scholarly journals Choosing the Adaptive Cardiac Phase for Assessing Cardiac Dimensions Using Cardiac Computed Tomography for Heart Disease

2021 ◽  
Author(s):  
Li Wang ◽  
Jin-Rong Zhou ◽  
Dong Chen ◽  
Yu-Jiao Deng ◽  
Jing Chen
Keyword(s):  
Wall Thickness ◽  
Mixed Model ◽  
Cardiac Ct ◽  
Linear Mixed Model ◽  
Cardiac Cycle ◽  
Cardiac Computed Tomography ◽  
Interventricular Septum ◽  
High Sensitivity ◽  
Cardiac Phase ◽  
Cardiac Chamber

Abstract Background Choosing a suitable cardiac cycle to measure cardiac chamber dimensions and wall thickness can be a more accurate assessment of cardiovascular disease. Methods Cardiac CT was performed on 137 patients for suspected coronary disease. The parameters of left atrium (LA), left ventricle (LV), right atrium (RA), and right ventricle (RV), as well as the wall thickness of LV were measured in different cardiac phases. The general linear mixed model was used to analyze differences in different phases and the correlation between these parameters and traditional risk factors. ROC analysis was performed to estimate LA enlargement. Results The dimensions of LA, RA, and LV wall thickness achieved the maximum at the phase of 35–45%, and those of LV and RV, at 95–5%. Whereas, the changes of LA-B (antero-posterior diameter), LV-D1 (basal dimension), RA-B (minor dimension) and RV-D2 (mid cavity dimension) were relatively more stable during the cardiac cycle. The maximum LA-B diameter(95%CI 36.92,38.48mm), LV-D1 diameter(95%CI 44.36,45.83mm), RA-B diameter(95%CI 48.75,50.61mm), and RV-D2 diameter(95%CI 30.83,32.84mm) and the maximum interventricular septum thickness( 95%CI 10.79,11.51mm) was acquired. Heart rate (HR) and smoking were potential indicators of LVD2 (mid cavity dimension), while HR and LV myocardial mass were potential indicators of LVD3 (apical-basal dimension). In phase 45%, the cut-off value of LA-B was 37.12mm has high sensitivity of 90.9% for predicting LA enlargement. Conclusion Cardiac chamber dimensions and wall thickness vary with the cardiac phase. Choosing the adaptive cardiac phase for evaluating these parameters obtained by cardiac CT could provide a more accurate clinical measurement. Trial registration retrospectively registered.

scholarly journals Choosing The Adaptive Cardiac Phase for Assessing Cardiac Dimensions Using Cardiac Computed Tomography for Heart Disease

2021 ◽  
Author(s):  
Li Wang ◽  
Jin-Rong Zhou ◽  
Dong Chen ◽  
Yu-Jiao Deng ◽  
Jing Chen
Keyword(s):  
Wall Thickness ◽  
Mixed Model ◽  
Cardiac Ct ◽  
Linear Mixed Model ◽  
Cardiac Cycle ◽  
Interventricular Septum ◽  
High Specificity ◽  
Cardiac Phase ◽  
Cardiac Chamber ◽  
Traditional Risk Factors

Abstract Background: Choosing a suitable cardiac cycle to measure cardiac chamber dimensions and wall thickness can be a more accurate assessment of cardiovascular disease.Methods: Cardiac CT was performed on 137 patients for suspected coronary disease. The parameters of left atrium (LA), left ventricle (LV), right atrium (RA), and right ventricle (RV), as well as the wall thickness of LV were measured in different cardiac phases. The general linear mixed model was used to analyze differences in different phases and the correlation between these parameters and traditional risk factors. ROC analysis was performed to estimate LA enlargement. Results:The dimensions of LA, RA, and LV wall thickness achieved the maximum at the phase of 35%–45%, and the dimensions of LV and RV reached the maximum at 95%–5%. Whereas, the changes of LA-B (antero-posterior diameter), LV-D1 (basal dimension), RA-B (minor dimension) and RV-D2 (mid cavity dimension) were relatively more stable during the cardiac cycle. The maximum LA-B diameter(95%CI 36.92,38.48mm), LV-D1 diameter(95%CI 44.36,45.83mm), RA-B diameter(95%CI 48.75,50.61mm), and RV-D2 diameter(95%CI 30.83,32.84mm) and the maximum interventricular septum thickness( 95%CI 10.79,11.51mm) was acquired. Heart rate (HR) and smoking were potential indicators of LVD2 (mid cavity dimension), while HR and LV myocardial mass were potential indicators of LVD3 (apical-basal dimension). In phase 45%, the cut-off value of LA-A with 77.57mm has high specificity.Conclusion: Cardiac chamber dimensions and wall thickness vary with the cardiac phase. Choosing the adaptive cardiac phase for evaluating these parameters obtained by cardiac CT could provide a more accurate clinical measurement.

