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Effects of gender, age and method variations on contractility in extremity lymphatic collectors using indocyanine green fluorescence lymphangiography 性别、年龄和方法变化对使用吲哚菁绿荧光淋巴管造影的四肢淋巴收集器收缩性的影响
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-15 DOI: 10.1111/cpf.70017
Mads Fich Lønnee, Mads Radmer Jensen, Bryan Haddock, Lene Simonsen, Tonny Karlsmark, Jens Bülow

The objectives of this study were to examine how extremity lymphatic collector contraction frequency is influenced by gender, age, and methodological variations in indocyanine green (ICG) injection using near infrared fluorescence (NIRF) imaging in healthy adults. Ten women (19–46 years) and eight men (18–59 years) were examined with 30-min NIRF videos recorded at different time points 0–150 min after injection of ICG. Variations in ICG volume (0.1 mL vs. 0.3 mL), -concentration (1 mg/mL vs. 2.5 mg/mL), -injection site (hand vs. foot), -route of administration (subcutaneous vs. intradermal) were applied to all subjects. The primary outcome was mean contraction frequency with maximum contraction frequency and number of visualised extremity lymphatic collectors as secondary outcomes. The median of mean contraction frequencies for females and males were 0.42 min−1 (IQR 0,19 min−1) and 0.25 min−1 (IQR 0,15 min−1), respectively (p = 0.022). The median of maximum contraction frequencies for females and males were 0.70 min−1 (IQR 0,26 min−1) and 0.34 min−1 (IQR 0,15 min−1), respectively (p = 0.015). Neither age, method variations nor imaging delay had any significant effect on contraction frequencies. Number of visualised collectors increased slightly during 150 min (p = 0.02). Mean and maximum contraction frequencies were significantly higher in women compared to men. This is a novel finding that warrants verification in future studies. Contraction frequency measured with 30-min NIRF imaging using an ICG volume as little as 0.1 mL and a concentration of 1 mg/mL is seemingly robust and readily available. This method is recommendable for perturbation studies of lymphatic collector function and pathophysiology.

本研究的目的是利用近红外荧光(NIRF)成像技术研究健康成人注射吲哚菁绿(ICG)时,性别、年龄和方法变化对下肢淋巴收集器收缩频率的影响。10名女性(19-46岁)和8名男性(18-59岁)在注射ICG后0-150分钟的不同时间点记录30分钟NIRF视频。ICG体积(0.1 mL vs. 0.3 mL)、浓度(1mg /mL vs. 2.5 mg/mL)、注射部位(手vs.脚)、给药途径(皮下vs.皮内)的变化应用于所有受试者。主要结果是平均收缩频率,最大收缩频率和可见的四肢淋巴收集器数量作为次要结果。女性和男性的平均收缩频率中位数分别为0.42 min−1 (IQR 0,19 min−1)和0.25 min−1 (IQR 0,15 min−1)(p = 0.022)。女性和男性的最大收缩频率中位数分别为0.70 min−1 (IQR 0,26 min−1)和0.34 min−1 (IQR 0,15 min−1)(p = 0.015)。年龄、方法变化和成像延迟对收缩频率均无显著影响。在150分钟内,可视化收集器的数量略有增加(p = 0.02)。女性的平均和最大宫缩频率明显高于男性。这是一个新颖的发现,值得在未来的研究中验证。使用ICG体积低至0.1 mL,浓度为1mg /mL,用30分钟NIRF成像测量收缩频率似乎是可靠的,并且容易获得。该方法适用于淋巴收集功能和病理生理的摄动研究。
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引用次数: 0
Evaluation of [18F]PSMA-1007 uptake variability in patients with prostate cancer 前列腺癌患者PSMA-1007摄取变异性的评价[18F]
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-15 DOI: 10.1111/cpf.70016
Elin Trägårdh, Måns Larsson, David Minarik, Olof Enqvist, Lars Edenbrandt

Background

The biodistribution of PSMA-ligands is of interest in radionuclide therapy planning. We investigated the variability of [18F]PSMA-1007 uptake in organs at risk and in relation to tumour burden in prostate cancer patients.

