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1.
J Psychiatr Res ; 136: 402-408, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33647855

RESUMO

Major depressive disorder (MDD) is characterized by heterogeneous cognitive, affective and somatic symptoms. Hence, the investigation of differential treatment effects on these symptoms as well as the identification of symptom specific biomarkers might crucially contribute to the development of individualized treatment strategies. We here aimed to examine symptom specific responses to treatment with ketamine, which repeatedly demonstrated rapid antidepressant effects in severe MDD. Additionally, we investigated working memory (WM) related brain activity associated with changes in distinct symptoms in order to identify specific response predictors. In a sample of 47 MDD patients receiving a single sub-anesthetic dose of ketamine, we applied a three-factor solution of the Beck Depression Inventory (BDI) to detect symptom specific changes 24 h post-infusion. A subsample of 16 patients underwent additional fMRI scanning during an emotional working memory task prior to ketamine treatment. Since functional aberrations in the default mode network (DMN) as well as in the dorsolateral prefrontal cortex (DLPFC) have been associated with impaired cognitive and emotional processing in MDD, we investigated neural activity in these regions. Our results showed that ketamine differentially affects MDD symptoms, with the largest symptom reduction in the cognitive domain. WM related neuroimaging results indicated that a more pronounced effect of ketamine on cognitive symptoms is predicted by lower DMN deactivation and higher DLPFC activation. Findings thereby not only indicate that ketamine's antidepressant efficacy is driven by a pro-cognitive mechanism, but also suggest that this might be mediated by increased potential for adaptive adjustment in the circumscribed brain regions.


Assuntos
Transtorno Depressivo Maior , Ketamina , Antidepressivos/uso terapêutico , Mapeamento Encefálico , Cognição , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/tratamento farmacológico , Humanos , Ketamina/farmacologia , Ketamina/uso terapêutico , Imageamento por Ressonância Magnética
2.
Vet J ; 228: 7-12, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29153110

RESUMO

This study tested the hypothesis that adrenocortical function would be altered in horses with equine gastric ulcer syndrome (EGUS). Twenty-six sport horses competing at national or international levels in eventing (n=15) or endurance (n=11) were subjected to a gastroscopic examination and an adrenocorticotropic hormone (ACTH) stimulation test. Salivary cortisol concentrations were measured before (baseline) and after (30, 60, 90, 120 and 150min) IV ACTH injection (1µg/kg bodyweight). Within EGUS, two distinct diseases, equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), can be distinguished. ESGD was diagnosed in 8/11 (73%; 95% confidence intervals [95%CI], 43-92%) endurance horses and 5/15 (33%; 95% CI, 14-58%) eventing horses. EGGD was observed in 9/11 (82%; 95% CI, 53-96%) endurance horses and 9/15 (60%; 95% CI, 35-81%) eventing horses. The presence or severity of ESGD was unrelated to the presence or severity of EGGD. ACTH stimulation induced a larger increase in cortisol concentration in horses with moderate EGGD than in horses with mild EGGD. Cortisol concentration during the entire sampling period (total increase in cortisol concentration during the entire sampling period [dAUC], 31.1±6.4ng/mL) and the highest measured concentration at a single time point (maximal increase in cortisol concentration [dMAX], 10.3±2.3ng/mL) were increased (P=0.005 and P=0.038, respectively), indicating that horses with glandular gastric disease exhibited increased adrenocortical responses to ACTH stimulation. These results suggest that EGGD might be associated with an enhanced adrenocortical sensitivity. Further investigations are warranted to confirm the association between adrenocortical sensitivity and EGGD and to elucidate the pathophysiological mechanisms involved.


