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1.
Ecol Appl ; 28(4): 1003-1010, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29450936

RESUMEN

Home-range estimation is an important application of animal tracking data that is frequently complicated by autocorrelation, sampling irregularity, and small effective sample sizes. We introduce a novel, optimal weighting method that accounts for temporal sampling bias in autocorrelated tracking data. This method corrects for irregular and missing data, such that oversampled times are downweighted and undersampled times are upweighted to minimize error in the home-range estimate. We also introduce computationally efficient algorithms that make this method feasible with large data sets. Generally speaking, there are three situations where weight optimization improves the accuracy of home-range estimates: with marine data, where the sampling schedule is highly irregular, with duty cycled data, where the sampling schedule changes during the observation period, and when a small number of home-range crossings are observed, making the beginning and end times more independent and informative than the intermediate times. Using both simulated data and empirical examples including reef manta ray, Mongolian gazelle, and African buffalo, optimal weighting is shown to reduce the error and increase the spatial resolution of home-range estimates. With a conveniently packaged and computationally efficient software implementation, this method broadens the array of data sets with which accurate space-use assessments can be made.


Asunto(s)
Ecología/métodos , Algoritmos , Distribución Animal , Animales , Búfalos , Femenino , Movimiento , Rajidae
2.
Ecology ; 97(3): 576-82, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27197385

RESUMEN

An animal's trajectory is a fundamental object of interest in movement ecology, as it directly informs a range of topics from resource selection to energy expenditure and behavioral states. Optimally inferring the mostly unobserved movement path and its dynamics from a limited sample of telemetry observations is a key unsolved problem, however. The field of geostatistics has focused significant attention on a mathematically analogous problem that has a statistically optimal solution coined after its inventor, Krige. Kriging revolutionized geostatistics and is now the gold standard for interpolating between a limited number of autocorrelated spatial point observations. Here we translate Kriging for use with animal movement data. Our Kriging formalism encompasses previous methods to estimate animal's trajectories--the Brownian bridge and continuous-time correlated random walk library--as special cases, informs users as to when these previous methods are appropriate, and provides a more general method when they are not. We demonstrate the capabilities of Kriging on a case study with Mongolian gazelles where, compared to the Brownian bridge, Kriging with a more optimal model was 10% more precise in interpolating locations and 500% more precise in estimating occurrence areas.


Asunto(s)
Antílopes/fisiología , Modelos Biológicos , Actividad Motora/fisiología , Animales , Telemetría
3.
Ecology ; 96(5): 1182-8, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-26236833

RESUMEN

Quantifying animals' home ranges is a key problem in ecology and has important conservation and wildlife management applications. Kernel density estimation (KDE) is a workhorse technique for range delineation problems that is both statistically efficient and nonparametric. KDE assumes that the data are independent and identically distributed (IID). However, animal tracking data, which are routinely used as inputs to KDEs, are inherently autocorrelated and violate this key assumption. As we demonstrate, using realistically autocorrelated data in conventional KDEs results in grossly underestimated home ranges. We further show that the performance of conventional KDEs actually degrades as data quality improves, because autocorrelation strength increases as movement paths become more finely resolved. To remedy these flaws with the traditional KDE method, we derive an autocorrelated KDE (AKDE) from first principles to use autocorrelated data, making it perfectly suited for movement data sets. We illustrate the vastly improved performance of AKDE using analytical arguments, relocation data from Mongolian gazelles, and simulations based upon the gazelle's observed movement process. By yielding better minimum area estimates for threatened wildlife populations, we believe that future widespread use of AKDE will have significant impact on ecology and conservation biology.


Asunto(s)
Distribución Animal/fisiología , Fenómenos de Retorno al Lugar Habitual/fisiología , Modelos Biológicos , Animales , Antílopes/fisiología , Simulación por Computador , Interpretación Estadística de Datos , Ecosistema , Modelos Estadísticos , Movimiento
4.
Mov Ecol ; 10(1): 6, 2022 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-35123584

