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Objective: This systematic review aims to determine the extent, scope, and nature of research using the sonographic measurement of intraneural blood flow within the median nerve and to identify, characterize, and compare image acquisition and analysis protocols that have been reported as potential candidate techniques for standardizing research and clinical applications. Materials and Methods: This systematic review summarizes image acquisition protocols and analysis methodologies from 52 current research studies using Doppler ultrasound to examine median nerve intraneural blood flow. Results: Four types of Doppler technologies were identified: power Doppler, color Doppler, spectral Doppler, and Superb Microvascular Imaging, but there were inconsistencies in how images were acquired and analyzed. Intraneural blood flow measurements were categorized into four types based on a combination of measurement level (e.g., binary, ordinal, continuous) and type of flow indicator (e.g., pixel count, intensity, velocity). Conclusion: Standardized imaging protocols and reporting guidelines are needed to improve consistency. Future studies should evaluate the accuracy and reliability of different image acquisition methods and analysis measurements. [ABSTRACT FROM AUTHOR]

Background: To explore the correlation between left atrial appendage morphology, blood flow velocity and plasma galectin-3 and thrombosis in patients with atrial fibrillation. Methods: Patients with atrial fibrillation who received treatment and completed ultrasound examination in hospital from 2022 to December 2023 were enrolled. According to whether there was left atrial appendage thrombosis, the patients were divided into a control group (no left atrial appendage thrombosis was found) and a study group (left atrial appendage thrombosis was found). The morphology and structure of the left atrial appendage, blood flow velocity and plasma galectin-3 level were recorded exploring its correlation with left atrium thrombosis. Results: A total of 330 patients with atrial fibrillation were enrolled, including 278 in the control group and 52 in the study group. Left group and the control group of morphological structure differences (P < 0.05). The main lobe length, ostial area, longest diameter, shortest diameter, left atrial appendage volume and left atrial volume in the study group were higher than those in the control group (P <0.05). The left atrial appendage emptying velocity, filling velocity and left ventricular ejection fraction of the study group were lower than those of the control group, and the left ventricular end-diastolic diameter was higher than that of the control group (P < 0.05). Group of white blood cell count, neutrophils/lymphocyte ratio, plasma galactose lectin-3 levels were higher than control group (P < 0.05). ROC curve analysis of left atrial appendage emptying velocity, left atrial appendage filling velocity, left atrial enddiastolic diameter and left atrial ejection fraction had higher diagnostic value (P < 0.05). Conclusions: Left atrial appendage morphology, blood flow velocity and plasma galectin-3 level are important factors to evaluate the risk of left atrial appendage thrombosis in patients with atrial fibrillation. This study improves the understanding of thrombosis, further elucidates the risk factors for thrombosis, and improves patient prognosis. [ABSTRACT FROM AUTHOR]

Post‐traumatic stress disorder (PTSD) is associated with increased cardiovascular disease (CVD) risk. Compared with males, females are twice as likely to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. We aimed to examine hemodynamic responses to acute mental stress in trauma‐exposed females with and without a clinical diagnosis of PTSD. We hypothesized that females with PTSD would have higher heart rate (HR), blood pressure (BP), and lower blood flow velocity (BFV) responsiveness compared with controls. We enrolled 21 females with PTSD and 21 trauma‐exposed controls. We continuously measured HR using a three‐lead electrocardiogram, BP using finger plethysmography, and brachial BFV using Doppler ultrasound. All variables were recorded during 10 min of supine rest, 5 min of mental arithmetic, and 5 min of recovery. Females with PTSD were older, and had higher BMI and higher resting diastolic BP. Accordingly, age, BMI, and diastolic BP were covariates for all repeated measures analyses. Females with PTSD had a blunted brachial BFV response to mental stress (time × group, p = 0.005) compared with controls, suggesting greater vasoconstriction. HR and BP responses were comparable. In conclusion, our results suggest early impairment of vascular function in premenopausal females with PTSD. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to investigate the relationship between posterior tibial artery blood flow velocity and plantar heel pain (PHP). Methods: The PHP group comprised patients diagnosed with plantar fasciitis with plantar heel pain during gait, and the control group comprised healthy participants without plantar heel pain. The peak systolic velocity of the posterior tibial artery was measured using ultrasonography; it was measured three times on each side, and the mean value was calculated. Receiver operating characteristic curve analysis was performed to calculate the peak systolic velocity cutoff value for plantar heel pain. Results: 23 patients (age 58.0 ± 16.5 years; 13 males and 10 females) and 23 healthy participants (age 51.3 ± 17.3 years; 10 males and 13 females) formed the PHP and control groups, respectively. Peak systolic velocity on the affected side was significantly greater in the PHP group (44.1 ± 13.1 cm/s) than in the control group (32.7 ± 5.9 cm/s). No significant difference was observed between the left and right sides in the PHP (7.1 ± 9.8 cm/s) and control (3.7 ± 3.0 cm/s) groups. A cutoff value of 38.2 cm/s was observed on the affected side. Conclusions: We quantified the increase in posterior tibial artery blood flow velocity in patients with plantar heel pain. Peak systolic velocity measurements can aid in quantitatively evaluating these patients. This study was registered as a clinical trial (UMIN000046875) on 1 October 2021. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Acupuncture & Tuina Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Post‐traumatic stress disorder (PTSD) is associated with increased cardiovascular disease (CVD) risk. Compared with males, females are twice as likely to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. We aimed to examine hemodynamic responses to acute mental stress in trauma‐exposed females with and without a clinical diagnosis of PTSD. We hypothesized that females with PTSD would have higher heart rate (HR), blood pressure (BP), and lower blood flow velocity (BFV) responsiveness compared with controls. We enrolled 21 females with PTSD and 21 trauma‐exposed controls. We continuously measured HR using a three‐lead electrocardiogram, BP using finger plethysmography, and brachial BFV using Doppler ultrasound. All variables were recorded during 10 min of supine rest, 5 min of mental arithmetic, and 5 min of recovery. Females with PTSD were older, and had higher BMI and higher resting diastolic BP. Accordingly, age, BMI, and diastolic BP were covariates for all repeated measures analyses. Females with PTSD had a blunted brachial BFV response to mental stress (time × group, p = 0.005) compared with controls, suggesting greater vasoconstriction. HR and BP responses were comparable. In conclusion, our results suggest early impairment of vascular function in premenopausal females with PTSD.

Abstract Background Phase-contrast magnetic resonance imaging (PC-MRI) quantifies blood flow and velocity noninvasively. Challenges arise in neurovascular disorders due to small vessels. We evaluated the impact of voxel size, number of signal averages (NSA), and velocity encoding (VENC) on PC-MRI measurement accuracy and precision in a small-lumen vessel phantom. Methods We constructed an in vitro model with a constant flow rate using a 2.2-mm inner diameter plastic tube. A reservoir with a weight scale and timer was used as standard reference. Gradient-echo T1 weighted PC-MRI sequence was performed on a 3-T scanner with varying voxel size (2.5, 5.0, 7.5 mm3), NSA (1, 2, 3), and VENC (200, 300, 400 cm/s). We repeated measurements nine times per setting, calculating mean flow rate, maximum velocity, and least detectable difference (LDD). Results PC-MRI flow measurements were higher than standard reference values (mean ranging from 7.3 to 9.5 mL/s compared with 6.6 mL/s). Decreased voxel size improved accuracy, reducing flow rate measurements from 9.5 to 7.3 mL/s. The LDD for flow rate and velocity varied between 1 and 5%. The LDD for flow rate decreased with increased voxel size and NSA (p = 0.033 and 0.042). The LDD for velocity decreased with increased voxel size (p

Background: To explore the correlation between left atrial appendage morphology, blood flow velocity and plasma galectin-3 and thrombosis in patients with atrial fibrillation. Methods: Patients with atrial fibrillation who received treatment and completed ultrasound examination in hospital from 2022 to December 2023 were enrolled. According to whether there was left atrial appendage thrombosis, the patients were divided into a control group (no left atrial appendage thrombosis was found) and a study group (left atrial appendage thrombosis was found). The morphology and structure of the left atrial appendage, blood flow velocity and plasma galectin-3 level were recorded exploring its correlation with left atrium thrombosis. Results: A total of 330 patients with atrial fibrillation were enrolled, including 278 in the control group and 52 in the study group. Left group and the control group of morphological structure differences (P < 0.05). The main lobe length, ostial area, longest diameter, shortest diameter, left atrial appendage volume and left atrial volume in the study group were higher than those in the control group (P < 0.05). The left atrial appendage emptying velocity, filling velocity and left ventricular ejection fraction of the study group were lower than those of the control group, and the left ventricular end-diastolic diameter was higher than that of the control group (P < 0.05). Group of white blood cell count, neutrophils/lymphocyte ratio, plasma galactose lectin-3 levels were higher than control group (P < 0.05). ROC curve analysis of left atrial appendage emptying velocity, left atrial appendage filling velocity, left atrial enddiastolic diameter and left atrial ejection fraction had higher diagnostic value (P < 0.05). Conclusions: Left atrial appendage morphology, blood flow velocity and plasma galectin-3 level are important factors to evaluate the risk of left atrial appendage thrombosis in patients with atrial fibrillation. This study improves the understanding of thrombosis, further elucidates the risk factors for thrombosis, and improves patient prognosis.