Assuntos
Hormônio Adrenocorticotrópico/uso terapêutico , Doenças dos Cavalos/tratamento farmacológico , Condicionamento Físico Animal , Esportes , Gastropatias/veterinária , Hormônio Adrenocorticotrópico/administração & dosagem , Animais , Feminino , Doenças dos Cavalos/sangue , Cavalos , Hidrocortisona/sangue , Masculino , Gastropatias/tratamento farmacológico , Resultado do Tratamento
3.
Domest Anim Endocrinol ; 57: 43-7, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27565229

RESUMO

The aim of this study was to further characterize the ACTH stimulation test as reflected by salivary cortisol response and to measure the short- and long-term repeatability of it in healthy horses as a tool to assess the capacity of the adrenal cortex to secrete cortisol. Nineteen healthy horses were subjected to 3 ACTH stimulation tests. Intervals were 2 wk and 5 mo between the first and second and the second and third tests, respectively. A dose of 1-µg/kg BW synthetic ACTH was injected intravenously. Saliva samples were collected at baseline and at 30, 60, 90, 120, 150, and 180 min after administration for cortisol measurements using a competitive enzyme immunoassay. A repeated measures ANOVA was used to compare values within and among horses. Mean ± SD total increase in cortisol concentrations integrated over the entire sampling period was 34.5 ± 11.0 ng/mL. The highest measured concentration at a single time point was 9.7 ± 2.7 ng/mL and was reached after 122 ± 22 min. For the short- and long-term repeatability, intraclass correlation coefficient was 0.90 and 0.33, respectively. The 3 ACTH stimulation tests results differed significantly among (P < 0.00001) but not within (P = 0.538) individual horses. The Freiberger stallions had a higher salivary cortisol baseline concentration and a lower response to ACTH stimulation as compared with Warmblood mares and geldings. The present study confirmed that the administration of ACTH in healthy horses reliably stimulates the salivary secretion of cortisol and shows that the test is repeatable in the short- and long-term.


Assuntos
Hormônio Adrenocorticotrópico/farmacologia , Cavalos/metabolismo , Hidrocortisona/metabolismo , Saliva/química , Animais , Feminino , Hidrocortisona/química , Masculino , Saliva/metabolismo
4.
Mol Psychiatry ; 19(5): 625-32, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23628984

RESUMO

Long-lasting neuroadaptations in the glutamatergic corticostriatal circuitry have been suggested to be responsible for the persisting nature of drug addiction. In particular, animal models have linked the metabotropic glutamate receptor 5 (mGluR5) to drug-seeking behavior and extinction learning. Accordingly, blocking mGluR5s attenuated self-administration of cocaine and other addictive drugs in rats. How these animal findings extend to humans remains unclear. Therefore, we investigated if human cocaine users (CU) exhibit altered mGluR5 availability compared with drug-naïve control subjects. Seventeen male controls (11 smokers) and 18 male cocaine users (13 smokers) underwent positron emission tomography with (11)C-ABP688 to quantify mGluR5 availability in 12 volumes of interest in addiction-related brain areas. Drug use was assessed by self-report and quantitative hair toxicology. CU and controls did not significantly differ in regional mGluR5 availability. In contrast, smokers (n=24) showed significantly lower mGluR5 density throughout the brain (mean 20%) compared with non-smokers (n=11). In terms of effect sizes, lower mGluR5 availability was most pronounced in the caudate nucleus (d=1.50, 21%), insula (d=1.47, 20%), and putamen (d=1.46, 18%). Duration of smoking abstinence was positively associated with mGluR5 density in all brain regions of interest, indicating that lower mGluR5 availability was particularly pronounced in individuals who had smoked very recently. Specifically tobacco smoking was associated with lower mGluR5 availability in both CU and controls, while cocaine use was not linked to detectable mGluR5 alterations. These findings have important implications regarding the development of novel pharmacotherapies aimed at facilitating smoking cessation.


Assuntos
Encéfalo/metabolismo , Transtornos Relacionados ao Uso de Cocaína/metabolismo , Receptor de Glutamato Metabotrópico 5/metabolismo , Fumar/metabolismo , Tabagismo/metabolismo , Adulto , Encéfalo/diagnóstico por imagem , Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/metabolismo , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/metabolismo , Transtornos Relacionados ao Uso de Cocaína/diagnóstico por imagem , Humanos , Entrevistas como Assunto , Masculino , Oximas , Tomografia por Emissão de Pósitrons , Putamen/diagnóstico por imagem , Putamen/metabolismo , Piridinas , Compostos Radiofarmacêuticos , Autorrelato , Fatores de Tempo , Tabagismo/diagnóstico por imagem
5.
Pacing Clin Electrophysiol ; 24(2): 199-205, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11270700

