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Photo Acoustic Energy Applications for the Detection of Human Arterial Blockages via Multiple Skin/Bone Layers, a Non-Invasive Approach

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World Journal of Cardiovascular Diseases 2017年第8期7卷 251-270页

作者： Monika Kakani neeraj Rathi Ahdy Helmy Ashok Kumar Thella M. D. James Rizkalla Paul Salama Maher E. Rizkalla Department of Electrical and Computer Engineering Indiana University Purdue University Indianapolis (IUPUI) Indianapolis USA va Hospital Indiana University School of Medicine Indianapolis USA Baylor University Medical Center (BUMC) Dallas USA Integrated Nanosystems Development Institute IUPUI Indianapolis USA Richard G. Lugar Center for Renewable Energy IUPUI Indianapolis USA

The impact of arterial narrowing/blocking caused by plaque buildup in arteries leads to many life-threatening consequences. This is recognized as a cause in heart attacks and peripheral vascular disease. Diagnosing the illness is only feasible after symptoms have presented to the patient. Currently, the standard for visualizing coronary arteries is through angiography, which may have complications, and impact on the healthcare system. Furthermore, cardiac catheterization may also places high health risks, given its overall invasiveness. Cardiac arrhythmias, infection, and contrast dye nephrotoxicity are recognized complications within this process. Therefore, a noninvasive approach may have potentials to reduce patient complications, finances surrounding healthcare, and more efficient patient care through earlier screening and diagnosing. This research addresses a new approach using photoacoustic (PA) imaging. The transmission properties of atherosclerosis within walls of arteries, can be exploited using photo acoustics, to better visualize and characterize the degree and severity of atherosclerosis. The delivered energy is absorbed by components of the vascular tissue converted into heat, leading to transient thermos elastic expansion, which creates an acoustic emission. The thermal response was analyzed for its fall and recovery times that are attributed to the artery fat type. The control parameters, including the frequency, penetration depth, energy levels, and tissue layer sizes, for multilayered structures were considered. The structures investigated were fatty infiltrate within the artery, blood, bones, and skin, within frequency range from 1 MHz to 3 MHz, and typical tissue sizes in the milli to centimeter range. As high as 14 MPas in the acoustic pressure at 1 MHz, resulted in temperature difference of up to 3.4 K. When the operating frequency was altered to 2 MHz, the temperature changed to 23 K. Furthermore, when the frequency was changed to 3 MHz, the te

关键词： Acoustic Thermal Cardiovascular Diagnosis MEMS/NEMS COMSOL Multilayers Non-Invasive

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Who benefits from percutaneous closure of patent foramen ovale vs medical therapy for stroke prevention? In-depth and updated metaanalysis of randomized trials

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World Journal of Cardiology 2019年第4期11卷 126-136页

作者： Khagendra Dahal Adil Yousuf Hussam Watti Brannen Liang Sharan Sharma Jharendra Rijal Pavan Katikaneni Kalgi Modi neeraj TANDon Michael Azrin Juyong Lee Division of Cardiology Department of Medicine Louisiana State University Health Sciences Center Department of Medicine University of Connecticut Health Center Kansas City Heart Rhythm Institute Overland Park Division of Cardiology Hartford Medical Center Cardiology Section Overton Brooks VA Medical Center Division of Cardiology University of Connecticut Health Center

BACKGROUND A few randomized clinical trials(RCT) and their meta-analyses have found patent foramen ovale closure(PFOC) to be beneficial in prevention of stroke compared to medical therapy. Whether the benefit is extended across all groups of patients remains *** To evaluate the efficacy and safety of PFOC vs medical therapy in different groups of patients presenting with stroke, we performed this meta-analysis of *** Electronic search of PubMed, EMBASE, Cochrane Central, CINAHL and ProQuest Central and manual search were performed from inception through September 2018 for RCTs. Ischemic stroke(IS), transient ischemic attack(TIA), a composite of IS, TIA and systemic embolism(SE), mortality, major bleeding,atrial fibrillation(AF) and procedural complications were the major ***-effects model was used to perform *** Meta-analysis of 6 RCTs including 3560 patients showed that the PFOC,compared to medical therapy reduced the risk of IS [odds ratio: 0.34; 95%confidence interval: 0.15-0.78; P = 0.01] and the composite of IS, TIA and SE [0.55(0.32-0.93); P = 0.02] and increased the AF risk [4.79(2.35-9.77); P < 0.0001]. No statistical difference was observed in the risk of TIA [0.86(0.54-1.38); P = 0.54],mortality [0.74(0.28-1.93); P = 0.53] and major bleeding [0.81(0.42-1.56); P = 0.53]between two strategies. Subgroup analyses showed that compared to medical therapy, PFOC reduced the risk of stroke in persons who were males, ≤ 45 years of age and had large shunt or atrial septal *** In certain groups of patients presenting with stroke, PFOC is beneficial in preventing future stroke compared to medical therapy.

关键词： Patent foramen ovale Stroke Antiplatelet therapy Anticoagulation Metaanalysis

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Erythropoietin therapy after out-of-hospital cardiac arrest:A systematic review and meta-analysis

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World Journal of Cardiology 2017年第12期9卷 830-837页

作者： Rahul Chaudhary Jalaj Garg Parasuram Krishnamoorthy Kevin Bliden neeraj Shah Nayan Agarwal Rahul Gupta Abhishek Sharma Karl B Kern Nainesh C Patel Paul Gurbel Department of Medicine Sinai Hospital of BaltimoreBaltimoreMD 21215United States Division of Cardiology Lehigh Valley Health NetworkAllentownPA 18103United States Department of Medicine Division of CardiologyEinstein Healthcare NetworkPhiladelphiaPA 19141United States Inova Heart and vascular Institute Inova Medical CenterFairfaxVA 22042United States Division of Cardiovascular Medicine University of FloridaGainesvilleFL 32611United States Queens Cardiac Care QueensNY 11428United States Division of Cardiovascular Medicine State University of New YorkBrooklynNY 12246United States Division of Cardiology University of Arizona College of MedicineTucsonAZ 85721United States

AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,*** criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end *** efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical *** significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was *** Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.

关键词： Erythropoietin Thrombosis Cardiac arrest Cardiopulmonary resuscitation

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