Pressure Ratio Research Articles

Mechanical Characteristics of Tailings in Different Depositional Zones: A Case Study of Caijiagou Tailings Pond in Shaanxi, China

This study examines the widespread practice of upstream tailings dam construction in metallurgical mines in China, conducting comprehensive testing and research on tailings from various depositional zones of the Caijiagou tailings pond. Analysis of the test results from three types of tailings reveals a systematic relationship between the mechanical characteristics of tailings and their depositional zones: the farther from the dam, the finer the tailings particles, categorized as silty clay tailing, silt tailing, and sandy silt tailing. Consistent patterns were observed in the consolidated-drained shear strength and consolidated-undrained effective shear strength of these tailings. Among these, sandy silt tailing exhibited the highest strength, whereas silty clay tailing displayed the lowest. The dynamic stress–strain relationships of all three tailings types are described using the Hardin equivalent viscous-elastic model, where the initial dynamic shear modulus and the maximum dynamic shear stress in the model increased with effective confining pressure. The damping ratios exhibited a three-stage trend with increasing dynamic strain: gradual increase, rapid growth, and then gradual stabilization. Under various consolidated stress conditions, the ratio of the damping ratio to the maximum damping ratio versus the reduction in dynamic shear modulus showed a favorable linear relationship. Under vibration conditions, the dynamic shear stress corresponding to tailings failure increased with higher effective confining pressure and consolidated stress ratio. Finally, this study summarizes the parameters and indicators related to the saturated tailings of iron mines used in the research. Our work provides a foundation and reference for the design of tailings dams and the development and utilization of abandoned tailings ponds.

Refrigeration experiments of gas wave rotor based on calibration-free WMS-TDLAS method

The refrigeration efficiency is mainly dependent on the low temperature generated by gas wave dynamics in oscillation channel. In this paper, a temperature rapid monitoring method for short light path based on the calibration-free wavelength modulation spectroscopy-tunable diode laser absorption spectroscopy (WMS-TDLAS) method is proposed. The selection of absorption wavelength, measurement procedure and data processing are specifically introduced. The wave dynamics and medium temperature under different pressure ratios and rotary speeds are studied, and the energy transfer efficiency of the gas wave refrigerator is evaluated. As the pressure ratio increases, the temperature in the cold zone behind the expansion wave gradually decreases to 257.6 K and the relative humidity of the cold zone inside the channel increases, which is caused by local condensation. At the same time, the expansion refrigeration efficiency is increasing from 27.3 % to 64.9 %. The increasing rotary speed of rotor also benefit to refrigeration efficiency from 45.8 % to 75.6 % as low temperature decreases to 252.1 K, which illustrates that rotary speed has more improvement effect on refrigeration efficiency than just higher-pressure ratio.

Air tab location effect on supersonic jet mixing

Abstract Mixing of Mach 2.1 circular, jet issuing from a straight convergent-divergent circular nozzle, in the presence of sonic air tabs at exit and shifted locations along the jet axis was investigated experimentally at nozzle pressure ratios (NPR) 3–6, insteps of 1. Two constant area tubes of 1 mm diameter positioned diametrically opposite, at 0 D, 0.25 D, 0.5 D and 0.75 D (where D is the nozzle exit diameter), were used for fluidic injection. The injection pressure ratio (IPR) of air tabs was maintained at 6. The Mach 2.1 jet operated at nozzle pressure ratio (NPR) in the range of overexpanded states corresponding to NPR 3–6 was controlled with the sonic air tabs operating at the underexpanded state corresponding to IPR 6. The impact of air tabs on jet mixing was studied from the measured Pitot pressure along the jet centerline. The centerline pressure decay of the jet confirms that the air tab promotes jet mixing with the entrained air mass, and the mixing promotion caused by the air tab is dependent on tab location as well as the NPR. In the presence of air tabs, the jet possesses shorter core and experiences faster decay than the uncontrolled jet. Also, the air tabs were effective in reducing the number of shock cells and rendering the waves weaker in the jet core. Among the tab locations, the mixing promoting effectiveness of air tabs at 0 D is better than the tabs at shifted locations. The jet core length reduction caused by the air tab at 0 D increases from 25.4 % to 77.2 %, with increasing NPR from 3 to 6. The same trend was noticed for tab location 0.75 D, but not for 0.25 D and 0.5 D locations. The core length reduction for 0.75 D tab location is about 61.4 %, at NPR 6, and 62.1 % and 55.8 %, for NPR 5 and 4 for tab locations 0.25 D and 0.5 D, respectively. Shadowgraph images of the waves present in the jet core confirms the findings of centerline pressure decay results.

