Hypervolaemic haemodilution makes myocardial perfusion more homogenous as reflected by reduced fractal dimension of regional myocardial perfusion. The clinically more commonly performed acute normovolaemic haemodilution, however, has not yet been studied in this respect. Hyperoxic ventilation with 100% oxygen is used in conjunction with haemodilution to compensate for low oxygen content by increasing physically dissolved oxygen in plasma. Since hyperoxia is known to cause disturbance in microcirculatory regulation we studied the effects of acute normovolaemic haemodilution to haematocrit (hct) 20 +/- 1% and hyperoxia on regional myocardial perfusion heterogeneity in 22 anaesthetized dogs using fractal and correlation analysis. Regional myocardial perfusion was assessed with radioactive microspheres. The results of the study were that heart rate, blood volume and arterial pressure were unchanged during haemodilution. Cardiac index was 3.6 +/- 0.7 L min-1 m-2 before and 4.6 +/- 0.7 L min-1 m-2 after haemodilution (P < 0.05). Fractal dimension (D) of regional myocardial perfusion was 1.17 +/- 0.10 at baseline. Neither haemodilution (D = 1.19 +/- 0.10) nor hyperoxia (D = 1.17 +/- 0.10) altered fractal properties of regional myocardial perfusion. Spatial correlation of blood flow to adjacent tissue samples before haemodilution was 0.58 +/- 0.15. Haemodilution and hyperoxia did not significantly influence spatial correlation (0.57 +/- 0.12 vs. 0.60 +/- 0.09; ns). We conclude that neither acute normovolaemic haemodilution nor haemodilution in combination with hyperoxic ventilation alter physiological myocardial perfusion heterogeneity.
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http://dx.doi.org/10.1046/j.1365-201X.1998.0289f.x | DOI Listing |
PLoS One
January 2025
Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil.
This paper proposes the use of artificial intelligence techniques, specifically the nnU-Net convolutional neural network, to improve the identification of left ventricular walls in images of myocardial perfusion scintigraphy, with the objective of improving the diagnosis and treatment of coronary artery disease. The methodology included data collection in a clinical environment, followed by data preparation and analysis using the 3D Slicer Platform for manual segmentation, and subsequently, the application of artificial intelligence models for automated segmentation, focusing on the efficiency of identifying the walls of the left ventricular. A total of 83 clinical routine exams were collected, each exam containing 50 slices, which is 4,150 images.
View Article and Find Full Text PDFCurr Cardiol Rep
January 2025
Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
Purpose Of Review: Critical Care Echocardiography (CCE) is now established as an important tool in the intensive care unit (ICU). This paper aims to examine the expanding role of cardiovascular ultrasound in the ICU, focusing on its applications, benefits, and challenges, while highlighting recent advancements shaping the future of critical care echocardiography.
Recent Findings: Non-invasive echocardiographic measurement of hemodynamic parameters including stroke volume, cardiac output, left ventricular filling pressures, and pulmonary pressures have been well-validated against invasive measurements.
J Nucl Med
January 2025
Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York;
Cardiac allograft vasculopathy (CAV) causes impaired blood flow in both epicardial vessels and microvasculature and remains a leading cause of posttransplant morbidity and mortality. This study examined the prognostic value and outcomes of CAV, assessed by N-ammonia PET/CT myocardial perfusion imaging in heart transplant recipients. PET/CT and invasive coronary angiography (ICA) were graded using validated scales.
View Article and Find Full Text PDFHeart
January 2025
Cardiology, University Hospital of Copenhagen, Copenhagen, Denmark.
Acute myocardial infarction-related cardiogenic shock (AMI-CS) is a severe, life-threatening condition characterised by inadequate tissue perfusion due to the heart's inability to pump blood effectively. The pathophysiology of AMI-CS usually arises from the sudden loss of myocardial contractility, leading to a decrease in cardiac output and systemic hypoperfusion. In approximately 90% of AMI-CS cases, the left ventricle is the primary site of dysfunction.
View Article and Find Full Text PDFCurr Pediatr Rep
May 2024
Coronary Artery Anomalies Program, Division of Cardiology, Texas Children's Hospital, 6651 Main Street MC-E1920, Houston, TX 77030 USA.
Purpose Of Review: We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA).
Recent Findings: Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention.
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