| 1. |
- Cain, Peter A, et al.
(author)
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Age and gender specific normal values of left ventricular mass, volume and function for gradient echo magnetic resonance imaging: a cross sectional study.
- 2009
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In: BMC medical imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 9:2
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Journal article (peer-reviewed)abstract
- Knowledge about age-specific normal values for left ventricular mass (LVM), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) by cardiac magnetic resonance imaging (CMR) is of importance to differentiate between health and disease and to assess the severity of disease. The aims of the study were to determine age and gender specific normal reference values and to explore the normal physiological variation of these parameters from adolescence to late adulthood, in a cross sectional study.
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| 2. |
- Cain, Peter, et al.
(author)
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Physiological determinants of the variation in left ventricular mass from early adolescence to late adulthood in healthy subjects
- 2005
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In: Clin Physiol Funct Imaging. - 1475-0961. ; 25:6, s. 332-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: The physiological determinants of left ventricular mass (LVM) measured by cardiac magnetic resonance (CMR) imaging are not well defined as prior investigators have studied either adults or adolescents in isolation or have not strictly excluded hypertension or accounted for the effects of exercise habits, haemodynamic, demographic, or body shape characteristics. METHODS: A total of 102 healthy volunteers (12-81 years, 53 males) underwent CMR. All parameters [unstandardized and adjusted for body surface area (BSA)] were analysed according to gender and by adolescence versus adulthood (adolescents <20 years, adults > or = 20 years). The influence of haemodynamic factors, exercise, and demographic factors on LVM were determined with multivariate linear regression. Results: LVM rose during adolescence and declined in adulthood. LVM and LVMBSA were higher in males both in adults (LVM: 188 +/- 22 g versus 139 +/- 21 g, P < 0.001; LVMBSA: 94 +/- 11 g m(-2) versus 80 +/- 11 g m(-2), P < 0.001) and in adolescents when adjusted for BSA (LVM: 128 +/- 29 g versus 107 +/- 20 g, P = 0.063; LVMBSA: 82 +/- 8 g m(-2) versus 71 +/- 10 g m(-2), P = 0.025). In adults, systolic blood pressure (SBP) and self-reported physical activity increased while meridional and circumferential wall stress were constant with age. Multivariate regression analysis revealed age, gender, and BSA as the major determinants of LVM (global R2 = 0.69). CONCLUSIONS: Normal LVM shows variation over a broad age range in both genders with a rise in adolescence and subsequent decline with increasing age in adulthood despite an increase in SBP and physical activity. BSA, age, and gender were found to be major contributors to the variation in LVM in healthy adults, while haemodynamic factors, exercise, and wall stress were not.
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| 3. |
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| 4. |
- Heerspink, Hiddo J. L., et al.
(author)
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Reduction in albuminuria with dapagliflozin cannot be predicted by baseline clinical characteristics or changes in most other risk markers
- 2019
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In: Diabetes, obesity and metabolism. - : Wiley-Blackwell Publishing Inc.. - 1462-8902 .- 1463-1326. ; 21:3, s. 720-725
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Journal article (peer-reviewed)abstract
- The sodium glucose co-transporter-2 inhibitor dapagliflozin has been shown to decrease urinary albumin-to-creatinine ratio (UACR). This effect, however, varies among individual patients. In this study, we assessed the baseline characteristics and concurrent changes in other cardiovascular risk markers that might be associated with UACR response to dapagliflozin. A pooled analysis of 11 phase 3 randomized, controlled clinical trials was performed. UACR change from baseline after 24 weeks treatment with dapagliflozin 10 mg/d in 531 patients with type 2 diabetes and UACR ≥30 mg/g at baseline was determined. UACR response was defined as >30% reduction from baseline at 24 weeks, whereas UACR non-response was defined as ≤30% reduction at 24 weeks. A total of 288 (54%) patients were classified as responders and 243 (46%) as non-responders. At 24 weeks, the UACR-adjusted mean change from baseline was −71.2% and 25.9% in responders and non-responders, respectively. Baseline characteristics were similar between both groups. Changes in HbA1c and body weight were comparable across groups. Responders showed a numerically larger reduction in estimated glomerular filtration rate and systolic blood pressure versus non-responders. UACR reduction to dapagliflozin is an individual characteristic that cannot be predicted by baseline clinical features or changes in metabolic variables. Whether UACR response would improve long-term renal and cardiovascular outcomes remains to be determined.