Numerical and Experimental Study on the Influence of Honeycomb Bushing Wear on the Leakage Flow Characteristics of Labyrinth Seal

Abstract Honeycomb bushing wear has a significant effect on the leakage characteristics of the labyrinth seal. In this paper, four kinds of honeycomb bushing labyrinth seals was designed and processed. The leakage characteristics of honeycomb bushing labyrinth seal were studied experimentally under different inlet and outlet pressure ratios and sealing clearance conditions. At the same time, the numerical model of honeycomb bushing labyrinth seals were established, and the influence of honeycomb bushing wear on the flow field characteristics of labyrinth seals was analyzed by numerical simulation. The existing leakage formula was modified by the correction coefficient method. The results show that with the increase in wear depth, the leakage of the honeycomb bushing labyrinth seal increases, and the maximum leakage can be increased by 59.59%. The wear groove weakens the throttling effect of the labyrinth, causing the leakage of the seal to increase. The increase of the depth of the wear groove changes the flow area and the direction of the jet so that the leakage increases slightly. The influence of the wear groove on the leakage characteristics of the honeycomb bushing labyrinth seal is gradually reduced under the condition of large clearance. The theoretical formula of leakage is corrected by the correction coefficient method. The value calculated by the corrected theoretical formula of leakage is in good agreement with the experiment, and the error is within 10%. It meets the practical application of the project.

Thermodynamic investigation of a Carnot battery based multi-energy system with cascaded latent thermal (heat and cold) energy stores

Carnot batteries store electricity in thermal form, allowing for power balancing and also multi-vector energy management as a unique asset. Cascaded thermal energy storage therefore has a vital role in Carnot battery, particularly multi-energy systems delivering electricity and thermal energy at various temperatures. Here, we propose a Carnot battery multi-energy system with cascaded latent thermal energy stores. The effects of compressor pressure ratio, total stage number, stage area and fluid velocity in tubes, on system-level coefficient of performance and total exergy efficiency are investigated. The results show that both the coefficient of performance and exergy efficiency increase significantly and then level off with the total stage number and stage area increasing, while they only increase slightly before a significant decrease with the increase of fluid velocity in tubes. The selection of compressor pressure ratios relates to the demands of cold, heat and electricity. The multi-energy system achieves a maximum coefficient of performance of 95.0% in combined cooling, heating and power mode. Although the thermodynamic performance yileds comparable with Carnot battery systems integrated with packed-bed or liquid-based sensible heat stores, the Carnot battery multi-energy system can deliver electricity and multi-grade heat and cold simultaneously, thus increasing flexibility in future energy systems.

Pressure and non-ideal axial ratio effects on thermodynamic properties of hexagonal close-packed Mg and Zn metals

ABSTRACT The Debye model has been developed to study the pressure dependence of the extended X-ray absorption fine structure Debye–Waller factor, the Debye frequency and temperature of hexagonal close-packed (hP2) metals. The effects of the non-ideal axial ratio c/a of hP2 structure on these thermodynamic quantities at high pressures have also been considered. Additionally, based on the combination of the Debye model and the Lindemann melting law, we derive the analytic expression of melting temperature of hP2 metals as a function of pressure. Numerical calculations have been implemented for Mg and Zn metals up to 20 and 50 GPa, respectively. We have shown that Debye frequency and temperature, as well as melting temperature of these two metals increase robustly with pressure and non-ideal axial ratio plays important role in these thermodynamic quantities. The remarkable consistency observed between our calculations and various experimental results validates the reliability of the currently presented melting curve. Meanwhile, at high pressure non-ideal axial ratio gives a small contribution to pressure-dependent Debye–Waller factor of Mg (up to 20 GPa) and Zn (beyond 20 GPa), and can be safely neglected in the suggested pressure range.

