Impact of Transcatheter Pulmonary Artery Intervention Following Superior Cavopulmonary Connection on Pulmonary Artery Growth

2021 ◽  
Vol 12 (5) ◽  
pp. 635-642
Author(s):  
Kasey J. Chaszczewski ◽  
Jing Huang ◽  
Stephanie Fuller ◽  
Christopher L. Smith ◽  
Yoav Dori ◽  
...  
Keyword(s):  
Growth Rate ◽  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Lower Lobe ◽  
Differential Growth ◽  
Mixed Effect ◽  
Effect Model ◽  
Distal Branch ◽  
The Impact ◽  
Cavopulmonary Connection

Introduction: Balloon and stent angioplasty of the pulmonary arteries (PAs) are frequently performed following superior cavopulmonary connection (SCPC), not only to normalize the caliber of the affected PA but also in hopes of maximizing downstream growth over time. There are limited data on the impact on subsequent PA growth prior to total cavopulmonary connection (TCPC). Methods: A single-center, retrospective cohort study was performed on children who underwent transcatheter (TC) PA intervention following SCPC between January 1, 2010, and December 31, 2018. Growth of treated and contralateral PAs was measured at the lobar bifurcation (distal branch PA [DBPA]) and in the proximal lower lobe (lower lobe branch [LLB]) on serial angiograms. Growth rate was evaluated using a mixed-effect model clustered by individual patient with an interaction term for treated PA and time to evaluate for differential growth rates between treated and contralateral PAs. Results: Thirty-five patients underwent TC PA intervention following SCPC, at a median of 70 days (interquartile range: 19-297 days) postoperatively. Significant growth was seen at both DBPA and LLB for raw (0.8 mm/year, 95% CI: 0.6-1.0, P < .001 for both) and body surface area (BSA) adjusted measures (8.4mm/m2/year, 95% CI: 5.6-11.2, P < .001; 7.9 mm/m2/year, 95% CI: 5.5-10.2, P < .001). The growth rate of the treated vessel was not significantly different from that of the contralateral vessel at the DBPA or LLB positions for raw ( P = .71, .70) or BSA-adjusted measurements ( P = .86, .64). Conclusion: Transcatheter PA intervention was associated with normal distal PA growth rate relative to the untreated side.

scholarly journals Differential Thermotolerance Adaptation between Species of Coccidioides

2020 ◽  
Vol 6 (4) ◽  
pp. 366
Author(s):  
Heather L. Mead ◽  
Paris S. Hamm ◽  
Isaac N. Shaffer ◽  
Marcus de Melo Teixeira ◽  
Christopher S. Wendel ◽  
...  
Keyword(s):  
Growth Rate ◽  
Linear Mixed Effect Model ◽  
Phenotypic Difference ◽  
Dimorphic Fungi ◽  
Mixed Effect ◽  
Valley Fever ◽  
Solid Media ◽  
Effect Model ◽  
Molecular Phylogenetic ◽  
Similar Growth

Coccidioidomycosis, or Valley fever, is caused by two species of dimorphic fungi. Based on molecular phylogenetic evidence, the genus Coccidioides contains two reciprocally monophyletic species: C. immitis and C. posadasii. However, phenotypic variation between species has not been deeply investigated. We therefore explored differences in growth rate under various conditions. A collection of 39 C. posadasii and 46 C. immitis isolates, representing the full geographical range of the two species, was screened for mycelial growth rate at 37 °C and 28 °C on solid media. The radial growth rate was measured for 16 days on yeast extract agar. A linear mixed effect model was used to compare the growth rate of C. posadasii and C. immitis at 37 °C and 28 °C, respectively. C. posadasii grew significantly faster at 37 °C, when compared to C. immitis; whereas both species had similar growth rates at 28 °C. These results indicate thermotolerance differs between these two species. As the ecological niche has not been well-described for Coccidioides spp., and disease variability between species has not been shown, the evolutionary pressure underlying the adaptation is unclear. However, this research reveals the first significant phenotypic difference between the two species that directly applies to ecological research.

