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1.
J Zoo Wildl Med ; 50(4): 822-836, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926512

RESUMEN

Cardiovascular disease (CVD) has been identified as a major cause of mortality in all four great ape taxa in zoologic institutions. In an effort to better understand and treat CVD in captive great apes, a program called the Great Ape Heart Project (GAHP), based at Zoo Atlanta, collects and maintains a database of echocardiograms and other relevant medical information relating to the cardiac health status of great apes. Cardiac health assessments have become standard practice among North American zoos that house great apes and are recommended by all four great ape Species Survival Plans (SSP) for the assessment of CVD in captive great apes. As of December 31, 2017, more than 70 ape-holding institutions have submitted approximately 1,100 cardiac examinations of great apes to the GAHP, information from which is stored in the GAHP database. Transthoracic echocardiography is one of the most practical and cost-effective diagnostic imaging techniques for the evaluation of cardiac function in great apes. Standardization of echocardiographic measurements is critical for maximizing the diagnostic value of an echocardiographic exam and for utilization of stored information in comparative studies within and between the great ape taxa. The following manuscript offers suggestions for standardization of nomenclature, imaging technique, echocardiographic measurements, data storage, and reporting of cardiac exams for submission into the GAHP database with the goal of promoting consistency and quality in data collection.


Asunto(s)
Enfermedades del Simio Antropoideo/diagnóstico por imagen , Ecocardiografía/veterinaria , Cardiopatías/veterinaria , Hominidae , Guías de Práctica Clínica como Asunto , Animales , Animales de Zoológico , Ecocardiografía/métodos , Cardiopatías/diagnóstico por imagen
2.
Int J Cardiovasc Imaging ; 36(1): 149-159, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31538258

RESUMEN

Evaluation of myocardial regional function is generally performed by visual "eyeballing" which is highly subjective. A robust quantifiable parameter of regional function is required to provide an objective, repeatable and comparable measure of myocardial performance. We aimed to evaluate the clinical utility of novel regional myocardial strain software from cardiac computed tomography (CT) datasets. 93 consecutive patients who had undergone retrospectively gated cardiac CT were evaluated by the software, which utilizes a finite element based tracking algorithm through the cardiac cycle. Circumferential (CS), longitudinal (LS) and radial (RS) strains were calculated for each of 16 myocardial segments and compared to a visual assessment, carried out by an experienced cardiologist on cine movies of standard "echo" views derived from the CT data. A subset of 37 cases was compared to speckle strain by echocardiography. The automated software performed successfully in 93/106 cases, with minimal human interaction. Peak CS, LS and RS all differentiated well between normal, hypokinetic and akinetic segments. Peak strains for akinetic segments were generally post-systolic, peaking at 50 ± 17% of the RR interval compared to 43 ± 9% for normokinetic segments. Using ROC analysis to test the ability to differentiate between normal and abnormal segments, the area under the curve was 0.84 ± 0.01 for CS, 0.80 ± 0.02 for RS and 0.68 ± 0.02 for LS. There was a moderate agreement with speckle strain. Automated 4D regional strain analysis of CT datasets shows a good correspondence to visual analysis and successfully differentiates between normal and abnormal segments, thus providing an objective quantifiable map of myocardial regional function.


Asunto(s)
Algoritmos , Cardiopatías/diagnóstico por imagen , Tomografía Computarizada Multidetector/métodos , Contracción Miocárdica , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Programas Informáticos , Función Ventricular Izquierda , Anciano , Automatización , Ecocardiografía , Femenino , Cardiopatías/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos
3.
Radiol Clin North Am ; 58(1): 133-150, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31731897

RESUMEN

Imaging plays a central role in the evaluation of patients following cardiothoracic surgery, both for monitoring in the early postoperative period and for assessing for suspected complications. Patients with postsurgical complications can develop a range of signs and symptoms, from hypotension and tachycardia, as the result of severe bleeding, to fever and leukocytosis because of infection. The radiologist is an important member of the care team in the postoperative period, helping identify and manage complications of cardiothoracic surgery. This article reviews the common complications of cardiothoracic surgery focusing on the role of imaging and clues to diagnosis.


