Clinical Physiology and Functional Imaging最新文献_第4页

The patterns in urine excretion and transvascular fluid exchange in human subjects during intravenous fluid infusion: A quantitative analysis 静脉输液过程中人体尿液排泄和跨血管液体交换的模式：定量分析。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-05-16 DOI: 10.1111/cpf.12887

FitzRoy E. Curry, C. Charles Michel

Introduction

Investigations of responses of animals and humans to changes of plasma volume are usually reported as average responses of groups of individuals. This ignores considerable quantitative variation between individuals. We examined the hypothesis that individual responses follow a common temporal pattern with variations reflecting different parameters describing that pattern.

Methods

We illustrate this approach using data of Hahn, Lindahl and Drobin (Acta Anaesthesiol Scand.2011, 55:987-94) who measured urine volume and haemoglobin dilution of 10 female subjects during intravenous Ringer infusions for 30 min and subsequent 3.5 h. The published time courses were digitised and analysed to determine if a family of mathematical functions accounted for the variation in individual responses.

Results

Urine excretion was characterised by a time delay (Td) before urine flow increased and a time course of cumulative urine excretion described by a logarithmic function. This logarithmic relation forms the theoretical basis of a family of linear relations describing urine excretion as a function of Td. Measurement of Td enables estimation of subsequent values of urine excretion and thereby the fraction of infused fluid retained in the body.

Conclusion

The approach might be useful for physiologists and clinical investigators to compare the response to infusion protocols when both test and control responses can be described by linear relations between cumulative urine volume at specific times and Td. The approach may also be useful for clinicians by complementing strategies to guide fluid therapy by enabling the later responses of an individual to be predicted from their earlier response.

导言：有关动物和人类对血浆容量变化的反应的调查报告通常是以群体个体的平均反应为基础的。这忽略了个体之间相当大的数量差异。我们研究了一个假设，即个体反应遵循一个共同的时间模式，其变化反映了描述该模式的不同参数：我们使用 Hahn、Lindahl 和 Drobin（Acta Anaesthesiol Scand.2011，55:987-94）的数据说明了这种方法，他们测量了 10 名女性受试者在静脉注射林格液 30 分钟和随后 3.5 小时内的尿量和血红蛋白稀释情况：结果：尿液排泄的特点是尿流增加前的时间延迟（Td）和用对数函数描述的累积尿液排泄时间过程。这种对数关系构成了描述尿液排泄量与 Td 关系的一系列线性关系的理论基础。测量 Td 可以估算出随后的尿液排泄值，从而估算出输液在体内的留存率：当测试和对照组的反应都可以用特定时间的累积尿量与 Td 之间的线性关系来描述时，这种方法可能有助于生理学家和临床研究人员比较输液方案的反应。该方法还可用于临床医生，补充指导输液治疗的策略，从个体的早期反应预测其后期反应。

{"title":"The patterns in urine excretion and transvascular fluid exchange in human subjects during intravenous fluid infusion: A quantitative analysis","authors":"FitzRoy E. Curry, C. Charles Michel","doi":"10.1111/cpf.12887","DOIUrl":"10.1111/cpf.12887","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Investigations of responses of animals and humans to changes of plasma volume are usually reported as average responses of groups of individuals. This ignores considerable quantitative variation between individuals. We examined the hypothesis that individual responses follow a common temporal pattern with variations reflecting different parameters describing that pattern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We illustrate this approach using data of Hahn, Lindahl and Drobin (Acta Anaesthesiol Scand.2011, 55:987-94) who measured urine volume and haemoglobin dilution of 10 female subjects during intravenous Ringer infusions for 30 min and subsequent 3.5 h. The published time courses were digitised and analysed to determine if a family of mathematical functions accounted for the variation in individual responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Urine excretion was characterised by a time delay (Td) before urine flow increased and a time course of cumulative urine excretion described by a logarithmic function. This logarithmic relation forms the theoretical basis of a family of linear relations describing urine excretion as a function of Td. Measurement of Td enables estimation of subsequent values of urine excretion and thereby the fraction of infused fluid retained in the body.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The approach might be useful for physiologists and clinical investigators to compare the response to infusion protocols when both test and control responses can be described by linear relations between cumulative urine volume at specific times and Td. The approach may also be useful for clinicians by complementing strategies to guide fluid therapy by enabling the later responses of an individual to be predicted from their earlier response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"396-406"},"PeriodicalIF":1.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944173","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}

引用次数: 0

Normal baseline cardiac autonomic function and increased pupillary parasympathetic tone in patients with vasovagal syncope 血管迷走性晕厥患者的基线心脏自主神经功能正常，瞳孔副交感神经张力增强

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-28 DOI: 10.1111/cpf.12884

Udi Nussinovitch, Sapir Barak-Lanciano, Itay Shavit, Ishay Avivi, Ella Haber-Kaptsenel, Hagar Palacci, Chen Chaiat, Ronen Rubinshtein

It is controversial whether people with vasovagal syncope (VVS) have abnormal autonomic responses at baseline and whether specific diagnostic manoeuvres have a diagnostic value. We investigated whether the pupillary light reflex and cardiac autonomic tests can be used to identify autonomic dysfunction in volunteers with a medical history of VVS. The study groups included 128 healthy volunteers, of whom 31 reported a history of typical VVS. The right pupil was evaluated using an automated, commercial infra-red pupillometer under strict conditions. In addition to miosis and mydriasis kinetics, pupil diameters were measured. Heart rate variability at rest and heart rate changes to standing were quantified with high-resolution electrocardiography and designated software. The demographic and clinical characteristics of both groups were statistically similar. Average constriction velocity (ACV) was significantly higher in VVS patients following a univariate analysis (3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s, p = 0.042) and after correcting for potential confounders (p = 0.049). All other pupillometric and heart rate indices were comparable between groups. Patients with a history of VVS depict pupillary parasympathetic overactivity in response to light stimuli, manifested as increased ACV. The prognostic implications of this finding and the significance of using this simple clinical tool to identify patients who are at risk for developing frequent episodes of VVS or physical injuries following a syncope merits further study.