RESUMO

Magnetic resonance imaging (MRI) is a widely accepted tool for the diagnosis of a variety of disease states. However, the presence of an implanted pacemaker is considered to be a strict contraindication to MRI in a vast majority of centers due to safety concerns. In phantom studies, the authors investigated the force and torque effects of the static magnetic field of MRI on pacemakers and ICDs. Thirty-one pacemakers (15 dual chamber and 16 single chamber units) from eight manufacturers and 13 ICDs from four manufacturers were exposed to the static magnetic field of a 1.5-Tesla MRI scanner. Magnetic force and acceleration measurements were obtained quantitatively, and torque measurements were made qualitatively. For pacemakers, the measured magnetic force was in the range of 0.05-3.60 N. Pacemakers released after 1995 had low magnetic force values as compared to the older devices. For these devices, the measured acceleration was even lower than the gravity of the earth (< 9.81 N/kg). Likewise, the torque levels were significantly reduced in newer generation pacemakers (< or = 2 from a scale of 6). ICD devices, except for one recent model, showed higher force (1.03-5.85 N), acceleration 9.5-34.2 N/kg), and torque (5-6 out of 6) levels. In conclusion, modern pacemakers present no safety risk with respect to magnetic force and torque induced by the static magnetic field of a 1.5-Tesla MRI scanner. However, ICD devices, despite considerable reduction in size and weight, may still pose problems due to strong magnetic force and torque.


Assuntos
Desfibriladores Implantáveis , Campos Eletromagnéticos , Imageamento por Ressonância Magnética/instrumentação , Marca-Passo Artificial , Contraindicações , Humanos , Imagens de Fantasmas , Segurança , Torque
7.
Coron Artery Dis ; 11(3): 261-7, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10832560

RESUMO

BACKGROUND: Both systolic and diastolic dysfunction have been observed in patients with anterolateral myocardial infarction. Diastolic dysfunction is related to disturbances in relaxation and diastolic filling. OBJECTIVE: To analyse cardiac rotation, regional shortening and diastolic relaxation in patients with anterolateral infarction. METHODS: Cardiac rotation and relaxation in controls and patients with chronic anterolateral infarction were assessed by myocardial tagging. Myocardial tagging is based on magnetic resonance imaging and allows us to label specific myocardial regions for imaging cardiac motion (rotation, translation and radial displacement). A rectangular grid was placed on the myocardium (basal, equatorial and apical short-axis plane) of each of 18 patients with chronic anterolateral infarction and 13 controls. Cardiac rotation, change in area and shortening of circumference were determined in each case. RESULTS: The left ventricle in controls performs a systolic wringing motion with a clockwise rotation at the base and a counterclockwise rotation at the apex when viewed from the apex. During relaxation a rotational motion in the opposite direction (namely untwisting) can be observed. In patients with anterolateral infarction, there is less systolic rotation at the apex and diastolic untwisting is delayed and prolonged in comparison with controls. In the presence of a left ventricular aneurysm (n = 4) apical rotation is completely lost. There is less shortening of circumference in infarcted and remote regions. CONCLUSIONS: The wringing motion of the myocardium might be an important mechanism involved in maintaining normal cardiac function with minimal expenditure of energy. This mechanism no longer operates in patients with left ventricular aneurysms and operates significantly less than normal in those with anterolateral hypokinaesia. Diastolic untwisting is significantly delayed and prolonged in patients with anterolateral infarction, which could explain the occurrence of diastolic dysfunction in these patients.


