wedge pressure

BACKGROUND: In patients with valgus alignment and degenerative changes in the lateral compartment, both distal femoral osteotomy (DFO) and high tibial osteotomy (HTO) can be used to unload the lateral compartment. Prior studies have shown that in valgus knees, the tibial wear is posterior and DFO exerts the greatest effect in extension; however, its effect is decreased as flexion angle rises. HYPOTHESIS: Medial closing-wedge (MCW) HTO would significantly decrease contact area, mean contact pressure (MCP), and peak contact pressure (PCP) in the lateral knee compartment through knee flexion to a greater extent compared with lateral opening-wedge (LOW) DFO...

To better understand the three-dimensional topology of the interaction between the shock train and the background wave, the steady and dynamic characteristics of a shock train were investigated using wind-tunnel experiments and numerical simulation. A 14° wedge placed at the bottom and sidewalls was used to generate background waves traveling in different directions. Mounting the wedge on the bottom wall at an incoming Mach number of 1.85 leads to the formation of two symmetric and two asymmetric λ-shaped shock train leading shocks (STLSs), while an incoming Mach number of 2...

BACKGROUND: With emerging therapies, early diagnosis of heart failure with preserved ejection fraction (HFpEF) comes to the fore. Whilst the reference standard of exercise-stress right heart catheterisation is well established, the clinical routine struggles between feasibility of exercise-stress and diagnostic accuracy of available tests. METHODS: The HFpEF Stress Trial (DZHK-17) prospectively enrolled 75 patients with exertional dyspnoea and echocardiographic signs of diastolic dysfunction (E/e' > 8) who underwent simultaneous rest and exercise-stress echocardiography and RHC...

BACKGROUND: Reduced hindfoot eversion motion has been proposed as a cause of increased lateral foot pressure following lateral column lengthening (LCL) for progressive collapsing foot deformity (PCFD). A subjective intraoperative assessment of passive eversion has been suggested to help evaluate correction; however, it is unclear how passive eversion correlates with objective measurements of foot stiffness. Our objectives were to quantify the relationship between the maximum passive eversion in hindfoot joints following LCL with plantar pressure during stance and to determine the influence of wedge size on these outcomes...

BACKGROUND: Our study aimed to assess the clinical and hemodynamic characteristics of pulmonary hypertension (PH) in patients with overlapping obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), referred to OSA-COPD overlap syndrome (OS). METHODS: We enrolled a total of 116 patients with OS, COPD, or OSA who underwent right heart catheterization (RHC) due to suspected pulmonary hypertension (PH). We conducted a retrospective analysis of the clinical and hemodynamic characteristics of these patients...

Simultaneous multiplexed analysis can provide comprehensive information for disease diagnosis. However, the current multiplex methods rely on sophisticated barcode technology, which hinders its wider application. In this study, an ultrasimple size encoding method is proposed for multiplex detection using a wedge-shaped microfluidic chip. Driving by negative pressure, microparticles are naturally arranged in distinct stripes based on their sizes within the chip. This size encoding method demonstrates a high level of precision, allowing for accuracy in distinguishing 3-5 sizes of microparticles with a remarkable accuracy rate of up to 99%, even the microparticles with a size difference as small as 0...

Objective: This study aims to investigate the patterns of plantar pressure distribution during running for patients with subtle cavus foot (SCF) and determine the impact of personalized orthopedic insoles with forefoot wedge on plantar pressure distribution in patients with SCF. Methods: Sixteen undergraduate participants (8 with SCF and 8 with normal arches) were recruited based on arch height index measurements. Two full-length insoles were personalized for each SCF based on plantar pressures during running, an arch support insole (ASI) and an arch support with forefoot wedge insole (AFI)...

OBJECTIVES: To identify preoperative predictors of post-cardiotomy cardiogenic shock in patients with ischemic and non-ischemic cardiomyopathy and evaluate trajectory of postoperative ventricular function. METHODS: From 1/2017-1/2020, 238 patients with ejection fraction <30% (206/238) or 30-34% with at least moderately severe mitral regurgitation (32/238) underwent conventional cardiac surgery at Cleveland Clinic, 125 with ischemic and 113 with non-ischemic cardiomyopathy...

AIMS: Obesity and epicardial adiposity play a role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF), and both are associated with increased filling pressures and reduced exercise capacity. The haemodynamic basis for these observations remains inaccurately defined. We hypothesize that an abundance of epicardial adipose tissue (EAT) within the pericardial sac is associated with haemodynamic signs of pericardial constraint. METHODS AND RESULTS: HFpEF patients who underwent invasive heart catheterization with simultaneous echocardiography were included...

BACKGROUND: Identification of increased pulmonary capillary wedge pressure (PCWP) by right heart catheterisation (RHC) is the reference standard for the diagnosis of heart failure with preserved ejection fraction (HFpEF). Recently, cardiovascular magnetic resonance (CMR) imaging estimation of PCWP at rest was introduced as a non-invasive alternative. Since many patients are only identified during physiological exercise-stress we hypothesised that novel exercise-stress CMR derived PCWP emerges superior compared to its assessment at rest...

