scholarly journals ANOVA-Based Analysis of Early Blood Transfusions on Hemodynamics with Severely Injured Trauma Using Bedside Ultrasound Imaging

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lei Song ◽  
Jianguo Zhang ◽  
Junliang Liu
Keyword(s):  
Flow Velocity ◽  
Peak Flow ◽  
Vena Cava ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Bedside Ultrasound ◽  
Blood Transfusions ◽  
Severely Injured ◽  
Peak Flow Velocity ◽  
Left Ventricular Outflow

The focus of the study was to quantitatively analyze the influence of early massive blood transfusions (MBTs) on the hemodynamics and prognostic living quality of patients with severely injured trauma. 114 patients with severely injured trauma were enrolled into MBT group (67 cases) and nonmassive blood transfusions (NBT) group (47 cases) according to whether they accepted MBTs within 24 hours after the admission. All patients had bedside ultrasound technology scanning. Furthermore, the indexes were calculated for inferior vena cava (IVC), peripheral arteries, and heart. The prognostic deaths were recorded. It was found that, in the MBT group, the mortality was lower (7.55% vs. 24.23%) ( P < 0.05 ), and these indexes were higher for the IVC expansion (IVCE), the respiration variation index (RVI) of IVC (ΔIVC2), the peak flow velocity RVI of brachial artery (ΔVpeakBA), femoral artery (ΔVpeakFA), left ventricular outflow tract (ΔVpeakL), and aorta (ΔVpeakAO), as well as peak flow velocity time integral RVI of aorta (ΔVTIAO) ( P < 0.05 ). In conclusion, early MBTs can elevate survival rate and prognostic living quality and alleviate the atrophy degree of IVC, peripheral artery, and blood vessel of patients with severely injured trauma. Furthermore, bedside ultrasound scanning demonstrated superb capabilities in quantitatively displaying hemodynamics and outcomes of MBTs of patients with severely injured trauma.

scholarly journals Pathophysiological and Clinical Approach to Cirrhotic Cardiomyopathy

2014 ◽  
Vol 23 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Alida Páll ◽  
Árpád Czifra ◽  
Zsuzsanna Vitális ◽  
Mária Papp ◽  
György Paragh ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Flow Velocity ◽  
Natriuretic Peptide ◽  
Peak Flow ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Clinical Approach ◽  
Cirrhotic Cardiomyopathy ◽  
Peak Flow Velocity ◽  
Diastolic Left Ventricular Dysfunction

Hyperdynamic circulation, systolic and diastolic left ventricular dysfunction and certain electrophysiological abnormalities have been associated with cirrhosis and known for a long time. These clinical features have been introduced as cirrhotic cardiomyopathy (CCM), which is characterized by blunted myocardial contractile responsiveness to physical, physiological and pharmacological stress. Importantly, cardiac dysfunction can be reversible and can improve due to effective medical treatment and also after liver transplantation. Echocardiography and electrocardiography are essential tools for recognizing the characteristic changes in the myocardial function and also the alterations in the electrophysiological properties of the heart. Laboratory markers are auxiliary modalities further aiding the establishment of the correct diagnosis. In this review, we aimed to collect the pathophysiological background and clinical characteristics of CCM with the intention of summarizing the current possibilities for the diagnosis establishment and treatment of this cardio-hepatic disorder.Abbreviations: A: late diastolic transmitral peak flow velocity; ACE: angiotensin converting enzyme; ANP: atrial natriuretic peptide; ARB: angiotensin receptor blocker; BNP: brain natriuretic peptide; cAMP: cyclic adenosine monophosphate; CCM: cirrhotic cardiomyopathy; CGRP: calcitonin gene-related peptide; CO: carbon monoxide; DD: diastolic dysfunction; DT: deceleration time; E: early diastolic transmitral peak flow velocity; Ea: early diastolic velocity of the septal mitral annulus; EF: ejection fraction; MUGA: Multi Gated Acquisition Scan; NO: nitric oxide; NSBB: non-selective beta-blocker; pro-BNP: pro-brain natriuretic peptide; QTc: corrected QT interval; RAAS: renin-angiotensin aldosterone system; RALES: Randomized Aldactone Evaluation Study; suPAR: urokinase-type plasminogen activator receptor; TDI: Tissue Doppler Imaging; TIPS: transjugular intrahepatic portosystemic shunt; TNF-alpha: tumor necrosis factor-alpha.

