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Cardiac perfusion

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https://www.readbyqxmd.com/read/28718260/cerebral-oximetry-use-for-cardiac-surgery
#1
Syed Shahmeer Raza, Farhan Ullah, Chandni, Edward Bruce Savage
BACKGROUND: Studies have shown maintaining good cerebral perfusion during Cardiac Surgeries is very important in terms of patient outcomes and reducing the hospital stay, which may have its financial and clinical implications. The aim of this review study was to determine the effectiveness of Cerebral Oximetry (Transcranial Near-Infrared Spectroscopy-NIRS to monitor cerebral oxygenation) for Cardiac Surgery and to propose a possible concluding remark about its potential applications, overall clinical value and whether to keep using it or not...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712068/qualitative-angiographic-and-quantitative-myocardial-perfusion-assessment-using-fluorescent-cardiac-imaging-during-graded-coronary-artery-bypass-stenosis
#2
Christian Detter, Detlef Russ, Jan Felix Kersten, Hermann Reichenspurner, Sabine Wipper
Intraoperative graft assessment in coronary artery bypass (CAB) grafting is important to avoid early graft failure. This study aimed to evaluate the accuracy of fluorescent cardiac imaging (FCI) for intraoperative qualitative angiographic and quantitative myocardial perfusion assessment during graded CAB stenosis compared to coronary angiography (CA). After CAB grafting to the left anterior descending coronary artery, graded distal bypass stenoses were created in ten pigs by 25, 50, 75, and 100% flow reduction assessed by transit-time flow measurement (TTFM)...
July 15, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28710899/effects-of-dobutamine-dopamine-phenylephrine-and-noradrenaline-on-systemic-haemodynamics-and-intestinal-perfusion-in-isoflurane-anaesthetised-horses
#3
C Dancker, K Hopster, K Rohn, S B Kästner
BACKGROUND: In the horse, effects of cardiovascular-active drugs on local perfusion of the gastrointestinal tract are poorly understood. OBJECTIVES: To determine the effect of drugs commonly used to support blood pressure, on local intestinal blood flow and tissue oxygenation under isoflurane anaesthesia. STUDY DESIGN: In vivo randomised crossover experiment METHODS: Ten horses were anaesthetised with isoflurane. After 90 minutes of equilibration three doses (μg/kg bwt/min) of dobutamine (DOB 0...
July 15, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28709866/mesenchymal-stem-cell-transplantation-carried-in-svvyglr-modified-self-assembling-peptide-promoted-cardiac-repair-and-angiogenesis-after-myocardial-infarction
#4
Xi-Ren Gao, Hai-Jun Xu, Li-Fang Wang, Chong-Bin Liu, Feng Yu
The efficiency of stem cell therapy for myocardial infarction (MI) was very low due to the hostile microenvironment and poor blood perfusion. In this study, we designed a new self-assembling peptide through adding angiogenic polypeptide SVVYGLR to the carboxyl terminal of RADA16, and evaluated the therapeutic potential of mesenchymal stem cell (MSC) transplantation carried in this designer self-assembling peptide (DSP) on MI. After the model of cell ischemia and hypoxia was established in vitro, cytoprotective effect of DSP on MSC was detected by AO/EB staining...
July 11, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#5
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yutaka Fujii, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
BACKGROUND: Femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to maintain blood flow in patients with cardiogenic shock. However, retrograde blood flow increases left ventricular (LV) afterload during femoral VA-ECMO. Additional support by means of an intraaortic balloon pump (IABP) alleviates LV afterload but is associated with significant adverse events. We previously developed a system for rotational speed modulation in synchrony with the native cardiac cycle, for use with implantable continuous-flow LV assist devices...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709156/gastrointestinal-impedance-spectroscopy-to-detect-hypoperfusion-during-hemorrhage
#6
Andreas Bloch, Andreas Kohler, Horst Posthaus, David Berger, Laura Santos, Stephan Jakob, Jukka Takala, Matthias Haenggi
BACKGROUND: Changes in tissue impedance (Ω) have been proposed as early signs of impaired tissue perfusion. We hypothesized that hemorrhage may induce early changes in alimentary tract tissue impedance and that these can be detected by impedance spectroscopy. We evaluated impedance spectroscopy in an acute hemorrhage model in pigs. METHODS: Twenty anesthetized pigs were randomized to stepwise hemorrhage to mean arterial blood pressure (MAP) targets of 60 mm Hg, 50 mm Hg, 45 mm Hg, and 40 mm Hg, followed by retransfusion in two steps, or control (n = 10 each)...