Asunto(s)
Cardiopatías/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Enfermedades Respiratorias/diagnóstico por imagen , Procedimientos Quirúrgicos Torácicos/efectos adversos , Tomografía Computarizada por Rayos X/métodos , Enfermedades Vasculares/diagnóstico por imagen , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Cardiopatías/etiología , Humanos , Complicaciones Posoperatorias/etiología , Radiografía/métodos , Enfermedades Respiratorias/etiología , Enfermedades Vasculares/etiología
4.
Radiol Clin North Am ; 58(1): 93-103, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31731905

RESUMEN

This article describes an approach to analyzing the distribution of intravenous contrast on chest computed tomography and illustrates the various pathologies and pitfalls that may be encountered by the imager, especially in the hospitalized patient. Understanding normal and abnormal distribution of intravenous contrast can be used as a clue to detect alterations in physiology and flow.


Asunto(s)
Medios de Contraste , Cardiopatías/diagnóstico por imagen , Pacientes Internos , Embolia Pulmonar/diagnóstico por imagen , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X/métodos , Corazón/diagnóstico por imagen , Hospitalización , Humanos , Pulmón/diagnóstico por imagen , Radiografía Torácica/métodos
5.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 460-465, jan.-dez. 2020. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1053063

RESUMEN

Objetivo: Determinar a prevalência da nefropatia induzida por contraste em pacientes cardiopatas submetidos a procedimentos angiográficos de diagnóstico e/ou tratamento. Método: Estudo prospectivo, quantitativo, realizado no setor de hemodinâmica de um hospital de grande porte, situado na região norte do Rio Grande do Sul, Brasil. A amostra foi constituída por 79 participantes através do cálculo de tamanho amostral. Resultados: A amostra foi formada por 52 (65,8%) homens e 27 (34,2%) mulheres. A idade média foi de 65,9 ± 9,52 anos. A incidência de nefropatia induzida por contraste foi de 30,38%, totalizando 24 pacientes. Conclusão: Foi evidenciada uma alta prevalência de nefropatia por contraste, apesar dos pacientes apresentarem poucos fatores de risco, o que ressalta a necessidade de medidas preventivas e redução do volume de contraste


Objective: To determine the prevalence of contrast-induced nephropathy in cardiac patients undergoing diagnostic and / or treatment angiographic procedures. Method: A prospective, quantitative study in the hemodynamics sector of a large hospital, located in the northern region of Rio Grande do Sul, Brazil. The sample consisted of 79 participants through the calculation of sample size. Results: The sample consisted of 52 (65.8%) men and 27 (34.2%) women. The mean age was 65.9 ± 9.52 years. The incidence of contrast-induced nephropathy was 30,38%, totaling 24 patients. Conclusion: A high prevalence of contrast nephropathy was evidenced, despite the fact that patients presented few risk factors, which highlights the need for preventive measures and reduction of contrast volume


Objetivo: Determinar la prevalencia de la nefropatía inducida por contraste en pacientes cardiopatas sometidos a procedimientos angiográficos de diagnóstico y / o tratamiento. Método: Estudio prospectivo, cuantitativo, realizado en el sector de hemodinámica de un hospital de gran porte, situado en la región norte de Rio Grande do Sul, Brasil. La muestra fue constituida por 79 participantes a través del cálculo de tamaño muestral. Resultados: La muestra fue formada por 52 (65,8%) hombres y 27 (34,2%) mujeres. La edad media fue de 65,9 ± 9,52 años. La incidencia de nefropatía inducida por contraste fue del 30,38%, totalizando 24 pacientes. Conclusión: Se evidenció una alta prevalencia de nefropatía por contraste, a pesar de que los pacientes presentaban pocos factores de riesgo, lo que resalta la necesidad de medidas preventivas y reducción del volumen de contraste