血管迷走性晕厥（VVS）患者在基线时是否会出现异常的自主神经反应，以及特定的诊断方法是否具有诊断价值，这些问题都存在争议。我们研究了瞳孔光反射和心脏自主神经测试是否可用于识别有血管迷走性晕厥病史的志愿者的自主神经功能障碍。研究小组包括 128 名健康志愿者，其中 31 人有典型的 VVS 病史。在严格的条件下，使用自动商用红外线瞳孔计对右侧瞳孔进行了评估。除了瞳孔缩小和瞳孔散大动力学外，还测量了瞳孔直径。使用高分辨率心电图和指定软件对静息时的心率变异性和站立时的心率变化进行了量化。两组患者的人口统计学和临床特征相似。经单变量分析（3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s，p = 0.042）和校正潜在混杂因素（p = 0.049）后，VVS 患者的平均收缩速度（ACV）明显更高。所有其他瞳孔测量指数和心率指数在各组之间具有可比性。有 VVS 病史的患者对光刺激的反应表现为瞳孔副交感神经过度活跃，表现为 ACV 增加。这一发现对预后的影响以及使用这一简单的临床工具来识别晕厥后有可能频繁发生 VVS 或身体损伤的患者的意义值得进一步研究。

{"title":"Normal baseline cardiac autonomic function and increased pupillary parasympathetic tone in patients with vasovagal syncope","authors":"Udi Nussinovitch, Sapir Barak-Lanciano, Itay Shavit, Ishay Avivi, Ella Haber-Kaptsenel, Hagar Palacci, Chen Chaiat, Ronen Rubinshtein","doi":"10.1111/cpf.12884","DOIUrl":"10.1111/cpf.12884","url":null,"abstract":"<p>It is controversial whether people with vasovagal syncope (VVS) have abnormal autonomic responses at baseline and whether specific diagnostic manoeuvres have a diagnostic value. We investigated whether the pupillary light reflex and cardiac autonomic tests can be used to identify autonomic dysfunction in volunteers with a medical history of VVS. The study groups included 128 healthy volunteers, of whom 31 reported a history of typical VVS. The right pupil was evaluated using an automated, commercial infra-red pupillometer under strict conditions. In addition to miosis and mydriasis kinetics, pupil diameters were measured. Heart rate variability at rest and heart rate changes to standing were quantified with high-resolution electrocardiography and designated software. The demographic and clinical characteristics of both groups were statistically similar. Average constriction velocity (ACV) was significantly higher in VVS patients following a univariate analysis (3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s, <i>p</i> = 0.042) and after correcting for potential confounders (<i>p</i> = 0.049). All other pupillometric and heart rate indices were comparable between groups. Patients with a history of VVS depict pupillary parasympathetic overactivity in response to light stimuli, manifested as increased ACV. The prognostic implications of this finding and the significance of using this simple clinical tool to identify patients who are at risk for developing frequent episodes of VVS or physical injuries following a syncope merits further study.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"381-387"},"PeriodicalIF":1.3,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811302","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}

引用次数: 0

Peripheral quantitative computed tomography is a valid imaging technique for tracking changes in skeletal muscle cross-sectional area 外周定量计算机断层扫描是跟踪骨骼肌横截面积变化的有效成像技术。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-26 DOI: 10.1111/cpf.12885

Bradley A. Ruple, Christopher G. Vann, Casey L. Sexton, Shelby C. Osburn, Morgan A. Smith, Joshua S. Godwin, Petey W. Mumford, Matt S. Stock, Michael D. Roberts, Kaelin C. Young

Peripheral quantitative computed tomography (pQCT) has recently expanded to quantifying skeletal muscle, however its validity to determine muscle cross-sectional area (mCSA) compared to magnetic resonance imaging (MRI) is unknown. Eleven male participants (age: 22 ± 3 y) underwent pQCT and MRI dual-leg mid-thigh imaging before (PRE) and after (POST) 6 weeks of resistance training for quantification of mid-thigh mCSA and change in mCSA. mCSA agreement at both time points and absolute change in mCSA across time was assessed using Bland-Altman plots for mean bias and 95% limits of agreement (LOA), as well as Lin's concordance correlation coefficients (CCC). Both pQCT and MRI mCSA increased following 6 weeks of resistance training (∆mCSA_pQCT: 6.7 ± 5.4 cm², p < 0.001; ∆mCSA_MRI: 6.0 ± 6.4 cm², p < 0.001). Importantly, the change in mCSA was not different between methods (p = 0.39). Bland-Altman analysis revealed a small mean bias (1.10 cm², LOA: −6.09, 8.29 cm²) where pQCT tended to overestimate mCSA relative to MRI when comparing images at a single time point. Concordance between pQCT and MRI mCSA at PRE and POST was excellent yielding a CCC of 0.982. For detecting changes in mCSA, Bland-Altman analysis revealed excellent agreement between pQCT and MRI (mean bias: −0.73 cm², LOA: −8.37, 6.91 cm²). Finally, there was excellent concordance between pQCT and MRI mCSA change scores (CCC = 0.779). Relative to MRI, pQCT imaging is a valid technique for measuring both mid-thigh mCSA at a single time point and mCSA changes following a resistance training intervention.

外周定量计算机断层扫描（pQCT）最近已扩展到骨骼肌的定量分析，但与磁共振成像（MRI）相比，它在确定肌肉横截面积（mCSA）方面的有效性尚不清楚。11 名男性参与者（年龄：22 ± 3 岁）在 6 周阻力训练之前（PRE）和之后（POST）分别接受了 pQCT 和 MRI 双腿大腿中部成像，以量化大腿中部 mCSA 和 mCSA 的变化。阻力训练 6 周后，pQCT 和 MRI mCSA 均有所增加（∆mCSApQCT：6.7 ± 5.4 cm2，p < 0.001；∆mCSAMRI：6.0 ± 6.4 cm2，p < 0.001）。重要的是，mCSA 的变化在不同方法之间没有差异（p = 0.39）。Bland-Altman分析显示，在比较单个时间点的图像时，pQCT相对于MRI倾向于高估mCSA，平均偏差较小（1.10 cm2，LOA：-6.09，8.29 cm2）。pQCT 和 MRI mCSA 在前和后的一致性非常好，CCC 为 0.982。在检测 mCSA 的变化方面，Bland-Altman 分析显示 pQCT 和 MRI 的一致性极佳（平均偏差：-0.73 平方厘米，LOA：-8.37，6.91 平方厘米）。最后，pQCT 和 MRI mCSA 变化评分之间的一致性非常好（CCC = 0.779）。与核磁共振成像相比，pQCT 成像是一种有效的技术，既能测量单个时间点的大腿中部 mCSA，也能测量阻力训练干预后的 mCSA 变化。