scholarly journals Assessment of thoracic aorta in different cardiac phases in patients with non-aorta diseases using cardiac CT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xue Zheng ◽  
Yu-jiao Deng ◽  
Fu-Gang Han ◽  
Jin-Rong Zhou ◽  
Li Luo ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Mixed Model ◽  
Cardiac Ct ◽  
Linear Mixed Model ◽  
Main Pulmonary Artery ◽  
Aortic Disease ◽  
Aortic Diameter ◽  
Maximum Diameter ◽  
Cardiac Phase ◽  
Descending Aorta

AbstractThe aim was to evaluate the thoracic aorta in different cardiac phases to obtain the correct cardiac phase for measuring the maximum diameter required to predict aortic disease. Cardiac CT was performed on 97 patients for suspected coronary artery disease. The average diameter of ascending (AAD) and descending aorta (DAD) in the plane of pulmonary bifurcation, in the plane of the sinus junction (AAD [STJ] and DAD [STJ]), descending aorta in the plane of the diaphragm (DAD [Dia]), the diameter of the main pulmonary artery (MPAD), distance from the sternum to the spine (S-SD), and distance from the sternum to the ascending aorta (S-AAD) were assessed at 20 different time points in the cardiac cycle. Differences in aortic diameter in different cardiac phases and the correlation between aortic diameter and traditional risk factors were analyzed by the general linear mixed model. The diameter of the thoracic aorta reached the minimum at the phase of 95–0%, and reached the maximum at 30–35%. The maximum values of AAD, AAD (STJ), DAD, DAD (STJ), and DAD (Dia) were 32.51 ± 3.35 mm, 28.86 ± 3.01 mm, 23.46 ± 2.88 mm, 21.85 ± 2.58 mm, and 21.09 ± 2.66 mm, respectively. The maximum values of MPAD/AAD and DAD/AAD (STJ) were 0.8140 ± 0.1029, 0.7623 ± 0.0799, respectively. The diameter of the thoracic aorta varies with the cardiac phase. Analyzing the changes in aortic diameter, which can be done using cardiac CT, could provide a more accurate clinical measurement for predicting aortic disease.

Abstract 18009: Clinical-officer Led Echocardiographic Screening is Sensitive for Diagnosing Rheumatic Heart Disease in Malawi, Africa

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Amy E Sims ◽  
Craig A Sable ◽  
Mina Hosseinipour ◽  
Melissa Karlsten ◽  
Peter N Kazembe ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
High Sensitivity ◽  
Kappa Statistic ◽  
Clinical Officer ◽  
Pediatric Cardiologist ◽  
Asymptomatic Children ◽  
Rheumatic Heart