Study on inherent mechanism between thermodynamic performance and mass evaluation of MW-class nuclear powered spacecraft

Nuclear powered spacecraft (NPS) with multiple Brayton loops (NPS-MBL) exhibit high efficiency, compact size, low weight, and operational stability, making them promising candidates for future deep space exploration and planetary bases. Optimizing NPS design requires an in-depth understanding of the relationship between thermodynamic performance and mass. In this study, comprehensive models were developed to evaluate the thermodynamic performance and mass of NPS-MBL. The influences of key parameters on thermodynamic performance and mass were analyzed. The results indicated that increasing the turbine inlet temperature and turbomachine efficiency enhanced the thermodynamic performance and reduced the total mass of NPS. The optimal specific mass was achieved by increasing the compressor inlet temperature, recuperator effectiveness, pressure ratio, and helium molar fraction. Additionally, theoretical upper limits for power generation and specific mass of NPS-MBL were obtained. For an NPS with quadruple Brayton loops and a reactor power of 5 MW, schemes maximizing power generation at 1.6 MW with a specific mass of 10.91 t∙MW-1 and minimizing specific mass at 5.52 t∙MW-1 with a power generation of 1.32 MW were identified. This study serves as a valuable reference for NPS design and optimization.

Effect of TRPV4 Antagonist GSK2798745 on Chlorine Gas-Induced Acute Lung Injury in a Swine Model.

As a regulator of alveolo-capillary barrier integrity, Transient Receptor Potential Vanilloid 4 (TRPV4) antagonism represents a promising strategy for reducing pulmonary edema secondary to chemical inhalation. In an experimental model of acute lung injury induced by exposure of anesthetized swine to chlorine gas by mechanical ventilation, the dose-dependent effects of TRPV4 inhibitor GSK2798745 were evaluated. Pulmonary function and oxygenation were measured hourly; airway responsiveness, wet-to-dry lung weight ratios, airway inflammation, and histopathology were assessed 24 h post-exposure. Exposure to 240 parts per million (ppm) chlorine gas for ≥50 min resulted in acute lung injury characterized by sustained changes in the ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration (PaO2/FiO2), oxygenation index, peak inspiratory pressure, dynamic lung compliance, and respiratory system resistance over 24 h. Chlorine exposure also heightened airway response to methacholine and increased wet-to-dry lung weight ratios at 24 h. Following 55-min chlorine gas exposure, GSK2798745 marginally improved PaO2/FiO2, but did not impact lung function, airway responsiveness, wet-to-dry lung weight ratios, airway inflammation, or histopathology. In summary, in this swine model of chlorine gas-induced acute lung injury, GSK2798745 did not demonstrate a clinically relevant improvement of key disease endpoints.

High-speed photography and particle image velocimetry of cavitation in a Venturi tube

This article details the construction of an experimental visualization platform for observing cavitation. The platform uses high-speed photography and particle image velocimetry (PIV) techniques to conduct experimental research into the flow pattern and vortex field of cavitation in Venturi tubes. Dynamic mode decomposition is employed to extract the energy distribution characteristics of the cavitation flow field. Cavitation occurs at an exit-to-inlet pressure ratio of 0.595, and the length of the cavitation zone increases as this ratio decreases. When the pressure ratio reaches 0.280, the flow rate remains almost constant and the flow becomes chocked. The cavitation shape evolves periodically in the chocking flow, and the cavitation zone can be divided into three parts: an initiation and development area, a fusion area, and a collapse area. The fusion area exhibits periodic changes in the form of contraction, expansion, and re-contraction. Near the wall, the collapse area exhibits complex boundary conditions, with re-entrant jet causing bubble aggregation, rolling, and shedding. PIV and energy extraction reveal that vortices primarily appear near the wall, where they undergo a periodic process of fragmentation and fusion. The strength of the vortices exhibits a small–large–small pattern that is related to the cloud aggregation, rolling, and shedding caused by the re-entrant jet.