{"title":"Peripheral quantitative computed tomography is a valid imaging technique for tracking changes in skeletal muscle cross-sectional area","authors":"Bradley A. Ruple, Christopher G. Vann, Casey L. Sexton, Shelby C. Osburn, Morgan A. Smith, Joshua S. Godwin, Petey W. Mumford, Matt S. Stock, Michael D. Roberts, Kaelin C. Young","doi":"10.1111/cpf.12885","DOIUrl":"10.1111/cpf.12885","url":null,"abstract":"<p>Peripheral quantitative computed tomography (pQCT) has recently expanded to quantifying skeletal muscle, however its validity to determine muscle cross-sectional area (mCSA) compared to magnetic resonance imaging (MRI) is unknown. Eleven male participants (age: 22 ± 3 y) underwent pQCT and MRI dual-leg mid-thigh imaging before (PRE) and after (POST) 6 weeks of resistance training for quantification of mid-thigh mCSA and change in mCSA. mCSA agreement at both time points and absolute change in mCSA across time was assessed using Bland-Altman plots for mean bias and 95% limits of agreement (LOA), as well as Lin's concordance correlation coefficients (CCC). Both pQCT and MRI mCSA increased following 6 weeks of resistance training (∆mCSA<sub>pQCT</sub>: 6.7 ± 5.4 cm<sup>2</sup>, <i>p</i> < 0.001; ∆mCSA<sub>MRI</sub>: 6.0 ± 6.4 cm<sup>2</sup>, <i>p</i> < 0.001). Importantly, the change in mCSA was not different between methods (<i>p</i> = 0.39). Bland-Altman analysis revealed a small mean bias (1.10 cm<sup>2</sup>, LOA: −6.09, 8.29 cm<sup>2</sup>) where pQCT tended to overestimate mCSA relative to MRI when comparing images at a single time point. Concordance between pQCT and MRI mCSA at PRE and POST was excellent yielding a CCC of 0.982. For detecting changes in mCSA, Bland-Altman analysis revealed excellent agreement between pQCT and MRI (mean bias: −0.73 cm<sup>2</sup>, LOA: −8.37, 6.91 cm<sup>2</sup>). Finally, there was excellent concordance between pQCT and MRI mCSA change scores (CCC = 0.779). Relative to MRI, pQCT imaging is a valid technique for measuring both mid-thigh mCSA at a single time point and mCSA changes following a resistance training intervention.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"407-414"},"PeriodicalIF":1.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652869","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}

引用次数: 0

Reproducibility and sex differences in muscle oxygenation during brachial artery occlusion in healthy participants 健康参与者肱动脉闭塞时肌肉氧合的可重复性和性别差异。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-26 DOI: 10.1111/cpf.12886

Tommi Jeskanen, Venla Ylinen, Rasmus I. P. Valtonen, Mikko P. Tulppo

Significance

Near-infrared spectroscopy (NIRS) measurement is a widely used technique to measure muscle oxygenation. A knowledge of the reproducibility of NIRS measurements is essential for the correct interpretation of data.

Aim

Our aim was to test the reproducibility and sex differences of NIRS measurements during brachial artery occlusion in healthy participants.

Approach

An NIRS device was used to measure muscle oxygenation and microvascular function during a 5 min brachial occlusion. Muscle oxygen consumption (mVO₂) and tissue saturation index (TSI%) were used. The occlusion test was performed three times on separate days for males (n = 13, 28 ± 8 years) and females (n = 13, 29 ± 7 years).

Results

During the occlusion phase, the reproducibility of mVO₂ was excellent (intraclass correlation; ICC = 0.90). During the reperfusion phase, the maximal change in TSI% revealed the best reproducibility (ICC = 0.77). There were no sex differences in reproducibility. Male participants had higher muscle oxygenation during occlusion (mVO₂, 0.054 ± 0.010 vs. 0.038 ± 0.012 mLO₂/min/100 g, p = 0.001, male and female, respectively). There were no sex differences during the reperfusion phase.

Conclusion

The reproducibility of NIRS to measure muscle oxygenation and microvascular function during circulation occlusion and reperfusion is good to excellent. Muscle oxygen capacity measured during occlusion is higher in males compared to females, and there are no sex differences in microvascular function during the reperfusion phase.

意义耳红外光谱（NIRS）测量是一种广泛用于测量肌肉氧合的技术。我们的目的是测试健康参与者在肱动脉闭塞期间进行近红外测量的可重复性和性别差异。方法使用近红外设备测量 5 分钟肱动脉闭塞期间的肌肉氧合和微血管功能。使用肌肉耗氧量（mVO2）和组织饱和度指数（TSI%）。男性（n = 13，28 ± 8 岁）和女性（n = 13，29 ± 7 岁）分别在不同的日期进行了三次闭塞测试。结果在闭塞阶段，mVO2 的重现性非常好（类内相关；ICC = 0.90）。在再灌注阶段，TSI% 的最大变化显示出最佳的再现性（ICC = 0.77）。重现性方面没有性别差异。男性参与者在闭塞期间的肌肉氧合较高（mVO2, 0.054 ± 0.010 vs. 0.038 ± 0.012 mLO2/min/100 g, p = 0.001，男性和女性分别如此）。结论在循环闭塞和再灌注期间，近红外光谱测量肌肉氧合和微血管功能的重现性良好至极佳。闭塞期间测量的肌肉氧容量男性高于女性，再灌注阶段的微血管功能没有性别差异。

{"title":"Reproducibility and sex differences in muscle oxygenation during brachial artery occlusion in healthy participants","authors":"Tommi Jeskanen, Venla Ylinen, Rasmus I. P. Valtonen, Mikko P. Tulppo","doi":"10.1111/cpf.12886","DOIUrl":"10.1111/cpf.12886","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Near-infrared spectroscopy (NIRS) measurement is a widely used technique to measure muscle oxygenation. A knowledge of the reproducibility of NIRS measurements is essential for the correct interpretation of data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Our aim was to test the reproducibility and sex differences of NIRS measurements during brachial artery occlusion in healthy participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>An NIRS device was used to measure muscle oxygenation and microvascular function during a 5 min brachial occlusion. Muscle oxygen consumption (mVO<sub>2</sub>) and tissue saturation index (TSI%) were used. The occlusion test was performed three times on separate days for males (<i>n</i> = 13, 28 ± 8 years) and females (<i>n</i> = 13, 29 ± 7 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the occlusion phase, the reproducibility of mVO<sub>2</sub> was excellent (intraclass correlation; ICC = 0.90). During the reperfusion phase, the maximal change in TSI% revealed the best reproducibility (ICC = 0.77). There were no sex differences in reproducibility. Male participants had higher muscle oxygenation during occlusion (mVO<sub>2</sub>, 0.054 ± 0.010 vs. 0.038 ± 0.012 mLO<sub>2</sub>/min/100 g, <i>p</i> = 0.001, male and female, respectively). There were no sex differences during the reperfusion phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The reproducibility of NIRS to measure muscle oxygenation and microvascular function during circulation occlusion and reperfusion is good to excellent. Muscle oxygen capacity measured during occlusion is higher in males compared to females, and there are no sex differences in microvascular function during the reperfusion phase.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"388-395"},"PeriodicalIF":1.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140653010","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}

