPA"...
December 1, 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#19
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27903207/direct-cerebral-perfusion-and-cooling-in-experimental-cardiac-arrest
#20
Rinaldo Bellomo, Bruno Marino, Peter Angelopoulos, Scott Carson, Glenn Eastwood, Junko Kosaka, Naoya Iguchi, Andrew Hilton, Clive May
BACKGROUND: Cerebral protection is a key priority during cardiac arrest (CA). However, current approaches are suboptimal. OBJECTIVE: To test whether direct perfusion and cooling of the anterior cerebral circulation by means of cerebral vessel cannulation and extracorporeal membrane oxygenation (ECMO) increases cerebral oxygenation and induces cerebral hypothermia during CA. METHODS: We performed proof-of-concept animal experiments in sheep...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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