Assuntos
Contração Miocárdica/fisiologia , Infarto do Miocárdio/fisiopatologia , Idoso , Velocidade do Fluxo Sanguíneo , Aneurisma Coronário/fisiopatologia , Feminino , Hemodinâmica/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Rotação , Sístole/fisiologia
8.
Eur Heart J ; 21(7): 582-9, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10775013

RESUMO

BACKGROUND: Diastolic dysfunction with delayed relaxation and abnormal passive elastic properties has been described in patients with severe pressure overload hypertrophy. The purpose of this study was to evaluate the time course of rotational motion of the left ventricle in patients with aortic valve stenosis using myocardial tagging. METHODS: Myocardial tagging is a non-invasive method based on magnetic resonance which makes it possible to label ('tag') specific myocardial regions. From the motion of the tag's cardiac rotation, radial displacement and translational motion can be determined. In 12 controls and 13 patients with severe aortic valve stenosis systolic and diastolic wall motion was assessed in an apical and basal short axis plane. RESULTS: The normal left ventricle performs a systolic wringing motion around the ventricular long axis with clockwise rotation at the base (-4.4+/-1.6 degrees) and counter-clockwise rotation at the apex (+6.8+/-2.5 degrees) when viewed from the apex. During early diastole an untwisting motion can be observed which precedes diastolic filling. In patients with aortic valve stenosis systolic rotation is reduced at the base (-2.4+/-2.0 degrees; P<0.01) but increased at the apex (+12.0+/-6.0 degrees; P<0.05). Diastolic untwisting is delayed and prolonged with a decrease in normalized rotation velocity (-6.9+/-1.1 s(-1)) when compared to controls (-10.7+/-2.2 s(-1); P<0.001). Maximal systolic torsion is 8.0+/-2.1 degrees in controls and 14.1+/-6.4 degrees (P<0.01) in patients with aortic valve stenosis. CONCLUSIONS: Left ventricular pressure overload hypertrophy is associated with a reduction in basal and an increase in apical rotation resulting in increased torsion of the ventricle. Diastolic untwisting is delayed and prolonged. This may explain the occurrence of diastolic dysfunction in patients with severe pressure overload hypertrophy.


Assuntos
Estenose da Valva Aórtica/fisiopatologia , Contração Miocárdica , Função Ventricular Esquerda , Adulto , Idoso , Estenose da Valva Aórtica/diagnóstico , Diástole , Feminino , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade
9.
MAGMA ; 10(1): 18-26, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10697222

RESUMO

OBJECTIVES: Magnetic resonance (MRI) velocity mapping was used to evaluate non-invasively the flow profiles of the ascending aorta in normal volunteers and in patients with an aortic (mechanical) valve prosthesis. BACKGROUND: In patients with artificial aortic valves the flow profile in the ascending aorta is severely altered. These changes have been associated with an increased risk of thrombus formation and mechanical hemolysis. METHODS: Velocity profiles were determined 30 mm distal to the aortic valve in six healthy volunteers and seven patients with aortic valve replacement (replacement within the last 2 years) using ECG triggered phase contrast MRI. Peak flow, mean flow and mean reverse flow were measured in intervals of 25 ms during the entire heart cycle. Systolic reverse flow, end-systolic closing and diastolic leakage volume were calculated for all subjects. RESULTS: Peak flow velocity during mid-systole was significantly higher in patients with valvular prosthesis than in normals (mean + SD, 1.9 +/- 0.4 m/s vs. 1.2 +/- 0.03 m/s, P < 0.001) with a double peak and a zone of reversed flow close to the inner (left lateral) wall of the ascending aorta of the patients. Closing volume was significantly larger in patients than in controls (-3.3 +/- 1.2 ml/beat vs. -0.9 +/- 0.5 ml/beat; P < 0.001). There was reverse flow during systole in valvular patients amounting to 15.7 +/- 6.7% of total cardiac output compared to 2.3 +/- 1.2% in controls (P < 0.001). Diastolic mean flow was negative in patients after valve replacement but not in controls (-11.0 +/- 15.2 ml/beat vs. 6.8 +/- 3.2 ml/beat; P < 0.01). CONCLUSIONS: The following three major quantitative observations have been made in the present study: (1) Mechanical valve prostheses have an increased peak flow velocity with a systolic reverse flow at the inner (left lateral) wall of the ascending aorta. (2) A double peak flow velocity pattern can be observed in patients with bileaflet (mechanical) prosthesis. (3) The blood volume required for leaflet closure and the diastolic leakage blood volume are significantly higher for the examined bileaflet valve than for native heart valves.


