End-diastolic Velocity Research Articles

Evaluation of Ventricular Dyssynchrony Measured by Tissue Doppler Indices in Fetuses of Diabetic Mothers: A Case-Control Study

Background: This study aimed to evaluate the effects of overt maternal diabetes on fetal cardiac function. Methods: In this case-control study, 26 pregnant women with overt diabetes (the case group) and 26 women with uncomplicated pregnancies (the control group) were examined using tissue Doppler echocardiography. Cardiac function was assessed twice in the fetal period (18–22 weeks and 28 weeks of gestation) and once in the neonatal period (1 week postnatal). Fetal cardiac function was assessed using early-diastolic maximum velocity index (Em), end-diastolic maximum velocity index (Am), Em/Am, left ventricular myocardial function index (LVMPI), and interventricular mechanical delay index (IVMDI). Results: The case and control groups were not significantly different in maternal and gestational age in fetal Doppler evaluation. Em (P=0.007), Am (P<0.001), LVMPI (P=0.003), and IVMDI (P=0.026) were significantly higher in the case group than in the control group, while there was no significant difference in Em/Am (P=0.264). Eight fetuses (30.8%) of diabetic mothers had dyssynchrony, while no cases of dyssynchrony were seen in fetuses of non-diabetic mothers (P=0.004). Infants of diabetic mothers were 8.8 times more likely to develop adverse neonatal outcomes than infants of healthy mothers (RR: 8.8, 95% CI: 1.71 to 45.31, P=0.009). Conclusion: The findings of the current study revealed significant cardiac dysfunction and dyssynchrony in fetuses of diabetic pregnant women. Additionally, IVMDI and LVMPI can be used to predict adverse neonatal outcomes in pregnancies complicated with overt diabetes.

Ratio of initial mitral flow velocity and end-diastolic mitral flow velocity as prognostic factors in the primary care: a survival analysis

Introduction: Diastolic dysfunction (DD) has a significant impact on the non-hospitalized population and is associated with heart failure with preserved ejection fraction (HFpEF) and higher mortality. Early diagnosis is crucial and echocardiography, due to its accessibility and correlation with invasive data, is essential. Among the parameters assessed, the E/A ratio stands out for reflecting diastolic function and is fundamental in the early identification of alterations that can modify the course of the disease, reducing individual and collective impacts. Aim: To assess the potential of the ratio between initial mitral flow velocity and end-diastolic mitral flow velocity (E/A) as a prognostic factor for hospitalization for cardiovascular causes and deaths in primary health care. Method: A community-based longitudinal observational ecological study was carried out, recruiting 633 individuals for clinical evaluation and echocardiography with tissue Doppler and pulsed Doppler spectral analysis to measure the velocity of the E/A ratio, with two different cut-off points for characterizing DD. Results: After six years, 560 participants completed the study to investigate the causes of hospitalization and death. Survival and hazard ratio analyses were carried out. Multivariate Cox regression with Schoenfeld residual analysis in the univariate analysis, and a final model were created. 355 (63%) were women aged around 59. 405 participants (72.3%) were diagnosed with hypertension, 133 (23.8%) were diagnosed with diabetes and 99 (17.7%) were current smokers. A crude HR of 3.47 and 3.60 and 3.02 and 0.41 was identified for DD class II and III at cut-off points 1 and 2 respectively (p<0.01). After adjusting for gender and age, the HR was 1.69, 2.80 and 1.53 and 0.49 for DD class II and III at cut-off points 1 and 2 respectively (p>0.1). Conclusion: The E/A ratio showed an altered pattern in the majority of study participants who were not diagnosed with heart failure, which may characterize its subclinical form, stage B HF.

Optic nerve sonographic parameters in idiopathic intracranial hypertension, case-control study

The most common diagnostic error of IIH is inaccurate funduscopic examination. Moreover, IIH could be diagnosed without papilledema. Trans orbital sonography could be used as a non-invasive and cheap tool for discovering increased ICP (intracranial Pressure). Aim of our study was discovering the changes in ultra-sonographic indices and which one could predict the increased ICP. Sixty-eight patients were diagnosed as definite IIH and 68 healthy volunteers are included in the study who had the same sex and age. ONSD, peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were estimated by transorbital color Doppler. Multivariate linear regression was used to discover the predictors of increased ICP. ROC curve was plotted for the predictor. A statistically significant difference was found between IIH patients and controls regarding ONSD, EDV and RI. Multivariate linear regression revealed that ONSD is the only predictor of increased CSP pressure. Its cut-off value indicating high ICP was 5.7 mm on Rt and Lt eye (AUC: 0.916; 95% confidence interval 0.867–0.965; p < 0.001; 90% sensitivity, 80% specificity at Rt eye. AUC: 0.902; 95% confidence interval 0.845–0.958; p < 0.001; 91% sensitivity, 80% specificity at Lt eye).

