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Stroke volume variability

Abdul Majeed Alwan Hammadi, Fizel Alhimyari
OBJECTIVES: This study aimed to show the positive effects of autologous bone marrow-derived mononuclear cells in the functional recovery of adult patients with subacute and chronic ischemic stroke. Stroke is a leading cause of morbidity and long-term disability in the world, with about one-third of survivors being permanently disabled. Bone marrowderived mononuclear cell concentrate is thought to improve cerebral blood flow and to speed recovery in animal models. Many types of stem cells have been used, including mesenchymal, cord blood cells, and embryonic, with different administration methods, including intrathecal, intravenous, intraarterial, and intracerebral, all with variable degrees of success...
January 2019: Experimental and Clinical Transplantation
Boeun Kim, Min Jang, Jungmin Sohn, Hyunjung Oh, Sangmin Jo, Mincheol Choi, Inhyung Lee, Junghee Yoon
The effects of intramuscular injection of alfaxalone ([ALF] 5 mg/kg), acepromazine ([ACE] 0.05 mg/kg), and an ALF-ACE combination ([AA] 0.025 mg/kg ACE followed by 2.5 mg/kg ALF) on the sedation, echocardiographic, biochemical, and blood gas indexes and recovery were evaluated in seven cats. No sedation was obtained with ACE, and sedation scores were higher with ALF than with AA treatment. Compared with baseline, an increase in heart rate occurred after ACE, and all treatments caused a decrease in systemic arterial pressure...
March 2019: Journal of the American Animal Hospital Association
Gauravpal S Gill, Gaby Weissman, Yael F Meirovich, Diego Medvedofsky, Selma F Mohammed, Ron Waksman, Hector M Garcia-Garcia
BACKGROUND: Multi-detector gated cardiac computed tomography (CCT) allows three-dimensional (3D) quantification of cardiac chambers and is clinically indicated to assess left ventricular assist device (LVAD) malfunction and complications. Automated volumetric analysis is, however, disrupted by inflow cannula artifact in patients with LVAD. With this study, we evaluated intra-observer variability in semi-automated 3D cardiac volumetric analysis using CCT in patients with LVADs. METHODS: Ten clinically indicated CCTs were studied retrospectively from 9 patients with LVADs...
January 23, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
David Houghton, Paweł Zalewski, Kate Hallsworth, Sophie Cassidy, Christian Thoma, Leah Avery, Joanna Slomko, Timothy Hardy, Alastair D Burt, Dina Tiniakos, Kieren G Hollingsworth, Roy Taylor, Christopher P Day, Steven Masson, Stuart McPherson, Quentin M Anstee, Julia L Newton, Michael I Trenell
BACKGROUND: Cardiovascular disease is the principle cause of death in patients with elevated liver fat unrelated to alcohol consumption, more so than liver related morbidity and mortality. OBJECTIVES: The aim of this study was to evaluate the relationship between liver fat and cardiac and autonomic function. Secondly, how impairment in cardiac and autonomic function is influenced by metabolic risk factors. METHODS: Cardiovascular and autonomic function were assessed in 96 sedentary individuals: 1) NAFLD (n = 46, hepatic steatosis >5% by magnetic resonance spectroscopy), 2) Hepatic steatosis and alcohol (DAFLD) (n = 16, >5%, consuming >20g/day of alcohol) and 3) CONTROLS (n = 34, no cardiac, liver or metabolic disorders, <20g/day of alcohol)...
February 12, 2019: Journal of Hepatology
Chiara Nardin, Kaisa M. Maki-Petaja, Karen L. Miles, Yasmin, Barry J. McDonnell, John R. Cockcroft, Ian B. Wilkinson, Carmel M. McEniery
Blood pressure (BP) in young adults predicts BP in later life. We aimed to identify metabolic, hemodynamic, and autonomic characteristics associated with raised BP in young adults and whether these differ between males and females. Three thousand one hundred forty-five healthy subjects, aged 18 to 40 years, were grouped according to sex and BP category following the recent reclassification of BP as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire and detailed metabolic, hemodynamic, and autonomic assessments...
