Publications by authors named "Loon R"

Introduction: Current family screening approaches in dilated cardiomyopathy (DCM) depend on the presence or absence of a familial genetic variant, in which variant pathogenicity (i.e. benign or pathogenic) classification drives screening recommendations.

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The acute response to therapeutic afterload reduction differs between heart failure with preserved (HFpEF) versus reduced ejection fraction (HFrEF), with larger left ventricular (LV) stroke work augmentation in HFrEF compared to HFpEF. This may (partially) explain the neutral effect of HFrEF-medication in HFpEF. It is unclear whether such differences in hemodynamic response persist and/or differentially trigger reverse remodeling in case of long-term afterload reduction.

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Noise simulations are an important part of noise studies that investigate the impact of noise sources on the environment. In noise simulation, noise levels at receiver points are calculated based on the noise propagation paths between the receiver and source points. These paths are derived from the height of the terrain.

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This work proposes a modelling framework to analyse flow and pressure distributions throughout the lung of mechanically ventilated COVID-19 patients. The methodology involves: segmentation of the lungs and major airways from patient CT images; a volume filling algorithm that creates a dichotomous airway network in the remaining volume of the lung; an estimate of resistance and compliance within the lung based on Hounsfield unit values from the CT scan; and a computational fluid dynamics model to analyse flow, lung inflation, and pressure throughout the airway network. Mechanically ventilated patients with differing progression and severity of the disease were simulated.

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Computational models can be at the basis of new powerful technologies for studying and classifying disorders like pre-eclampsia, where it is difficult to distinguish pre-eclamptic patients from non-pre-eclamptic based on pressure when patients have a track record of hypertension. Computational models now enable a detailed analysis of how pregnancy affects the cardiovascular system. Therefore, new non-invasive biomarkers were developed that can aid the classification of pre-eclampsia through the integration of six different measured non-invasive cardiovascular signals.

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Background: Left atrial volume index (LAVI) serves as a crucial marker for assessing left atrial (LA) remodeling, particularly in patients with mitral valve regurgitation (MR). Recent guidelines recommend a LAVI exceeding 60 mL/m as Class IIa recommendation for mitral valve repair surgery in asymptomatic MR patients with preserved left ventricular function. Traditionally, echocardiography is the standard for assessing LAVI in MR patients.

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We present the case of a patient who was shot through the heart with an air rifle and presented in a stable condition at our emergency department. At the time of presentation, the bullet was still present within the myocardium. Imaging, management, and outcome are discussed in this report.

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Changes in cerebral blood flow are often associated with the initiation and development of different life-threatening medical conditions including aneurysm rupture and ischemic stroke. Nevertheless, it is not fully clear how haemodynamic changes in time across the Circle of Willis (CoW) are related with intracranial aneurysm (IA) growth. In this work, we introduced a novel reduced-order modelling strategy for the systematic quantification of longitudinal blood flow changes across the whole CoW in patients with stable and unstable/growing aneurysm.

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Introduction: Supine sleep position is associated with stillbirth, likely secondary to inferior vena cava compression, and a reduction in cardiac output (CO) and uteroplacental perfusion. Evidence for the effects of prone position in pregnancy is less clear. This study aimed to determine the effect maternal prone position on maternal haemodynamics and fetal heart rate, compared with left lateral position.

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Background: Cor triatriatum sinistra (CTS) is a rare condition where the left atrium (LA) is divided by a thin membrane into an upper and lower chamber. Incidentally, the diagnosis is made in late adulthood, usually because of a favourable variant such as in our patient who presented with partial CTS.

Case Summary: We present the case of a 62-year-old female who presented with COVID-19.

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Background: The invasive microvascular function indices, coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR), exhibit a dynamic pattern after ST-segment-elevation myocardial infarction. The effects of microvascular injury on the evolution of the microvascular function and the prognostic significance of the evolution of microvascular function are unknown. We investigated the relationship between the temporal changes of CFR and IMR, and cardiovascular magnetic resonance-derived microvascular injury characteristics in reperfused ST-segment-elevation myocardial infarction patients, and their association with 1-month left ventricular ejection fraction and infarct size (IS).

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Microwave ablation therapy is a hyperthermic treatment for killing cancerous tumours whereby microwave energy is dispersed into a target tissue region. Modelling can provide a prediction for the outcome of ablation, this paper explores changes in size and shape of temperature and Specific absorption rate fields throughout the course of simulated treatment with different probe concepts. Here, an axisymmetric geometry of a probe embedded within a tissue material is created, solving coupled electromagnetic and bioheat equations using the finite element method, utilizing hp discretisation with the NGSolve library.