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Angiografía/efectos adversos , Cardiopatías/complicaciones , Cardiopatías/diagnóstico por imagen , Enfermedades Renales/inducido químicamente , Enfermedades Renales/epidemiología , Estudios Prospectivos , Medios de Contraste/efectos adversos , Enfermedad Coronaria/complicaciones , Lesión Renal Aguda/inducido químicamente , Hemodinámica
7.
Pan Afr Med J ; 33: 156, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31565118

RESUMEN

Cardiac manifestations develop in the majority of patients with systemic lupus erythematosus (SLE) at some time during the course of their disease. This study was designed to assess cardiac abnormalities in patients with SLE by echocardiography and to compare the 2 groups of patients with and without cardiac manifestations. It was a transversal, descriptive study, conducted in the Internal Medicine Department at the Military Hospital of Tunis from January 2016 to June 2018. Eighty lupus patients, diagnosed on the basis of ACR (American college of rheumatology) criteria, were enrolled in the study and were evaluated by standard echocardiography with color Doppler. Out of 80 patients 42 (52%) had abnormal echocardiographic findings. Pericardial effusion was found in 55%, valvular abnormalities in 52% and 38% had pulmonary hypertension. Patients with pleural effusion (45 vs 15%) were more vulnerable to cardiac involvement as well as renal impairment (57 vs 44%). The difference, however, were not statistically significant (p>0.05) in the renal involvement. Active disease with low complement (80%) was associated with higher frequency of cardiac involvement than disease in remission (64%) but the result was not statistically significant (p=0.11). Cardiac abnormalities are very common in lupus patients even when clinically asymptomatic form. Echocardiography is an excellent non-invasive tool for cardiac evaluation. Their research must be systematic with echocardiography in order to reduce subsequent cardiac morbidity and mortality among the lupus patients.


Asunto(s)
Ecocardiografía/métodos , Cardiopatías/diagnóstico por imagen , Lupus Eritematoso Sistémico/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Cardiopatías/epidemiología , Cardiopatías/etiología , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Enfermedades de las Válvulas Cardíacas/epidemiología , Enfermedades de las Válvulas Cardíacas/etiología , Hospitales Militares , Humanos , Hipertensión Pulmonar/diagnóstico por imagen , Hipertensión Pulmonar/epidemiología , Hipertensión Pulmonar/etiología , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/epidemiología , Derrame Pericárdico/etiología , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/epidemiología , Derrame Pleural/etiología , Túnez
8.
Medicine (Baltimore) ; 98(38): e17256, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31567998

RESUMEN

RATIONALE: Cardiac amyloidosis, considered for the last years to be a rare disease, is one of the determinants of HFpEF. The non-specific clinical presentation and the difficulties related to endomyocardial biopsy have made cardiac amyloidosis an underdiagnosed clinical entity. Improvement of non-invasive diagnostic techniques and the development of new therapies increased clinical awareness for this form of restrictive cardiomyopathy. We here summarize echocardiography and Tc-HDP scintigraphy findings in 6 cases of cardiac amyloidosis and review the literature data of this progressive and fatal cardiomyopathy. PATIENTS CONCERNS: The main clinical manifestations were fatigue, low exercise tolerance and edemas. The right heart failure symptoms usually dominated the clinical picture. DIAGNOSES: All cases were evaluated by echocardiography; 3 cases were further examined by bone scintigraphy and 4 cases a peripheral biopsy was performed. Electrocardiography showed low-voltage QRS complexes and "pseudo-infarct" pattern in the precordial leads, contrary to the echocardiographic aspect, which revealed thickening of ventricle walls. Biatrial dilation and diastolic disfunction were observed. Impaired systolic function was detected in advanced stages of the disease. Tc-HDP scintigraphy revealed cardiac uptake of radiopharmaceutical and managed to confirm the diagnosis in 1 case of cardiac amyloidosis in which salivary gland biopsy was negative. INTERVENTIONS: The treatment was based on managing fluid balance, with the mainstream therapy represented by diuretics. Neurohormonal agents, usually used in heart failure treatment were avoided, due to poor tolerance and worsening of disease course. The management of these 6 cases was challenging due to the refractory manifestation of congestive heart failure. OUTCOMES: During follow-up, 4 of the 6 patients from the current study died in the first year after the final diagnosis was established. LESSONS: Nuclear imaging of cardiac amyloidosis has a revolutionary development nowadays. Bone scintigraphy presents promising results for identifying patients at early stages of disease and to differentiate between cardiac amyloidosis types. Further studies are necessary for the standardization of imaging protocol and development of non-invasive diagnostic tools, especially in assessing the response to treatment and disease progression, for which little is known.