Methods

A total of 1086 patients who underwent PSMA PET-CT for staging or recurrence of prostate cancer were included. Total lesion volume (TLV) and total lesion uptake (TLU) were calculated from manual segmentations. The mean standardized uptake value (SUVmean) in the organs at risk kidneys, liver, parotid glands and spleen was obtained. Correlations between TLV/TLU and SUVmean in normal tissues were calculated using Spearman rank correlation. SUVmean in normal tissues was stratified into groups based on TLV.

Results

The median (IQR) SUVmean of the kidneys, liver, parotid glands, and spleen was 13.1 (IQR 4.6), 11.8 (4.4), 18.6 (6.8) and 11.3 (5.8), respectively. The median TLV was 3.8 cm3 (9.7) and median TLU was 31.2 cm3 (106.3). There was no significant correlation between TLV or TLU and SUVmean for the liver, parotid glands, or spleen, but a weak negative correlation between TLV/TLU and SUVmean in the kidneys (r = −0.011, p = 0.0005; r = −0.09, p = 0.003). There was a tendency towards a lower SUVmean in the kidneys and parotid glands in patients with a very high TLV.

Conclusions

There was a large uptake variability in organs at risk, which demonstrates the need for individual pretherapy dosimetry. There may be a tumour sink effect in the kidneys and parotid glands in patients with a very high TLV.

背景psma配体的生物分布在放射性核素治疗计划中具有重要意义。我们研究了前列腺癌患者危险器官中[18F]PSMA-1007摄取的变异性以及与肿瘤负荷的关系。方法对1086例经PSMA PET-CT检查前列腺癌分期或复发的患者进行分析。通过人工分割计算病灶总体积(TLV)和病灶总摄取(TLU)。获得危险器官肾脏、肝脏、腮腺和脾脏的平均标准化摄取值(SUVmean)。采用Spearman秩相关计算正常组织TLV/TLU与SUVmean的相关性。正常组织的SUVmean按TLV分层。结果肾脏、肝脏、腮腺和脾脏的中位(IQR) SUVmean分别为13.1 (IQR 4.6)、11.8(4.4)、18.6(6.8)和11.3(5.8)。中位TLV为3.8 cm3(9.7),中位TLU为31.2 cm3(106.3)。肝脏、腮腺和脾脏的TLV或TLU与SUVmean无显著相关,但肾脏的TLV/TLU与SUVmean呈弱负相关(r = - 0.011, p = 0.0005;R =−0.09,p = 0.003)。高TLV患者的肾脏和腮腺有较低的SUVmean的趋势。结论:在危险器官中有很大的摄取变异性,这表明有必要进行个体化治疗前剂量测定。高TLV患者的肾脏和腮腺可能存在肿瘤沉降效应。
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引用次数: 0
Author's reply to ‘considerations for fasting and dehydration effects on pupillary light reflex: A commentary on Adam et al.’ 作者对“禁食和脱水对瞳孔光反射影响的考虑:对Adam等人的评论”的答复。
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-11 DOI: 10.1111/cpf.70018
Mehmet Adam, Ali Osman Gündoğan, Ali Tezcan, Refik Oltulu, Selman Belviranlı, Enver Mirza, Mehmet Okka
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引用次数: 0
Ventilation/perfusion SPECT in children: Feasibility, impact on clinical decision-making and interrater agreement 儿童通气/灌注SPECT:可行性、对临床决策的影响及专家共识
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-05 DOI: 10.1111/cpf.70012
Lise Borgwardt, Mette Louise Mørk, Henrik Gutte, Anne Kiil Berthelsen, Robin de Nijs, Ronan M. G. Berg, Jann Mortensen

Introduction

It remains to be established whether it provides any clinical or diagnostic benefits to perform ventilation/perfusion (V/Q) scintigraphy as a single photon emission computed tomography in children. Here, we report our experience with this modality, evaluate its impact on clinical decision-making and assess its interrater agreement.

