scholarly journals HIGH PREVALENCE OF UNEXPECTED ABNORMALITIES IN NORMAL VOLUNTEERS UNDERGOING QUANTITATIVE STRESS PERFUSION PET

2011 ◽  
Vol 57 (14) ◽  
pp. E793
Author(s):  
Stefano Sdringola-Maranga ◽  
Nils P. Johnson ◽  
Richard L. Kirkeeide ◽  
Hemang A. Vaniya ◽  
Emma Cid ◽  
...  
Keyword(s):  
Stress Perfusion ◽  
Normal Volunteers ◽  
High Prevalence ◽  
Quantitative Stress

scholarly journals Automated Quantitative Stress Perfusion in a Clinical Routine

2019 ◽  
Vol 27 (3) ◽  
pp. 507-520
Author(s):  
Kristopher D. Knott ◽  
Juliano Lara Fernandes ◽  
James C. Moon
Keyword(s):  
Stress Perfusion ◽  
Clinical Routine ◽  
Quantitative Stress

scholarly journals Myocardial Perfusion Imaging After Severe COVID-19 Infection Demonstrates Regional Ischemia Rather Than Global Blood Flow Reduction

2021 ◽  
Vol 8 ◽  
Author(s):  
George D. Thornton ◽  
Abhishek Shetye ◽  
Dan S. Knight ◽  
Kris Knott ◽  
Jessica Artico ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Perfusion ◽  
Left Ventricular ◽  
Regional Perfusion ◽  
Left Ventricular Ejection ◽  
Stress Perfusion ◽  
Post Discharge ◽  
High Prevalence ◽  
Perfusion Defects ◽  
Perfusion Cmr

Background: Acute myocardial damage is common in severe COVID-19. Post-mortem studies have implicated microvascular thrombosis, with cardiovascular magnetic resonance (CMR) demonstrating a high prevalence of myocardial infarction and myocarditis-like scar. The microcirculatory sequelae are incompletely characterized. Perfusion CMR can quantify the stress myocardial blood flow (MBF) and identify its association with infarction and myocarditis.Objectives: To determine the impact of the severe hospitalized COVID-19 on global and regional myocardial perfusion in recovered patients.Methods: A case-control study of previously hospitalized, troponin-positive COVID-19 patients was undertaken. The results were compared with a propensity-matched, pre-COVID chest pain cohort (referred for clinical CMR; angiography subsequently demonstrating unobstructed coronary arteries) and 27 healthy volunteers (HV). The analysis used visual assessment for the regional perfusion defects and AI-based segmentation to derive the global and regional stress and rest MBF.Results: Ninety recovered post-COVID patients {median age 64 [interquartile range (IQR) 54–71] years, 83% male, 44% requiring the intensive care unit (ICU)} underwent adenosine-stress perfusion CMR at a median of 61 (IQR 29–146) days post-discharge. The mean left ventricular ejection fraction (LVEF) was 67 ± 10%; 10 (11%) with impaired LVEF. Fifty patients (56%) had late gadolinium enhancement (LGE); 15 (17%) had infarct-pattern, 31 (34%) had non-ischemic, and 4 (4.4%) had mixed pattern LGE. Thirty-two patients (36%) had adenosine-induced regional perfusion defects, 26 out of 32 with at least one segment without prior infarction. The global stress MBF in post-COVID patients was similar to the age-, sex- and co-morbidities of the matched controls (2.53 ± 0.77 vs. 2.52 ± 0.79 ml/g/min, p = 0.10), though lower than HV (3.00 ± 0.76 ml/g/min, p< 0.01).Conclusions: After severe hospitalized COVID-19 infection, patients who attended clinical ischemia testing had little evidence of significant microvascular disease at 2 months post-discharge. The high prevalence of regional inducible ischemia and/or infarction (nearly 40%) may suggest that occult coronary disease is an important putative mechanism for troponin elevation in this cohort. This should be considered hypothesis-generating for future studies which combine ischemia and anatomical assessment.

scholarly journals Myocardial perfusion after COVID-19 infection: No persisting impaired myocardial blood flow in surviving patients

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
G Thornton ◽  
A Shetye ◽  
K Knott ◽  
Y Razvi ◽  
K Vimalesvaran ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Microvascular Disease ◽  
Myocardial Damage ◽  
Stress Perfusion ◽  
Perfusion Image ◽  
Funding Sources ◽  
Perfusion Defects ◽  
Quantitative Stress ◽  
Perfusion Cmr