Asunto(s)
Amiloidosis/diagnóstico por imagen , Ecocardiografía , Cardiopatías/diagnóstico por imagen , Cintigrafía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Amiloidosis/diagnóstico , Amiloidosis/patología , Difosfonatos , Femenino , Corazón/diagnóstico por imagen , Cardiopatías/diagnóstico , Cardiopatías/patología , Humanos , Masculino , Persona de Mediana Edad , Miocardio/patología , Compuestos de Organotecnecio
9.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 466-470, 2019 Jul.
Artículo en Chino | MEDLINE | ID: mdl-31642220

RESUMEN

OBJECTIVE: To detect cardiac amyloidosis (CA) using cardiac magnetic resonance feature tracking(CMR-FT). METHODS: Forty-three CA patients and 24 healthy volunteers underwent steady-state free precession cine sequence on 3.0T MRI after injection of Magnevist. Software cvi 42 was used for analyzing the left ventricular function including left ventricular mass (diastole) (LVMD), left ventricular mass (systole) (LVMS), left ventricle end-diastolic volume (LVEDV), left ventricle end-systolic volume (LVESV), left ventricle stroke volume (LVSV), and left ventricular ejection fraction (LVEF), as well as myocardial strains including 3D global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS), and 2D endocardial and epicardial longitudinal strain, circumferential strain, and radial strain (ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS). The global and layer-specific strains were compared between the CA patients with LVEF >50%, the CA patients with LVEF ≤50%, and the healthy controls. RESULTS: For the left ventricular function, the CA patients had greater myocardial mass than the healthy controls (P < 0.05); the CA patients with LVEF ≤50% had greater LVESV and lower LVSV than those with LVEF >50% (P < 0.05). For the global strains, significant differences also appeared in GLS and GCS among the three groups (all P < 0.05). The CA patients had lower GRS than the healthy controls (P < 0.05), while no significant difference was found in GRS between the CA patients with LVEF >50% and those with LVEF ≤50% (P>0.05). For the layer-specific strains, significant differences in ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS were found among the three groups (all P < 0.05). There were significant correlations between GLS and LVEF (r=-0.404, P=0.016), and between GCS and LVEF (r=-0.602, P < 0.001) in the CA patients. CONCLUSION: CMR-FT can assess not only global strains but also layer-specific strains for the myocardial function of CA patients.


Asunto(s)
Amiloidosis/diagnóstico por imagen , Cardiopatías/diagnóstico por imagen , Imagen por Resonancia Magnética , Función Ventricular Izquierda , Estudios de Casos y Controles , Humanos , Reproducibilidad de los Resultados , Volumen Sistólico , Sístole
10.
Praxis (Bern 1994) ; 108(12): 807-813, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31530132

RESUMEN

Color Doppler ultrasound is the diagnostic cornerstone of vascular assessment. Almost all arteries and veins of the human body are accessible to this diagnostic imaging, which as a result is very often used as first-line diagnostic test. Recent technological developments in high-end ultrasound machines enable us to optimize image quality in color-coded duplex ultrasound of arteries and veins. To obtain an optimal instrument setting, all relevant adjustments of imaging must be considered. In B-Mode ultrasound, the basic vascular imaging method, the most important settings to optimize are ultrasound frequency, gain, dynamic range, and focus, whereas color Doppler depends on angle supersonic sounding and its application in clinical practice. Most mistakes in measuring blood flow velocities, a frequent cause of misinterpretation, result from insufficient angle correction. Cardiac pathologies may result in typical changes of arterial and venous Doppler curves.