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| 5. |
- Sator, Lea, et al.
(author)
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Overdiagnosis of COPD in Subjects With Unobstructed Spirometry A BOLD Analysis
- 2019
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In: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 156:2, s. 277-288
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Journal article (peer-reviewed)abstract
- BACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012.METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7).RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication.CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.
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| 6. |
- Stefánsson, Bergur V., et al.
(author)
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Correction of anemia by dapagliflozin in patients with type 2 diabetes
- 2020
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In: Journal of diabetes and its complications. - : Elsevier. - 1056-8727 .- 1873-460X. ; 34:12
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Journal article (peer-reviewed)abstract
- Aims: Anemia is common in type 2 diabetes (T2D), particularly in patients with kidney impairment, and often goes unrecognized. Dapagliflozin treatment increases hemoglobin and serum erythropoietin levels. We investigated the effect of dapagliflozin 10-mg/day on hemoglobin in T2D patients with and without anemia. Methods: Data from 5325 patients from 14 placebo-controlled, dapagliflozin-treatment studies of at least 24-weeks duration were pooled. Dapagliflozin's effects (vs. placebo) on hemoglobin, serum albumin, estimated glomerular filtration rate (eGFR), systolic blood pressure, body weight, and safety in patients with and without anemia were evaluated. Results: At baseline, 13% of all T2D patients and 28% of those with chronic kidney disease (eGFR <60 mL/min/1.73 m2) had anemia. Hemoglobin increased continuously to at least week 8 and was sustained throughout 24-weeks follow-up in dapagliflozin-treated patients. Serum albumin increased in dapagliflozin-treated patients at week 4 and remained stable thereafter. Dapagliflozin was well tolerated and corrected anemia in 52% of patients with anemia at baseline (placebo: 26%). Incidences of new-onset anemia were lower in dapagliflozin-treated (2.3%) versus placebo-treated (6.5%) patients. Conclusions: Treatment with dapagliflozin can correct and prevent anemia in T2D patients. A gradual increase in hemoglobin beyond week 4 may indicate an erythropoiesis-stimulating effect of sodium-glucose cotransporter 2 inhibition.
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| 7. |
- Stefánsson, Bergur V., et al.
(author)
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Data from a pooled post hoc analysis of 14 placebo-controlled, dapagliflozin treatment studies in patients with type 2 diabetes with and without anemia at baseline
- 2021
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In: Data in Brief. - : Elsevier. - 2352-3409. ; 37, s. 1-11
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Journal article (peer-reviewed)abstract
- Dapagliflozin is a highly selective sodium-glucose cotransporter 2 inhibitor associated with stabilization of estimated glomerular filtration rate (eGFR); reductions in glycated hemoglobin (HbA1c), systolic blood pressure, body weight, and albuminuria; and a small and consistent increase in hematocrit [1–4]. This data set is based on the associated article [5] analyzing data from 5325 patients with type 2 diabetes from 14 placebo-controlled, phase 3 (one phase 2/3), double-blind dapagliflozin treatment studies of 24–104 weeks’ duration. Data on dapagliflozin's effects (vs. placebo) on hemoglobin (Hb), hematocrit, serum albumin, serum total protein concentrations, urine albumin/creatinine ratio, eGFR, heart rate, blood pressure, body weight, and safety in patients with type 2 diabetes with and without anemia were pooled and analyzed. Patients were divided into two groups according to baseline Hb levels: anemia (Hb <13 g/dL in men and <12 g/dL in women) and no anemia. Some biomarkers associated with erythropoiesis and the presence of anemia, such as iron, transferrin, ferritin, reticulocytes, and hepcidin, were not included in the original studies and therefore data for these biomarkers were not available. Descriptive statistics were used for baseline characteristics and safety data and a longitudinal repeated-measures mixed model for efficacy data. Changes in Hb concentrations were evaluated, and the proportion of patients with baseline anemia who were no longer anemic at week 24 was determined, as was the occurrence of polycythemia (Hb >16.5 g/dL in men and >16.0 g/dL in women). Because anemia commonly occurs in patients with diabetes and chronic kidney disease [6], the data can be of value to further analyze trends in relevant physiological and pathophysiological parameters.