Assuntos
Valva Aórtica/fisiologia , Próteses Valvulares Cardíacas , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Humanos , Masculino , Pessoa de Meia-Idade , Sístole , Fatores de Tempo
10.
J Biomech ; 33(2): 137-44, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10653026

RESUMO

The presence of atherosclerotic plaques has been shown to be closely related to the vessel geometry. Studies on postmortem human arteries and on the experimental animal show positive correlation between the presence of plaque thickness and low shear stress, departure of unidirectional flow and regions of flow separation and recirculation. Numerical simulations of arterial blood flow and direct blood flow velocity measurements by magnetic resonance imaging (MRI) are two approaches for the assessment of arterial blood flow patterns. In order to verify that both approaches give equivalent results magnetic resonance velocity data measured in a compliant anatomical carotid bifurcation model were compared to the results of numerical simulations performed for a corresponding computational vessel model. Cross sectional axial velocity profiles were calculated and measured for the midsinus and endsinus internal carotid artery. At both locations a skewed velocity profile with slow velocities at the outer vessel wall, medium velocities at the side walls and high velocities at the flow divider (inner) wall were observed. Qualitative comparison of the axial velocity patterns revealed no significant differences between simulations and in vitro measurements. Even quantitative differences such as for axial peak flow velocities were less than 10%. Secondary flow patterns revealed some minor differences concerning the form of the vortices but maximum circumferential velocities were in the same range for both methods.


Assuntos
Artérias Carótidas/fisiologia , Modelos Cardiovasculares , Animais , Simulação por Computador , Hemodinâmica/fisiologia , Humanos , Imageamento por Ressonância Magnética , Fluxo Sanguíneo Regional/fisiologia
11.
MAGMA ; 9(1-2): 85-91, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10555178

RESUMO

Myocardial tagging has shown to be a useful magnetic resonance modality for the assessment and quantification of local myocardial function. Many myocardial tagging techniques suffer from a rapid fading of the tags, restricting their application mainly to systolic phases of the cardiac cycle. However, left ventricular diastolic dysfunction has been increasingly appreciated as a major cause of heart failure. Subtraction based slice-following CSPAMM myocardial tagging has shown to overcome limitations such as fading of the tags. Remaining impediments to this technique, however, are extensive scanning times (approximately 10 min), the requirement of repeated breath-holds using a coached breathing pattern, and the enhanced sensitivity to artifacts related to poor patient compliance or inconsistent depths of end-expiratory breath-holds. We therefore propose a combination of slice-following CSPAMM myocardial tagging with a segmented EPI imaging sequence. Together with an optimized RF excitation scheme, this enables to acquire as many as 20 systolic and diastolic grid-tagged images per cardiac cycle with a high tagging contrast during a short period of sustained respiration.


Assuntos
Coração/anatomia & histologia , Coração/fisiologia , Imageamento por Ressonância Magnética/métodos , Adulto , Diástole , Imagem Ecoplanar/métodos , Eletrocardiografia , Humanos , Masculino , Respiração , Sístole
12.
J Magn Reson Imaging ; 10(5): 826-32, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10548795

RESUMO

Interactive real-time examination of left ventricular function in healthy volunteers both under rest and stress conditions has been performed. For this purpose, a system combining an interactive user interface, an ultrafast segmented echo-planar imaging sequence, and real-time reconstruction and display of the acquired images was designed. Magnetic resonance images were acquired at rates of up to 20 images per second with multiple receiver coils. By using a sliding window reconstruction technique, reconstruction rates of up to 60 images per second were achieved with a latency of < 100 msec. The quality of the real-time images was evaluated both qualitatively and quantitatively and was found to be appropriate for the determination of left ventricular function. It is concluded that the combination of dedicated components provides a convenient modality for the high-quality visualization of left ventricular function under rest and stress conditions at video frame rates with magnetic resonance imaging. J. Magn. Reson. Imaging 1999;10:826-832.