Asunto(s)
Cardiopatías , Ultrasonografía Doppler en Color , Ultrasonografía Doppler Dúplex , Arterias , Velocidad del Flujo Sanguíneo , Cardiopatías/diagnóstico por imagen , Humanos , Ultrasonografía
11.
BMJ Case Rep ; 12(9)2019 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-31527203

RESUMEN

Sarcoidosis is a multisystem disorder characterised by non-caseating granulomas that typically affect the lungs, skin and lymph nodes. Sarcoidosis has been associated with various cancers, and we describe the case of a patient with systemic sarcoidosis associated with testicular seminoma. This was originally diagnosed as stable sarcoid-like reaction. He subsequently presented with ventricular tachycardia. Cardiovascular MRI suggested cardiac sarcoidosis, which was confirmed by myocardial biopsy. This case highlights the association between some types of cancer and sarcoidosis. In addition, it highlights the importance of close follow-up for patients with a history of malignancy to monitor for sarcoid-like reactions and sarcoidosis, which are often difficult to differentiate clinically.


Asunto(s)
Cardiopatías/etiología , Sarcoidosis/etiología , Seminoma/complicaciones , Neoplasias Testiculares/complicaciones , Adulto , Desfibriladores Implantables , Diagnóstico Diferencial , Cardiopatías/diagnóstico por imagen , Humanos , Letargia , Masculino , Sarcoidosis/diagnóstico por imagen , Seminoma/diagnóstico por imagen , Neoplasias Testiculares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Vómitos
12.
Vasc Med ; 24(5): 431-438, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31543030

RESUMEN

Optimal management of patients with internal carotid artery (ICA) stenosis concurrent with severe cardiac disease remains undefined. The aim of this study is to evaluate the safety and feasibility of the one-day, sequential approach by carotid artery stenting (CAS) immediately followed by cardiac surgery. The study included 70 consecutive patients with symptomatic > 50% or ⩾ 80% asymptomatic ICA stenosis coexisting with severe coronary/valve disease, who underwent one-day, sequential CAS + cardiac surgery. The majority of patients (85.7%) had CSS class III or IV angina and 10% had non-ST elevation myocardial infarction. The EuroSCORE II risk was 2.4% (IQR 1.69-3.19%). All CAS procedures were performed according to the 'tailored' algorithm with a substantial use of proximal neuroprotection devices of 44.3%. Closed-cell (75.7%) and mesh-covered (18.6%) stents were implanted in most cases. The majority of patients underwent isolated coronary artery bypass grafting (88.6%) or isolated valve replacement (7.1%). No major adverse cardiac and cerebrovascular events (MACCE) occurred at the CAS stage. There were three (4.3%) perioperative MACCE: one myocardial infarction and two deaths. All MACCE were related to cardiac surgery and were due to the high surgical risk profile of the patients. Up to 30 days, no further MACCE were observed. No perioperative or 30-day neurological complications occurred. In this patient series, one-day, sequential CAS and cardiac surgery was relatively safe and did not result in neurological complications. Thus, a strategy of preoperative CAS could be considered for patients with severe or symptomatic ICA stenosis who require urgent cardiac surgery.


