RepoMed (Medizinische Hochschule Hannover)
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Arterial attenuation in individualized computed tomography pulmonary angiography injection protocol adjusted based on the patient's body mass index.
Get PDFBackground: The aim of this study was to optimize computed tomography pulmonary angiography (CTPA) protocols with regard to improve vascular attenuation without increasing contrast media (CM) volumes. Therefore, we compared the standard CTPA protocol to an individualized contrast media injection protocols adjusted for the patient's body mass index (BMI). Materials and methods: Two groups of 295 patients with suspected pulmonary embolism (PE) have been receiving CTPA. Group 1 received a standard protocol without taking patient's BMI into account. Group 2 received a CTPA scan, where dose and flow rate of CM injections were adjusted for the patient's BMI. Images were retrospectively analyzed by drawing regions of interests in defined positions in the superior vena cava, descending aorta, the pulmonary main trunk as well as the left and right lower lobe arteries. Intravascular attenuation, contrast volumes, and flow rates were compared using unpaired t-tests. Furthermore, a qualitative image analysis was performed by two experienced readers blinded for the protocol used for image acquisition to evaluate the image quality and arterial attenuation. Results: Patient's BMI was similar in both the groups (27.5 ± 1.5 kg/m2 vs. 28.4 ± 2.1 kg/m2; P = 0.67). Contrast volumes were lower (54.2 ± 4.8 ml vs. 55 ml; P < 0.05), and flow rates (4.1 ± 0.3 ml/s vs. 3.5 ml/s; P < 0.05) were significantly higher in the individualized protocol. The qualitative image analysis yielded an agreement on diagnostic interpretability in the individualized and standard group of 49% and 51% (95% Wilson confidence interval for mean), respectively. Conclusion: An individualized CTPA protocol based on the patient's BMI reduced the contrast media volume and led to an increased pulmonary artery enhancement improving image quality, particularly in the evaluation of the peripheral pulmonary arteries. Thus, contrast media volumes in CTPA should be adjusted for the patient's BMI
Different mr-proANP-release in High Volume High Intensity Interval Exercise and Continuous Exercise Regimens with Matched Mean Intensity: a Cross-over Design Study
Get PDFObjectives: Prevalence and risk factors of arterial stiffness and diabetes can be improved through physical activity and exercise. Atrial natriuretic peptid (ANP) does impact vasodilation and lipid metabolism and thus is connected to both pathologies. To extend insights in ANP-release we measured mid regional-proANP (mr-proANP) in different exercise training protocols in rest and at cessation of exercise. We evaluated a high volume high intensity interval (HVHIT), high volume sprint interval training (HVSIT) and a continuous exercise (CE) regimen with matched mean intensity. Methods: Subjects completed HVHIT (30s interval/30s pause), HVSIT (6s interval /24s pause) and continuous exercise (CE) over 45 min, as well as an initial graded exercise test (GXT) to asses maximum power output (PmaxGXT). Intervals during HVHIT were set to 100% PmaxGXT, intervals during SIT were set to 250% PmaxGXT and load during CE was set to 50% PmaxGXT. HVHIT, HVSIT and CE sessions were initiated with a 10 min warm-up and concluded with a 10 min cool-down. Venous blood samples were drawn at rest and after cessation of exercise. Results: Δmr-proANP was significantly different (p=0.048; RM ANOVA) between the three different exercise regimens. Δmr-proANP during CE was 17.8 (±2.0) pmol*l-1, during HVHIT 22.5 (±4.5) pmol*l-1 and during SIT 24.5 (±7.8) pmol*l-1. [Δmr-proANP] was not correlated to absolute power during intervals, peak oxygen uptake or heartrate, but was significantly correlated to Δlactate. Conclusions: We conclude that high intensity exercise causes a higher ANP-release than CE. This can be caused by the recurrent shift from relaxing and stressing of the heart muscle, which is known to trigger ANP-release. Other factors are likely to contribute to ANP-releas
Entwicklung, Erprobung und Evaluation einer Checkliste zur Unterstützung Jugendlicher mit chronischen Erkrankungen während der Transition
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Low Ethanol Concentrations Promote Endothelial Progenitor Cell Capacity and Reparative Function
Get PDFBackground Endothelial progenitor cells (EPCs) are recruited to injured endothelium and contribute to its regeneration. There is evidence that moderate ethanol consumption prevents the development and progression of atherosclerosis in a variety of in vitro and in vivo models and increases the mobilization of progenitor cells. Furthermore, there are studies that identified ethanol at low concentration as a therapeutic tool to mobilize progenitor cells in peripheral blood. At the same time, the cell number of EPCs represents a close link to cardiovascular system constitution and function and contributes to cardiovascular risk. The aim of this study was to evaluate the effect of low dose ethanol on typical features of endothelial colony-forming cells (ECFCs), a proliferative subtype of EPCs. Methods and Results We tested whether ethanol impacts the functional abilities of ECFC (e.g., migration, tube formation, and proliferation) using in vitro assays, the intercommunication of ECFC by exploring cell surface molecules by flow cytometry, and the expression of (anti-)angiogenic molecules by ELISA. Low concentrations of ethanol concentration promoted migration, proliferation, and tubule formation of ECFC. The expression of the cell surface marker VE-cadherin, a protein which plays an important role in cell-cell interaction, was enhanced by ethanol, while (anti-)angiogenic molecule expression was not impacted. Conclusion Ethanol at moderate concentrations increases the angiogenic abilities of endothelial progenitor cells thus possibly contributing to vasoprotection