Femoral vein homograft as Sano shunt results in improved pulmonary artery growth after Norwood operation

2017 ◽  
Vol 28 (1) ◽  
pp. 118-125 ◽  
Author(s):  
Mario Briceno-Medina ◽  
T. K. Susheel Kumar ◽  
Shyam Sathanandam ◽  
Umar Boston ◽  
Michael Perez ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Diastolic Pressure ◽  
Femoral Vein ◽  
Pulmonary Arteries ◽  
Individual Branch ◽  
Study Population ◽  
Systemic Oxygen ◽  
The Individual ◽  
Left Heart Syndrome ◽  
The Impact

AbstractObjectiveTo evaluate differences in interstage growth of pulmonary arteries between use of polytetrafluoroethylene and femoral vein homograft as Sano shunt during stage-I Norwood palliation.MethodsA retrospective review of all patients who survived to the second stage following Norwood–Sano operation at two institutions was performed. Either polytetrafluoroethylene or the valved segment of femoral vein homograft was used for construction of the Sano shunt. The size of pulmonary arteries was compared at pre-Glenn catheterisation.ResultsA total of 48 neonates with the diagnosis of hypoplastic left heart syndrome or its variants comprised the study population. Femoral vein homograft of 5–6 mm diameter was used in 14 and polytetrafluoroethylene graft of 5 mm was used in 34 patients. The two groups were comparable in terms of preoperative demographics and age at time of pre-Glenn catheterisation (3.9±0.7 versus 3.4±0.8 months, p=0.06). Patients who received femoral vein homograft demonstrated a significantly higher pre-Glenn Nakata index [264 (130–460) versus 165 (108–234) mm2/m2, p=0.004]. The individual branch pulmonary arteries were significantly larger in the femoral vein group (right, 7.8±3.6 versus 5.0±1.2, p=0.014; left, 7.2±2.1 versus 5.6±1.9, p=0.02). There were no differences in cardiac index, Qp:Qs, ventricular end-diastolic pressure or systemic oxygen saturations.ConclusionsUtilisation of a valved segment of femoral vein homograft as right ventricle to pulmonary artery conduit during Norwood–Sano operation confers better interstage growth of the pulmonary arteries. Further studies are needed to evaluate the impact of femoral vein homograft on single ventricle function.

Bayesian multi-response nonlinear mixed-effect model: application of two recent HIV infection biomarkers

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Charlotte Castel ◽  
Cécile Sommen ◽  
Edouard Chatignoux ◽  
Yann Le Strat ◽  
Ahmadou Alioum
Keyword(s):  
Hiv Transmission ◽  
Real Data ◽  
Mixed Effect Model ◽  
Hiv Incidence ◽  
Mixed Effect ◽  
Nonlinear Mixed Effect Model ◽  
Nonlinear Mixed Effect ◽  
Effect Model ◽  
Recent Hiv Infection ◽  
The Impact

Abstract Since the discovery of the human immunodeficiency virus (HIV) 35 years ago, the epidemic is still ongoing in France. To monitor the dynamics of HIV transmission and assess the impact of prevention campaigns, the main indicator is the incidence. One method to estimate the HIV incidence is based on biomarker values at diagnosis and their dynamics over time. Estimating the HIV incidence from biomarkers first requires modeling their dynamics since infection using external longitudinal data. The objective of the work presented here is to estimate the joint dynamics of two biomarkers from the PRIMO cohort. We thus jointly modeled the dynamics of two biomarkers (TM and V3) using a multi-response nonlinear mixed-effect model. The parameters were estimated using Bayesian Hamiltonian Monte Carlo inference. This procedure was first applied to the real data of the PRIMO cohort. In a simulation study, we then evaluated the performance of the Bayesian procedure for estimating the parameters of multi-response nonlinear mixed-effect models.

