Effects of the Mueller Maneuver on aortic area

2014 ◽  
Vol 173 (1) ◽  
pp. 128-129 ◽  
Author(s):  
Harish Raj Seetha Rammohan ◽  
Kinnari Murthy ◽  
Gregg S. Pressman
Keyword(s):  
Mueller Maneuver ◽  
Aortic Area

Use of Cardiac Magnetic Resonance Imaging Based Measurements of Inferior Vena Cava Cross-Sectional Area in the Diagnosis of Pericardial Constriction

2015 ◽  
Vol 66 (3) ◽  
pp. 231-237 ◽  
Author(s):  
Kate Hanneman ◽  
Paaladinesh Thavendiranathan ◽  
Elsie T. Nguyen ◽  
Hadas Moshonov ◽  
Rachel Wald ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Inferior Vena ◽  
Vena Cava ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Aortic Area

Purpose To evaluate the value of cardiac magnetic resonance imaging (MRI)–based measurements of inferior vena cava (IVC) cross-sectional area in the diagnosis of pericardial constriction. Methods Patients who had undergone cardiac MRI for evaluation of clinically suspected pericardial constriction were identified retrospectively. The diagnosis of pericardial constriction was established by clinical history, echocardiography, cardiac catheterization, intraoperative findings, and/or histopathology. Cross-sectional areas of the suprahepatic IVC and descending aorta were measured on a single axial steady-state free-precession (SSFP) image at the level of the esophageal hiatus in end-systole. Logistic regression and receiver-operating curve (ROC) analyses were performed. Results Thirty-six patients were included; 50% (n = 18) had pericardial constriction. Mean age was 53.9 ± 15.3 years, and 72% (n = 26) were male. IVC area, ratio of IVC to aortic area, pericardial thickness, and presence of respirophasic septal shift were all significantly different between patients with constriction and those without ( P < .001 for all). IVC to aortic area ratio had the highest odds ratio for the prediction of constriction (1070, 95% confidence interval [8.0-143051], P = .005). ROC analysis illustrated that IVC to aortic area ratio discriminated between those with and without constriction with an area under the curve of 0.96 (95% confidence interval [0.91-1.00]). Conclusions In patients referred for cardiac MRI assessment of suspected pericardial constriction, measurement of suprahepatic IVC cross-sectional area may be useful in confirming the diagnosis of constriction when used in combination with other imaging findings, including pericardial thickness and respirophasic septal shift.

Abstract P247: Ethnic Differences in Infrarenal Aortic Diameter and Area in a Population-Based Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
David E Timaran ◽  
Eric B Rosero ◽  
Adriana J Higuera ◽  
Ron Peshock ◽  
R James Valentine ◽  
...  
Keyword(s):  
Body Size ◽  
Ethnic Differences ◽  
Population Based ◽  
Aortic Diameter ◽  
Hispanic Ethnicity ◽  
Female Sex ◽  
Abdominal Aortic ◽  
Aortic Area ◽  
Blacks And Whites ◽  
Lower Height

Objective: Abdominal aortic aneurysms are defined as a 50% or greater increase in infrarenal aortic diameter (IAD). However, normal IAD has not been defined for all ethnic groups as minorities have been underrepresented in most studies. The aim of the study was to assess ethnic differences in IAD and infrarenal aortic area (AoA) adjusting for the effects of age, gender and body size in the general population. Methods: Participants (2,515) in a population based study underwent high-resolution magnetic resonance imaging (MRI) of the abdominal aorta. Analyses of variance and multiple regression analyses were used to assess the relationship between race/ethnicity, age, gender and body size and IAD and aortic area. Subjects with AAA detected by MRI (defined as IAD ≥ 3.0 cm) were excluded from the analysis. Results: Decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced IAD by multivariate linear regression (all P < 0.001). Of these, female sex and Hispanic ethnicity were the factors more strongly associated with aortic size. Female sex was associated with 0.27 cm reduction in IAD and Hispanic ethnicity with 0.39 cm reduction in IAD. Similarly, decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced AoA. Female sex was associated with a 51 cm 2 reduction in AoA and Hispanic ethnicity with 11.1 cm 2 reduction in AoA. Although Hispanics had higher BMI than blacks and whites ( P =.01), and lower height values than blacks and whites (P<.0001), IADs and AoAs were consistently lower among Hispanics. Conclusions: Ethnic differences exist in infrarenal aortic diameter. Despite larger body size, Hispanics have significantly lower IAD than blacks and whites in the general population. The reduced aortic size in Hispanics suggests that the thresholds for abdominal aortic aneurysm diagnosis, rupture and repair may be lower and need to be established.