Assuntos
Imagem Ecoplanar , Função Ventricular Esquerda , Imagem Ecoplanar/instrumentação , Coração/anatomia & histologia , Humanos , Processamento de Imagem Assistida por Computador
13.
Magn Reson Med ; 42(5): 952-62, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10542355

RESUMO

New theoretical and practical concepts are presented for considerably enhancing the performance of magnetic resonance imaging (MRI) by means of arrays of multiple receiver coils. Sensitivity encoding (SENSE) is based on the fact that receiver sensitivity generally has an encoding effect complementary to Fourier preparation by linear field gradients. Thus, by using multiple receiver coils in parallel scan time in Fourier imaging can be considerably reduced. The problem of image reconstruction from sensitivity encoded data is formulated in a general fashion and solved for arbitrary coil configurations and k-space sampling patterns. Special attention is given to the currently most practical case, namely, sampling a common Cartesian grid with reduced density. For this case the feasibility of the proposed methods was verified both in vitro and in vivo. Scan time was reduced to one-half using a two-coil array in brain imaging. With an array of five coils double-oblique heart images were obtained in one-third of conventional scan time. Magn Reson Med 42:952-962, 1999.


Assuntos
Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Modelos Teóricos , Encéfalo/anatomia & histologia , Análise de Fourier , Coração/anatomia & histologia , Humanos , Aumento da Imagem , Imagens de Fantasmas , Sensibilidade e Especificidade
14.
Magn Reson Med ; 42(5): 970-8, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10542357

RESUMO

A method for magnetic resonance cine velocity mapping through heart valves with adaptation of both slice offset and angulation according to the motion of the valvular plane of the heart is presented. By means of a subtractive labeling technique, basal myocardial markers are obtained and automatically extracted for quantification of heart motion at the valvular level. The captured excursion of the basal plane is used to calculate the slice offset and angulation of each required time frame for cine velocity mapping. Through-plane velocity offsets are corrected by subtracting velocities introduced by basal plane motion from the measured velocities. For evaluation of the method, flow measurements downstream from the aortic valve were performed both with and without slice adaptation in 11 healthy volunteers and in four patients with aortic regurgitation. Maximum through-plane motion at the aortic root level as calculated from the labeled markers averaged 8.9 mm in the volunteers and 6.5 mm in the patients. The left coronary root was visible in 2-4 (mean: 2.2) time frames during early diastole when imaging with a spatially fixed slice. Time frames obtained with slice adaptation did not contain the coronary roots. Motion correction increased the apparent regurgitant volume by 5.7 +/- 0.4 ml for patients with clinical aortic regurgitation, for an increase of approximately 50%. The proposed method provides flow measurements with correction for through-plane motion perpendicular to the aortic root between the valvular annulus and the coronary ostia throughout the cardiac cycle. Magn Reson Med 42:970-978, 1999.


Assuntos
Insuficiência da Valva Aórtica/fisiopatologia , Valva Aórtica/fisiologia , Coração/fisiologia , Imagem Cinética por Ressonância Magnética/métodos , Adulto , Insuficiência da Valva Aórtica/diagnóstico , Velocidade do Fluxo Sanguíneo/fisiologia , Diástole/fisiologia , Feminino , Coração/fisiopatologia , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-Idade , Volume Sistólico/fisiologia , Sístole/fisiologia
15.
Circulation ; 100(4): 361-8, 1999 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-10421595

RESUMO

BACKGROUND: MR tissue tagging allows the noninvasive assessment of the locally and temporally resolved motion pattern of the left ventricle. Alterations in cardiac torsion and diastolic relaxation of the left ventricle were studied in patients with aortic stenosis and were compared with those of healthy control subjects and championship rowers with physiological volume-overload hypertrophy. METHODS AND RESULTS: Twelve aortic stenosis patients, 11 healthy control subjects with normal left ventricular function, and 11 world-championship rowers were investigated for systolic and diastolic heart wall motion on a basal and an apical level of the myocardium. Systolic torsion and untwisting during diastole were examined by use of a novel tagging technique (CSPAMM) that provides access to systolic and diastolic motion data. In the healthy heart, the left ventricle performs a systolic wringing motion, with a counterclockwise rotation at the apex and a clockwise rotation at the base. Apical untwisting precedes diastolic filling. In the athlete's heart, torsion and untwisting remain unchanged compared with those of the control subjects. In aortic stenosis patients, torsion is significantly increased and diastolic apical untwisting is prolonged compared with those of control subjects or athletes. CONCLUSIONS: Torsional behavior as observed in pressure- and volume-overloaded hearts is consistent with current theoretical findings. A delayed diastolic untwisting in the pressure-overloaded hearts of the patients may contribute to a tendency toward diastolic dysfunction.


