| 1. |
- Magiera, Sylwia, et al.
(författare)
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A liquid chromatography and tandem mass spectrometry method for the determination of potential biomarkers of cardiovascular disease
- 2013
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Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 919, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- A simple, accurate and sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and validated for the quantitation of alpha-ketoglutaric acid (alpha-KG), L-carnitine (L-CAR) and acetyl-L-carnitine (acetyl-L-CAR) in human urine as potential biomarkers of cardiovascular disease. The separation was performed using an isocratic elution of 0.1% formic acid in water and acetonitrile (97:3, v/v) on an Acclaim 120 C8 column (150 mm x 4.6 mm, 3.0 mu m). The flow rate of the mobile phase was 1.2 mL/min and the total assay run time was 3 min. Detection was performed on a triple-quadrupole mass spectrometer in selected reaction monitoring (SRM) mode via an electrospray ionization (ESI) source in positive and negative ion modes. This method covered a linearity range of 0.1-500 ng/mL for L-CAR and acetyl-L-CAR and 1-1000 ng/mL for alpha-KG with lower limits of quantification (LLOQ) of 0.08 ng/mL for L-CAR, 0.04 ng/mL for acetyl-L-CAR and 0.8 ng/mL for alpha-KG. The intra-day and inter-day precision and accuracy of the quality control samples exhibited relative standard deviations of less than 5.54% and relative error values from -5.95% to 3.11%. Analyte stability was evaluated under various sample preparation, analysis and storage conditions and varied from -9.89% to -0.47%. A two-step solid-phase extraction (SPE) procedure using silica gel and quaternary amine cartridges was used for urine sample cleanup. The average recoveries for all analyzed compounds were better than 86.64% at three concentrations. The method was successfully applied for the quantitation of alpha-KG, L-CAR and acetyl-L-CAR in human urine samples.
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| 2. |
- Ahn, Henrik, et al.
(författare)
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An implantable pressure sensor for long-term wireless monitoring of cardiac function- first study in man
- 2016
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Ingår i: Journal of Cardiovascular Diseases & Diagnosis. - : Omics Publishing Group. - 2329-9517. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Heart failure is a huge health problem. The possibility of long-term monitoring heart function more accurately in these patients has gained increasing interest. The primary aim of this study was to see if a wireless pressure sensor can be safely implanted to give accurate and reproducible long-term intracardiac pressure recordings. Another aim was to see if there are any adverse effects connected with the implant. A control group was included for comparison of clinical data.Methods: Forty patients with heart failure, 31 scheduled for open heart surgery and 9 for transcatheter aortic valve replacement (TAVR) were included to test the safety and feasibility of the Titan™ pressure sensor. The patients were randomized to the implant or control group.Findings: Initial sensor measurements showed very good correlation with reference pressure values from a fluid-filled catheter, and there was no need for calibration of the sensor. At the 6-month follow-up 11 patients had been wearing the implant for >1 year with a median time of 560 days. Ten of these had adequate sensor function. Compared to the control group there was no difference in adverse clinical events and the overall number of complications was low.Conclusions: This first study in man on a new implantable wireless hemodynamic monitor showed favorable results regarding our primary endpoints; accuracy of recordings over time and safety profile. The technology has great potential for monitoring at home since it is easy to use in the out-patient setting.
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| 3. |
- Ahn, Henrik Casimir, et al.
(författare)
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Can predilatation in transcatheter aortic valve implantation be omitted? - a prospective randomized study
- 2016
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Ingår i: Journal of Cardiothoracic Surgery. - : BIOMED CENTRAL LTD. - 1749-8090. ; 11:124
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of a balloon expandable stent valve includes balloon predilatation of the aortic stenosis before valve deployment. The aim of the study was to see whether or not balloon predilatation is necessary in transcatheter aortic valve replacement (TAVI). Methods: Sixty consecutive TAVI patients were randomized to the standard procedure or to a protocol where balloon predilatation was omitted. Results: There were no significant differences between the groups regarding early hemodynamic results or complication rates. Conclusions: TAVI can be performed safely without balloon predilatation and with the same early results as achieved with the standard procedure including balloon predilatation. The reduction in the number of pacing periods required may be beneficial for the patient.
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| 4. |
- Ahn, Henrik Casimir, et al.
(författare)
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Transvenous Implantation of a Stent Valve in Patients With Degenerated Mitral Prostheses and Native Mitral Stenosis
- 2016
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Ingår i: Annals of Thoracic Surgery. - : Elsevier. - 0003-4975 .- 1552-6259. ; 101:6, s. 2279-2284
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of this study was to report the use of a transvenous transseptal approach using a stent valve in patients with degenerated biological mitral valve prostheses, regurgitation after mitral repair, and native mitral stenosis.METHODS: Ten patients (median age, 74 years; range, 20-89 years; 5 men and 5 women) with degenerated mitral bioprosthetic valves (n = 7), failed mitral repair (n = 1), or calcified native stenotic valves (n = 2) underwent transvenous implantation of a stent valve.RESULTS: The procedure was initially successful in all patients. Predilation was performed for balloon sizing only in the 2 patients with native mitral stenosis. The stent valve was deployed during 1 period of rapid pacing. A guidewire, as a loop from the right femoral vein and through the left ventricular apex, facilitated a good angle and secure positioning of the stent valve. An ultrasonographically guided puncture of the apex was carried out in 6 patients, and in the other 4 we performed a minithoracotomy before apical puncture. All valves were implanted in a good position with improved function and without significant paravalvular leakage (PVL). There were no periprocedural deaths. The 30-day survival was 80% (8 of 10 patients), and 60% (6 of 10) of patients were still alive a median time of 290 days after the procedure.CONCLUSIONS: Transvenous transseptal implantation of a stent valve was performed in 10 patients with mitral valve disease, with good early functional results. These high-risk patients must be carefully selected by a multidisciplinary team because the procedure carries a high mortality.
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| 5. |
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| 6. |
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| 7. |
- Balata, Dilan, et al.
