| 1. |
- Kronander, Håkan, et al.
(författare)
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Analysis of ST/HR hysteresis improves long-term prognostic value of exercise ECG test.
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 148:1, s. 64-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: ST/HR hysteresis is one of the better diagnostic exercise ECG variables for coronary artery disease. This study evaluates the long-term prognostic value of ST/HR hysteresis in predicting acute myocardial infarction (AMI) and all-cause mortality in men and women. METHODS: The study population consisted of 8317 patients who had undergone routine exercise test on bicycle ergometer at one Swedish centre. Information on AMI and all-cause mortality was obtained from national Swedish registers covering a mean follow-up period of 9.5 years. RESULTS: The adjusted hazard ratio for AMI at a diagnostic cut point of ≤-20 µV for ST/HR hysteresis was 1.88 (95% CI, 1.62-2.17) in men and 2.31 (95% CI, 1.83-2.91) in women. For all-cause death the adjusted hazard ratio was 1.72 (95% CI, 1.52-1.96) in men and 1.90 (95% CI, 1.57-2.29) in women. The corresponding hazard ratios for ST-segment depression with horizontal or down-sloping ST-segment, ST-segment depression, ST/HR index, and ST/HR slope were lower. For comparison, the adjusted hazard ratio for AMI using maximal workload in percent of predicted was 2.02 (95% CI, 1.77-2.32) in men and 2.14 (95% CI, 1.71-2.67) in women. Area under the ROC curves for prediction of AMI was significantly larger using ST/HR hysteresis than using any of three other evaluated ECG indicators. CONCLUSIONS: ST/HR hysteresis appears to improve the prognostic ability of an exercise ECG test for AMI and all-cause mortality in a long-term perspective compared to conventional ST-segment and ST/HR indicators in both genders and clearly more markedly in women.
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| 2. |
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| 3. |
- Kronander, Håkan, et al.
(författare)
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Diagnostic performance and partition values of exercise electrocardiographic variables in the detection of coronary artery disease - improved accuracy by using ST/HR hysteresis
- 2010
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961 .- 1475-097X. ; 30:2, s. 98-106
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Tidskriftsartikel (refereegranskat)abstract
- P>Exercise electrocardiography is widely used for initial identification of patients with coronary artery disease (CAD). This study compares the measurements of ST-segment changes during exercise and during early postexercise recovery in terms of diagnostic discrimination capacity and optimal partition values. Data from 1876 patients undergoing a routine bicycle exercise test were analysed. CAD was angiographically verified in 668 patients, and excluded by angiography (n = 119), myocardial scintigraphy (n = 250), and on clinical grounds (n = 839) in 1208 patients. Postexercise ST/HR hysteresis was calculated as normalized for heart rate (HR) ST/HR loop area during the first 3 min of recovery. ST/HR index was obtained by dividing the overall ST amplitude change during exercise by exercise-induced HR change, and ST/HR slope was calculated using linear regression analysis of ST/HR data pairs during exercise. ST-segment depression was measured during, and for 3 min after the exercise. Discriminating capacity of the methods was evaluated in terms of receiver operating characteristic areas and optimal partition values providing the combination of the best sensitivity and specificity were established. The best diagnostic discrimination was provided by ST/HR hysteresis at optimal partition value of -15 mu V, followed by postexercise ST amplitude measurements at gender-specific partition values of -10 to -90 mu V, ST/HR slope [partition value 2 center dot 4 mu V (beats/min)-1], ST/HR index [partition value 1 center dot 6 mu V (beats/min)-1], and ST-segment depression during exercise (partition value 70 mu V in men and 90 mu V in women). The results demonstrate that analysis of postexercise ST/HR hysteresis offers the most accurate and gender indifferent identification of patients with CAD.
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| 4. |
- Kronander, Håkan, et al.
(författare)
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Exercise electrocardiography for diagnosis of coronary artery disease: impact of sampling rate on the diagnostic performance of ST/HR-loop based on data from early recovery phase
- 2007
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Ingår i: Clinical Physiology and Functionel Imaging. - 1475-0961. ; 28:2, s. 96-100
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Tidskriftsartikel (refereegranskat)abstract
- Quantitative analysis of electrocardiographic ST-segment/heart rate relationship (ST/HR loop) during early recovery phase of exercise stress test provides a sensitive tool for the detection of coronary artery disease (CAD). This study evaluates the effect of data sampling frequency on the diagnostic performance of ST/HR loop in 1876 patients undergoing a routine exercise test on a bicycle ergometer. CAD was verified angiographically in 668 patients and excluded by coronary angiography (n = 119), myocardial scintigraphy (n = 250) and on clinical grounds (n = 839) in 1208 patients. The normalized ST/HR loop area was calculated in all cases by integration of ST-segment amplitude difference from the end of exercise to the end of the first 3 min of recovery period over HR and dividing the integral by the HR difference over the integration period. The effect of different sampling rates (one, two and five samples per minute) on the CAD discrimination ability of ST/HR loop area was subsequently evaluated using receiver operating characteristic (ROC) curves. Reduction in ST/HR data sampling frequency from two to one sample per minute resulted in a significantly decreased diagnostic performance of the ST/HR loop whereas no differences in CAD discrimination capacity were observed between sampling frequencies of two and five samples per minute. The choice of ST/HR data sampling frequency may have a significant impact on the CAD diagnostic ability of the ST/HR loop. The use of sampling frequency below two samples per minute results in a significantly diminished diagnostic performance, a fact that should be taken into consideration when employing ST/HR diagnostic procedures.
