Journal for vascular ultrasound : JVU最新文献

英文中文

Transcranial Color-Coded Doppler Cerebral Hemodynamics Following Aerobic Exercise Training: Outcomes From a Pilot Randomized Clinical Trial. 有氧运动训练后经颅彩色编码多普勒脑血流动力学:一项随机临床试验的结果。

Journal for vascular ultrasound : JVU

Pub Date : 2022-09-01 DOI: 10.1177/15443167221099274

Carol Mitchell, J Max Gaitán, Ryan J Pewowaruk, Adam D Gepner, Timothy Hess, Stephanie M Wilbrand, Robert J Dempsey, Ryan J Dougherty, Dane B Cook, Ozioma Okonkwo

Introduction: An active lifestyle with regular exercise is thought to decrease or delay the onset of Alzheimer dementia through increasing blood flow to the brain. We examined the mean flow velocity (MFV) and pulsatility index (PI) in the middle cerebral arteries of individuals randomized into two groups-a Usual Physical Activity (UPA) group and an Enhanced Physical Activity (EPA) exercise intervention group-to determine if exercise training is related to changes in cerebral blood flow.

Methods: We examined 23 participants, randomized into a UPA group (n=12) and an EPA group (n=11), with transcranial color-coded Doppler (TCCD) and cardiorespiratory fitness (VO₂peak, mL/kg/min) testing at baseline and following a 26-week intervention. TCCD was used to measure MFV and PI. Participants in the EPA group completed supervised aerobic exercise training for 26 weeks. Kendall's tau b correlation was used to examine relationships between variables. The Wilcoxon Rank Sum tests were used to examine changes between the UPA and EPA groups.

Results: There was no significant change in MFV or PI in the UPA group or the EPA group (p-values >0.05) between baseline and 26 weeks; the change between the UPA and EPA groups was also not significant (p=0.603). There was no evidence of an association between change in VO₂peak and change in MFV or PI (all p-values >0.05). Participants in the EPA group significantly increased their VO₂peak compared to the UPA group (p=0.027).

Conclusion: This study did not demonstrate evidence of a significant change in the MFV in the middle cerebral arteries or evidence of a significant change in the PI between UPA and EPA groups. Future studies should be performed in larger cohorts and should consider use of personalized exercise programs to maximize understanding of how cerebrovascular hemodynamics change in structure and function with exercise for adults at risk for Alzheimer dementia.

导读:积极的生活方式加上有规律的锻炼被认为可以通过增加大脑的血流量来减少或延缓阿尔茨海默氏症的发作。我们检测了随机分为两组的个体大脑中动脉的平均血流速度(MFV)和脉搏指数(PI)——常规体育活动(UPA)组和增强体育活动(EPA)运动干预组，以确定运动训练是否与脑血流量的变化有关。方法:我们检查了23名参与者，随机分为UPA组(n=12)和EPA组(n=11)，在基线和26周干预后进行经颅彩色编码多普勒(TCCD)和心肺健康(VO2peak, mL/kg/min)测试。TCCD测量MFV和PI。EPA组的参与者完成了为期26周的有氧运动训练。Kendall’s tau b相关被用来检验变量之间的关系。使用Wilcoxon秩和检验来检查UPA组和EPA组之间的变化。结果:UPA组和EPA组的MFV和PI在基线和26周之间无显著变化(p值>0.05);UPA组与EPA组间差异也不显著(p=0.603)。没有证据表明vo2峰值的变化与MFV或PI的变化有关联(p值均>0.05)。与UPA组相比，EPA组的参与者的vo2峰值显著增加(p=0.027)。结论:本研究没有证明UPA组和EPA组之间大脑中动脉MFV有显著变化或PI有显著变化的证据。未来的研究应在更大的队列中进行，并应考虑使用个性化的运动计划，以最大限度地了解有阿尔茨海默病风险的成年人在运动时脑血管血流动力学的结构和功能变化。

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引用次数: 2

Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients. 全双工超声诊断 COVID-19 危重患者深静脉血栓的作用。

Journal for vascular ultrasound : JVU

Pub Date : 2021-03-01 DOI: 10.1177/1544316720985812

Matteo Pozzi, Marco Giani, Benedetta Fumagalli, Mariangela Calabria, Davide Leni, Vittorio Segramora, Giacomo Bellani, Giuseppe Foti

An increased risk of deep vein thrombosis (DVT) has been reported in critical COVID-19 patients, despite adequate thromboprophylaxis, and most of DVT are probably asymptomatic. As a screening approach has been advocated, the best examination protocol is unknown. The objective of this study is to assess the role of a Complete Duplex Ultrasound (CDUS) examination in detecting DVT in a large population of COVID-19 patients admitted to intensive care unit (ICU) for respiratory failure. Single-center retrospective study of 145 COVID-19 patients admitted to ICU. DVT was assessed with a CDUS performed by experienced radiologist after ICU admission. DVT was confirmed in 38 patients (26%). Most DVT were distal to the knee (66%), while only 16% were proximal. At the time of the examination, 55% of the patients received full-dose anticoagulation, while 45% received thromboprophylaxis, and there were no differences in anticoagulation regimen between positive and negative patients. Patients with DVT had higher dimers compared with those with negative CDUS (P < .002). The observed frequency of DVT is high despite adequate anticoagulation. A comprehensive and experienced ultrasound examination protocol can allow to recognize a large number of distal DVT otherwise missed, albeit their clinical significance is unknown.

有报道称，尽管采取了充分的血栓预防措施，COVID-19 危重病人发生深静脉血栓（DVT）的风险仍有所增加，而且大多数深静脉血栓可能是无症状的。由于一直提倡筛查方法，最佳检查方案尚不清楚。本研究的目的是评估在大量因呼吸衰竭入住重症监护室（ICU）的 COVID-19 患者中，完全双相超声（CDUS）检查在检测深静脉血栓中的作用。单中心回顾性研究针对 145 名入住重症监护室的 COVID-19 患者。入住重症监护室后，由经验丰富的放射科医生通过 CDUS 对深静脉血栓进行评估。38名患者（26%）被证实患有深静脉血栓。大多数深静脉血栓发生在膝关节远端（66%），只有 16% 发生在膝关节近端。检查时，55%的患者接受了全剂量抗凝治疗，45%的患者接受了血栓预防治疗，阳性和阴性患者的抗凝治疗方案没有差异。与 CDUS 阴性患者相比，深静脉血栓患者的二聚体更高（P < .002）。尽管进行了充分的抗凝治疗，但观察到的深静脉血栓发生率仍然很高。全面而经验丰富的超声检查方案可以识别出大量被漏诊的远端深静脉血栓，尽管其临床意义尚不清楚。

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