Background Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P

Maturational differences exist in cardiopulmonary and cerebrovascular function at sea-level, but the impact of maturation on acclimatization responses to high altitude is unknown. Ten children (9.8 ± 2.5 years) and 10 adults (34.7 ± 7.1 years) were assessed at sea-level (BL), 3000 m and twice over 4 days at 3800 m (B1, B4). Measurements included minute ventilation ( V̇E${\dot{V}}_{\rm{E}}$ ), end-tidal partial pressures of oxygen ( PETO2${P}_{{\rm{ETO}}_{\rm{2}}}$ ) and carbon dioxide, echocardiographic assessment of pulmonary artery systolic pressure (PASP) and stroke volume (SV) and ultrasound assessment of blood flow through the internal carotid and vertebral arteries was performed to calculate global cerebral blood flow (gCBF). At 3000 m, V̇E${\dot{V}}_{\rm{E}}$ was increased from BL by 19.6 ± 19.1% (P = 0.031) in children, but not in adults (P = 0.835); SV was reduced in children (-11 ± 13%, P = 0.020) but not adults (P = 0.827), which was compensated for by a larger increase in heart rate in children (+26 beats min-1 vs. +13 beats min-1 , P = 0.019). Between B1 and B4, adults increased V̇E${\dot{V}}_{\rm{E}}$ by 38.5 ± 34.7% (P = 0.006), while V̇E${\dot{V}}_{\rm{E}}$ did not increase further in children. The rise in PASP was not different between groups; however, ∆PASP from BL was related to ∆ PETO2${P}_{{\rm{ETO}}_{\rm{2}}}$ in adults (R2  = 0.288, P = 0.022), but not children. At BL, gCBF was 43% higher in children than adults (P = 0.017), and this difference was maintained at high altitude, with a similar pattern and magnitude of change in gCBF between groups (P = 0.845). Despite V̇E${\dot{V}}_{\rm{E}}$ increasing in children but not adults at a lower altitude, the pulmonary vascular and cerebrovascular responses to prolonged hypoxia are similar between children and adults. KEY POINTS: Children have different ventilatory and metabolic requirements from adults, which may present differently in the pulmonary and cerebral vasculature upon ascent to high altitude. Children (ages 7-14) and adults (ages 23-44) were brought from sea level to high altitude (3000 to 3800 m) and changes in ventilation, pulmonary artery systolic pressure (PASP) and cerebral blood flow (CBF) were assessed over 1 week. Significant increases in ventilation and decreases in left ventricle stroke volume were observed at a lower altitude in children than adults. PASP and CBF increased by a similar relative amount between children and adults at 3800 m. These results help us better understand age-related differences in compensatory responses to prolonged hypoxia in children, despite similar changes in pulmonary artery pressure and CBF between children and adults.

Background: Phase-contrast magnetic resonance imaging (PC-MRI) quantifies blood flow and velocity noninvasively. Challenges arise in neurovascular disorders due to small vessels. We evaluated the impact of voxel size, number of signal averages (NSA), and velocity encoding (VENC) on PC-MRI measurement accuracy and precision in a small-lumen vessel phantom. Methods: We constructed an in vitro model with a constant flow rate using a 2.2-mm inner diameter plastic tube. A reservoir with a weight scale and timer was used as standard reference. Gradient-echo T1 weighted PC-MRI sequence was performed on a 3-T scanner with varying voxel size (2.5, 5.0, 7.5 mm3), NSA (1, 2, 3), and VENC (200, 300, 400 cm/s). We repeated measurements nine times per setting, calculating mean flow rate, maximum velocity, and least detectable difference (LDD). Results: PC-MRI flow measurements were higher than standard reference values (mean ranging from 7.3 to 9.5 mL/s compared with 6.6 mL/s). Decreased voxel size improved accuracy, reducing flow rate measurements from 9.5 to 7.3 mL/s. The LDD for flow rate and velocity varied between 1 and 5%. The LDD for flow rate decreased with increased voxel size and NSA (p = 0.033 and 0.042). The LDD for velocity decreased with increased voxel size (p < 10-16). No change was observed when VENC varied. Conclusions: PC-MRI overestimated flow. However, it has high precision in a small-vessel phantom with constant flow rate. Improved accuracy was obtained with increasing spatial resolution (smaller voxels). Improved precision was obtained with increasing signal-to-noise ratio (larger voxels and/or higher NSA). Relevance statement: Phase-contrast MRI is clinically used in large vessels. To further investigate the possibility of using phase-contrast MRI for smaller intracranial vessels in neurovascular disorders, we need to understand how acquisition parameters affect phase-contrast MRI-measured flow rate and velocity in small vessels. Key points: • PC-MRI measures flow and velocity in a small lumen phantom with high precision but overestimates flow rate. • The precision of PC-MRI measurements matches the precision of standard reference for flow rate measurements. • Optimizing PC-MRI settings can enhance accuracy and precision in flow rate and velocity measurements. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Acupuncture & Tuina Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Measurement of blood flow velocity is key to understanding physiology and pathology in vivo. While most measurements are performed at the middle of the blood vessel, little research has been done on characterizing the instantaneous blood flow velocity distribution. This is mainly due to the lack of measurement technology with high spatial and temporal resolution. Here, we tackle this problem with our recently developed dual-wavelength line-scan third-harmonic generation (THG) imaging technology. Simultaneous acquisition of dual-wavelength THG line-scanning signals enables measurement of blood flow velocities at two radially symmetric positions in both venules and arterioles in mouse brain in vivo. Our results clearly show that the instantaneous blood flow velocity is not symmetric under general conditions. [ABSTRACT FROM AUTHOR]

Abstract Background Practical blood flow restriction (pBFR) during exercise is a cost-saving alternative to traditional blood flow restriction using pneumatic cuffs, particularly when exercising in a group setting. Depending on the pBFR technique, several factors (e.g., cuff width, limb circumference) have already been shown to be of importance when applying the pBFR pressure. Given that elastic cuffs are often used for pBFR, the cuff stiffness might be an additional influencing factor. Therefore, the present study compared the acute effects of three elastic cuffs with identical width but different stiffness (high stiffness (HS), medium stiffness (MS), and low stiffness (LS)) on hemodynamic measures and perceived cuff pressure at rest. Methods In a randomized, counter-balanced cross-over study, 36 young and normotensive participants completed three experimental trials. After a 10-min rest period in supine position, the cuff was loosely and proximally applied to the right upper arm. Following baseline data recording, the cuff was successively tightened in 10%-increments with respect to the limb circumference (%overlap) until arterial blood flow was occluded. At baseline and during each %overlap, systolic peak blood flow velocity of the brachial artery, rating of perceived cuff pressure, as well as muscle oxygen saturation and total hemoglobin concentration of the biceps brachii muscle were recorded. Results The %overlap required to occlude arterial blood flow was different between the three cuffs (HS: 30.9 ± 3.8%, MS: 43.9 ± 6.1%, LS: 54.5 ± 8.3%). Furthermore, at 30% overlap, systolic peak blood flow velocity was lower when applying the HS (9.0 ± 10.9 cm∙s− 1) compared to MS (48.9 ± 21.9 cm∙s− 1) and LS cuff (62.9 ± 19.1 cm∙s− 1). Rating of perceived cuff pressure at 30% overlap was higher when using the HS (6.5 ± 1.5 arbitrary unit (a.u.)) compared to MS (5.1 ± 1.4 a.u.) and LS cuff (4.9 ± 1.5 a.u.) with no difference between the MS and LS cuff. However, muscle oxygen saturation and total hemoglobin concentration were not different between the three cuffs. Conclusions The present study revealed that the cuff stiffness influenced blood flow velocity and arterial occlusion pressure. Therefore, cuff stiffness seems an important factor for the application of pBFR.

