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Ischaemic MR

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https://www.readbyqxmd.com/read/28540481/impact-of-perfusion-lesion-in-corticospinal-tract-on-response-to-reperfusion
#1
Ying Zhou, Ruiting Zhang, Sheng Zhang, Shenqiang Yan, Ze Wang, Bruce C V Campbell, David S Liebeskind, Min Lou
OBJECTIVES: We aimed to examine the impact of corticospinal tract (CST) involvement in acute ischaemic stroke (AIS) patients on functional outcome and the interaction with reperfusion. METHODS: We retrospectively examined data in consecutive anterior circulation AIS patients undergoing thrombolysis. MR perfusion (time to maximum of tissue residue function, Tmax) and apparent diffusion coefficient (ADC) images were transformed into standard space and the volumes of CST involvement by Tmax > 6 s (CST-Tmax) and ADC < 620 × 10(-6) mm(2)/s (CST-ADC) lesions were calculated...
May 24, 2017: European Radiology
https://www.readbyqxmd.com/read/28536224/impella-percutaneous-left-ventricular-assist-device-for-severe-acute-ischaemic-mitral-regurgitation-as-a-bridge-to-surgery
#2
Bilal Jalil, Karim El-Kersh, Jarrod Frizzell, Shozab Ahmed
Ischaemic papillary muscle rupture causing acute severe mitral regurgitation (MR) has a dramatic presentation and a very high mortality. Emergent surgical repair improves outcomes, which necessitates robust preoperative stabilisation. Here we discuss a patient with cardiogenic shock with an acute severe MR that was deemed very high risk for emergent valve replacement due to haemodynamic instability and respiratory failure. A percutaneous left ventricular assist device Impella 2.5 (Abiomed, Danvers, MA) drastically improved clinical status, and the patient underwent a successful surgical mitral valve replacement soon after placement of the temporary assist device...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28468840/selection-of-patients-for-intra-arterial-treatment-for-acute-ischaemic-stroke-development-and-validation-of-a-clinical-decision-tool-in-two-randomised-trials
#3
RANDOMIZED CONTROLLED TRIAL
Esmee Venema, Maxim J H L Mulder, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Bart J Emmer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (derivation cohort) and 58 hospitals in the United States, Canada, Australia, and Europe (validation cohort).Participants 500 patients from the Multicenter Randomised Clinical Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands trial (derivation cohort) and 260 patients with intracranial occlusion from the Interventional Management of Stroke III trial (validation cohort)...
May 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#4
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28347575/validation-of-a-basic-neurosonology-laboratory-for-detecting-cervical-carotid-artery-stenosis
#5
C de la Cruz Cosme, M S Dawid Milner, G Ojeda Burgos, A Gallardo Tur, M Márquez Martínez, T Segura
INTRODUCTION: Most of the cases of ischaemic stroke in our setting are of atherothrombotic origin. Detecting intracranial and cervical carotid artery stenosis in patients with ischaemic stroke is therefore essential. Ultrasonography has become the tool of choice for diagnosing carotid artery stenosis because it is both readily accessibility and reliable. However, use of this technique must be validated in each laboratory. The purpose of this study is to validate Doppler ultrasound in our laboratory as a means of detecting severe carotid artery stenosis...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28336740/towards-personalised-intra-arterial-treatment-of-patients-with-acute-ischaemic-stroke-a-study-protocol-for-development-and-validation-of-a-clinical-decision-aid
#6
Maxim J H L Mulder, Esmee Venema, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
INTRODUCTION: Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. METHODS AND ANALYSIS: We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28329173/mitral-valve-repair-for-secondary-mitral-regurgitation-in-non-ischaemic-dilated-cardiomyopathy-is-associated-with-left-ventricular-reverse-remodelling-and-increase-of-forward-flow
#7
Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, William Kok Fai Kong, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Aims: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results: Seventy-six patients (65 ± 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated...
