Книги з теми "Cardiac function analysis"
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1
Paul, Richard, and Paul Grant. Blood gas analysis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0018_update_001.
Анотація:
Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid-base derangements are reversed by treatment of the underlying disease process, rather than simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than the extent of pH value deviation. Within this chapter, a six-step approach is presented for prompt and accurate acid-base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment is required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed within this chapter.
2
Lancellotti, Patrizio, and Bernard Cosyns. Assessment of Diastolic Function. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0005.
Анотація:
Diastole is the part of the cardiac cycle starting at aortic valve closure and ending at mitral valve closure. Evaluation of diastolic function by echocardiography is useful to diagnose heart failure with preserved ejection fraction, and regardless of ejection fraction, echocardiography can be used to estimate left ventricular filling pressure. Assessment of diastolic function includes analysis of left ventricular relaxation and compliance, left atrial and left ventricular filling pressures. This chapter describes the phases of diastole and covers the integrated approach of LV diastolic function through M-Mode and 2D/3D echocardiography, pulsed-wave Doppler echocardiography, and pulsed-wave tissue Doppler echocardiography.
3
De Deyne, Cathy, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0016.
Анотація:
Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables such as invasive arterial blood pressure monitoring or arterial blood gas analysis.
4
De Deyne, Cathy, Ward Eertmans, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0016_update_001.
Анотація:
Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables—with possible impact on optimal cerebral perfusion/oxygenation—such as invasive arterial blood pressure monitoring or arterial blood gas analysis.
5
Paul, Richard, Pavlos Myrianthefs, George Baltopoulos, and Shaun McMaster. Blood gas analysis: acid–base, fluid, and electrolyte disorders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0018.
Анотація:
Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid-base derangements are reversed by treatment of the underlying disease process, rather than simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than the extent of pH value deviation. Within this chapter, a six-step approach is presented for prompt and accurate acid-base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment is required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed within this chapter.
6
Monaghan, M., and S. Adhya. Three dimensional echocardiography. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0003.
Анотація:
Three-dimensional (3D) echocardiography allows the real-time acquisition of volumes containing entire cardiac structures. The analysis of 3D volumes does not require any assumptions as to the shape of structures.3D echocardiography is more accurate than two-dimensional (2D) in the assessment of left ventricular (LV) volumes, mass, and function, and is comparable to cardiac magnetic resonance imaging. This makes it an ideal modality for measuring LV function particularly when this will determine significant interventions such as implanting of cardioverter/defibrillators, biventricular pacing, and the commencement and continuation of cancer chemotherapy. 3D echocardiography makes it easy to visualize valves and define pathological mechanisms. 3D assessment of dyssynchrony, myocardial strain, and stress imaging are attractive.However, 3D echocardiography is limited by the need for specialist software and lower spatial and temporal resolution when compared to 2D echocardiography.
7
Ruiz-Villalba, Adrián, Nikolaos Frangogiannis, and José Maria Pérez-Pomares. Origin and diversity of cardiac fibroblasts: developmental substrates of adult cardiac fibrosis. Edited by José Maria Pérez-Pomares, Robert G. Kelly, Maurice van den Hoff, José Luis de la Pompa, David Sedmera, Cristina Basso, and Deborah Henderson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757269.003.0012.
Анотація:
Cardiac connective tissues are primarily formed by cardiac fibroblasts (CF) of diverse embryonic origins. Whereas CF specific roles in cardiac morphogenesis remain under-researched, their involvement in adult cardiac fibrosis is clinically relevant. Cardiac fibrosis is a common element of several chronic cardiac conditions characterized by the loss of ventricular wall mechanical function, ultimately driving to heart failure. In the ischaemic heart early reparative fibrosis evidences the very restricted regenerative potential of the myocardium. In non-ischaemic diseases fibrosis is activated by unknown signals. We summarize current knowledge on the origin of CFs and their developmental roles, and discuss the differential disease-dependent response of different CF subpopulations to various pathological stimuli. We also describe the characteristic cell-cell and cell-matrix interactions that determine the fibrotic remodelling of the myocardium. We analyse experimental models for the study of cardiac fibrosis, and suggest future directions in the search for new markers and therapeutic targets.
8
De Bono, Christopher, Magali Théveniau-Ruissy, and Robert G. Kelly. Cardiac fields and myocardial cell lineages. Edited by José Maria Pérez-Pomares, Robert G. Kelly, Maurice van den Hoff, José Luis de la Pompa, David Sedmera, Cristina Basso, and Deborah Henderson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757269.003.0004.