As a material that can release infrared rays, volcanic rock polymer fibers can be used in textiles to improve human microcirculation, which is helpful to relieve chronic inflammatory diseases such as perishoulder arthritis. In this article, there are two different kinds of exterior yarns. Volcanic rock blended polyester, volcanic rock blended polyamide, polyester and polyamide are chosen as the material type of exterior yarn Ⅰ, whereas the material type of exterior yarn II is conductive polyamide yarn. The exterior yarn feed ratio of exterior yarn Ⅰ and exterior yarn II is designed as 8:0, 7:1 and 6:2 when weft plain stitch, 1 + 1 mock rib and 1 + 3 mock rib are used as the knitted structure of the fabric. According to the three-factor four-level orthogonal experimental design method, the sample protocol was established, and 16 knitted sample fabrics were produced. Then, the promotion multiple of blood flow velocity on human epidermal microcirculation of each sample was tested and analyzed. The results show that the promotion multiple of blood flow velocity on human epidermal microcirculation of the fabrics woven by volcanic rock polymer fibers is better than that of the blank control group, and the difference between fabrics with different volcanic rock polymer fibers is small. The higher the proportion of exterior yarn Ⅰ is, the better the promotion multiple of blood flow velocity on human epidermal microcirculation of fabric will be. The effect of knitted structure on the promotion multiple of blood flow velocity on human epidermal microcirculation of fabrics is not obvious. This study provides reference for the design of medical or health textiles for chronic inflammatory diseases.

A comparative analysis between intravascular guidewire-obtained and computational fluid dynamic (CFD) flow velocity and pressure data using simplified carotid stenosis models was performed. This information was used to evaluate the viability of using guidewire pressure data to provide inlet conditions for CFD flow, and to study the relationship between stenotic length and hemodynamic behavior. Carotid stenosis models differing in diameter and length were prepared and connected to a vascular pulsatile flow simulator. Time-dependent flow velocity and pressure measurements were taken by microcatheter guidewires and compared with CFD data. Guidewire and CFD-generated pressure profiles matched closely in all measurement locations. The guidewire was unable to reliably measure flow velocity at areas associated with higher CFD flow velocities (r = 0.92). CFD results showed that an increased length of stenosis generated expansive regions of elevated wall shear stress (WSS) within and distal to the stenosis. Low WSS was found immediately outside the stenosis outlet. An increase in stenotic length produced higher flow velocities with minimal lengthening of the distal high velocity flow jet due to faster dissipation of translational kinetic energy through turbulence. We found the accuracy of guidewire-obtained velocity measurements is limited to regions unaffected by disturbed flow. WSS and turbulence behavior distal to the stenosis may be important markers to evaluate the severity of atherosclerotic progression as a function of stenotic length.

Wide-field and noncontact imaging technique called laser speckle contrast imaging (LSCI) is utilized to map blood flow. To greatly improve prediction accuracy, the block-matching along 3-dimensional transform domain collaborative filtering-dependent denoising technique is developed. To implement real-time denoising, the processing time makes complexity. Due to the existence of considerable noise and artifacts, this is challenging to achieve the acceptable level with less raw speckle images. Notwithstanding, it acts poorly while learning from the original LSCI speckle contrast images because of the uneven noise distribution. To overcome this issue, an evolutionary gravitational neocognitron neural network-based blood flow velocity prediction using multiple exposure laser speckle contrast imaging (EGNNN-BFVP-MeLSCI) is proposed. Initially, the input MeLSCI datasets are collected from real-time dataset. The input picture is enhanced and noise is removed using pre-processing technique called altered phase preserving dynamic range compression (APPDRC). Gray level co-occurrence matrix (GLCM) window adaptive approach-dependent feature extraction approach is used for the preprocessed pictures. Using GLCM window adaptive method, the picture characteristics, such as intensity information, images derivative, geodesic information, contrasts, energy, correlations, homogeneity, and entropy, are retrieved. Then, the extracted features are transferred into the EGNNN classifier for accurately predicting the blood flow velocity. The performance of proposed method is executed at python and evaluated under certain performance metrics, such as accuracy, precision, sensitivity, specificity, F -measure, ROC, computation time, mean squared error, root mean squared error, predicted velocity. The proposed EGNNN-BFVP-MeLSCI method attains higher accuracy of 96.31%, 97.06%, and 93.52%, lower computational time of 97.22%, 91.39%, 96.41% compared with existing approaches, like DnCNN-BFVP-MeLSCI, CFD-BFVP-MeLSCI, DLS-BFVP-MeLSCI, CNN-BFVP-MeLSCI, DBN-BFVP-MeLSCI, CGAN-BFVP-MeLSCI and MVN-BFVP-MeLSCI, respectively. [ABSTRACT FROM AUTHOR]

Background: Practical blood flow restriction (pBFR) during exercise is a cost-saving alternative to traditional blood flow restriction using pneumatic cuffs, particularly when exercising in a group setting. Depending on the pBFR technique, several factors (e.g., cuff width, limb circumference) have already been shown to be of importance when applying the pBFR pressure. Given that elastic cuffs are often used for pBFR, the cuff stiffness might be an additional influencing factor. Therefore, the present study compared the acute effects of three elastic cuffs with identical width but different stiffness (high stiffness (HS), medium stiffness (MS), and low stiffness (LS)) on hemodynamic measures and perceived cuff pressure at rest. Methods: In a randomized, counter-balanced cross-over study, 36 young and normotensive participants completed three experimental trials. After a 10-min rest period in supine position, the cuff was loosely and proximally applied to the right upper arm. Following baseline data recording, the cuff was successively tightened in 10%-increments with respect to the limb circumference (%overlap) until arterial blood flow was occluded. At baseline and during each %overlap, systolic peak blood flow velocity of the brachial artery, rating of perceived cuff pressure, as well as muscle oxygen saturation and total hemoglobin concentration of the biceps brachii muscle were recorded. Results: The %overlap required to occlude arterial blood flow was different between the three cuffs (HS: 30.9 ± 3.8%, MS: 43.9 ± 6.1%, LS: 54.5 ± 8.3%). Furthermore, at 30% overlap, systolic peak blood flow velocity was lower when applying the HS (9.0 ± 10.9 cm∙s− 1) compared to MS (48.9 ± 21.9 cm∙s− 1) and LS cuff (62.9 ± 19.1 cm∙s− 1). Rating of perceived cuff pressure at 30% overlap was higher when using the HS (6.5 ± 1.5 arbitrary unit (a.u.)) compared to MS (5.1 ± 1.4 a.u.) and LS cuff (4.9 ± 1.5 a.u.) with no difference between the MS and LS cuff. However, muscle oxygen saturation and total hemoglobin concentration were not different between the three cuffs. Conclusions: The present study revealed that the cuff stiffness influenced blood flow velocity and arterial occlusion pressure. Therefore, cuff stiffness seems an important factor for the application of pBFR. [ABSTRACT FROM AUTHOR]

