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Author: Mark A. Fogel
Publisher: John Wiley & Sons
ISBN: 1405173491
Category : Medical
Languages : en
Pages : 392
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Book Description
Infants, children and adolescents with congenital heart disease(CHD) are a challenge to manage and an ever-increasing number arereaching adulthood. CHD is one of the most important topics in cardiology today, yetthis book is the only clinically-orientated monograph devotedexclusively to ventricular function and blood flow as it relates toCHD. Written by a distinguished panel of cardiologists, bioengineers,physiologists, and clinical investigators, Ventricular Functionand Blood Flow in Congenital Heart Disease is an extensive andcomprehensive presentation of the key aspects of this branch ofCHD.
Author: Mark A. Fogel
Publisher: John Wiley & Sons
ISBN: 1405173491
Category : Medical
Languages : en
Pages : 392
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Book Description
Infants, children and adolescents with congenital heart disease(CHD) are a challenge to manage and an ever-increasing number arereaching adulthood. CHD is one of the most important topics in cardiology today, yetthis book is the only clinically-orientated monograph devotedexclusively to ventricular function and blood flow as it relates toCHD. Written by a distinguished panel of cardiologists, bioengineers,physiologists, and clinical investigators, Ventricular Functionand Blood Flow in Congenital Heart Disease is an extensive andcomprehensive presentation of the key aspects of this branch ofCHD.
Author: Alexandru Grigorescu Fredriksson
Publisher: Linköping University Electronic Press
ISBN: 9176854159
Category :
Languages : en
Pages : 95
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Book Description
The spectrum of cardiovascular diseases is the leading cause of morbidity and mortality globally. Early assessment and treatment of these conditions, acquired as well as congenital, is therefore of paramount importance. The human heart has a great ability to adapt to various hemodynamic conditions by cardiac remodeling. Pathologic cardiac remodeling can occur as a result of cardiovascular disease in an effort to maintain satisfactory cardiac function. With time, cardiac function diminishes leading to disease progression and subsequent heart failure, the end-point of many heart diseases, associated with very poor prognosis. Within the normal cardiac ventricles blood flows in highly organized patterns, and changes in cardiac configuration or function will affect these flow patterns. Conversely, altered flows and pressures can bring about cardiac remodeling. In congenital heart disease, even after corrective surgery, cardiac anatomy and thereby intracardiac blood flow patterns are inherently altered. The clinically most available imaging technique, ultrasound with Doppler, allows only for one-directional flow assessment and is limited by the need of clear examination windows, thus failing to fully assess the complex three-dimensional blood flow within the beating heart. Cardiovascular magnetic resonance imaging (CMR) with phase-contrast has the ability to acquire three-dimensional (3D), three-directional time resolved velocity data (3D + time = 4D flow data) from which visualization and quantification of blood flow patterns over the complete cardiac cycle can be performed. Four functional blood flow components have previously been defined based on the blood route and distribution through the ventricle, where the inflowing blood that passes directly to the outflow is called Direct flow. From these components, various quantitative measures can be derived, such as component volumes and kinetic energy (KE) throughout the cardiac cycle. In addition, the 4D flow technique has the ability to quantify and visualize turbulent flow with increased velocity fluctuations in the heart and vessels, turbulent kinetic energy (TKE). The technique has been developed and evaluated for assessment of left ventricular (LV) blood flow in healthy subjects and in patients with dilated dysfunctional left ventricles, showing significant changes in blood flow patterns and energetics with disease. There is however still no study addressing the gap in the spectrum from the healthy cohorts to patients with moderate to severe left ventricular remodeling. In Paper III, 4D flow CMR was utilized to assess LV blood flow in patients with subtle LV dysfunction, and a shift in blood flow component volumes and KE was seen from the Direct flow to the non-ejecting blood flow components. In patients with both left- and right-sided acquired and congenital heart disease, right ventricular (RV) function is of great prognostic significance, however this ventricle has historically been somewhat overseen. With its complex geometry, advanced physiology and retrosternal location, assessment of the RV is still challenging and the right ventricular blood flow is still incompletely described. In Paper I, the RV blood flow in healthy subjects was assessed, and the proportionally larger Direct flow component was located in the most basal region of the ventricle and possessed higher levels of KE at end-diastole than the other flow components suggesting that this portion of blood was prepared for efficient systolic ejection. In Paper II, the blood flow was assessed in the RV of patients with subtle primary LV disease, and even if conventional echocardiographic or CMR RV parameters did not show any RV dysfunction, alterations of flow patterns suggestive of RV impairment were found in the patients with the more remodeled LVs. With improvements of the cardiovascular health care, including the surgical techniques, the number of adult patients with surgically corrected complex congenital heart diseases increases, one of which is tetralogy of Fallot (ToF). Surgical repair of ToF involves widening of the pulmonary stenosis, which postoperatively may cause pulmonary insufficiency and regurgitation (PR). Disturbed or turbulent flow patterns are rare in the healthy cardiovascular system. With pathological changes, such as valvular insufficiency, increased amounts of TKE have been demonstrated. Turbulence is known to be harmful to organic tissues and could be significant in the development of ventricular remodeling, such as dilation and other complications seen in Fallot patients. In Paper IV, the RV intraventricular TKE levels were assessed in relation to conventional measures of PR. Results showed that RV TKE was increased in ToF patients with PR compared to healthy controls, and that these 4D flow-specific measures related slightly stronger to indices of RV remodeling than the conventional measures of PR. 4D flow CMR analysis of the intracardiac blood flow has the potential of adding to pathophysiological understanding, and thereby provide useful diagnostic information and contribute to optimization of treatment of heart disease at earlier stages before irreversible and clinically noticeable changes occur. The flow specific measures used in this thesis could be utilized to detect these alterations of intracardiac blood flow and could thus act as potential markers of progressing ventricular dysfunction, pathological remodeling or used for risk stratification in adults with early repair tetralogy of Fallot. Visualizations of intracardiac flow patterns could provide useful information to cardiac/thoracic surgeons pre- and post-operatively.