Prediction of post-contrast acute kidney injury by bedside ultrasonography

BackgroundThe incidence of contrast-induced acute kidney injury (CI-AKI) in the general population ranges from 0.6 to 2.3%, whereas for specific high-risk patients, the incidence can reach more than 30–40%. Ultrasound measurements of the development of CI-AKI after contrast-enhanced imaging for diagnosis in the emergency department (ED) have yet to be adequately studied. Accordingly, we aimed to evaluate the usefulness of Doppler ultrasound measurements for predicting CI-AKI in patients with normal renal function.MethodsThis prospective, observational, single-center study was conducted in the ED of a tertiary teaching and research hospital between 1 January and 1 July 2024. All patients who presented to the tertiary training and research hospital ED, who were admitted to the hospital with a decision to undergo contrast-enhanced tomography for diagnosis, and who did not meet any exclusion criteria were included in the study. Patients included in the study were evaluated by ultrasonographic measurements (interlobar renal artery peak systolic velocity (PSV), interlobar renal artery end-diastolic velocity (EDV), inferior vena cava (IVC) collapsibility index, and renal resistive index (RRI)).ResultsThe postcontrast RRI cutoff values were calculated to predict CI-AKI. The area under the curve (AUC) for the postcontrast RRI was 0.914, and the cutoff value for the postcontrast RRI was 0.70 (≥), exhibiting 72.7% sensitivity and 95.6% specificity.ConclusionPostcontrast RRI ultrasound measurements performed after diagnostic contrast imaging in the ED show high specificity in predicting CI-AKI development. Postcontrast ultrasound measurements may predict CI-AKI development, allowing further measures to be taken. Further studies are needed to confirm these findings.Trial registrationClinical trial number: not applicable.

Vascular hemodynamic effects of penile revascularization surgery and the role of resistive index in follow-up

BackgroundTo evaluate the effects of penile revascularization surgery on penile vascular hemodynamics and to assess the utility of the resistive index (RI) as an objective parameter for postoperative patient follow-up.MethodsThis study included a total of 35 patients who underwent penile revascularization. Penile color Doppler ultrasonography was performed preoperatively and at the third postoperative month to evaluate cavernosal arteries, dorsal arteries, deep dorsal vein, and inferior epigastric artery. During these evaluations, peak systolic velocity, end diastolic velocity, and resistive index were measured. The International Index of Erectile Function questionnaire was administered before surgery and at the third postoperative month. In addition, corpus cavernosum electromyography and cavernosometry tests were performed in all cases preoperatively. Anastomotic patency was assessed using computed tomography angiography at the end of the follow-up period.ResultsThe mean preoperative resistive index values were determined to be 0.74 ± 0.07 and 0.73 ± 0.09 cm/s for the right and left cavernosal arteries, respectively, and these values increased to 0.95 ± 0.09 and 0.96 ± 0.06 cm/s, respectively, at the last postoperative control. The mean International Index of Erectile Function-5, 15 scores for the right and left cavernosal arteries were 8.52 ± 4.83 and 19.4 ± 8.54, respectively, preoperatively, and these scores improved to 15.26 ± 4.50 and 35.76 ± 13.65, respectively, at the last postoperative follow-up.ConclusionThe results of this study suggest that the resistive index can be used as an objective parameter in the diagnosis of erectile dysfunction of vascular origin and in the follow-up and management of the disease following penile revascularization.Trial registrationNCT06350019/04/03/2024 (retrospectively registered).

Perinatal Outcomes in Appropriately Grown Monochorionic Diamniotic Twins With Intermittent Absent and Reversed End-Diastolic Umbilical Artery Flow Compared to Selective Fetal Growth Restriction Type III.

Umbilical artery Doppler intermittent absent and reversed end-diastolic flow (iAREDF) is associated with increased perinatal morbidity and mortality in monochorionic twins with selective fetal growth restriction. The clinical significance of umbilical artery iAREDF in appropriately grown monochorionic twins is not well described. This is a single-institution retrospective cohort study describing characteristics and outcomes of monochorionic diamniotic twins with appropriate for gestational age growth and umbilical artery iAREDF in comparison to monochorionic diamniotic twins with selective fetal growth restriction and iAREDF,or sFGR type III. The cohorts were compared for antenatal resolution of iAREDF, estimated gestational age at delivery, fetal and maternal complications, delivery characteristics, and survival outcomes. Ten appropriately grown monochorionic diamniotic twin pairs with umbilical artery iAREDF and 23 with sFGR Type III delivered at a mean gestational age of 30.4 (±5) weeks and 30.7 (±4) weeks, respectively (p=0.93). No significant differences were observed in the Doppler course (deterioration or improvement) prior to delivery, fetal or maternal complications, delivery characteristics (with the exception of the persistence of the growth differences), or survival outcomes between groups. Monochorionic diamniotic twins with intermittent absent and reversed end-diastolic umbilical artery velocity may be at increased risk for adverse perinatal outcomes even if criteria for selective fetal growth restriction are not met.