Malawi, Africa has a high prevalence of rheumatic heart disease (RHD). Echocardiographic (echo) screening for RHD in asymptomatic children may enable early diagnosis and treatment in order to prevent progression of RHD. Malawi has few physicians, and no pediatric cardiologists in the country. Therefore, physician-led RHD screening is not feasible. Clinical officers (CO’s) are mid-level providers who may be able to perform RHD echo screening. Hypothesis: After training, CO’s will have similar results in identifying RHD by echocardiography as a pediatric cardiologist. Methods: 8 CO’s with no previous echo experience completed 3 half-days of didactic and computer-module based training as well as 2 days of clinical attachments at a local school. On the attachments, CO’s completed an average of 60 mentored RHD screening echos with a Philips portable CX50 echo machine. CO’s were evaluated by performing screening echos on 20 children with and without RHD who were screened in the previous year. They indicated whether the children should be referred for follow-up. Screening protocol called for referral if a mitral regurgitation jet measured more than 1.5 cm or an aortic regurgitation jet measured more than 1 cm. Kappa statistic was calculated based on agreement with a pediatric cardiologist’s screening result (referral vs. no referral). Sensitivity and specificity were estimated using a generalized linear mixed model. Results: The mean kappa statistic comparing CO reads to the pediatric cardiologist was 0.72 (95% CI: 0.62, 0.82). Kappa ranged from a minimum of 0.57 to a maximum of 0.90. Overall, sensitivity was 0.92 (95% CI: 0.86, 0.95), and specificity was 0.80 (95% CI: 0.68, 0.88). Conclusion: There is substantial agreement between the CO and pediatric cardiologist diagnoses. In addition, CO’s had a high sensitivity in detecting RHD. With short-course training, CO-led echo screening for RHD is a viable alternative to physician-led screening in resource-limited settings.

Analyzing discontinuities in longitudinal count data: A multilevel generalized linear mixed model.

2020 ◽  
Author(s):  
James L. Peugh ◽  
Sarah J. Beal ◽  
Meghan E. McGrady ◽  
Michael D. Toland ◽  
Constance Mara
Keyword(s):  
Count Data ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Generalized Linear Mixed Model ◽  
Longitudinal Count Data

Assessment of Myocardial Viability in Persistent Defects on Thallium-201 SPECT after Reinjection Using Gradient-Echo MRI

1996 ◽  
Vol 35 (05) ◽  
pp. 146-152 ◽  
Author(s):  
A. Kögler ◽  
H.-A. Schmitt ◽  
D. Emrich ◽  
H. Kreuzer ◽  
D. L. Munz ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Myocardial Viability ◽  
Cardiac Cycle ◽  
Single Photon ◽  
Contractile Function ◽  
Left Ventricular ◽  
Wall Thickening ◽  
Gradient Echo ◽  
Systolic Wall Thickening

SummaryThis prospective study assessed myocardial viability in 30 patients with coronary heart disease and persistent defects despite reinjection on TI-201 single-photon computed tomography (SPECT). In each patient, three observers graded TI-201 uptake in 7 left ventricular wall segments. Gradient-echo magnetic resonance imaging in the region of the persistent defect generated 12 to 16 short axis views representing a cardiac cycle. A total of 120 segments were analyzed. Mean end-diastolic wall thickness and systolic wall thickening (± SD) was 11.5 ± 2.7 mm and 5.8 ± 3.9 mm in 48 segments with normal TI-201 uptake, 10.1 ± 3.4 mm and 3.7 ± 3.1 mm in 31 with reversible lesions, 11.3 ± 2.8 mm and 3.3 ± 1.9 mm in 10 with mild persistent defects, 9.2 ± 2.9 mm and 3.2 ±2.2 mm in 15 with moderate persistent defects, 5.8 ± 1.7 mm and 1.3 ± 1.4 mm in 16 with severe persistent defects, respectively. Significant differences in mean end-diastolic wall thickness (p <0.0005) and systolic wall thickening (p <0.005) were found only between segments with severe persistent defects and all other groups, but not among the other groups. On follow-up in 11 patients after revascularization, 6 segments with mild-to-moderate persistent defects showed improvement in mean systolic wall thickening that was not seen in 6 other segments with severe persistent defects. These data indicate that most myocardial segments with mild and moderate persistent TI-201 defects after reinjection still contain viable tissue. Segments with severe persistent defects, however, represent predominantly nonviable myocardium without contractile function.

