Stine Sundgaard Langaa, Camilla Lundgreen Duus, Marie Houmaa Vrist, Frank Holden Mose, Claire Anne Fynbo, Jørn Theil, June Anita Ejlersen, Jesper Nørgaard Bech
Background
Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal 82Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([99mTc]Tc-MAG3) clearance as a first attempt to validate 82Rb PET/CT for renal perfusion estimation using a reference method.
Methods
Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a 82Rb PET/CT scan and a [99mTc]Tc-MAG3 clearance study.
Results
82Rb clearance correlated positively with [99mTc]Tc-MAG3 clearance in both treatment periods. The [99mTc]Tc-MAG3-to-82Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively.
Conclusion
The correlation between 82Rb clearance and [99mTc]Tc-MAG3 clearance may indicate that PET/CT determined 82Rb clearance can act as an estimator of renal perfusion. The [99mTc]Tc-MAG3-to-82Rb clearance ratios suggest that the extraction fraction of 82Rb is higher than that of [99mTc]Tc-MAG3, further suggesting 82Rb clearance as an estimator of flow. However, further studies are warranted to validate use of 82Rb PET/CT for flow estimation.
{"title":"Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique","authors":"Stine Sundgaard Langaa, Camilla Lundgreen Duus, Marie Houmaa Vrist, Frank Holden Mose, Claire Anne Fynbo, Jørn Theil, June Anita Ejlersen, Jesper Nørgaard Bech","doi":"10.1111/cpf.70000","DOIUrl":"https://doi.org/10.1111/cpf.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (<sup>82</sup>Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal <sup>82</sup>Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([<sup>99m</sup>Tc]Tc-MAG3) clearance as a first attempt to validate <sup>82</sup>Rb PET/CT for renal perfusion estimation using a reference method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a <sup>82</sup>Rb PET/CT scan and a [<sup>99m</sup>Tc]Tc-MAG3 clearance study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><sup>82</sup>Rb clearance correlated positively with [<sup>99m</sup>Tc]Tc-MAG3 clearance in both treatment periods. The [<sup>99m</sup>Tc]Tc-MAG3-to-<sup>82</sup>Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The correlation between <sup>82</sup>Rb clearance and [<sup>99m</sup>Tc]Tc-MAG3 clearance may indicate that PET/CT determined <sup>82</sup>Rb clearance can act as an estimator of renal perfusion. The [<sup>99m</sup>Tc]Tc-MAG3-to-<sup>82</sup>Rb clearance ratios suggest that the extraction fraction of <sup>82</sup>Rb is higher than that of [<sup>99m</sup>Tc]Tc-MAG3, further suggesting <sup>82</sup>Rb clearance as an estimator of flow. However, further studies are warranted to validate use of <sup>82</sup>Rb PET/CT for flow estimation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milan Mohammad, Rie S. Thomsen, Iben E. Rasmussen, Amalie B. Andersen, Jacob P. Hartmann, Ronan M. G. Berg
Background
Cardiopulmonary exercise testing (CPET) is usually considered the gold standard for assessing maximal oxygen consumption (V̇O2max), a health and performance marker in patients with chronic obstructive pulmonary disease (COPD). Despite the widespread application of CPET, the absolute and relative test-retest reliability of CPET-derived metrics remains unexamined.
Objective
To examine and compare test-retest reliability of CPET derived metrics in individuals with COPD and healthy matched controls.
Methods
12 individuals with COPD and 12 healthy age- and sex-matched controls were included in this case-control study. Each participant completed two CPET on a bicycle ergometer on two different days. Absolute reliability was reported as smallest real difference (SRD) and relative reliability as coefficient of variance (CV) and intraclass correlation coefficients (ICC).
Main Results
SRD for peak oxygen uptake was 451.6 (267.4;1006.4) mL/min and CV was 7.8 (4.7;11.0)% in patients with COPD, whereas SRD was 244.2 (151.4;491.5) mL/min and CV was 3.0 (1.8;4.2)% in healthy controls but with no significant between group difference for SRD. CV values for all CPET derived metrics were found to be below 10%. Apart from peak workload achieved and peak minute ventilation, SRD and CV were significantly higher in COPD than in controls for all other CPET-derived metrics.
Conclusion
This study provides test-retest reliability estimates of the most widely used CPET derived metrics in individuals with COPD and healthy matched controls. Test-retest reliability for most metrics derived from CPET were found to be lower in individuals with COPD when compared to healthy controls.