Methods

All V/Q scintigraphies performed in children over a 1-year period were identified, and patient files were reviewed. Two nuclear medicine physicians, blinded to patient data and each other's readings, interpreted all scintigraphies.

Results

A total of 20 planar and SPECT V/Q scintigraphies were identified. In 17/20 cases (85%), the results of the scan were found to directly inform clinical decision-making. SPECT mainly ruled out the presence of ventilation and perfusion defects that were suspected on planar scintigraphy. In terms of interrater agreement, Cohen's ϰ coefficients for planar ventilation and perfusion scintigraphy were 0.34 and 0.38 (fair agreement), respectively, while the corresponding values for SPECT were 0.42 and 0.61 (moderate to substantial agreement).

Conclusion

It is both feasible and clinically meaningful to perform V/Q SPECT in children. In this patient group, V/Q SPECT furthermore seems to have better interrater agreement than planar scintigraphy.

在儿童中进行通气/灌注(V/Q)闪烁成像作为单光子发射计算机断层扫描是否提供任何临床或诊断益处仍有待确定。在这里,我们报告了我们使用这种模式的经验,评估了其对临床决策的影响,并评估了其相互之间的协议。方法对1年以上儿童进行的所有V/Q扫描进行识别,并查阅患者档案。两名核医学医生,对病人的数据和彼此的读数一无所知,解释了所有的闪烁图。结果共鉴定出20个平面和SPECT V/Q闪烁图。在17/20例(85%)的病例中,扫描结果可以直接指导临床决策。SPECT主要排除了平面显像所怀疑的通气和灌注缺陷的存在。在一致性方面,平面通气显像和灌注显像的Cohen’s通告系数分别为0.34和0.38(基本一致),SPECT显像的相应系数分别为0.42和0.61(中等至基本一致)。结论对儿童进行V/Q SPECT是可行的,具有一定的临床意义。在该患者组中,V/Q SPECT似乎比平面显像具有更好的相互一致性。
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引用次数: 0
Prior beetroot juice ingestion prevents the temporal reduction of endothelial function following acute high-intensity resistance exercise 事先摄入甜菜根汁可防止急性高强度阻力运动后内皮功能的暂时性降低
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-03 DOI: 10.1111/cpf.70014
Takuma Morishima, Sahiro Mizuno, Gaku Murakami, Rikako Yamazaki, Eisuke Ochi

Backgrounds

Nutritional strategies for preventing endothelial function impairment following high-intensity resistance exercise remain largely unknown. Considering that beetroot juice (BRJ) ingestion enhances nitric oxide levels, we aimed to evaluate whether prior BRJ ingestion would prevent endothelial function impairment following high-intensity resistance exercise.

Methods

Twelve young males underwent two experimental trials of high-intensity resistance exercise with prior: (1) placebo ingestion (PLA trial) and (2) BRJ ingestion (BRJ trial). All participants ingested 140 mL of PLA or BRJ (approximately 0.0055 or 12.8 mmol of nitrate, respectively) before the high-intensity resistance exercise (leg extension). Participants performed a resistance exercise session comprising five sets of 10 repetitions at 70% of one repetition maximum. During each intervention trial, heart rate (HR) and blood pressure were continuously measured. Brachial artery diameter, velocity, and flow-mediated dilation (FMD) were measured at pre-, 60 min after PLA or BRJ ingestion, and 10 and 60 min after the resistance exercise.

Results

No differences in systolic blood pressure, shear rate, blood flow, and vascular conductance in response to resistance exercise were noted between the trials (p > 0.05). However, at post-10 min after the resistance exercise, the BRJ trial exhibited a greater brachial artery FMD than the PLA trial (p < 0.05). Moreover, the BRJ trial had a significantly higher ΔFMD from pre- to the post-10–min period than the PLA trial (p < 0.05).

Conclusions

BRJ ingestion prevents endothelial function impairment immediately after a high-intensity resistance exercise.