Asunto(s)
Arteria Carótida Interna , Estenosis Carotídea/terapia , Puente de Arteria Coronaria , Procedimientos Endovasculares/instrumentación , Cardiopatías/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Stents , Anciano , Anciano de 80 o más Años , Arteria Carótida Interna/diagnóstico por imagen , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/mortalidad , Puente de Arteria Coronaria/efectos adversos , Puente de Arteria Coronaria/mortalidad , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Estudios de Factibilidad , Femenino , Cardiopatías/complicaciones , Cardiopatías/diagnóstico por imagen , Cardiopatías/mortalidad , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Sistema de Registros , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento
13.
F1000Res ; 82019.
Artículo en Inglés | MEDLINE | ID: mdl-31543951

RESUMEN

Over the last 15 years, cardiovascular magnetic resonance (CMR) imaging has progressively evolved to become an indispensable tool in cardiology. It is a non-invasive technique that enables objective and functional assessment of myocardial tissue. Recent innovations in magnetic resonance imaging scanner technology and parallel imaging techniques have facilitated the generation of T1 and T2 parametric mapping to explore tissue characteristics. The emergence of strain imaging has enabled cardiologists to evaluate cardiac function beyond conventional metrics. Significant progress in computer processing capabilities and cloud infrastructure has supported the growth of artificial intelligence in CMR imaging. In this review article, we describe recent advances in T1/T2 mapping, myocardial strain, and artificial intelligence in CMR imaging.


Asunto(s)
Cardiopatías , Corazón , Espectroscopía de Resonancia Magnética , Miocardio , Corazón/diagnóstico por imagen , Cardiopatías/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Valor Predictivo de las Pruebas
14.
Int Heart J ; 60(5): 1106-1112, 2019 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-31484874

RESUMEN

A useful biomarker for detecting cardiac amyloidosis (CA) has not been fully established. We aimed to investigate the utility of several biomarkers to detect CA in patients with amyloid light-chain (AL) amyloidosis.We examined the plasma levels of B-type natriuretic peptide (BNP), N-terminal fragment of the pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), serum amyloid A, and the difference between kappa and lambda free light chain (dFLC) between CA patients (n = 30, 47.6%) and non-CA patients (n = 33, 52.4%). Levels of BNP were significantly higher in the CA group compared to the non-CA group (1200.0 versus 224.0 pg/mL, P = 0.001). From the ROC analysis, the sensitivity and specificity of BNP for detecting CA (with a cut-off value of 412 pg/mL) were 83% and 70%, respectively, and the area under the receiver operating curve was 0.75 (95% CI 0.61-0.90, P < 0.001) in all AL amyloidosis patients (n = 63). In contrast, other markers such as NT-proBNP, hs-cTnT, serum amyloid A, and dFLC were not useful for detecting CA in AL amyloidosis patients. Additionally, in the Cox proportional hazard analysis, BNP was a predictor of all-cause mortality (hazard ratio 3.266, 95% confidence interval 1.498-7.119, P = 0.003).BNP is a useful biomarker for detecting cardiac involvement and predicting prognosis in AL amyloidosis patients.


Asunto(s)
Cardiopatías/sangre , Cardiopatías/epidemiología , Amiloidosis de Cadenas Ligeras de las Inmunoglobulinas/sangre , Péptido Natriurético Encefálico/sangre , Troponina T/sangre , Anciano , Biomarcadores/sangre , Causas de Muerte , Estudios de Cohortes , Progresión de la Enfermedad , Ecocardiografía Doppler/métodos , Electrocardiografía/métodos , Femenino , Cardiopatías/diagnóstico por imagen , Hospitales Universitarios , Humanos , Amiloidosis de Cadenas Ligeras de las Inmunoglobulinas/fisiopatología , Japón , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Medición de Riesgo , Análisis de Supervivencia
15.
Gac Med Mex ; 155(4): 436-444, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31486800

RESUMEN

Positron-emission tomography (PET) is a medical diagnostic technique by means of which functional images are obtained by recording the spatio-temporal biodistribution of specific radiopharmaceuticals targeted at specific molecular objectives, which provides biochemical information at the molecular level. Early in the first decade of this 21st century, the Faculty of Medicine of the National Autonomous University of Mexico acquired the technology to implement this diagnostic technique in Mexico, thus becoming a pioneer in PET applications in the country and in Latin America. Almost two decades after its implementation in Mexico, PET has become an essential tool in medical clinics. This article describes the background, current state and perspectives of PET molecular imaging in Mexico, and the impact it has had on the management of patients with oncological, neurological and heart diseases.