The objective of the study is to explore the use of internal jugular vein diameter, respiratory variability, and blood flow velocity in predicting blood volume of patients with intestinal obstruction. A total of sixty patients with acute intestinal obstruction who were admitted to our hospital from June 2019 to June 2021 were included and including 33 males and 27 females. The patients were graded ASA I to III on the basis of their physical condition. Using the random number table method, the patients were divided into the inferior vena cava (IVC) and internal jugular vein (IJV) groups. The maximum diameter (Dmax) and the minimum diameter (Dmin) of the IVC and IJV groups were measured by M-type ultrasound, and the respiratory variation index (RVI) was calculated. The maximum blood flow velocity (BVmax) and the minimum blood flow velocity (BVmin) of each vessel were also measured in the respective groups by Doppler ultrasound, and the blood flow variation index (BVI) was calculated. Each patient was then infused with 5 ml/kg crystalloid solution, and the above parameters were measured again and compared to the respective pre-infusion values. The correlation between each measurement index and CVP and their ability to predict CVP > 6 mmHg were statistically evaluated. The RVI of IVC decreased significantly post-infusion (P = 0.018). Compared to the pre-infusion values, the Dmin of IJV increased (P = 0.042), while the RVI and BVI decreased significantly after infusion (P = 0.004 and P = 0.047). The relevant measurement data could not be obtained for one patient in the IVC group due to obvious intestinal pneumatosis. There was a positive correlation between the Dmin of IVC and CVP (pre-infusion R = 0.684 and P = 0.000; post-infusion R = 0.442 and P = 0.016), and a negative correlation between RVI and CVP (pre-infusion R = − 0.826 and P = 0.000; post-infusion R = − 0.663 and P = 0.000) before and after infusion. In addition, CVP was positively correlated to the Dmin, BVmax, and BVmin of IJV before and after infusion (pre-infusion R = 0.652, 0.655, 0.795, and all P = 0.000; post-infusion R = 0.571, 0.586, 0.684, and P = 0.001, 0.001, and 0.000), and negatively with RVI and BVI (pre-infusion R = − 0.808, − 0.677, and all P = 0.000; post-infusion R = − 0.589, − 0.592, and all P = 0.001). The specificity of the Dmin of IVC was 92.9%, and the sensitivity of RVI was 100% prior to the infusion, the post-infusion RVI could predict the blood volume with 100% sensitivity. In contrast, all indices of IJV except Dmax predicted the blood volume before and after infusion. The area under the curve of RVI was the largest, indicating the highest predictive accuracy. The sensitivity and specificity of RVI were, respectively, 100 and 93.3% before infusion and 88.9 and 95.2% after infusion. The ultrasonically measured variability in the diameter and blood flow velocity of IJV can be used to predict the blood volume of patients with intestinal obstruction and has higher accuracy compared to the indices of IVC. [ABSTRACT FROM AUTHOR]

High resolution assessment of cardiac functional parameters is crucial in translational animal research. The chick embryo is a historically well‐used in vivo model for cardiovascular research due to its many practical advantages, and the conserved form and function of the chick and human cardiogenesis programs. This review aims to provide an overview of several different technical approaches for chick embryo cardiac assessment. Doppler echocardiography, optical coherence tomography, micromagnetic resonance imaging, microparticle image velocimetry, real‐time pressure monitoring, and associated issues with the techniques will be discussed. Alongside this discussion, we also highlight recent advances in cardiac function measurements in chick embryos. Key Findings: Studying the physiology of the chick embryo is critical to understand many diseases such as CHDs.Advancements have been made in techniques to measure the blood flow velocity such as using Doppler Electrocardiography, Optical Coherence Tomography and micro‐MRI.Measurement of Blood pressure is equally important and techniques have been developed to measure the blood pressure through direct measurement and through servo null micropressure technique. [ABSTRACT FROM AUTHOR]

Measurement of blood flow velocity is key to understanding physiology and pathology in vivo. While most measurements are performed at the middle of the blood vessel, little research has been done on characterizing the instantaneous blood flow velocity distribution. This is mainly due to the lack of measurement technology with high spatial and temporal resolution. Here, we tackle this problem with our recently developed dual-wavelength line-scan third-harmonic generation (THG) imaging technology. Simultaneous acquisition of dual-wavelength THG line-scanning signals enables measurement of blood flow velocities at two radially symmetric positions in both venules and arterioles in mouse brain in vivo. Our results clearly show that the instantaneous blood flow velocity is not symmetric under general conditions.

Background Four-dimensional (4D) flow MRI has the potential to provide hemodynamic insights for a variety of abdominopelvic vascular diseases, but its clinical utility is currently impaired by background phase error, which can be challenging to correct. Purpose To assess the feasibility of using deep learning to automatically perform image-based background phase error correction in 4D flow MRI and to compare its effectiveness relative to manual image-based correction. Materials and Methods A convenience sample of 139 abdominopelvic 4D flow MRI acquisitions performed between January 2016 and July 2020 was retrospectively collected. Manual phase error correction was performed using dedicated imaging software and served as the reference standard. After reserving 40 examinations for testing, the remaining examinations were randomly divided into training (86% [85 of 99]) and validation (14% [14 of 99]) data sets to train a multichannel three-dimensional U-Net convolutional neural network. Flow measurements were obtained for the infrarenal aorta, common iliac arteries, common iliac veins, and inferior vena cava. Statistical analyses included Pearson correlation, Bland-Altman analysis, and F tests with Bonferroni correction. Results A total of 139 patients (mean age, 47 years ± 14 [standard deviation]; 108 women) were included. Inflow-outflow correlation improved after manual correction (ρ = 0.94, P < .001) compared with that before correction (ρ = 0.50, P < .001). Automated correction showed similar results (ρ = 0.91, P < .001) and demonstrated very strong correlation with manual correction (ρ = 0.98, P < .001). Both correction methods reduced inflow-outflow variance, improving mean difference from -0.14 L/min (95% limits of agreement: -1.61, 1.32) (uncorrected) to 0.05 L/min (95% limits of agreement: -0.32, 0.42) (manually corrected) and 0.05 L/min (95% limits of agreement: -0.38, 0.49) (automatically corrected). There was no significant difference in inflow-outflow variance between manual and automated correction methods (P = .10). Conclusion Deep learning automated phase error correction reduced inflow-outflow bias and variance of volumetric flow measurements in four-dimensional flow MRI, achieving results comparable with manual image-based phase error correction. © RSNA, 2021 See also the editorial by Roldán-Alzate and Grist in this issue.

Wall shear stress (WSS) contributes to the mechanotransduction underlying microvascular development and regeneration. Using computational fluid dynamics, we elucidated the interplay between WSS and vascular remodelling in a zebrafish model of tail amputation and regeneration. The transgenic Tg (fli1:eGFP; Gata1:ds-red) zebrafish line was used to track the three-dimensional fluorescently labelled vascular endothelium for post-image segmentation and reconstruction of the fluid domain. Particle image velocimetry was used to validate the blood flow. Following amputation to the dorsal aorta and posterior cardinal vein (PCV), vasoconstriction developed in the dorsal longitudinal anastomotic vessel (DLAV) along with increased WSS in the proximal segmental vessels (SVs) from amputation. Angiogenesis ensued at the tips of the amputated DLAV and PCV where WSS was minimal. At 2 days post amputation (dpa), vasodilation occurred in a pair of SVs proximal to amputation, followed by increased blood flow and WSS; however, in the SVs distal to amputation, WSS normalized to the baseline. At 3 dpa, the blood flow increased in the arterial SV proximal to amputation and through anastomosis with DLAV formed a loop with PCV. Thus, our in silico modelling revealed the interplay between WSS and microvascular adaptation to changes in WSS and blood flow to restore microcirculation following tail amputation.

OBJECTIVE: Doppler ultrasonography of the common carotid artery is used to infer stroke volume change and a wearable Doppler ultrasound has been designed to improve this workflow. Previously, in a human model of hemorrhage and resuscitation comprising approximately 50,000 cardiac cycles, we found a strong, linear correlation between changing stroke volume, and measures from the carotid Doppler signal, however, optimal Doppler thresholds for detecting a 10% stroke volume change were not reported. In this Research Note, we present these thresholds, their sensitivities, specificities and areas under their receiver operator curves (AUROC). RESULTS: Augmentation of carotid artery maximum velocity time integral and corrected flowtime by 18% and 4%, respectively, accurately captured 10% stroke volume rise. The sensitivity and specificity for these thresholds were identical at 89% and 100%. These data are similar to previous investigations in healthy volunteers monitored by the wearable ultrasound.