Establishing Reference Ranges for Doppler Parameters of the Fetal Aortic Isthmus in the Third Trimester

Objective: This study evaluated the significance of Doppler indices of the fetal aortic isthmus in diagnosing fetal hemodynamic disorders early. The aim was to determine the Doppler values within the fetal aortic isthmus in the third trimester of pregnancy. Materials and Methods: Patients who presented with pregnancies between 28 and 40 weeks of gestation were examined for Doppler indices of the fetal aorta and compared with the gestational age. Among these, 325 normal fetuses (mean gestational age, 25 weeks) were included in the study. The correlation between Doppler indices and gestational age was evaluated using regression equations. Linear, quadratic, and cubic models were applied to all the variables. Results: Curve estimation analysis showed that peak systolic velocity ( R2 = 0.168), end-diastolic velocity ( R2 = 0.042), pulsatility index ( R2 = 0.101), and time-averaged maximum velocity ( R2 = 0.090) correlated with gestational age (cubic model, p &lt; .001). However, S/D, resistance index, and isthmic systolic index were not significantly correlated with gestational age. Notably, the R2 values were low for all variables. Conclusion: In this fetal cohort, the suggested normal reference values for Doppler indices based on gestational age in the third trimester of pregnancy were determined.

The association between changes in cerebral hemodynamics and cerebrovascular complications during ECMO treatment in neonates.

To investigate whether changes in cerebrovascular hemodynamic parameters during extracorporeal membrane oxygenation (ECMO) treatment in neonates are associated with the occurrence of cerebrovascular complications. This study selected neonatal patients who received ECMO treatment at a pediatric hospital in China from June 2021 to June 2024. Relevant clinical data were collected from the electronic medical record system. Data from cranial ultrasound examinations before and during ECMO treatment, as well as the occurrence of cerebrovascular complications, were collected for further analysis. A total of 37 neonates were enrolled in this study. Among them, 15 neonates who developed cerebrovascular complications during ECMO were included in the complication group, while the remaining 22 neonates were included in the non-complication group. The age difference between the two groups was statistically significant. The systolic blood pressure coefficient of variation (SBP-CV) and diastolic blood pressure CV (DBP-CV) were significantly higher in the complication group compared to the non-complication group. Additionally, the anterior cerebral artery peak systolic velocity CV (ACA-PSV-CV) and ACA resistance index CV (ACA-RI-CV) were significantly higher in the complication group than in the non-complication group. However, there was no significant difference in the ACA end-diastolic velocity CV (ACA-EDV-CV) between the two groups. The receiver operating characteristic (ROC) curve analysis of risk factors for cerebrovascular complications indicated that the area under the curve (AUC) for ACA-RI-CV was 0.765 (95% CI: 0.608-0.923, p = 0.007). The AUC for ACA-SBP-CV was 0.815 (95% CI: 0.666-0.964, p = 0.001). Moreover, when ACA-RI-CV and ACA-SBP-CV were combined, the AUC was 0.873 (95% CI: 0.758-0.988, p<0.001). High ACA-RI-CV and ACA-SBP-CV were associated with the occurrence of cerebrovascular complications during ECMO treatment in neonates. The combined detection of ACA-RI-CV and ACA-SBP-CV had a predictive role in the early identification of cerebrovascular complications in neonatal ECMO patients.

Color Doppler Imaging Assessment of Ocular Blood Flow Following Ab Externo Canaloplasty in Primary Open-Angle Glaucoma.

Background/Objectives: Glaucomatous neuropathy, a progressive deterioration of retinal ganglion cells, is the leading cause of irreversible blindness worldwide. While elevated intraocular pressure (IOP) is a well-established modifiable risk factor, increasing attention is being directed towards IOP-independent factors, such as vascular alterations. Color Doppler imaging (CDI) is a prominent technique for investigating blood flow parameters in extraocular vessels. This prospective, nonrandomized clinical trial aimed to assess the impact of ab externo canaloplasty on ocular blood flow parameters in patients with primary open-angle glaucoma (POAG) at a three-month follow-up. Methods: Twenty-five eyes of twenty-five patients with early or moderate POAG underwent canaloplasty with simultaneous cataract removal. CDI was used to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs) before and after surgery. Results: The results showed a significant reduction in IOP and improvement in mean deviation at three months post-surgery. Best corrected visual acuity and retinal nerve fiber layer thickness significantly increased at each postoperative control visit. However, no significant changes were observed in PSV, EDV, and RI in the studied vessels. Conclusions: In conclusion, while canaloplasty effectively reduced IOP and medication burden, it did not significantly improve blood flow parameters in vessels supplying the optic nerve at three months post-surgery. Careful patient selection considering glaucoma severity and vascular risk factors is crucial when choosing between canaloplasty and more invasive procedures like trabeculectomy. Further larger studies are needed to comprehensively analyze this issue.

