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https://www.readbyqxmd.com/read/29454105/assessing-the-repeatability-of-absolute-cmro-2-oef-and-haemodynamic-measurements-from-calibrated-fmri
#1
Alberto Merola, Michael A Germuska, Kevin Murphy, Richard G Wise
As energy metabolism in the brain is largely oxidative, the measurement of cerebral metabolic rate of oxygen consumption (CMRO 2 ) is a desirable biomarker for quantifying brain activity and tissue viability. Currently, PET techniques based on oxygen isotopes are the gold standard for obtaining whole brain CMRO 2 maps. Among MRI techniques that have been developed as an alternative are dual calibrated fMRI (dcFMRI) methods, which exploit simultaneous measurements of BOLD and ASL signals during a hypercapnic-hyperoxic experiment to modulate brain blood flow and oxygenation...
February 14, 2018: NeuroImage
https://www.readbyqxmd.com/read/29453328/management-of-atrial-fibrillation-in-patients-with-rheumatic-mitral-stenosis
#2
REVIEW
Bernard Iung, Antoine Leenhardt, Fabrice Extramiana
Atrial fibrillation (AF) is frequent in patients with rheumatic mitral stenosis (MS). Pressure overload leads to marked structural and electrical remodelling of left atrium. The frequency of persistent AF increases with age and paroxysmal, asymptomatic, AF seems even more frequent. The occurrence of AF worsens the haemodynamic tolerance of MS and markedly increases the risk of thromboembolic events. AF has a negative impact on the natural history of MS and on its outcome after commissurotomy. The respective indications of rhythm and rate control should be adapted to patient characteristics, particularly the consequences of MS, and take into account the high risk of recurrence of AF...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29452815/variable-versus-conventional-lung-protective-mechanical-ventilation-during-open-abdominal-surgery-provar-a-randomised-controlled-trial
#3
P M Spieth, A Güldner, C Uhlig, T Bluth, T Kiss, C Conrad, K Bischlager, A Braune, R Huhle, A Insorsi, F Tarantino, L Ball, M J Schultz, N Abolmaali, T Koch, P Pelosi, M Gama de Abreu
BACKGROUND: Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. METHODS: Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452370/blood-cardioplegia-for-cardiac-surgery-in-acute-myocardial-infarction-rat-experiments-with-two-widely-used-solutions
#4
Andreas Boening, Lena Assling-Simon, Martina Heep, Kerstin Boengler, Bernd Niemann, Julia Schipke, Christian Mühlfeld, Philippe Grieshaber
OBJECTIVES: Blood cardioplegia (BCP) can be used in different ways to protect the heart from ischaemia-reperfusion injury during cardiac surgery. Because there could be differences between warm and cold intermittent cardioplegia with or without warm reperfusion, we investigated the influence of 2 blood cardioplegia solutions on cardiac function, metabolism and infarct size in stable and infarcted rat hearts. METHODS: The hearts of 32 male Wistar rats were excised and inserted into a blood-perfused isolated heart apparatus...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29452351/impact-of-treatment-delay-on-mortality-in-st-segment-elevation-myocardial-infarction-stemi-patients-presenting-with-and-without-haemodynamic-instability-results-from-the-german-prospective-multicentre-fitt-stemi-trial
#5
Karl Heinrich Scholz, Sebastian K G Maier, Lars S Maier, Björn Lengenfelder, Claudius Jacobshagen, Jens Jung, Claus Fleischmann, Gerald S Werner, Hans G Olbrich, Rainer Ott, Harald Mudra, Karlheinz Seidl, P Christian Schulze, Christian Weiss, Josef Haimerl, Tim Friede, Thomas Meyer
Aims: The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results: Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI)...
February 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29445529/cardiorespiratory-interaction-with-continuous-positive-airway-pressure
#6
REVIEW
Martino F Pengo, Sara Bonafini, Cristiano Fava, Joerg Steier
The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29442340/aortic-valve-replacement-using-autologous-pericardium-single-centre-experience-with-the-ozaki-technique
#7
Oliver Reuthebuch, Luca Koechlin, Ulrich Schurr, Martin Grapow, Jens Fassl, Friedrich S Eckstein
OBJECTIVE: To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD: Between September 2015 and May 2017 30 patients (20 males, mean ± standard deviation age 66.83 ± 10.55 years) suffering from aortic stenosis (AS, n = 7), aortic regurgitation (AR, n = 12), or a combination of both (AS/AR, n = 11) were assigned for an Ozaki procedure...