RESUMEN

CONTEXT: Asian elephant numbers are declining across much of their range driven largely by serious threats from land use change resulting in habitat loss and fragmentation. Myanmar, holding critical range for the species, is undergoing major developments due to recent sociopolitical changes. To effectively manage and conserve the remaining populations of endangered elephants in the country, it is crucial to understand their ranging behavior. OBJECTIVES: Our objectives were to (1) estimate the sizes of dry, wet, and annual ranges of wild elephants in Myanmar; and quantify the relationship between dry season (the period when human-elephant interactions are the most likely to occur) range size and configurations of agriculture and natural vegetation within the range, and (2) evaluate how percentage of agriculture within dry core range (50% AKDE range) of elephants relates to their daily distance traveled. METHODS: We used autocorrelated kernel density estimator (AKDE) based on a continuous-time movement modeling (ctmm) framework to estimate dry season (26 ranges from 22 different individuals), wet season (12 ranges from 10 different individuals), and annual range sizes (8 individuals), and reported the 95%, 50% AKDE, and 95% Minimum Convex Polygon (MCP) range sizes. We assessed how landscape characteristics influenced range size based on a broad array of 48 landscape metrics characterizing aspects of vegetation, water, and human features and their juxtaposition in the study areas. To identify the most relevant landscape metrics and simplify our candidate set of informative metrics, we relied on exploratory factor analysis and Spearman's rank correlation coefficient. Based on this analysis we adopted a final set of metrics into our regression analysis. In a multiple regression framework, we developed candidate models to explain the variation in AKDE dry season range sizes based on the previously identified, salient metrics of landscape composition. RESULTS: Elephant dry season ranges were highly variable averaging 792.0 km2 and 184.2 km2 for the 95% and 50% AKDE home ranges, respectively. We found both the shape and spatial configuration of agriculture and natural vegetation patches within an individual elephant's range play a significant role in determining the size of its range. We also found that elephants are moving more (larger energy expenditure) in ranges with higher percentages of agricultural area. CONCLUSION: Our results provide baseline information on elephant spatial requirements and the factors affecting them in Myanmar. This information is important for advancing future land use planning that takes into account space-use requirements for elephants. Failing to do so may further endanger already declining elephant populations in Myanmar and across the species' range.

5.
Mov Ecol ; 10(1): 47, 2022 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-36357952

RESUMEN

Reintroduced animals-especially those raised in captivity-are faced with the unique challenge of navigating a wholly unfamiliar environment, and often make erratic or extensive movements after release. Naïveté to the reintroduction landscape can be costly, e.g., through increased energy expenditure, greater exposure to predation, and reduced opportunities to forage. Integration with an extant population may provide opportunities for social information transfer. However, in the absence of interactions with residents, it is unclear how individual and social learning may affect an animal's ability to track resources in an unfamiliar landscape. We use integrated step selection functions (iSSFs) to address these knowledge gaps, by evaluating the extent to which environmental factors, individual experience (time since release), and social information-sharing (group size) influence movement decisions by scimitar-horned oryx (Oryx dammah) reintroduced into their native range for the first time in ca. 30 years. We found that both experience and social factors influenced the habitat selection and movement behavior of reintroduced oryx. Of four candidate iSSFs, the model that included environmental, experience, and group size variables performed best in both dry and wet periods. Statistically significant interaction terms between environmental variables and experience were generally larger than similar terms for group size, indicating that experience may affect habitat selection by reintroduced oryx more strongly than social factors. These findings may inform the management of recovering wildlife populations, update widely-held expectations about how released ungulates acclimate to novel landscapes, and demonstrate the utility of long-term monitoring of reintroduced populations.

6.
J Am Coll Cardiol ; 8(6): 1271-6, 1986 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-2946740

RESUMEN

This double-blind, randomized study evaluated the effect of nifedipine on restenosis after coronary angioplasty. Two hundred forty-one patients with dilation of 271 coronary sites were randomized at the time of hospital discharge to receive nifedipine, 10 mg (123 patients), or placebo (118 patients) four times daily for 6 months. No patient was known to have coronary artery spasm. The mean duration of therapy was 4.4 +/- 2 (mean +/- SD) months for nifedipine and 4.3 +/- 2 months for placebo. A restudy angiogram was available in 100 patients (81%) in the nifedipine group and 98 patients (83%) in the placebo group. A recurrent coronary stenosis was noted in 28% of patients in the nifedipine group and in 29.5% of those in the placebo group (p = NS). The mean diameter stenosis was 36.4 +/- 23% for the nifedipine group and 36.7 +/- 23% for the placebo group (p = NS). By pill count, 78% of patients receiving nifedipine and 82% of those receiving placebo complied with the study drug regimen. Coronary stenosis recurred in 33% of patients in the placebo group and in 29% of patients in the nifedipine group who complied with the regimen and had angiograms (p = NS). In conclusion, the study did not demonstrate a significant beneficial effect of nifedipine on the incidence of recurrent stenosis after successful percutaneous transluminal coronary angioplasty.


