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Non invasive cardiac output

Paul R Territo, Amanda A Riley, Brian P McCarthy, Gary D Hutchins
Recent advancements in PET instrumentation have made the non-invasive assessment of cardiovascular function in small animals a reality. The majority of small animal PET systems use stationary detector gantries, thus affording high temporal resolution imaging of cardiac function. Systems designed to maximize spatial resolution and detection sensitivity employing rotating gantry designs are suboptimal when high temporal resolution imaging is needed. To overcome this limitation, the current work developed a novel view-sharing data analysis scheme suitable for dynamic cardiac PET imaging using (18)F-NaF as the tracer and tracer kinetic model analysis...
December 2016: EJNMMI Physics
Pavol Sajgalik, Vaclav Kremen, Alex R Carlson, Vratislav Fabian, Chul-Ho Kim, Courtney M Wheatley, Vaclav Gerla, John A Schirger, Thomas P Olson, Bruce D Johnson
Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology and anesthesiology. Non-invasive techniques available are technically challenging, and thus difficult to use outside of the clinical or laboratory setting. We propose a novel method of non-invasive CO assessment using a single upper arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20 second intervals of suprasystolic occlusion. This method was evaluated on a cohort of 12 healthy individuals (age of 27...
October 20, 2016: Journal of Applied Physiology
Kara Rye, Gerri Mortimore, Andrew Austin, Jan Freeman
BACKGROUND/AIMS: Cirrhosis and portal hypertension are characterised by a hyperdynamic circulation, which is independently associated with variceal size. Non-invasive techniques for measurement of systemic haemodynamics are now available. The aim of the study was to prospectively assess the accuracy of systemic haemodynamics measured non-invasively for the detection of oesophageal varices in cirrhotic patients as compared to other currently available non-invasive methods. METHODS: In a study of 29 cirrhotic patients, systemic haemodynamics were studied non-invasively using the Finometer(®) (mean arterial pressure (MAP), cardiac output (CO)/index, heart rate (HR), peripheral vascular resistance) and portal pressure was assessed by hepatic venous pressure gradient...
September 2016: Journal of Clinical and Experimental Hepatology
Saulius Sadauskas, Albinas Naudžiūnas, Alvydas Unikauskas, Edita Mašanauskienė, Giedrė Bakšytė, Andrius Macas
BACKGROUND Heart failure (HF) accounts for about 5% of all causes of urgent hospital admissions, and the overall mortality of HF patients within 1 year after hospitalization is 17-45%. Transthoracic impedance cardiography (ICG) is a safe, non-invasive diagnostic technique that helps to detect various parameters that define different cardiac functions. The aim of this study was to investigate the value of ICG parameters in patients hospitalized due to HF flare-ups. MATERIAL AND METHODS The study included 60 patients (24 women and 36 men) who were admitted to intensive care units because of an acute episode of HF without signs of myocardial infarction...
October 9, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
M C Vallejo, A F Attaallah, O M Elzamzamy, D T Cifarelli, A L Phelps, G R Hobbs, R E Shapiro, P Ranganathan
BACKGROUND: During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. METHODS: Eighty-five parturients having spinal anesthesia for elective cesarean delivery were randomized to Group P (phenylephrine 0...
August 28, 2016: International Journal of Obstetric Anesthesia
Dimuthu Vinayagam, Sophie Bowe, Elaine Sheehan, Basky Thilaganathan, Asma Khalil
BACKGROUND: Due to the importance of cardiovascular dysfunction and advances in the development and use of non-invasive cardiac output (CO) monitoring devices, there is a growing interest in their use in the obstetric population. The aim of this study was to compare two commercially available, non-invasive CO monitors in the assessment of heart rate (HR), stroke volume (SV), CO, cardiac index (CI) and total peripheral resistance (TPR) in an obstetric population. METHODS: This was a prospective, comparative study including two groups...
October 6, 2016: Fetal Diagnosis and Therapy
Mengyang Liu, Zhe Chen, Behrooz Zabihian, Christoph Sinz, Edward Zhang, Paul C Beard, Laurin Ginner, Erich Hoover, Micheal P Minneman, Rainer A Leitgeb, Harald Kittler, Wolfgang Drexler
Cutaneous blood flow accounts for approximately 5% of cardiac output in human and plays a key role in a number of a physiological and pathological processes. We show for the first time a multi-modal photoacoustic tomography (PAT), optical coherence tomography (OCT) and OCT angiography system with an articulated probe to extract human cutaneous vasculature in vivo in various skin regions. OCT angiography supplements the microvasculature which PAT alone is unable to provide. Co-registered volumes for vessel network is further embedded in the morphologic image provided by OCT...
