Cardiovascular diseases

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Furore over increased balloon angioplasty units

A decision by Ab Klink, Minister of Public Health, Wellbeing and Sports, to increase the number of balloon angioplasty facilities in hospitals to 30, has prompted the NVVC - the Dutch cardiologists association - to express concern that there will be too many centres and too few patients, and specialists will not be able to maintain the level of skills for this procedure.

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CTA benefits coronary artery bypass graft patients

Cardiac CT angiography (CTA) performed after coronary artery bypass grafting surgery can reveal a high prevalence of unsuspected cardiac and significant non-cardiac findings that might otherwise be overlooked, according to a study by researchers at the University of Maryland Medical Centre, Baltimore ('Cardiac CT Angiography after Coronary Bypass Surgery: Prevalence of Incidental Findings', Pub:…

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Monitoring of Surgical Bypasses

The aortocoronary bypass is an important surgical method for multivessel coronary revascularization, especially in the presence of complex lesions and in diabetic patients. It is can improve the prognosis of patients with three vessel disease and with left ventricular dysfunction1 . With regard to the type of graft used, bypasses are split into venous and arterial types. The use of venous…

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Cardiac MSCT Study Assessment with Sure Plaque-Software

Ongoing refinement of modern helical multi-slice CT (MSCT) scanners offers the opportunity for very high temporal and spatial resolution thin-slice data set acquisition. The reconstruction techniques offered (multisegment reconstruction) result in improved temporal resolution down to 40-200 ms and thus also reducing motion artifacts. The SURECardio software package makes possible optimum studies…

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Tissue Doppler Imaging

Tissue Doppler Imaging (TDI) is an emergingnon-invasive ultrasound technique that makes it possible to measure velocities at any point of the ventricular wall during the cardiac cycle. Over the last ten years, TDI has been proposed as a feasible and useful imaging tool that provides information on regional wall motion dynamics.

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Cardiac CT

Along with a high local resolution, the cardiac CT imaging also requires a high time resolution where the image data acquisition must be synchronised with the cardiac cycle by means of parallel ECG recording, and the measuring volume must be acquired in a single breathhold cycle. The multi-slice CT copes well with these requirements as it allows for acquiring continuous volume data sets of the…

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Automatic Quantification of Left-ventricular Function

The evaluation of the size and function of the left ventricle in patients with suspected heart disease is a central diagnostic problem. In contrast to other methods of evaluating left-ventricular function (e.g., angiocardiography, right-sided heart catheterization, radionuclide ventriculography or MRI), transthoracic echocardiography is a widespread and readily available procedure that is not…

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Tissue Doppler Imaging for assessment of pseudonormalization of the mitral inflow pattern

Impairment of left ventricular relaxation may lead to pulmonary congestion and symptoms of heart failure even in patients with preserved systolic function. Doppler echocardiography has become the non-invasive method of choice for the assessment of both systolic and diastolic dysfunction. However, Doppler-derived parameters such as mitral inflow velocity, deceleration time and isovolumic…

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Everything Echocardiography Offers - at 4559 Meters Above Sea Level

It has long been known that remaining at high altitudes leads to an increase in pulmonary arterial pressure caused by hypoxia. Its effects on cardiac function have also been considered well documented. The increase in pressure in the pulmonary circulation causes an enlargement of the right ventricle and thereby causes a displacement of the left ventricle that is accompanied by a relaxation…

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Optimization of Temporal and Spatial Resolution for Cardiac CT Diagnostics

Further developments in computer and detection technology over the last few months and years have made it possible to overcome, to a large degree, the previously limitations of medical computer tomography in spatial and temporal resolution, and thus to permit “detail-true” representation of the beating heart. The diagnostic workflow and computer-tomographic diagnosis of the heart using the…

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A Small Primer on the Clinical Use of MSCT for Heart Exams

Because of the rapid technical and scientific development over the past few years, multislice computer tomography of the heart has become increasingly established in the clinical routine. This requires, among other things, knowledge of the anatomy of the coronary arteries, the meaningful evaluation of the calcium score and the appropriate reproduction of the function of the left ventricle.

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Cardiac Imaging in a Small Animal Model

In the last 10 years, small animal models have played an important role in cardiological research. These research models are especially important since today various cardiac illness entities can be investigated in transgene animal models. Because of the animals ease of handling and fast generation time, research projects with rats and mice are particularly interesting. Until the 1980s,…

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Contrast agents in Sonography

Ultrasound contrast agents (USCA) or echo enhancers consist of minute gas containing microbubbles that have a high reflectivity when exposed to an ultrasound field. The history of USCA started in the mid of the 1960s. The cardiologist Joyner performed echo cardiography during the injection of saline solution into the aortic root via a catheter. During the injection he observed bright signals on…

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Carotid Stenting

Arteriosclerosis is well known as a vascular disease and cardiovascular risk factor. In its generalised form it affects not only the peripheral vessels (pelvis, legs) but also the coronary vessels and the carotid arteries. Arteriosclerosis is primarily a manifestation of advancing age, hence it is often accompanied by other diseases of the lungs and the heart as well as by metabolic diseases…

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The Non-Surgical Closure of Congenital Heart Defects

What is an “open foramen ovale”? The open foramen ovale medical abbreviation PFO for “patent foramen ovale”) is a usually small, only a few millimeter thick, membrane-covered slit in the septum between the atria of the heart. It is a remnant from human embryonic development that usually closes during the newborn period; however, in 10-25% of newborns a small opening remains that generally…

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Everything Echocardiography Offers - at 4 559 Meters Above Sea Level

It has long been known that hypoxia at high altitudes leads to an increase of pulmonaryarterial pressure. For sensitive persons, one crucial factor for the development of HAPE is the overwhelming rise in pressure in the pulmonary circulation. Using right heart catheterization average pulmonary-arterial pressures of 60 mmHg were encountered in earlier studies of HAPE patients. A pressure increase…

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Vascular Imaging in Prenatal Medicine

The following two articles look at the advantages of a new ultrasound technique in prenatal diagnostics: Advanced Dynamic Flow (ADF). While the authors use ADF for different purposes - K. S. Heling applies ADF for general vascular imaging and R. Schmitz focuses on fetal liver tumours and a fetal aneurysm in the vein of Galen - they both arrive at remarkably similar conclusions. But read for…

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Cardiac Multislice Computed Tomography (MSCT) Angiography

Spiral computed tomography first allowed the seamless acquisition of entire volumina without first separating them into individual slices. With the newest generation of MSCT devices having the 16-slice technology, short gantry rotation time of < 0.5 seconds, and a high performance processor, it is now possible to acquire large amounts of data in a short period of time with high spatial and…

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