Asunto(s)
Angioplastia de Balón , Enfermedad Coronaria/terapia , Nifedipino/uso terapéutico , Adulto , Anciano , Enfermedad Coronaria/prevención & control , Humanos , Persona de Mediana Edad , Nifedipino/administración & dosificación , Nifedipino/efectos adversos , Cooperación del Paciente , Recurrencia , Factores de Tiempo
7.
J Am Coll Cardiol ; 9(6): 1214-8, 1987 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-2953771

RESUMEN

Over a 5 year period at three centers, 53 patients underwent percutaneous transluminal angioplasty of a right coronary artery ostial stenosis. The procedure was successful in 42 patients (79%) and unsuccessful in 11, of whom 5 (9.4%) required emergency coronary artery bypass grafting because of abrupt closure. The right coronary ostial lesion had distinctive technical requirements to achieve success, including high pressure balloon inflation (10 +/- 4 atm) and the need for unconventional right coronary guide catheters. Technical factors that account for increased difficulty in these patients include: problems with guide catheter impaction and ostial trauma; inability to inflate the balloon with adequate guide catheter support; and need for increased intracoronary manipulation. The stenoses were quite discrete (4 +/- 5 mm) and calcified in the majority (40) of the 53 patients. Long-term follow-up (mean 12.5 months, range 4 to 60) of these patients demonstrated clinical recurrence of angina in 20 patients (48%) and angiographically proved restenosis in 16 (38%). Repeat coronary angioplasty was successful in three of six patients for relief of symptoms for over 6 months. In conclusion, angioplasty of the right coronary ostial lesion compared with nonostial dilation leads to a suboptimal early success rate; an apparent high risk of emergency bypass surgery; and a high restenosis rate. Careful assessment of the patient with this lesion and improved technology appear to be warranted.


Asunto(s)
Angioplastia de Balón/normas , Enfermedad Coronaria/terapia , Angiografía , Angioplastia de Balón/efectos adversos , Ensayos Clínicos como Asunto , Puente de Arteria Coronaria , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/cirugía , Estudios de Seguimiento , Humanos , Recurrencia
8.
Am J Cardiol ; 56(12): 712-7, 1985 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-2932902

RESUMEN

Three distinct periods in catheter design have been identified since the advent of percutaneous transluminal coronary angioplasty (PTCA) in 1977. In the first period PTCA was performed using a double-lumen balloon catheter that had a fixed, flexible guidewire at the tip. In the second period, an independent, steerable guidewire and the steerable catheter system were used. In the third period, low-profile catheters were introduced. A total of 2,969 patients who had single-vessel PTCA of a native coronary artery was separated into groups according to the period during which PTCA was performed. Introduction of the steerable catheter system was accompanied by improvement in primary success rate in PTCA attempts on the right coronary artery (78% vs 88%, p less than 0.005). Introduction of the low-profile catheter was accompanied by improved primary success in PTCA attempts on the left anterior descending coronary artery (LAD) (90% vs 94%, p less than 0.005). The percentage of PTCA attempts on the LAD decreased over the 3 periods (70% to 60% to 56%), while the percentage of attempts on the left circumflex artery increased (7% to 12% to 16%). Before steerable and low-profile catheters were used, there were significant differences in ability to reach and cross stenoses among the 3 major coronary arteries. These differences no longer exist. These results indicate that technical improvements and operator experience have made stenoses in all 3 major coronary arteries equally accessible to dilatation catheters and that primary success rates and reasons for failure in these arteries are now similar.