(författare)
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Non-Bacterial Thrombotic Endocarditis : A Presentation of COVID-19
- 2020
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Ingår i: European journal of case reports in internal medicine. - : SMC Media. - 2284-2594. ; 7:8
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Tidskriftsartikel (refereegranskat)abstract
- The SARS-CoV-2 virus is a newly emergent pathogen first identified in Wuhan, China, and responsible for the COVID-19 global pandemic. In this case report we describe a manifestation of non-bacterial thrombotic endocarditis with continuous peripheral embolization in a COVID-19-positive patient. The patient responded well to high-dose LMWH treatment with cessation of the embolic process.
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| 8. |
- Baranowska, Irena, et al.
(författare)
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Clinical applications of fast liquid chromatography: A review on the analysis of cardiovascular drugs and their metabolites
- 2013
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Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 927:SI, s. 54-79
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Forskningsöversikt (refereegranskat)abstract
- One of the major challenges facing the medicine today is developing new therapies that enhance human health. To help address these challenges the utilization of analytical technologies and high-throughput automated platforms has been employed; in order to perform more experiments in a shorter time frame with increased data quality. In the last decade various analytical strategies have been established to enhance separation speed and efficiency in liquid chromatography applications. Liquid chromatography is an increasingly important tool for monitoring drugs and their metabolites. Furthermore, liquid chromatography has played an important role in pharmacokinetics and metabolism studies at these drug development stages since its introduction. This paper provides an overview of current trends in fast chromatography for the analysis of cardiovascular drugs and their metabolites in clinical applications. Current trends in fast liquid chromatographic separations involve monolith technologies, fused-core columns, high-temperature liquid chromatography (HTLC) and ultra-high performance liquid chromatography (UHPLC). The high specificity in combination with high sensitivity makes it an attractive complementary method to traditional methodology used for routine applications. The practical aspects of, recent developments in and the present status of fast chromatography for the analysis of biological fluids for therapeutic drug and metabolite monitoring, pharmacokinetic studies and bioequivalence studies are presented.
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| 9. |
- Baranowska, Irena, et al.
(författare)
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Determination of selected drugs in human urine by differential pulse voltammetry technique
- 2008
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Ingår i: Bioelectrochemistry. - : Elsevier BV. - 1567-5394 .- 1878-562X. ; 73:1
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Tidskriftsartikel (refereegranskat)abstract
- A new, simple and selective differential pulse voltammetry (DPV) method for the simultaneous determination of selected drugs in model solutions and spiked human urine samples with prior extraction was developed and validated. The objects of analysis were paracetamol, furosemide, dipyrone, cefazolin and dexamethasone belonging to four different therapeutic groups (antibiotics, analgesic, demulcent and diuretic). Analytical methods for the preparation of urine samples for voltammetric analysis (liquid-liquid extraction - LLE and solid-phase extraction - SPE) were worked out and optimized. Hanging mercury drop electrode (HMDE) and graphite electrode were used as working electrodes. Reference electrode was Ag vertical bar AgCl vertical bar KCI(sat.), whereas auxiliary electrode - platinum electrode. The optimal conditions for quantitative determination were obtained in a Britton-Robinson (BR) buffer at pH 2.4. Quantification was performed by means of calibration curve and standard addition methods. The calibration curves of analysed drugs are linear within the range of concentration: 6.61-66.10, 6.05-54.42, 6.00-65.00, 4.20-33.58 and 0.51-3.06 mu M for paracetamol, furosemide, dipyrone, cefazolin and dexamethasone, respectively. The levels of analysed compounds in human urine can be successfully determined using this developed method with no matrix effect. (C) 2008 Elsevier B.V. All rights reserved.
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| 10. |
- Baranowska, Irena, et al.
(författare)
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Development and Validation of an HPLC Method for the Simultaneous Analysis of 23 Selected Drugs Belonging to Different Therapeutic Groups in Human Urine Samples
- 2009
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Ingår i: ANALYTICAL SCIENCES. - : Springer Science and Business Media LLC. - 0910-6340 .- 1348-2246. ; 25:11, s. 1307-1313
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Tidskriftsartikel (refereegranskat)abstract
- We have developed and validated a new and reliable gradient reversed-phase high-performance liquid chromatography (RP-HPLC) method with a diode array detector (DAD) for the simultaneous separation and determination of 23 frequently prescribed selected drugs belonging to different therapeutic groups in human urine samples. For the drugs listed below, this method of analysis for human urine was also successfully applied to determine urine concentrations of these drugs in samples from treated patients: enalapril (ENA), paracetamol (PAR), sotatol (SOT), dipyrone (DIP), vancomycin (VAN), captopril (CAP), fluconazole (FLU), cefazolin (CEF), metoprolol (MET), aspirin (ASP), ticlopidine (TIC), prednisolone (PRE), propranolol (PRO), digoxin (DIG), sildenafil (SIL), furosemide (FUR), dexamethasone (DEX), carvedilol (CAR), ketoprofen (KET), nifedipine (NIF), terbinafine (TER), acenocoumarol (ACE) and spironolactone (SPI). Separation of the analytes was achieved by RP-HPLC-DAD with a mobile phase composed of acetonitrile, methanol and 0.05% trifluoroacetic acid in water using a gradient elution program. Good linear relationships over the investigated concentration ranges were observed with values of r(2) higher than 0.998 for all of the drugs. The intra-day and inter-day precisions of this method were evaluated with RSD values less than 4.26 and 5.42%, respectively. The relative recoveries of the 23 investigated compounds ranged from 93.60 to 106.00% with RSD values less than 4.46%. An expanded uncertainty budget was constructed for all investigated drugs in human urine samples.
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| 11. |
- Baranowska, Irena, et al.
