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排序方式: 共有711条查询结果,搜索用时 203 毫秒
81.
Ronak Delewi Robin Nijveldt Alexander Hirsch Constantin B. Marcu Lourens Robbers Marriela E.C.J. Hassell Rianne H.A. de Bruin Jim Vleugels Anja M. van der Laan Berto J. Bouma René A. Tio Jan G.P. Tijssen Albert C. van Rossum Felix Zijlstra Jan J. Piek 《European journal of radiology》2012
Introduction
Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI.Methods
200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events.Results
On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53).Conclusion
LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large. 相似文献82.
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Karim Taha Wouter P. te Rijdt Tom E. Verstraelen Maarten J. Cramer Rudolf A. de Boer Rianne H.A.C.M. de Bruin-Bon Berto J. Bouma Folkert W. Asselbergs Arthur A.M. Wilde Maarten P. van den Berg Arco J. Teske 《JACC: Cardiovascular Imaging》2021,14(5):885-896
ObjectivesThis study aimed to explore echocardiographic characteristics of phospholamban (PLN) p.Arg14del mutation carriers to investigate whether structural and/or functional abnormalities could be identified before onset of symptoms.BackgroundCarriers of the genetic PLN p.Arg14del mutation may develop arrhythmogenic and/or dilated cardiomyopathy. Overt disease is preceded by a pre-symptomatic phase of variable length in which disease expression seems to be absent.MethodsPLN p.Arg14del mutation carriers with an available echocardiogram were included. Mutation carriers were classified as pre-symptomatic if they had no history of ventricular arrhythmias (VAs), a premature ventricular complex count of <500/24 h, and a left ventricular (LV) ejection fraction of ≥45%. In addition, we included 70 control subjects with similar age and sex distribution as the pre-symptomatic mutation carriers. Comprehensive echocardiographic analysis (including deformation imaging) was performed.ResultsThe final study population consisted of 281 PLN p.Arg14del mutation carriers, 139 of whom were classified as pre-symptomatic. In comparison to control subjects, pre-symptomatic mutation carriers had lower global longitudinal strain and higher LV mechanical dispersion (both p < 0.001). In addition, post-systolic shortening (PSS) in the LV apex was observed in 43 pre-symptomatic mutation carriers (31%) and in none of the control subjects. During a median follow-up of 3.2 years (interquartile range: 2.1 to 5.6 years) in 104 pre-symptomatic mutation carriers, nonsustained VA occurred in 13 (13%). Presence of apical PSS was the strongest echocardiographic predictor of VA (multivariable hazards ratio: 5.11; 95% confidence interval [CI]: 1.37 to 19.08; p = 0.015), which resulted in a negative predictive value of 96% (95% CI: 89% to 98%) and a positive predictive value of 29% (95% CI: 21% to 40%).ConclusionsGlobal and regional LV mechanical alterations in PLN p.Arg14del mutation carriers precede arrhythmic symptoms and overt structural disease. Pre-symptomatic mutation carriers with normal deformation patterns in the apex are at low risk of developing VA within 3 years, whereas mutation carriers with apical PSS appear to be at higher risk. 相似文献
87.
Romberg-Camps MJ Korsten HH Botman CJ Bindels AJ Roos AN 《The Netherlands journal of medicine》2000,57(3):94-97
Right ventricular failure can be the result of acute respiratory distress syndrome (ARDS). A patient with eclampsia and sepsis with Staphylococcus aureus developed life-threatening right ventricular failure as a result of ARDS. She finally stabilized after treatment with inhaled nitric oxide (NO). The pathophysiology of right ventricular failure in ARDS is described. 相似文献
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Nuray Gül Liane Babes Kerstin Siegmund Rianne Korthouwer Marijn B?gels Rens Braster Gestur Vidarsson Timo L.M. ten Hagen Paul Kubes Marjolein van Egmond 《The Journal of clinical investigation》2014,124(2):812-823
The use of monoclonal antibodies (mAbs) as therapeutic tools has increased dramatically in the last decade and is now one of the mainstream strategies to treat cancer. Nonetheless, it is still not completely understood how mAbs mediate tumor cell elimination or the effector cells that are involved. Using intravital microscopy, we found that antibody-dependent phagocytosis (ADPh) by macrophages is a prominent mechanism for removal of tumor cells from the circulation in a murine tumor cell opsonization model. Tumor cells were rapidly recognized and arrested by liver macrophages (Kupffer cells). In the absence of mAbs, Kupffer cells sampled tumor cells; however, this sampling was not sufficient for elimination. By contrast, antitumor mAb treatment resulted in rapid phagocytosis of tumor cells by Kupffer cells that was dependent on the high-affinity IgG-binding Fc receptor (FcγRI) and the low-affinity IgG-binding Fc receptor (FcγRIV). Uptake and intracellular degradation were independent of reactive oxygen or nitrogen species production. Importantly, ADPh prevented the development of liver metastases. Tumor cell capture and therapeutic efficacy were lost after Kupffer cell depletion. Our data indicate that macrophages play a prominent role in mAb-mediated eradication of tumor cells. These findings may help to optimize mAb therapeutic strategies for patients with cancer by helping us to aim to enhance macrophage recruitment and activity. 相似文献
90.
Charles J. Blijdorp Omar A. Z. Tutakhel Thomas A. Hartjes Thierry P. P. van den Bosch Martijn H. van Heugten Juan Pablo Rigalli Rob Willemsen Usha M. Musterd-Bhaggoe Eric R. Barros Roger Carles-Fontana Cristian A. Carvajal Onno J. Arntz Fons A. J. van de Loo Guido Jenster Marian C. Clahsen-van Groningen Cathy A. Cuevas David Severs Robert A. Fenton Martin E. van Royen Joost G. J. Hoenderop Ren J. M. Bindels Ewout J. Hoorn 《Journal of the American Society of Nephrology : JASN》2021,32(5):1210