scholarly journals Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study

2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Xiaodan Zhao ◽  
Liwei Hu ◽  
Shuang Leng ◽  
Ru-San Tan ◽  
Ping Chai ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Healthy Controls ◽  
Residual Volume ◽  
4D Flow ◽  
Direct Flow ◽  
Age And Gender ◽  
4D Flow Cmr ◽  
Flow Parameters ◽  
Flow Components ◽  
And Gender

Abstract Background Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) allows quantification of biventricular blood flow by flow components and kinetic energy (KE) analyses. However, it remains unclear whether 4D flow parameters can predict cardiopulmonary exercise testing (CPET) as a clinical outcome in repaired tetralogy of Fallot (rTOF). Current study aimed to (1) compare 4D flow CMR parameters in rTOF with age- and gender-matched healthy controls, (2) investigate associations of 4D flow parameters with functional and volumetric right ventricular (RV) remodelling markers, and CPET outcome. Methods Sixty-three rTOF patients (14 paediatric, 49 adult; 30 ± 15 years; 29 M) and 63 age- and gender-matched healthy controls (14 paediatric, 49 adult; 31 ± 15 years) were prospectively recruited at four centers. All underwent cine and 4D flow CMR, and all adults performed standardized CPET same day or within one week of CMR. RV remodelling index was calculated as the ratio of RV to left ventricular (LV) end-diastolic volumes. Four flow components were analyzed: direct flow, retained inflow, delayed ejection flow and residual volume. Additionally, three phasic KE parameters normalized to end-diastolic volume (KEiEDV), were analyzed for both LV and RV: peak systolic, average systolic and peak E-wave. Results In comparisons of rTOF vs. healthy controls, median LV retained inflow (18% vs. 16%, P = 0.005) and median peak E-wave KEiEDV (34.9 µJ/ml vs. 29.2 µJ/ml, P = 0.006) were higher in rTOF; median RV direct flow was lower in rTOF (25% vs. 35%, P < 0.001); median RV delayed ejection flow (21% vs. 17%, P < 0.001) and residual volume (39% vs. 31%, P < 0.001) were both greater in rTOF. RV KEiEDV parameters were all higher in rTOF than healthy controls (all P < 0.001). On multivariate analysis, RV direct flow was an independent predictor of RV function and CPET outcome. RV direct flow and RV peak E-wave KEiEDV were independent predictors of RV remodelling index. Conclusions In this multi-scanner multicenter 4D flow CMR study, reduced RV direct flow was independently associated with RV dysfunction, remodelling and, to a lesser extent, exercise intolerance in rTOF patients. This supports its utility as an imaging parameter for monitoring disease progression and therapeutic response in rTOF. Clinical Trial Registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT03217240.

scholarly journals Left ventricular four-dimensional blood flow energetics and vorticity in chronic myocardial infarction patients with/without left ventricular thrombus

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
A Demirkiran ◽  
M ECJ Hassell ◽  
P Garg ◽  
M SM Elbaz ◽  
R Delewi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vortex Ring ◽  
Left Ventricular ◽  
Residual Flow ◽  
4D Flow ◽  
Direct Flow ◽  
4D Flow Cmr ◽  
Ventricular Thrombus ◽  
The Mean ◽  
Flow Components

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The British Heart Foundation [FS/10/62/28409] and Dutch ZonMw [104003001]. Background Left ventricular thrombus (LVT) formation is a frequent and serious complication of myocardial infarction (MI). How global LV flow characteristics are related to this phenomenon is yet uncertain. In this study, we investigated LV flow differences using 4D flow cardiovascular magnetic resonance (CMR) between chronic MI patients with LVT [MI-LVT(+)] and without LVT [MI-LVT(-)], and healthy controls. Methods In this prospective cohort study, the 4D flow CMR data were acquired in 19 chronic MI patients (MI-LVT(+), n= 9 and MI-LVT(-), n= 10) and 9 age-matched controls. All included subjects were in sinus rhythm. The following LV flow parameters were obtained: LV flow components (direct, retained, delayed, residual), mean and peak KE values (indexed to instantaneous LV volume), mean and peak vorticity values, and diastolic vortex ring properties (position, orientation, shape). Results The MI patients demonstrated a significantly larger amount of delayed and residual flow, and a smaller amount of direct flow compared to controls (p = 0.02, p = 0.03, and p &lt; 0.001, respectively). The MI-LVT(+) patients demonstrated numerically increased residual flow and reduced retained and direct flow in comparison to MI-LVT(-) patients. Systolic mean and peak LV blood flow KE values were significantly lower in MI patients compared to controls (p = 0.04, p = 0.03, respectively). Overall, the mean and peak LV vorticity values were significantly lower in MI patients compared to controls. The mean vorticity at the basal level was significantly higher in MI-LVT(+) than in MI-LVT(-) patients (p &lt; 0.01). The vortex ring core during E-wave in MI-LVT(-) group was located closer to the mitral annulus and in a less tilted orientation to the LV compared to MI-LVT(+) group (p = 0.05, p &lt; 0.01, respectively). Conclusion Chronic MI patients with LVT express a different distribution of LV flow components, irregular vorticity vector fields, and altered diastolic vortex ring geometric properties as assessed by 4D flow CMR. Larger prospective studies are warranted to further evaluate these initial observations.