(författare)
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DEVELOPMENT AND VALIDATION OF RP-HPLC-DAD METHOD FOR DETERMINATION OF NINE DRUGS AND THEIR ELEVEN METABOLITES IN PLASMA AND URINE: PLASMA SAMPLES MEASUREMENTS
- 2013
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Ingår i: Journal of Liquid Chromatography & Related Technologies. - : Taylor and Francis: STM, Behavioural Science and Public Health Titles / Taylor and Francis. - 1082-6076 .- 1520-572X. ; 36:12, s. 1597-1615
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Tidskriftsartikel (refereegranskat)abstract
- A new RP-HPLC-DAD method for determination of nine drugs and eleven metabolites in body fluids was developed. The separation of drugs and metabolites (PAR, SOT, MET, ASP, PRO, NIF, CAR, DEX, KET, PAR-S, PAR-G, MET-H, D-MET, SAL, GENT, PRO-S, D-NIF, ODMC, O-DEX, and KET-G) was achieved using Develosil RP-AQUEOUS-AR5 C30 column in 30min. The obtained MQL values (0.02 mu g/mL0.23 mu g/mL) are suitable for urine/plasma measurements. Correlation coefficient (r(2)) was higher than 0.98 for all analytes. The recoveries ranged from 72.1% to 115.2% (RSD andlt;6.4%). Chromatographic data were obtained with accuracy in the range from 0.3 to 5.6%.
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| 12. |
- Baranowska, Irena, et al.
(författare)
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PLC analysis of methylxanthines and selected drugs in urine samples
- 2006
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Ingår i: Chemia Analityczna. - 0009-2223. ; 51:5, s. 751-760
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Tidskriftsartikel (refereegranskat)abstract
- A HPLC system for separation and determination of methylxanthines and selected drugs has been developed. Teophylline, 1-methylxanthine, 3-methylxanthine, 1,3-dimethyluric acid, caffeine, paracetamol, furosemide, dexamethasone, prednisolone, cefazolin and imipenem have been determined. A RP-18e column with a RP-18 pre-column and a DAD detector were used. Gradient elution with 0.05% TFA aqueous solution with acetononitrile at the flow rate of 0.8 mL min-1 was applied. The developed system was used to determine the examined compounds in urine samples.
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| 13. |
- Baranowska, Irena, et al.
(författare)
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Rapid UHPLC Method for Simultaneous Determination of Vancomycin, Terbinafine, Spironolactone, Furosemide and Their Metabolites: Application to Human Plasma and Urine
- 2010
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Ingår i: Analytical Sciences. - : The Japan Society of Analytical Chemistry / The Japan Society for Analytical Chemistry. - 0910-6340 .- 1348-2246. ; 26:7, s. 755-759
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Tidskriftsartikel (refereegranskat)abstract
- The ultra high performance liquid chromatography (UHPLC)-UV method for the simultaneous determination of furosemide, saluamine (furosemide metabolite), spironolactone, carnenone (spironolactone active metabolite), terbinafine, N-desmethylcarboxy terbinafine (terbinafine metabolite) and vancomycin in human plasma and urine is proposed. Good separation of the analytes was achieved with the gradient RP-UHPLC-UV with the mobile phase composed as acetonitrile and 0.1% formic acid. The determined substances were eluted from a Hypersil GOLD C(18)e (50 mm x 2.1 mm, 1.7 mu m particles) column in 3.3 min. Good linear relationships were observed for all of the analytes (R-2 higher than 0.994). The limit of detection (LOD) values varied from 0.01 to 0.07 mu g ml(-1), with vancomycin as an exception (0.11 mu g ml(-1)). After protein precipitation and solid-phase extraction, samples of plasma and urine were analyzed. Thanks to the short analysis time and small quantities of urine or plasma needed, this method can be applied to routine clinical analysis.
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| 14. |
- Baranowska, Irena, et al.
(författare)
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Simultaneous determination of sildenafil, its N-desmethyl metabolite and other drugs in human urine by gradient RP-HPLC method
- 2007
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Ingår i: Chemia Analityczna. - 0009-2223. ; 52:4, s. 645-671
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Tidskriftsartikel (refereegranskat)abstract
- A new, rapid, sensitive and accurate gradient reversed-phase high-performance liquid chromatography technique for simultaneous separation and analysis of sildenafil citrate (SC), its N-desmethyl active metabolite - N-desmethylsildenafil (UK-103,320) in the presence of different drugs in human urine was developed. The analysed drugs were extracted from urine by liquid-liquid extraction. Effective RP-HPLC separation of the examined drugs was performed using a Merck LiChroCART® analytical column (Purospher® STAR RP-18 endcapped, 125 x 3 mm, particle size 5 μm) with a gradient mobile phase system and diode array or fluorescence detector. Linear ranges of detection for SC and UK-103,320 were found to be 0.03-8.5 μg mL-1 (r 2 = 0.9994) for both compounds. Linear ranges for other drugs (analgesic, antibiotic, diuretic and demulcent), which could exist in urine from patients treated with SC were also determined. Complete separation of all analytes was achieved below 25 min. The retention times for all studied analytes ranged from 4.76 to 18.84 min. The limits of detection and limits of quantification for both analysed compounds were calculated and recovery studies were also performed. The mean absolute recoveries of SC and UK-103,320 were > 94%. The new procedure was suitably validated and successfully applied for the analysis of SC, its active metabolite and other drugs in urine samples of patients with pulmonary hypertension.
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| 15. |
- Baranowska, Irena, et al.
(författare)
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UHPLC Method for the Simultaneous Determination of beta-Blockers, Isoflavones, and Flavonoids in Human Urine
- 2011
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Ingår i: Journal of Chromatographic Science. - : Oxford University Press (OUP): Policy F. - 0021-9665 .- 1945-239X. ; 49:10, s. 764-773
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Tidskriftsartikel (refereegranskat)abstract
- A simple method using solid-phase extraction (SPE) and ultra high-performance liquid chromatography (UHPLC) for the simultaneous determination of β-blockers, isoflavones, and flavonoids in human urine is developed. A statistical central composite design and response surface analysis is used to optimize the separation of the analytes. These multivariate procedures are efficient in determining the optimal separation condition using resolutions and retention time as responses. A gradient elution using a mobile phase consisting of 0.05% trifluoroacetic acid in water and acetonitrile is applied on a Hypersil GOLD column within a short analysis time of 4.5 min. UV detection was used to monitor the analytes. The suggested method was linear in a concentration range from 0.04-20.00 μg/mL, depending on the compound. The limits of detection ranged from 8.9 to 66.2 ng/mL. The precision was lower than 2.74%, and the accuracy was between 0.01-3.65%. The Oasis HLB column, with the highest recoveries, is selected for the pre-concentration step. This present paper reports, for the first time, a method for the simultaneous determination of β-blockers, isoflavones, and flavonoids in human urine samples. Furthermore, the developed method can also be applied to the routine determination of examined compounds concentrations in human urine.