February 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29442245/retrobulbar-and-intraocular-blood-flow-in-anterior-ischaemic-optic-neuropathy-are-linked-to-the-functional-impairment
#8
David Kuerten, Matthias Fuest, Marion Bienert, Niklas Plange
PURPOSE: Evaluation of ocular haemodynamics in patients with acute non-arteritic anterior ischaemic optic neuropathy (NAION) by colour Doppler imaging and fluorescein angiography and correlation of blood flow parameters to visual field loss and visual acuity. METHODS: Blood flow velocities (peak systolic velocity (PSV), end-diastolic velocity (EDV)) of the ophthalmic artery (OA), central retinal artery (CRA) and nasal and temporal posterior ciliary arteries (PCAs) were measured via colour Doppler imaging...
February 13, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#9
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29440192/impact-of-anticoagulation-therapy-on-valve-haemodynamic-deterioration-following-transcatheter-aortic-valve-replacement
#10
María Del Trigo, Antonio J Muñoz-García, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Luis Nombela-Franco, Enrique Gutierrez, Asim N Cheema, Vicenç Serra, Ignacio J Amat-Santos, Joelle Kefer, Luis Miguel Benitez, Florence Leclercq, Antonio Mangieri, Hervé Le Breton, Pilar Jiménez-Quevedo, Bruno Garcia Del Blanco, Antonio Dager, Omar Abdul-Jawad Altisent, Rishi Puri, Philippe Pibarot, Josep Rodés-Cabau
OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group)...
February 13, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29440184/household-air-pollution-and-measures-of-blood-pressure-arterial-stiffness-and-central-haemodynamics
#11
Jill Baumgartner, Ellison Carter, James J Schauer, Majid Ezzati, Stella S Daskalopoulou, Marie-France Valois, Ming Shan, Xudong Yang
OBJECTIVE: We evaluated the exposure-response associations between personal exposure to air pollution from biomass stoves and multiple vascular and haemodynamic parameters in rural Chinese women. METHODS: We analysed the baseline information from a longitudinal study in southwestern China. Women's brachial and central blood pressure and pulse pressure, carotid-femoral pulse wave velocity and augmentation index, and their 48-hour personal exposures to fine particulate matter (PM 2...
February 9, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-uk-major-trauma-centres
#12
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma from two urban major trauma centres and discuss contemporary management of these injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11 year period, 63 patients presented with penetrating renal injuries...
February 13, 2018: BJU International
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#13
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29437733/cough-as-the-sole-manifestation-of-pericardial-effusion
#14
Hee Kong Fong, Obai Abdullah, Sandeep Gautam
A 59-year-old woman with paroxysmal atrial fibrillation (AF) presented with severe non-productive cough, malaise, low-grade fever and AF flare-up 3 weeks following pulmonary vein isolation with radiofrequency catheter ablation. She denied chest pain or dyspnoea. Patient was haemodynamically stable. There was no pulsus paradoxus. Laboratories showed leucocytosis and elevated C-reactive protein. ECG showed sinus tachycardia. CT abdomen and pelvis showed a large pericardial effusion (PE). Shortly after admission, she developed AF with rapid ventricular response, responsive to intravenous amiodarone...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436381/subcutaneous-treprostinil-in-congenital-heart-disease-related-pulmonary-arterial-hypertension
#15
Nika Skoro-Sajer, Christian Gerges, Olga Hajnalka Balint, Dora Kohalmi, Monika Kaldararova, Iveta Simkova, Johannes Jakowitsch, Harald Gabriel, Helmut Baumgartner, Mario Gerges, Roela Sadushi-Kolici, David S Celermajer, Irene Marthe Lang
OBJECTIVE: To assess the efficacy and safety of subcutaneous treprostinil in adult patients with congenital heart disease (CHD)-associated pulmonary arterial hypertension (PAH) after 12 months of treatment. METHODS: Consecutive adult patients with CHD-PAH received subcutaneous treprostinil to maximum tolerated doses in an observational study. RESULTS: Advanced CHD-PAH patients with WHO class III or IV disease (n=32, age 40±10 years, 20 females) received treprostinil for suboptimal response to bosentan (n=12), WHO functional class IV disease (FC, n=7) or prior to bosentan approval (n=13)...