scholarly journals P1512 Combination of mitral annular peak systolic and early diastolic velocities with early transmitral peak flow velocity: a new prognostic echo index in patients with acute coronary syndrome

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Nakamura ◽  
A Yamada ◽  
M Kato ◽  
S Jinno ◽  
A Takahashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Flow Velocity ◽  
Peak Flow ◽  
Left Ventricular ◽  
Volume Index ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Peak Flow Velocity

Abstract Background One of the novel echocardiographic indices reflecting left ventricular (LV) diastolic filling is the combination of mitral annular peak systolic (s’) and early diastolic velocities (e’) with early transmitral peak flow velocity (E); E/(e’ x s’). This index is reported to be useful to predict a prognosis of heart failure patients regardless of their LV ejection fraction (LVEF).Purpose: The aim of this study was to examine whether or not E/(e’ x s’) could predict cardiac events in patients with acute coronary syndrome (ACS).Methods: We studies consecutive ACS patients hospitalized in our institution between December 2009 and February 2012. They underwent echo examination within 7 days after admission. By use of Doppler tissue imaging, e’ and s’ were respectively calculated by averaging the peak velocities measured at both septal and lateral mitral annulus in 4-chamber view. The exclusion criteria were as follows: atrial fibrillation, significant valvular diseases and inadequate echo images. Cardiac events were defined as re-hospitalization due to recurrent ACS and/or heart failure, and cardiac mortality.Results: In total, 168 patients were eligible for this study (mean age 67 ± 11 years, mean LVEF 51.7 ± 10.3 %). Median follow-up period was 22.5 months. During the follow-up, cardiac events occurred in 27 patients (16.1%). Between the patients with cardiac events and those without, there were significant differences in LV end-systolic volume (44.2 ± 29.1 vs 33.2 ± 13.6 ml, p &lt; 0.05), LV mass index (122.4 ± 38.9 vs 107.5 ± 26.4 g/m², p &lt; 0.05), left atrial volume index (31.7 ± 9.2 vs 27.6 ± 9.4 ml/m², p &lt; 0.05), LVEF (45.7 ± 13.5 vs 52.9 ± 9.2 %, p &lt; 0.05), s’ (5.1 ± 1.6 vs 7.1 ± 1.7 cm/sec, p &lt; 0.001), e’ (4.8 ± 1.3 vs 6.0 ± 1.9 cm/sec, p &lt; 0.05), E/e’ (16.4 ± 6.6 vs 12.5 ± 4.9, p &lt; 0.05), E/(e’ x s’) (3.78 ± 2.52 vs 1.94 ± 1.08, p &lt; 0.001), and serum B-type natriuretic peptide (334.7 ± 420.1 vs 113.8 ± 177.2 pg/ml, p &lt; 0.05). While Cox proportional hazard multivariate analysis detected that E/(e’ x s’) and E/e’ were independent predictors of cardiac events, E/(e’ x s’) was more powerful than E/e’ (p = 0.0002 vs p = 0.0072). ROC analysis revealed that 2.35 of E/(e’ x s’) was the optimal cutoff values to predict cardiac events in ACS patients (AUC 0.79). Patients with E/(e’ x s’) &lt;2.35 had significantly better prognosis than the rest (p &lt; 0.0001, Log-rank; Figure)Conclusion: E/(e’ x s’) could be a useful echo marker to predict cardiac events in ACS patients. Abstract P1512 Figure.