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| 16. |
- Baranowska, Irena, et al.
(författare)
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UHPLC method for the simultaneous determination of beta-blockers, isoflavones and their metabolites in human urine
- 2011
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Ingår i: JOURNAL OF CHROMATOGRAPHY B-ANALYTICAL TECHNOLOGIES IN THE BIOMEDICAL AND LIFE SCIENCES. - : Elsevier Science B.V., Amsterdam.. - 1570-0232. ; 879:9-10, s. 615-626
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Tidskriftsartikel (refereegranskat)abstract
- A rapid-resolution ultra high-performance liquid chromatography separation method (UHPLC) for the simultaneous determination of the following beta-blockers: milrinone, sotalol, metoprolol, propranolol and carvedilol, and their metabolites: 5-hydroxylphenyl-carvedilol, O-desmethylcarvedilol, 4-hydroxypropranolol, alpha-hydroxy-metoprolol, O-desmethyl-metoprolol; the following isoflavones: genistein, daidzein, glycitin, glycitein, puerarin and biochanin A; as well as their metabolites: dihydrogenistein, desmethylglycitein, 8-hydroxygenistein, daidzein-7,4-diglucoside, 8-hydroxydaidzein, dihydrobiochanin A in human urine was optimized. The analysed compounds were extracted from human urine by means of solid phase extraction (SPE). The effective UHPLC separation of the examined compounds was applied on a Hypersil GOLD (TM) (50 mm x 2.1 mm, 1.9 mu m) column with a gradient mobile phase system and a UV detector. The complete separation of all analytes was achieved within 8.0 min. The method was validated for the determination of the aforementioned substances in human urine. The linear ranges, limits of detection CLOD) and limits of quantification (LOQ) for beta-blockers, isoflavones and their metabolites were determined. The intra- and inter-day precision (%C.V.) was less than 4.48%, and the intra-day and inter-day accuracy was less than 4.74%. The tested SPE sorbent proved that appropriate absolute recoveries can be obtained for Oasis HLB (Waters). The mean recovery of the analytes, using the new SPE procedure, amounted from 70.14% to 99.85%. The present paper reports, for the first time, the method for the determination of beta-blockers, isoflavones and their metabolites in human urine samples. The newly developed method was suitably validated and successfully applied for the analysis of the certain of the aforementioned analytes in human urine samples obtained from the patients suffering cardiovascular disease.
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| 17. |
- Baranowska, Irena, et al.
(författare)
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ULTRA HPLC METHOD FOR THE SIMULTANEOUS ANALYSIS OF DRUGS AND FLAVONOIDS IN HUMAN URINE
- 2011
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Ingår i: JOURNAL OF LIQUID CHROMATOGRAPHY and RELATED TECHNOLOGIES. - : Taylor and Francis. - 1082-6076 .- 1520-572X. ; 34:6, s. 421-435
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Tidskriftsartikel (refereegranskat)abstract
- A validated reverse-phase Ultra HPLC method for the simultaneous determination of drugs sotalol, metoprolol, propranolol, carvedilol, salicylic acid, dexamethasone, prednisolone, and ketoprofen and flavonoids: (+/-)-catechin, (-)-epicatechin, rutin, hesperidin, neohesperidin, quercitrin, (+/-)-naringenin, hesperetin in human urine has been developed. Urine samples were pretreated by solid-phase extraction using SDB and C18 cartridges. The extraction efficiencies of each analyte from urine ranged from 76.21% to 101.29%. Gradient separation is achieved by using a Chromolith (R) Fast Gradient Monolithic C18e (50mmx2mm) column and Hypersil Gold (50mmx2.1mm, 1.9 mu m) column, using UV detection to monitor the analytes at 227, 240, 254, and 280nm. The mobile phase consists of mixed 0.05% trifluoroacetic acid in water and acetonitrile in the gradient elution. All sixteen compounds were analyzed within 4min. The LOD and LOQ of drugs and flavonoids are 0.01 mu g/mL and 0.03 mu g/mL; 0.02 mu g/mL and 0.07 mu g/mL, respectively. The developed procedure allows the determination of drugs in urine in concentrations from 0.2 to 40 mu g/mL. The following concentrations of the examined drugs in human urine, belonging to people treated with -blockes, were detected. What is more, an amount of flavonoids occur in urine in higher concentrations than calculated LOD and LOQ. The method has been proved to be precise, accurate, and well suited to the routine determination of all these flavonoid and drug concentrations in human urine samples.
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| 18. |
- Baranowska, Irena, et al.
(författare)
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Use of multivariate statistical techniques to optimize the separation of isoflavones by liquid chromatography
- 2011
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Ingår i: Central European Journal of Chemistry. - : Springer Verlag (Germany). - 1895-1066 .- 1644-3624. ; 9:6, s. 972-981
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper is to optimize and validate a high performance liquid chromatography (HPLC) method for separation and quantification of five isoflavones. A statistical central composite design was used to separate all peaks. These multivariate procedures were efficient in determining the optimal separation condition using resolution, capacity factor, asymmetry and number of theoretical plates. less thanbrgreater than less thanbrgreater thanThe effective separation of the examined compounds was applied on a Develosil RP Aqueous AR 5 RP-30 column with a gradient mobile phase system and a DAD detector. less thanbrgreater than less thanbrgreater thanThe isolation and preconcentration of the isoflavones from urine and plasma samples were conducted by means of the solid-phase extraction (SPE). For optimize SPE conditions various sorbents were tested. Furthermore, high recoveries and good relative standard deviations were obtained when the samples were passed through the Oasis HLB column. The developed method was validated and successfully applied for determination of isoflavones in urine and plasma.
