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71 results on '"Rausch, Christopher"'

70. The Older Driver: When Is It Time to Take Away the Keys?

Author

Finestone, Albert J and Rausch, Christopher J

Abstract

The article discusses the effective ways to determine the fitness of older adults to drive. The elderly population in the US is growing and therefore it is extremely important to determine when to ask the older people to stop driving. Public policy on restricted licensing and stringent renewal procedures reduce the number of older drivers; physicians must also inform the department of motor vehicles if they find an individual has a condition that makes him/her unfit for driving.

Published
2012

71. Abstract 10453: Wave Propagation Through Systemic Vasculature is Abnormal in Patients With Fontan Circulation and Correlates With Functional Exercise Indices

Author

Schafer, Michal, Frank, Benjamin, Jacobsen, Roni, Rausch, Christopher, Mitchell, Max B, Jaggers, James, Browne, Lorna, Barker, Alexander J, Hunter, Kendall S, Ivy, Dunbar D, and Younoszai, Adel K

Abstract

Introduction:Elevated systemic afterload in patients with Fontan circulation may lead to impaired single ventricular function. Wave intensity analysis (WIA) enables evaluation of compression and expansion waves traveling through vasculature. Unfavorable wave propagation causing excessive afterload may be an important contributor to limited functional capacity in this patient population.Hypothesis:Patients with Fontan circulation have abnormal WIA that will correlate with a reduction in aerobic capacity (VO2).Methods:Patients with hypoplastic left heart syndrome (HLHS) (n=23), single left ventricle (SLV) (n=26), and normal controls (n=10) underwent phase-contrast MRI based WIA analysis evaluated in the ascending aorta. Forward compression wave (FCW) representing dP/dt, backward compression wave (BCW) reflecting vascular stiffness, and forward expansion wave (FEW) representing LV relaxation were recorded and indexed to each other.Results:FCW was lowest in HLHS patients (1098 mm5/s), followed by SLV group (1457 mm5/s), and controls (6457 mm5/s) (P<0.001) (Figure). FCW/FEW was reduced in both HLHS (2.8) and SLV (2.6) groups compared to controls (12.6) (P<0.001). FCW/BCW was increased in HLHS (0.22) and SLV (0.14) groups compared to controls (0.08) (P=0.003). Peak VO2 correlated with FCW (R=0.50, P=0.01) and FEW (R=0.41, P=0.04).Conclusions:Patients with HLHS and SLV have unfavorable aortic WIA patterns with increased FCW/BCW ratio indicating increased systemic afterload due to retrograde compression waves. Reduced FCW and FEW correlated with peak VO2 suggesting that abnormal systolic and diastolic wave propagation through systemic vasculature may play a role in exercise intolerance for Fontan patients.

Published
2019
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