Photocoagulation of blood vessels offers unambiguous advantages to current radiofrequency approaches considering the high specificity of blood absorption at available laser wavelengths (e.g., 532 nm and 1.064 µm). Successful treatment of pediatric vascular lesions, such as port-wine stains requiring microvascular hemostasis, has been documented. Although laser treatments have been successful in smaller diameter blood vessels, photocoagulation of larger sized vessels is less effective. The hypothesis for this study is that a primary limitation in laser coagulation of large diameter blood vessels (500-1000 µm) originates from shear stress gradients associated with higher flow velocities along with temperature-dependent viscosity changes. Laser (1.07 µm) coagulation of blood vessels was tested in the chicken chorio-allantoic membrane (CAM). A finite element model is developed that includes hypothetical limitations in laser coagulation during irradiation. A protocol to specify laser dosimetry is derived from OCT imaging and angiography observations as well as finite element model results. Laser dosimetry is applied in the CAM model to test the experimental hypothesis that blood shear stress and flow velocity are important parameters for laser coagulation and hemostasis of large diameter blood vessels (500-1000 µm). Our experimental results suggest that shear stress and flow velocity are fundamental in the coagulation of large diameter blood vessels (500-1000 µm). Laser dosimetry is proposed and demonstrated for successful coagulation and hemostasis of large diameter CAM blood vessels.

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

ObjectiveThis study aims at developing a pipeline that provides the capability to include the catheter effect in the computational fluid dynamics (CFD) simulations of the cardiovascular system and other human vascular flows carried out with the open-source software SimVascular. This tool is particularly useful for CFD simulation of interventional radiology procedures such as tumor embolization where estimation of a therapeutic agent distribution is of interest.ResultsA pipeline is developed that generates boundary condition files which can be used in SimVascular CFD simulations. The boundary condition files are modified such that they simulate the effect of catheter presence on the flow field downstream of the inlet. Using this pipeline, the catheter flow, velocity profile, radius, wall thickness, and deviation from the vessel center can be defined. Since our method relies on the manipulation of the boundary condition that is imposed on the inlet, it is sensitive to the mesh density. The finer the mesh is (especially around the catheter wall), the more accurate the velocity estimations are. In this study, we also utilized this pipeline to qualitatively investigate the effect of catheter presence on the flow field in a truncated right hepatic arterial tree of a liver cancer patient.

Background/Objectives: This study aimed to investigate the relationship between posterior tibial artery blood flow velocity and plantar heel pain (PHP). Methods: The PHP group comprised patients diagnosed with plantar fasciitis with plantar heel pain during gait, and the control group comprised healthy participants without plantar heel pain. The peak systolic velocity of the posterior tibial artery was measured using ultrasonography; it was measured three times on each side, and the mean value was calculated. Receiver operating characteristic curve analysis was performed to calculate the peak systolic velocity cutoff value for plantar heel pain. Results: 23 patients (age 58.0 ± 16.5 years; 13 males and 10 females) and 23 healthy participants (age 51.3 ± 17.3 years; 10 males and 13 females) formed the PHP and control groups, respectively. Peak systolic velocity on the affected side was significantly greater in the PHP group (44.1 ± 13.1 cm/s) than in the control group (32.7 ± 5.9 cm/s). No significant difference was observed between the left and right sides in the PHP (7.1 ± 9.8 cm/s) and control (3.7 ± 3.0 cm/s) groups. A cutoff value of 38.2 cm/s was observed on the affected side. Conclusions: We quantified the increase in posterior tibial artery blood flow velocity in patients with plantar heel pain. Peak systolic velocity measurements can aid in quantitatively evaluating these patients. This study was registered as a clinical trial (UMIN000046875) on 1 October 2021.

Biomechanical forces intimately contribute to cardiac morphogenesis. However, volumetric imaging to investigate the cardiac mechanics with high temporal and spatial resolution remains an imaging challenge. We hereby integrated light-field microscopy (LFM) with light-sheet fluorescence microscopy (LSFM), coupled with a retrospective gating method, to simultaneously access myocardial contraction and intracardiac blood flow at 200 volumes per second. While LSFM allows for the reconstruction of the myocardial function, LFM enables instantaneous acquisition of the intracardiac blood cells traversing across the valves. We further adopted deformable image registration to quantify the ventricular wall displacement and particle tracking velocimetry to monitor intracardiac blood flow. The integration of LFM and LSFM enabled the time-dependent tracking of the individual blood cells and the differential rates of segmental wall displacement during a cardiac cycle. Taken together, we demonstrated a hybrid system, coupled with our image analysis pipeline, to simultaneously capture the myocardial wall motion with intracardiac blood flow during cardiac development.

Background: The aim of this research was to determine the functional state of regional blood flow in young people with varying degrees of anatomical and functional disorders of periodontal tissues. Methods and Results: One hundred and thirty-five young patients with varying degrees of anatomical and functional disorders of periodontal tissues (AFDP) and 52 controls with intact periodontium were examined. All patients with AFDP were divided into three groups: Group 1 included 33 patients in the compensation stage (low degree of periodontal risk, intact periodontium, no clinical symptoms, pale pink gums, no bleeding on probing, dentogingival attachment is not disturbed); Group 2 included 38 patients in the sub-compensation stage (average degree of periodontal risk, disorders of the mucogingival complex, without clinical symptoms); and 64 patients in the decompensation stage (high degree of periodontal risk, disorders of the mucogingival complex, the presence of clinical symptoms, individual or combined signs of periodontal pathology, gingival recession (Class I and II according to Miller's classification). We studied the regional blood flow of periodontal tissues, which was assessed by an ultrasound Doppler graph in a non-invasive way. The parameters of linear (PSV, peak systolic velocity) and volumetric (Qs, maximum systolic volume velocity) velocities of blood flow, as well as the parameters of the wall vascularization (PI, pulsation index; RI, resistance index). Results: The PSV increased statistically significantly with a load compared to rest in the control and sub-compensation groups and decreased in the decompensation group with a load, compared to the rest condition. The PSV increased relative to the control in the subcompensation and decompensation groups in rest and under load. The Qs indicator showed a similar trend in the groups. Qs significantly increased under load, compared to the rest condition in the control, compensation, and subcompensation groups, and decreased in the decompensation group. The Qs values, in comparison with the control, increased in the subcompensation and decompensation groups in the rest condition and under load. The PI increased with the load relative to the rest condition in the control, compensation, and decompensation group. At the same time, PI decreased under the load, compared to the rest condition, in the subcompensation group. In comparison with the control, the PI values decreased in the subcompensation and decompensation groups in the rest condition and under load. The RI significantly changed only in the subcompensation group under load, compared to the rest condition. Only RI values decreased significantly in the subcompensation group under load, compared to the control. Conclusion: The use of Doppler ultrasonography in assessing the state of regional blood flow of periodontal tissues is a highly informative and non-invasive method. The velocity characteristics (linear and volumetric velocities) of blood flow are important diagnostic indicators, allowing the most rapid and reliable assessment of the degree of anatomical and functional disorders of periodontal tissues.

Оbjective. This study determines the factors that can affect the value of the parameters of intraoperative flowmetry of coronary bypass grafts. Material and methods. TTFM is a routine procedure accompanying coronary artery bypass grafting at the Federal State Budgetary Institution FTSSSh (Penza). This retrospective study included 995 consecutive patients who underwent isolated coronary artery bypass grafting of the left coronary artery. The exclusion criteria were damage to the right coronary artery bed, the emergency nature of the operation, and the combined pathology of the valvular apparatus. Patients who underwent anastomosis revision due to flowmetry parameters changes were also excluded from the study. Intraoperative assessment of coronary artery bypass grafts was performed using VeryQ and MiraQ MediStim flowmeters (Norway). Results. A total of 1733 arterial and 479 venous grafts were evaluated. The following factors influenced the average volumetric blood flow velocity value: composite shunting of the border stenosis increases the chance of reducing the volumetric blood flow below the threshold value by 1.841 times (OR=1.841; p=0.018), the combination of occlusion and borderline stenosis with composite shunting increases the chance of reducing the volumetric blood flow velocity by 3.91 times (OR=3.91; p=0.041), an increase in the diameter of the bypassed artery by 1.0 mm reduces the chance of a decrease in blood flow volume velocity by 53.7% (OR=0.423; p=0.05). Conclusion. The following factors influence the peripheral resistance index: coronary artery diameter (OR=0.21; p=0.001), degree of artery proximal stenosis (OR=0.987; p=0.034), the vascular wall condition (OR=2.25; p=0.05), type of conduit used (OR=0.298; p=0.002), and shunting method (OR=1.699; p=0.017). The following factors influence the mean volumetric blood flow velocity value: bypass method (OR=1.841; p=0.018), a combination of occlusion and borderline stenosis in composite bypass grafting (OR=3.91; p=0.041), and the bypassed artery diameter (OR=0.423; p=0.423; p=0.05).