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| 19. |
- Baranowski, Jacek, et al.
(författare)
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A simplified protocol for transcatheter aortic valve implantation that reduces procedure-related risk
- 2016
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Ingår i: Journal of Cardiovascular Diseases & Diagnosis. - : Omics Publishing Group. - 2329-9517. ; 4:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Transcatheter Aortic Valve Implantation is now a well-established procedure and continuous development has improved the technique. The object of this paper is to describe the successive steps taken at our department to improve our protocol, resulting in a more effective and patient-safe procedure.Design: An echo-guided method for aortic cusp alignment was used in 229 patients. In 139 patients pre-dilatation was excluded from the protocol. In the last 47 of the patients we exchanged the stiff guide-wire in the left ventricle with a soft wire for valve placement.Results: There was a significant decrease in the use of contrast medium during the period with 90% of patients receiving less than 50 ml contrast and 35% no contrast at all. In more than half the patients we only used rapid pacing in association with deployment of the stent valve. We had six cases ofpericardial bleeding due to penetration of the stiff guide wire through the left ventricular (LV) wall. This complication was avoided in all subsequent patients where we exchanged the stiff catheter to a soft guidewire in the ascending aorta before introduction of the wire and stent valve into the LV.Conclusions: We have successively modified our standard protocol for implantation of a balloon-expandable transcatheter aortic valve. This has simplified the procedure and reduced the risk for certain procedure-related complications.
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| 20. |
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| 21. |
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| 22. |
- Baranowski, Jacek, et al.
(författare)
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Echo-guided presentation of the aortic valve minimises contrast exposure in transcatheter valve recipients
- 2011
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Ingår i: Catheterization and cardiovascular interventions. - : Wiley. - 1522-1946 .- 1522-726X. ; 77:2, s. 272-275
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We have developed a method using transthoracic echocardiography in establishing optimal visualization of the aortic root, to reduce the amount of contrast medium used in each patient. BACKGROUND: During transcatheter aortic valve implantation, it is necessary to obtain an optimal fluoroscopic projection for deployment of the valve showing the aortic ostium with the three cusps aligned in the beam direction. This may require repeat aortic root angiograms at this stage of the procedure with a high amount of contrast medium with a risk of detrimental influence on renal function. METHODS: We studied the conventional way and an echo guided way to optimize visualisation of the aortic root. Echocardiography was used initially allowing easier alignment of the image intensifier with the transducer's direction. RESULTS: Contrast volumes, radiation/fluoroscopy exposure times, and postoperative creatinine levels were significantly less in patients having the echo-guided orientation of the optimal fluoroscopic angles compared with patients treated with the conventional approach. CONCLUSION: We present a user-friendly echo-guided method to facilitate fluoroscopy adjustment during transcatheter aortic valve implantation. In our series, the amounts of contrast medium and radiation have been significantly reduced, with a concomitant reduction in detrimental effects on renal function in the early postoperative phase.
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Baranowski, Jacek, et al.
(författare)
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TAVI without BAV
- 2014
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Konferensbidrag (refereegranskat)
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| 30. |
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| 31. |
- Bouhafs, Chamseddine, 1984-
(författare)
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Structural and Electronic Properties of Graphene on 4H- and 3C-SiC
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Graphene is a one-atom-tick carbon layer arranged in a honeycomb lattice. Graphene was first experimentally demonstrated by Andre Geim and Konstantin Novoselov in 2004 using mechanical exfoliation of highly oriented pyrolytic graphite (exfoliated graphene flakes), for which they received the Nobel Prize in Physics in 2010. Exfoliated graphene flakes show outstanding electronic properties, e.g., very high free charge carrier mobility parameters and ballistic transport at room temperature. This makes graphene a suitable material for next generation radio-frequency and terahertz electronic devices. Such applications require fabrication methods of large-area graphene compatible with electronic industry. Graphene grown by sublimation on silicon carbide (SiC) offers a viable route towards production of large-area, electronic-grade material on semi-insulating substrate without the need of transfer. Despite the intense investigations in the field, uniform wafer-scale graphene with very high-quality that matches the properties of exfoliated graphene has not been achieved yet. The key point is to identify and control how the substrate affects graphene uniformity, thickness, layer stacking, structural and electronic properties. Of particular interest is to understand the effects of SiC surface polarity and polytype on graphene properties in order to achieve large-area material with tailored properties for electronic applications. The main objectives of this thesis are to address these issues by investigating the structural and electronic properties of epitaxial graphene grown on 4HSiC and 3C-SiC substrates with different surface polarities. The first part of the thesis includes a general description of the properties of graphene, bilayer graphene and graphite. Then, the properties of epitaxial graphene on SiC by sublimation are detailed. The experimental techniques used to characterize graphene are described. A summary of all papers and contribution to the field is presented at the end of Part I. Part II consists of seven papers.
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| 32. |
- De Backer, Ole, et al.