{"title":"Test-retest reliability of cardiopulmonary exercise test-derived metrics in individuals with COPD versus healthy controls","authors":"Milan Mohammad, Rie S. Thomsen, Iben E. Rasmussen, Amalie B. Andersen, Jacob P. Hartmann, Ronan M. G. Berg","doi":"10.1111/cpf.12927","DOIUrl":"10.1111/cpf.12927","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiopulmonary exercise testing (CPET) is usually considered the gold standard for assessing maximal oxygen consumption (V̇O<sub>2max</sub>), a health and performance marker in patients with chronic obstructive pulmonary disease (COPD). Despite the widespread application of CPET, the absolute and relative test-retest reliability of CPET-derived metrics remains unexamined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine and compare test-retest reliability of CPET derived metrics in individuals with COPD and healthy matched controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>12 individuals with COPD and 12 healthy age- and sex-matched controls were included in this case-control study. Each participant completed two CPET on a bicycle ergometer on two different days. Absolute reliability was reported as smallest real difference (SRD) and relative reliability as coefficient of variance (CV) and intraclass correlation coefficients (ICC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>SRD for peak oxygen uptake was 451.6 (267.4;1006.4) mL/min and CV was 7.8 (4.7;11.0)% in patients with COPD, whereas SRD was 244.2 (151.4;491.5) mL/min and CV was 3.0 (1.8;4.2)% in healthy controls but with no significant between group difference for SRD. CV values for all CPET derived metrics were found to be below 10%. Apart from peak workload achieved and peak minute ventilation, SRD and CV were significantly higher in COPD than in controls for all other CPET-derived metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides test-retest reliability estimates of the most widely used CPET derived metrics in individuals with COPD and healthy matched controls. Test-retest reliability for most metrics derived from CPET were found to be lower in individuals with COPD when compared to healthy controls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fuat Yuksel, Nevin Guzel, Ömer Burak Tor, Koray Akkan
Background
Optimizing hamstring exercises is crucial for injury prevention and performance. This study explored the effects of blood flow restriction (BFR) during Nordic hamstring exercises (NHE) on hamstring muscle activation and vascular function.
Methods
A randomized, single-blind study included 14 healthy, physically active males (mean age: 27.5 years). Each participant's lower extremities were randomly assigned to BFR or control groups. In the BFR group, blood flow was restricted to 60% of arterial occlusion pressure. Participants performed three sets of five NHE repetitions. Endothelial function was assessed by flow-mediated dilation (FMD) via Doppler ultrasound before and after exercise. Surface electromyography (EMG) recorded neuromuscular activation of the semitendinosus (ST) and biceps femoris (BF) muscles during exercises.
Results
FMD values showed no significant differences between BFR and control groups (F(1,13) = 0.156, p = 0.7, partial η² = 0.012). Neuromuscular activations of ST and BF muscles decreased across sets in both groups but did not differ significantly between groups (ST: F(2,26) = 1.172, p = 0.448, partial η² = 0.09; BF: F(2,26) = 1.442, p = 0.527, partial η² = 0.1).
Conclusions
BFR did not produce acute additional effects on muscle activation or endothelial function compared to standard NHE. This suggests that incorporating BFR in NHE may not enhance immediate neuromuscular or vascular responses. Further research is needed to evaluate its long-term benefits.
{"title":"Blood flow restriction combined with nordic hamstring exercise does not impair endothelial function but does not increase neuromuscular activation","authors":"Fuat Yuksel, Nevin Guzel, Ömer Burak Tor, Koray Akkan","doi":"10.1111/cpf.12926","DOIUrl":"https://doi.org/10.1111/cpf.12926","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Optimizing hamstring exercises is crucial for injury prevention and performance. This study explored the effects of blood flow restriction (BFR) during Nordic hamstring exercises (NHE) on hamstring muscle activation and vascular function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized, single-blind study included 14 healthy, physically active males (mean age: 27.5 years). Each participant's lower extremities were randomly assigned to BFR or control groups. In the BFR group, blood flow was restricted to 60% of arterial occlusion pressure. Participants performed three sets of five NHE repetitions. Endothelial function was assessed by flow-mediated dilation (FMD) via Doppler ultrasound before and after exercise. Surface electromyography (EMG) recorded neuromuscular activation of the semitendinosus (ST) and biceps femoris (BF) muscles during exercises.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FMD values showed no significant differences between BFR and control groups (F(1,13) = 0.156, <i>p</i> = 0.7, partial η² = 0.012). Neuromuscular activations of ST and BF muscles decreased across sets in both groups but did not differ significantly between groups (ST: F(2,26) = 1.172, <i>p</i> = 0.448, partial η² = 0.09; BF: F(2,26) = 1.442, <i>p</i> = 0.527, partial η² = 0.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BFR did not produce acute additional effects on muscle activation or endothelial function compared to standard NHE. This suggests that incorporating BFR in NHE may not enhance immediate neuromuscular or vascular responses. Further research is needed to evaluate its long-term benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delayed onset muscle soreness (DOMS) is a well-established phenomenon characterized by ultrastructural muscle damage that typically develops following unfamiliar or high-intensity exercise. DOMS manifests with a constellation of symptoms, including muscle tenderness, stiffness, edema, mechanical hyperalgesia, and a reduced range of joint motion. In recent years, the application of blood flow restriction (BFR) has garnered attention for its potential impact on DOMS.