The effect of executive control ability on the comprehension of second language metaphor

2017 ◽  
Vol 23 (1) ◽  
pp. 87-101
Author(s):  
Junmei Lü ◽  
Lijuan Liang ◽  
Baoguo Chen
Keyword(s):  
Second Language ◽  
Executive Control ◽  
Linear Mixed Effect Model ◽  
Response Latencies ◽  
Mixed Effect ◽  
Metaphor Comprehension ◽  
Effect Model ◽  
L2 Learners ◽  
Stimulus Materials ◽  
The Impact

Aims: The present study examined the effect of language-related executive control ability on second language (L2) metaphor comprehension in L2 learners. Design: All participants were Chinese–English bilinguals. The Stroop task was used to measure language-related executive control ability. Three types of sentences were used as stimulus materials, including familiar metaphoric sentences, unfamiliar metaphoric sentences and literal sentences. Participants were asked to determine whether the sentence presented was metaphoric or not. Data and analysis: Both response latencies and accuracy scores were obtained. Linear mixed effect model was used for statistical analysis. Findings: The effect of executive control ability on L2 metaphor comprehension is modulated by the familiarity of the metaphor. Specifically, for familiar metaphor sentences, the response time of participants with higher executive control ability was significantly faster than those with lower executive control ability. However, for the unfamiliar metaphor sentences and literal sentences, the effect of executive control ability was not significant. Originality: This study directly explored the impact of language-related executive control on metaphor comprehension in L2 learners. Significance/Implications: Our results found that the Predication Model is also applicable to L2 learners.

scholarly journals The Role of Collagen Synthesis in Ventricular and Vascular Adaptation to Hypoxic Pulmonary Hypertension

2013 ◽  
Vol 135 (2) ◽  
Author(s):  
David Schreier ◽  
Timothy Hacker ◽  
Gouqing Song ◽  
Naomi Chesler
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Collagen Synthesis ◽  
Chronic Hypoxia ◽  
Coupling Efficiency ◽  
Pulmonary Arteries ◽  
Collagen Accumulation ◽  
The Impact ◽  
Rv Function

Pulmonary arterial hypertension (PAH) is a rapidly fatal disease in which mortality is typically due to right ventricular (RV) failure. An excellent predictor of mortality in PAH is proximal pulmonary artery stiffening, which is mediated by collagen accumulation in hypoxia-induced pulmonary hypertension (HPH) in mice. We sought to investigate the impact of limiting vascular and ventricular collagen accumulation on RV function and the hemodynamic coupling efficiency between the RV and pulmonary vasculature. Inbred mice were exposed to chronic hypoxia for 10 days with either no treatment (HPH) or with treatment with a proline analog that impairs collagen synthesis (CHOP-PEG; HPH + CP). Both groups were compared to control mice (CTL) exposed only to normoxia (no treatment). An admittance catheter was used to measure pressure-volume loops at baseline and during vena cava occlusion, with mice ventilated with either room air or 8% oxygen, from which pulmonary hemodynamics, RV function, and ventricular-vascular coupling efficiency (ηvvc) were calculated. Proline analog treatment limited increases in RV afterload (neither effective arterial elastance Ea nor total pulmonary vascular resistance significantly increased compared to CTL with CHOP-PEG), limited the development of pulmonary hypertension (CHOP-PEG reduced right ventricular systolic pressure by 10% compared to HPH, p < 0.05), and limited RV hypertrophy (CHOP-PEG reduced RV mass by 18% compared to HPH, p < 0.005). In an acutely hypoxic state, treatment improved RV function (CHOP-PEG increased end-systolic elastance Ees by 43%, p < 0.05) and maintained ηvvc at control, room air levels. CHOP-PEG also decreased lung collagen content by 12% measured biochemically compared to HPH (p < 0.01), with differences evident in large and small pulmonary arteries by histology. Our results demonstrate that preventing new collagen synthesis limits pulmonary hypertension development by reducing collagen accumulation in the pulmonary arteries that affect RV afterload. In particular, the proline analog limited structural and functional changes in distal pulmonary arteries in this model of early and somewhat mild pulmonary hypertension. We conclude that collagen plays an important role in small pulmonary artery remodeling and, thereby, affects RV structure and function changes induced by chronic hypoxia.

scholarly journals Uninterrupted Classroom Sitting is Associated with Increased Discomfort and Sleepiness Among College Students