(författare)
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Efficacy and safety of the Lotus Valve System for treatment of patients with severe aortic valve stenosis and intermediate surgical risk: Results from the Nordic Lotus-TAVR registry
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 219, s. 92-97
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Tidskriftsartikel (refereegranskat)abstract
- Background: Transcatheter aortic valve replacement (TAVR) has becomean established therapeutic option for patients with symptomatic, severe aortic valve stenosis (AS) who are ineligible or at high risk for conventional valvular surgery. In Northwestern Europe, the TAVR technology is also increasingly used to treat patients with an intermediate risk profile. Methods and results: The study was designed as an independent Nordic multicenter registry of intermediate risk patients treated with the Lotus Valve System (Boston Scientific, MA, USA; N = 154). Valve Academic Research Consortium (VARC)-defined device success was obtained in 97.4%. A Lotus Valve was successfully implanted in all patients. There was no valve migration, embolization, ectopic valve deployment, or TAV-in-TAV deployment. The VARC-defined combined safety rate at 30 days was 92.2%, with a mortality rate of 1.9% and stroke rate of 3.2%. The clinical efficacy rate after 30 days was 91.6% - only one patient had moderate aortic regurgitation. When considering only those patients in the late experience group (N=79), the combined safety and clinical efficacy rates were 93.7% and 92.4%, respectively. The pacemaker implantation rate was 27.9% - this rate was 12.8% in case of a combined implantation depth amp;lt;4 mm and a device/annulus ratio amp;lt; 1.05. Conclusions: The present study demonstrates the efficacy and safety of the repositionable, retrievable Lotus Valve System in intermediate risk patients with AS. The VARC-defined device success rate was 97.4% with a 30-day patient safety and clinical efficacy rate of more than 90%. Less than moderate aortic regurgitation was obtained in 99.4% of patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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| 33. |
- Droppa, Michal, et al.
(författare)
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Risk factors for permanent pacemaker implantation in patients receiving a balloon-expandable transcatheter aortic valve prosthesis
- 2020
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Ingår i: Heart and Vessels. - : Springer. - 0910-8327 .- 1615-2573. ; 35, s. 1735-1745
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Tidskriftsartikel (refereegranskat)abstract
- Permanent pacemaker implantation (PPI) is a widely recognized complication associated with TAVI (incidence up to 20%). Smaller registries have identified several variables associated with PPI. The objective was to validate patient- and transcatheter aortic valve implantation (TAVI)-related procedural variables associated with PPI. We performed a retrospective analysis of patients from six European centers undergoing TAVI with the Edwards SAPIEN 3 prosthesis. Baseline variables and pre-procedural ECG characteristics and CT-scans were taken into account. Data for 1745 patients were collected; 191 (10.9%) required PPI after TAVI. The baseline variables pulmonary hypertension (OR 1.64; 95% CI 1.01-2.59), QRS duration > 117 ms (OR 2.58; 95% CI 1.73-3.84), right bundle branch block (RBBB; OR 5.14; 95% CI 3.39-7.72), left anterior hemi block (OR 1.92; 95% CI 1.19-3.02) and first-degree atrioventricular block (AVB, OR 1.63; 95%CI 1.05-2.46) were significantly associated with PPI. RBBB (OR 8.11; 95% CI 3.19-21.86) and first-degree AVB (OR 2.39; 95% CI 1.18-4.66) remained significantly associated in a multivariate analysis. Procedure-related variables included access site (TF; OR 1.97; 95% CI 1.07-4.05), implanted valve size (29 mm; OR 1.88; 95% CI 1.35-2.59), mean TAVI valve implantation depth below the annulus > 30% (OR 3.75; 95% CI 2.01-6.98). Patients receiving PPI had longer ICU stays and later discharges. Acute kidney injury stage 2/3 was more common in patients with PPI until discharge (15.2 vs. 3.1%;p = 0.007), but was not statistically significant thereafter. Further differences in outcomes at 30 days did not reach significance. The data will aid pre- and post-procedural patient management and prevent adverse long-term outcomes. Clinical Trial: NCT03497611.
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| 34. |
- Escobar Kvitting, John-Peder, et al.
(författare)
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Surgical management of outflow tract obstruction after transapical mitral valve implantation
- 2018
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Ingår i: Journal of cardiac surgery. - : Wiley-Blackwell Publishing Inc.. - 0886-0440 .- 1540-8191. ; 33:9, s. 545-547
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Tidskriftsartikel (refereegranskat)abstract
- Left ventricular outflow tract (LVOT) obstruction due to systolic anterior motion of the anterior mitral valve leaflet (AML) is a known complication after mitral valve repair or transfemoral/transapical mitral valve implantation (TMVI). We present a patient with a previous mitral valve repair who developed LVOT obstruction after TMVI in whom the AML was surgically resected using a transaortic approach.
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| 35. |
- Hübbert, Laila, et al.
(författare)
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Endovascular stenting of an outflow graft thrombosis in a continuous-flow left ventricular assist device.
- 2017
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Ingår i: ASAIO journal (1992). - 1058-2916 .- 1538-943X. ; 63:1, s. e3-e5
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Tidskriftsartikel (refereegranskat)abstract
- We report the endovascular stenting of an outflow tract thrombosis in a left ventricular assist device in a patient with relative contraindications to sternotomy and pump exchange. This report highlights the importance of simultaneous prevention of stroke using filter devices in the common carotid arteries.
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| 36. |
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| 37. |
- Hubbert, Laila, et al.
(författare)
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Left atrial pressure monitoring with an implantable wireless pressure sensor following implantation of a left ventricular assist device
- 2017
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Ingår i: ASAIO journal (1992). - 1058-2916 .- 1538-943X. ; 63:5, s. E60-E65
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Tidskriftsartikel (refereegranskat)abstract
- Following implantation of a continuous-flow left ventricular assist device (LVAD), left atrial pressure (LAP) monitoring allows for precise management of intravascular volume, inotropic therapy and pump speed. In this case series of 4 LVAD recipients we report the first clinical use of this wireless pressure sensor for long-term monitoring of LAP during LVAD support. A wireless microelectromechanical system (MEMS) pressure sensor, (Titan™, ISS Inc., Ypsilanti, MI, USA) was placed in the left atrium in four patients at the time of LVAD implantation. Titan sensor LAP was measured in all 4 patients on the ICU and in 3 patients at home. Ramped speed tests were performed using LAP and echocardiography in 3 patients. The left ventricular end diastolic diameter (cm), flow (L/min), power consumption (W) and blood pressure (mmHg) were measured at each step.Measurements were performed over 36, 84, 137, and 180 days, respectively. The three discharged patients had equipment at home and were able to perform daily recordings. There were significant correlations between sensor pressure and pump speed, LV and LA size and pulmonary capillary wedge pressure, respectively (r= 0.92-0.99, p < 0.05). There was no device failure and there were no adverse consequences of its use.