The influence of yoga exercises with voluntary pulmonary ventilation changes on intracranial arterial blood flow

Introduction. Yoga breathing exercises that involve voluntary changes in pulmonary ventilation parameters can potentially influence cerebral circulation due to changes in CO2 content in arterial blood. Objective. To assess the effect of yoga breathing exercises with changes in pulmonary ventilation levels on blood flow parameters in the middle cerebral artery (MCA). Methods. The study included 21 participants, with an average age of 39.5±8.7 years, who were capable of performing yoga exercises at respiratory rates (RR) of 3–3.5/min and 1–1.5/min. For 5 minutes, participants underwent three stages: free breathing (stage 1), breathing with RR=3–3.5/min (stage 2), and breathing with RR=1–1.5/min (stage 3). During stages 2 and 3, the «full breathing» technique, which involves maximum deep inhalation and exhalation, was employed. Respiratory rate (RR), tidal volume (TI), minute ventilation (MV), end-tidal CO2 partial pressure (PetCO2), and oxygen fraction in exhaled air (FeO2) were recorded using spiro-gas analysis. Transcranial duplex scanning was used to measure peak systolic blood flow velocity (Vps), end-diastolic blood flow velocity (Vd), time-averaged maximum blood flow velocity (TAMAX), and resistance index (RI) in the right MCA. The velocity variation index (VVI) was calculated for each stage. Results. Compared to stage 1 (free breathing), stage 2 (RR = 3–3.5/min) showed an increase in MV and FeO2, a decrease in PetCO2, and reductions in Vps, Vd, and TAMAX, with an increase in RI. VVI decreased statistically insignificantly. In stage 3 (RR = 1–1.5/min), compared to stage 1, there was an increase in PetCO2, a decrease in MV and FeO2, and increases in Vps, Vd, and TAMAX, with a decrease in RI. VVI increased significantly. Conclusions. Yoga breathing exercises at respiratory rates of 3–3.5/min and 1–1.5/min result in multidirectional shifts in ventilation and gas exchange parameters, leading to changes in arterial cerebral blood flow (a decrease and increase in blood flow velocity with an increase and decrease in MV, respectively). VVI, reflecting fluctuations in blood flow velocity, increases significantly with reduced MV, likely due to the vasodilatory effect of CO2.

Prospective Evaluation of Autonomic Function and Intestinal Blood Flow in Health and Irritable Bowel Syndrome Shows Differences Limited to Patients With Constipation Predominance.

Autonomic dysfunction may contribute to symptom generation in irritable bowel syndrome (IBS), possibly driven by psychological morbidity and activation of the hypothalamic-pituitary-adrenal axis. Previous data are conflicting, perhaps due to lack of accounting for differential bowel patterns in IBS (constipation vs. diarrhea) or by diverse methodologies used to measure autonomic function. Our aim was to determine if autonomic response differed between IBS subtypes and healthy controls. Forty female volunteers (20 IBS and 20 healthy) underwent comprehensive autonomic testing, fasting and postprandially, and in response to cold pressor and deep breathing challenges. Pulse transit time (PTT) and ultrasound measurements of intestinal blood flow were used as measures of systemic and local autonomic function, respectively. Outcomes were adjusted for baseline psychological comorbidities and gastric emptying (measured concurrently with scintigraphy). Findings, confined to IBS patients with predominant constipation (IBS-C), included (1) lower fasting and a trend to larger postprandial increase in superior mesenteric artery end-diastolic velocity; (2) lower fasting PTT, suggesting higher sympathetic tone, but no difference in postprandial PTT change; and (3) attenuated increase in postprandial aortic peak systolic velocity. Response to systemic autonomic challenges did not differ between IBS and health. Some psychological factors mediated differences between groups in the fasting, but not postprandial, state. IBS-C patients display systemic and local autonomic imbalance providing some support for recent therapies aimed at modulating autonomic state specifically in this patient group (e.g., acustimulation).