Asunto(s)
Angioplastia de Balón , Enfermedad Coronaria/terapia , Angiografía , Angioplastia de Balón/métodos , Cateterismo Cardíaco , Enfermedad Coronaria/diagnóstico por imagen , Humanos
11.
Z Kardiol ; 74 Suppl 6: 107-10, 1985.
Artículo en Inglés | MEDLINE | ID: mdl-2937222

RESUMEN

The role of PTCA in the management of coronary artery disease has continued to evolve during the past six years as experience has grown and technical advances have been made. As has been clearly demonstrated in its relatively short history, PTCA offers an effective means of immediate palliation in symptomatic coronary artery disease. The natural history of coronary artery disease is one of progression and the ideal therapy is one which can be used repeatedly through the years. Advances in diagnostic technique hopefully will enable physicians to intervene earlier in the course of the disease, prior to the compromise of ventricular function which often accompanies triple vessel disease. The main question, however, is still unanswered and that is whether PTCA is an alternative approach to coronary artery bypass graft surgery in patients with multivessel disease. Preliminary reports indicate safety and good results may be obtained when PTCA is performed in these patients. However, the true usefulness and exact role needs to be carefully determined in a randomized study comparing coronary artery bypass surgery and PTCA in patients with multivessel disease. Hopefully in the future, patients with coronary artery disease can be diagnosed early before their disease progresses to severe triple vessel disease, when it may be too late for PTCA.


Asunto(s)
Angioplastia de Balón , Angioplastia de Balón/efectos adversos , Angioplastia de Balón/métodos , Puente de Arteria Coronaria , Enfermedad Coronaria/cirugía , Enfermedad Coronaria/terapia , Femenino , Humanos , Masculino , Infarto del Miocardio/epidemiología , Recurrencia
12.
Environ Monit Assess ; 74(2): 141-66, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11878640

RESUMEN

Landscape structure in a forest mosaic changes with spatial scale (i.e. spatial extent) and thresholds may occur where structure changes markedly. Forest management alters landscape structure and may affect the intensity and location of thresholds. Our purpose was to examine landscape structure at different scales to determine thresholds where landscape structure changes markedly in managed forest mosaics of the Appalachian Mountains in the eastern United States. We also investigated how logging influences landscape structure and whether these management activities change threshold values. Using threshold and autocorrelation analyses, we found that thresholds in landscape indices exist at 400, 500, and 800 m intervals from the outer edge of management units in our study region. For landscape indices that consider all landcover categories, such as dominance and contagion, landscape structure and thresholds did not change after logging occurred. Measurements for these overall landscape indices were strongly influenced by midsuccessional deciduous forest, the most common landcover category in the landscape. When restricting analyses for mean patch size and percent cover to individual forest types, thresholds for early-successional forests changed after logging. However, logging changed the landscape structure at small spatial scale, but did not alter the structure of the entire forest mosaic. Previous forest management may already have increased the heterogeneity of the landscape beyond the point where additional small cuts alter the overall structure of the forest. Because measurements for landscape indices yield very different results at different spatial scales, it is important first to identify thresholds in order to determine the appropriate scales for landscape ecological studies. We found that threshold and autocorrelation analyses were simple but powerful tools for the detection of appropriate scales in the managed forest mosaic under study.


Asunto(s)
Monitoreo del Ambiente , Agricultura Forestal , Árboles , Dinámica Poblacional , Estados Unidos
13.
Circulation ; 68(3): 612-20, 1983 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-6872172

RESUMEN

Clinical reports indicate that right ventricular diastolic collapse (RVDC) is associated with cardiac tamponade. To assess the hemodynamic abnormalities associated with RVDC, we studied six chronically instrumented conscious dogs (group A) with two-dimensional echocardiography during cardiac tamponade induced by continuous saline infusion into the pericardial space. We recorded cardiac output (electromagnetic flowmeter), heart rate, respiration, and aortic, intrapericardial, and right atrial pressures. In four additional animals (group B), we recorded right ventricular pressure and placed a hydraulic occluder around the pulmonary artery so that short-term reversible obstruction to right ventricular outflow could be produced. None of the dogs had RVDC when the pericardial space was empty, but all dogs showed RVDC during cardiac tamponade. The appearance of RVDC in group A was associated with a 21% reduction in cardiac output (p less than .01) and no change in mean aortic pressure. Short-term partial pulmonary artery obstruction led to increased right ventricular pressures and a striking reduction in RVDC in early tamponade, suggesting that RVDC is caused by pericardial pressure exceeding right ventricular pressure in early diastole. An additional animal had right ventricular hypertrophy caused by a severe "heart worm" infestation and did not show RVDC during cardiac tamponade. These observations suggest that in the absence of increased resistance to right ventricular outflow or right ventricular hypertrophy, RVDC occurs early in the course of cardiac tamponade and is associated with a hemodynamically important decrease in cardiac output.