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| 38. |
- Magiera, Sylwia, et al.
(författare)
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Comparison of different sorbent materials for solid-phase extraction of selected drugs in human urine analyzed by UHPLC-UV
- 2014
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Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 958, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- A procedure based on solid-phase extraction (SPE) followed by ultra-high-performance liquid chromatography (UHPLC) with UV detection has been developed for the analysis of multiple drugs in human urine. The compounds evaluated were aliskiren, prasugrel, rivaroxaban, prednisolone, propranolol, ketoprofen, nifedipine, naproxen, terbinafine, ibuprofen, diclofenac, sildenafil and acenocoumarol. Seventeen different solid phase extraction (SPE) cartridges were tested to evaluate their applicability for the isolation of drugs from human urine. Comparison were recovery of different drugs and reproducibility. The samples were analyzed by UHPLC using a Poroshell 120 EC-C18 column and acetonitrile -0.05% TFA in water as the mobile phase under gradient elution conditions. SPE combined with UHPLC UV allowed the determination of drugs over a linear range of 0.01-30.0 mu g/mL, with limits of detection at 0.003-0.217 mu g/mL and precision of 0.8-7.1%. Phenyl (C6H5) sorbent was found to provide the most effective clean-up, removing the greatest amount of interfering substance and simultaneously ensuring analyte recoveries higher than 85.5% with relative standard deviations (RSD)less than10%. The method was applied with good accuracy and precision in the determination of drugs in human urine obtained from patients treated with selected drugs.
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| 39. |
- Magiera, Sylwia, et al.
(författare)
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Determination of carnitine and acylcarnitines in human urine by means of microextraction in packed sorbent and hydrophilic interaction chromatography-ultra-high-performance liquid chromatography-tandem mass spectrometry
- 2015
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Ingår i: Journal of Pharmaceutical and Biomedical Analysis. - : Elsevier. - 0731-7085 .- 1873-264X. ; 109, s. 171-176
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Tidskriftsartikel (refereegranskat)abstract
- A method using semi-automatic microextraction by packed sorbent (eVol (R)-MEPS) and hydrophilic interaction chromatography-ultra-high-performance liquid chromatography-tandem mass spectrometry (HILIC-UHPLC-MS/MS) was described for the simultaneous determination of carnitine and acylcarnitines in human urine. The optimal conditions of MEPS extraction were obtained using C2 of M1 (C8 + SCX) phase as a sorbent Chromatographic separation of the analytes was achieved within 2.5 min on Acquity UPLC BEH HILIC column using a gradient elution program with water containing 5 mM ammonium acetate and acetonitrile as the mobile phase. The detection was performed on a triple-quadrupole tandem mass spectrometer in a positive ion mode via electrospray ionization (ESI). The linearity of the calibration curves for all compounds was found over a range from 0.1 ng/mL to 500 ng/mL. The method afforded satisfactory results in terms of sensitivity, specificity, precision, accuracy, recovery as well as stability of the analyte under various conditions. The method was used successfully for determination of carnitine and acylcarnitines in human urine.
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| 40. |
- Magiera, Sylwia, et al.
(författare)
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Salting-out assisted extraction method coupled with hydrophilic interaction liquid chromatography for determination of selected beta-blockers and their metabolites in human urine
- 2016
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Ingår i: Journal of chromatography. B. - : ELSEVIER SCIENCE BV. - 1570-0232 .- 1873-376X. ; 1022, s. 93-101
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Tidskriftsartikel (refereegranskat)abstract
- In this study, a new analytical method was developed and validated for the simultaneous analysis of beta-blockers (metoprolol, propranolol, carvedilol) and their metabolites (5-hydroxycarvedilol, O-desmethylcarvedilol, alpha-hydroxymetoprolol, O-desmethylmetoprolol, 5-hydroxypropranolol) in human urine. A salting-out assisted liquid-liquid extraction (SALLE) procedure was used for sample preparation. Several parameters affecting the extraction efficiency and method sensitivity including the type and volume of the extraction solvent, the type and quantity of the inorganic salt, extraction time and sample pH were investigated. Hydrophilic interaction liquid chromatography-ultraviolet detection (HILIC-UV) was used for the determination of allanalytes. During method development, the effects of mobile phase components (type, pH, concentration of salt, organic modifier type and content, flow rate, column temperature) on the retention and separation of beta-blockers and metabolites on the five different HILIC columns were examined. The method was linear for concentrations ranging from 0.1 to 8.0 mu g/mL, with determination coefficients higher than 0.993 for all analytes. The limits of quantification were in the range from 0.1 to 0.2 mu g/mL. Intra- and inter-day precision ranged from 0.1 to 8.9%, and accuracy was within +/- 13% interval for all analytes. Under the optimized conditions, extraction efficiency was greater than 83.4% for determined compounds. The validated method was then applied to the measurement of beta-blockers and their metabolites in human urine samples. (C) 2016 Elsevier B.V. All rights reserved.
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| 41. |
- Markowski, Piotr, et al.