背景:预防高强度阻力运动后内皮功能损伤的营养策略在很大程度上仍然未知。考虑到摄入甜菜根汁(BRJ)会提高一氧化氮水平,我们的目的是评估事先摄入BRJ是否会预防高强度阻力运动后的内皮功能损伤。方法12名年轻男性进行高强度抗阻运动实验,实验前分别服用安慰剂(PLA试验)和BRJ (BRJ试验)。所有参与者在高强度阻力运动(腿部伸展)前摄入140 mL PLA或BRJ(分别约为0.0055或12.8 mmol硝酸盐)。参与者进行了一项阻力运动,包括五组,每组10次重复,每次最多重复70%。在每次干预试验期间,连续测量心率(HR)和血压。在PLA或BRJ摄入前、60分钟以及阻力运动后10和60分钟测量肱动脉直径、流速和血流介导扩张(FMD)。结果两组抗阻运动后的收缩压、剪切率、血流量和血管导度无显著差异(p > 0.05)。然而,在阻力运动后10分钟,BRJ试验显示肱动脉FMD大于PLA试验(p < 0.05)。此外,BRJ试验在10分钟前至10分钟后的ΔFMD显著高于PLA试验(p < 0.05)。结论:在高强度阻力运动后立即摄入BRJ可防止内皮功能损伤。
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引用次数: 0
Absolute and relative changes in muscle thickness and muscle cross-sectional area 肌肉厚度和肌肉横截面积的绝对和相对变化
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-03 DOI: 10.1111/cpf.70013
Samuel L. Buckner, Selena L. Gonzalez, John M. Holtje, Enrique N. Moreno, Scott J. Dankel

Introduction

Changes in muscle size are often measured as a change in muscle thickness (MT) or as a change in muscle cross-sectional area (CSA). Differences in how muscles are measured is an important consideration as different absolute and relative changes in muscle size may carry different meaning.

Purpose

The purpose of the present study was to compare acute changes in MT and CSA in the rectus femoris following five sets of knee extension exercise.

Methods

Thirty-four participants visited the laboratory for one visit. Participant's dominant leg was placed into the exercise condition, and their contralateral leg was used as a non-exercise control. Ultrasound images were taken in both legs, before performing five sets of unilateral knee extension exercise in the dominant leg. Following exercise, participants had ultrasound images re-assessed. Pre and post values of MT and CSA were calculated from all images.

Results

Muscle size increased in the exercise condition when measured as MT (mean change [95% CI] = 0.404 [−0.347 to 0.460] cm, p < 0.00) or CSA (mean change [95% CI] = 0.734 [0.522−0.946] cm2, p < 0.001). In relative teams, MT increased by 25.5%, and the effect size of the change was 2.49. For CSA, the relative change was 37.3% and the effect size of the change was 1.20.

Conclusions

The relative change in MT following five sets of knee extension exercise was smaller than the relative change in CSA; however, the effect was larger, suggesting that the smaller relative change may have been easier to detect.