Author: David C. Warltier
Publisher: Lippincott Williams & Wilkins
ISBN:
Category : Medical
Languages : en
Pages : 404
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Book Description
Author: Forrest H. Adams
Publisher: Univ of California Press
ISBN: 9780520016309
Category : Medical
Languages : en
Pages : 464
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Book Description
Author: Robert. E Shaddy
Publisher: Springer Science & Business Media
ISBN: 1849964807
Category : Medical
Languages : en
Pages : 182
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Book Description
This book will provide both an evidence base and practical recommendations for the treatment of patients with congenital heart disease. It will be a resource to all health care providers, including pediatric cardiologists, pediatric intensivists, pediatric heart surgeons, fetal specialists, maternal fetal medicine specialists, neonatologists, nurses, advanced practice nurses, in addition to trainees in the field. It will summarize world knowledge on the topic of heart failure in patients with congenital heart disease. It will provide an in depth analysis of the current methods of diagnosis and treatment of heart failure. Now that surgical results are at record success rates, more patients with congenital heart disease are surviving, and thus at risk for sequelae from their disease, including heart failure. It will provide evidence based and practical recommendations to the practitioner for the management of heart failure signs and symptoms.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030915698X
Category : Medical
Languages : en
Pages : 304
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Book Description
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
Author: Andrew N. Redington
Publisher: Springer Science & Business Media
ISBN: 1848003781
Category : Medical
Languages : en
Pages : 321
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Book Description
'Congenital Heart Disease in the Right Heart' is an exhaustive review of the malformations of the right ventricle with particular emphasis on the ability of the ventricle to support circulation and the results of right heart malformations on circulation. Edited by the world’s foremost authorities on the subject, the book benefits from an international team of contributors.
Author: Wyman W. Lai
Publisher: John Wiley & Sons
ISBN: 1118337255
Category : Medical
Languages : en
Pages : 1618
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Book Description
Echocardiography is essential in the practice of pediatric cardiology. A clinical pediatric cardiologist is expected to be adept at the non-invasive diagnosis of congenital heart disease and those who plan to specialize in echocardiography will need to have knowledge of advanced techniques. Echocardiography in Pediatric and Congenital Heart Disease addresses the needs of trainees and practitioners in this field, filling a void caused by the lack of material in this fast-growing area. This new title comprehensively covers the echocardiographic assessment of congenital heart disease, from the fetus to the adult, plus acquired heart disease in children. Topics covered include: ultrasound physics laboratory set-up a protocol for a standard pediatric echocardiogram quantitative methods of echocardiographic evaluation, including assessment of diastolic function in depth coverage of congenital cardiovascular malformations acquired pediatric heart disease topics of special interest, such as 3D echocardiography, transesophageal echocardiography, and fetal echocardiography The approach of this book is a major advancement for educational materials in the field of pediatric cardiology, and greatly enhances the experience for the reader. An accompanying DVD with moving images of the subjects covered in the textbook will further enhance the learning experience.
Author: P. Syamasundar Rao
Publisher: BoD – Books on Demand
ISBN: 9533074728
Category : Medical
Languages : en
Pages : 368
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Book Description
There are significant advances in the understanding of the molecular mechanisms of cardiac development and the etiology of congenital heart disease (CHD). However, these have not yet evolved to such a degree so as to be useful in preventing CHD at this time. Developments such as early detection of the neonates with serious heart disease and their rapid transport to tertiary care centers, availability of highly sensitive noninvasive diagnostic tools, advances in neonatal care and anesthesia, progress in transcatheter interventional procedures and extension of complicated surgical procedures to the neonate and infant have advanced to such a degree that almost all congenital cardiac defects can be diagnosed and "corrected". Treatment of the majority of acyanotic and simpler cyanotic heart defects with currently available transcatheter and surgical techniques is feasible, effective and safe. The application of staged total cavo-pulmonary connection (Fontan) has markedly improved the long-term outlook of children who have one functioning ventricle. This book, I hope, will serve as a rich source of information to the physician caring for infants, children and adults with CHD which may help them provide optimal care for their patients.