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| 5. |
- Kronander, Håkan, et al.
(författare)
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Improved capacity of exercise electrocardiography in the detection of coronary artery disease by focusing on diagnostic variables during the early recovery phase
- 2005
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 0022-0736 .- 1532-8430. ; 38:2, s. 130-138
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Tidskriftsartikel (refereegranskat)abstract
- The temporal distribution of the diagnostic information for the detection of coronary artery disease (CAD) provided by exercise-induced electrocardiographic (ECG) ST-segment amplitude changes in different ECG leads in men and women has not been fully investigated. To shed further light in this area, 1877 electrocardiograms selected from 8322 patients undergoing a routine exercise test on a bicycle ergometer were evaluated. ST-segment amplitude and the difference between heart rate-matched recovery and exercise ST-segment amplitudes (ST/HR difference) were measured. Coronary artery disease was verified angiographically in 669 patients and excluded in 1208 patients by angiography (n = 119), by myocardial scintigraphy (n = 250), or on clinical grounds (n = 839). The diagnostic performance of the 2 ECG methods used was assessed by constructing receiver operating characteristic curves for each sampling point every 12 seconds during 10 minutes of recovery as well as the last 4 minutes of exercise for the ST-segment amplitude. ST-segment amplitude performed better after exercise than during exercise and best within the first 2 minutes of recovery. Its diagnostic ability did not differ from the ST-amplitude hysteresis assessed by the difference between recovery ST-segment amplitude and exercise ST-segment amplitude at matched heart rate. Both methods performed better in men and the diagnostic information appeared mainly in leads I, -aVR, II, V-4, V-5, and V-6. The best discrimination of CAD is provided by analysis of ST-segment amplitude changes in 6 specific leads early during the recovery phase. This information should be targeted by exercise ECG diagnostic methods.
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| 6. |
- Söderqvist, Emil, et al.
(författare)
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Design of a single segment conductance catheter for measurement of left ventricular volume
- 2001
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Ingår i: Annual Reports of the Research Reactor Institute, Kyoto University. ; , s. 151-154
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Konferensbidrag (refereegranskat)abstract
- The objective of this paper is to investigate how to best position the sensing electrodes on a single segment conductance catheter, and to calculate the expected performance. Using electrode potential data, obtained with the present five segment conductance catheter in pig experiments, we have interpolated the electrical field at any given point of time, and calculated what volume curve to expect with only two sensing electrodes. Comparison shows that the deviation between our calculated method and the present one is stable and small. Mean deviation with optimized electrode positions was 0.05% per sample, and the maximum deviation found for a single time sample was 2.57%. This indicates that it is possible to build a thin single segment catheter with as good performance as for the present five segment conductance catheter.
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| 7. |
- Adegoke, Olutayo, 1979-, et al.
(författare)
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Influence of laser powder bed fusion process parameters on the microstructure and cracking susceptibility of nickel-based superalloy Alloy 247LC
- 2022
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Ingår i: Results in Materials. - : Elsevier. - 2590-048X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Microstructures of material conditions of nickel-based superalloy Alloy 247LC fabricated using laser powder bed fusion (L-PBF) were investigated. Experiments designed in a prior study revealed the L-PBF process parameters for which the material conditions displayed a reduced susceptibility to cracking. Certain process parameters produced material conditions with an increased susceptibility to cracking. In this study, the material conditions were investigated in detail to reveal their microstructure and to determine the cause of cracking. The reason for the transition between a reduced to an increased susceptibility to cracking was examined. The results revealed solidification cracking occurred at high-angle grain boundaries. Solidification cracking may have been promoted at high-angle grain boundaries because of the undercooling contribution of the grain boundary energy. Furthermore, Si segregation was observed in the cracks. Thus, the presence of Si most likely promoted solidification cracking. It was observed that a high crack density, which occurred in the high energy density material condition, was associated with a large average grain size. The fact that certain combination of process parameters produced microstructures with a low susceptibility to cracking, indicates that reliable Alloy 247LC material may be printed using L-PBF by employing improved process parameters. © 2022
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| 8. |
- Adegoke, Olutayo, 1979-, et al.