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| 8. |
- Bergvall, Erik, et al.
(author)
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A fast and highly automated approach to myocardial motion analysis using phase contrast magnetic resonance imaging.
- 2006
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In: Journal of Magnetic Resonance Imaging. - : Wiley. - 1522-2586 .- 1053-1807. ; 23:5, s. 652-661
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Journal article (peer-reviewed)abstract
- Purpose: To develop a fast and highly automated method for calculating two-dimensional myocardial motion and deformation using velocity encoded magnetic resonance imaging. Materials and Methods: Two-dimensional phase contrast magnetic resonance imaging was used to acquire time resolved velocity maps of the myocardium. Cardiac motion was calculated by an iterative integration-regularization scheme of low computational cost. Image segmentation was performed using active appearance models. Results: Validation of motion tracking was performed in N = 47 subjects using saturation grid-tagging and closely followed "tag-lines." Image segmentation was validated vs. manual delineation. Conclusion: The speed and limited user interaction gives the method good potential for use in clinical practice.
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| 9. |
- Cain, Peter, et al.
(author)
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A novel extended family of stromal thioredoxins
- 2009
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In: Plant Molecular Biology. - : Springer. - 0167-4412 .- 1573-5028. ; 70:3, s. 273-281
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Journal article (peer-reviewed)abstract
- Thioredoxins play key regulatory roles in chloroplasts by linking photosynthetic light reactions to a series of plastid functions. In addition to the established groups of thioredoxins, f, m, x, and y, novel plant thioredoxins were also considered to include WCRKC motif proteins, CDSP32, the APR proteins, the lilium proteins and HCF164. Despite their important roles, the subcellular locations of many novel thioredoxins has remained unknown. Here, we report a study of their subcellular location using the cDNA clone resources of TAIR. In addition to filling all gaps in the subcellular map of the established chloroplast thioredoxins f, m, x and y, we show that the members of the WCRKC family are targeted to the stroma and provide evidence for a stromal location of the lilium proteins. The combined data from this and related studies indicate a consistent stromal location of the known Arabidopsis chloroplast thioredoxins except for thylakoid-bound HCF164.
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| 10. |
- Cain, Peter, et al.
(author)
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Quantitative polar representation of left ventricular myocardial perfusion, function and viability using SPECT and cardiac magnetic resonance: initial results.
- 2005
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In: Clinical Physiology and Functional Imaging. - 1475-0961. ; 25:4, s. 215-222
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Journal article (peer-reviewed)abstract
- Background: The clinical management of patients with coronary artery disease (CAD) often involves a complex assessment of the extent and severity of changes in left ventricular (LV) myocardial perfusion, function and viability. We aimed to explore the feasibility of integrative quantitative representation of LV perfusion, function and viability in adjacent polar plots. In order to assess the clinical usefulness of the quantitative methods, we also explored the relationship and determined the agreement between visual scoring and quantitative measurement of regional perfusion and function. Methods: Ten patients with CAD underwent rest and stress 99mTc-tetrofosmin single photon emission computed tomography (SPECT) and cardiac magnetic resonance (CMR) imaging. Software was developed in-house for generating polar plots from semi-automatic quantification of rest and stress perfusion from SPECT, function from cine CMR and viability from delayed contrast enhancement (DE) CMR. The agreement between visual assessment and quantification of both perfusion and function was tested by Kendall's coefficient of concordance (W). Results: Polar plots were created using quantitative data from the semi-automatic analysis of perfusion, function and viability. Kendall's W for agreement between quantitative measurement and visual scoring was 1·0 (P<0·001) for perfusion and 0·85 (P<0·001) for function. Conclusions: Side-by-side quantitative polar representation of LV perfusion, function and viability is feasible and may aid in the complex assessment of these parameters. The agreement between quantitative measurement and visual scoring was very good for both perfusion and function.
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| 11. |
- Carlsson, Marcus, et al.
(author)
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Center of volume and total heart volume variation in healthy subjects and patients before and after coronary bypass surgery.