Objective
This study aimed to investigate the effects of different BFR intensities on biomechanical alterations induced by DOMS in healthy individuals.
Design and Methods
Thirty participants were split into two groups receiving either 80% or 20% BFR applied during low-intensity resistance exercise following DOMS induction. Pain perception, pressure pain threshold, muscle biometric characteristics, and strength were assessed before DOMS, after DOMS, and following BFR application at 24, 48, and 72 h.
Results
The 80% BFR group experienced faster reductions in pain perception compared to the 20% BFR group. Muscle strength recovery was also statistically faster in the 80% BFR group. No significant differences were observed between groups in muscle stiffness, flexibility, or other mechanical properties.
Conclusions
These findings suggest that BFR, particularly at higher intensities, may alleviate DOMS symptoms and accelerate muscle strength recovery. However, the lack of a control group and limitations in muscle property assessment warrant further research to definitively determine BFR's efficacy in managing DOMS.
{"title":"Impact of blood flow restriction intensity on pain perception and muscle recovery post-eccentric exercise","authors":"Ozgur Surenkok, Gamze Aydin, Ebru Aloglu Ciftci, Kubra Kendal, Emine Atici","doi":"10.1111/cpf.12925","DOIUrl":"10.1111/cpf.12925","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Delayed onset muscle soreness (DOMS) is a well-established phenomenon characterized by ultrastructural muscle damage that typically develops following unfamiliar or high-intensity exercise. DOMS manifests with a constellation of symptoms, including muscle tenderness, stiffness, edema, mechanical hyperalgesia, and a reduced range of joint motion. In recent years, the application of blood flow restriction (BFR) has garnered attention for its potential impact on DOMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the effects of different BFR intensities on biomechanical alterations induced by DOMS in healthy individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Thirty participants were split into two groups receiving either 80% or 20% BFR applied during low-intensity resistance exercise following DOMS induction. Pain perception, pressure pain threshold, muscle biometric characteristics, and strength were assessed before DOMS, after DOMS, and following BFR application at 24, 48, and 72 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 80% BFR group experienced faster reductions in pain perception compared to the 20% BFR group. Muscle strength recovery was also statistically faster in the 80% BFR group. No significant differences were observed between groups in muscle stiffness, flexibility, or other mechanical properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that BFR, particularly at higher intensities, may alleviate DOMS symptoms and accelerate muscle strength recovery. However, the lack of a control group and limitations in muscle property assessment warrant further research to definitively determine BFR's efficacy in managing DOMS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laryngopharyngeal reflux (LPR) management guidelines are currently derived from the management of gastroesophageal reflux disease (GORD) which has been shown to be poorly effective in controlling symptoms for these patients. Erythromycin is a macrolide antibiotic that has been used extensively as a prokinetic agent for the gastrointestinal tract. The management of LPR with prokinetics is a novel therapy being investigated with regard to its effectiveness. The purpose of this pilot study was to observe the effect of erythromycin on oesophageal motility with high resolution manometry (HRM) to establish if further study is warranted regarding its utility in management.
Methods
Consecutive patients were retrospectively identified from a prospectively maintained database at a single centre of patients with findings suggestive of LPR who had also undergone HRM. These patients all received lifestyle modification and erythromycin 250 mg BD with repeat HRM after 6 weeks of therapy.
Results
16 patients met inclusion criteria. Mean age was 56.2 ± 14.9. Mean ineffective swallows were 54.38% ± 41.3% compared with 34.4% ± 35.2% pre and post-erythromycin therapy (p = 0.018). Mean distal contractile integral at baseline was 793.61 ± 854.96 mmHg at baseline increasing to 1347 ± 1094.73 mmHg after erythromycin therapy (p = 0.013). IRP also showed improvement from 8.99 ± 7.58 increasing to 10.93 ± 7.9 mmHg (p = 0.045). Subgroup analysis of patients with ineffective oesophageal motility reinforced above findings as well as increase in the amount of ‘normal’ peristalsis.
Conclusion
This pilot study shows early evidence that erythromycin improves oesophageal motility. Further study is warranted to explore these findings in more detail.