Predicting bycatch hotspots based on suitable habitat derived from fishery-independent data

2020 ◽  
Vol 641 ◽  
pp. 159-175
Author(s):  
J Runnebaum ◽  
KR Tanaka ◽  
L Guan ◽  
J Cao ◽  
L O’Brien ◽  
...  
Keyword(s):  
Habitat Suitability ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Gulf Of Maine ◽  
Homarus Americanus ◽  
Management Tool ◽  
American Lobster ◽  
Suitable Habitat ◽  
Climate Conditions ◽  
Suitability Index

Bycatch remains a global problem in managing sustainable fisheries. A critical aspect of management is understanding the timing and spatial extent of bycatch. Fisheries management often relies on observed bycatch data, which are not always available due to a lack of reporting or observer coverage. Alternatively, analyzing the overlap in suitable habitat for the target and non-target species can provide a spatial management tool to understand where bycatch interactions are likely to occur. Potential bycatch hotspots based on suitable habitat were predicted for cusk Brosme brosme incidentally caught in the Gulf of Maine American lobster Homarus americanus fishery. Data from multiple fisheries-independent surveys were combined in a delta-generalized linear mixed model to generate spatially explicit density estimates for use in an independent habitat suitability index. The habitat suitability indices for American lobster and cusk were then compared to predict potential bycatch hotspot locations. Suitable habitat for American lobster has increased between 1980 and 2013 while suitable habitat for cusk decreased throughout most of the Gulf of Maine, except for Georges Basin and the Great South Channel. The proportion of overlap in suitable habitat varied interannually but decreased slightly in the spring and remained relatively stable in the fall over the time series. As Gulf of Maine temperatures continue to increase, the interactions between American lobster and cusk are predicted to decline as cusk habitat continues to constrict. This framework can contribute to fisheries managers’ understanding of changes in habitat overlap as climate conditions continue to change and alter where bycatch interactions could occur.

Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?

2019 ◽  
Vol 24 (2) ◽  
pp. 200-208
Author(s):  
Ravindra Arya ◽  
Francesco T. Mangano ◽  
Paul S. Horn ◽  
Sabrina K. Kaul ◽  
Serena K. Kaul ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Seizure Onset

OBJECTIVEThere is emerging data that adults with temporal lobe epilepsy (TLE) without a discrete lesion on brain MRI have surgical outcomes comparable to those with hippocampal sclerosis (HS). However, pediatric TLE is different from its adult counterpart. In this study, the authors investigated if the presence of a potentially epileptogenic lesion on presurgical brain MRI influences the long-term seizure outcomes after pediatric temporal lobectomy.METHODSChildren who underwent temporal lobectomy between 2007 and 2015 and had at least 1 year of seizure outcomes data were identified. These were classified into lesional and MRI-negative groups based on whether an epilepsy-protocol brain MRI showed a lesion sufficiently specific to guide surgical decisions. These patients were also categorized into pure TLE and temporal plus epilepsies based on the neurophysiological localization of the seizure-onset zone. Seizure outcomes at each follow-up visit were incorporated into a repeated-measures generalized linear mixed model (GLMM) with MRI status as a grouping variable. Clinical variables were incorporated into GLMM as covariates.RESULTSOne hundred nine patients (44 females) were included, aged 5 to 21 years, and were classified as lesional (73%), MRI negative (27%), pure TLE (56%), and temporal plus (44%). After a mean follow-up of 3.2 years (range 1.2–8.8 years), 66% of the patients were seizure free for ≥ 1 year at last follow-up. GLMM analysis revealed that lesional patients were more likely to be seizure free over the long term compared to MRI-negative patients for the overall cohort (OR 2.58, p < 0.0001) and for temporal plus epilepsies (OR 1.85, p = 0.0052). The effect of MRI lesion was not significant for pure TLE (OR 2.64, p = 0.0635). Concordance of ictal electroencephalography (OR 3.46, p < 0.0001), magnetoencephalography (OR 4.26, p < 0.0001), and later age of seizure onset (OR 1.05, p = 0.0091) were associated with a higher likelihood of seizure freedom. The most common histological findings included cortical dysplasia types 1B and 2A, HS (40% with dual pathology), and tuberous sclerosis.CONCLUSIONSA lesion on presurgical brain MRI is an important determinant of long-term seizure freedom after pediatric temporal lobectomy. Pediatric TLE is heterogeneous regarding etiologies and organization of seizure-onset zones with many patients qualifying for temporal plus nosology. The presence of an MRI lesion determined seizure outcomes in patients with temporal plus epilepsies. However, pure TLE had comparable surgical seizure outcomes for lesional and MRI-negative groups.

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