- 2005
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In: Clinical Physiology and Functional Imaging. - 1475-0961. ; 25:4, s. 226-233
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Journal article (peer-reviewed)abstract
- BACKGROUND: Total heart volume variation (THVV) and center of volume variation (COVV) likely affects the efficiency of cardiac pumping, but no study has determined COVV of the heart throughout the cardiac cycle or the effect of surgery on THVV in adults. Therefore, the purposes of this study were to determine COVV in healthy adults and patients with cardiac failure due to ischemic heart disease (IHD), identify any difference in THVV between these two groups, and determine how these parameters are affected by coronary bypass surgery. METHODS: Six healthy volunteers and eight patients before and after surgery were investigated with cardiovascular magnetic resonance imaging. The atrioventricular plane movement (AVPM), THVV and time resolved three-dimensional coordinates of the center of the cardiac volume (COVV) were measured. RESULTS: COVV followed a loop in 3D space that between the end-points was approximately 2 mm with no difference between healthy subjects and patients before surgery (P = 0.093), although AVPM was significantly lower in patients (P = 0.002). However, after surgery the COVV during the cardiac cycle doubled (P = 0.012) and the increase in THVV was significant (P = 0.050), although of very small magnitude, and the AVPM remained unchanged (P = 0.401). CONCLUSION: COVV and THVV were similar in patients and healthy subjects even though AVPM was lower in the patient population. After surgery, however, COVV doubled despite a very small change in THVV and no change in AVPM. Taken together, the results of this study may provide new insights into the energy expenditure and efficiency of cardiac pumping.
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| 12. |
- Carlsson, Marcus, et al.
(author)
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Total heart volume variation throughout the cardiac cycle in man.
- 2004
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In: American Journal of Physiology: Heart and Circulatory Physiology. - : American Physiological Society. - 1522-1539 .- 0363-6135. ; 287:1, s. 243-250
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Journal article (peer-reviewed)abstract
- Variations in total heart volume (atria plus ventricles) during a cardiac cycle affect efficiency of cardiac pumping. The goals of this study were to confirm the presence, extent, and contributors of total heart volume variation during the cardiac cycle in healthy volunteers with the use of MRI. Eight healthy volunteers were examined by MRI at rest. Changes in total cardiac volume throughout the cardiac cycle were calculated using the following methods: 1) planimetry derived from gradient-echo cine images and 2) flow-sensitive sequences to quantify flow in all vessels leading to and from the heart. The maximum total heart volume diminished during systole by 8.2 +/- 0.8% (SEM, range 4.8-10.6%) measured by method 1 and 8.8 +/- 1.0% (SEM, range 5.6-11.8%) by method 2 with good agreement between the methods [difference according to Bland-Altman analysis -0.6% +/- 1.0% (SD), intraclass correlation coefficient = 0.999]. This decrease in volume is predominantly explained by variation at the midcardiac level at the widest diameter of the heart with a left-sided predominance. In the short axis of the heart, the change of slice volume was proportional to the end-diastolic slice volume. The present study has confirmed the presence of total heart volume variation that predominantly occurs in the region of atrioventricular plane movement and on the left side. The total heart volume variation may relate to the efficiency of energy use by the heart to minimize displacement of surrounding tissue while accounting for the energy required to draw blood into the atria during ventricular systole.
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| 13. |
- Hedström, Erik, et al.
(author)
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Peak CKMB and cTnT accurately estimates myocardial infarct size after reperfusion
- 2007
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In: Scand Cardiovasc J.. - : Informa UK Limited. ; 41:1, s. 44-50
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To find the time-to-peak for creatine kinase MB(mass) (CKMB) and cardiac troponin T (cTnT) after acute reperfusion, to compare peak and cumulative values to estimate infarct size (IS), and to evaluate clinical routine sampling for assessment of IS. DESIGN: Acute primary percutaneous coronary intervention (PCI) was performed in 38 patients with first-time myocardial infarction. In 21 patients, CKMB and cTnT were acquired before PCI and at 1.5, 3, 6, 12, 18, 24, and 48 hours thereafter. In 17 patients, clinical routine samples were acquired at arrival, and at 10 and 20 h. IS was assessed by delayed contrast-enhanced MRI (DE-MRI). RESULTS: Time-to-peak was 7.6+/-3.6 h for CKMB and 8.1+/-3.4 h for cTnT. Peak values correlated strongly to cumulative values (r(s)=0.97-0.98) as well as to DE-MRI (r(s)=0.8-0.82). Clinical routine sampling showed lower rs values (0.47-0.60). CONCLUSIONS: Peak values are likely captured if CKMB and cTnT are acquired at 3, 6, and 12 h after acute PCI. These peak values can be used to estimate myocardial infarct size after acute PCI
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| 14. |
- Mulay, A. L., et al.