Asunto(s)
Tomografía de Emisión de Positrones/métodos , Radiofármacos/administración & dosificación , Cardiopatías/diagnóstico por imagen , Humanos , México , Neoplasias/diagnóstico por imagen , Enfermedades del Sistema Nervioso/diagnóstico por imagen
18.
BMC Med Imaging ; 19(1): 59, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31370821

RESUMEN

BACKGROUND: T1 mapping sequences such as MOLLI, ShMOLLI and SASHA make use of different technical approaches, bearing strengths and weaknesses. It is well known that obtained T1 relaxation times differ between the sequence techniques as well as between different hardware. Yet, T1 quantification is a promising tool for myocardial tissue characterization, disregarding the absence of established reference values. The purpose of this study was to evaluate the feasibility of native and post-contrast T1 mapping methods as well as ECV maps and its diagnostic benefits in a clinical environment when scanning patients with various cardiac diseases at 3 T. METHODS: Native and post-contrast T1 mapping data acquired on a 3 T full-body scanner using the three pulse sequences 5(3)3 MOLLI, ShMOLLI and SASHA in 19 patients with clinical indication for contrast enhanced MRI were compared. We analyzed global and segmental T1 relaxation times as well as respective extracellular volumes and compared the emerged differences between the used pulse sequences. RESULTS: T1 times acquired with MOLLI and ShMOLLI exhibited systematic T1 deviation compared to SASHA. Myocardial MOLLI T1 times were 19% lower and ShMOLLI T1 times 25% lower compared to SASHA. Native blood T1 times from MOLLI were 13% lower than SASHA, while post-contrast MOLLI T1-times were only 5% lower. ECV values exhibited comparably biased estimation with MOLLI and ShMOLLI compared to SASHA in good agreement with results reported in literature. Pathology-suspect segments were clearly differentiated from remote myocardium with all three sequences. CONCLUSION: Myocardial T1 mapping yields systematically biased pre- and post-contrast T1 times depending on the applied pulse sequence. Additionally calculating ECV attenuates this bias, making MOLLI, ShMOLLI and SASHA better comparable. Therefore, myocardial T1 mapping is a powerful clinical tool for classification of soft tissue abnormalities in spite of the absence of established reference values.


Asunto(s)
Cardiopatías/diagnóstico por imagen , Imagen por Resonancia Cinemagnética/métodos , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Volumen Cardíaco , Medios de Contraste , Estudios de Factibilidad , Cardiopatías/fisiopatología , Humanos , Sensibilidad y Especificidad
19.
High Blood Press Cardiovasc Prev ; 26(5): 383-389, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31444783

RESUMEN

INTRODUCTION: The ESC-2018 guidelines suggest the use of Unattended automated office blood pressure (UAOBP) to avoid or at least reduce the white coat effect, even if do not support its use as preferred method. AIM: To assess the pressure difference between UAOBP and Attended office blood pressure (AOBP) and to evaluate their correlations with target organ damage in hypertensive patients. METHODS: UAOBP and AOBP were taken in a cohort of 48 outpatients. The pressure difference between the 2 methods and their correlation with anthropometric and cardiac parameters were analyzed. RESULTS: Unattended systolic and diastolic BP were lower than Attended systolic and diastolic BP (135 ± 17 mmHg vs 139 ± 21 mmHg and 79 ± 10 mmHg vs 82 ± 10 mmg). ΔDBP was significantly directly correlated with female sex (r = 0.347, p = 0.016) and it was lower in men compared to women (0.11 ± 8.9 mmHg vs 6.07 ± 7.42 mmHg, p = 0.016). Correlation coefficients for LVMi and RWT for attended and unattended BP were not statistically different (for LVMi r = 0.286 vs r = 0.381, p = 0.61, for RWT r = 0.413 vs r = 0.363, p = 0.78). The relationship between attended and unattended BP was described by the following equation: y = - 4.68 + 1.06*x; where Y is the attended systolic BP and X is the unattended systolic BP; in accordance with this equation, an unattended systolic BP of 140 mmHg corresponds to an attended systolic BP of 143.7 mmHg. CONCLUSIONS: UAOBP provides significantly lower values than AOBP. The difference in BP values between the two methods is much lower than the one obtained in most clinical studies.