{"title":"Positive effect of erythromycin on ineffective oesophageal motility in laryngopharyngeal reflux patients: Room for a novel treatment?","authors":"Fienne Sime, David Tovmassian, Gregory L. Falk","doi":"10.1111/cpf.12924","DOIUrl":"10.1111/cpf.12924","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laryngopharyngeal reflux (LPR) management guidelines are currently derived from the management of gastroesophageal reflux disease (GORD) which has been shown to be poorly effective in controlling symptoms for these patients. Erythromycin is a macrolide antibiotic that has been used extensively as a prokinetic agent for the gastrointestinal tract. The management of LPR with prokinetics is a novel therapy being investigated with regard to its effectiveness. The purpose of this pilot study was to observe the effect of erythromycin on oesophageal motility with high resolution manometry (HRM) to establish if further study is warranted regarding its utility in management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients were retrospectively identified from a prospectively maintained database at a single centre of patients with findings suggestive of LPR who had also undergone HRM. These patients all received lifestyle modification and erythromycin 250 mg BD with repeat HRM after 6 weeks of therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>16 patients met inclusion criteria. Mean age was 56.2 ± 14.9. Mean ineffective swallows were 54.38% ± 41.3% compared with 34.4% ± 35.2% pre and post-erythromycin therapy (<i>p</i> = 0.018). Mean distal contractile integral at baseline was 793.61 ± 854.96 mmHg at baseline increasing to 1347 ± 1094.73 mmHg after erythromycin therapy (<i>p</i> = 0.013). IRP also showed improvement from 8.99 ± 7.58 increasing to 10.93 ± 7.9 mmHg (<i>p</i> = 0.045). Subgroup analysis of patients with ineffective oesophageal motility reinforced above findings as well as increase in the amount of ‘normal’ peristalsis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study shows early evidence that erythromycin improves oesophageal motility. Further study is warranted to explore these findings in more detail.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.
Methods
A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [99mTc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.
Results
SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all p < 0.05). RIVs showed a significant negative correlation with injury duration (r = −0.57, p < 0.05), and a positive correlation with LVH (r = 0.43, p < 0.05). Multiple linear regression analysis confirmed that injury duration was an independent predictor of RIVs (p < 0.05).
Conclusion
SPECT/CT is useful for detecting and differentiating fresh fractures from old fractures in patients having OVCF who cannot undergo MRI after BPIT validation, allowing these patients to achieve excellent clinical outcomes following PVP. The RIV serves as a valuable parameter for assessing the duration of fresh versus old OVCFs.
目的：本研究的目的是评估单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）在MRI禁忌症患者疑似新鲜骨质疏松性椎体压缩性骨折（OVCFs）病例中检测和定位病因椎体的有效性。方法：通过x线片和腰痛诱发试验（BPIT）初步确定21例重度腰痛患者，31个疑似OVCF节段，MRI禁忌症。经皮椎体成形术（PVP）前使用[99mTc]MDP SPECT/CT确定责任椎体。临床结果和影像学参数，包括基本人口统计学、损伤持续时间、局灶性后凸（FK）、椎体高度损失（LVH）以及靶节段和非靶节段在SPECT/CT上的相对强度值（RIVs）。结果：SPECT/CT检出14例旧OVCFs， 26例新OVCFs。其中，18例26个新鲜OVCF节段患者接受了PVP治疗，并取得了满意的结果。新旧OCVF组RIV、FK、LVH值差异均有统计学意义（p < 0.05）。RIVs与损伤持续时间呈显著负相关（r = -0.57, p < 0.05），与LVH呈正相关（r = 0.43, p < 0.05）。多元线性回归分析证实，损伤时间是RIVs的独立预测因子（p < 0.05）。结论：对于BPIT验证后无法接受MRI的OVCF患者，SPECT/CT可用于检测和区分新骨折和旧骨折，使这些患者在PVP后获得良好的临床结果。RIV是评估新鲜OVCFs与旧OVCFs持续时间的一个有价值的参数。试验注册：ChiCTR， ChiCTR 2300077570。追溯登记，http://www.chictr.org.cn/showproj.html?proj=206192。
{"title":"The value of semiquantitative analysis of [99mTc]MDP SPECT/CT in localizing responsible lesions for suspected fresh osteoporotic vertebral compression fractures in patients with contraindications to MRI","authors":"Sheng Shi, Hai-Dong Cai, Gai-Xia Lu, Li-Guo Zhang, Shuang Zheng, Shi-Sheng He","doi":"10.1111/cpf.12923","DOIUrl":"10.1111/cpf.12923","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [<sup>99m</sup>Tc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all <i>p</i> < 0.05). RIVs showed a significant negative correlation with injury duration (r = −0.57, <i>p</i> < 0.05), and a positive correlation with LVH (r = 0.43, <i>p</i> < 0.05). Multiple linear regression analysis confirmed that injury duration was an independent predictor of RIVs (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SPECT/CT is useful for detecting and differentiating fresh fractures from old fractures in patients having OVCF who cannot undergo MRI after BPIT validation, allowing these patients to achieve excellent clinical outcomes following PVP. The RIV serves as a valuable parameter for assessing the duration of fresh versus old OVCFs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ChiCTR, ChiCTR 2300077570. Retrospectively registered, http://www.chictr.org.cn/showproj.html?proj=206192.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehmet Adam, Ali Osman Gündoğan, Ali Tezcan, Refik Oltulu, Selman Belviranlı, Enver Mirza, Mehmet Okka