Diaphragm-Induced Attenuation in Shock Tubes

This is a numerical and experimental study on shock attenuation in shock tubes. Tube geometry, boundary layer, and reduction in cross-sectional area induced by burst diaphragms are often considered the main causes of shock speed reduction (or shock attenuation) observed during the experiments. In order to distinguish how each single phenomenon contributes toward shock attenuation, the National Cheng Kung University shock tube is simulated for driver and test (driver–test) gas pairs involving air–air and He–air. For low pressure ratios, the diaphragm effect was found to be negligible. For a pressure ratio of 200 and helium as driver gas, the shock speed was found to decrease linearly with the size of the diaphragm orifice. In general, wall viscous effects caused a 2.5% decrease in shock speed, while an additional 7% reduction was caused by the presence of the diaphragm. The gradual opening of the diaphragm mainly contributed to a decrease in shock oscillations.

Supercritical Carbon Dioxide Extraction of Citronella Oil Review: Process Optimization, Product Quality, and Applications

This review paper explores the utilization of supercritical carbon dioxide (SC-CO2) extraction to isolate citronella oil, delving into its multifaceted dimensions, including process optimization, product quality enhancement, and diverse potential applications. Citronella oil, renowned for its myriad bioactive compounds with demonstrated health benefits, is a coveted essential oil in the pharmaceutical, cosmetics, and food industries. The transition from traditional extraction techniques to SC-CO2 extraction presents a paradigm shift due to its manifold advantages, such as heightened yield rates, expedited extraction durations, and elevated product quality. However, the efficacy of SC-CO2 extraction is intricately interwoven with an array of parameters encompassing pressure, temperature, flow rate, particle size, and co-solvent ratios. Accordingly, meticulous process optimization is indispensable in achieving the desired product quality while maximizing yield. Furthermore, the paper explores the extensive spectrum of potential applications for citronella oil, extending its reach into formulations with antimicrobial, insecticidal, and antioxidant properties. These applications underscore the versatility and commercial appeal of citronella oil. The review establishes SC-CO2 extraction of citronella oil as a promising and sustainable alternative to conventional extraction methodologies, offering myriad applications across the pharmaceutical, cosmetics, and food sectors. This scholarly work provides valuable insights into the intricacies of process optimization and product quality. It outlines future perspectives and avenues for further exploration in SC-CO2 extraction of citronella oil.

Valor pronóstico de la razón desplazamiento sistólico del plano del anillo tricuspídeo/presión arterial pulmonar sistólica en la amiloidosis cardiaca

Introduction and objectivesThe tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/SPAP) ratio is a noninvasive surrogate of right ventricular to pulmonary circulation that has prognostic implications in patients with heart failure (HF) or pulmonary hypertension. Our purpose was to evaluate the prognostic value of the TAPSE/SPAP ratio in patients with cardiac amyloidosis. MethodsWe used the database of the AMIGAL study, a prospective, observational registry of patients with cardiac amyloidosis recruited in 7 hospitals of the Autonomous Community of Galicia, Spain, from January 1, 2018 to October 31, 2022. We selected patients whose baseline TAPSE/SPAP ratio was calculated with transthoracic echocardiography. Long-term survival and survival free of HF hospitalization were assessed by means of 5 different multivariable Cox regression models. Median follow-up was 680 days. ResultsWe studied 233 patients with cardiac amyloidosis, among whom 209 (89.7%) had transthyretin type. The baseline TAPSE/SPAP ratio correlated significantly with clinical outcomes. Depending on the multivariable model considered, the adjusted hazard ratios estimated per 0.1mm/mmHg increase of baseline TAPSE/SPAP ratio ranged from 0.76 to 0.84 for all-cause mortality. Similarly, the ratios for all-cause mortality of HF hospitalization ranged from 0.79 to 0.84. The addition of the baseline TAPSE/SPAP ratio to the predictive model of the United Kingdom National Amyloidosis Centre resulted in an increase in Harrell's c-statistic from 0.662 to 0.705 for all-cause mortality and from 0.668 to 0.707 for all-cause mortality or HF hospitalization. ConclusionsReduced TAPSE/SPAP ratio is an independent adverse prognostic marker in patients with cardiac amyloidosis.

Simulation research on aerodynamic noise characteristics of a compressor under different working conditions.

