scholarly journals VP15.10: Retrograde flow in aortic isthmus in normal and congenital heart defect fetuses by principal component analysis and computational fluid dynamics

2020 ◽  
Vol 56 (S1) ◽  
pp. 115-115
Author(s):  
Z. Chen ◽  
H. Zhao ◽  
Y. Zhao ◽  
J. Han ◽  
Y. Xu ◽  
...  
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Chen ◽  
S H Lin ◽  
T Amy ◽  
J C Han ◽  
X Yang ◽  
...  

Abstract Background and objectives Retrograde flow (RF) in the aortic isthmus is frequently observed in fetuses in various hemodynamic states including congenital heart defects (CHD). This study sought to: 1) establish the association between this observation and variables of CHD by fetal echocardiography (FE); and 2) to computer flow dynamic (CFD) model to probe the causes and mechanisms underlying this observation. Methods A total of 256 (gestational age (GA) 26.3±9.8 weeks) fetuses with CHD and 168 (GA: 25.8±10.3weeks) with normal FE were examined from January, 2011 to May, 2016. The study group was divided into: 1) no RF, 2) end systolic RF, end diastolic RF, systolic RF, diastolic RF, and systolic and diastolic RF sub-groups (Figure upper). GA, cerebroplacental ratio (CPR) of pulsatility index (PI) in middle cerebral and umbilical arteries, cardiothoracic area ratio (CTR), left and right atrial dimensions (LA/RA), left and right ventricular dimensions (LV/RV), aortic and pulmonary artery dimensions (AO/PA), and aortic isthmus and ductal arch dimensions (AI/DA), velocity ratio of aorta and pulmonary artery (AO/PAv), aortic isthmus and ductal arch in systolic (AI/DAvs) and diastolic (AI/DAvd). Using principal component analysis (PCA), the component score coefficient matrix and optional variance percent (OVP) was calculated by PCA and the RF pattern was simulated by CFD (Figure lower). Results RF modeling by CFD was feasible (Figure B). Component analysis by PCA showed that four types of variables were associated with RF: 1) Structural variables contribute 23.7% OVP, including LV/RV, LA/ RA, AO/PA, and IS/DA; 2) Resistance variables 16.8% OVP, i.e. CPR; 3) Growth variables 12.2% OVP, i,e, GA and CTR; and 4) Velocity variables 10.9% OVP, i.e. AO/PAv, AI/DAvd. Retrograde flow by fetal echo and CFD Conclusions Retrograde flow in the aortic isthmus is associated with structural, resistance, growth, and velocity variables in fetal circulation in various CHD and normal 3rd trimester pregnancies. Simulation and modeling by CFD is feasible and may be useful to understand the causes and mechanisms of retrograde flow and its utility in diagnosis and prognosis in CHD. Acknowledgement/Funding Research on prevention and control of reproductive health and major birth defects


VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 333-342 ◽  
Author(s):  
Kirchberger ◽  
Finger ◽  
Müller-Bühl

Background: The Intermittent Claudication Questionnaire (ICQ) is a short questionnaire for the assessment of health-related quality of life (HRQOL) in patients with intermittent claudication (IC). The objective of this study was to translate the ICQ into German and to investigate the psychometric properties of the German ICQ version in patients with IC. Patients and methods: The original English version was translated using a forward-backward method. The resulting German version was reviewed by the author of the original version and an experienced clinician. Finally, it was tested for clarity with 5 German patients with IC. A sample of 81 patients were administered the German ICQ. The sample consisted of 58.0 % male patients with a median age of 71 years and a median IC duration of 36 months. Test of feasibility included completeness of questionnaires, completion time, and ratings of clarity, length and relevance. Reliability was assessed through a retest in 13 patients at 14 days, and analysis of Cronbach’s alpha for internal consistency. Construct validity was investigated using principal component analysis. Concurrent validity was assessed by correlating the ICQ scores with the Short Form 36 Health Survey (SF-36) as well as clinical measures. Results: The ICQ was completely filled in by 73 subjects (90.1 %) with an average completion time of 6.3 minutes. Cronbach’s alpha coefficient reached 0.75. Intra-class correlation for test-retest reliability was r = 0.88. Principal component analysis resulted in a 3 factor solution. The first factor explained 51.5 of the total variation and all items had loadings of at least 0.65 on it. The ICQ was significantly associated with the SF-36 and treadmill-walking distances whereas no association was found for resting ABPI. Conclusions: The German version of the ICQ demonstrated good feasibility, satisfactory reliability and good validity. Responsiveness should be investigated in further validation studies.


2020 ◽  
Vol 4 (11) ◽  
pp. 676-681
Author(s):  
V.V. Sapozhnikova ◽  
◽  
A.L. Bondarenko ◽  

Aim: to determine the association between clinical laboratory parameters, the production of cytokines (IL-17A, -23, -33, -35), and specific IgM and IgG in the serum of patients with Lyme borreliosis without erythema migrans. Patients and Methods: complete blood count, the concentrations of IL-17A, -23, -33, -35, and the levels of specific IgM and IgG were measured during acute infection and convalescence (n=30). The control group included age- and sex-matched healthy individuals (n=30). Statistical analysis was performed using the StatSoft Statistica v 10.0 software (parametric and non-parametric methods and multifactorial analysis, i.e., principal component analysis). Results: most (80%) patients with Lyme borreliosis without erythema migrans are the people of working age. In most patients, the combination of the specific antibodies against Borrelia afzelii and Borrelia garinii (76.7%) and severe intoxication and inflammatory process (100%) were detected. Moderate and severe disease associated with meningism was diagnosed in 90% and 10%, respectively. The mean duration of hectic period was 8.3±1.27 days. Abnormal ECG was reported in 40% of patients, i.e., conduction abnormalities in 20%, sinus bradycardia in 16.7%,and sinus tachycardia in 3.3%. The clinical laboratory signs of hepatitis without jaundice were identified in 26.7%. During treatment, the significant reduction in band and segmented neutrophil counts as well as the significant increase in platelet count were revealed compared to these parameters at admission. Abnormal cytokine levels (i.e., the increase in IL-17A, -23, -33 and the deficiency of IL-35) were detected. Conclusions: multifactorial analysis has demonstrated that the severity of immunological abnormalities in patients with Lyme borreliosis without erythema migrans is associated with fever, cardiac and liver disorders, the high levels of IL-23 and IL-33, and the lack of IL-35 and specific IgM and IgG. KEYWORDS: tick-borne borreliosis, Lyme disease without erythema migrans, clinical laboratory signs, cytokines, specific antibodies, multifactorial analysis, principal component analysis. FOR CITATION: Sapozhnikova V.V., Bondarenko A.L. Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans. Russian Medical Inquiry. 2020;4(11):676–681. DOI: 10.32364/2587-6821-2020-4-11-676-681.


2018 ◽  
Vol 6 (7) ◽  
pp. 715-723 ◽  
Author(s):  
Stephany C. de Rezende ◽  
Jo鉶 A. Pinto ◽  
Isabel P. Fernandes ◽  
Fernanda V. Leimann and Maria-Filomena Barreiro

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