Therapeutic Efficacy of Persimmon Leaf Flavonoids Extract in Ischemic Cerebrovascular Disease

In this research, the effects of persimmon leaf extract in treating ischemic cerebrovascular disease (ICVD) were analyzed, and the therapeutic outcomes were evaluated using techniques such as computed tomography (CT) angiography. Firstly, the impact of extraction conditions on the yield of flavonoids from persimmon leaves was assessed, and their scavenging rates (SRs) against three types of free radicals (DPPH, hydroxyl, and superoxide anion) were measured. Subsequently, 80 patients with ICVD were enrolled. Before treatment, patients’ carotid artery atherosclerotic plaque composition was evaluated using gemstone spectral CT, and the effects of conventional therapy (Ctrl group) were compared with those of treatment using persimmon leaf extract (Test group) on the patients’ blood lipids (BLs), blood glucose (BG) levels, hemorheology, hemodynamics, and CT angiography/perfusion imaging characteristics. Additionally, the post-treatment recurrence rate was recorded. The results revealed that the solvent concentration, ultrasonic power, temperature, time, and solid-liquid ratio markedly influenced the yield of persimmon leaf extract. Furthermore, the persimmon leaf extract demonstrated remarkable efficacy in scavenging three types of free radicals, namely DPPH, hydroxyl, and superoxide anion. The clinical results demonstrated that the main components of carotid artery plaque in ICVD patients were lipids, fibrous matrix, and hemorrhage, and the spectral curve combined with CT values accurately differentiated these plaque components. Patients in Test group exhibited notable improvements versus Ctrl group (P &lt;0.05) in their serum lipid profiles (reduced total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels, increased low-density lipoprotein cholesterol (LDL-C) levels), BG levels (decreased fasting BG (FBG), glycosylated hemoglobin (HbA1c), and postprandial 2-hour BG (2h-PG) levels), hemorheological parameters (decreased low-shear whole blood viscosity (LSBV), high-shear whole blood viscosity (HSBV), blood viscosity (PV), packed cell volume (PCV), platelet adhesion rate (PAR), and fibrinogen (FIB) levels), transcranial Doppler ultrasound parameters (increased mean blood flow velocity (Vm), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of middle cerebral artery (CA), anterior CA, and basilar artery), and CT angiography with perfusion imaging parameters (increased cerebral blood flow (rCBF) and region cerebral blood volume (rCBV), shortened time to peak (TTP)). Additionally, recurrence rates of transient ischemic attack and cerebral infarction were lower in Test group compared to Ctrl group. In summary, the findings suggest that persimmon leaf extract possesses potent antioxidant properties. Spectral CT can identify and distinguish carotid artery plaque components. Furthermore, persimmon leaf extract effectively improved blood lipids, blood pressure, hemorheology, hemodynamics, and cerebral perfusion status, thereby reducing the risk of recurrence in ICVD.

OPtimal TIming of antenatal COrticosteroid administration in pregnancies complicated by early-onset fetal growth REstriction: results of a large, multicenter cohort study (the OPTICORE study).

Early-onset fetal growth restriction as consequence of placental insufficiency frequently requires iatrogenic, preterm birth. Administration of antenatal corticosteroids reduces risks of neonatal morbidity and mortality following preterm birth and is most beneficial if the neonate is delivered within two weeks following treatment. International guidelines on fetal growth restriction pregnancies do not provide directives regarding the timing of antenatal corticosteroids, resulting in practice variation. (s): This study compared the two main timing strategies of antenatal corticosteroids administration in the Netherlands for early-onset fetal growth restriction pregnancies: administration when the umbilical artery shows a pulsatility index above the 95th centile with (A) positive end-diastolic flow versus (B) absent or reversed end-diastolic velocity. A multicenter, retrospective cohort study was performed in six tertiary hospitals in the Netherlands between 2012-2021. Three hospitals practiced timing strategy A and three strategy B. The primary outcome was defined as a composite of perinatal and in-hospital mortality. Secondary outcomes were in line with the core outcome set for fetal growth restriction (COSGROVE). Mixed effects analyses were performed adjusted for birthweight z-score and gestational age at birth to compare the two timing strategies. A total of 1,453 patients were included, of whom 871 and 582 were treated according to timing strategy A and B, respectively. Corticosteroids were administered at a mean gestational age of 28 weeks and 3 days (standard deviation 16.0 days) in timing strategy A and 28 weeks and 4 days (standard deviation 15.8 days) in timing strategy B. The median birthweights were 1050 (range 795, 1350) and 1060 (range 801, 1339) in timing strategy A and B, respectively. Although not statistically significant, rates of perinatal and in-hospital mortality were increased in timing strategy B infants (7.2% versus 9.8%; adjusted odds ratio 1.47; 95% confidence interval 0.97-2.22, reference A). 52.8% and 53.6% of patients in strategy A and B, respectively, delivered within the corticosteroids therapeutic window of 2 to 14 days (P-value 0.663), with a median time between corticosteroid administration and delivery of 6 days for strategy A and 6 days for strategy B. Timing strategy B was associated with more necrotizing enterocolitis (3.7% versus 7.6%; adjusted odds ratio 2.18; 95% confidence interval 1.29-3.69), but less respiratory distress syndrome (39.6% versus 34.5%; adjusted odds ratio 0.63; 95% confidence interval 0.45-0.88) and bronchopulmonary dysplasia (18.9% versus 17.4%; adjusted odds ratio 0.69; 95% confidence interval 0.50-0.96). Other outcomes were similar between groups. Timing strategy B seemed to be associated with higher rates of the composite of perinatal and in-hospital mortality, which could not be explained by a difference in time intervals between corticosteroid administration and delivery. Importantly, most pregnant women delivered outside the presumed therapeutic corticosteroid window. Future research should focus on the improvement of the timing of antenatal corticosteroids in pregnancies complicated by early-onset fetal growth restriction and the identification of other differences in ante- and/or postnatal management to explain differences in outcomes, given the high risk for neonatal morbidity and mortality in this setting.

