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hemodynamic optimization

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https://www.readbyqxmd.com/read/27920830/impact-of-catheter-ablation-of-ventricular-tachycardia-in-patients-with-prior-myocardial-infarctions
#1
Masato Fukunaga, Masahiko Goya, Kenichi Hiroshima, Kentaro Hayashi, Masatsugu Ohe, Yu Makihara, Michio Nagashima, Yoshimori An, Shinichi Shirai, Kenji Ando, Hiroyoshi Yokoi, Masashi Iwabuchi
BACKGROUND: Catheter ablation can reduce episodes of ventricular tachycardia (VT) after myocardial infarction (MI). However, the optimal endpoint of the ablation procedure remains unclear. METHODS: Fifty-one consecutive patients who received catheter ablation for VT after MI were included. The procedures targeted the isthmus of all the induced, sustained VTs. When the patients with induced VTs were hemodynamically stable, radiofrequency energy was delivered at the mid-diastolic potential recording site during VT...
December 2016: Journal of Arrhythmia
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
#2
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/27919850/detection-and-differentiation-of-early-hepatocellular-carcinoma-from-cirrhosis-using-ct-perfusion-in-a-rat-liver-model
#3
Jin-Ping Li, Guang-Long Feng, Da-Qing Li, Hai-Bo Wang, De-Li Zhao, Yong Wan, Hui-Jie Jiang
BACKGROUND: Functional imaging such as CT perfusion can detect morphological and hemodynamic changes in hepatocellular carcinoma (HCC). Pre-carcinoma and early HCC nodules are difficult to differentiate by observing only their hemodynamics changes. The present study aimed to investigate hemodynamic parameters and evaluate their differential diagnostic cut-off between pre-carcinoma and early HCC nodules using CT perfusion and receiver operating characteristic (ROC) curves. METHODS: Male Wistar rats were randomly divided into control (n=20) and experimental (n=70) groups...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27917341/the-effect-of-n-acetyl-cysteine-nac-on-aluminum-phosphide-poisoning-inducing-cardiovascular-toxicity-a-case-control-study
#4
Fakhreddin Taghaddosinejad, Esmaeil Farzaneh, Mahdi Ghazanfari-Nasrabad, Nastaran Eizadi-Mood, Morteza Hajihosseini, Omid Mehrpour
BACKGROUND: Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning. METHODS: This research was a case-control study to evaluate 63 AlP poisoned patients during 2010-2012. Patients with cardiovascular complications of AlP to be treated with intravenous NAC plus conventional treatment were considered as the case group and compared with patients who did not receive NAC...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27916351/circumflex-scapular-artery-myocutaneous-and-or-vascularized-scapular-chimeric-flap
#5
Arzu Akcal, Tahsin Gorgulu, Seckin Aydin Savas, Mehmet Af Akcal, Mehmet Can Ubur, Cumhur Ibrahim Bassorgun
BACKGROUND: Chimeric osteomyocutaneous flaps harvested from the subscapular artery system have been used in clinical practice. We describe the use of a novel circumflex scapular artery myocutaneous and/or vascularized scapular chimeric flap in a rat model and demonstrate optimal skin flap dimensions. MATERIALS AND METHODS: An 8 × 4-cm-rectangular skin flap based on the circumflex scapular artery flap was harvested, and the mean percentage of the surviving flap area and the necrotic area were calculated to be 71% ± 17...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27912248/mean-arterial-blood-pressure-management-of-acute-spinal-cord-injured-patients-during-the-pre-hospital-and-early-admission-period
#6
Jin Wee Tee, Farhaan Altaf, Lise M Belanger, Tamir Ailon, John Street, Scott J Paquette, Michael C Boyd, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5 to 7 days following acute traumatic SCI is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU) or operating room (OR)...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27912199/right-ventricular-dyssynchrony-predicts-clinical-outcomes-in-patients-with-pulmonary-hypertension
#7
Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Yugo Minakata, Jin Endo, Hikaru Tsuruta, Yuji Itabashi, Yuichiro Maekawa, Keiichi Fukuda
BACKGROUND: RV dyssynchrony has been described in patients with pulmonary hypertension (PH) and is an independent predictor of clinical worsening; however, the optimal method for measuring RV dyssynchrony has not been fully established. This study aimed to investigate whether RV dyssynchrony is correlated with hemodynamics and prognosis in PH patients and to identify the best parameter for evaluating RV dyssynchrony. METHODS: This study assessed 100 PH patients, measuring mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) by right heart catheterization (RHC)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27908148/local-attenuation-curve-optimization-framework-for-high-quality-perfusion-maps-in-low-dose-cerebral-perfusion-ct