The shear stress transport turbulence model is employed to conduct a detailed study of flow characteristics at the highest efficiency point and near-stall point in a full-channel 1.5-stage compressor in this paper. The simulation results for the compressor's total pressure ratio and efficiency exhibit good agreement with experimental data. Emphasis is placed on examining the internal flow structure in the tip area of the compressor rotor under near-stall conditions. The results reveal that significant differences in flow structure primarily occur in the tip area as the compressor approaches stall. Specifically, a reduction in turbulent kinetic energy is observed in a region spanning approximately 20%-60% of the chord length on the rotor suction face near-stall conditions. Two additional peak frequencies, at 0.8 and 1.6 times the blade passage frequency, are observed, and the intricate flow phenomena are elaborated at the near-stall point. The near-stall point exhibits greater noise levels than the highest efficiency point, where the intensity of the surface source increases by more than 10 dB, peaking at 20 dB. This additional peak serves as a significant supplementary noise source near the stall point, leading to a maximum increase of 33.3 dB in the free radiated sound power. The acoustic response within the duct indicates that the compressor operating at the near-stall point continues to produce substantial noise on the actual test bench, showing an average increase of 6 dB in noise levels, and the distribution of the additional peak single-tone noise at the entrance significantly differs from that observed at the highest efficiency point.

Dynamic characteristics and application of dual throat fluidic thrust vectoring nozzle

Thrust vectoring technology plays an important role in improving the maneuverability of aircraft. In order to overcome the disadvantages of mechanical thrust vectoring nozzles, such as complications of structure and significant increases in weight and cost, fluidic thrust vectoring nozzles are proposed. Dual Throat fluidic thrust vectoring Nozzle (DTN) has received wide attention due to its excellent thrust vectoring efficiency and minimal thrust loss. In this study, three-dimensional unsteady numerical simulations of a single axisymmetric DTN are conducted first to analyze its dynamic response. Then the pitch and yaw control characteristics of DTN equipped on a flying-wing aircraft are investigated. It is found that the dynamic response will experience three stages: rapid-deflecting stage, oscillating stage, and steady stage. A complete recirculation zone forms at the end of the rapid-deflecting stage, which pushes the primary flow to attach to the wall opposite the secondary injection. Meanwhile, the exhaust flow is deflected. In terms of DTN’s application, the DTN equipped on the flying-wing aircraft is capable of providing effective pitch and yaw moments at all angles of attack and Mach numbers. In addition, continuous pitch and yaw moments can be obtained by adjusting the secondary mass flow ratios. The control moment is generated due to the asymmetrical pressure distribution of nozzle surface, which is mainly contributed by the pressure decrease on the secondary injection surface. Moreover, the DTN equipped on the flying-wing aircraft has a relatively high thrust vectoring efficiency of around 5°/% and a thrust coefficient of around 0.95 when nozzle pressure ratio equals 4. These results provide an important theoretical basis for the practical application of DTN.

Determine attenuation coefficients of saturated sand from standard penetration test, applied to Nhon Hoi economic zone

Vietnam is located in a strong earthquake zone with many areas having a ground acceleration (a<sub>g</sub>) of greater than 0.08 g (TCVN 9386:2012). According to Vietnamese standard TCVN 9386:2012, the calculation and design of construction grade III or higher in areas where have ground acceleration a<sub>g</sub> ≥ 0.08 g must include seismic design. In calculations of earthquake-resistant pile foundation, the bearing capacity of the pile including the tip resistance strength (q<sub>b</sub>) and endurance strength (f<sub>i</sub>) need to be multiplied by attenuation coefficients (g<sub>eq1</sub> and g<sub>eq2</sub>). They are the most important parameters and depend on the soil types, saturation conditions, and earthquake intensity. The article introduces a method to determine the attenuation coefficients according to the standard TCVN 10304:2014. In addition, analyzing the theoretical basis to give the expression to determine attenuation coefficients based on the durability factor (I<sub>red</sub>) and pore water pressure ratio (R<sub>u</sub>) of saturated sand under the earthquakes. Furthermore, the paper presents a method to determine R<sub>u</sub> from the results of standard penetration test (SPT) by combining the method of Seed and Alba (1986) with the method of Marcuson and Hynes (1990). In which, Seed and Alba's method was used to determine factor of safety against liquefaction (F<sub>SL</sub>), and then Marcuson and Hynes' method was used to determine R<sub>u</sub> from F<sub>SL</sub>. The application in Nhon Hoi Economic Zone shows that: The silty fine grained sand, which is medium dense and saturated, has a attenuation coefficient of tip resistance g<sub>eq1</sub> = 0.74÷0.76 and attenuation coefficient of friction g<sub>eq2</sub> = 0.90; The fine grained sand, which is dense and saturated, has g<sub>eq1</sub> = 0.79÷0.82 and g<sub>eq2</sub> = 0.94. 