2019 ◽  
Vol 16 (14) ◽  
pp. 2498 ◽  
Author(s):  
Katie R. Hosteng ◽  
Alison Phillips Reichter ◽  
Jacob E. Simmering ◽  
Lucas J. Carr
Keyword(s):  
College Students ◽  
Undergraduate Students ◽  
Best Practice ◽  
Sitting Time ◽  
Linear Mixed Effect Model ◽  
Single Class ◽  
Mixed Effect ◽  
Effect Model ◽  
Stanford Sleepiness Scale ◽  
The Impact

Acute bouts of uninterrupted sitting has been associated with discomfort and fatigue in adult populations. However, little is known regarding the impact of uninterrupted sitting on such outcomes among college students. Understanding these relations would be useful for informing best practice and future interventions. The present study explored the relation between uninterrupted sitting and perceived levels of physical discomfort and sleepiness among college students in a real classroom setting. We recruited 54 undergraduate students enrolled in a single class at a Midwestern university. Participants remained seated throughout a 2.5 h lecture while completing the Stanford Sleepiness Scale (SSS) and General Comfort Scale (GCS) every 15 min. Linear mixed effect model analyses were used to determine the relations between the independent and dependent variables and the duration at which students reported significant impairments in discomfort and/or sleepiness. Classroom sitting time was associated with increases in discomfort (r = 0.28, p < 0.01) and sleepiness (r = 0.30, p < 0.01). Students reported significant impairments in discomfort and sleepiness after 75 and 15 min, respectively. These findings support further research into the acceptability, feasibility and efficacy of interventions designed to interrupt classroom sitting on discomfort, sleepiness and measures of academic performance.

scholarly journals Differential thermotolerance adaptation between species of Coccidioides

2020 ◽  
Author(s):  
Heather L. Mead ◽  
Paris S. Hamm ◽  
Isaac N. Shaffer ◽  
Marcus de Melo Teixeira ◽  
Christopher S. Wendel ◽  
...  
Keyword(s):  
Growth Rate ◽  
Linear Mixed Effect Model ◽  
Phenotypic Difference ◽  
Dimorphic Fungi ◽  
Mixed Effect ◽  
Valley Fever ◽  
Solid Media ◽  
Effect Model ◽  
Molecular Phylogenetic ◽  
Similar Growth

AbstractCoccidioidomycosis, or Valley fever, is caused by two species of dimorphic fungi. Based on molecular phylogenetic evidence, the genus Coccidioides contains two reciprocally monophyletic species: C. immitis and C. posadasii. However, phenotypic variation between species has not been deeply investigated. We therefore explored differences in growth rate under various conditions. A collection of 39 C. posadasii and 46 C. immitis isolates, representing the full geographical range of the two species, were screened for mycelial growth rate at 37°C and 28°C on solid media. The radial growth rate was measured over 16 days on yeast extract agar. A linear mixed effect model was used to compare the growth rate of C. posadasii and C. immitis at 37°C and 28°C respectively. C. posadasii grew significantly faster at 37°C, when compared to C. immitis; whereas both species had similar growth rates at 28°C. These results indicate thermotolerance differs between these two species. As the ecological niche has not been well-described for Coccidioides spp., and disease variability between species has not been shown, the evolutionary pressure underlying the adaptation is unclear. However, this research reveals the first significant phenotypic difference between the two species that directly applies to ecological and clinical research.

Chronic Thromboembolic Pulmonary Hypertension

2010 ◽  
pp. 224-227
Author(s):  
Edward C. Rosenow
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Lower Lobe ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Progressive Dyspnea ◽  
Thromboembolic Pulmonary Hypertension ◽  
Hilar Adenopathy

Enlarged central pulmonary arteries mimic hilar adenopathy, which does not explain dyspnea on exertion. Enlarged right lower lobe pulmonary artery is 20 mm in width (normal, 〈14 mm) (arrow) • 15-year-old girl • Progressive dyspnea on exertion • CXR findings were interpreted as normal

scholarly journals Bronchial Artery to Pulmonary Artery Fistula Presenting with Massive Hemoptysis in a Pediatric Patient

2021 ◽  
Author(s):  
Aoife Corcoran ◽  
Silvia Cardenas
Keyword(s):  
Pulmonary Artery ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Lower Lobe ◽  
Massive Hemoptysis ◽  
Recurrent Bleeding ◽  
Moderate Volume ◽  
The Right ◽  
Pulmonary Artery Fistula ◽  
Right Bronchial Artery