Анотація:
We focus on the origin of myocardial cells in the first and second heart fields in splanchnic mesoderm in the early embryo. Genetic lineage tracing using Cre recombinase activated conditional reporter genes has made a major contribution to our understanding of cardiac progenitor cells and will be discussed together with other experimental approaches to analysing cell lineages at the clonal level. Interactions between myocardial, epicardial and endocardial lineages are essential for coordinated function and homeostasis of the normal heart. Perturbation of heart field development and myocardial lineage contributions to the heart through developmental or acquired pathologies results in and modulates the progression of cardiac disease. Understanding the origin of myocardial lineages during embryonic development and how they converge to generate an integrated heart is thus a major biomedical objective. Furthermore, reactivation of developmental programmes is likely to be of major importance in strategies aimed at repair of the damaged heart.
9
Prout, Jeremy, Tanya Jones, and Daniel Martin. Cardiovascular system. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0001.
Анотація:
This chapter covers the assessment and investigation of perioperative cardiac risk, the principles of perioperative haemodynamic monitoring and physiological changes in cardiac comorbidity with their relevance to anaesthetic management. Perioperative cardiovascular risk includes assessment of cardiac risk factors, functional capacity and evidence-based guidelines for preassessment. Cardiovascular investigations such as cardiopulmonary exercise testing and scoring systems for cardiac risk are included. Management of the cardiac patient for non-cardiac surgery is detailed. Invasive monitoring with arterial, central venous and pulmonary artery catheters is described. Cardiac output measurement systems including dilution techniques, pulse contour analysis and Doppler are compared. The physiological changes, management and implications for anaesthesia of common cardiac comorbidity including ischaemic heart disease, heart failure, valvular heart disease, pacemakers and pulmonary hypertension are described.
10
Voigt, Jens Uwe, Peter Søgaard, and Emer Joyce. Heart failure: left ventricular dyssynchrony. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0026.
Анотація:
Echocardiography plays a pivotal role in the management of patients with dilative cardiomyopathy and conduction disease, particularly in the setting of cardiac resynchronization therapy (CRT). Current CRT guidelines recommend the echocardiographic assessment of left ventricular size and function. Furthermore, echocardiography has the potential of analysing regional myocardial mechanics with high temporal resolution and without radiation burden or danger for the patient. Assessment of left ventricular dyssynchrony has therefore become the next challenge. Besides the visual approaches, newer methods of functional imaging such as tissue Doppler and speckle tracking allow the exact quantification of regional myocardial function. This chapter reviews the current status of left ventricular dyssynchrony assessment by echocardiography and introduces emerging techniques which can better link conduction abnormalities and mechanical events and, thus, potentially improve clinical decision-making in this field.
11
Cruz, Dinna N., Anna Giuliani, and Claudio Ronco. Acute kidney injury in heart failure. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0248.
Анотація:
Acute kidney injury (AKI) occurring during heart failure (HF) has been labelled cardiorenal syndrome (CRS) type 1. CRS is defined as a group of ‘disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other’. This consensus definition was proposed by the Acute Dialysis Quality Initiative, with the aim to standardize those disorders where cardiac and renal diseases coexist. Five subtypes have been proposed, according to which organ is affected first (cardiac vs renal) and whether the dysfunction is acute or chronic. Another subtype which includes systemic conditions leading to both heart and kidney dysfunction is also described.The term ‘worsening renal function’ has been regularly used to describe the acute and/or subacute changes that occur in the kidneys following HF. However, the AKI classification according to the current consensus definition better represents the entire spectrum of AKI in the setting of HF.The pathophysiology of heart–kidney interaction is complex and still poorly understood. Factors beyond the classic haemodynamic mechanisms appear to be involved: neurohormonal activation, venous congestion, and inflammation have all been implicated.Diuretics are still a cornerstone in the management of HF. Intravenous administration by bolus or continuous infusion appears to be equally efficacious. Biomarkers and bioelectrical impedance analysis can be helpful in estimating the real volume overload and may be useful to predict and avoid AKI. The role of ultrafiltration remains controversial, and it is currently recommended only for diuretic-resistant patients as it has not been associated with better outcomes. The occurrence of AKI during HF is associated with substantially greater short- and long-term mortality.
12
Maizel, Julien, and Michel Slama. Doppler echocardiography in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0141.
Анотація:
The capacity of echocardiography to non-invasively identify the major causes of circulatory failure has made it increasingly popular in the intensive care unit (ICU) setting. Assessing cardiac performance in shocked patients is a key point in therapeutic support decision-making. Analysing left and right ventricular function and morphology should be mandatory in the training curriculum of ICU physicians. Haemodynamic evaluation relies on several parameters examining left ventricular systolic and diastolic function, left ventricular filling pressure, fluid responsiveness, and right ventricular function. To correctly interpret the echocardiographic findings and adapt patient management appropriately, physicians must be aware of the limits of these parameters.
13
Winker, Margaret A., and Stephen J. Lurie. Study Design and Statistics. Oxford University Press, 2009. http://dx.doi.org/10.1093/jama/9780195176339.003.0020.
