Clinical Physiology and Functional Imaging最新文献

This study aimed to determine how behavioural restrictions due to the emergency declaration following the coronavirus disease 2019 (COVID-19) pandemic affect exercise tolerance and its outcomes in patients in Phase III cardiac rehabilitation programme. This is a multicenter retrospective cohort study. Participants in outpatient cardiac rehabilitation programmes and cardiopulmonary exercise testing before and after the emergency declarations were included. A total of 90 participants were included (median age 75.0 years, 69% male), and the changes in physical function and exercise tolerance were compared before and after the emergency declaration. Patients were divided into a decline-in-peak oxygen uptake (VO₂) group and a nondecline-in-peak VO₂ group. Comparison before and after the emergency declaration showed that the anaerobic threshold declined significantly and peak VO₂ exhibited a downward trend. The decline-in-peak VO₂ group consisted of 16 patients (17%) with better exercise tolerance, multiple comorbidities, and declined lower extremity muscle strength. These patients also had a higher rate of subsequent composite events (hazard ratio, 5.2; 95% confidence interval, 1.4–18.8, p = 0.01). Before and after the emergency declaration, the patient's exercise tolerance may decline, leading to a poor prognosis. This study suggests the importance of maintaining exercise tolerance during the COVID-19 pandemic.

Skin tissue holds a prominent role in microcirculatory research as an easily accessible vascular bed for the noninvasive evaluation of microvascular function. Skin microvascular changes have been associated to alterations in distinct target organs and vascular beds, reinforcing the hypothesis that skin microcirculation can be used as a model of generalized microvascular function. In addition, skin microvascular dysfunction has been documented in cardiovascular disease and patients of increased cardiovascular risk where it has been associated with multiple cardiovascular risk factors, rendering it a candidate surrogate marker of vascular damage. Laser speckle contrast imaging (LSCI) is a noninvasive, dynamic laser technique that allows assessment of skin microvascular function (SMF) by obtaining two-dimensional maps of the skin perfusion in real time with high spatial and temporal resolution and, most importantly, with the highest reproducibility compared to other laser methods. An ever-increasing number of studies using LSCI is confirming evidence of impaired SMF in several cardiovascular risk groups, therefore expanding its application in microvascular research and showing its potential clinical utility. This review attempts to present the growing importance of SMF in cardiovascular research and the emergence of LSCI technique as a robust imaging modality with a promising role to explore skin microvascular physiology. After a short description of the relevant technique and its main principle of function, we have also opted to present the most up to date studies using LSCI for the investigation of SMF in patients with cardiovascular disease as well as various groups of increased cardiovascular risk.

Chronic kidney disease (CKD) is a major population disease. In diabetes as well as hypertension, kidney disease is one of the most serious complications. Recent research has demonstrated that chronic hypoxia is a key actor in the pathogenesis of CKD. In this review, we focus on how functional magnetic resonance imaging (fMRI) techniques can shed light on pathogenetic mechanisms and monitor new treatments aimed at preventing or ameliorating the disease. Multiparametric MRI techniques can measure changes in renal artery flow, tissue perfusion, and oxygenation repetitively over short time periods, enabling high time resolution. Furthermore, renal fibrosis can be quantified noninvasively by MRI diffusion tensor imaging, and techniques are upcoming to measure renal oxygen consumption. These techniques are all radiation and contrast-free.

We briefly present data, demonstrating that fMRI techniques can play a major role in future research in CKD, and possibly also in daily clinical practice.

Breast cancer (BC) is the most common type of cancer among women. Radiotherapy (RT) is one of the main and primary treatment options for BC, especially in breast-conserving surgery (BCS). BC patients who underwent RT experience a wide range of symptoms, in which breast oedema and irritation of the skin take the lion's share. Breast oedema/lymphedema, which is also a prominent side effect after RT should be well determined in earlier settings due to the chronicity of lymphedema. Therefore, this study aimed to analyze the biophysical parameters of skin on the ipsilateral (IL) and contralateral (CL) sites via Tissue dielectric constant (TDC) and Transepidermal water loss (TEWL) methods in terms of oedema and skin barrier function (SBF). The following reference points before and after the RT were measured: (R1: Pectoralis muscle, R2: Upper breast, R3: Lower breast, R4: Lateral site of the thorax). A total of 24 BC patients (mean age and BMI: 52.78 ± 9.85 years and 28.42 ± 5.64 kg/m²) were evaluated. In the IL site, the SBF was not found significant in R1-R3, whereas significantly lower SBF was observed in R4 after RT (t = −3.361, p = 0.003). A significant increase in TDC was observed in R2 at the 5.0 mm depth (t = −2.500, p = 0.02). We suggest that a longer period of follow-up should be carefully carried out to track changes in terms of SBF and oedema in the irradiated breast. The increased need for early detection of changes associated with breast lymphedema can be achievable via noninvasive, safe, cheap, and easily repeatable devices.