引用次数: 0

Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single-centre retrospective cohort study 负荷超声心动图收缩期后缩短与冠状动脉明显狭窄的关系：一项单中心回顾性队列研究。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-25 DOI: 10.1111/cpf.12883

Joel Toftgård, Henrik Hedskog, Lars Rune, Jan Svedenhag, Gabriel Riva

Background

Postsystolic shortening (PSS) is one of the proposed quantitative measures to predict myocardial ischaemia in the stress echocardiographic (SE) evaluation. It is previously known that hypo-/akinesia (HA) correlates well with coronary stenosis. However, some patients undergoing SE only present with PSS, and their risk of significant coronary stenosis is less clear. This study aimed to evaluate the association between PSS and significant coronary stenosis compared with HA.

Methods

This was a retrospective cohort study at the hospital of S:t Görans, Stockholm, Sweden. All patients who underwent SE to investigate inducible ischaemia between 1 January 2018 and 15 October 2021 were eligible for inclusion. Exclusion criteria were normal SE and inconclusive test. Pathological SE were divided into two groups, patients with HA and those with PSS. Outcome was significant coronary artery stenosis visualized by invasive coronary angiography.

Results

The final study population consisted of 108 patients (73 PSS, 35 HA). The presence of HA was associated with a higher risk of significant stenosis compared to those with PSS (63% vs. 23%, p < 0.001). This relationship was observed among males (p < 0.001), but not among females (p = 0.133). Nonsignificant stenosis trended to be more common among patients with PSS (21% vs. 6%, p = 0.053)

Conclusions

The finding of PSS without HA was associated with a lower risk of significant coronary stenosis than HA. However, patients with PSS still often had nonsignificant coronary stenosis and PSS in the evaluation for nonobstructive coronary artery disease (CAD) should be further investigated.

背景收缩期缩短（PSS）是压力超声心动图（SE）评估中预测心肌缺血的量化指标之一。之前人们已经知道，收缩缩短（HA）与冠状动脉狭窄有很好的相关性。然而，一些接受 SE 检查的患者仅表现为 PSS，他们出现明显冠状动脉狭窄的风险并不明确。本研究旨在评估与 HA 相比，PSS 与明显冠状动脉狭窄之间的关系。方法这是瑞典斯德哥尔摩 S:t Görans 医院的一项回顾性队列研究。所有在 2018 年 1 月 1 日至 2021 年 10 月 15 日期间接受 SE 检查以调查诱发性缺血的患者均符合纳入条件。排除标准为 SE 正常和检测结果不确定。病理SE分为两组，即HA患者和PSS患者。结果最终研究对象包括 108 名患者（73 名 PSS，35 名 HA）。与 PSS 患者相比，HA 患者发生明显狭窄的风险更高（63% 对 23%，P < 0.001）。在男性中观察到了这种关系（p < 0.001），但在女性中没有观察到（p = 0.133）。无明显狭窄的趋势在 PSS 患者中更为常见（21% vs. 6%，p = 0.053）：与HA相比，发现无HA的PSS患者发生冠状动脉明显狭窄的风险较低。然而，PSS 患者仍常伴有非显著性冠状动脉狭窄，因此在评估非阻塞性冠状动脉疾病（CAD）时应进一步研究 PSS。

{"title":"Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single-centre retrospective cohort study","authors":"Joel Toftgård, Henrik Hedskog, Lars Rune, Jan Svedenhag, Gabriel Riva","doi":"10.1111/cpf.12883","DOIUrl":"10.1111/cpf.12883","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postsystolic shortening (PSS) is one of the proposed quantitative measures to predict myocardial ischaemia in the stress echocardiographic (SE) evaluation. It is previously known that hypo-/akinesia (HA) correlates well with coronary stenosis. However, some patients undergoing SE only present with PSS, and their risk of significant coronary stenosis is less clear. This study aimed to evaluate the association between PSS and significant coronary stenosis compared with HA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cohort study at the hospital of S:t Görans, Stockholm, Sweden. All patients who underwent SE to investigate inducible ischaemia between 1 January 2018 and 15 October 2021 were eligible for inclusion. Exclusion criteria were normal SE and inconclusive test. Pathological SE were divided into two groups, patients with HA and those with PSS. Outcome was significant coronary artery stenosis visualized by invasive coronary angiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final study population consisted of 108 patients (73 PSS, 35 HA). The presence of HA was associated with a higher risk of significant stenosis compared to those with PSS (63% vs. 23%, <i>p</i> < 0.001). This relationship was observed among males (<i>p</i> < 0.001), but not among females (<i>p</i> = 0.133). Nonsignificant stenosis trended to be more common among patients with PSS (21% vs. 6%, <i>p</i> = 0.053)</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The finding of PSS without HA was associated with a lower risk of significant coronary stenosis than HA. However, patients with PSS still often had nonsignificant coronary stenosis and PSS in the evaluation for nonobstructive coronary artery disease (CAD) should be further investigated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"371-380"},"PeriodicalIF":1.3,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140653610","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}

引用次数: 0

Skeletal muscle architecture and aging: A comparison of ultrasound techniques and an assessment of intrarater reliability 骨骼肌结构与衰老：超声波技术比较与内部可靠性评估

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-14 DOI: 10.1111/cpf.12882

Andrew C. D'Lugos, Nathan J. Skotak, Jacquelyn J. Faris, Nicholas T. Thomas, Corey E. Mazo, Jonathan J. Dickinson, Jessy G. Moore, Theresa M. Jorgensen, Jared M. Dickinson

Objective

To assess intrarater reliability of ultrasound-determined measurements of skeletal muscle characteristics across different measurement outcomes, imaging techniques, and age groups.