The pupillary light reflex could serve as a valuable method for measuring dynamic responses in the autonomic nervous system (ANS). However, it remains unclear whether physiological conditions such as fasting and dehydration affect pupillary reflexes. In this study, we investigated the effects of fasting and dehydration on pupillary responses using pupillometry. Measurements were taken after at least 12 h of Ramadan fasting (RF) and under a normal dietary pattern (NDP). Forty-nine volunteers, who had no complaints related to the ANS, participated in the study. The initial pupil diameter (IPD), amplitude of contraction, contraction velocity, contraction latency, dilatation duration, and dilation velocity were recorded. The IPD was 5.91 ± 0.65 mm in the RF condition and 5.72 ± 0.65 mm in the NDP condition (p < 0.001). Both contraction amplitude (CA) and dilatation velocity (DV) were higher in the RF condition (p = 0.010 and p = 0.022, respectively). Females exhibited a greater IPD in the NDP condition (p = 0.023). Differences between genders in the RF condition were observed in CA (p = 0.002), dilation duration (p = 0.016) and dilation latency (p = 0.041). These findings indicate that fasting and dehydration influence IPD, CA and DV. Therefore, it is informative to consider fasting and dehydration status when evaluating pupillometry results.
瞳孔光反射是测量自主神经系统动态反应的一种有价值的方法。然而，目前尚不清楚是否生理条件，如禁食和脱水影响瞳孔反射。在这项研究中，我们用瞳孔测量法研究了禁食和脱水对瞳孔反应的影响。在斋月禁食（RF）至少12小时后，在正常饮食模式（NDP）下进行测量。49名志愿者参加了这项研究，他们没有对ANS有任何抱怨。记录初始瞳孔直径（IPD）、收缩幅度、收缩速度、收缩潜伏期、扩张持续时间和扩张速度。RF组IPD为5.91±0.65 mm， NDP组为5.72±0.65 mm （p < 0.05）
{"title":"The effects of fasting and dehydration on pupillary light reflex as detected by pupillometry","authors":"Mehmet Adam, Ali Osman Gündoğan, Ali Tezcan, Refik Oltulu, Selman Belviranlı, Enver Mirza, Mehmet Okka","doi":"10.1111/cpf.12921","DOIUrl":"10.1111/cpf.12921","url":null,"abstract":"<p>The pupillary light reflex could serve as a valuable method for measuring dynamic responses in the autonomic nervous system (ANS). However, it remains unclear whether physiological conditions such as fasting and dehydration affect pupillary reflexes. In this study, we investigated the effects of fasting and dehydration on pupillary responses using pupillometry. Measurements were taken after at least 12 h of Ramadan fasting (RF) and under a normal dietary pattern (NDP). Forty-nine volunteers, who had no complaints related to the ANS, participated in the study. The initial pupil diameter (IPD), amplitude of contraction, contraction velocity, contraction latency, dilatation duration, and dilation velocity were recorded. The IPD was 5.91 ± 0.65 mm in the RF condition and 5.72 ± 0.65 mm in the NDP condition (<i>p</i> < 0.001). Both contraction amplitude (CA) and dilatation velocity (DV) were higher in the RF condition (<i>p</i> = 0.010 and <i>p</i> = 0.022, respectively). Females exhibited a greater IPD in the NDP condition (<i>p</i> = 0.023). Differences between genders in the RF condition were observed in CA (<i>p</i> = 0.002), dilation duration (<i>p</i> = 0.016) and dilation latency (<i>p</i> = 0.041). These findings indicate that fasting and dehydration influence IPD, CA and DV. Therefore, it is informative to consider fasting and dehydration status when evaluating pupillometry results.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study examined the relationships between trunk tissue distribution, metabolic risk factors, and physical performance in young Japanese individuals using cross-sectional and longitudinal analyses. Thirty-six healthy Japanese men (n = 20, body mass index [BMI]: 20.8 ± 2.0 kg/m2) and women (n = 16, BMI: 19.6 ± 2.0 kg/m2) aged 20–26 years old visited our laboratory twice with an interval of 1 year. The thicknesses of skeletal muscle (MT), subcutaneous adipose tissue (SCAT), and the intra-abdominal cavity (IAT) were assessed by ultrasound imaging and adjusted by body mass1/3 (BM1/3). Blood properties related to hepatic function or metabolic syndrome, brachial-ankle pulse wave velocity, hand grip strength, two-step-length/height scores, and sit-and-reach test scores were also measured. As a result of the cross-sectional analysis, significant relationships were observed between SCAT/BM1/3 and indices of glucose metabolism (HOMA-IR and QUICKI) in men (r = 0.513 and -0.583), and between IAT/BM1/3 and fasting blood glucose in women (r = 0.524). Longitudinal analyses of women showed that changes (%) in IAT and MT/IAT correlated with % changes in the indices of hepatic function (AST) and glucose metabolism (HOMA-IR and HOMA-β) (r = −0.673 to 0.686). Significant correlations were also observed between MT/IAT and walking ability (two-step-length/height) in cross-sectional and longitudinal analyses of men (r = 0.463 and 0.525). In conclusion, the trunk tissue distribution could be used to detect the early symptoms of metabolic risks and declines in physical performance in young men and women.