Hemoptysis is a serious and potentially life-threatening event. Mortality is estimated at 13% for this chief complaint with age, volume of hemoptysis and receipt of blood products as risk factors for mortality. Hemoptysis is mostly seen in those with underlying congenital cardiac conditions or Cystic Fibrosis. We describe a unique case of a previously healthy 10 year old male who presented to the ED by EMS with a moderate volume episode of hemoptysis. He was admitted to the PICU where a sudden episode of massive hemoptysis precipitated by forced respiratory effort occurred during his examination. He decompensated and was emergently brought to the OR for airway evaluation by ENT and pulmonology. A large clot was found in the RML segment with brisk bleeding following removal of the clot. A 5 Fr bronchial blocker was placed to achieve hemostasis. Bronchial artery angiogram by IR demonstrated extravasation of contrast from right bronchial artery to segmental right lower lobe pulmonary artery shunt. He underwent embolization of the right bronchial artery. He was extubated the following day after no recurrent bleeding was confirmed with bronchoscopy. BA-PA fistulas are rare vascular anomalies in which an anastomosis is formed between systemic and pulmonary arteries. They are most commonly acquired, often described as secondary to chronic inflammatory lung diseases. BA-PA fistulas can also be congenital and have been seldom described in the literature. Our case highlights the importance of this rare diagnosis, which must remain on a pediatric pulmonologist’s differential due to the significant associated mortality.

The comparative role of echocardiography and MRI for identifying critical lesions in patients with single-ventricle physiology, before bidirectional cavopulmonary connection

2016 ◽  
Vol 26 (7) ◽  
pp. 1373-1382 ◽  
Author(s):  
Sylvia Krupickova ◽  
Michael A. Quail ◽  
Robert Yates ◽  
Roman Gebauer ◽  
Marina Hughes ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Odds Ratio ◽  
Single Ventricle ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Atrioventricular Valve ◽  
Valve Regurgitation ◽  
Atrioventricular Valve Regurgitation ◽  
Cavopulmonary Connection ◽  
Bidirectional Cavopulmonary Connection

AbstractBackgroundIn the era of multi-modality imaging, this study compared contemporary, pre-operative echocardiography and cardiac MRI in predicting the need for intervention on additional lesions before surgical bidirectional cavopulmonary connection.MethodsA total of 72 patients undergoing bidirectional cavopulmonary connection for single-ventricle palliation between 2007 and 2012, who underwent pre-operative assessment using both echocardiography and MRI, were included. The pre-determined outcome measure was any additional surgical or catheter-based intervention within 6 months of bidirectional cavopulmonary connection. Indices assessed were as follows: indexed dimensions of right and left pulmonary arteries, coarctation of the aorta, adequacy of interatrial communication, and degree of atrioventricular valve regurgitation.ResultsMedian age at bidirectional cavopulmonary connection was 160 days (interquartile range 121–284). The following MRI parameters predicted intervention: Z score for right pulmonary artery (odds ratio 1.77 (95% confidence interval 1.12–2.79, p=0.014)) and left pulmonary artery dimensions (odds ratio 1.45 (1.04–2.00, p=0.027)) and left pulmonary artery report conclusion (odds ratio 1.57 (1.06–2.33)). The magnetic resonance report predicted aortic arch intervention (odds ratio 11.5 (3.5–37.7, p=0.00006)). The need for atrioventricular valve repair was associated only with magnetic resonance regurgitation fraction score (odds ratio 22.4 (1.7–295.1, p=0.018)). Echocardiography assessment was superior to MRI for predicting intervention on interatrial septum (odds ratio 27.7 (6.3–121.6, p=0.00001)).ConclusionFor branch pulmonary arteries, aortic arch, and atrioventricular valve regurgitation, MRI parameters more reliably predict the need for intervention; however, echocardiography more accurately identified the adequacy of interatrial communication. Approaching bidirectional cavopulmonary connection, the diagnostic strengths of MRI and echocardiography should be acknowledged when considering intervention.

Sign in / Sign up

Export Citation Format

Share Document