December 2018: Hypertension
Miki Tsujiuchi, Takenori Yamauchi, Mio Ebato, Hideyuki Maezawa, Ayaka Nogi, Naoko Ikeda, Takuya Mizukami, Sakura Nagumo, Yoshitaka Iso, Toshio Nakadate, Akatsuki Kokaze, Hiroshi Suzuki
BACKGROUND: The prognostic value of indices for left atrial volumes (LAV) and reservoir function measured by 3D speckle-tracking analysis (3DSTA) has not been determined. Methods and Results: LA maximal and minimal volume indices (LAVImax, LAVImin), and LA emptying fraction (LAEmpF) were measured via 2D echocardiography (2DE) and 3DSTA in 514 patients (62% male, mean age: 66±15 years) with various cardiovascular diseases. Two cutoff values using normal±2SD (cutoff criterion 1) and receiver-operating characteristic analysis (cutoff criterion 2) were evaluated...
February 13, 2019: Circulation Journal: Official Journal of the Japanese Circulation Society
Mariann Berhés, Norbert Németh, Katalin Pető, Ádám Deák, Endre Hajdú, Ábel Molnár, Péter Árkosy, Judit Szabó, Béla Fülesdi
BACKGROUND: The aim of the present work was to assess systemic hemodynamic changes using PiCCo monitoring in a porcine model of E. coli-induced fulminant sepsis. METHODS: Thirty-one healthy female Hungahib pigs were randomly assigned into control (n = 15) or septic groups (n = 16). In the sepsis group Escherichia coli culture was intravenously administrated in a continuously increasing manner according to the following protocol: 2 ml of bacterial culture suspended in physiological saline was injected in the first 30 min, then 4 ml of bacterial culture was administered within 30 min, followed by infusion of 32 ml bacterial culture for 2 h...
February 13, 2019: European Journal of Medical Research
Søren Christensen, Michael Mlynash, Stephanie Kemp, Amarnath Yennu, Jeremy J Heit, Michael P Marks, Maarten G Lansberg, Gregory W Albers
Background and Purpose- Efficacy of endovascular thrombectomy has been demonstrated up to 24 hours after stroke onset in patients selected with perfusion imaging. We hypothesized that a persistent favorable perfusion profile exists in some patients beyond 24 hours from the onset and can be predicted by a lower baseline hypoperfusion intensity ratio, which indicates favorable collaterals. Methods- We identified control arm patients from the DEFUSE 3 trial (The Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) with a diffusion weighted imaging and perfusion magnetic resonance imaging performed 24 hours following randomization and compared imaging and clinical variables between patients with persistent mismatch versus patients who no longer had a mismatch 24 hours after randomization...
February 8, 2019: Stroke; a Journal of Cerebral Circulation
Melissa Trotman-Lucas, Michael E Kelly, Justyna Janus, Claire L Gibson
The ischemic stroke is a major cause of adult long-term disability and death worldwide. The current treatments available are limited, with only tissue plasminogen activator (tPA) as an approved drug treatment to target ischemic strokes. Current research in the field of ischemic stroke focuses on better understanding the pathophysiology of stroke, to develop and investigate novel pharmaceutical targets. Reliable experimental stroke models are crucial for the progression of potential treatments. The middle cerebral artery occlusion (MCAO) model is clinically relevant and the most frequently used surgical model of ischemic stroke in rodents...
January 23, 2019: Journal of Visualized Experiments: JoVE
Won Ho Kim, Hye-Won Oh, Seong-Mi Yang, Je Hyuk Yu, Hyung-Chul Lee, Chul-Woo Jung, Kyung-Suk Suh, Kook Hyun Lee
BACKGROUND: Acute kidney injury (AKI) after living donor liver transplantation (LDLT) is associated with increased mortality. We sought to identify associations between intraoperative hemodynamic variables and postoperative AKI. METHODS: We retrospectively reviewed 734 cases of LDLT. Intraoperative hemodynamic variables of systemic and pulmonary arterial pressure, central venous pressure (CVP), and pulmonary artery catheter-derived parameters including mixed venous oxygen saturation (SvO2), right ventricular end-diastolic volume (RVEDV), stroke volume, systemic vascular resistance, right ventricular ejection fraction, and stroke work index were collected...