{"title":"Relationships between trunk tissue distribution, metabolic risk factors and physical performance in young people—A pilot study","authors":"Noriko Ishiguro-Tanaka, Funa Kitagawa, Hiroshi Akima","doi":"10.1111/cpf.12922","DOIUrl":"10.1111/cpf.12922","url":null,"abstract":"<p>The present study examined the relationships between trunk tissue distribution, metabolic risk factors, and physical performance in young Japanese individuals using cross-sectional and longitudinal analyses. Thirty-six healthy Japanese men (<i>n</i> = 20, body mass index [BMI]: 20.8 ± 2.0 kg/m<sup>2</sup>) and women (<i>n</i> = 16, BMI: 19.6 ± 2.0 kg/m<sup>2</sup>) aged 20–26 years old visited our laboratory twice with an interval of 1 year. The thicknesses of skeletal muscle (MT), subcutaneous adipose tissue (SCAT), and the intra-abdominal cavity (IAT) were assessed by ultrasound imaging and adjusted by body mass<sup>1/3</sup> (BM<sup>1/3</sup>). Blood properties related to hepatic function or metabolic syndrome, brachial-ankle pulse wave velocity, hand grip strength, two-step-length/height scores, and sit-and-reach test scores were also measured. As a result of the cross-sectional analysis, significant relationships were observed between SCAT/BM<sup>1/3</sup> and indices of glucose metabolism (HOMA-IR and QUICKI) in men (<i>r</i> = 0.513 and -0.583), and between IAT/BM<sup>1/3</sup> and fasting blood glucose in women (<i>r</i> = 0.524). Longitudinal analyses of women showed that changes (%) in IAT and MT/IAT correlated with % changes in the indices of hepatic function (AST) and glucose metabolism (HOMA-IR and HOMA-β) (<i>r</i> = −0.673 to 0.686). Significant correlations were also observed between MT/IAT and walking ability (two-step-length/height) in cross-sectional and longitudinal analyses of men (<i>r</i> = 0.463 and 0.525). In conclusion, the trunk tissue distribution could be used to detect the early symptoms of metabolic risks and declines in physical performance in young men and women.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular disease progresses after menopause. Conventional risk factors, particularly diabetes, for atherosclerosis are well-established predictors of phenotypic arterial disease. The aim of this study is to assess the predictors of subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women.
Methods
This prospective study included 117 consecutive postmenopausal women (mean age 59 ± 7 years) referred from the outpatient Rheumatology Clinic of the University Clinical Centre of Kosovo, recruited between September 2021 and December 2022. Clinical, biochemical, carotid ultrasound and coronary CT angiography data were analysed. Subclinical atherosclerosis was diagnosed when plaque and/or carotid intima-media thickness >1.00 mm were present.
Results
Women who had subclinical atherosclerosis had higher erythrocyte sedimentation (p = 0.022), higher total cholesterol (p = 0.013), higher CAC score (p = 0.017), and higher prevalence of CAC > 100 HU and CAC > 400 HU (p = 0.017 and p = 0.034, respectively) compared to those without subclinical atherosclerosis. Women who had mild coronary calcification (CAC score ≥10 HU) were older (p = 0.005), in longer menopause (p = 0.005), had thicker CIMT (p = 0.008) with higher prevalence (p = 0.03) compared to those with CAC score <10 HU. Women with moderate coronary calcification (CAC score ≥100 HU) had higher triglycerides, worse CIMT (p = 0.005) with higher prevalence (p = 0.039) compared to those with CAC score <100 HU. In multivariate analysis [odds ratio 95% confidence interval], age [1.101 (1.032–1.174), p = 0.037] and cholesterol [2.020 (1.225–3.331), p = 0.006] independently predicted the presence of subclinical atherosclerosis.
Conclusions
In addition to the impact of age, hypercholesterolaemia is an important predictor of subclinical atherosclerosis in non-diabetic postmenopausal women.