scholarly journals Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1978
Author(s):  
Tjaša Filipčič ◽  
Špela Bogataj ◽  
Jernej Pajek ◽  
Maja Pajek
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Everyday Life ◽  
Habitual Physical Activity ◽  
Healthy Controls ◽  
Age And Gender ◽  
Comorbidity Score ◽  
Sf 36 ◽  
And Gender

Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age; in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (ModelHD 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (ModelHD 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (ModelHD 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (ModelH 1: p < 0.001), LTI, FTI, and Davies comorbidity score (ModelH 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (ModelH 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort.

scholarly journals Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

2012 ◽  
Vol 70 (11) ◽  
pp. 847-851 ◽  
Author(s):  
Luciana Ulhôa Guedes ◽  
Juliana Melo Rodrigues ◽  
Aline Andrioni Fernandes ◽  
Francisco E. Cardoso ◽  
Verônica Franco Parreira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Statistical Analysis ◽  
Healthy Controls ◽  
Maximal Inspiratory Pressure ◽  
Age And Gender ◽  
Dopaminergic Dysfunction ◽  
And Gender ◽  
Student’S T ◽  
Student’S T Test

OBJECTIVE: To investigate the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in patients with Parkinson's disease (PD) during the on and off periods of levodopa and to compare with healthy controls. METHODS: Twenty-six patients were analyzed with Hoehn and Yahr scores (2-3) and 26 age and gender matched-controls. Statistical analysis was performed with Student's t-test for paired and independent samples. RESULTS: MIP and MEP values in patients were significantly lower than the values obtained in controls both for off and on stages -excepted for MIP in women (p=0.28). For patients with PD, the studied parameters did not differ between stages on and off, with the exception of MEP in women (p=0.00). CONCLUSIONS: Patients with PD have respiratory pressure lower than controls, even in early stages of the disease, and dopamine replacement has little impact over these respiratory pressures. These findings suggest that respiratory changes in PD may be unrelated to dopaminergic dysfunction.

scholarly journals Improved Efficiency of Intraventricular Blood Flow Transit Under Cardiac Stress: A 4D Flow Dobutamine CMR Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Jonathan Sundin ◽  
Jan Engvall ◽  
Eva Nylander ◽  
Tino Ebbers ◽  
Ann F. Bolger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Human Heart ◽  
Flow Patterns ◽  
Relative Increase ◽  
Dobutamine Infusion ◽  
Residual Volume ◽  
4D Flow ◽  
Lv Dysfunction ◽  
Flow Components

Introduction: The effects of heart rate, inotropy, and lusitropy on multidimensional flow patterns and energetics within the human heart remain undefined. Recently, reduced volume and end-diastolic kinetic energy (KE) of the portion of left ventricular (LV) inflow passing directly to outflow, Direct flow (DF), have been shown to reflect inefficient LV pumping and to be a marker of LV dysfunction in heart failure patients. In this study, we hypothesized that increasing heart rate, inotropy, and lusitropy would result in an increased efficiency of intraventricular blood flow transit. Therefore, we sought to investigate LV 4D blood flow patterns and energetics with dobutamine infusion.Methods: 4D flow and morphological cardiovascular magnetic resonance (CMR) data were acquired in twelve healthy subjects: at rest and with dobutamine infusion to achieve a target heart rate ~60% higher than the resting heart rate. A previously validated method was used for flow analysis: pathlines were emitted from the end-diastolic (ED) LV blood volume and traced forward and backward in time to separate four functional LV flow components. For each flow component, KE/mL blood volume at ED was calculated.Results: With dobutamine infusion there was an increase in heart rate (64%, p &lt; 0.001), systolic blood pressure (p = 0.02) and stroke volume (p = 0.01). Of the 4D flow parameters, the most efficient flow component (DF), increased its proportion of EDV (p &lt; 0.001). The EDV proportion of Residual volume, the blood residing in the ventricle over at least two cardiac cycles, decreased (p &lt; 0.001). The KE/mL at ED for all flow components increased (p &lt; 0.001). DF had the largest absolute and relative increase while Residual volume had the smallest absolute and relative increase.Conclusions: This study demonstrates that it is feasible to compare 4D flow patterns within the normal human heart at rest and with stress. At higher heart rate, inotropy and lusitropy, elicited by dobutamine infusion, the efficiency of intraventricular blood flow transit improves, as quantified by an increased relative volume and pre-systolic KE of the most efficient DF component of the LV volume. The change in these markers may allow a novel assessment of LV function and LV dysfunction over a range of stress.

scholarly journals Changes in the concentrations of trimethylamine N-oxide (TMAO) and its precursors in patients with amyotrophic lateral sclerosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lu Chen ◽  
Yong Chen ◽  
Mingming Zhao ◽  
Lemin Zheng ◽  
Dongsheng Fan
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Gut Microbiota ◽  
Metabolic Pathway ◽  
Plasma Concentrations ◽  
Disease Onset ◽  
Healthy Controls ◽  
Age And Gender ◽  
And Gender ◽  
Als Patients ◽  
Lateral Sclerosis