Involvement of Melatonin, Oxidative Stress, and Inflammation in the Protective Mechanism of the Carotid Artery over the Torpor-Arousal Cycle of Ground Squirrels.

Hibernating mammals experience severe hemodynamic changes over the torpor-arousal cycle, with oxygen consumption reaching peaks during the early stage of torpor to re-enter arousal. Melatonin (MT) can improve mitochondrial function and reduce oxidative stress and inflammation. However, the regulatory mechanisms of MT action on the vascular protective function of hibernators are still unclear. Morphology, hemodynamic, mitochondrial oxidative stress, and inflammatory factors of the carotid artery were assessed in ground squirrels who were sampled during summer active (SA), late torpor (LT), and interbout arousal (IBA) conditions. Changes were assessed by methods including hematoxylin and eosin staining, color Doppler ultrasound, ELISA, Western blots, and qPCR. Changes in arterial blood and serum melatonin were also measured by blood gas analyzer and ELISA, whereas mitochondrial oxidative stress and inflammation factors of primary vascular smooth muscle cells (VSMCs) were assessed by qPCR. (1) Intima-media carotid thickness, peak systolic velocity (PSV), end diastolic blood flow velocity (EDV), maximal blood flow rate (Vmax) and pulsatility index (PI) were significantly decreased in the LT group as compared with the SA group, whereas there were no difference between the SA and IBA groups. (2) PO2, oxygen saturation, hematocrit and PCO2 in the arterial blood were significantly increased, and pH was significantly decreased in the LT group as compared with the SA and IBA groups. (3) The serum melatonin concentration was significantly increased in the LT group as compared with the SA and IBA groups. (4) MT treatment significantly reduced the elevated levels of LONP1, NF-κB, NLRP3 and IL-6 mRNA expression of VSMCs under hypoxic conditions. (5) Protein expression of HSP60 and LONP1 in the carotid artery were significantly reduced in the LT and IBA groups as compared with the SA group. (6) The proinflammatory factors IL-1β, IL-6, and TNF-α were reduced in the carotid artery of the LT group as compared with the SA and IBA groups. The carotid artery experiences no oxidative stress or inflammatory response during the torpor-arousal cycle. In addition, melatonin accumulates during torpor and alleviates oxidative stress and inflammatory responses caused by hypoxia in vitro in VSMCs from ground squirrels.

Ophthalmic Artery Doppler as a Predictor of Adverse Neonatal Outcomes in Women With Preeclampsia.

This study aimed to evaluate the association between ophthalmic artery (OA) Doppler indices and adverse neonatal outcomes in women with pregnancies complicated by preeclampsia (PE). A prospective cross-sectional study involving 110 pregnant women who were diagnosed with PE in the first 24 h of hospitalization was conducted at three hospitals in southeastern Brazil from April 2020 to December 2022. The ophthalmic parameters analyzed were the resistance index (RI), pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), ratio of PSV2 to PSV1 (PSV ratio or the peak ratio [PR]), and end-diastolic velocity (EDV). The outcome measures were neonatal death (during hospitalization), neonatal intensive care unit (ICU) admission, gestational age at delivery < 32 weeks, birth weight < 1500 g, birth weight < 10th percentile, the presence of comorbidities associated with prematurity, the use of invasive mechanical ventilation, an Apgar score at the 5th minute < 7.0, and signs of neurological impairment. Pregnant women with severe features of PE showed higher values of systolic (152.8 ± 20.7 vs. 136.3 ± 11.9, p = 0.000) and diastolic (98.1 ± 12.8 vs. 88.1 ± 10.8, p = 0.000) blood pressure values and lower gestational age at admission (31.5 ± 3.8 vs. 33.7 ± 4.3, p = 0.009) than PE without severe features. No significant differences were found between the mean values of the OA Doppler indices when comparing the presence or absence of neonatal outcomes in the women with PE. OA Doppler, while valuable for the prediction, diagnosis, and evaluation of adverse maternal outcomes, does not independently predict adverse neonatal outcomes in women with severe features of PE.