Objective To investigate the clinical value of monitoring lower extremity venous flow velocity by ultrasound in screening the risk of lower extremity deep vein thrombosis (DVT). Methods 353 postoperative patients admitted to the Department of Neurosurgery from April 2020 to April 2021 were selected. Color Doppler ultrasound was used to monitor the lower extremity venous blood flow 4 times a day on the 1st to 3rd day after surgery. Patients were divided into DVT group and non-DVT group according to whether DVT occurred during hospitalization. Data were analyzed to analyze and evaluate the value of monitoring lower extremity blood flow velocity for screening the risk of DVT. Results There were significant differences in the flow velocity of femoral vein, popliteal vein and great saphenous vein between DVT group and non-DVT group (P<0.01). ROC curve analysis on the first postoperative day showed that the AUC of popliteal blood flow velocity screening for postoperative thrombosis risk in neurosurgery patients was the largest, and the sensitivity was 99.7% and the specificity was 100% when the cut-off value was 13. 504 cm/s. Conclusion Monitoring the lower extremity venous flow velocity, especially the popliteal vein flow velocity, has important clinical value in screening the risk of DVT2 after neurosurgery. [ABSTRACT FROM AUTHOR]

Volumetric imaging of a mouse brain in vivo with one-photon and two-photon ultralong anti-diffracting (UAD) beam illumination was performed. The three-dimensional (3D) structure of blood vessels in the mouse brain were mapped to a two-dimensional (2D) image. The speed of volumetric imaging was significantly improved due to the long focal length of the UAD beam. Comparing one-photon and two-photon UAD beam volumetric imaging, we found that the imaging depth of two-photon volumetric imaging (80 μm) is better than that of one-photon volumetric imaging (60 μm), and the signal-to-background ratio (SBR) of two-photon volumetric imaging is two times that of one-photon volumetric imaging. Therefore, we used two-photon UAD volumetric imaging to perform dynamic volumetric imaging of mouse brain blood vessels in vivo, and obtained the blood flow velocity. [ABSTRACT FROM AUTHOR]

Ultrasound imaging is the preferred noninvasive technique to measure blood flow to diagnose cardiovascular disease such as heart failure, carotid stenosis, and renal failure. Conventional ultrasound techniques such as Doppler ultrasound, ultrasound imaging velocimetry, vector Doppler and transverse oscillation beamforming have been used for blood flow velocity profile measurement. However, these techniques were limited to measuring blood flow velocities within the 2-D lateral (across the ultrasound beam) plane of a vessel, and the blood flow velocity profile was derived by assuming that blood vessels have a circular cross-section with axis symmetry. This assumption is incorrect because most vessels have complex geometries, such as tortuosity and branches, and an asymmetric flow profile in the presence of vascular plaque. Consequently, ultrasound speckle decorrelation has been proposed to measure blood flow from transverse views of blood vessels wherein the ultrasound beam is perpendicular to the vessel axis. In this review, we present a summary of recent progress in ultrasound speckle decorrelation-based blood flow measurement techniques. [ABSTRACT FROM AUTHOR]

Few studies have explored the effects of fine particulate matter (PM2.5) and its constituents on the progression of cerebral blood flow velocity (BFV) and the potential modifying role of greenness. In this study, we investigated the association of PM2.5 and its constituents, including sulfate (SO42−), nitrate (NO3−), ammonium (NH4+), organic matter (OM), and black carbon (BC), with the progression of BFV in the middle cerebral artery. Participants from the Beijing Health Management Cohort who underwent at least two transcranial Doppler sonography examinations during 2015–2020 were recruited. BFV change and BFV change rate were used to define the progression of cerebral BFV. Linear mixed effects models were employed to analyze the data, and the weighted quantile sum regression assessed the contribution of PM2.5 constituents. Additionally, greenness was examined as a modifier. Among the examined constituents, OM exhibited the strongest association with BFV progression. An interquartile range increase in PM2.5 and OM exposure concentrations was associated with a decrease of −16.519 cm/s (95% CI: −17.837, −15.201) and −15.403 cm/s (95% CI: −16.681, −14.126) in BFV change, and −10.369 cm/s/year (95% CI: −11.387, −9.352) and −9.615 cm/s/year (95% CI: −10.599, −8.632) in BFV change rate, respectively. Furthermore, stronger associations between PM2.5 and BFV progression were observed in individuals working in areas with lower greenness, those aged under 45 years, and females. In conclusion, reducing PM2.5 levels in the air, particularly the OM constituent, and enhancing greenness could potentially contribute to the protection of cerebrovascular health. Plain Language Summary: Fine particulate matter in the atmosphere has been shown to be associated with cerebrovascular disease, however, the adverse effects of fine particulate matter chemical constituents on cerebral hemodynamics and the role of greenness in this are yet to be evaluated. In this study, we evaluated the association of fine particulate matter and its constituents (sulfate, nitrate, ammonium, black carbon, and organic matter) with cerebral arterial blood flow velocity (BFV) and the modifying effect of greenness. We found that fine particulate matter and its constituents accelerate the reduction of cerebral arterial BFV and that the association is stronger where greenness levels are low. Our findings provide new evidence that reducing fine particle exposure and enhancing urban greenery may be an effective way to protect cerebrovascular health. Key Points: PM2.5 and its constituents were associated with a greater and faster reduction in the cerebral artery blood flow velocityThe impacts of PM2.5 and its constituents were modified by greennessYounger people and females were found to be more vulnerable [ABSTRACT FROM AUTHOR]

Cerebrovascular reactivity (CVR) reflects the capacity of the brain to meet changing physiological demands and can predict the risk of cerebrovascular diseases. CVR can be obtained by measuring the change in cerebral blood flow (CBF) during a brain stress test where CBF is altered by a vasodilator such as acetazolamide. Although the gold standard to quantify CBF is PET imaging, the procedure is invasive and inaccessible to most patients. Arterial spin labeling (ASL) is a non-invasive and quantitative MRI method to measure CBF, and a consensus guideline has been published for the clinical application of ASL. Despite single post labeling delay (PLD) pseudo-continuous ASL (PCASL) being the recommended ASL technique for CBF quantification, it is sensitive to variations to the arterial transit time (ATT) and labeling efficiency induced by the vasodilator in CVR studies. Multi-PLD ASL controls for the changes in ATT, and velocity selective ASL is in theory insensitive to both ATT and labeling efficiency. Here we investigate CVR using simultaneous 15O-water PET and ASL MRI data from 19 healthy subjects. CVR and CBF measured by the ASL techniques were compared using PET as the reference technique. The impacts of blood T1 and labeling efficiency on ASL were assessed using individual measurements of hematocrit and flow velocity data of the carotid and vertebral arteries measured using phase-contrast MRI. We found that multi-PLD PCASL is the ASL technique most consistent with PET for CVR quantification (group mean CVR of the whole brain = 42±19% and 40±18% respectively). Single-PLD ASL underestimated the CVR of the whole brain significantly by 15±10% compared with PET (p