Анотація:
Statistical concepts, such as the margin of error in a public opinion poll or the probability of rain or snow, appear in everyday conversation. But, just as one may understand how the heart functions and how blood circulates but not be able to perform a cardiac catheterization, an understanding of statistical concepts does not enable one to perform the work of a statistician. Although the concepts may be familiar, the tools of statistics may be misapplied and the results misinterpreted without a statistician’s help. In medical research, the quality of the statistical analysis and clarity of presentation of statistical results are critical to a study’s validity. Decisions about statistical analysis are best made at the time that the study is designed and generally should not be deferred until after the data have been collected. Even the most sophisticated statistical analysis cannot salvage a fundamentally flawed study. Regardless of the statistician’s role, authors (who may include statisticians) are responsible for the appropriate design, analysis, and presentation of the study’s results...
14
Rost, Christian, and Frank A. Flachskampf. Transoesophageal and intracardiac echocardiography. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0004.
Анотація:
Transoesophageal echocardiography (TOE), a minimal-risk, semi-invasive imaging procedure is nowadays an indispensable part of routine echocardiography. It is mainly necessary and indicated: ◆ To analyse some structures insufficiently seen transthoracically, such as the left atrial appendage or the thoracic aorta. ◆ In situations that prohibit the use of conventional transthoracic windows, such as the patient undergoing cardiac surgery.As in transthoracic echocardiography (TTE), the TOE examination consists of a sequence of views defined by internal landmarks; unlike TTE, depending on the patient’s tolerance and the clinical question, not all of these have to be obtained in every examination. Important typical indications for TOE are the search for signs of endocarditis, the search for cardiogenic emboli, diagnosis of left atrial (appendage) thrombi before cardioversion, diagnosis of aortic dissection, characterization of mitral and aortic valve pathology especially in the context of surgical repair, intraoperative monitoring of left ventricular function, and monitoring of interventional cardiac procedures monitored.For some indications, intracardiac echocardiography has been found useful. This procedure involves insertion of a transducer-tipped catheter into the caval vein and advancement to the right heart, or intra-aortic placement. Applications are electrophysiological procedures, interventional closure of atrial septal defect, aortic stent placement, and others.
15
Magee, Patrick, and Mark Tooley. Intraoperative monitoring. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0043.
Анотація:
Chapter 25 introduced some basic generic principles applicable to many measurement and monitoring techniques. Chapter 43 introduces those principles not covered in Chapter 25 and discusses in detail the clinical applications and limitations of the many monitoring techniques available to the modern clinical anaesthetist. It starts with non-invasive blood pressure measurement, including clinical and automated techniques. This is followed by techniques of direct blood pressure measurement, noting that transducers and calibration have been discussed in Chapter 25. This is followed by electrocardiography. There then follows a section on the different methods of measuring cardiac output, including the pulmonary artery catheter, the application of ultrasound in echocardiography, pulse contour analysis (LiDCO™ and PiCCO™), and transthoracic electrical impedance. Pulse oximetry is then discussed in some detail. Depth of anaesthesia monitoring is then described, starting with the electroencephalogram and its application in BIS™ monitors, the use of evoked potentials, and entropy. There then follow sections on gas pressure measurement in cylinders and in breathing systems, followed by gas volume and flow measurement, including the rotameter, spirometry, and the pneumotachograph, and the measurement of lung dead space and functional residual capacity using body plethysmography and dilution techniques. The final section is on respiratory gas analysis, starting with light refractometry as the standard against which other techniques are compared, infrared spectroscopy, mass spectrometry, and Raman spectroscopy (the principles of these techniques having been introduced in Chapter 25), piezoelectric and paramagnetic analysers, polarography and fuel cells, and blood gas analysis.
16
Reykowski, Janusz. Disenchantment with Democracy. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780190078584.001.0001.
Анотація:
The main theme of the book is the resurgence in the countries of liberal democracy, the political movements that express an approval for violence as a mean of attaining group goals. From ancient time, violence was a commonly accepted, dominant way of gaining wealth, prestige, and fame, as well as a means of social control and socialization of young generations. Human communities attempted to regulate and curtail violence, primarily in intragroup relations. A major change in attitude toward violence was brought about by the development of liberal culture and liberal institutions that saw individual freedom and individual rights as fundamental values. The role of violence was to be limited by two main institutions: the free market and liberal democracy, both of which regard individual freedom as a cardinal principle. However, they have both turned out to be fallible. Conflicts of interests, ideological or world views contradictions, and identity differences are sources of destructive conflicts that trigger various forms of violence: political, economic, symbolic, and physical. This book focuses on two issues. One refers to the psychological nature of the main conflicts and the question of whether those conflicts are intractable and must necessarily lead to destructive consequences. The other, concerns the imperfections of liberal institutions, which render them unable to perform sufficiently well one of their basic functions, that is, removing violence from the sphere of human relations. This analysis is carried out from a specific perspective, focusing on psychological sources and consequences of the phenomena discussed in the book.