Grading portal vein stenosis following partial hepatectomy by high-frequency ultrasonography: an in vivo study of rats.

To evaluate the diagnostic value of ultrasound in grading portal vein stenosis (PVS) in a rat model of 70% partial hepatectomy (PH). A total of 96 Sprague-Dawley rats were randomly divided into a PH group and PVS groups with mild, moderate, and severe PVS following PH. Hemodynamic parameters were measured using high-frequency ultrasound (5-12 MHz high-frequency linear transducer), including pre-stenotic, stenotic, and post-stenotic portal vein diameters (PVDpre, PVDs, PVDpost); pre-stenotic and stenotic portal vein velocity (PVVpre, PVVs); hepatic artery peak systolic velocity (PSV); end-diastolic velocity; and resistive index. The portal vein diameter ratio (PVDR) and portal vein velocity ratio (PVVR) were calculated using the following formulas: PVDR=PVDpre/PVDs and PVVR=PVVs/PVVpre. The value of these parameters in grading PVS was assessed. Portal vein hemodynamics showed gradient changes as PVS aggravated. For identifying >50% PVS, PVDs and PVDR were the best parameters, with areas under the curve (AUC) of 0.85 and 0.86, respectively. For identifying >65% PVS, PVDs, PVDR, and PVVR were relatively better, with AUCs of 0.94, 0.85, and 0.88, respectively. The AUC of hepatic artery PSV for identifying >65% PVS was 0.733. High-frequency ultrasonography can be used to grade PVS in rats, with PVDs, PVDR, and PVVR being particularly useful. Hepatic artery PSV may help in predicting >65% PVS. These findings provide valuable information for PVS rat model research and offer an experimental basis for further studies on PVS evaluation in living-donor liver transplantation (LDLT). Ultrasonography serves as a first-line technology for diagnosing PVS following LDLT. However, the grading criteria for PVS severity remain unclear. Investigating the use of ultrasonic hemodynamics in the early diagnosis of PVS and grading stenosis severity is important for early postoperative intervention and improving recipient survival rates.

The feasibility study of shear wave elastography in the diagnosis of erectile dysfunction

The aim of this study was to explore the value of Shear wave elastography (SWE) in evaluating vascular and nonvascular erectile dysfunction. In this study, erectile dysfunction (ED) patients enrolled (n = 114) received SWE and Doppler ultrasonography (PCDU) exams. The peak systolic velocity (PSV) and end-diastolic velocity (EDV) were used as the classification standard. The performance of the SWE was assessed with the receiver operating characteristic curve, sensitivity and specificity. The rigidity alterations of corpus cavernosum penis with age was also investigated. SWE values of corpus cavernosum penis (CCP) before intracavernosal injection (ICI) negatively correlated with age of patients in vascular ED group (r = -0.288, P < 0.05). In erectile or flaccid state, the SWE value of vascular ED was significantly larger than non-vascular ED. When the cut-off value for SWE values of CCP 0.88 m/s in erectile state and 2.32 m/s in flaccid state, the areas under the receiver operating characteristic (ROC) curve were 0.700 (sensitivity: 77.78%, specificity: 60.00%) and 0.612(sensitivity: 68.52%, specificity: 51.67%) in erectile or flaccid state, respectively. This study provides preliminary evidence that SWE in flaccid state could be non-invasive methods used to moderate predict vascular ED.

Predictors of corporo-venocclusive dysfunction in men with bilateral nerve-sparing radical prostatectomy.

