SummaryLeft ventricular (LV) myocardial atrophy and diminished cardiac function have been shown to accompany chronic human tetraplegia. These changes are attributable both to physical immobilisation and abnormal autonomic circulatory regulation imposed by a spinal cord injury (SCI). To test whether exercise training increases LV mass following chronic SCI, 8 neurologically complete quadriplegic males at 2 SCI rehabilitation and research centres underwent one month of electrically-stimulated quadriceps strengthening followed by 6 months of electrically-stimulated cycling exercise. Resting M-mode and 2-D echocardiograms were measured before and after exercise training to quantify the interventricular septal and posterior wall thicknesses at end-diastole (IVST ED and PWT ED, respectively), and the LV internal dimension at end-diastole (L VI D ED). LV mass was computed from these measurements using standard cube function geometry. Results showed a 6·5% increase in LVIDED foliowing exercise training (p<0·02), with increases in IVSTED and PWTED of 17·8 (p<0·002) and 20·3% (p
Galhardo Jr C, Botelho ESL, Diego LAS -Intraoperative Monitoring with Transesophageal Echocardiography in Cardiac Surgery. Background and objectives:Since its clinical introduction in the 80s, intraoperative transesophageal echocardiography (TEE) has represented one of the greatest advances in modern cardiac anesthesia. It is a semi-invasive technique that allows direct and fast visualization of structural anatomy of the heart and great vessels as well as contributes to hemodynamic and functional evaluation of the cardiovascular system. Thus, it has become an important monitor in aiding the diagnosis of cardiac pathologies and anesthesia and surgical interventions. The objective of this report was to perform a comprehensive review on the use of intraoperative TEE in cardiac surgery. Contents:This article reviews some aspects of ultrasound physics, imaging techniques, echocardiographic cuts used more oftenly, indications, and main clinical applications in addition to contraindications and complications. Conclusions:Intraoperative TEE is a safe method of cardiovascular monitoring, which is useful in the formulation of a surgical strategy, orientation of hemodynamic interventions, and immediate assessment of surgical outcomes. Once qualified to use the method, the anesthesiologist expands its role in perioperative medicine, providing clinical information necessary to the anesthetic-surgical procedure in cardiac surgery.
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