scholarly journals Echocardiography for left ventricular outflow tract velocity time integral versus inferior vena cava collapsibility index as a predictor to fluid responsiveness in severe sepsis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
D A M Nasr ◽  
A A Moharam ◽  
M M K Abdallah ◽  
A A S M Karam
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Fluid Responsiveness ◽  
Host Response ◽  
Vena Cava ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Collapsibility Index ◽  
Left Ventricular Outflow ◽  
Sepsis And Septic Shock

Abstract Background Severe sepsis is the most common cause of death for patients admitted to the critical care units. Sepsis is a multifaceted host response to an infecting pathogen that may be significantly amplified by endogenous factors. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. This emphasizes the primacy of the non-homeostatic host-response to infection, the potential lethality that is considerably in excess of a straightforward infection, and the need for urgent recognition. Aims The aim of this work is to compare Left ventricular Outflow Tract (LVOT) velocity time Integral (VTI) and inferior Vena Cava (IVC) collapsibility index as a predictor to fluid responsiveness in patients with severe sepsis and septic shock. Methodology This study was conducted on 40 patients of both sex who were admitted to the intensive care unit were diagnosed as severe sepsis and /or septic shock. Patients were divided in two groups: Responders (R): 22 patients with LVOT ΔVTI 500 ≥ 15%. Non-responders (NR): 18 patients with LVOT ΔVTI 500 &lt; 15%. Results Our results showed that IVCCI 100 and 500 were a less reliable predictor to fluid responsiveness in patients with severe sepsis and septic shock than ΔVTI 500. However when using IVCCI after 100 or 500 cc of fluid resuscitation, patients with IVCCI 100 above 38% or IVCCI 500 above 30% are more likely to respond to fluid challenge. More precisely, an IVCCI 100 below 38% and IVCCI 500 value below 30% cannot exclude fluid responsiveness. Conclusions IVC collapsibility Index is less reliable predictor than VTI (LVOT) in predicting fluid responsiveness in spontaneously breathing patients diagnosed with severe sepsis and/ or septic shock Recommendations IVCCI should be used more cautiously as a predictor to fluid responsiveness in spontaneously breathing patients diagnosed with severe sepsis and /or septic shock.

Effect of prophylactic digitalization on the development of myocardial hypertrophy

1977 ◽  
Vol 233 (5) ◽  
pp. H600-H604
Author(s):  
A. F. Cutilletta ◽  
M. Rudnik ◽  
R. A. Arcilla ◽  
R. Straube
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Flow Velocity ◽  
Ventricular Hypertrophy ◽  
Peak Flow ◽  
Myocardial Hypertrophy ◽  
Left Ventricular ◽  
Heart Weight ◽  
Aortic Constriction ◽  
Flow Acceleration ◽  
Peak Flow Velocity

The effect of prophylactic digitalization on the development of left ventricular hypertrophy was studied in adult rats. Digitoxin, 0.1 mg/100 g body wt or solvent was given daily for 1 wk prior to either aortic constriction or sham operation and was continued until the animals were killed, either 1 or 4 wk after surgery. A hemodynamic study was done in those animals killed 1 wk after surgery; hearts of all animals were examined for evidence of myocardial hypertrophy. Constriction of the ascending aorta had no significant effect on cardiac output but did reduce peak flow velocity and flow acceleration. An increase in left ventricular mass, RNA, and hydroxyproline was found in the animals with aortic constriction. Digitoxin treatment did not alter peak flow velocity or flow acceleration, but did significantly increase isovolumic (dP/dt)P-1. Digitoxin had no effect on body weight, heart weight, RNA, or hydroxyproline in either the sham-operated animals or in the animals with aortic constriction. Therefore, despite plasma digitoxin levels sufficient to affect myocardial contractility, left ventricular hypertrophy still developed after aortic constriction.

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