February 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28188427/the-prognostic-value-of-right-ventricular-long-axis-strain-in-non-ischaemic-dilated-cardiomyopathies-using-standard-cardiac-magnetic-resonance-imaging
#8
Nisha Arenja, Johannes H Riffel, Manuel Halder, Charly N Djiokou, Thomas Fritz, Florian Andre, Fabian Aus dem Siepen, Thomas Zelniker, Benjamin Meder, Elham Kayvanpour, Grigorios Korosoglou, Hugo A Katus, Sebastian J Buss
OBJECTIVE: To investigate the association of right ventricular long axis strain (RV-LAS), a parameter of longitudinal function, with outcome in patients with non-ischaemic dilated cardiomyopathy (NIDCM). METHODS: In 441 patients with NIDCM, RV-LAS was analysed retrospectively by measuring the length between the epicardial border of the left ventricular apex and the middle of a line connecting the origins of the tricuspidal valve leaflets in end-diastole and end-systole on non-contrast standard cine sequences...
February 10, 2017: European Radiology
https://www.readbyqxmd.com/read/28007909/mendelian-randomization-estimates-of-alanine-aminotransferase-with-cardiovascular-disease-guangzhou-biobank-cohort-study
#9
Lin Xu, Chao Qiang Jiang, Tai Hing Lam, Wei Sen Zhang, Feng Zhu, Ya Li Jin, G Neil Thomas, Kar Keung Cheng, C Mary Schooling
Observational studies of the association of alanine aminotransferase (ALT) levels with ischaemic heart disease (IHD) and cardiovascular disease (CVD) risk factors are inconsistent, probably because of confounding and reverse causality. Mendelian randomization (MR) provides less confounded results. We used MR analysis to assess the associations of ALT (U/L) with IHD, diabetes and other CVD risk factors. We used instrumental variable analysis based on two single nucleotide polymorphism (SNPs) HSD17B13/MAPK10 (rs6834314) and PNPLA3/SAMM50 (rs738409) to assess the associations of ALT (U/L) with IHD, diabetes and other CVD risk factors in the Guangzhou Biobank Cohort Study (GBCS)...
January 15, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/27940585/adult-primary-angiitis-of-the-central-nervous-system-isolated-small-vessel-vasculitis-represents-distinct-disease-pattern
#10
Hubert de Boysson, Grégoire Boulouis, Achille Aouba, Boris Bienvenu, Loïc Guillevin, Mathieu Zuber, Emmanuel Touzé, Olivier Naggara, Christian Pagnoux
Objectives.: We aimed to identify whether presentations and outcomes in adult patients with isolated small-vessel primary angiitis of the CNS (PACNS) would differ from other patients with large/medium-vessel involvement. Methods.: In the French PACNS cohort, we compared the characteristics, treatments and outcomes of patients with isolated small-vessel disease (normal CT, MR and/or conventional angiograms, brain biopsy positive for vasculitis) with other patients who had large/medium-vessel involvement (vessel abnormalities on CT, MR or conventional angiograms)...
March 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/27933193/outcomes-of-ischaemic-mitral-regurgitation-in-anterior-versus-inferior-st-elevation-myocardial-infarction
#11
Amgad Mentias, Mohammad Q Raza, Amr F Barakat, Elizabeth Hill, Dalia Youssef, Amar Krishnaswamy, Milind Y Desai, Brian Griffin, Stephen Ellis, Venu Menon, E Murat Tuzcu, Samir R Kapadia
BACKGROUND: Ischaemic mitral regurgitation (IMR) is a detrimental complication of ST elevation myocardial infarction (STEMI). OBJECTIVE: We sought to determine patient characteristics and outcomes of patients with IMR with focus on anterior or inferior location of STEMI. METHODS: All patients presenting with STEMI complicated by IMR to our centre who underwent primary percutaneous coronary intervention within the first 12 hours of presentation from 1995 to 2014 were included...