{"title":"Predictors of subclinical atherosclerosis in asymptomatic healthy non-diabetic postmenopausal women","authors":"Jehona Ismaili, Pranvera Ibrahimi, Venera Berisha-Muharremi, Rona Karahoda, Mimoza Berbatovci-Ukimeraj, Nora Istrefi, Bujar Gjikolli, Arlind Batalli, Afrim Poniku, Shpend Elezi, Michael Y. Henein, Gani Bajraktari","doi":"10.1111/cpf.12920","DOIUrl":"10.1111/cpf.12920","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Cardiovascular disease progresses after menopause. Conventional risk factors, particularly diabetes, for atherosclerosis are well-established predictors of phenotypic arterial disease. The aim of this study is to assess the predictors of subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 117 consecutive postmenopausal women (mean age 59 ± 7 years) referred from the outpatient Rheumatology Clinic of the University Clinical Centre of Kosovo, recruited between September 2021 and December 2022. Clinical, biochemical, carotid ultrasound and coronary CT angiography data were analysed. Subclinical atherosclerosis was diagnosed when plaque and/or carotid intima-media thickness >1.00 mm were present.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women who had subclinical atherosclerosis had higher erythrocyte sedimentation (<i>p</i> = 0.022), higher total cholesterol (<i>p</i> = 0.013), higher CAC score (<i>p</i> = 0.017), and higher prevalence of CAC > 100 HU and CAC > 400 HU (<i>p</i> = 0.017 and <i>p</i> = 0.034, respectively) compared to those without subclinical atherosclerosis. Women who had mild coronary calcification (CAC score ≥10 HU) were older (<i>p</i> = 0.005), in longer menopause (<i>p</i> = 0.005), had thicker CIMT (<i>p</i> = 0.008) with higher prevalence (<i>p</i> = 0.03) compared to those with CAC score <10 HU. Women with moderate coronary calcification (CAC score ≥100 HU) had higher triglycerides, worse CIMT (<i>p</i> = 0.005) with higher prevalence (<i>p</i> = 0.039) compared to those with CAC score <100 HU. In multivariate analysis [odds ratio 95% confidence interval], age [1.101 (1.032–1.174), <i>p</i> = 0.037] and cholesterol [2.020 (1.225–3.331), <i>p</i> = 0.006] independently predicted the presence of subclinical atherosclerosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In addition to the impact of age, hypercholesterolaemia is an important predictor of subclinical atherosclerosis in non-diabetic postmenopausal women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Akil, J. Castaings, P. Thind, T. Åhlfeldt, M. Akhtar, A. T. Gonon, M. Quintana, K. Bouma
Background
In clinical routine, health care professionals with various levels of experience assess left ventricular ejection fraction (LVEF) by echocardiography. The aim was to investigate to what extent visual and Simpson's biplane assessment of LVEF, using two-dimensional (2D) transthoracic echocardiography (TTE), is affected by the evaluator's experience.
Methods
Ultrasound images of 140 patients were assessed, visually and with Simpson's biplane method, by six evaluators divided into three groups based on echocardiographic experience level (beginner, intermediate and expert). The evaluators were blinded to each other's LVEF assessments. Bland-Altman analyses (bias±SD) were performed to assess agreement. P-values < 0.05 with the performed paired t-test were considered statistically significant.
Results
Level of agreement in LVEF was good between evaluators within the expert group: visual = LVEFexpert 1 vs LVEFexpert 2: −0.4 ± 6.4 (p = 0.46); Simpson's biplane = LVEFexpert 1 vs LVEFexpert 2: 0.96 ± 7.0 (p = 0.11), somewhat lower within the intermediate group: visual = LVEFintermediate 1 vs LVEFintermediate 2: −1.2 ± 4.4 (p = 0.004); Simpson's biplane = LVEFintermediate 1 vs LVEF intermediate 2: −3.3 ± 5.0 (p < 0.001) and lowest for beginners: visual = LVEFbeginner 1 vs LVEFbeginner 2: 2.3 ± 9.8 (p = 0.007), Simpson's biplane = LVEFbeginner 1 vs LVEF beginner 2: −1.8 ± 8.7 (p = 0.02). The agreement between LVEFexpert and LVEFs by the two other groups was: visual = LVEFexpert vs LVEFbeginner: 1.5 ± 6.0 (p = 0.005); LVEFintermediate: −3.0 ± 4.4 (p < 0.001) and Simpson's biplane = LVEFexpert vs LVEFbeginner: 3.2 ± 6.3 (p < 0.001); LVEFintermediate: −2.2 ± 4.7 (p < 0.001).