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Article Synopsis
  • Chest CT (ULDCT) was evaluated against chest X-ray (CXR) to see which better impacts health outcomes for patients with suspected lung disease in the emergency department.
  • A randomized clinical trial included 2418 patients, measuring their health status 28 days later using a specific health score, along with hospital admission rates and lengths of stay.
  • Results showed that while ULDCT provided slightly better health scores and found more incidental issues, overall short-term health and admissions were similar to those using CXR, suggesting ULDCT isn't necessary for routine use in these cases.
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Covalent tRNA modifications play multi-faceted roles in tRNA stability, folding, and recognition, as well as the rate and fidelity of translation, and other cellular processes such as growth, development, and stress responses. Mutations in genes that are known to regulate tRNA modifications lead to a wide array of phenotypes and diseases including numerous cognitive and neurodevelopmental disorders, highlighting the critical role of tRNA modification in human disease. One such gene, THUMPD1, is involved in regulating tRNA N4-acetylcytidine modification (ac4C), and recently was proposed as a candidate gene for autosomal-recessive intellectual disability.

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  • Patients with ST-elevation myocardial infarction (STEMI) require quick restoration of blood flow, and a new method called sonothrombolysis uses ultrasound and microbubbles to break down clots and improve blood circulation.
  • A study tested the feasibility of using sonothrombolysis in ambulances for STEMI patients, assessing how long the treatment lasted and its safety during patient transport.
  • Out of twelve screened patients, three were treated; the method showed promising results without complications, highlighting the need for larger clinical trials to confirm its effectiveness and safety.
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Background: This study evaluated the feasibility of a short-term, multimodal trauma-focused treatment approach adapted specifically for unaccompanied refugee minors (URMs) in the Netherlands. This approach aims to overcome barriers to mental health care and to reduce symptoms of posttraumatic stress disorder (PTSD) and depression.

Methods: An uncontrolled study was conducted, evaluating the main request for help, treatment integrity and feasibility, and the course of symptoms of PTSD (Children's Revised Impact of Event Scale-13) and depression (Patient Health Questionnaire modified for Adolescents).

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To evaluate the effect of percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs) on left ventricular (LV) strain assessed using cardiac magnetic resonance (CMR) tissue tracking. In 150 patients with a CTO, longitudinal (LS), radial (RS) and circumferential shortening (CS) were determined using CMR tissue tracking before and 3 months after successful PCI. In patients with impaired LV strain at baseline, global LS (10.

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Objectives: This study evaluated myocardial viability as well as global and regional functional recovery after successful chronic coronary total occlusion (CTO) percutaneous coronary intervention (PCI) using sequential quantitative cardiac magnetic resonance (CMR) imaging.

Background: The patient benefits of CTO PCI are being questioned.

Methods: In a single high-volume CTO PCI center patients were prospectively scheduled for CMR at baseline and 3 months after successful CTO PCI between 2013 and 2018.

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Aims: Dilated cardiomyopathy (DCM) associated with dystrophin gene (DMD) mutations in individuals with mild or absent skeletal myopathy is often indistinguishable from other DCM forms. We sought to describe the phenotype and prognosis of DMD associated DCM in DMD mutation carriers without severe skeletal myopathy.

Methods And Results: At 26 European centres, we retrospectively collected clinical characteristics and outcomes of 223 DMD mutation carriers (83% male, 33 ± 15 years).

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This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. This retrospective cohort study included infants born between 2005 and 2018 with CH measured by echocardiography [interventricular septum (IVS) and/or left ventricular posterior wall (LVPW) thickness with Z-score ≥ 2.0].

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Article Synopsis
  • A study was conducted on 552 patients who were resuscitated after cardiac arrest without STEMI, comparing immediate versus delayed coronary angiography and its impact on heart function.
  • Results showed no significant improvement in left ventricular function, with ejection fractions of 45.2% and 48.4% for immediate and delayed groups, respectively.
  • The conclusion indicates that immediate coronary angiography does not enhance heart dimensions or function compared to delaying the procedure after neurological recovery.
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One way to address substance misuse is to train health professional students in Screening, Brief Intervention, and Referral to Treatment (SBIRT), an early intervention strategy. This study evaluated a semester-long, 50-hour elective SBIRT training that blended online coursework with interprofessional experiences. Medicine, nursing, pharmacy, and social work students completed an interprofessional standardized patient experience and completed a minimum of two interprofessional SBIRT experiences at community agencies.

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We report a case of a 73-year-old female patient, who was admitted to the coronary care unit due to chest pain, malaise and near syncope. During physical examination, the patient was hypotensive and there were signs of left-sided heart failure and a loud systolic murmur. Echocardiogram showed apical ballooning with dynamic left ventricular outflow tract obstruction, based on systolic anterior motion of the mitral valve with important mitral valve regurgitation.

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A 74-year-old man returned to the clinic for follow-up of residual nonculprit lesions after reperfused acute inferior ST-segment elevation myocardial infarction. Stress cardiac magnetic resonance perfusion imaging demonstrated a severe perfusion defect in the anterior wall. Surprisingly, subsequent invasive assessment did not reveal hemodynamically significant obstruction in the nonculprit vessels.

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