Methods

2D ultrasound images (B-mode) of the quadriceps were obtained from young (26 ± 4 year, n = 8 M, 8 F) and older (70 ± 7 year, n = 7 M, 5 F) adults on two occasions, separated by 6 ± 3 days. With participants in both standing and supine postures, images were collected from five anatomical sites along the anterior (two sites) and lateral (three sites) compartments of the thigh corresponding to 56%, 39%, and 22% (lateral only) of femur length. Images were analysed for muscle thickness, pennation angle, and echogenicity. Intraclass correlation coefficients (ICC) were used to assess reliability.

Results

Muscle thickness values were higher (p < 0.05) on images collected in the stand versus supine posture only for muscles of the anterior compartment, independent of age. Echogenicity values were higher (p < 0.05) in the vastus intermedius on images collected in the supine versus stand posture only in older adults. Pennation angle values were not impacted by imaging posture (p > 0.05). ICC values for thickness, echogenicity, and pennation angle were generally higher for analyses conducted on images collected in the supine versus stand posture. Imaging posture generated a greater difference in ICC values in the lateral versus anterior muscles and in older versus younger participants.

Conclusion

Our findings suggest that participant posture during imaging impacts the absolute values and intrarater reliability of ultrasound-determined muscle characteristics in a muscle-specific fashion, and this effect is greater in older compared to younger individuals.

方法分两次从年轻人（26 ± 4 岁，n = 8 名男性，8 名女性）和老年人（70 ± 7 岁，n = 7 名男性，5 名女性）身上获取股四头肌的二维超声波图像（B 型），每次间隔 6 ± 3 天。研究人员采取站立和仰卧姿势，从大腿前侧（两个部位）和外侧（三个部位）的五个解剖部位收集图像，这些部位分别占股骨长度的 56%、39% 和 22%（仅外侧）。对图像进行了肌肉厚度、五连角和回声分析。结果在站立与仰卧姿势下采集的图像中，仅前部肌肉的肌肉厚度值较高（p < 0.05），与年龄无关。仅在老年人中，仰卧位与站立位采集的图像上中阔肌的回声值更高（p < 0.05）。彭氏角值不受成像姿势的影响（p > 0.05）。对仰卧位与站立位采集的图像进行分析时，厚度、回声性和垂线角的 ICC 值普遍较高。我们的研究结果表明，成像时参与者的姿势会以肌肉特异性的方式影响超声波确定的肌肉特征的绝对值和内部可靠性，而且这种影响在老年人身上比在年轻人身上更大。

{"title":"Skeletal muscle architecture and aging: A comparison of ultrasound techniques and an assessment of intrarater reliability","authors":"Andrew C. D'Lugos, Nathan J. Skotak, Jacquelyn J. Faris, Nicholas T. Thomas, Corey E. Mazo, Jonathan J. Dickinson, Jessy G. Moore, Theresa M. Jorgensen, Jared M. Dickinson","doi":"10.1111/cpf.12882","DOIUrl":"10.1111/cpf.12882","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess intrarater reliability of ultrasound-determined measurements of skeletal muscle characteristics across different measurement outcomes, imaging techniques, and age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>2D ultrasound images (B-mode) of the quadriceps were obtained from young (26 ± 4 year, <i>n</i> = 8 M, 8 F) and older (70 ± 7 year, <i>n</i> = 7 M, 5 F) adults on two occasions, separated by 6 ± 3 days. With participants in both standing and supine postures, images were collected from five anatomical sites along the anterior (two sites) and lateral (three sites) compartments of the thigh corresponding to 56%, 39%, and 22% (lateral only) of femur length. Images were analysed for muscle thickness, pennation angle, and echogenicity. Intraclass correlation coefficients (ICC) were used to assess reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Muscle thickness values were higher (<i>p</i> < 0.05) on images collected in the stand versus supine posture only for muscles of the anterior compartment, independent of age. Echogenicity values were higher (<i>p</i> < 0.05) in the vastus intermedius on images collected in the supine versus stand posture only in older adults. Pennation angle values were not impacted by imaging posture (<i>p</i> > 0.05). ICC values for thickness, echogenicity, and pennation angle were generally higher for analyses conducted on images collected in the supine versus stand posture. Imaging posture generated a greater difference in ICC values in the lateral versus anterior muscles and in older versus younger participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that participant posture during imaging impacts the absolute values and intrarater reliability of ultrasound-determined muscle characteristics in a muscle-specific fashion, and this effect is greater in older compared to younger individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"359-370"},"PeriodicalIF":1.3,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577152","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}

引用次数: 0

Point-of-care β-hydroxybutyrate measurement predicts adequate glucose metabolism suppression in cardiac FDG-PET/CT 护理点β-羟丁酸测量可预测心脏 FDG-PET/CT 是否能充分抑制葡萄糖代谢

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-08 DOI: 10.1111/cpf.12881

Suvi Hartikainen, Tuomo Tompuri, Tiina Laitinen, Tomi Laitinen

Aims

The aims of our study were to evaluate whether point-of-care β-hydroxybutyrate (BHB) measurement can be used to identify patients with adequate cardiac glucose metabolism suppression for cardiac [¹⁸F]-fluoro-2-deoxy-d-glucose-positron emission tomography with computerized tomography (FDG-PET/CT) and to develop a pretest probability calculator of myocardial suppression using other metabolic factors attainable before imaging.

Methods and Results

We recruited 193 patients with any clinical indication for whole body [¹⁸F]-FDG-PET/CT. BHB level was measured with a point-of-care device. Maximal myocardial standardized uptake value using lean body mass (SULmax) was measured from eight circular regions of interest with 1 cm circumference and background from left ventricular blood pool. Correlations SULmax and point-of-care measured BHB were analysed. The ability of BHB test to predict adequate suppression was evaluated with receiver operating characteristic analysis. Liver and spleen attenuation in computed tomography were measured to assess the presence of fatty liver. BHB level correlated with myocardial uptake and, using a cut-off value of 0.35 mmol/L to predict adequate myocardial suppression, we reached specificity of 90% and sensitivity of 56%. Other variables to predict adequate suppression were diabetes, obesity, ketogenic diet and fatty liver. Using information attainable before imaging, we created a pretest probability calculator of inadequate myocardial glucose metabolism suppression. The area under the curve for BHB test alone was 0.802 and was 0.857 for the pretest calculator (p = 0.319).

Conclusions

BHB level measured with a point-of-care device is useful in predicting adequate myocardial glucose metabolism suppression. More detailed assessment of other factors potentially contributing to cardiac metabolism is needed.