February 7, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29435772/heart-failure-interventions-targeting-impaired-left-ventricles-in-structural-heart-disease
#16
REVIEW
Mitsunobu Kitamura, Tobias Schmidt, Karl-Heinz Kuck, Christian Frerker
PURPOSE OF REVIEW: Interventional techniques have been developed for a wide spectrum of mechanisms of heart failure (HF), especially in valvular heart disease and cardiomyopathies (ischaemic cardiomyopathy and hypertrophic cardiomyopathy). In this article, we review recent reports on catheter interventions to treat patients with HF. RECENT FINDINGS: Direct modification using the Parachute device and the REVIVENT-TC device for patients with impaired left ventricle with large infarct scars improves geometry and haemodynamic efficiency, resulting in a reduction of HF symptoms...
February 12, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29433494/incidental-finding-of-large-pneumothorax-on-cardiac-mr-scan
#17
J P M Andrews, G McKillop, M R Dweck
BACKGROUND: We believe this is the first case report of a pneumothorax being identified using cardiac magnetic resonance imaging. This case also illustrates the haemodynamic effect a large pneumothorax can have on right ventricular filling in diastole. CASE PRESENTATION: A 26-year-old attended for an interval follow up Cardiac Magnetic Resonance (CMR) of his thoracic aorta after a thoracic co-arctation repair aged 3. He was found to have an incidental large pneumothorax by the reporting cardiology fellow which was confirmed by the on-call radiologist...
February 12, 2018: BMC Medical Imaging
https://www.readbyqxmd.com/read/29432379/dexmedetomidine-as-a-part-of-general-anaesthesia-for-caesarean-delivery-in-patients-with-pre-eclampsia-efficacy-and-foetal-outcome-a-randomised-double-blinded-trial
#18
Ashraf M Eskandr, Ahmed A Metwally, Abd-Elrahman A Ahmed, Elham M Elfeky, Islam M Eldesoky, Manar A Obada, Osama A Abd-Elmegid
BACKGROUND: During general anaesthesia, endotracheal intubation of patients with pre-eclampsia causes stimulation of the sympathetic nervous system and catecholamine release, which may lead to maternal and neonatal complications. OBJECTIVE: To attenuate both the stress response and the haemodynamic response to tracheal intubation in patients with pre-eclampsia. DESIGN: A randomised, double-blind, controlled study. SETTING: Single University Hospital...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29432293/is-spinal-anaesthesia-in-young-infants-really-safer-and-better-than-general-anaesthesia
#19
Nicola Disma, Natasha Clunies-Ross, George A Chalkiadis
PURPOSE OF REVIEW: Concerns regarding the potential neurotoxic effects of general anaesthesia have seen resurgence in awake spinal anaesthesia in neonates and infants. This review includes recently published data from a large prospective randomized controlled trial with view to determining if spinal anaesthesia is safer and better than general anaesthesia in this population. RECENT FINDINGS: Compared with general anaesthesia, spinal anaesthesia results in less haemodynamic instability and fewer early (<30 min) apnoeic episodes in neonates and infants undergoing inguinal herniorraphy; the overall incidence of apnoeas in the first 12 h postoperatively was similar...
February 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29431284/increased-blood-lactate-is-prevalent-and-identifies-poor-prognosis-in-patients-with-acute-heart-failure-without-overt-peripheral-hypoperfusion
#20
Robert Zymliński, Jan Biegus, Mateusz Sokolski, Paweł Siwołowski, Sylwia Nawrocka-Millward, John Todd, Ewa A Jankowska, Waldemar Banasiak, Gad Cotter, John G Cleland, Piotr Ponikowski
AIMS: Lactate is produced by anaerobic metabolism and may reflect inadequate tissue perfusion in conditions such as acute heart failure (AHF). We evaluated the prevalence and clinical significance of elevated blood lactate on admission in patients with AHF. METHODS AND RESULTS: We enrolled 237 patients with AHF (mean age 67 ± 12 years; 70% men) presenting without overt clinical evidence of peripheral hypoperfusion ('warm haemodynamic profile'). Median (upper and lower quartiles) blood lactate on admission was 1...
February 12, 2018: European Journal of Heart Failure
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