Erectile dysfunction (ED) is seen in some men who have undergone bilateral nerve-sparing surgery. Corporo-venocclusive dysfunction (CVOD) is the major pathway to permanent ED after radical prostatectomy (RP). To identify comorbidity factors that are associated with the presence of CVOD in men who had undergone bilateral nerve-sparing RP. We included patients who had no ED before RP, underwent bilateral nerve-sparing RP, were unresponsive to pharmacotherapy, and had a penile Duplex Doppler Ultrasound (PDDU) with a diagnosis of CVOD. PDDU was performed with a redosing vasoactive agent protocol. A logistic regression model was created to define predictors of CVOD, defined as end-diastolic velocity (EDV) ≥5cm/s bilaterally. CVOD diagnosis. 135 patients with a median age of 60 (IQR 54, 64) years were included. 45% reported ≥2 comorbidities, 10% diabetes, 28% obstructive sleep apnea (OSA), and 44% were current or former smokers. At PDDU, 34% had less than penetration hardness erections, and 43% received 100units of vasoactive agent. 44% were diagnosed with CVOD. Increased age at RP (OR 2.12 per 10years, 95% CI 2.35, 3.73, P= .007) and OSA (OR 2.44, 95% CI 1.07, 5.73, P= .036) were associated with a diagnosis of CVOD. Comorbidities, especially OSA, have a role in erection recovery after surgery. The study used a well-established institutional RP nerve-sparing score, a strict PDDU vasoactive agent redosing protocol, validated cut-offs for CVOD diagnosis, and a validated erectile function questionnaire both pre- and post-operatively. The major limitation is that this is a cohort of men seeking treatment at a sexual medicine clinic for post-operative ED, which limits the generalizability of the results to patients without ED symptoms or who decided not to seek treatment. The dichotomous definition of comorbidities is also a limitation since patients can have differing degrees of comorbidities' severity. Older patients and the presence of OSA were associated with the presence of CVOD.

Chemical castration in dogs using calcium chloride: effects on testicular hemodynamics and semen characteristic and serum levels of testosterone

Dog overpopulation and stray dogs are global issues that are detrimental to public health and animal welfare. Thus, the goal of the current study was to provide alternatives for surgical castration. Therefore, calcium chloride was employed in this study, which might be an option for castration. Ten dogs were divided into two groups of five: a calcium chloride-treated group and a control group. The treated group received a single bilateral intratesticular injection of 1 ml of sterile saline containing calcium chloride dihydrate (CaCl2•2 H2O) at a dose of 20 mg/kg per testicle. While the control group was treated with 1 ml of sterile saline solution, Semen and blood collection, as well as Doppler ultrasonography, were routinely carried out every week on days 0, 7, 14, 21, and 28 in order to evaluate the impact of the injection on semen parameters and testicular blood flow. The testicular volume and echogenicity in the CaCl2-treated group were significantly (P < 0.001) lower in weeks 2 through 4 than in the control group. Furthermore, in canine semen, CaCl2 dramatically decreased the amount, motility, and viability of sperm. When compared to vehicle-control animals, azoospermia was seen 2 weeks after the injection and persisted for the end of the study. The testes of all dogs were surgically removed at 30 days post-injection, and testes were put in 10% neutral buffered formalin for tissue processing. When compared to the control group, the average weight of testes in the chemical groups was dramatically reduced. Significant decreases in spermatogenic processes, necrosis, and degeneration of seminiferous tubules packed with necrotic debris, and fibrosed interstitial tissue, necrosed and calcified Sertoli, and Leydig cells were seen 30 days after CaCl2 injection. There was a significant decrease in testosterone levels compared to day 0 before CaCl2 injection and the control group. From weeks 1 through 4, there was a substantial decrease in both peak systolic velocity (PSV) and end-diastolic velocity (EDV) values (P < 0.001) following a single intratesticular injection of CaCl2. The resistance index (RI) and pulsatility index (PI) showed the opposite tendency. Based on the histopathological and semen evaluations in this investigation, the study concludes that a single intratesticular injection of CaCl2 appears to be a practical and generally applicable approach for chemical sterilization of dogs.

Maternal-Fetal Blood Flow and Progesterone Concentration in Ewes Sheared at Mid or Late-Pregnancy.

These studies aimed to determine if shearing ewes at the second or last third of gestation modify the uterine and placentome blood flow, placentome size, and maternal progesterone concentration. Pregnant ewes were assigned to four groups of 12 ewes each according to the gestation period: mid-pregnancy sheared (on day 90 of pregnancy) or unshorn group; and late-pregnancy sheared group (on day 121 of pregnancy) or unshorn group. In both experimental periods, using spectral Doppler ultrasonography, placentomes and uterine artery blood flow and placentome size were evaluated 14 days before and 6 days after shearing. An additional measurement was performed 26 days after shearing in mid-pregnant ewes. Serum progesterone concentration was measured before shearing 4, 24, 72 h, and 22 days after shearing. The uterine artery's end-diastolic velocity (EDV) tended to be greater in the sheared than in the non-sheared ewes (p = 0.1). Peak systolic velocity (PSV) and EDV of placentome increased (p = 0.05 and p = 0.008, respectively) on day 26, accompanied by an increase in placentome area (p = 0.035) in mid-pregnant ewes. In late-pregnant ewes, uterine artery and placentome blood flow and size did not vary. Progesterone concentration varied with time but was not affected by shearing. In conclusion, shearing triggered an increase in placentome size and some changes in blood flow only when ewes were sheared during the second third of their pregnancy. Shearing ewes either the second or last third of gestation did not affect uterine artery blood flow and progesterone secretion.