(author)
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Borderline personality disorder diagnosis in a new key
- 2019
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In: Borderline Personality Disorder and Emotion Dysregulation. - : Springer Science and Business Media LLC. - 2051-6673. ; 6:1
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Journal article (peer-reviewed)abstract
- Background Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD). Method Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined. Results Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes. Conclusions Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.
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| 15. |
- Scholtes, Rosalie A., et al.
(author)
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The effects of dapagliflozin on cardio-renal risk factors in patients with type 2 diabetes with or without renin-angiotensin system inhibitor treatment : a post hoc analysis
- 2020
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In: Diabetes, obesity and metabolism. - : John Wiley & Sons. - 1462-8902 .- 1463-1326. ; 22:4, s. 549-556
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Journal article (peer-reviewed)abstract
- Aims: Renin-angiotensin system inhibitors (RASi) are the most effective treatments for diabetic kidney disease but significant residual renal risk remains, possibly because of other mechanisms of kidney disease progression unrelated to RAS that may be present. Sodium-glucose co-transporter-2 inhibitors reduce albuminuria and may complement RASi by offering additional renal protection. This post hoc analysis investigated the effects of dapagliflozin on cardio-renal risk factors in patients with type 2 diabetes (T2D) with increased albuminuria treated with or without RASi at baseline. Materials and methods: We evaluated the effects of dapagliflozin 10 mg/day over 12–24 weeks across 13 placebo-controlled studies in patients with T2D with a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g at baseline. Patients were divided into two subgroups based on treatment with or without RASi at baseline. Results: Compared with patients with RASi at baseline (n = 957), patients without RASi (n = 302) were younger, had a shorter duration of diabetes (7 vs. 12 years), higher estimated glomerular filtration rate (eGFR) and lower UACR, serum uric acid (sUA), body weight and systolic blood pressure. Placebo-adjusted treatment effects of dapagliflozin on UACR, eGFR, glycated haemoglobin and haematocrit over 24 weeks were similar across groups. Mean reductions in body weight and sUA were more distinct in patients without RASi treatment at baseline. Conclusions: Treatment with dapagliflozin over 24 weeks provides similar clinically relevant improvements in metabolic and haemodynamic parameters, and similar reductions in UACR, in patients with T2D with elevated albuminuria treated with or without RASi at baseline. © 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
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| 16. |
- Storaa, Camilla, et al.
(author)
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Tissue motion imaging of the left ventricle--quantification of myocardial strain, velocity, acceleration and displacement in a single image
- 2004
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In: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 5:5, s. 375-385
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Journal article (peer-reviewed)abstract
- AIMS: Several methods of parametric imaging of left ventricular function including tissue velocity imaging (TVI) and strain rate imaging (SRI) have previously been presented, however, they have the limitation that they can, respectively, portray only one physiological myocardial parameter. The aims of this pilot study were to implement and validate tissue motion imaging (TMI) for the first time, a visualization technique which permits acceleration, velocity, displacement and strain to be interpreted quantitatively or semi-quantitatively in a single image. METHODS AND RESULTS: TMI is achieved by the color coding of temporal tissue velocity integrals. The principles behind this technique are validated, and case examples demonstrating its use in the clinical setting are provided. Limitations of the method as well as future applications and improvements are discussed. CONCLUSION: As this method allows representation of a multitude of variables and is visually attractive, it may facilitate more widespread use of myocardial quantitation in everyday practice.
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| 17. |
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| 18. |
- Söderqvist, Emil, et al.