#8
Vincent Van Nieuwenhove, Geert Van Eyndhoven, K Joost Batenburg, Nico Buls, Jef Vandemeulebroucke, Jan De Beenhouwer, Jan Sijbers
PURPOSE: Cerebral perfusion x-ray computed tomography (PCT) is a powerful tool for noninvasive imaging of hemodynamic information throughout the brain. Conventional PCT requires the brain to be imaged multiple times during the perfusion process, and hence radiation dose is a major concern. The authors propose a PCT reconstruction algorithm that allows for lowering the dose while maintaining a high quality of the perfusion maps. It relies on an accurate estimation of the arterial input function (AIF), which in turn depends on the quality of the attenuation curves in the arterial region...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27892886/safety-profile-and-utility-of-treadmill-exercise-in-patients-with-high-gradient-hypertrophic-cardiomyopathy
#9
Lars Lindholm Sorensen, Hsin-Yueh Liang, Aurelio Pinheiro, Alex Hilser, Veronica Dimaano, Niels Thue Olsen, Thomas Fritz Hansen, Peter Sogaard, Alexandra Nowbar, Chiara Pisanello, Iraklis Pozios, Susan Phillip, Xun Zhou, Roselle Abraham, Theodore P Abraham
: Exercise echocardiography in the evaluation of hypertrophic cardiomyopathy (HCM) provides valuable information for risk stratification, selection of optimal treatment, and prognostication. However, HCM patients with left ventricular outflow tract gradients ≥30mm Hg are often excluded from exercise testing because of safety considerations. We examined the safety and utility of exercise testing in patients with high-gradient HCM. METHODS: We evaluated clinical characteristics, hemodynamics, and imaging variables in 499 consecutive patients with HCM who performed 959 exercise tests...
October 20, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27890512/safety-and-efficacy-of-valve-repositioning-during-transcatheter-aortic-valve-replacement-with-the-lotus-valve-system
#10
Hashrul N Z Rashid, Robert Gooley, Liam McCormick, Sarah Zaman, Satish Ramkumar, Damon Jackson, Ameera Amiruddin, Arthur Nasis, James Cameron, Ian T Meredith
OBJECTIVE: To determine the safety and efficacy of valve repositioning following transcatheter aortic valve replacement (TAVR) with the Lotus Valve System (Boston Scientific, Marlborough, MA, USA). INTRODUCTION: TAVR is a well-established treatment for severe aortic stenosis. The Lotus Valve System is fully repositionable and retrievable. Valve repositioning has the potential to minimize TAVR-related complications caused by valve malposition; however, the effect on adverse event rates such as stroke is unknown...
November 24, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27886925/the-role-of-atrioventricular-and-interventricular-optimization-for-cardiac-resynchronization-therapy
#11
REVIEW
Daniel B Cobb, Michael R Gold
Many patients with left ventricular systolic dysfunction may benefit from cardiac resynchronization therapy; however, approximately 30% of patients do not experience significant clinical improvement with this treatment. AV and VV delay optimization techniques have included echocardiography, device-based algorithms, and several other novel noninvasive techniques. Using these techniques to optimize device settings has been shown to improve hemodynamic function acutely; however, the long-term clinical benefit is limited...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27885752/biventricular-paced-qrs-area-predicts-acute-hemodynamic-crt-response-better-than-qrs-duration-or-qrs-amplitudes
#12
Jan DE Pooter, Milad El Haddad, Marc DE Buyzere, Hernandez Alfonso Aranda, Richard Cornelussen, Berthold Stegemann, Christopher A Rinaldi, Maciej Sterlinski, Adam Sokal, Darrel P Francis, Luc Jordaens, Roland X Stroobandt, Frederic VAN Heuverswyn, Frank Timmermans
INTRODUCTION: Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR). METHODS AND RESULTS: VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system...
November 25, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27885749/biophysical-modeling-to-determine-the-optimization-of-left-ventricular-pacing-site-and-av-vv-delays-in-the-acute-and-chronic-phase-of-cardiac-resynchronization-therapy
#13
Angela Lee, Andrew Crozier, Eoin R Hyde, Pablo Lamata, Michael Truong, Manav Sohal, Thomas Jackson, Jonathan M Behar, Simon Claridge, Anoop Shetty, Eva Sammut, Gernot Plank, Christopher Aldo Rinaldi, Steven Niederer
BACKGROUND: Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. OBJECTIVE: To predict the effects of chronic CRT on the optimal LV lead location and device timing settings over time. METHODS: Biophysical computational cardiac models were generated for 3 patients, immediately post-implant (ACUTE) and after at least 6 months of CRT (CHRONIC)...