肌肉大小的变化通常被测量为肌肉厚度(MT)的变化或肌肉横截面积(CSA)的变化。肌肉测量方式的差异是一个重要的考虑因素,因为肌肉大小的绝对和相对变化可能具有不同的含义。目的本研究的目的是比较五组膝关节伸展运动后股骨直肌MT和CSA的急性变化。方法34名受试者进行一次访视。参与者的主腿被置于运动状态,而他们的对侧腿被用作非运动对照组。在主腿进行5组单侧膝关节伸展运动前,对两条腿进行超声成像。运动后,参与者的超声图像被重新评估。从所有图像中计算MT和CSA的前后值。结果在运动条件下,以MT(平均变化[95% CI] = 0.404[−0.347 ~ 0.460]cm, p < 0.00)或CSA(平均变化[95% CI] = 0.734 [0.522 ~ 0.946] cm2, p < 0.001)测量肌肉大小增加。在相对团队中,MT增加了25.5%,变化的效应量为2.49。CSA的相对变化为37.3%,变化的效应量为1.20。结论5组膝关节伸展运动后MT的相对变化小于CSA的相对变化;然而,影响更大,这表明较小的相对变化可能更容易被发现。
{"title":"Absolute and relative changes in muscle thickness and muscle cross-sectional area","authors":"Samuel L. Buckner,&nbsp;Selena L. Gonzalez,&nbsp;John M. Holtje,&nbsp;Enrique N. Moreno,&nbsp;Scott J. Dankel","doi":"10.1111/cpf.70013","DOIUrl":"https://doi.org/10.1111/cpf.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Changes in muscle size are often measured as a change in muscle thickness (MT) or as a change in muscle cross-sectional area (CSA). Differences in how muscles are measured is an important consideration as different absolute and relative changes in muscle size may carry different meaning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of the present study was to compare acute changes in MT and CSA in the rectus femoris following five sets of knee extension exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-four participants visited the laboratory for one visit. Participant's dominant leg was placed into the exercise condition, and their contralateral leg was used as a non-exercise control. Ultrasound images were taken in both legs, before performing five sets of unilateral knee extension exercise in the dominant leg. Following exercise, participants had ultrasound images re-assessed. Pre and post values of MT and CSA were calculated from all images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Muscle size increased in the exercise condition when measured as MT (mean change [95% CI] = 0.404 [−0.347 to 0.460] cm, <i>p</i> &lt; 0.00) or CSA (mean change [95% CI] = 0.734 [0.522−0.946] cm<sup>2</sup>, <i>p</i> &lt; 0.001). In relative teams, MT increased by 25.5%, and the effect size of the change was 2.49. For CSA, the relative change was 37.3% and the effect size of the change was 1.20.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The relative change in MT following five sets of knee extension exercise was smaller than the relative change in CSA; however, the effect was larger, suggesting that the smaller relative change may have been easier to detect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197154","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
Considerations for fasting and dehydration effects on pupillary light reflex: A commentary on Adam et al. (2025) 禁食和脱水对瞳孔光反射影响的考虑:对Adam等人(2025)的评述
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-06-01 DOI: 10.1111/cpf.70015
Kong Siang Syuan, Lien-Chung Wei
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引用次数: 0
Physiological alterations around the menopause transition—A 2-year follow-up in PRE, PERI, and POST menopause females 绝经前后的生理变化——绝经前、绝经期和绝经后女性的2年随访
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-05-12 DOI: 10.1111/cpf.70011
Paul A. Baker, Sam R. Moore, Abbie E. Smith-Ryan

Introduction

The menopause transition is a critical period marked by significant physiological adaptations. Data on the dynamic changes in body composition and metabolism during this transition are limited. The purpose was to determine body composition and metabolic changes over a 2-year follow-up in a cross-sectional sample of premenopausal (PRE), perimenopausal (PERI), and postmenopausal (POST) females.

Methods

Twenty-three females who previously participated in a cross-sectional study returned for a 2-year follow-up visit were classified as PRE, PERI, or POST based on menstrual history and a Menopause Health Questionnaire. Muscle size [muscle cross-sectional area (mCSA)] and muscle quality [echo intensity, (EI)] were evaluated in the vastus lateralis with ultrasound. Bone mass and body composition were assessed using dual-energy X-ray absorptiometry, and metabolic flexibility through submax exercise with indirect calorimetry.

Results

At the 2-year follow-up, POST females had an increase in EI (change: 26.93 ± 12.82 a.u., group×time p-adjusted = 0.001) with no change in mCSA (change: −2.03 ± 2.40 cm², group×time p = 0.980). PERI compared to PRE females had lower total bone mass (group×time p-adjusted = 0.029) with an even lower bone mass in POST compared to PERI females (group×time p-adjusted = 0.023). No differences in metabolic flexibility at any exercise intensity were observed between groups over time (group×time p = ≥ 0.05).

Conclusion

This study highlights a decline in muscle quality and total bone mass despite stable muscle size, emphasizing the need for targeted exercise and nutrition interventions to support muscle and bone health in females around the menopause transition.