目的我们的研究旨在评估是否可以使用护理点β-羟丁酸（BHB）测量来识别心脏[18F]-氟-2-脱氧-d-葡萄糖-正电子发射计算机断层扫描（FDG-PET/CT）中有足够的心脏葡萄糖代谢抑制的患者，并使用成像前可获得的其他代谢因素来开发心肌抑制的预测概率计算器。方法和结果我们招募了 193 名具有全身 [18F]-FDG-PET/CT 任何临床指征的患者。使用床旁设备测量 BHB 水平。以瘦体重为标准的最大心肌标准化摄取值（SULmax）由八个周长为 1 厘米的圆形感兴趣区和左心室血池背景测得。分析了 SULmax 与护理点测量的 BHB 之间的相关性。通过接收器操作特征分析评估了 BHB 测试预测充分抑制的能力。通过测量计算机断层扫描中的肝脏和脾脏衰减来评估是否存在脂肪肝。BHB水平与心肌摄取量相关，以0.35毫摩尔/升为临界值预测心肌抑制是否充分，我们得出的特异性为90%，灵敏度为56%。预测充分抑制的其他变量包括糖尿病、肥胖、生酮饮食和脂肪肝。利用成像前可获得的信息，我们创建了心肌糖代谢抑制不足的测前概率计算器。结论使用护理点设备测量的 BHB 水平有助于预测心肌糖代谢抑制是否充分。需要对可能影响心脏代谢的其他因素进行更详细的评估。

{"title":"Point-of-care β-hydroxybutyrate measurement predicts adequate glucose metabolism suppression in cardiac FDG-PET/CT","authors":"Suvi Hartikainen, Tuomo Tompuri, Tiina Laitinen, Tomi Laitinen","doi":"10.1111/cpf.12881","DOIUrl":"10.1111/cpf.12881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aims of our study were to evaluate whether point-of-care β-hydroxybutyrate (BHB) measurement can be used to identify patients with adequate cardiac glucose metabolism suppression for cardiac [<sup>18</sup>F]-fluoro-2-deoxy-<span>d</span>-glucose-positron emission tomography with computerized tomography (FDG-PET/CT) and to develop a pretest probability calculator of myocardial suppression using other metabolic factors attainable before imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We recruited 193 patients with any clinical indication for whole body [<sup>18</sup>F]-FDG-PET/CT. BHB level was measured with a point-of-care device. Maximal myocardial standardized uptake value using lean body mass (SULmax) was measured from eight circular regions of interest with 1 cm circumference and background from left ventricular blood pool. Correlations SULmax and point-of-care measured BHB were analysed. The ability of BHB test to predict adequate suppression was evaluated with receiver operating characteristic analysis. Liver and spleen attenuation in computed tomography were measured to assess the presence of fatty liver. BHB level correlated with myocardial uptake and, using a cut-off value of 0.35 mmol/L to predict adequate myocardial suppression, we reached specificity of 90% and sensitivity of 56%. Other variables to predict adequate suppression were diabetes, obesity, ketogenic diet and fatty liver. Using information attainable before imaging, we created a pretest probability calculator of inadequate myocardial glucose metabolism suppression. The area under the curve for BHB test alone was 0.802 and was 0.857 for the pretest calculator (<i>p</i> = 0.319).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BHB level measured with a point-of-care device is useful in predicting adequate myocardial glucose metabolism suppression. More detailed assessment of other factors potentially contributing to cardiac metabolism is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 5","pages":"349-358"},"PeriodicalIF":1.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577084","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}

引用次数: 0

Pulmonary volumes and signs of chronic airflow limitation in quantitative computed tomography 定量计算机断层扫描中的肺活量和慢性气流受限迹象

IF 1.8 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-04 DOI: 10.1111/cpf.12880

Emelie Bäcklin, Adrian Gonon, Magnus Sköld, Örjan Smedby, Eva Breznik, Birgitta Janerot-Sjoberg

Background

Computed tomography (CT) offers pulmonary volumetric quantification but is not commonly used in healthy individuals due to radiation concerns. Chronic airflow limitation (CAL) is one of the diagnostic criteria for chronic obstructive pulmonary disease (COPD), where early diagnosis is important. Our aim was to present reference values for chest CT volumetric and radiodensity measurements and explore their potential in detecting early signs of CAL.

Methods

From the population-based Swedish CArdioPulmonarybioImage Study (SCAPIS), 294 participants aged 50–64, were categorized into non-CAL (n = 258) and CAL (n = 36) groups based on spirometry. From inspiratory and expiratory CT images we compared lung volumes, mean lung density (MLD), percentage of low attenuation volume (LAV%) and LAV cluster volume between groups, and against reference values from static pulmonary function test (PFT).

Results

The CAL group exhibited larger lung volumes, higher LAV%, increased LAV cluster volume and lower MLD compared to the non-CAL group. Lung volumes significantly deviated from PFT values. Expiratory measurements yielded more reliable results for identifying CAL compared to inspiratory. Using a cut-off value of 0.6 for expiratory LAV%, we achieved sensitivity, specificity and positive/negative predictive values of 72%, 85% and 40%/96%, respectively.

Conclusion

We present volumetric reference values from inspiratory and expiratory chest CT images for a middle-aged healthy cohort. These results are not directly comparable to those from PFTs. Measures of MLD and LAV can be valuable in the evaluation of suspected CAL. Further validation and refinement are necessary to demonstrate its potential as a decision support tool for early detection of COPD.

背景计算机断层扫描（CT）可提供肺容积定量，但由于辐射问题，在健康人中并不常用。慢性气流受限（CAL）是慢性阻塞性肺病（COPD）的诊断标准之一，早期诊断非常重要。我们的目的是提出胸部 CT 容积和放射密度测量的参考值，并探索它们在检测 CAL 早期症状方面的潜力。方法在基于人群的瑞典 CArdioPulmonarybioImage 研究（SCAPIS）中，294 名 50-64 岁的参与者根据肺活量被分为非 CAL 组（n = 258）和 CAL 组（n = 36）。通过吸气和呼气 CT 图像，我们比较了组间肺容积、平均肺密度（MLD）、低衰减容积百分比（LAV%）和 LAV 簇容积，并与静态肺功能测试（PFT）的参考值进行了对比。肺活量明显偏离 PFT 值。呼气测量结果比吸气测量结果更可靠。采用 0.6 的呼气 LAV% 临界值，我们的灵敏度、特异性和阳性/阴性预测值分别为 72%、85% 和 40%/96%。这些结果不能直接与 PFT 的结果相比较。测量 MLD 和 LAV 对评估疑似 CAL 很有价值。要证明其作为早期检测 COPD 的决策支持工具的潜力，还需要进一步的验证和改进。

