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- Juffermans, Joe F., et al.
(författare)
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Multicenter Consistency Assessment of Valvular Flow Quantification With Automated Valve Tracking in 4D Flow CMR
- 2021
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Ingår i: JACC: Cardiovascular Imaging. - : Elsevier BV. - 1936-878X. ; 14:7, s. 1354-1366
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study determined: 1) the interobserver agreement; 2) valvular flow variation; and 3) which variables independently predicted the variation of valvular flow quantification from 4-dimensional (4D) flow cardiac magnetic resonance (CMR) with automated retrospective valve tracking at multiple sites. Background: Automated retrospective valve tracking in 4D flow CMR allows consistent assessment of valvular flow through all intracardiac valves. However, due to the variance of CMR scanners and protocols, it remains uncertain if the published consistency holds for other clinical centers. Methods: Seven sites each retrospectively or prospectively selected 20 subjects who underwent whole heart 4D flow CMR (64 patients and 76 healthy volunteers; aged 32 years [range 24 to 48 years], 47% men, from 2014 to 2020), which was acquired with locally used CMR scanners (scanners from 3 vendors; 2 1.5-T and 5 3-T scanners) and protocols. Automated retrospective valve tracking was locally performed at each site to quantify the valvular flow and repeated by 1 central site. Interobserver agreement was evaluated with intraclass correlation coefficients (ICCs). Net forward volume (NFV) consistency among the valves was evaluated by calculating the intervalvular variation. Multiple regression analysis was performed to assess the predicting effect of local CMR scanners and protocols on the intervalvular inconsistency. Results: The interobserver analysis demonstrated strong-to-excellent agreement for NFV (ICC: 0.85 to 0.96) and moderate-to-excellent agreement for regurgitation fraction (ICC: 0.53 to 0.97) for all sites and valves. In addition, all observers established a low intervalvular variation (≤10.5%) in their analysis. The availability of 2 cine images per valve for valve tracking compared with 1 cine image predicted a decreasing variation in NFV among the 4 valves (beta = −1.3; p = 0.01). Conclusions: Independently of locally used CMR scanners and protocols, valvular flow quantification can be performed consistently with automated retrospective valve tracking in 4D flow CMR.
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- Scown, Murray W., et al.
(författare)
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Global change scenarios in coastal river deltas and their sustainable development implications
- 2023
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Ingår i: Global Environmental Change. - 0959-3780. ; 82
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Tidskriftsartikel (refereegranskat)abstract
- Deltas play a critical role in the ambition to achieve global sustainable development given their relatively large shares in population and productive croplands, as well as their precarious low-lying position between upstream river basin development and rising seas. The large pressures on these systems risk undermining the persistence of delta societies, economies, and ecosystems. We analyse possible future development in 49 deltas around the globe under the Shared Socio-economic and Representative Concentration Pathways until 2100. Population density, urban fraction, and total and irrigated cropland fraction are three to twelve times greater in these deltas, on average, than in the rest of the world. Maximum river water discharges are projected to increase by 11–33 % and river sediment discharges are projected to decrease 26–37 % on average, depending on the scenario. Regional sea-level rise reaches almost 1.0 m by 2100 for certain deltas in the worst-case scenario, increasing to almost 2.0 m of relative rise considering land subsidence. Extreme sea levels could be much higher still—reaching over 4.0 m by 2100 for six of the 49 deltas analysed. Socio-economic conditions to support adaptation are the weakest among deltas with the greatest pressures, compounding the challenge of sustainable development. Asian and African deltas stand out as having heightened socio-economic challenges—huge population and land use pressures in most Asian deltas and the Nile delta; low capacity for adaptation in most African deltas and the Irrawaddy delta. Although, deltas in other parts of the world are not immune from these and other pressures, either. Because of unique pressures and processes operating in deltas, as in other “hotspots” such as small islands, mountains, and semi-arid areas, we recommend greater consideration and conceptualisation of environmental processes in global sustainable development agendas and in the Integrated Assessment Models used to guide global policy.
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