September 1, 2016: Biomedical Optics Express
D Vinayagam, O Patey, B Thilaganthan, A Khalil
INTRODUCTION: There is a paucity of data regarding the accuracy, reliability and reproducibility of non-invasive cardiac output monitors in pregnancy. The aim of this study was to compare cardiac output estimations obtained by USCOM® against those obtained by 2-dimensional transthoracic echocardiography (TTE). METHODS: Prospective, observational study in which 114 healthy pregnant and postpartum women had haemodynamic indices obtained by USCOM® and TTE. Accuracy and precision statistics (Bland Altman analysis) are presented as bias, precision, 95% limits of agreement (LOA) and mean percentage difference (MPD)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, Elena Mantovani, B Thilaganthan, A Khalil
BACKGROUND: Hypertensive disorders in pregnancy (HDP) are associated with altered maternal haemodynamics, which can be investigated using non-invasive methodologies. OBJECTIVE: To assess maternal haemodynamics using USCOM 1A® in patients presenting with non-medicated, hypertensive disorders of pregnancy and normotensive controls. METHODS: A prospective, nested case-control study in 65 patients presenting with unmedicated hypertension. The control population consisted of 400 subjects who did not have a history of hypertensive disorders...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, Juan Gutierrez, J Binder, B Thilaganathan, A Khalil
BACKGROUND: The increase in the prevalence of and the adverse risks to both mother and foetus associated with maternal obesity is a global concern. The adverse cardiovascular risk associated with obesity is well-known, however, there is a paucity of data assessing central haemodynamics in class 3 (morbid) obesity (BMI440 kg/m(2)) during pregnancy. OBJECTIVE: To compare the haemodynamic profile in women with class 3 maternal obesity against those with a normal BMI (20-30 kg/m(2)), using ultrasound-based, non-invasive haemodynamic monitoring...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, S Bampoe, B Thilaganathan, A Khalil
BACKGROUND: Intraoperative haemodynamic monitoring is carried out in high-risk surgical patients, often using invasive methods, including pulmonary artery catheterisation. Early goal-directed therapy in high-risk surgical patients reduces tissue hypoxia, organ failure and improves outcomes. Significant maternal morbidity arises as a result of perioperative haemorrhage. At present, heart rate and brachial blood pressure are used as proxy markers to aid in fluid resuscitation, however, we know that these exhibit minimal change during early stages of shock, and are poor indicators of the adequacy of therapeutic intervention...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Farsetti, D Lo Presti, I Pisani, G M Tiralongo, G Gagliardi, B Vasapollo, G P Novelli, H Valensise
INTRODUCTION: The purpose of our study was to evaluate the maternal haemodynamic profile in women diagnosed with threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease. METHODS: Sixty-eight patients diagnosed with TPD were enrolled and assessed using a non-invasive method (USCOM®) to determine the haemodynamic parameters. Cervix length assessment, vaginal and rectal swabs, blood inflammatory indexes, foetal vessel Doppler velocimetry, gestational age at the delivery and neonatal outcomes were considered...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
J Tay, L Foo, C McEniery, I Wilkinson, C Lees
INTRODUCTION: This pilot study aims to compare cardiac output (CO) and total peripheral resistance (TPR) in pregnancies with fetal growth restriction (FGR) with healthy normal third trimester of pregnancies. Most studies previously done on cardiac parameters in pregnancy focused mainly on pre-eclampsia (PE) and FGR with PE, but not in normotensive FGR women. METHODS: Eight pregnancies with FGR (AC < 10th percentile with raised umbilical PI) in the third trimester (27-35 weeks gestation) compared with 42 uncomplicated ongoing pregnancies within similar gestation bands...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, O Patey, B Thilaganthan, A Khalil
INTRODUCTION: There is a paucity of data regarding the accuracy, reliability and reproducibility of non-invasive cardiac output monitors in pregnancy. The aim of this study was to compare cardiac output estimations obtained by USCOM® against those obtained by two-dimensional transthoracic echocardiography (TTE). METHODS: Prospective, observational study in which 114 healthy pregnant and postpartum women had haemodynamic indices obtained by USCOM® and TTE. Accuracy and precision statistics (Bland Altman analysis) are presented as bias, precision, 95% limits of agreement (LOA) and mean percentage difference (MPD)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Lin Foo, Jerome Cornette, Jasmine Tay, Christoph Lees
INTRODUCTION: There are multiple modalities used to measure cardiac output in pregnancy. The accepted gold standard is cardiac catheterisation, then measurement via direct Fick method or thermo-dilution. These methods are invasive and not feasible for assessment of healthy pregnant women. There are several non-invasive devices widely used to measure cardiac output including Innocor, an inert gas re-breathing technique which has been validated against thermodilution [1-3] and direct Fick methods [4,5] for measurement of pulmonary blood flow and thus, cardiac output...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
P Schraverus, M M Kuijpers, J Coumou, C A Boly, C Boer, S van Kralingen
Morbidly obese patients are at increased risk of intra-operative haemodynamic instability, which may necessitate intensive monitoring. Non-invasive monitoring is increasingly used to measure cardiac output; however, it is unknown whether the weight-based algorithm utilised in these devices is applicable to patients with morbid obesity. We compared the level of agreement and trending ability of non-invasive cardiac output measurements (Nexfin(®) ) with the gold-standard thermodilution technique in 30 morbidly obese patients undergoing laparoscopic surgery...