January 30, 2019: Transplantation
Timothy G White, Hussam Abou-Al-Shaar, Jung Park, Jeffrey Katz, David J Langer, Amir R Dehdashti
OBJECTIVECerebral revascularization for carotid occlusion was previously a mainstay procedure for the cerebrovascular neurosurgeon. However, the 1985 extracranial-intracranial bypass trial and subsequently the Carotid Occlusion Surgery Study (COSS) provided level 1 evidence via randomized controlled trials against bypass for symptomatic atherosclerotic carotid occlusion disease. However, in a small number of patients optimal medical therapy fails, and some patients with flow-limiting stenosis develop a perfusion-dependent neurological examination...
February 1, 2019: Neurosurgical Focus
Daniel J Friedman, Jeffrey G Gaca, Tongrong Wang, S Chris Malaisrie, David R Holmes, Jonathan P Piccini, Rakesh M Suri, Michael J Mack, Vinay Badhwar, Jeffrey P Jacobs, Eric D Peterson, Shein-Chung Chow, J Matthew Brennan
PURPOSE: Patients with atrial fibrillation (AF) undergoing cardiac surgery are at substantially increased risk for stroke. Increasing evidence has suggested that surgical left atrial appendage occlusion (S-LAAO) may have the potential to substantially mitigate this stroke risk; however, S-LAAO is performed in a minority of patients with AF undergoing cardiac surgery. We sought to identify factors associated with usage of S-LAAO. METHODS: In a nationally-representative, contemporary cohort (07/2011-06/2012) of older patients undergoing cardiac surgery with preoperative AF (n = 11,404) from the Medicare-linked Society of Thoracic Surgeons Adult Cardiac Surgery Database, we evaluated patient and hospital characteristics associated with S-LAAO use by employing logistic and linear regression models...
February 2, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Bjørn Erik Neerland, Torgeir Bruun Wyller, Vegard Bruun Bratholm Wyller
BACKGROUND: Alterations in autonomic nervous system (ANS) activity might be involved in the pathophysiology of delirium. The aim was to explore autonomic cardiovascular control in older patients with and without delirium. METHODS: Fourteen patients (five with delirium) acutely admitted to the geriatric ward with an infection were enrolled in the study. Patients with atrial fibrillation, a pacemaker, or on treatment with beta-blockers, calcium channel blockers or acetylcholinesterase inhibitors were not eligible...
January 25, 2019: BMC Geriatrics
Pralay Shankar Ghosh, Afzal Azim, Sai Saran, Arvind Kumar Baronia, Banani Poddar, Ratender Kumar Singh, Mohan Gurjar, Prabhaker Mishra
Introduction: Lung-protective ventilation strategy and prone positioning are the strategies practiced to manage patients suffering from acute respiratory distress syndrome (ARDS). Inferior Vena Cava Distensibility (dIVC) Index has been used for predicting fluid responsiveness (FR) in supine position. We conducted this study to observe the utility of dIVC in prone position in ARDS patients and compare it with esophageal Doppler (ED) parameters. Materials and Methods: After ethical clearance, a prospective observational pilot study was conducted in a 12-bedded tertiary care hospital...
December 2018: Indian Journal of Critical Care Medicine
Alexander Y Lau, Vincent Mok, Jack Lee, Yuhua Fan, Jinsheng Zeng, Bonnie Lam, Adrian Wong, Chloe Kwok, Maria Lai, Benny Zee
Objective: We investigated whether an automatic retinal image analysis (ARIA) incorporating machine learning approach can identify asymptomatic older adults harboring high burden of white matter hyperintensities (WMH) using MRI as gold standard. Methods: In this cross-sectional study, we evaluated 180 community-dwelling, stroke-, and dementia-free healthy subjects and performed ARIA by acquiring a nonmydriatic retinal fundus image. The primary outcome was the diagnostic performance of ARIA in detecting significant WMH on MRI brain, defined as age-related white matter changes (ARWMC) grade ≥2...