Asunto(s)
Taponamiento Cardíaco/fisiopatología , Diástole , Modelos Animales de Enfermedad , Hemodinámica , Contracción Miocárdica , Animales , Presión Sanguínea , Gasto Cardíaco , Taponamiento Cardíaco/diagnóstico , Taponamiento Cardíaco/etiología , Perros , Ecocardiografía , Ventrículos Cardíacos/fisiopatología , Derrame Pericárdico/etiología , Volumen Sistólico
14.
Circulation ; 72(5): 1044-52, 1985 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-2931211

RESUMEN

We prospectively recorded all in-hospital complications of the first 3500 consecutive patients to undergo elective coronary angioplasty (PTCA) at Emory University Hospitals from July 14, 1980, to August 28, 1984, by three operators. PTCA was attempted in a total of 3933 lesions, with a primary success rate of 91%. Multiple-lesion PTCA was performed in 401 patients, and PTCA of saphenous vein grafts was attempted in 172. No complications were recorded in 3116 (89%) cases, isolated minor complications occurred in 241 (6.9%), and major complications (emergency surgery, myocardial infarction, death) were observed in 145 (4.1%). Emergency coronary artery bypass graft surgery (CABG) was performed in 96 patients (2.7%), with a myocardial infarction rate of 49% (47/96), a Q wave infarction rate of 23% (22/96), and an emergency surgery mortality rate of 2% (2/96). Hospital discharge occurred within 2 weeks of attempted PTCA in 91% (87/96) of patients undergoing emergency CABG. The overall myocardial infarction rate was 2.6% (94/3500). There were two nonsurgical deaths, giving a total mortality rate of 0.1% (4/3500). Univariate and multivariate analysis of 3099 patients undergoing single-lesion PTCA identified five preprocedure predictors of a major complication: multivessel coronary disease, lesion eccentricity, presence of calcium in the lesion, female gender, and lesion length. Unstable angina, duration of angina, lesion severity, previous CABG, and vein graft dilatation were not associated with an increased incidence of major complications. The strongest predictor of a major complication was the procedural appearance of an intimal dissection. Intimal dissection was evident in 894/3099 (29%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Angioplastia de Balón/mortalidad , Enfermedad Coronaria/terapia , Puente de Arteria Coronaria , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias
15.
Am Heart J ; 110(4): 720-6, 1985 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-2931968

RESUMEN

Perfusion of the coronary artery distal to an occluding angioplasty balloon was performed in 34 patients undergoing coronary angioplasty (PTCA). A randomized crossover study was employed using two exogenous substances as perfusates: lactated Ringer's solution (LR) and a fluorocarbon emulsion (FL), Fluosol-DA 20%. Both substances are electrolyte solutions, but the FL will dissolve more oxygen than the LR. During two attempted coronary artery occlusions of 90 seconds each, we perfused through the central lumen (guidewire channel) of the PTCA catheter at 60 ml/min. With FL perfusion the mean time to onset of angina after occlusion was delayed (41 +/- 21 vs 33 +/- 16 seconds, mean +/- SD; p less than 0.05), the mean duration of angina was shortened (77 +/- 58 vs 92 +/- 70 seconds, p less than 0.05), and the rise in the ST segment of the ECG was reduced (0.15 +/- 0.24 vs 0.2 +/- 0.23 mV, p less than 0.001) when compared to LR perfusion. Balloon occlusion time was able to be extended with FL perfusion (71 +/- 22 vs 59 +/- 22 seconds p less than 0.001). These results indicate that perfusion of the distal coronary artery is possible during PTCA and can reduce ischemia during a prolonged balloon occlusion time.