(författare)
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Influence of laser powder bed fusion process parameters on the microstructure of solution heat-treated nickel-based superalloy Alloy 247LC
- 2022
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Ingår i: Materials Characterization. - : Elsevier. - 1044-5803 .- 1873-4189. ; 183
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Tidskriftsartikel (refereegranskat)abstract
- In this study, Alloy 247LC samples were built with different laser powder bed fusion (L-PBF) process parameters. The samples were then subjected to solution heat treatment at 1260 °C for 2 h. The grain size of all the samples increased significantly after the heat treatment. The relationship between the process parameters and grain size of the samples was investigated by performing a design of experiment analysis. The results indicated that the laser power was the most significant process parameter that influenced the grain height and aspect ratio. The laser power also significantly influenced the grain width. The as-built and as-built + heat-treated samples with high, medium, and low energy densities were characterized using a field emission gun scanning electron microscope equipped with an electron backscatter diffraction detector. The micrographs revealed that the cells present in the as-built samples disappeared after the heat treatment. Isolated cases of twinning were observed in the grains of the as-built + heat-treated samples. The disappearance of cells, increase in the grain size, and appearance of twins suggested that recrystallization occurred in the alloy after the heat treatment. The occurrence of recrystallization was confirmed by analyzing the grain orientation spread of the alloy, which was lower and more predominantly <1° in the as-built + heat-treated conditions than in the as-built conditions. The microhardness of the as-built + heat-treated samples were high which was plausible because γ’ precipitates were observed in the samples. However, the L-PBF process parameters had a very low correlation with the microhardness of the as-built + heat-treated samples.
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| 9. |
- Adegoke, Olutayo, et al.
(författare)
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Influence of laser powder bed fusion process parameters on voids, cracks, and microhardness of nickel-based superalloy alloy 247LC
- 2020
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Ingår i: Materials. - 1996-1944 .- 1996-1944. ; 13:17
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Tidskriftsartikel (refereegranskat)abstract
- The manufacturing of parts from nickel-based superalloy Alloy 247LC by laser powder bed fusion (L-PBF) is challenging, primarily owing to the alloy’s susceptibility to cracks. Apart from the cracks, voids created during the L-PBF process should also be minimized to produce dense parts. In this study, samples of Alloy 247LC were manufactured by L-PBF, several of which could be produced with voids and crack density close to zero. A statistical design of experiments was used to evaluate the influence of the process parameters, namely laser power, scanning speed, and hatch distance (inherent to the volumetric energy density) on void formation, crack density, and microhardness of the samples. The window of process parameters, in which minimum voids and/or cracks were present, was predicted. It was shown that the void content increased steeply at a volumetric energy density threshold below 81 J/mm3. The crack density, on the other hand, increased steeply at a volumetric energy density threshold above 163 J/mm3. The microhardness displayed a relatively low value in three samples which displayed the lowest volumetric energy density and highest void content. It was also observed that two samples, which displayed the highest volumetric energy density and crack density, demonstrated a relatively high microhardness; which could be a vital evidence in future investigations to determine the fundamental mechanism of cracking. The laser power was concluded to be the strongest and statistically most significant process parameter that influenced void formation and microhardness. The interaction of laser power and hatch distance was the strongest and most significant factor that influenced the crack density. © 2020 by the authors.
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| 10. |
- Adegoke, Olutayo, et al.
(författare)
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Laser beam powder bed fusion and post processing of alloy 247LC
- 2019
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Ingår i: MS and T 2019 - Materials Science and Technology. - : Materials Science and Technology. - 9780873397704 ; , s. 27-34
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Konferensbidrag (refereegranskat)abstract
- Alloy 247LC is sensitive to cracking during laser beam powder bed fusion (PBF-LB) manufacturing. Post processing is thus required to close cracks and achieve desired properties. In this study, samples of Alloy 247LC were manufactured by PBF-LB and subsequently post processed by hot isostatic pressing (HIP), HIP + solution and ageing heat treatments. The microstructure was characterized. Results showed cracks in the as-built condition. Cracks were not detected after HIP. Bright microconstituents were observed in the region between the cells, mainly, because of the partitioning of Hf and Ta into the intercellular region, where they presumably form carbides. What is assumed to be oxides were prominent in the microstructure. Thermodynamic calculations showed rapid formation of ?’ precipitates in the alloy, due to the high total concentration of Al and Ta and this was linked to the high hardness values in the as-built condition. © 2019 MS&T19®
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