August 2017: Shock
https://www.readbyqxmd.com/read/28708664/esmolol-administration-to-control-tachycardia-in-an-ovine-model-of-peritonitis
#7
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Adriano José Pereira, Antoine Herpain, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Excessive adrenergic signaling may be harmful in sepsis. Using β-blockers to reduce sympathetic overactivity may modulate sepsis-induced cardiovascular, metabolic, immunologic, and coagulation alterations. Using a randomized ovine fecal peritonitis model, we investigated whether administration of a short-acting β-blocker, esmolol, could control tachycardia without deleterious effects on hemodynamics, renal perfusion, cerebral perfusion, cerebral metabolism, or outcome. METHODS: After induction of fecal peritonitis, 14 anesthetized, mechanically ventilated, and hemodynamically monitored adult female sheep were randomly assigned to receive a continuous intravenous infusion of esmolol to control heart rate between 80 and 100 bpm (n = 7) or a saline infusion (control group, n = 7)...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28707739/angiotensin-ii-preconditioning-is-associated-with-increased-pkc%C3%AE%C2%B5-pkc%C3%AE-ratio-and-prosurvival-kinases-in-mitochondria
#8
Rebeca E Nuñez, Sabzali Javadov, Nelson Escobales
Angiotensin II preconditioning (APC) has been shown to reproduce the cardioprotective effects of ischaemic preconditioning (IPC), however, molecular mechanisms mediating the effects of APC remain unknown. In this study, Langendorff-perfused rat hearts were subjected to IPC, APC or both (IPC/APC) followed by ischaemia-reperfusion (IR), to determine translocation of PKCε, PKCδ, Akt, Erk1/2, JNK, p38 MAPK and GSK-3β to mitochondria as an indicator of activation of the protein kinases. In agreement with previous observations, IPC, APC and IPC/APC increased the recovery of left ventricular developed pressure (LVDP), reduced infarct size (IS) and lactate dehydrogenase (LDH) release, compared to controls...
July 14, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28707262/exercise-n-13-cardiac-positron-emission-tomography-myocardial-perfusion-imaging-detecting-ischemia-in-an-adult-patient-with-anomalous-aortic-origin-of-the-left-main-coronary-artery-from-the-right-coronary-sinus
#9
Matthew R Summers, Hani Najm, James L Gentry Iii, Wael A Jaber
Anomalous aortic origin of a coronary artery is a rare congenital condition that has variable presentations from atypical chest pain to syncope and cardiac arrest. Commonly used myocardial perfusion imaging techniques, stress agents, and perfusion agents may have limited ability to detect inducible ischemia in this rare patient group. We herein describe a unique case of anomalous left main coronary artery from a common right coronary sinus ostium with a subpulmonic and intramyocardial course. This patient had multiple atypical chest pain presentations and multiple-negative pharmacologic single-photon emission-computed tomography stress tests performed...
July 13, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#10
Yu Wang, Steven C Koenig, Michael A Sobieski, Mark S Slaughter, Guruprasad A Giridharan
Mechanical circulatory support (MCS) devices have become a standard therapy for heart failure (HF) patients. MCS device designs may differ by level of support, inflow and/or outflow cannulation sites, and mechanism(s) of cardiac unloading and blood flow delivery. Investigation and direct comparison of hemodynamic parameters that help characterize performance of MCS devices has been limited. We quantified cardiac and vascular hemodynamic responses for different types of MCS devices. Continuous flow (CF) left ventricular (LV) assist devices (LVAD) with LV or left atrial (LA) inlet, counterpulsation devices, percutaneous CF LVAD, and intra-aortic rotary blood pumps (IARBP) were quantified using established computer simulation and mock flow loop models...
July 13, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28706270/comprehensive-multi-dimensional-mri-for-the-simultaneous-assessment-of-cardiopulmonary-anatomy-and-physiology
#11
Joseph Y Cheng, Tao Zhang, Marcus T Alley, Martin Uecker, Michael Lustig, John M Pauly, Shreyas S Vasanawala
Diagnostic testing often assesses the cardiovascular or respiratory systems in isolation, ignoring the major pathophysiologic interactions between the systems in many diseases. When both systems are assessed currently, multiple modalities are utilized in costly fashion with burdensome logistics and decreased accessibility. Thus, we have developed a new acquisition and reconstruction paradigm using the flexibility of MRI to enable a comprehensive exam from a single 5-15 min scan. We constructed a compressive-sensing approach to pseudo-randomly acquire highly subsampled, multi-dimensionally-encoded and time-stamped data from which we reconstruct volumetric cardiac and respiratory motion phases, contrast-agent dynamics, and blood flow velocity fields...