September 26, 2016: Anaesthesia
Sabri Soussi, Benjamin Deniau, Axelle Ferry, Charlotte Levé, Mourad Benyamina, Véronique Maurel, Maïté Chaussard, Brigitte Le Cam, Alice Blet, Maurice Mimoun, Jêrome Lambert, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand
BACKGROUND: Impact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients. METHODS: Retrospective, single-center cohort study was conducted in a university hospital. Forty critically ill burn patients with total body surface area (TBSA) burn-injured >20 % with invasive blood pressure and cardiac output monitoring (transpulmonary thermodilution technique) within 8 h from trauma were included...
December 2016: Annals of Intensive Care
Martina Maass, Benjamin Krausgrill, Simon Eschrig, Tobias Kaluschke, Katja Urban, Gabriel Peinkofer, Tobias G Plenge, Simon Oeckenpöhler, Martin Raths, Dennis Ladage, Marcel Halbach, Jürgen Hescheler, Jochen Müller-Ehmsen
Cardiac cell replacement therapy is a promising therapy to improve cardiac function in heart failure. Persistence, structural and functional maturation and integration of transplanted cardiomyocytes into recipient's hearts are crucial for a safe and efficient replacement of lost cells. We studied histology, electrophysiology and quantity of intramyocardially transplanted rat neonatal cardiomyocytes (NCM) and performed a detailed functional study with repeated invasive (pressure-volume-catheter) and non-invasive (echocardiography) analyses of infarcted female rat hearts including pharmacological stress before and 3 weeks after intramyocardial injection of 5x10(6) (low-NCM) or 25x10(6) (high-NCM) syngeneic male NCM or medium as placebo (Ctrl)...
August 17, 2016: Cell Transplantation
Thomas Freidl, Nariae Baik, Gerhard Pichler, Bernhard Schwaberger, Barbara Zingerle, Alexander Avian, Berndt Urlesberger
BACKGROUND: Substantial haemodynamic changes occur during the first minutes after birth. Currently, only heart rate (HR) and arterial oxygen saturation are routinely used to monitor haemodynamic transition after birth. OBJECTIVES: The aim of the present study was to continuously assess haemodynamic changes during transition in term infants for the first time by using electrical velocimetry (EV), a new method of non-invasive cardiac output monitoring (NICOM), based on impedance cardiography technology...
August 17, 2016: Neonatology
Guido Claessen, Andre La Gerche, Thibault Petit, Hilde Gillijns, Jan Bogaert, Mathias Claeys, Steven Dymarkowski, Piet Claus, Marion Delcroix, Hein Heidbuchel
BACKGROUND: Non-invasive estimates have suggested that asymptomatic BMPR2 mutation carriers may have an abnormal pulmonary vascular response to exercise and hypoxia. However, this has not been assessed with "gold standard" invasive measures. METHODS: Eight controls and 8 asymptomatic BMPR2 mutation carriers underwent cardiac magnetic resonance imaging with simultaneous invasive pressure recording during bicycle exercise in normoxia, hypoxia and after sildenafil administration...
June 24, 2016: Journal of Heart and Lung Transplantation
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