Abstract Funding Acknowledgements Type of funding sources: None. Background  Acute myocardial damage is common in hospitalized patients with severe COVID-19, with evidence of myocardial infarction and myocarditis demonstrated on cardiovascular magnetic resonance (CMR). Post-mortem studies have also implicated microvascular thrombosis, which may cause persistent microvascular disease.  Purpose  To determine the long-term coronary sequelae in recovered COVID-19 using multiparametric CMR including state-of-the-art inline quantitative stress myocardial blood flow (sMBF) mapping to assess global and regional sMBF. Methods  Prospective, multicentre observational study of recovered COVID-19 patients scanned at three London CMR units. Results were compared to a propensity-matched, pre-COVID chest pain cohort (104 patients referred for perfusion CMR, with subsequently demonstrated unobstructed coronary arteries) and 27 healthy volunteers (HV). Perfusion image analysis was performed using a novel artificial intelligence approach deriving global and regional stress and rest MBF with a cut-off of >2.25mL/g/min signifying normal sMBF and <1.82mL/g/min abnormal sMBF (Kotecha JCVI 2019).  Results  104 recovered, post-COVID patients (median age 62 years, 76% male; 89[87%] hospitalised, 41/89[46%] requiring ICU) underwent adenosine-stress perfusion CMR at a median 131(IQR 43-179) days from COVID-19 diagnosis. Median LVEF was 67% (IQR 60-71%; 12 (11.5%) with impaired LVEF), 51 patients (49%) had late gadolinium enhancement (LGE); 18% infarct-pattern and 33% non-ischaemic LGE.  Global stress MBF in post-COVID patients was no different to age-, sex- and co-morbidities-matched controls (2.57 ± 0.77 vs. 2.40 ± 0.75 ml/g/min, p = 0.11, Figure 1), though lower than HV (3.00 ± 0.76 ml/g/min, p = 0.001). Post-COVID, multivariate predictors of low sMBF were male sex (OR 0.57, 95%CI 0.41-0.80, p = 0.001) and hypertension (OR 0.67, 95%CI 0.51-0.88, p = 0.004), but not COVID-19 disease severity (ICU admission) or presence of scar (ischemic/non-ischemic).  21/42 with reduced sMBF (<2.25mL/g/min) had regional perfusion defects consistent with epicardial coronary disease. Conclusions   COVID-19 survivors do not demonstrate evidence of reduced global MBF by CMR compared to risk factor matched controls. Stress perfusion CMR identifies etiology of acute myocardial damage (infarction/myocarditis) and presence of occult coronary ischemia.

scholarly journals Automated Quantitative Stress Perfusion Cardiac Magnetic Resonance in Pediatric Patients

2021 ◽  
Vol 9 ◽  
Author(s):  
Cian M. Scannell ◽  
Hadeer Hasaneen ◽  
Gerald Greil ◽  
Tarique Hussain ◽  
Reza Razavi ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Heart Diseases ◽  
Stress Perfusion ◽  
Coronary Perfusion ◽  
Cardiac Events ◽  
Large Aneurysm ◽  
Quantitative Stress ◽  
Perfusion Cmr

Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients.Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults.Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002].Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

scholarly journals Prognostic Value of Quantitative Stress Perfusion Cardiac Magnetic Resonance

2018 ◽  
Vol 11 (5) ◽  
pp. 686-694 ◽  
Author(s):  
Eva C. Sammut ◽  
Adriana D.M. Villa ◽  
Gabriella Di Giovine ◽  
Luke Dancy ◽  
Filippo Bosio ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Stress Perfusion ◽  
Quantitative Stress

Bioelectronic Measurement of Nasality in Trainable Mentally Retarded Children

1977 ◽  
Vol 42 (3) ◽  
pp. 436-439 ◽  
Author(s):  
David A. Daly
Keyword(s):  
Mentally Retarded ◽  
High Prevalence ◽  
Mentally Retarded Children ◽  
Trainable Mentally Retarded

Fifty trainable mentally retarded children were evaluated with TONAR II, a bioelectronic instrument for detecting and quantitatively measuring voice parameters. Results indicated that one-half of the children tested were hypernasal. The strikingly high prevalence of excessive nasality was contrasted with results obtained from 64 nonretarded children and 50 educable retarded children tested with the same instrument. The study demonstrated the need of retarded persons for improved voice and resonance.

Multiple Perspectives on the Barriers to Identification and Management of Pediatric Voice Disorders

2017 ◽  
Vol 2 (3) ◽  
pp. 49-56
Author(s):  
Jana Childes ◽  
Alissa Acker ◽  
Dana Collins
Keyword(s):  
Academic Success ◽  
Voice Disorders ◽  
School Personnel ◽  
Voice Disorder ◽  
Multiple Perspectives ◽  
Vocal Qualities ◽  
High Prevalence ◽  
Pediatric Populations ◽  
Low Incidence ◽  
University Settings

Pediatric voice disorders are typically a low-incidence population in the average caseload of clinicians working within school and general clinic settings. This occurs despite evidence of a fairly high prevalence of childhood voice disorders and the multiple impacts the voice disorder may have on a child's social development, the perception of the child by others, and the child's academic success. There are multiple barriers that affect the identification of children with abnormal vocal qualities and their access to services. These include: the reliance on school personnel, the ability of parents and caretakers to identify abnormal vocal qualities and signs of misuse, the access to specialized medical services for appropriate diagnosis, and treatment planning and issues related to the Speech-Language Pathologists' perception of their skills and competence regarding voice management for pediatric populations. These barriers and possible solutions to them are discussed with perspectives from the school, clinic and university settings.

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