July 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28705745/massive-diltiazem-and-metoprolol-overdose-rescued-with-extracorporeal-life-support
#12
James A Chenoweth, Daniel K Colby, Mark E Sutter, Joshua B Radke, Jonathan B Ford, J Nilas Young, John R Richards
The management of overdoses of cardioactive medications in the emergency department can be challenging. The reversal of severe toxicity from one or more types of cardioactive medication may fail maximal medical therapies and require extreme invasive measures such as transvenous cardiac pacing and extracorporeal life support. We present a case of massive diltiazem and metoprolol overdose refractory to maximal medical therapy, including intravenous calcium, glucagon, vasopressors, high dose insulin, and lipid emulsion...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28701611/the-utility-of-targeted-perioperative-transthoracic-echocardiography-in-managing-an-adult-patient-with-anomalous-origin-of-the-left-coronary-artery-pulmonary-artery-for-noncardiac-surgery
#13
Anudeep Jafra, Suman Arora, Aveek Jayant
Congenital coronary artery anomalies as a whole are uncommon. Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is probably the most common congenital coronary defect. An overwhelming majority of the patients with untreated ALCAPA do not survive to adulthood. As yet, there is no consensus on the management of adults with ALCAPA. We describe a patient with breast malignancy and incidentally detected ALCAPA; primacy was given to treatment of the oncologic condition as a first step...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#14
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28695407/nuclear-cardiology-in-china-2017
#15
Gongshun Tang
This paper provides the current state of nuclear cardiology in China and contrasts it with the state of nuclear cardiology in the United States (US). The West China Hospital and New York-Presbyterian Hospital (NYPH) were used as representative hospitals to contrast nuclear cardiology in China and the US, respectively. In 2015, there were 101 medical cyclotrons, 774 SPECT or SPECT/CT, 240 PET/CT, and 6 PET/MR cameras in China. Most (~90%) of the nuclear cardiology studies are gated SPECT myocardial perfusion imaging (MPI), and ~10% are other types of studies including MUGA, PET/CT MPI, and viability studies...
July 10, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#16
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28689799/cardioprotective-effects-of-viscum-album-l-subsp-album-european-misletoe-leaf-extracts-in-myocardial-ischemia-and-reperfusion
#17
Eylem Suveren, Gary F Baxter, Alper B Iskit, Arzu Ucar Turker
ETHNOPHARMACOLOGICAL RELEVANCE: Viscum album L. (European mistletoe) is a hemiparasitic plant belonging to Loranthaceae family and has been used in Turkish traditional medicine for the treatment of cardiovascular disorders and heart diseases such as hypertension, tachycardia and angina pectoris. AIM OF THE STUDY: The present study investigated the cardioprotective effects of V. album leaf extracts in myocardial ischemia and reperfusion injury in rats. MATERIAL AND METHODS: Lyophilized aqueous (AVa) and methanolic (MVa) extracts of V...
July 6, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28689254/desensitization-of-the-human-5-ht4-receptor-in-isolated-atria-of-transgenic-mice
#18
Ulrich Gergs, Julia Fritsche, Stephanie Fabian, Josepha Christ, Joachim Neumann
In the human cardiovascular system, serotonin (5-HT) exerts positive inotropic and chronotropic effects mediated by 5-HT4 receptors. Moreover, 5-HT4 receptor stimulation can cause arrhythmias in the human heart. Response to 5-HT can fade due to desensitization of the receptor system and/or activation of phosphodiesterases. In this study, we investigated a potential desensitization of the human 5-HT4(a) receptor expressed in the mouse heart. Therefore, we have used atrial preparations of transgenic (TG) mice with cardiac myocyte-specific overexpression of the human 5-HT4(a) receptor and their non-transgenic littermates (WT)...
July 8, 2017: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/28687967/relationship-of-non-invasive-quantification-of-myocardial-blood-flow-to-arrhythmic-events-in-patients-with-implantable-cardiac-defibrillators
#19
Michael Ghannam, Krasimira Mikhova, Hong Jun Yun, John J Lazarus, Matthew Konerman, Ashraf Saleh, Richard L Weinberg, Ryan Cunnane, Ravi V Shah, Keri M Hiller, Edward P Ficaro, James R Corbett, Venkatesh L Murthy
BACKGROUND: Ischemia contributes to arrhythmogenesis though its role is incompletely understood. Abnormal myocardial perfusion measured by PET imaging may predict ventricular arrhythmias (VAs) in a high-risk population. METHODS: Patients with implantable cardiac defibrillators who had undergone rubidium-82 cardiac PET imaging were identified. Patients were stratified by median MBF and MFR values for analysis. The Cox proportional hazards model was used to assess the impact of myocardial perfusion on survival free of VT independent of critical covariates...
July 7, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28687587/foxo1-regulates-myocardial-glucose-oxidation-rates-via-transcriptional-control-of-pyruvate-dehydrogenase-kinase-4-expression
#20
Keshav Gopal, Bruno Saleme, Rami Al Batran, Hanin Aburasayn, Amina Eshreif, Kim L Ho, Wayne K Ma, Malak Almutairi, Farah Eaton, Manoj Gandhi, Edwards A Park, Gopinath Sutendra, John R Ussher
Pyruvate dehydrogenase (PDH) is the rate-limiting enzyme for glucose oxidation and a critical regulator of metabolic flexibility during the fasting to feeding transition. PDH is regulated via both PDH kinases (PDHK), and PDH phosphatases, which phosphorylate/inactivate and dephosphorylate/activate PDH, respectively. Our goal was to determine whether the transcription factor, forkhead box O1 (FoxO1) regulates PDH activity and glucose oxidation in the heart via increasing expression of Pdk4, the gene encoding PDHK4...
July 7, 2017: American Journal of Physiology. Heart and Circulatory Physiology
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