{"title":"Pulmonary volumes and signs of chronic airflow limitation in quantitative computed tomography","authors":"Emelie Bäcklin, Adrian Gonon, Magnus Sköld, Örjan Smedby, Eva Breznik, Birgitta Janerot-Sjoberg","doi":"10.1111/cpf.12880","DOIUrl":"10.1111/cpf.12880","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Computed tomography (CT) offers pulmonary volumetric quantification but is not commonly used in healthy individuals due to radiation concerns. Chronic airflow limitation (CAL) is one of the diagnostic criteria for chronic obstructive pulmonary disease (COPD), where early diagnosis is important. Our aim was to present reference values for chest CT volumetric and radiodensity measurements and explore their potential in detecting early signs of CAL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the population-based Swedish CArdioPulmonarybioImage Study (SCAPIS), 294 participants aged 50–64, were categorized into non-CAL (<i>n</i> = 258) and CAL (<i>n</i> = 36) groups based on spirometry. From inspiratory and expiratory CT images we compared lung volumes, mean lung density (MLD), percentage of low attenuation volume (LAV%) and LAV cluster volume between groups, and against reference values from static pulmonary function test (PFT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CAL group exhibited larger lung volumes, higher LAV%, increased LAV cluster volume and lower MLD compared to the non-CAL group. Lung volumes significantly deviated from PFT values. Expiratory measurements yielded more reliable results for identifying CAL compared to inspiratory. Using a cut-off value of 0.6 for expiratory LAV%, we achieved sensitivity, specificity and positive/negative predictive values of 72%, 85% and 40%/96%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We present volumetric reference values from inspiratory and expiratory chest CT images for a middle-aged healthy cohort. These results are not directly comparable to those from PFTs. Measures of MLD and LAV can be valuable in the evaluation of suspected CAL. Further validation and refinement are necessary to demonstrate its potential as a decision support tool for early detection of COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 4","pages":"340-348"},"PeriodicalIF":1.8,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576935","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}

引用次数: 0

Improving sensitivity through data augmentation with synthetic lymph node metastases for AI-based analysis of PSMA PET-CT images 在基于人工智能的 PSMA PET-CT 图像分析中使用合成淋巴结转移来增强数据，从而提高灵敏度。

IF 1.8 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-04-02 DOI: 10.1111/cpf.12879

Elin Trägårdh, Johannes Ulén, Olof Enqvist, Lars Edenbrandt, Måns Larsson

Background

We developed a fully automated artificial intelligence (AI)AI-based-based method for detecting suspected lymph node metastases in prostate-specific membrane antigen (PSMA)(PSMA) positron emission tomography-computed tomography (PET-CT)(PET-CT) images of prostate cancer patients by using data augmentation that adds synthetic lymph node metastases to the images to expand the training set.

Methods

Synthetic data were derived from original training images to which new synthetic lymph node metastases were added. Thus, the original training set from a previous study (n = 420) was expanded by one synthetic image for every original image (n = 840), which was used to train an AI model. The performance of the AI model was compared to that of nuclear medicine physicians and a previously developed AI model. The human readers were alternately used as a reference and compared to either another reading or AI model.

Results

The new AI model had an average sensitivity of 84% for detecting lymph node metastases compared with 78% for human readings. Our previously developed AI method without synthetic data had an average sensitivity of 79%. The number of false positive lesions were slightly higher for the new AI model (average 3.3 instances per patient) compared to human readings and the previous AI model (average 2.8 instances per patient), while the number of false negative lesions was lower.

Conclusions

Creating synthetic lymph node metastases, as a form of data augmentation, on [18F]PSMA-1007F]PSMA-1007 PETPET-CT-CT images improved the sensitivity of an AI model for detecting suspected lymph node metastases. However, the number of false positive lesions increased somewhat.

背景：我们开发了一种基于人工智能（AI）的全自动检测前列腺癌患者前列腺特异性膜抗原（PSMA）（PSMA）正电子发射计算机断层扫描（PET-CT）（PET-CT）图像中疑似淋巴结转移的方法：方法：合成数据来自原始训练图像，并在其中添加了新的合成淋巴结转移灶。因此，先前研究中的原始训练集（n = 420）每增加一张原始图像（n = 840）就增加一张合成图像，用于训练人工智能模型。人工智能模型的性能与核医学医生和之前开发的人工智能模型进行了比较。人类阅读器被交替用作参考，并与另一种阅读器或人工智能模型进行比较：结果：新的人工智能模型检测淋巴结转移的平均灵敏度为 84%，而人类读数的灵敏度为 78%。我们之前开发的无合成数据人工智能方法的平均灵敏度为 79%。与人类读数和之前的人工智能模型（平均每位患者 2.8 个实例）相比，新的人工智能模型的假阳性病变数量略高（平均每位患者 3.3 个实例），而假阴性病变数量较低：结论：在[18F]PSMA-1007F]PSMA-1007 PETPET-CT-CT 图像上创建合成淋巴结转移，作为一种数据增强形式，提高了人工智能模型检测疑似淋巴结转移的灵敏度。不过，假阳性病灶的数量有所增加。

{"title":"Improving sensitivity through data augmentation with synthetic lymph node metastases for AI-based analysis of PSMA PET-CT images","authors":"Elin Trägårdh, Johannes Ulén, Olof Enqvist, Lars Edenbrandt, Måns Larsson","doi":"10.1111/cpf.12879","DOIUrl":"10.1111/cpf.12879","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We developed a fully automated artificial intelligence (AI)AI-based-based method for detecting suspected lymph node metastases in prostate-specific membrane antigen (PSMA)(PSMA) positron emission tomography-computed tomography (PET-CT)(PET-CT) images of prostate cancer patients by using data augmentation that adds synthetic lymph node metastases to the images to expand the training set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Synthetic data were derived from original training images to which new synthetic lymph node metastases were added. Thus, the original training set from a previous study (<i>n</i> = 420) was expanded by one synthetic image for every original image (<i>n</i> = 840), which was used to train an AI model. The performance of the AI model was compared to that of nuclear medicine physicians and a previously developed AI model. The human readers were alternately used as a reference and compared to either another reading or AI model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The new AI model had an average sensitivity of 84% for detecting lymph node metastases compared with 78% for human readings. Our previously developed AI method without synthetic data had an average sensitivity of 79%. The number of false positive lesions were slightly higher for the new AI model (average 3.3 instances per patient) compared to human readings and the previous AI model (average 2.8 instances per patient), while the number of false negative lesions was lower.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Creating synthetic lymph node metastases, as a form of data augmentation, on [18F]PSMA-1007F]PSMA-1007 PETPET-CT-CT images improved the sensitivity of an AI model for detecting suspected lymph node metastases. However, the number of false positive lesions increased somewhat.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 4","pages":"332-339"},"PeriodicalIF":1.8,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334990","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}