Asunto(s)
Presión Arterial , Determinación de la Presión Sanguínea , Cardiopatías/etiología , Hipertensión/diagnóstico , Visita a Consultorio Médico , Hipertensión de la Bata Blanca/diagnóstico , Anciano , Automatización , Ecocardiografía Doppler en Color , Femenino , Cardiopatías/diagnóstico por imagen , Cardiopatías/fisiopatología , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , Factores Sexuales , Hipertensión de la Bata Blanca/fisiopatología
20.
Artículo en Japonés | MEDLINE | ID: mdl-31434848

RESUMEN

PURPOSE: A three-dimensional (3D) image from computed tomography (CT) angiography is a useful method for evaluation of complex anatomy such as congenital heart disease. However, 3D imaging requires high contrast enhancement for distinguishing between blood vessels and soft tissue. To improve the contrast enhancement, many are increasing the injection rate. However, one method is the use of fenestrated catheters, it allows use of a smaller gauge catheter for high-flow protocols. The purpose of this study was to compare the pressure of injection rate and CT number of a 24-gauge fenestrated catheter with an 22-gauge non-fenestrated catheter for i.v. contrast infusion during CT. METHODS: Between December 2014 and March 2015, 50 newborn patients were randomly divided into two protocols; 22-gauge conventional non-fenestrated catheter (24 newborn; age range 0.25-8 months, body weight 3.6±1.2 kg) and 24-gauge new fenestrated catheter (22 newborn; age range 0.25-12 months, body weight 3.3±0.9 kg). Helical scan of the heart was performed using a 64-detector CT (LightSpeed VCT, GE Healthcare) (tube voltage 80 kV; detector configuration 64×0.625 mm, rotation time 0.4 s/rot, helical pitch 1.375, preset noise index for automatic tube current modulation 40 at 0.625 mm slice thickness). RESULTS: We compared the maximum pressure of injection rate, CT number of aortic enhancement, and CT number of pulmonary artery enhancement between both protocols. The median injection rate, CT number of aortic enhancement, and CT number of pulmonary artery enhancement were 0.9 (0.5-3.4) ml/s, 455.5 (398-659) HU, and 500.0 (437-701) HU in 22-gauge conventional non-fenestrated catheter and 0.9 (0.5-2.0) ml/s, 436.5 (406-632) HU, and 479.5 (445-695) HU in the 24-gauge fenestrated catheter, respectively. There are no significantly different between a 24-gauge fenestrated catheter and 22-gauge non-fenestrated catheters at injection rate and CT number. Maximum pressure of injection rate was lower with 24-gauge non-fenestrated catheters (0.33 kg/cm2) than 22-gauge non-fenestrated catheters (0.55 kg/cm2) (p<0.01Conclusion: A 24-gauge fenestrated catheter performs similarly to an 22-gauge non-fenestrated catheter with respect to i.v. contrast infusion and aortic enhancement levels and can be placed in most subjects whose veins are deemed insufficient for an 22-gauge catheter.


Asunto(s)
Angiografía por Tomografía Computarizada , Medios de Contraste , Cardiopatías , Angiografía , Angiografía por Tomografía Computarizada/métodos , Medios de Contraste/administración & dosificación , Cardiopatías/congénito , Cardiopatías/diagnóstico por imagen , Humanos , Lactante , Recién Nacido , Tomografía Computarizada por Rayos X
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