Assuntos
Estenose da Valva Aórtica/complicações , Hipertensão/etiologia , Hipertensão/fisiopatologia , Contração Miocárdica/fisiologia , Adulto , Idoso , Diástole , Humanos , Hipertensão/diagnóstico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Movimento (Física) , Miocárdio/patologia , Valores de Referência , Rotação , Esportes , Sístole , Anormalidade Torcional , Função Ventricular Esquerda/fisiologia
16.
J Magn Reson Imaging ; 10(1): 41-51, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10398976

RESUMO

The segmentation of images obtained by cine magnetic resonance (MR) phase contrast velocity mapping using manual or semi-automated methods is a time consuming and observer-dependent process that still hampers the use of flow quantification in a clinical setting. A fully automatic segmentation method based on active contour model algorithms for defining vessel boundaries has been developed. For segmentation, the phase image, in addition to the magnitude image, is used to address image distortions frequently seen in the magnitude image of disturbed flow fields. A modified definition for the active contour model is introduced to reduce the influence of missing or spurious edge information of the vessel wall. The method was evaluated on flow phantom data and on in vivo images acquired in the ascending aorta of humans. Phantom experiments resulted in an error of 0.8% in assessing the luminal area of a flow phantom equipped with an artificial heart valve. Blinded evaluation of the volume flow rates from automatic vs. manual segmentation of gradient echo (FFE) phase contrast images obtained in vivo resulted in a mean difference of -0.9 +/- 3%. The mean difference from automatic vs. manual segmentation of images acquired with a hybrid phase contrast sequence (TFEPI) within a single breath-hold was -0.9 +/- 6%.


Assuntos
Aorta/fisiologia , Imagem Cinética por Ressonância Magnética , Reologia , Adulto , Algoritmos , Artefatos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Imagens de Fantasmas , Fluxo Sanguíneo Regional
17.
Magn Reson Imaging ; 17(4): 489-94, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10231175

RESUMO

Measuring the exercise-induced flow changes in the arteries of the body is a major challenge. The use of quantitative MR flow measurements for this purpose is hampered by movement artifacts and ECG triggering problems. To quantify exercise-induced flow changes in the abdominal aorta, we applied a fast hybrid phase contrast sequence with K-space segmentation and echo planar imaging readouts during a 12 heart beat, single breathhold post exercise scanning window after ergometer exercise in nine volunteers. Central k-space was acquired first. The changes in heart rate throughout the scanning window were quantified. The mean decrease in heart rate after six heart beats post exercise was less than 4% and less than 14% after 11 heart beats indicating that the exercise state was very well represented during the acquisition of central k-space. Abdominal aortic flow increased from 1.4+/-0.3 l/min at rest to 7.9+/-1.1 l/min at 131 watt. Retrograde flow reached a maximum value of 1.2 l/min at rest, and lasted 140 ms on average. Only for one out of the nine volunteers was there any retrograde flow present during exercise (at 33 watt and 65 watt exercise). It was concluded that retrograde flow patterns in the abdominal aorta associated with oscillating wall shear stresses and development of atherosclerosis disappeared with increasing levels of exercise. The feasibility of using fast quantitative phase contrast measurements during a post exercise scanning window to represent controlled exercise levels was demonstrated.