绝经过渡期是一个重要的生理适应时期。关于这一转变过程中身体成分和新陈代谢的动态变化的数据是有限的。目的是确定绝经前(PRE)、围绝经期(PERI)和绝经后(POST)女性的横断面样本在2年随访期间的身体组成和代谢变化。方法对23名曾参加过横断面研究的女性进行为期2年的随访,根据月经史和绝经健康问卷将其分为PRE、PERI或POST。用超声评估股外侧肌的肌肉大小[肌肉横截面积(mCSA)]和肌肉质量[回声强度(EI)]。采用双能x线骨量测定法评估骨量和体成分,并采用间接量热法通过极限运动评估代谢灵活性。结果随访2年,术后女性EI增加(变化:26.93±12.82 a.u, group×time p校正= 0.001),mCSA无变化(变化:−2.03±2.40 cm²,group×time p = 0.980)。与PRE组相比,PRE组女性的总骨量更低(group×time p调整= 0.029),而POST组女性的骨量更低(group×time p调整= 0.023)。各组在任何运动强度下的代谢柔韧性随时间变化均无差异(group×time p =≥0.05)。本研究强调了肌肉质量和总骨量的下降,尽管肌肉大小稳定,强调需要有针对性的锻炼和营养干预,以支持绝经期女性的肌肉和骨骼健康。
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引用次数: 0
Effect of 7-day dietary supplementation with grape seed extract on cardiac autonomic and hemodynamic responses in elevated and stage 1 hypertension 膳食补充葡萄籽提取物7天对高血压和1期高血压患者心脏自主神经和血流动力学反应的影响
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-05-08 DOI: 10.1111/cpf.70010
Albert Lira, William Boyer, Trevor Gillum, Sean Sullivan, Jong-Kyung Kim

Backgrounds

Evidence indicated that an increase in nitric oxide (NO) bioavailability via dietary supplementation decreased sympathetic output. Grape seed extract (GSE) supplement has been known to increase NO production and improve endothelial function in individuals with elevated and stage 1 hypertension (ES1H), but no studies have assessed the effects of this extract on autonomic balance. Accordingly, the aim of the study was to investigate the effect of 7 days of dietary GSE supplementation on cardiac autonomic and hemodynamic responses.

Methods

Ten males were recruited in this study. Each subject received GSE or placebo supplementation with a 1-week wash-out period. In a double-blinded, cross-over design, hemodynamic responses (heart rate (HR), stroke volume (SV), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean atrial pressure (MAP)), heart rate variability (HRV), and cold pressor test (CPT) were compared before and after either GSE or placebo supplementation.

Results

Our results indicated that GSE decreased resting DBP (75 ± 2 vs. 71 ± 3) and MAP (91 ± 2 vs. 88 ± 3) compared to the placebo (DBP:71 ± 3 vs. 74 ± 3; MAP: 89 ± 2 vs. 90 ± 2). However, MAP responses to CPT had no difference between post-PL and post-GSE supplementation when expressed as absolute increases (PL, Δ10.3 ± 1 mmHg, GSE, Δ9.1 ± 1 mmHg). There were no differences on the HR, SV, CO, SBP, and HRV between placebo and GSE treatments.

Conclusions

Our study suggests that GSE can be used as a dietary nutraceutical capable of reducing blood pressure and the risk of ES1H development. The reduction of blood pressure occurs via peripheral vasodilation, not associated with cardiac autonomic reactivity.