(författare)
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Simultaneous determination of l-arginine and 12 molecules participating in its metabolic cycle by gradient RP-HPLC method. Application to human urine samples
- 2007
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Ingår i: Analytica Chimica Acta. - : Elsevier BV. - 0003-2670 .- 1873-4324. ; 605:2, s. 205-217
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Tidskriftsartikel (refereegranskat)abstract
- We have developed and described a highly sensitive, accurate and precise reversed-phase high-performance liquid chromatography (RP-HPLC) method for the simultaneous determination of l-arginine and 12 molecules participating in its metabolic cycle in human urine samples. After pre-column derivatization with ortho-phthaldialdehyde (OPA) reagent containing 3-mercaptopropionic acid (3MPA), the fluorescent derivatives were separated by a gradient elution and detected by fluorescence measurement at 338 nm (excitation) and 455 nm (emission). l-Arginine (ARG) and its metabolites: l-glutamine (GLN), NG-hydroxy-l-arginine (NOHA), l-citrulline (CIT), NG-monomethyl-l-arginine (NMMA), l-homoarginine (HARG), asymmetric NG,NG-dimethyl-l-arginine (ADMA), symmetric NG,NG′-dimethyl-l-arginine (SDMA), l-ornithine (ORN), putrescine (PUT), agmatine (AGM), spermidine (SPERMD) and spermine (SPERM) were extracted in a cation-exchange solid-phase extraction (SPE) column and after derivatization separated in a Purospher® STAR RP-18e analytical column. The calibration curves of analysed compounds are linear within the range of concentration: 45-825, 0.2-15, 16-225, 12-285, 0.1-32, 15-235, 0.1-12, 0.1-12, 10-205, 0.02-12, 0.1-24, 0.01-10 and 0.01-8 nmol mL-1 for GLN, NOHA, CIT, ARG, NMMA, HARG, ADMA, SDMA, ORN, PUT, AGM, SPERMD and SPERM, respectively. The correlation coefficients are greater than 0.9980. Coefficients of variation are not higher than 6.0% for inter-day precision. The method has been determined or tested for limits of detection and quantification, linearity, precision, accuracy and recovery. All detection parameters of the method demonstrate that it is a reliable and efficient means of the comprehensive determination of ARG and its 12 main metabolites, making this approach suitable for routine clinical applications. The levels of analysed compounds in human urine can be successfully determined using this developed method with no matrix effect. © 2007 Elsevier B.V. All rights reserved.
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| 42. |
- Nielsen, Niels Erik, et al.
(författare)
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Minimizing the risk for left ventricular rupture during transcatheter aortic valve implantation by reducing the presence of stiff guidewires in the ventricle
- 2019
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Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : OXFORD UNIV PRESS. - 1569-9293 .- 1569-9285. ; 29:3, s. 365-370
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The presence of a stiff guidewire in the apex of the left ventricle (LV) is a known risk factor for LV perforation. Our goal was to minimize the risk of LV rupture during transcatheter aortic valve implantation (TAVI) by omitting the interaction between the stiff guidewire and the LV apex using a modified procedure. METHODS: A TAVI protocol designed to allow minimal interaction between a stiff guidewire and the LV was developed in Linkoping University Hospital in Sweden. A total of 316 patients were treated exclusively by this approach between March 2014 and May 2018. RESULTS: All procedures were completed successfully. There were no cases (0%) of ventricular perforation. Only 1 patient (0.3%) had a pericardial effusion, and it was due to annulus rupture. There was 1 case of acute kidney injury (0.3%). Five patients (1.6%) required a new permanent pacemaker. Stroke occurred in 3 patients (0.9%). No patient had valve embolization. Vascular complications were experienced by 6 patients (1.9%). A mild paravalvular leak occurred in 27 (8.5%) patients. At 30 days post-TAVI, 6 patients (2%) had died. The mortality rate at 1 year was 8.6% (n = 20/232). CONCLUSIONS: Our series shows that TAVI without the prolonged use of a stiff guidewire in the LV apex is feasible. The risk of LV perforation is eliminated by this approach, and other procedural complications are limited.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
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| 47. |
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| 48. |
- Nielsen, Niels Erik, et al.
(författare)
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Transvenous Implantation of a Stent Valve for Calcified Native Mitral Stenosis
- 2015
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Ingår i: Annals of Thoracic Surgery. - : ELSEVIER SCIENCE INC. - 0003-4975 .- 1552-6259. ; 100:1, s. E21-E23
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Tidskriftsartikel (refereegranskat)abstract
- We used a modified combination of the transseptal and transapical methods to facilitate the controlled delivery and use of a stent valve in a patient with calcified native mitral stenosis. A loop from the right femoral vein passing transseptally and then through the apex of the left ventricle was created, enabling highly controlled positioning and deployment of the stent valve.
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| 49. |
- Rudolph, Tanja, et al.
(författare)
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Modifiable risk factors for permanent pacemaker after transcatheter aortic valve implantation: CONDUCT registry
- 2023
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Ingår i: Open heart. - : BMJ PUBLISHING GROUP. - 2053-3624. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective The onset of new conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is still a relevant adverse event. The main objective of this registry was to identify modifiable procedural risk factors for an improved outcome (lower rate of PPI) after TAVI in patients at high risk of PPI.Methods Patients from four European centres receiving a balloon-expandable TAVI (Edwards SAPIEN 3/3 Ultra) and considered at high risk of PPI (pre-existing conduction disturbance, heavily calcified left ventricular outflow tract or short membranous septum) were prospectively enrolled into registry.Results A total of 300 patients were included: 42 (14.0%) required PPI after TAVI and 258 (86.0%) did not. Patients with PPI had a longer intensive care unit plus intermediate care stay (65.7 vs 16.3 hours, p < 0.001), general ward care stay (6.9 vs 5.3 days, p=0.004) and later discharge (8.6 vs 5.0 days, p < 0.001). Of the baseline variables, only pre-existing right bundle branch block at baseline (OR 6.8, 95% CI 2.5 to 18.1) was significantly associated with PPI in the multivariable analysis. Among procedure-related variables, oversizing had the highest impact on the rate of PPI: higher than manufacturer-recommended sizing, mean area oversizing as well as the use of the 29 mm valve (OR 3.4, 95% CI 1.4 to 8.5, p=0.008) all were significantly associated with PPI. Rates were higher with the SAPIEN 3 (16.1%) vs SAPIEN 3 Ultra (8.5%), although not statistically significant but potentially associated with valve sizing. Implantation depth and postdelivery balloon dilatation also tended to affect PPI rates but without a statistical significance.Conclusion Valve oversizing is a strong procedure-related risk factor for PPI following TAVI. The clinical impact of the valve type (SAPIEN 3), implantation depth, and postdelivery balloon dilatation did not reach significance and may reflect already refined procedures in the participating centres, giving attention to these avoidable risk factors.
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