November 25, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27884233/hypertension-left-ventricular-hypertrophy-and-myocardial-ischemia
#14
REVIEW
Tony Stanton, Francis G Dunn
The risks associated with hypertension emerge through a series of complex interactions. Myocardial ischemia is the major contributor to this risk. The mechanisms driving ischemia reflect many of the key factors in hypertension, including endothelial and neurohumoral factors, fibrosis, and hemodynamics. Left ventricular hypertrophy and fibrosis are of fundamental importance and together with hemodynamics provide an optimal template for myocardial ischemia. Understanding the pathophysiology has aided a more rational management approach but challenges remain which, if surmounted, will have an impact on the morbidity and mortality caused by myocardial ischemia in patients with hypertension...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27883333/design-of-a-simple-coronary-impedance-simulator-for-the-in-vitro-study-of-the-complex-coronary-hemodynamics
#15
Marco Piola, Riccardo Vismara, Giordano Tasca, Federico Lucherini, Paola Redaelli, Monica Soncini, Claudia Romagnoni, Andrea Mangini, Carlo Antona, Gianfranco Beniamino Fiore
Several novel approaches were recently developed to treat aortic root pathologies. The alteration induced by some of these approaches to the biomechanics of the aortic root could possibly affect the coronary perfusion, compromising the procedural outcome. In this scenario, the need to replicate in vitro the coronary flow pattern in physiological and pathological conditions is becoming crucial for the functional assessment of novel devices and techniques. This article describes the design of an easy-to-use, left-and-right coronary impedance simulator, coupled with native aortic roots for in vitro pulsatile tests...
November 24, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#16
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27871987/body-surface-mapping-using-an-ecg-belt-to-characterize-electrical-heterogeneity-for-different-left-ventricular-pacing-sites-during-cardiac-resynchronization-relationship-with-acute-hemodynamic-improvement
#17
W Ben Johnson, Pierce J Vatterott, Michael A Peterson, Suveer Bagwe, R Dent Underwood, Alan J Bank, Ryan M Gage, Brian Ramza, Blair W Foreman, Vincent Splett, Tarek Haddad, Jeffrey M Gillberg, Subham Ghosh
BACKGROUND: Electrical heterogeneity (EH) during cardiac resynchronization therapy (CRT) may vary with different left ventricular (LV) pacing sites. OBJECTIVE: The study aims to evaluate the relationship between such changes and acute hemodynamic response (AHR). METHODS: Two EH metrics, standard deviation of activation times (SDAT) and mean left thorax activation time (LTAT), were computed from isochronal maps based on 53-electrode body-surface mapping (BSM) during baseline AAI pacing and biventricular pacing (BiVp) from different pacing sites in coronary veins in 40 CRT-indicated patients...
November 18, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27871575/dose-requirements-of-alfentanil-to-eliminate-autonomic-responses-during-rapid-sequence-induction-with-thiopental-4-mg-kg-and-rocuronium-0-6-mg-kg
#18
Mohammad H Abou-Arab, Morten Rostrup, Tom Heier
STUDY OBJECTIVE: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. DESIGN: Prospective, randomized, observer-blinded, interventional clinical study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867139/in-vivo-validation-of-mathematically-derived-fractional-flow-reserve-for-assessing-hemodynamics-of-coronary-tandem-lesions
#19
Jihoon Kweon, Young-Hak Kim, Dong Hyun Yang, June-Goo Lee, Jae-Hyung Roh, Gary S Mintz, Seung-Whan Lee, Seong-Wook Park
AIMS: To propose a prediction model for the post-stenting fractional flow reserve (FFR'd,pred) at a position distal to the tandem lesion. METHODS AND RESULTS: Using the FFR at a position proximal to the tandem lesion (FFRp), the FFR gradients across proximal (ΔFFRp) and distal (ΔFFRd) stenoses, FFR'd,pred after treating either the distal or proximal lesion was predicted as FFRp-ΔFFRp/(1-1.33kΔFFRd) or FFRp- ΔFFRd/(1-1.33ΔFFRp), respectively. The flow fraction of the distal main branch (k) was estimated using the diameter ratio of side to distal main branches...
November 22, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27866675/hemodynamics-of-patient-specific-aorta-pulmonary-shunt-configurations
#20
Senol Piskin, H Firat Altin, Okan Yildiz, Ihsan Bakir, Kerem Pekkan
Optimal hemodynamics in aorta-pulmonary shunt reconstruction is essential for improved post-operative recovery of the newborn congenital heart disease patient. However, prior to in vivo execution, the prediction of post-operative hemodynamics is extremely challenging due to the interplay of multiple confounding physiological factors. It is hypothesized that the post-operative performance of the surgical shunt can be predicted through computational blood flow simulations that consider patient size, shunt configuration, cardiac output and the complex three-dimensional disease anatomy...
November 11, 2016: Journal of Biomechanics
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