BackgroundNon-invasive assessment of the hemodynamic changes of cirrhosis might help guide management of patients with liver disease but are currently limited.PurposeTo determine whether free-breathing 4D flow MRI can be used to quantify the hemodynamic effects of cirrhosis and introduce hydraulic circuit indexes of severity.Study typeRetrospective.PopulationForty-seven patients including 26 with cirrhosis.Field strength/sequence3 T/free-breathing 4D flow MRI with soft gating and golden-angle view ordering.AssessmentMeasurements of the supra-celiac abdominal aorta, supra-renal abdominal aorta (SRA), celiac trunk (CeT), superior mesenteric artery (SMA), splenic artery (SpA), common hepatic artery (CHA), portal vein (PV), and supra-renal inferior vena cava (IVC) were made by two radiologists. Measures of hepatic vascular resistance (hepatic arterial relative resistance [HARR]; portal resistive index [PRI]) were proposed and calculated.Statistical analysisBland-Altman, Pearson's correlation, Tukey's multiple comparison, and Cohen's kappa. P

The risk stratification and long-term survival of patients with orthotopic heart transplantation (OHT) is impacted by the complication of cardiac allograft vasculopathy (CAV). This study evaluates changes in myocardial blood flow (MBF) and myocardial coronary flow reserve (CFR) in a group of long-term OHT patients using quantitative cardiac 82Rb-positron emission tomography (PET). Twenty patients (7 females and 13 males, mean age = 72.7 ± 12.2 years with CAV and 62.9 ± 7.2 years without CAV and post-OHT mean time = 13.9 years), were evaluated retrospectively using dynamic cardiac 82Rb-PET at rest and regadenoson-induced stress. The patients also underwent selective coronary angiography (SCA) for diagnosis and risk stratification. CAV was diagnosed based on SCA findings and maximal intimal thickness greater than 0.5 mm, as defined by International Society of Heart and Lung Transplantation (ISHLT). Global and regional MBFs were estimated in three vascular territories using the standard 1-tissue compartment model for dynamic 82Rb-PET. The myocardial CFR was also calculated as the ratio of peak stress MBF to rest MBF. Among twenty patients, seven had CAV in, at least, one major coronary artery (ISHLT CAV grade 1 or higher) while 13 patients did not have CAV (NonCAV). Mean rate-pressure products (RPP) at rest were significantly elevated in CAV patients compared to those without CAV (P = 0.002) but it was insignificant at stress (P = NS). There was no significant difference in the stress MBFs between CAV and NonCAV patients (P = NS). However, the difference in RPP-normalized stress MBFs was significant (P = 0.045), while RPP-normalized MBFs at rest was not significant (P = NS). Both CFR and RPP-normalized CFR were significantly lower in CAV compared to NonCAV patients (P

Hemorrhagic shock (HS) is a severe life-threatening condition characterized by loss of blood volume and a lack of oxygen (O2) delivery to tissues. The objective of this study was to examine the impact of manipulating Starling forces in the microcirculation during HS to increase microvascular perfusion without restoring blood volume or increasing O2 carrying capacity. To decrease interstitial tissue pressure, we developed a non-contact system to locally apply negative pressure and manipulate the pressure balance in capillaries, while allowing for visualization of the microcirculation. Golden Syrian hamsters were instrumented with dorsal window chambers and subjected to a controlled hemorrhaged of 50% of the animal's blood volume without any fluid resuscitation. A negative pressure chamber was attached to the dorsal window chamber and a constant negative pressure was applied. Hemodynamic parameters (including microvascular diameter, blood flow, and functional capillary density [FCD]) were measured before and during the four hours following the hemorrhage, with and without applied negative pressure. Blood flow significantly increased in arterioles during negative pressure. The increase in flow through arterioles also improved microvascular perfusion as reflected by increased FCD. These results indicate that negative pressure increases flow in the microcirculation when fluid resuscitation is not available, thus restoring blood flow, oxygen delivery, and preventing the accumulation of metabolic waste. Applying negative pressure might allow for control of microvascular blood flow and oxygen delivery to specific tissue areas.

Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3- and 6-months poststroke. As a secondary objective, we grouped individuals according to the MCAv dynamic response to the exercise bout as responder or nonresponder. We tested whether physical activity, aerobic fitness, and exercise mean arterial blood pressure differed between groups. Methods and Results Transcranial Doppler ultrasound measured MCAv during a 90-second baseline followed by a 6-minute moderate intensity exercise bout. Heart rate, mean arterial blood pressure, and end-tidal CO2 were additional variables of interest. The MCAv dynamic response variables included the following: baseline, time delay, amplitude, and time constant. Linear mixed model revealed no significant differences in our selected outcomes between 3- and 6-months poststroke. Individuals characterized as responders demonstrated a faster time delay, higher amplitude, and reported higher levels of physical activity and aerobic fitness when compared with the nonresponders. No between-group differences were identified for baseline, time constant, or exercise mean arterial blood pressure. In the nonresponders, we observed an immediate rise in MCAv following exercise onset followed by an immediate decline to near baseline values, while the responders showed an exponential rise until steady state was reached. Conclusions The MCAv dynamic response profile has the potential to provide valuable information during an acute exercise bout following stroke. Individuals with a greater MCAv response to the exercise stimulus reported statin use and regular participation in exercise.

The aims of the present study were to determine uterine, vaginal and placental blood flows by Doppler ultrasound cross-buffalo gestation and to evaluate the relationships among reproductive Doppler parameters and serum metabolic parameters as well as oxidative stress. Uterine (UA) and vaginal (VA) arteries were scanned every month, and placentome was scanned from month 4 till 8 in gestation. Time-averaged maximum velocity (TAMV), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (SD) and arterial diameter (AD) were used for accessing UA and VA hemodynamics. Time-averaged maximum velocity positively correlated with and AD, and both negatively correlated with their PI, RI and SD in UA and VA. TAMV and AD increased constantly in pregnancy, with maximum increase in months 4 and 9. Pulsatility index, RI and AD of UA decreased between months 4 and 9, while PI, RI and AD of VA decreased between months 5 and 9 and then increased in month 10 in pregnancy. Time-averaged maximum velocity of placentome blood flow increased exponentially from months 4 to 8, but decreased at the last two months in pregnancy. Serum lipids were significantly higher in the first month compared to all other months, while glucose was significantly lower in months 9 and 10. Malondialdehyde increased from month 3 till term, but peaked in month 5 and 10. Glutathione and catalase were highest in the first month and remained after. Time-averaged maximum velocity and AD for both UA and VA negatively correlated with serum lipids, glucose, catalase and glutathione, while positively correlated with malondialdehyde and total protein. Thus, increases in uterine blood flow (UtBF), vaginal blood flow (VaBF) and placental blood flow (PaBF) are associated with increased metabolism and oxidative stress in buffalo pregnancy.

Multi-organ fibrosis among end stage renal disease (ESRD) patients cannot be explained by uremia alone. Despite mitigation of thrombosis during hemodialysis (HD), subsequent platelet dysfunction and tissue dysregulation are less understood. We comprehensively profiled plasma and platelets from ESRD patients before and after HD to examine HD-modulation of platelets beyond thrombotic activation. Basal plasma levels of proteolytic regulators and fibrotic factors were elevated in ESRD patients compared to healthy controls, with isoform-specific changes during HD. Platelet lysate (PL) RNA transcripts for growth and coagulative factors were elevated post-HD, with upregulation correlated to HD vintage. Platelet secretome correlations to plasma factors reveal acutely induced pro-fibrotic platelet phenotypes in ESRD patients during HD characterized by preferentially enhanced proteolytic enzyme translation and secretion, platelet contribution to inflammatory response, and increasing platelet dysfunction with blood flow rate (BFR) and Vintage. Compensatory mechanisms of increased platelet growth factor synthesis with acute plasma matrix metalloproteinase (MMP) and tissue inhibitor of MMPs (TIMP) increases show short-term mode-switching between dialysis sessions leading to long-term pro-fibrotic bias. Chronic pro-fibrotic adaptation of platelet synthesis were observed through changes in differential secretory kinetics of heterogenous granule subtypes. We conclude that chronic and acute platelet responses to HD contribute to a pro-fibrotic milieu in ESRD.

