Patients with a pressure gradient greater than 20 mm Hg should be good candidates for renal arterial dilatation, and use of the pressure guide wire will facilitate interventional decisions.
Studies on smooth muscle cell differentiation and those on vascular development in mouse and humans have long been hampered by the lack of suitable markers. Here we describe a novel, large isoform of smoothelin, a structural protein of differentiated, contractile smooth muscle cells. The protein, which is highly conserved in mouse and humans, shows homology with other cytoskeleton-associated smooth muscle cell proteins and contains an actinin-type actin-binding domain. Northern blot analysis from various mouse organs identified short and long smoothelin mRNA forms, which exhibit distinct tissue expression patterns. The short form is highly expressed in visceral muscle tissues such as intestine and stomach and is not detectable in brain, while the long mRNA form is expressed in all vascularized organs. These results may provide new tools and approaches to study both smooth muscle cell differentiation and proliferative vascular disease.
Left ventricular mass calculations are often performed to assess the need or effectiveness of antihypertensive drug therapy. However, there are multiple potential errors that may affect the accuracy of these calculations, which can possibly include acute changes in preload. Therefore, to assess the hypothesis that acute volume depletion might alter calculated left ventricular mass, 15 normotensive healthy male volunteers underwent standard M-mode echocardiographic evaluations (at the level of the chordae tendineae guided by two-dimensional echocardiography) before and 2 h after 40 mg of intravenous furosemide. One patient was eliminated due to hypotension prior to the final echocardiogram. The echocardiograms were blinded to patient identity and the time sequence and read separately by two investigators. Four to five cycles were read per echocardiogram by each investigator. All values measured were the mean of the two investigators. Echocardiographic measurements were derived by both the American Society of Echocardiography and Penn conventions. An average urine volume of 1728 mL was collected, and the mean weight change 2 h after furosemide administration was 1.78 kg (P = .001). Penn left ventricular diastolic diameter (1.8 mm, P = .015) and left ventricular mass index (10 g/m2, P = .04) were significantly decreased; however, there was no significant change in septal, posterior, or relative wall thicknesses. As it is unreasonable to believe that acute remodeling of the left ventricle resulted in a decline in left ventricular mass in 2 hours, it is concluded that acute volume changes resulted in a decrease in left ventricular mass measurement due to the influence of diastolic diameter on the calculation of cardiac mass.
IMR is a reproducible index in follow-up studies, independent of any overestimation existing when collateral flow status is neglected. Pv can be neglected for calculation of the IMR.
Conventional angiography allows a global view of regional vascular anatomy but precise information can only be deduced indirectly using contrast medium. The use of the three-dimensional picture of angioscopy, however, allows a direct evaluation of the vascular system. In order to extend our experiences with angioscopy, we employed a new micro-cardio-angioscopic system which consists of four components: a CCD color camera (360,000 pixels); a highly flexible optical probe which can be resterilised (1.4-0.6 mm diameter) incorporating 10,600-6,000 glass fibers, with a viewing angle of 140 degrees, 70 degrees, and 50 degrees and a focusing system that allows a distance from 2 mm to infinity; a high power light source and an insertion catheter with inflatable balloon. Using a known technique (intermittent blood-flow blockage and continual rinsing with NaCl solution), 36 cases involving 27 patients were examined before and after desobliteration of the femoral artery. In 88% of the cases it was possible to control the result of the intervention by angioscopy. Smaller intimal lips, the thrombotic wall, and intimal ruptures were clearly visible. Quantification of the stenoses was also successful in 88% of the cases, and in 8 patients the angioscopic findings deviated from the conventional angiogram. In 14% of the cases, angioscopic examination of the recanalisation result showed that thrombolytic therapy was necessary. Angioscopy offers the possibility of qualitative vascular diagnosis. It is a valuable addition to angiography.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.