Asunto(s)
Angioplastia de Balón , Enfermedad Coronaria/terapia , Perfusión , Adulto , Anciano , Angina de Pecho/fisiopatología , Arteriopatías Oclusivas/fisiopatología , Arteriopatías Oclusivas/terapia , Sustitutos Sanguíneos , Enfermedad Coronaria/fisiopatología , Combinación de Medicamentos/uso terapéutico , Electrocardiografía , Femenino , Fluorocarburos/uso terapéutico , Hemodinámica , Humanos , Derivados de Hidroxietil Almidón , Soluciones Isotónicas/uso terapéutico , Masculino , Persona de Mediana Edad , Presión Esfenoidal Pulmonar , Distribución Aleatoria , Lactato de Ringer , Factores de Tiempo
16.
Am Heart J ; 113(1): 37-48, 1987 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-3799440

RESUMEN

Intracoronary delivery of argon laser energy was studied in eight anesthetized mongrel dogs. A No. 4.5 French single lumen catheter, with steerable guidewire and an optical fiber, was introduced through a Judkins-type femoral-coronary guiding catheter into three left anterior descending and eight left circumflex coronary arteries. A total of 65 laser energy exposures were made coaxially at 24 sites in the 11 arteries. At five sites, angiographically evident arterial perforation occurred with the first laser exposure, while at seven sites multiple laser exposures were made without angiographically evident perforation. All eight dogs remained hemodynamically stable, and were electively killed 5 +/- 1 hours following the procedure. Sections of myocardium from territories supplied by treated arteries demonstrated minimal or no pathology in 10 cases, while one territory had a small zone of early myocardial necrosis. This study suggests that standard coronary artery catheterization techniques can be used to introduce and position a steerable guidewire and an optical fiber in canine coronary arteries. Laser energy can repeatedly be delivered coaxially. Short-term deleterious effects may be reduced or eliminated, and exposure of blood elements to argon laser energy does not appear to create debris.


Asunto(s)
Cateterismo Cardíaco/métodos , Rayos Láser/efectos adversos , Animales , Vasos Coronarios/lesiones , Vasos Coronarios/patología , Perros , Lesiones Cardíacas/etiología , Masculino
17.
Am Heart J ; 111(6): 1065-72, 1986 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-3716979

RESUMEN

Imprecision in guiding and positioning is a recurring problem with fiberoptic delivery of laser energy (E) in small arteries. Manipulation can produce mechanical perforation of the vessel, and noncoaxial alignment can result in thermal perforation at relatively low laser energy levels. A No. 4.5 French single-lumen catheter was designed to accommodate both a steerable guidewire and an optical fiber. It was passed, under fluoroscopic control, into the abdominal aorta in 18 atherosclerotic rabbits. Argon laser energy was delivered coaxially at three sites in each of 14 rabbits (total = 42 sites); four rabbits were controls. Laser power levels (1 to 6 W) and exposure times (20 to 60 seconds) were varied. Energy level in joules (J) was calculated for each exposure. Saline flush at 25 ml/min was delivered through the catheter during laser exposures. Angiographic or microscopic evidence of vessel perforation was observed at 10 sites (E = 174 +/- 108 J). Another six sites exhibited microscopic laser effect only, without evidence of vessel perforation (E = 155 +/- 91 J). The remaining 26 sites exhibited no effects of laser energy (E = 117 +/- 92 J). No angiographically visible perforation occurred with E less than 120 J. This study suggests that a fiberoptic catheter with steerable guidewire allows safer intravascular manipulation of optical fibers, improves coaxial alignment in the arterial lumen, and may permit substantial laser energy delivery into atherosclerotic arteries.


Asunto(s)
Enfermedades de la Aorta/cirugía , Arteriosclerosis/cirugía , Terapia por Láser , Animales , Aorta/patología , Aortografía , Cateterismo/métodos , Cineangiografía , Dieta Aterogénica , Modelos Animales de Enfermedad , Endotelio/patología , Tecnología de Fibra Óptica , Fibras Ópticas , Conejos , Factores de Tiempo
18.
Circulation ; 76(4): 792-801, 1987 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-2958172