Assuntos
Aorta Abdominal/fisiologia , Imagem Ecoplanar/métodos , Exercício Físico/fisiologia , Imageamento por Ressonância Magnética/métodos , Adulto , Aorta Abdominal/anatomia & histologia , Velocidade do Fluxo Sanguíneo/fisiologia , Teste de Esforço , Feminino , Humanos , Masculino
18.
Magn Reson Med ; 41(3): 639-43, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10204892

RESUMO

Magnetic resonance imaging with preceding tissue tagging is a robust method for assessing cardiac motion of the entire heartbeat cycle with a high degree of accuracy. One limitation of this technique, however, is the low resolution of the obtained displacement map of the labeled points within the myocardium. By a new tagging technique, which is based on the combination of two or more measurements of the same slice but with different grid positions, a highly improved resolution of cardiac motion data can be achieved. In combination with a multi-heart-phase echo-planar imaging sequence, such images with doubled grid frequency can be acquired in two short breath-hold periods.


Assuntos
Imagem Ecoplanar/métodos , Aumento da Imagem/métodos , Contração Miocárdica/fisiologia , Meios de Contraste , Coração/anatomia & histologia , Humanos , Modelos Cardiovasculares , Movimento (Física) , Imagens de Fantasmas , Sensibilidade e Especificidade
19.
Adv Exp Med Biol ; 471: 767-73, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10659212

RESUMO

Cerebral blood volume (CBV) can be quantified by both near infrared spectroscopy (NIRS) and magnetic resonance imaging (MRI). The aim is to compare CBV results obtained by NIRS and MRI in adult patients. 10 adult patients, 6 females and 4 males, age median 24 (range 21 to 76) years, were included in this study. All needed a MRI investigation with contrast medium for clinical reasons. The NIRS instrument, the Cerebral RedOx Monitor 2020 from Critikon, quantifies cerebral haemoglobin concentration using a sensor with two receiving channels at different distances. Geometrical detector arrangements of this type enable a ratio measurement to be achieved, which reduces the contribution of the skull and skin, thus allowing quantification. Cerebral haemoglobin concentration can be converted in CBV, as the haemoglobin concentration in the blood is known. CBV can be quantified by MRI using an indicator dilution method. The method requires an injection of a paramagnetic contrast agent. The input function can be measured at the throat and thus perfusion images can be quantified. CBV was measured by NIRS just before the patient entered the magnet and after he had left it. The sensor for the NIRS measurement was applied to the patients front three times for 1 minute to each side, avoiding the sinuses. CBV was determined by contrast enhanced MRI between the NIRS measurements. The mean CBV (NIRS) was 8.6 (SD 1.3) ml/100 g and CBV (MRI) was 7.1 (SD 2.5). The correlation between CBV (NIRS) and CBV (MRI) was Pearson's correlation coefficient -0.297 (p = 0.204) respectively Spearman's rho (nonparametric) -0.266 (p = 0.257). The CBV values obtained by NIRS and MRI, even though they are in the same range, do not correlate.


Assuntos
Encéfalo/irrigação sanguínea , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Adulto , Idoso , Volume Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Magn Reson Med ; 40(5): 645-55, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9797146

RESUMO

Methods are lacking for accurate, noninvasive circumferential edge detection and wall shear stress calculation. Using standard MR phase contrast sequences, parts of the velocity profiles were fitted to a multiple sectored three-dimensional paraboloid model enabling exact calculation of vessel wall position and wall shear stress in 24 locations evenly distributed around the luminal vessel wall. The model was evaluated by in vitro scans and computer simulations and applied to the common carotid artery of humans. In vitro, the luminal area of a glass tube was assessed with an error of 0.9%. Computer simulations of peak systolic data revealed errors of +/-0.9% (vessel area) and +/-3.25% (wall shear stress). The in vivo results showed substantial difference between anterior and posterior wall shear stress values due to skewed velocity profiles. A new noninvasive method for highly accurate measurement of circumferential subpixel vessel wall position and wall shear stress has been developed.


Assuntos
Artérias Carótidas/anatomia & histologia , Artérias Carótidas/fisiologia , Imagem Cinética por Ressonância Magnética/métodos , Modelos Cardiovasculares , Adulto , Velocidade do Fluxo Sanguíneo , Simulação por Computador , Feminino , Humanos , Masculino , Músculo Liso Vascular/fisiologia , Valores de Referência , Sensibilidade e Especificidade , Estresse Mecânico , Resistência Vascular
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