(author)
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Feasibility of creating estimates of left ventricular flow-volume dynamics using echocardiography
- 2006
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In: Cardiovascular Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120. ; :4:40
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Journal article (peer-reviewed)abstract
- Background:This study explores the feasibility of non-invasive assessment of left ventricular volume and flow relationship throughout cardiac cycle employing echocardiographic methods.Methods:Nine healthy individuals and 3 patients with severe left-sided valvular abnormalities were subject to resting echocardiography with automated endocardial border detection allowing real-time estimation of left ventricular volume throughout the cardiac cycle. Global and regional (6 different left ventricular segments) estimates of flow-volume loops were subsequently constructed by plotting acquired instantaneous left ventricular 2-D area data (left ventricular volume) vs. their first derivatives (flow).Results:Flow-volume loop estimates were obtainable in 75% of all echocardiographic images and displayed in normal individuals some regional morphological variation with more pronounced isovolumic events in the paraseptal segments and significantly delayed maximal systolic flow paraapically. In patients with aortic stenosis, maximal systolic flow occurred at a lower estimated left ventricular systolic volume whereas in mitral stenosis, maximal diastolic flow was observed at a higher estimated left ventricular diastolic volume. Aortic regurgitation caused a complex alteration of the estimated flow-volume loop shape during diastole.Conclusion:Non-invasive assessment of left ventricular flow-volume relationship with echocardiography is technically feasible and reveals the existence of regional variation in flow-volume loop morphology. Valvular abnormalities cause a clear and specific alteration of the estimates of the normal systolic or diastolic flow-volume pattern, likely reflecting the underlying pathophysiology.
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| 19. |
- Toto, Robert D., et al.
(author)
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Correction of hypomagnesemia by dapagliflozin in patients with type 2 diabetes : A post hoc analysis of 10 randomized, placebo-controlled trials
- 2019
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In: Journal of diabetes and its complications. - : Elsevier. - 1056-8727 .- 1873-460X. ; 33:10
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Journal article (peer-reviewed)abstract
- Aims: Hypomagnesemia (serum magnesium [Mg] <0.74 mmol/L [<1.8 mg/dL]) is commonly observed in patients with type 2 diabetes (T2D). This study investigated the effect of treatment with dapagliflozin 10 mg on Mg concentrations in patients with T2D. Methods: In this post hoc analysis, we used pooled data from 10 placebo-controlled studies of dapagliflozin over 24 weeks of treatment in patients with T2D. We evaluated the change in Mg in patients receiving dapagliflozin vs. placebo overall, and in subgroups with baseline hypomagnesemia and normal/hypermagnesemia (≥0.74 mmol/L [≥1.8 mg/dL]). We determined the proportion of patients with baseline hypomagnesemia who achieved Mg ≥0.74 mmol/L (≥1.8 mg/dL). Results: A total of 4398 patients with T2D were included. The mean change from baseline to week 24 in Mg was significantly larger with dapagliflozin vs. placebo; difference, 0.06 mmol/L (95% confidence interval [CI]: 0.05, 0.06). The proportion of patients with Mg within the population reference range after 24 weeks of treatment was significantly higher with dapagliflozin vs. placebo; difference, 47.8% (95% CI: 41.4, 53.9). The proportion of patients displaying hypermagnesemia did not increase with dapagliflozin treatment. Conclusions: Treatment with dapagliflozin 10 mg resulted in correction of Mg concentrations in patients with T2D and hypomagnesemia.
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| 20. |
- Ugander, Martin, et al.
(author)
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Chronic non-transmural infarction has a delayed recovery of function following revascularization
- 2010
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In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 10
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Journal article (peer-reviewed)abstract
- Background: The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic nontransmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods: Eighteen patients (mean age 69, range 52-84, 17 men) prospectively underwent cine magnetic resonance imaging (MRI), delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT) before, one and six months after elective coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Results: Dysfunctional myocardial segments (n = 337/864, 39%) were classified according to the presence (n = 164) or absence (n = 173) of infarction. Infarct transmurality in dysfunctional segments was largely non-transmural (transmurality = 31 +/- 22%). Quantitative stress perfusion and wall thickening increased at one month in dysfunctional segments without infarction (p < 0.001), with no further improvement at six months. Despite improvements in stress perfusion at one month (p < 0.001), non-transmural infarction displayed a slower and lesser improvement in wall thickening at one (p < 0.05) and six months (p < 0.001). Conclusions: Dysfunctional segments without infarction represent repetitively stunned or hibernating myocardium, and these segments improved both perfusion and function within one month after revascularization with no improvement thereafter. Although dysfunctional segments with non-transmural infarction improved in perfusion at one month, functional recovery was mostly seen between one and six months, possibly reflecting a more severe ischemic burden. These findings may be of value in the clinical assessment of regional functional recovery in the time period after revascularization.
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| 21. |
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