有证据表明,通过膳食补充增加一氧化氮(NO)的生物利用度会降低交感神经输出。已知葡萄籽提取物(GSE)补充剂可以增加一氧化氮的产生并改善1期高血压(ES1H)患者的内皮功能,但没有研究评估这种提取物对自主神经平衡的影响。因此,本研究的目的是研究饲粮中添加7天GSE对心脏自主神经和血流动力学反应的影响。方法本研究招募10名男性。每位受试者接受GSE或安慰剂补充,洗脱期为1周。在双盲、交叉设计中,比较了GSE或安慰剂补充前后的血流动力学反应(心率(HR)、卒中量(SV)、心输出量(CO)、收缩压(SBP)、舒张压(DBP)、平均心房压(MAP)、心率变异性(HRV)和冷压试验(CPT)。结果与安慰剂相比,GSE可降低静息DBP(75±2比71±3)和MAP(91±2比88±3)(DBP:71±3比74±3;MAP: 89±2 vs. 90±2)。然而,当以绝对增加表示(PL, Δ10.3±1 mmHg, GSE, Δ9.1±1 mmHg)时,添加GSE后和添加GSE后对CPT的MAP反应没有差异。安慰剂组和GSE组在HR、SV、CO、SBP和HRV方面没有差异。结论GSE可作为一种膳食营养保健品,具有降低血压和降低ES1H发生风险的作用。血压的降低是通过外周血管舒张发生的,与心脏自主神经反应无关。
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引用次数: 0
Diagnostic value of combined heart and lung ultrasound in emergency department patients with dyspnea 心肺联合超声对急诊科呼吸困难患者的诊断价值
IF 1.3 4区 医学 Q4 PHYSIOLOGY Pub Date : 2025-04-17 DOI: 10.1111/cpf.70009
Anna Bjällmark, Gustaf Hummel, Kambiz Shahgaldi

Background

Acute dyspnea in emergency departments (ED) requires prompt and accurate diagnosis due to its high mortality and readmission rates. Conventional diagnostic methods are resource-intensive and time-consuming. This study aimed to evaluate the diagnostic accuracy and time to diagnosis of combined heart and lung ultrasound (HeaLus) compared to standard emergency department evaluation in patients presenting with dyspnea.

Methods

A prospective study was conducted in a cohort of 61 patients at the ED of Danderyd Hospital, Sweden. HeaLus examinations were performed alongside routine investigations. Diagnostic performance of HeaLus and ED evaluation was assessed for accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, and agreement using Kappa index. Median time to diagnostics was compared between HeaLus and ED evaluation using Mann-Whitney U-test.

Results

Heart failure was the most common diagnosis (20%) among patients presenting with dyspnea. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 95% (95% CI: [87%, 98%]), 98% (95% CI: [88%, 100%]), 90% (95% CI: [69%, 97%]), 95% (95% CI: [85%, 99%]), and 94% (95% CI: [74%, 99%]), respectively. The agreement between HeaLus and ED diagnoses was 0.88. Time to diagnosis was significantly reduced with HeaLus (21 min vs. 3 h and 28 min).

Conclusions

HeaLus offers rapid and accurate assessment of dyspnea. These results suggest that HeaLus could be valuable in optimizing patient management, particularly in settings with limited resources and long ED wait times.

背景急诊急性呼吸困难由于其高死亡率和再入院率需要及时准确的诊断。传统的诊断方法需要大量的资源和时间。本研究旨在评价心肺联合超声(HeaLus)诊断呼吸困难患者的准确性和诊断时间,并与标准急诊科评估进行比较。方法对瑞典Danderyd医院急诊科的61例患者进行前瞻性研究。在常规检查的同时进行健康检查。采用Kappa指数评估HeaLus和ED诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值以及一致性。采用Mann-Whitney u检验比较HeaLus和ED评估的中位诊断时间。结果在出现呼吸困难的患者中,心衰是最常见的诊断(20%)。诊断准确性、敏感性、特异性、阳性预测值和阴性预测值分别为95% (95% CI:[87%, 98%])、98% (95% CI:[88%, 100%])、90% (95% CI:[69%, 97%])、95% (95% CI:[85%, 99%])和94% (95% CI:[74%, 99%])。HeaLus诊断与ED诊断的一致性为0.88。HeaLus显著缩短了诊断时间(21分钟vs. 3小时和28分钟)。结论HeaLus能快速准确地评估呼吸困难。这些结果表明HeaLus在优化患者管理方面很有价值,特别是在资源有限和急诊科等待时间长的情况下。
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Clinical Physiology and Functional Imaging
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