The left atrium (LA) mediates cardiopulmonary interactions. During ventricular systole, the LA functions as a compliant reservoir that is coupled to the left ventricle (LV) and offloads volume from the pulmonary vasculature. We aimed to describe LA reservoir function using phasic relationships between pulmonary artery wedge pressure (PAWP) and LA volume events. We included healthy adults (7M/6F, 56±8 years) who were studied at rest and during semi-recumbent cycle ergometry at a target 100 b/min. heart rate...

This paper develops an antagonistic variable-stiffness pneumatic flexible joint in which two groups of artificial muscles are symmetrically distributed on both sides of the elastic thin plate. The elastic thin plate restricts the axial movement of the joint. Therefore, the joint can achieve single-dimensional and bidirectional bending by controlling the air pressure value of the pneumatic artificial muscle. Two variable stiffness elastic dampers are also symmetrically installed on both sides of the elastic thin plate, using a positive-pressure driving method to achieve real-time posture maintenance function of the joint based on particle-blockage, wedge structure, and antagonistic effect...

INTRODUCTION: Assessing filling pressure (FP) remains a clinical challenge despite advancements in non-invasive imaging techniques. This study investigates the utility of echocardiographic left ventricular (LV) to left atrial (LA) volume ratio in estimating the resting FP in patients with dyspnoea and preserved ejection fraction (EF). METHODS: This study is a prospective, single-centre analysis of 53 consecutive patients with dyspnoea (New York Heart Association grade 2 or 3) and LVEF of ≥50% (mean age 71 ± 10 years) who underwent cardiac catheterisation, including direct measurement of LA pressure at rest using retrograde technique...

Assisting immobile individuals with regular repositioning to adjust pressure distribution on key prominences such as the back and buttocks is the most effective measure for preventing pressure ulcers. However, compared to active self-repositioning, passive assisted repositioning results in distinct variations in force distribution on different body parts. This incongruity can affect the comfort of repositioning and potentially lead to a risk of secondary injury, for certain trauma or critically ill patients...

BACKGROUND: Elevated filling pressure is a hallmark of heart failure (HF) and portends poor prognosis. Accurate diagnosis is challenging, given that patients with normal filling pressure at rest develop disproportionate elevation with sudden preload increase. We aimed to test the accuracy of the ratio between mitral inflow velocity (E) and left ventricular stroke volume (SV) to identify patients with elevated filling pressure with passive leg lifting (PLL) and compare this with other echocardiographic surrogates of filling pressure...

OBJECTIVE:  The aim of this study was to assess if the level of osteotomy (50 or 75% the length of the humerus), osteotomy angle (5, 10, or 20 degrees), direction of bone alteration (external rotational or medial opening wedge osteotomies), or orientation of osteotomy (perpendicular to the humeral long axis or perpendicular to the weight-bearing axis of the limb) affect pressure through the medial compartment of the elbow. STUDY DESIGN:  Humeral osteotomies were performed at 50 and 75% the length of the humerus on 12 canine cadaver thoracic limbs and patient-specific three-dimensional (3D) printed plates applied to induce the desired alteration...

Background - Recently, a method to estimate wedge pressure (Pw) corrected minimal microvascular resistance (MR) was introduced. However, this method has not been validated since and there are some theoretical concerns regarding the impact of different physiological conditions on the derivation of Pw-measurements. This study sought to validate the recently introduced method to estimate Pw-corrected MR in a doppler-derived study population and to evaluate the impact of different physiological conditions on the Pw-measurements and the derivation of Pw-corrected MR...

Objective: This study sought to determine the predictive value of aortic pulsatility index (API) on event-free survival in patients with heart failure with preserved ejection fraction (HFpEF). Methods: We retrospectively studied 121 patients with HFpEF who underwent right heart catheterization at Heart Failure Center in Fuwai Hospital, Chinese Academy of Medical Sciences, between November 2014 and August 2022. API was calculated as pulse pressure/pulmonary arterial wedge pressure. Patients were divided into three groups according to the tertiles of baseline API...

OBJECTIVES: The association of pulmonary hypertension (PH) with the outcome after mitral transcatheter edge-to-edge repair (M-TEER) focusing on the new ESC/ERS guidelines definition for PH. BACKGROUND: PH is frequently found in patients with mitral regurgitation and is associated with lower survival rates. Recent studies were based on echocardiographic parameters, but results based on invasive haemodynamics differentiating distinct types of PH using the new definition for PH are missing...

AIMS: Graft dysfunction (GD) after heart transplantation (HTx) can develop without evidence of cell- or antibody-mediated rejection. Cardiac magnetic resonance imaging (CMR) has an evolving role in detecting rejection; however, its role in biopsy-negative GD has not been described. This study examines CMR findings, evaluates outcomes based on CMR results, and seeks to identify the possibility of rejection missed through endomyocardial biopsy by using CMR in HTx recipients with biopsy-negative GD...