The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Feb 2013
Ultrasonographic investigation of the effect of positive end-expiratory pressure on the cross-sectional area of the femoral vein.
Femoral veins are commonly used as a relatively safe alternative route for central venous cannulation. Several maneuvers are used to increase the cross-sectional area of the vein. In this study, we assessed the effect of positive end-expiratory pressure (PEEP) on the cross-sectional area (CSA) of femoral veins, using ultrasound in adult patients under positive pressure ventilation. ⋯ The application of 10 cm H(2)O PEEP significantly increased the CSA of the right femoral vein by 47.6 % and the left femoral vein by 48.4 % (each P < 0.001). Mean arterial pressure decreased by 2.6 mmHg (95 % CI 1.3-3.9; P < 0.001), whereas no significant change in heart rate was observed (P = 0.861). The CSA of the femoral vein is augmented with the application of 10 cm H(2)O PEEP in adult patients undergoing positive pressure ventilation.
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Int J Cardiovasc Imaging · Feb 2013
Quantitative assessment of glucose metabolism in the vessel wall of abdominal aortic aneurysms: correlation with histology and role of partial volume correction.
Inflammatory-proteolytic processes in the vessel wall are essential in the pathophysiology of abdominal aortic aneurysm (AAA). It has been demonstrated that, (18)F-FDG-PET/CT may be useful for detection of pathological wall metabolism and therefore risk stratification. Quantification of the FDG-uptake in AAA wall is hampered by partial-volume (PV)-effects. ⋯ No correlation of (18)F-FDG-uptake and MMP-2 was found. In vivo correlations of detected FDG-uptake with clinical and histological results showed comparable results for corrected and uncorrected SUVs. PV-correction is not mandatory for qualitative clinical assessment of glucose metabolism in the vessel wall of AAA-patients but may be necessary to establish quantitative cut off values to stratify patients for aneurysm repair.
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Int J Cardiovasc Imaging · Jan 2013
Can ischemia and dyssynchrony be detected during early stages of dobutamine stress echocardiography by 2-dimensional speckle tracking echocardiography?
Strain and strain rate (SR) measured with 2-dimensional speckle tracking echocardiography (2-D STE) can quantitatively assess myocardial function. Our aim was to evaluate whether we could detect abnormalities in strain, strain rate, and dyssynchrony by applying 2-D STE in patients with severe coronary artery disease during early stages of dobutamine stress echocardiography. Thirty-four patients with angiographically documented severe 3-vessel coronary artery disease and preserved left ventricular ejection fraction were compared with 42 control patients without evidence of coronary artery disease. ⋯ Compared with control subjects, patients with coronary artery disease showed lower circumferential SR [-1.42 (0.34) s(-1) vs -1.64 (0.34) s(-1); P < .02] and significantly lower longitudinal strain [-15.41% (3.52%) vs -19.37% (3.21%); P < .001] and SR [-0.91 (0.18) s(-1) vs -1.19 (0.24) s(-1); P < .001] at intermediate doses; these values were also compromised at peak dose. The SD of longitudinal time to systolic peak strain at intermediate dose was significantly greater in patients with coronary artery disease than in control patients [37.89 (12.32) vs 27.21 (10.86); P < .001]. The 2-D STE-derived strain and SR detected myocardial dysfunction and asynchrony in patients with coronary artery disease during intermediate doses of dobutamine stress, with minimal changes in regional wall motion abnormalities at this stage.
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Int J Cardiovasc Imaging · Jan 2013
Transthoracic echocardiographic guidance during transcatheter closure of atrial septal defects in children and adults.
The purpose of this study was to evaluate the safety and efficacy of transcatheter atrial septal defect (ASD) closure guided by transthoracic echocardiography (TTE). Since 2004, ASD closure was performed successfully in total 337 patients. Transthoracic echocardiography guidance was used in 206 patients (61.1%) (group 1). ⋯ Transthoracic echocardiography guidance during transcatheter ASD closure is safe and effective in children and in many adults. Even complex ASDs could be closed with TTE in patients with good acoustic windows. Performing the procedure under TTE guidance significantly reduces procedure time and also provides increased patient's comfort.
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Int J Cardiovasc Imaging · Dec 2012
Paradoxical air embolism following contrast material injection through power injectors in patients with a patent foramen ovale.
In patients with a patent foramen ovale, use of air filters during intravenous infusions is common, but they are not compatible with power injection. Therefore we aimed to assess the incidence of paradoxical air embolism on CT of the chest and brain following contrast material injection through a power injector in patients with a patent foramen ovale, without the use of a filter. In this IRB approved, HIPAA compliant retrospective study, two independent radiologists reviewed 289 CT scans of the chest (n = 233) and brain (n = 56) for vascular air embolism following contrast material injection through a power injector in 93 subjects (43 men, mean age 66 y) with a known patent foramen ovale. ⋯ None had air in the left side of the heart or brain to suggest paradoxical air embolism. The inter-observer agreement for detection of vascular air was moderate (k = 0.6). Paradoxical air embolism in patients with a patent foramen ovale following contrast material injection with a power injector is rare.