引用次数: 0

Respiratory muscles's thermographic analysis in asthmatic youth with and without bronchospasm induced by eucapnic voluntary hyperpnea 呼吸肌热成像分析：对有和无支气管痉挛的青年哮喘患者进行的分析。

IF 1.8 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-03-27 DOI: 10.1111/cpf.12878

Camila M. de A. Santos, Polyanna G. C. Quirino, José Â. Rizzo, Décio Medeiros, José J. de A. Ferreira, Manoel da C. Costa, Nádia Gaua, Bayne Freya, Marcelle de O. Martins, Marco A. C. V. Junior

Objective

To compare the thermographic pattern of regions of interest (ROI) of respiratory muscles in young asthmatics with and without bronchospasm induced by eucapnic voluntary hyperpnea (EVH).

Materials and Methods

Cross-sectional study carried out with 55 young (55% male and 45% females) aged 12.5 ± 3.3 years, divided in nine nonasthmatics, 22 asthmatics without exercise-induced bronchospasm compatible response (EIB-cr) and 24 asthmatics with EIB-cr. The diagnosis of EIB was given to subjects with a fall in forced expiratory volume in the first second (FEV₁) ≥ 10% compared to baseline. Thermographic recordings of respiratory muscles were delimited in ROI of the sternocleidomastoid (SCM), pectoral, and rectus abdominis intention area. Thermal captures and FEV₁ were taken before and 5, 10, 15 and 30 min after EVH.

Results

Twenty-four (52.1%) of asthmatics had EIB-cr. There was a decrease in temperature at 10 min after EVH test in the SCM, pectoral and rectus abdominis ROIs in all groups (both with p < 0.05). There was a decrease in temperature (% basal) in asthmatic with EIB-cr compared to nonasthmatics in the rectus abdominis area (p < 0.05).

Conclusion

There was a decrease in temperature in the ROIs of different muscle groups, especially in asthmatics. The greater drop in FEV₁ observed in individuals with EIB-cr was initially associated with a decrease in skin temperature, with a difference between the nonasthmatics in the abdominal muscle area. It is likely that this decrease in temperature occurred due to a temporary displacement of blood flow to the most used muscle groups, with a decrease in the region of the skin evaluated in the thermography.

目的比较年轻哮喘患者的呼吸肌感兴趣区（ROI）的热成像模式，有无由宽松自愿过度呼吸（EVH）诱发的支气管痉挛：横断面研究：55 名青少年（55% 为男性，45% 为女性），年龄为（12.5 ± 3.3）岁，分为 9 名非哮喘患者、22 名无运动诱发支气管痉挛相容反应（EIB-cr）的哮喘患者和 24 名有 EIB-cr 的哮喘患者。第一秒用力呼气容积（FEV1）比基线下降≥10%的受试者被诊断为EIB。呼吸肌的热成像记录以胸锁乳突肌（SCM）、胸肌和腹直肌意向区的 ROI 为界。分别在 EVH 前、EVH 后 5、10、15 和 30 分钟进行热捕获和 FEV1 采集：结果：24 名哮喘患者（52.1%）有 EIB-cr。所有组别中，EVH 试验后 10 分钟，SCM、胸肌和腹直肌 ROI 的温度均有所下降（均为 p 结论：EVH 试验后 10 分钟，SCM、胸肌和腹直肌 ROI 的温度均有所下降：不同肌群 ROI 的温度均有所下降，尤其是哮喘患者。在 EIB-cr 患者中观察到的 FEV1 下降幅度较大，最初与皮肤温度下降有关，在腹部肌肉区域与非哮喘患者存在差异。体温下降可能是由于血流暂时流向了最常用的肌肉群，导致热成像评估的皮肤区域温度下降。

{"title":"Respiratory muscles's thermographic analysis in asthmatic youth with and without bronchospasm induced by eucapnic voluntary hyperpnea","authors":"Camila M. de A. Santos, Polyanna G. C. Quirino, José Â. Rizzo, Décio Medeiros, José J. de A. Ferreira, Manoel da C. Costa, Nádia Gaua, Bayne Freya, Marcelle de O. Martins, Marco A. C. V. Junior","doi":"10.1111/cpf.12878","DOIUrl":"10.1111/cpf.12878","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the thermographic pattern of regions of interest (ROI) of respiratory muscles in young asthmatics with and without bronchospasm induced by eucapnic voluntary hyperpnea (EVH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Cross-sectional study carried out with 55 young (55% male and 45% females) aged 12.5 ± 3.3 years, divided in nine nonasthmatics, 22 asthmatics without exercise-induced bronchospasm compatible response (EIB-cr) and 24 asthmatics with EIB-cr. The diagnosis of EIB was given to subjects with a fall in forced expiratory volume in the first second (FEV<sub>1</sub>) ≥ 10% compared to baseline. Thermographic recordings of respiratory muscles were delimited in ROI of the sternocleidomastoid (SCM), pectoral, and rectus abdominis intention area. Thermal captures and FEV<sub>1</sub> were taken before and 5, 10, 15 and 30 min after EVH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four (52.1%) of asthmatics had EIB-cr. There was a decrease in temperature at 10 min after EVH test in the SCM, pectoral and rectus abdominis ROIs in all groups (both with <i>p</i> < 0.05). There was a decrease in temperature (% basal) in asthmatic with EIB-cr compared to nonasthmatics in the rectus abdominis area (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was a decrease in temperature in the ROIs of different muscle groups, especially in asthmatics. The greater drop in FEV<sub>1</sub> observed in individuals with EIB-cr was initially associated with a decrease in skin temperature, with a difference between the nonasthmatics in the abdominal muscle area. It is likely that this decrease in temperature occurred due to a temporary displacement of blood flow to the most used muscle groups, with a decrease in the region of the skin evaluated in the thermography.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 4","pages":"324-331"},"PeriodicalIF":1.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305038","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}

引用次数: 0