2016: Open Heart
https://www.readbyqxmd.com/read/27902983/perinatal-asphyxia-and-erythropoietin-and-vegf-serial-serum-and-cerebrospinal-fluid-responses
#12
Deirdre U Sweetman, Chike Onwuneme, William R Watson, John F A Murphy, Eleanor J Molloy
BACKGROUND: Infants with neonatal encephalopathy (NE) of hypoxic-ischaemic origin are at risk of oxidative and ischaemia-reperfusion injury, which may induce abnormal inflammatory responses involving excessive cytokine production and release in serum and cerebrospinal fluid (CSF). Systemic inflammation is found in infants with NE, and we therefore were interested in cytokines associated with hypoxia, including vascular endothelial growth factor (VEGF) and erythropoietin (Epo). OBJECTIVE: To investigate the relationship between Epo, VEGF levels, brain injury and outcome in a group of term infants exposed to perinatal asphyxia (PA) compared to controls...
2017: Neonatology
https://www.readbyqxmd.com/read/27804974/mesenchymal-stem-cells-combined-with-hepatocyte-growth-factor-therapy-for-attenuating-ischaemic-myocardial-fibrosis-assessment-using-multimodal-molecular-imaging
#13
Huizhu Chen, Rui Xia, Zhenlin Li, Lizhi Zhang, Chunchao Xia, Hua Ai, Zhigang Yang, Yingkun Guo
Clinically, myocardial fibrosis is increasingly being recognized as a new therapeutic target for ischaemic heart diseases. The aim of this study was to investigate whether noninvasive multimodal molecular imaging could be used to dynamically assess whether the combination of bone marrow mesenchymal stem cells (BMSCs) and hepatocyte growth factor (HGF) therapy can synergistically attenuate myocardial fibrosis after myocardial infarction (MI). MI was induced in 28 rats by coronary ligation with subsequent injection of BMSCs/HGF, BMSCs, HGF, or saline into the border zone under echocardiography guidance...
November 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27756783/plasma-lipidomic-profiles-improve-on-traditional-risk-factors-for-the-prediction-of-cardiovascular-events-in-type-2-diabetes-mellitus
#14
RANDOMIZED CONTROLLED TRIAL
Zahir H Alshehry, Piyushkumar A Mundra, Christopher K Barlow, Natalie A Mellett, Gerard Wong, Malcolm J McConville, John Simes, Andrew M Tonkin, David R Sullivan, Elizabeth H Barnes, Paul J Nestel, Bronwyn A Kingwell, Michel Marre, Bruce Neal, Neil R Poulter, Anthony Rodgers, Bryan Williams, Sophia Zoungas, Graham S Hillis, John Chalmers, Mark Woodward, Peter J Meikle
BACKGROUND: Clinical lipid measurements do not show the full complexity of the altered lipid metabolism associated with diabetes mellitus or cardiovascular disease. Lipidomics enables the assessment of hundreds of lipid species as potential markers for disease risk. METHODS: Plasma lipid species (310) were measured by a targeted lipidomic analysis with liquid chromatography electrospray ionization-tandem mass spectrometry on a case-cohort (n=3779) subset from the ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation)...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27466359/misinterpretation-of-ischaemic-infarct-location-in-relationship-to-the-cerebrovascular-territories
#15
Nolan S Hartkamp, J Hendrikse, Laurens J L De Cocker, Gert Jan de Borst, L Jaap Kappelle, Reinoud P H Bokkers
PURPOSE: Cerebral perfusion territories are known to vary widely among individuals. This may lead to misinterpretation of the symptomatic artery in patients with ischaemic stroke to a wrong assumption of the underlying aetiology being thromboembolic or hypoperfusion. The aim of the present study was to investigate such potential misinterpretation with territorial arterial spin labelling (T-ASL) by correlating infarct location with imaging of the perfusion territory of the carotid arteries or basilar artery...
October 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27375137/comprehensive-imaging-of-stroke-looking-for-the-gold-standard
#16
Agnieszka Piliszek, Grzegorz Witkowski, Katarzyna Sklinda, Cezary Szary, Danuta Ryglewicz, Małgorzata Dorobek, Jerzy Walecki
BACKGROUND AND PURPOSE: Stroke is the third cause of death worldwide. In recent decade there has been a marked progress in treatment and prevention of stroke, which was possible largely due to modern neuroimaging techniques. Early radiological confirmation of the diagnosis allows for introduction of fibrinolytic therapy and evaluation of ischaemic penumbra. MATERIAL AND METHODS: We have analysed clinical and imaging data of 92 patients with early stages of stroke...