scholarly journals Changes in Left and Right Ventricular Mechanics During the Mueller Maneuver in Healthy Adults

2010 ◽  
Vol 3 (3) ◽  
pp. 282-289 ◽  
Author(s):  
Yuki Koshino ◽  
Hector R. Villarraga ◽  
Marek Orban ◽  
Charles J. Bruce ◽  
Gregg S. Pressman ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Healthy Adults ◽  
Ventricular Mechanics ◽  
Mueller Maneuver ◽  
Left And Right

The Supra-aortic Area

1988 ◽  
pp. 117-150 ◽  
Author(s):  
E. Robert Heitzman
Keyword(s):  
Aortic Area

Intrathoracic pressures and left ventricular configuration with respiratory maneuvers

1989 ◽  
Vol 66 (1) ◽  
pp. 481-491 ◽  
Author(s):  
S. M. Scharf ◽  
R. Brown ◽  
K. G. Warner ◽  
S. Khuri
Keyword(s):  
High Volume ◽  
Intermittent Positive Pressure Ventilation ◽  
Left Ventricular ◽  
Positive Pressure ◽  
Lateral Dimension ◽  
Mueller Maneuver ◽  
Pericardial Pressure ◽  
Lv Volume ◽  
The Relationship ◽  
Phrenic Stimulation

In 12 dogs, we examined the correspondence between esophageal (Pes) and pericardial pressures over the anterior, lateral, and inferior left ventricular (LV) surfaces. Pleural pressure was decreased by spontaneous inspiration, Mueller maneuver, and phrenic stimulation and increased by intermittent positive pressure ventilation (IPPV) and positive end-expiratory pressure (PEEP). To separate effects due to blood flow, we analyzed beating and nonbeating hearts. In beating hearts, there were no significant differences between changes in Pes and pericardial pressures. In arrested hearts, increasing LV pressure by 8 Torr increased pericardial pressures by only 3.6 Torr. With IPPV and PEEP, increases in Pes and pericardial pressures were equal in live hearts and in low-volume arrested hearts (LV pressure = 4 Torr). In high-volume arrested hearts (LV pressure = 12 Torr), the increase in pericardial pressure over the anterior LV surface was less than Pes, whereas that over the lateral and inferior LV surfaces was the same as Pes. At high LV volume, in arrested hearts pericardial pressures decreased less than Pes during negative pressure maneuvers. In another six dogs, external LV configuration and volume were measured. In beating hearts during spontaneous inspiration, Mueller maneuver, and phrenic stimulation (endotracheal tube open), septal-lateral dimension and LV volume decreased by approximately 3% (P less than 0.05). This was also true for PEEP. In arrested hearts, septal-lateral dimension and LV volume decreased only with PEEP. We conclude that 1) the relationship between Pes and pericardial pressures is complex and depends on LV volume, local pericardial compliance, and the means by which Pes is changed, 2) changes in measured pericardial pressures did not completely explain changes in LV configuration, and 3) during different respiratory maneuvers, different forces account for the same observed changes in LV volume and configuration.

scholarly journals Analysis of aortic area/height ratio in patients with thoracic aortic aneurysm and Type A dissection†