RESUMEN

The transstenotic pressure gradient recorded during coronary angioplasty (PTCA) reflects the dynamic relationship that exists between coronary blood flow and the effective cross-sectional area of the arterial lumen. An apparent relationship between the dynamic behavior of the pressure gradient and subsequent acute vessel closure was observed in our catheterization laboratory. We therefore examined the usefulness of the pressure gradient trend in predicting acute complications after 463 attempted PTCA procedures. Two pressure gradient trend patterns were identified: (1) a rising trend pattern identified by an increasing pressure gradient in the interval after deflation of the angioplasty, and (2) a stable trend pattern identified by a constant or decreasing pressure gradient. The incidence of acute vessel closure (17% vs 4%, p = .0001), emergency CABG (5.6% versus 1%, p less than .05), and myocardial infarction (13% versus 2%, p less than .0001) after the PTCA procedure was significantly higher among patients with rising trend patterns when compared with patients with stable trend patterns. Multivariate analysis identified independent predictors for an acute closure event as rising trend pattern (p less than .001), post-PTCA gradient (p less than .05), and post-PTCA percent diameter stenosis (p less than .02). Independent predictors for emergency coronary artery bypass grafting and myocardial infarction were post-PTCA gradient (p less than .001) and a rising trend pattern (odds ratio = 2.91, p less than .001), respectively. The dynamic behavior of the gradient trend provides additional useful information about the results of dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Angioplastia de Balón/efectos adversos , Enfermedad Coronaria/terapia , Vasos Coronarios/fisiopatología , Enfermedad Aguda , Anciano , Angiografía Coronaria , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Presión , Pronóstico , Factores de Riesgo
19.
Circulation ; 70(6): 966-71, 1984 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-6499153

RESUMEN

To determine the hemodynamic derangement associated with right ventricular diastolic collapse and to assess the value of right ventricular and right atrial collapse in identifying cardiac tamponade, two-dimensional echocardiograms were recorded simultaneously with measurement of right atrial, pulmonary capillary wedge, intrapericardial, and systemic arterial pressures and cardiac output in 16 patients as they underwent pericardiocentesis. Twelve patients (group I) had evidence of right ventricular or right atrial collapse or both on their echocardiograms and hemodynamic evidence of cardiac tamponade before pericardiocentesis. All hemodynamic parameters improved after pericardiocentesis (p less than or equal to .05). Continuous monitoring during pericardiocentesis in three of these patients showed significant improvement in all parameters except heart rate (p less than or equal to .02) at the point of disappearance of right ventricular diastolic collapse, with further improvement in cardiac output as pericardiocentesis continued (p less than .01). Right atrial collapse persisted after right ventricular collapse disappeared but was no longer present when pericardiocentesis was completed. Three patients (group II) had no right ventricular or right atrial collapse, no hemodynamic evidence of cardiac tamponade, and no improvement in hemodynamic parameters after pericardiocentesis. A single patient (group III) was found to have elevated right heart pressures and right ventricular hypertrophy before pericardiocentesis. Although there was hemodynamic evidence of cardiac tamponade in this patient, there was no evidence of right ventricular or right atrial collapse. In this study, the sensitivity of right ventricular collapse as a marker for cardiac tamponade was 92%, its specificity 100%, its accuracy 94%, and its predictive value 100%.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Taponamiento Cardíaco/fisiopatología , Ecocardiografía , Hemodinámica , Adulto , Anciano , Gasto Cardíaco , Taponamiento Cardíaco/cirugía , Diástole , Femenino , Atrios Cardíacos/fisiopatología , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertensión Pulmonar/fisiopatología , Masculino , Persona de Mediana Edad , Pericardio/cirugía , Volumen Sistólico , Sístole
20.
Circulation ; 72(3): 530-5, 1985 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-3160507

RESUMEN

We studied 986 patients who underwent follow-up angiography after successful percutaneous transluminal coronary angioplasty (PTCA) to determine the influence of uncomplicated intimal dissection on restenosis rate. Angiographic evidence of intimal dissection after PTCA was present in 248 patients or 25%. After a mean follow-up time of 7 +/- 5 months (SD) the restenosis rate in patients without intimal dissection was 30% compared with 24% in patients with intimal dissection (p = .08). Patients with available transstenotic pressure gradients were divided according to the hemodynamic result into two subgroups: those with final gradients at the conclusion of PTCA of 15 mm Hg or less (n = 638) and those with gradients greater than 15 mm Hg (n = 244). Patients with intimal dissection had a significantly lower restenosis rate than patients without intimal dissection if the final gradient was 15 mm Hg or less (19% vs 28%; p less than .05). If the final gradient was greater than 15 mm Hg, the presence or absence of intimal dissection had no significant influence on restenosis rate, which was 35% and 39%, respectively (p = NS). We conclude that an uncomplicated intimal dissection after a successful coronary angioplasty has no adverse influence on angiographic restenosis. An excellent angiographic long-term outcome can be expected if the intimal dissection is associated with a favorable hemodynamic result.


Asunto(s)
Angioplastia de Balón , Constricción Patológica/etiología , Enfermedad Coronaria/terapia , Hemodinámica , Humanos
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