July 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27302238/effect-of-baseline-alberta-stroke-program-early-ct-score-on-safety-and-efficacy-of-intra-arterial-treatment-a-subgroup-analysis-of-a-randomised-phase-3-trial-mr-clean
#17
RANDOMIZED CONTROLLED TRIAL
Albert J Yoo, Olvert A Berkhemer, Puck S S Fransen, Lucie A van den Berg, Debbie Beumer, Hester F Lingsma, Wouter J Schonewille, Marieke E S Sprengers, René van den Berg, Marianne A A van Walderveen, Ludo F M Beenen, Marieke J H Wermer, Geert J Lycklama À Nijeholt, Jelis Boiten, Sjoerd F M Jenniskens, Joseph C J Bot, Anna M M Boers, Henk A Marquering, Yvo B W E M Roos, Robert J van Oostenbrugge, Diederik W J Dippel, Aad van der Lugt, Wim H van Zwam, Charles B L M Majoie
BACKGROUND: Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN). METHODS: MR CLEAN was a randomised, controlled, open-label, phase 3 trial of intra-arterial treatment in patients (aged ≥18 years from the Netherlands) with proximal arterial occlusion of the anterior circulation, given intra-arterial treatment within 6 h of stroke onset...
June 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27291495/t2-prepared-velocity-selective-labelling-a-novel-idea-for-full-brain-mapping-of-oxygen-saturation
#18
Thomas Alderliesten, Jill B De Vis, Petra M A Lemmers, Frank van Bel, Manon J N L Benders, Jeroen Hendrikse, Esben T Petersen
BACKGROUND AND AIM: Disturbances in cerebral oxygenation saturation (SO2) have been linked to adverse outcome in adults, children, and neonates. In intensive care, the cerebral SO2 is increasingly being monitored by Near-InfraRed Spectroscopy (NIRS). Unfortunately NIRS has a limited penetration depth. The "modified T2-prepared Blood Imaging of Oxygen Saturation" (T2-BIOS) MR sequence provides a step towards full brain SO2 measurement. MATERIALS AND METHODS: tissue SO2, and venous SO2 (SvO2) were obtained simultaneously by T2-BIOS during a respiratory challenge in ten healthy volunteers...
June 9, 2016: NeuroImage
https://www.readbyqxmd.com/read/27174122/left-ventricular-partitioning-in-systolic-heart-failure-subjects-addressing-a-mechanistic-void-with-current-therapies
#19
Ulrich Schäfer
ICD patients with narrow QRS, CRT non-responders, and functional MR patients all have one mechanistic failure mode that is left untreated - the scar left behind following an MI. ICDs, CRTs, and MitraClip implantation are all well-proven therapies, but the Parachute device may address the mechanistic void that remains after each of these therapies has been used and may further improve patients' outcomes. A pooled analysis of 134 subjects was conducted using the first three clinical trials which included subjects with symptomatic ischaemic HF with LV wall motion abnormalities secondary to MI, and an LV ejection fraction less than 40%...
May 17, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27131928/operative-outcomes-with-myxomatous-mitral-valve-repair-experience-with-586-patients
#20
L Bassin, B Weiss, G Cranney, D Gimpel, P Gilhooly, R Smith, Z Akhunji, P Grant, H Wolfenden
INTRODUCTION: American Heart Association (AHA) guidelines recommend mitral valve repair for myxomatous mitral regurgitation whenever possible to prevent LV dysfunction and early mortality. Here we review our early operative outcomes with mitral valve repair for myxomatous mitral regurgitation. METHODS: We collected data from 586 consecutive patients that underwent mitral repair for myxomatous disease at the Prince Henry and Prince of Wales Hospitals Sydney between 1997 and 2012...
August 2016: Heart, Lung & Circulation
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