2018 ◽  
Vol 54 (4) ◽  
pp. 696-701 ◽  
Author(s):  
Metesh Nalin Acharya ◽  
Pouya Youssefi ◽  
Gopal Soppa ◽  
Oswaldo Valencia ◽  
Justin Nowell ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Type A ◽  
Height Ratio ◽  
Aortic Area ◽  
Type A Dissection

scholarly journals Reference Curves for the Aortic Area by Age

2013 ◽  
Vol 20 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Li-An Wu ◽  
Chung-I. Chang ◽  
Jou-Kou Wang ◽  
Tiffany Ting-Fang Shih ◽  
Mei-Hwan Wu ◽  
...  
Keyword(s):  
Aortic Area ◽  
Reference Curves

scholarly journals HUMAN IDENTIFICATION BASED ON HEART SOUND AUSCULTATION POINT

2017 ◽  
Vol 79 (7) ◽  
Author(s):  
I. Nur Fariza ◽  
Sh-Hussain Salleh ◽  
Fuad Noman ◽  
Hadri Hussain
Keyword(s):  
Heart Sound ◽  
Recognition Rate ◽  
Human Identification ◽  
Personal Identification ◽  
Heart Sounds ◽  
Electronic Stethoscope ◽  
The Past ◽  
Technology Advancement ◽  
Aortic Area ◽  
Mitral Area

The application of human identification and verification has widely been used for over the past few decades.  Drawbacks of such system however, are inevitable as forgery sophisticatedly developed alongside the technology advancement.  Thus, this study proposed a research on the possibility of using heart sound as biometric. The main aim is to find an optimal auscultation point of heart sounds from either aortic, pulmonic, tricuspid or mitral that will most suitable to be used as the sound pattern for personal identification.  In this study, the heart sound was recorded from 92 participants using a Welch Allyn Meditron electronic stethoscope whereas Meditron Analyzer software was used to capture the signal of heart sounds and ECG simultaneously for duration of 1 minute.  The system is developed by a combination Mel Frequency Cepstrum Coefficients (MFCC) and Hidden Markov Model (HMM).  The highest recognition rate is obtained at aortic area with 98.7% when HMM has 1 state and 32 mixtures, the lowest Equal Error Rate (EER) achieved was 0.9% which is also at aortic area.  In contrast, the best average performance of HMM for every location is obtained at mitral area with 99.1% accuracy and 17.7% accuracy of EER at tricuspid area.

scholarly journals Mechanisms of inspiration that modulate cardiovascular control: the other side of breathing

2019 ◽  
Vol 127 (5) ◽  
pp. 1187-1196 ◽  
Author(s):  
Victor A. Convertino
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Intrathoracic Pressure ◽  
The Other ◽  
Chronic Obstructive ◽  
Human Experiments ◽  
Mueller Maneuver ◽  
Clinical Benefits ◽  
Life Threatening ◽  
Cardiac Filling ◽  
Clinical Conditions

The objective of this minireview is to describe the physiology and potential clinical benefits derived from inspiration. Recent animal and clinical studies demonstrate that one of the body’s natural mechanisms associated with inspiration is to harness the respiratory pump to enhance circulation to vital organs. There is evidence that large reductions in intrathoracic pressure (>20 cmH2O) caused by some inspiration maneuvers (e.g., Mueller maneuver) or pathophysiology (e.g., heart failure, chronic obstructive lung disease) can result in adverse hemodynamic effects. However, the respiratory pump can improve cardiovascular functions when a “sweet spot” for generation of negative intrathoracic pressure during inspiration can be maintained at or less than 10 cmH2O below normal inspiration. These beneficial physiological effects include greater cardiac filling and output, lower intracranial pressure, cardiac baroreflex resetting, greater cerebral blood flow oscillatory patterns, increased vascular pressure gradients, and promoting sustained feedback between sympathetic nerve activity and arterial pressure. In addition to promoting gas exchange, data obtained from numerous animal and human experiments have provided new insights into “the other side of breathing”: the modulation of circulation by reduced intrathoracic pressure generated during inspiration. The translation of these physiological relationships form the basis for the development and application of technologies designed to optimize the intrathoracic pump for treatment of clinical conditions associated with hypovolemia including cardiac arrest, orthostatic hypotension, hemorrhagic shock, and traumatic brain injury. Harnessing these fundamental mechanisms that control cardiopulmonary physiology provides opportunities to use inspiration as a potential tool to help treat significant and often life-threatening circulatory disorders.

Sign in / Sign up

Export Citation Format

Share Document