Conclusions
The evaluator's level of experience affects visual and Simpson's biplane assessment of LVEF by 2D-TTE, with highest variability being among beginners. Furthermore, a second opinion is recommended when assessing reduced LVEF even for evaluators with intermediate and expert experience.
背景：在临床常规中，不同经验水平的医护人员通过超声心动图评估左室射血分数（LVEF）。目的是研究使用二维（2D）经胸超声心动图（TTE）对LVEF的视觉和辛普森双翼评估在多大程度上受到评估者经验的影响。方法：对140例患者的超声图像进行评估，采用辛普森双翼法，由6名评估者根据超声心动图经验水平分为3组（初级、中级和专家级）。评估者对彼此的LVEF评估是不知情的。采用Bland-Altman分析（偏倚±标准差）评估一致性。p值结果：专家组内评估者对LVEF的一致程度良好：视觉= LVEFexpert 1 vs LVEFexpert 2: -0.4±6.4 (p = 0.46)；辛普森氏双翼= LVEFexpert 1 vs LVEFexpert 2: 0.96±7.0 (p = 0.11)，中间组略低：目视= LVEFintermediate 1 vs LVEFintermediate 2: -1.2±4.4 (p = 0.004)；Simpson’s双翼= LVEF中级1 vs LVEF中级2:-3.3±5.0 (p = 0.007), Simpson’s双翼= LVEF初级1 vs LVEF初级2:-1.8±8.7 （p = 0.02）。LVEFexpert与其他两组LVEFs的一致性为：visual = LVEFexpert vs lvefbeginners: 1.5±6.0 (p = 0.005)；结论：评估者的经验水平影响2D-TTE对LVEF的视觉和Simpson双翼评估，在初学者中差异最大。此外，在评估降低的LVEF时，即使对于具有中级和专家经验的评估人员，也建议采用第二种意见。
{"title":"Impact of experience on visual and Simpson's biplane echocardiographic assessment of left ventricular ejection fraction","authors":"S. Akil, J. Castaings, P. Thind, T. Åhlfeldt, M. Akhtar, A. T. Gonon, M. Quintana, K. Bouma","doi":"10.1111/cpf.12918","DOIUrl":"10.1111/cpf.12918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In clinical routine, health care professionals with various levels of experience assess left ventricular ejection fraction (LVEF) by echocardiography. The aim was to investigate to what extent visual and Simpson's biplane assessment of LVEF, using two-dimensional (2D) transthoracic echocardiography (TTE), is affected by the evaluator's experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ultrasound images of 140 patients were assessed, visually and with Simpson's biplane method, by six evaluators divided into three groups based on echocardiographic experience level (beginner, intermediate and expert). The evaluators were blinded to each other's LVEF assessments. Bland-Altman analyses (bias±SD) were performed to assess agreement. <i>P</i>-values < 0.05 with the performed paired t-test were considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Level of agreement in LVEF was good between evaluators within the expert group: visual = LVEF<sub>expert 1</sub> vs LVEF<sub>expert 2</sub>: −0.4 ± 6.4 (<i>p</i> = 0.46); Simpson's biplane = LVEF<sub>expert 1</sub> vs LVEF<sub>expert 2</sub>: 0.96 ± 7.0 (<i>p</i> = 0.11), somewhat lower within the intermediate group: visual = LVEF<sub>intermediate 1</sub> vs LVEF<sub>intermediate 2</sub>: −1.2 ± 4.4 (<i>p</i> = 0.004); Simpson's biplane = LVEF<sub>intermediate 1</sub> vs LVEF <sub>intermediate 2</sub>: −3.3 ± 5.0 (<i>p</i> < 0.001) and lowest for beginners: visual = LVEF<sub>beginner 1</sub> vs LVEF<sub>beginner 2</sub>: 2.3 ± 9.8 (<i>p</i> = 0.007), Simpson's biplane = LVEF<sub>beginner 1</sub> vs LVEF beginner 2: −1.8 ± 8.7 (<i>p</i> = 0.02). The agreement between LVEF<sub>expert</sub> and LVEFs by the two other groups was: visual = LVEF<sub>expert</sub> vs LVEF<sub>beginner</sub>: 1.5 ± 6.0 (<i>p</i> = 0.005); LVEF<sub>intermediate</sub>: −3.0 ± 4.4 (<i>p</i> < 0.001) and Simpson's biplane = LVEF<sub>expert</sub> vs LVEF<sub>beginner</sub>: 3.2 ± 6.3 (<i>p</i> < 0.001); LVEF<sub>intermediate</sub>: −2.2 ± 4.7 (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The evaluator's level of experience affects visual and Simpson's biplane assessment of LVEF by 2D-TTE, with highest variability being among beginners. Furthermore, a second opinion is recommended when assessing reduced LVEF even for evaluators with intermediate and expert experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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