Abstract To compare the plasma concentrations of trimethylamine N-oxide (TMAO) and its precursors in amyotrophic lateral sclerosis (ALS) patients, their spouses and healthy controls and to find associations between gut microbiota metabolites and ALS. ALS patients were recruited at Peking University Third Hospital from January 2015 to December 2018. Information was collected from their spouses at the same time. Age and gender matched healthy controls were recruited from individuals who visited the physical examination center for health checkups. Blood samples were collected after at least 4 h of fasting. Concentrations of the metabolites were quantified using stable isotope dilution liquid chromatography–tandem mass spectrometry. Group differences were analyzed using parametric and nonparametric tests, as appropriate. In this study, 160 patients with ALS were recruited. In these patients, 63 were compared with their spouses, 148 were compared with age and gender matched controls, and 60 were compared with both their spouses and heathy controls in the same time. The carnitine concentration was significantly higher in patients than in their spouses, while there were no significant differences in the concentrations of other metabolites. The carnitine and betaine concentrations were higher, while the choline, TMAO and butyrobetaine concentrations were lower in ALS than in healthy controls. The concentrations of the metabolites in the spouses were more similar to the ALS patients rather than to the healthy controls. In the ALS group, the plasma concentrations of carnitine, betaine, choline and TMAO were inversely related to the severity of upper motor neuron impairment. The TMAO metabolic pathway of the gut microbiota is disturbed in both ALS patients and their spouses, which might suggest that the changes in the gut microbiota occurred before disease onset. The negative correlations between the involvement of UMNs and the concentrations of the metabolites might suggest that the inhibition of this metabolic pathway might lead to a better prognosis in ALS patients.

scholarly journals Characteristics of Nonmotor Symptoms in Progressive Supranuclear Palsy

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ruwei Ou ◽  
Wei Song ◽  
Qianqian Wei ◽  
Ke Chen ◽  
Bei Cao ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Progressive Supranuclear Palsy ◽  
Healthy Aging ◽  
Late Onset ◽  
Healthy Controls ◽  
Nonmotor Symptoms ◽  
Age And Gender ◽  
Attention Memory ◽  
And Gender ◽  
Control Study

Objectives. To explore the clinical correlates of nonmotor symptoms (NMS) in progressive supranuclear palsy (PSP) and their differences from healthy controls and patients with Parkinson’s disease (PD).Methods. Twenty-seven PSP patients, 27 age- and gender-matched healthy controls (HC), and 27 age- and gender-matched PD patients were included for this case-control study. NMS were assessed using the Nonmotor Symptoms Scale (NMSS, including 9 domains).Results. All PSP patients reported NMS. The frequency and severity of “sleep/fatigue,” “mood/apathy,” “attention/memory,” “gastrointestinal,” “sexual dysfunction,” and “miscellaneous” domains in PSP group were significantly higher than those in HC group (P<0.05). The frequency of “mood/apathy,” “attention/memory,” and “sexual dysfunction” domains and the severity of “attention/memory” and “gastrointestinal” domains in PSP group were significantly higher than those in PD group (P<0.05). The “attention/memory” domain in PSP had a significant but weak-to-moderate correlation with age (R=0.387,P=0.046) and onset age (R=0.406,P=0.036).Conclusions. NMS are common in PSP patients. Patients with PSP seem to be subjected to more frequent and severe specific NMS compared to healthy aging subjects and PD patients. Older PSP patients and late-onset patients are likely to be subjected to cognitive decline.

Brain 5-HT function in obsessive-compulsive disorder

1997 ◽  
Vol 171 (3) ◽  
pp. 280-282 ◽  
Author(s):  
N. A. Fineberg ◽  
A. Roberts ◽  
S. A. Montgomery ◽  
P. J. Cowen
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Age And Gender ◽  
Compulsive Disorder ◽  
Therapeutic Advantage ◽  
Neuroendocrine Function ◽  
Prolactin Response ◽  
And Gender ◽  
Drug Free

BackgroundDrugs that potentiate brain serotonin (5-HT) neurotransmission are effective in the treatment of obsessive–compulsive disorder (OCD), but it is unclear whether disturbances in brain 5-HT function play a role in the pathophysiology of OCD.MethodWe studied the prolactin response to the selective 5-HT releasing agent d-fenfluramine in 14 non-depressed, drug-free OCD patients, and 14 healthy controls matched for age and gender.ResultsThe prolactin response to d-fenfluramine was significantly increased in OCD patients compared with controls.ConclusionsThe disparate results of studies of 5-HT neuroendocrine function in OCD make it unlikely that disturbances of brain 5-HT function play a central role in the pathophysiology of OCD. Increased brain 5-HT neurotransmission in non-depressed OCD subjects may represent an adaptive neurobehavioural mechanism which can be amplified to therapeutic advantage by treatment with 5-HT potentiating drugs.

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