RESUMO
BACKGROUND/AIMS: Pulse wave analysis (PWA) and pulse wave velocity (PWV) provide information about arterial stiffness and elasticity, which is mainly used for cardiovascular risk stratification. In the presented prospective observational pilot study, we examined the hypothesis that radiocephalic fistula (RCF)-related changes of haemodynamics and blood vessel morphology including high as well as low flow can be seen in specific changes of pulse wave (PW) morphology. METHODS: Fifty-six patients with RCF underwent local ambilateral peripheral PWA and PWV measurement with the SphygmoCor® device. Given that the output parameters of the SphygmoCor® are not relevant for the study objectives, we defined new suitable parameters for PWA in direct proximity to fistulas and established an appropriate analysing algorithm. Duplex sonography served as reference method. RESULTS: Marked changes of peripheral PW morphology when considering interarm differences of slope and areas between the fistula and non-fistula arms were observed in the Arteria radialis, A. brachialis and arterialized Vena cephalica. The sum of the slope differences was found to correlate with an increased flow, while in patients with fistula failure no changes in PW morphology were seen. Moreover, PWV was significantly reduced in the fistula arm. CONCLUSION: Beside duplex sonography, ambilateral peripheral PWA and PWV measurements are potential new clinical applications to characterize and monitor RCF function, especially in terms of high and low flow.
Assuntos
Fístula Vascular/diagnóstico , Rigidez Vascular , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Análise de Onda de Pulso , Fístula Vascular/fisiopatologiaRESUMO
Multimodality imaging revealed a left circumflex coronary artery-left ventricle fistula in a 4-year-old boy. MRI tissue tracking revealed a slight abnormality in the left ventricular myocardial strain. Early surgery was suggested to avoid serious complications.
Assuntos
Ecocardiografia Doppler em Cores/métodos , Cardiopatias/diagnóstico , Ventrículos do Coração , Imagem Cinética por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Tomografia Computadorizada por Raios X/métodos , Fístula Vascular/diagnóstico , Procedimentos Cirúrgicos Cardíacos , Pré-Escolar , Diagnóstico Diferencial , Fístula/diagnóstico , Fístula/cirurgia , Cardiopatias/cirurgia , Humanos , Masculino , Fístula Vascular/cirurgiaAssuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Ecocardiografia , Ventrículos do Coração/diagnóstico por imagem , Miocárdio Ventricular não Compactado Isolado/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Imagem Multimodal , Criança , Anomalias dos Vasos Coronários/diagnóstico , Feminino , Ventrículos do Coração/anormalidades , Humanos , Miocárdio Ventricular não Compactado Isolado/diagnóstico , Fístula Vascular/diagnóstico , Fístula Vascular/diagnóstico por imagemRESUMO
The paper presents the data on the use of laser Doppler flowmetry (LDF) for microcirculation assessment in patients with lower limb angiodysplasias. Preliminary results suggest that LDF can be successfully used both for the quantification of microcirculatory disturbances and for the diagnosis of arterio-venous micro fistulas. LDF was used as a monitoring tool for compressive therapy effectiveness in patients with arterio-venous and venous forms of lower limb angiodysplasias. Compression stockings Relaxsan III class were shown to improve microcirculation in this patient population after 1 month wearing.