January 2019: Annals of Clinical and Translational Neurology
Julia Otten, Jonas Andersson, Jens Ståhl, Andreas Stomby, Ahmed Saleh, Maria Waling, Mats Ryberg, Jon Hauksson, Michael Svensson, Bengt Johansson, Tommy Olsson
Background The accumulation of myocardial triglycerides and remodeling of the left ventricle are common features in type 2 diabetes mellitus and represent potential risk factors for the development of diastolic and systolic dysfunction. A few studies have investigated the separate effects of diet and exercise training on cardiac function, but none have investigated myocardial changes in response to a combined diet and exercise intervention. This 12-week randomized study assessed the effects of a Paleolithic diet, with and without additional supervised exercise training, on cardiac fat, structure, and function...
January 22, 2019: Journal of the American Heart Association
Teatske M Altenburg, Joost Rotteveel, Erik H Serné, Mai J M Chinapaw
OBJECTIVES: Standing desks and stability balls are increasingly popular to increase muscle activity and thereby prevent potential adverse cardiometabolic effects of prolonged sitting. The present study examined the effects of (1) sitting on a stability ball ('active sitting') and (2) hourly 10-min standing interruptions during prolonged sitting on postprandial cardiometabolic biomarkers. DESIGN: Experimental crossover study. METHODS: Twenty healthy-weight males (19...
January 4, 2019: Journal of Science and Medicine in Sport
Koki Nakanishi, Zhezhen Jin, Shunichi Homma, Mitchell S V Elkind, Tatjana Rundek, Joseph E Schwartz, Tetz C Lee, Aylin Tugcu, Mitsuhiro Yoshita, Charles DeCarli, Clinton B Wright, Ralph L Sacco, Marco R Di Tullio
Aims: Although ambulatory blood pressure (BP) is a better predictor of cardiovascular outcomes than office BP, its association with subclinical cerebrovascular disease is not clarified. We investigated the associations of office and ambulatory BP values with subclinical cerebrovascular disease in a population based, predominantly elderly cohort without prior stroke. Methods and results: Eight hundred and twenty-eight participants underwent 24-h ambulatory BP monitoring (ABPM), 2D echocardiography and brain magnetic resonance imaging in the Cardiac Abnormalities and Brain Lesion (CABL) study...
January 10, 2019: European Heart Journal Cardiovascular Imaging
Neil Haranhalli, Nnenna Mbabuike, Sanjeet S Grewal, Tasneem F Hasan, Michael G Heckman, William D Freeman, Vivek Gupta, Prasanna Vibhute, Benjamin L Brown, David A Miller, Babak S Jahromi, Rabih G Tawk
OBJECTIVEThe role of CT perfusion (CTP) in the management of patients with acute ischemic stroke (AIS) remains a matter of debate. The primary aim of this study was to evaluate the correlation between the areas of infarction and penumbra on CTP scans and functional outcome in patients with AIS.METHODSThis was a retrospective review of 100 consecutively treated patients with acute anterior circulation ischemic stroke who underwent CT angiography (CTA) and CTP at admission between February 2011 and October 2014...
January 11, 2019: Journal of Neurosurgery
Kyriakos Dalamagkas, Magdalini Tsintou, Yogesh Rathi, Lauren J O'Donnell, Ofer Pasternak, Xue Gong, Anne Zhu, Peter Savadjiev, George M Papadimitriou, Marek Kubicki, Edward H Yeterian, Nikos Makris
The corticospinal tract (CST) is one of the most well studied tracts in human neuroanatomy. Its clinical significance can be demonstrated in many notable traumatic conditions and diseases such as stroke, spinal cord injury (SCI) or amyotrophic lateral sclerosis (ALS). With the advent of diffusion MRI and tractography the computational representation of the human CST in a 3D model became available. However, the representation of the entire CST and, specifically, the hand motor area has remained elusive. In this paper we propose a novel method, using manually drawn ROIs based on robustly identifiable neuroanatomic structures to delineate the entire CST and isolate its hand motor representation as well as to estimate their variability and generate a database of their volume, length and biophysical parameters...
January 8, 2019: Brain Imaging and Behavior
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