Abstract Background Different software programs are available for the evaluation of 4D Flow cardiovascular magnetic resonance (CMR). A good agreement of the results between programs is a prerequisite for the acceptance of the method. Therefore, the goal was to compare quantitative results from a cross-over comparison in individuals examined on two scanners of different vendors analyzed with four postprocessing software packages. Methods Eight healthy subjects (27 ± 3 years, 3 women) were each examined on two 3T CMR systems (Ingenia, Philips Healthcare; MAGNETOM Skyra, Siemens Healthineers) with a standardized 4D Flow CMR sequence. Six manually placed aortic contours were evaluated with Caas (Pie Medical Imaging, SW-A), cvi42 (Circle Cardiovascular Imaging, SW-B), GTFlow (GyroTools, SW-C), and MevisFlow (Fraunhofer Institute MEVIS, SW-D) to analyze seven clinically used parameters including stroke volume, peak flow, peak velocity, and area as well as typically scientifically used wall shear stress values. Statistical analysis of inter- and intrareader variability, inter-software and inter-scanner comparison included calculation of absolute and relative error (ER), intraclass correlation coefficient (ICC), Bland–Altman analysis, and equivalence testing based on the assumption that inter-software differences needed to be within 80% of the range of intrareader differences. Results SW-A and SW-C were the only software programs showing agreement for stroke volume (ICC = 0.96; ER = 3 ± 8%), peak flow (ICC: 0.97; ER = −1 ± 7%), and area (ICC = 0.81; ER = 2 ± 22%). Results from SW-A/D and SW-C/D were equivalent only for area and peak flow. Other software pairs did not yield equivalent results for routinely used clinical parameters. Especially peak maximum velocity yielded poor agreement (ICC ≤ 0.4) between all software packages except SW-A/D that showed good agreement (ICC = 0.80). Inter- and intrareader consistency for clinically used parameters was best for SW-A and SW-D (ICC = 0.56–97) and worst for SW-B (ICC = -0.01–0.71). Of note, inter-scanner differences per individual tended to be smaller than inter-software differences. Conclusions Of all tested software programs, only SW-A and SW-C can be used equivalently for determination of stroke volume, peak flow, and vessel area. Irrespective of the applied software and scanner, high intra- and interreader variability for all parameters have to be taken into account before introducing 4D Flow CMR in clinical routine. Especially in multicenter clinical trials a single image evaluation software should be applied.

Understanding the structure and function of vasculature in the brain requires us to monitor distributed hemodynamics at high spatial and temporal resolution in three-dimensional (3D) volumes in vivo. Currently, a volumetric vasculature imaging method with sub-capillary spatial resolution and blood flow-resolving speed is lacking. Here, using two-photon laser scanning microscopy (TPLSM) with an axially extended Bessel focus, we capture volumetric hemodynamics in the awake mouse brain at a spatiotemporal resolution sufficient for measuring capillary size and blood flow. With Bessel TPLSM, the fluorescence signal of a vessel becomes proportional to its size, which enables convenient intensity-based analysis of vessel dilation and constriction dynamics in large volumes. We observe entrainment of vasodilation and vasoconstriction with pupil diameter and measure 3D blood flow at 99 volumes/second. Demonstrating high-throughput monitoring of hemodynamics in the awake brain, we expect Bessel TPLSM to make broad impacts on neurovasculature research.

Background In a recent multicenter study of perinatal outcome in fetuses with Ebstein anomaly or tricuspid valve dysplasia, we found that one third of live-born patients died before hospital discharge. We sought to further describe postnatal management strategies and to define risk factors for neonatal mortality and circulatory outcome at discharge. Methods and Results This 23-center, retrospective study from 2005 to 2011 included 243 fetuses with Ebstein anomaly or tricuspid valve dysplasia. Among live-born patients, clinical and echocardiographic factors were evaluated for association with neonatal mortality and palliated versus biventricular circulation at discharge. Of 176 live-born patients, 7 received comfort care, 11 died

The leptomeningeal collateral status is an independent predictor of stroke outcome. By means of optical coherent tomography angiography to compare two mouse strains with different extent of native leptomeningeal collateralization, we determined the spatiotemporal dynamics of collateral flow and downstream hemodynamics following ischemic stroke. A robust recruitment of leptomeningeal collateral flow was detected immediately after middle cerebral artery (MCA) occlusion in C57BL/6 mice, with continued expansion over the course of seven days. In contrast, little collateral recruitment was seen in Balb/C mice during- and one day after MCAO, which coincided with a greater infarct size and worse functional outcome compared to C57BL/6, despite a slight improvement of cortical perfusion seven days after MCAO. Both strains of mice experienced a reduction of blood flow in the penetrating arterioles (PA) by more than 90% 30-min after dMCAO, although the decrease of PA flow was greater and the recovery was less in the Balb/C mice. Further, Balb/C mice also displayed a prolonged greater heterogeneity of capillary transit time after dMCAO in the MCA territory compared to C57BL/6 mice. Our data suggest that the extent of native leptomeningeal collaterals affects downstream hemodynamics with a long lasting impact in the microvascular bed after cortical stroke.

PurposeThree-dimensional, time-resolved blood flow measurement (4D-flow) is a powerful research and clinical tool, but improved resolution and scan times are needed. Therefore, this study aims to (1) present a postprocessing framework for optimization-driven simulation-based flow imaging, called 4D-flow High-resolution Imaging with a priori Knowledge Incorporating the Navier-Stokes equations and the discontinuous Galerkin method (4D-flow HIKING), (2) investigate the framework in synthetic tests, (3) perform phantom validation using laser particle imaging velocimetry, and (4) demonstrate the use of the framework in vivo.MethodsAn optimizing computational fluid dynamics solver including adjoint-based optimization was developed to fit computational fluid dynamics solutions to 4D-flow data. Synthetic tests were performed in 2D, and phantom validation was performed with pulsatile flow. Reference velocity data were acquired using particle imaging velocimetry, and 4D-flow data were acquired at 1.5 T. In vivo testing was performed on intracranial arteries in a healthy volunteer at 7 T, with 2D flow as the reference.ResultsSynthetic tests showed low error (0.4%-0.7%). Phantom validation showed improved agreement with laser particle imaging velocimetry compared with input 4D-flow in the horizontal (mean -0.05 vs -1.11 cm/s, P < .001; SD 1.86 vs 4.26 cm/s, P < .001) and vertical directions (mean 0.05 vs -0.04 cm/s, P = .29; SD 1.36 vs 3.95 cm/s, P < .001). In vivo data show a reduction in flow rate error from 14% to 3.5%.ConclusionsPhantom and in vivo results from 4D-flow HIKING show promise for future applications with higher resolution, shorter scan times, and accurate quantification of physiological parameters.

PurposeTo characterize the effect of hepatic vessel flow using 4-dimensional (4D) flow magnetic resonance (MR) imaging and correlate their effect on microwave ablation volumes in an in vivo non-cirrhotic porcine liver model.Materials and methodsMicrowave ablation antennas were placed under ultrasound guidance in each liver lobe of swine (n = 3 in each animal) for a total of 9 ablations. Pre- and post-ablation 4D flow MR imaging was acquired to quantify flow changes in the hepatic vasculature. Flow measurements, along with encompassed vessel size and vessel-antenna spacing, were then correlated with final ablation volume from segmented MR images.ResultsThe linear regression model demonstrated that the preablation measurement of encompassed hepatic vein size (β = -0.80 ± 0.25, 95% confidence interval [CI] -1.15 to -0.22; P = .02) was significantly correlated to final ablation zone volume. The addition of hepatic vein flow rate found via 4D flow MRI (β = -0.83 ± 0.65, 95% CI -2.50 to 0.84; P = .26), and distance from antenna to hepatic vein (β = 0.26 ± 0.26, 95% CI -0.40 to 0.92; P = .36) improved the model accuracy but not significantly so (multivariate adjusted R2 = 0.70 vs univariate (vessel size) adjusted R2 = 0.63, P = .24).ConclusionsHepatic vein size in an encompassed ablation zone was found to be significantly correlated with final ablation zone volume. Although the univariate 4D flow MR imaging-acquired measurements alone were not found to be statistically significant, its addition to hepatic vein size improved the accuracy of the ablation volume regression model. Pre-ablation 4D flow MR imaging of the liver may assist in prospectively optimizing thermal ablation treatment.