Author: Alexandru Grigorescu Fredriksson
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
The spectrum of cardiovascular diseases is the leading cause of morbidity and mortality globally. Early assessment and treatment of these conditions, acquired as well as congenital, is therefore of paramount importance. The human heart has a great ability to adapt to various hemodynamic conditions by cardiac remodeling. Pathologic cardiac remodeling can occur as a result of cardiovascular disease in an effort to maintain satisfactory cardiac function. With time, cardiac function diminishes leading to disease progression and subsequent heart failure, the end-point of many heart diseases, associated with very poor prognosis. Within the normal cardiac ventricles blood flows in highly organized patterns, and changes in cardiac configuration or function will affect these flow patterns. Conversely, altered flows and pressures can bring about cardiac remodeling. In congenital heart disease, even after corrective surgery, cardiac anatomy and thereby intracardiac blood flow patterns are inherently altered. The clinically most available imaging technique, ultrasound with Doppler, allows only for one-directional flow assessment and is limited by the need of clear examination windows, thus failing to fully assess the complex three-dimensional blood flow within the beating heart. Cardiovascular magnetic resonance imaging (CMR) with phase-contrast has the ability to acquire three-dimensional (3D), three-directional time resolved velocity data (3D + time = 4D flow data) from which visualization and quantification of blood flow patterns over the complete cardiac cycle can be performed. Four functional blood flow components have previously been defined based on the blood route and distribution through the ventricle, where the inflowing blood that passes directly to the outflow is called Direct flow . From these components, various quantitative measures can be derived, such as component volumes and kinetic energy (KE) throughout the cardiac cycle. In addition, the 4D flow technique has the ability to quantify and visualize turbulent flow with increased velocity fluctuations in the heart and vessels, turbulent kinetic energy (TKE). The technique has been developed and evaluated for assessment of left ventricular (LV) blood flow in healthy subjects and in patients with dilated dysfunctional left ventricles, showing significant changes in blood flow patterns and energetics with disease. There is however still no study addressing the gap in the spectrum from the healthy cohorts to patients with moderate to severe left ventricular remodeling. In Paper III , 4D flow CMR was utilized to assess LV blood flow in patients with subtle LV dysfunction, and a shift in blood flow component volumes and KE was seen from the Direct flow to the non-ejecting blood flow components. In patients with both left- and right-sided acquired and congenital heart disease, right ventricular (RV) function is of great prognostic significance, however this ventricle has historically been somewhat overseen. With its complex geometry, advanced physiology and retrosternal location, assessment of the RV is still challenging and the right ventricular blood flow is still incompletely described. In Paper I , the RV blood flow in healthy subjects was assessed, and the proportionally larger Direct flow component was located in the most basal region of the ventricle and possessed higher levels of KE at end-diastole than the other flow components suggesting that this portion of blood was prepared for efficient systolic ejection. In Paper II , the blood flow was assessed in the RV of patients with subtle primary LV disease, and even if conventional echocardiographic or CMR RV parameters did not show any RV dysfunction, alterations of flow patterns suggestive of RV impairment were found in the patients with the more remodeled LVs. With improvements of the cardiovascular health care, including the surgical techniques, the number of adult patients with surgically corrected complex congenital heart diseases increases, one of which is tetralogy of Fallot (ToF). Surgical repair of ToF involves widening of the pulmonary stenosis, which postoperatively may cause pulmonary insufficiency and regurgitation (PR). Disturbed or turbulent flow patterns are rare in the healthy cardiovascular system. With pathological changes, such as valvular insufficiency, increased amounts of TKE have been demonstrated. Turbulence is known to be harmful to organic tissues and could be significant in the development of ventricular remodeling, such as dilation and other complications seen in Fallot patients. In Paper IV , the RV intraventricular TKE levels were assessed in relation to conventional measures of PR. Results showed that RV TKE was increased in ToF patients with PR compared to healthy controls, and that these 4D flow-specific measures related slightly stronger to indices of RV remodeling than the conventional measures of PR. 4D flow CMR analysis of the intracardiac blood flow has the potential of adding to pathophysiological understanding, and thereby provide useful diagnostic information and contribute to optimization of treatment of heart disease at earlier stages before irreversible and clinically noticeable changes occur. The flow specific measures used in this thesis could be utilized to detect these alterations of intracardiac blood flow and could thus act as potential markers of progressing ventricular dysfunction, pathological remodeling or used for risk stratification in adults with early repair tetralogy of Fallot. Visualizations of intracardiac flow patterns could provide useful information to cardiac/thoracic surgeons pre- and post-operatively.