Investigation of the total pressure gain in rotating detonation combustors with dilution holes

Investigation of the total pressure gain in rotating detonation combustors with dilution holes

Soil nailing as a ground reinforcement method of a storey building constructed on weathered siltstone: Analytical and numerical evaluation

Vietnam is located in a strong earthquake zone with many areas having a ground acceleration (a<sub>g</sub>) of greater than 0.08 g (TCVN 9386:2012). According to Vietnamese standard TCVN 9386:2012, the calculation and design of construction grade III or higher in areas where have ground acceleration a<sub>g</sub> ≥ 0.08 g must include seismic design. In calculations of earthquake-resistant pile foundation, the bearing capacity of the pile including the tip resistance strength (q<sub>b</sub>) and endurance strength (f<sub>i</sub>) need to be multiplied by attenuation coefficients (g<sub>eq1</sub> and g<sub>eq2</sub>). They are the most important parameters and depend on the soil types, saturation conditions, and earthquake intensity. The article introduces a method to determine the attenuation coefficients according to the standard TCVN 10304:2014. In addition, analyzing the theoretical basis to give the expression to determine attenuation coefficients based on the durability factor (I<sub>red</sub>) and pore water pressure ratio (R<sub>u</sub>) of saturated sand under the earthquakes. Furthermore, the paper presents a method to determine R<sub>u</sub> from the results of standard penetration test (SPT) by combining the method of Seed and Alba (1986) with the method of Marcuson and Hynes (1990). In which, Seed and Alba's method was used to determine factor of safety against liquefaction (F<sub>SL</sub>), and then Marcuson and Hynes' method was used to determine R<sub>u</sub> from F<sub>SL</sub>. The application in Nhon Hoi Economic Zone shows that: The silty fine grained sand, which is medium dense and saturated, has a attenuation coefficient of tip resistance g<sub>eq1</sub> = 0.74÷0.76 and attenuation coefficient of friction g<sub>eq2</sub> = 0.90; The fine grained sand, which is dense and saturated, has g<sub>eq1</sub> = 0.79÷0.82 and g<sub>eq2</sub> = 0.94. 

The Effect of First Metatarsal Shortening and Sagittal Displacement on Forefoot Pressure in MIS Hallux Valgus Correction

Introduction/Purpose: Minimally invasive surgical (MIS) treatment of hallux valgus (HV) deformity is increasing in popularity. A 2mm-diameter burr is used to create a distal first metatarsal osteotomy prior to capital fragment translation and fixation. The metatarsal will shorten by the burr’s diameter (2mm). Plantar or dorsal capital fragment displacement may also cause load transference and possibly transfer metatarsalgia. In this study, we examine the effect of MIS HV on forefoot loading mechanics with respect to metatarsal shortening and sagittal plane displacement. Methods: Four lower-limb cadaveric specimens were studied. A pedobarography pressure-sensing mat was used to record forefoot plantar pressure in a controlled weightbearing stance position.10 Control and post-osteotomy measurements were obtained with the capital fragment fixated in 3 possible positions: 0mm, 5mm dorsal, and 5mm plantar displacement. Pedobarography data yielded pressure data within measurable graphical depictions. Raw mean contact pressure measurements were taken under the first and fifth metatarsal heads to establish medial and lateral forefoot loading pressure ratios. A priori power analysis was performed based on previous peer-reviewed pedobarographic data and our study was adequately powered. Results: 40 measurements were recorded and ratios of medial-to-lateral forefoot loading were constructed. Medial forefoot pressure change control versus 0mm displacement, and control versus dorsal displacement was not found to be statistically significant (p=0.525, p=0.55 respectively). Significant medial pressure increase was identified comparing control versus plantar displacement (p=0.006). Lateral pressure increased significantly with dorsal displacement of the osteotomy (p=0.013). Conclusion: MIS hallux valgus correction does not appear to cause increase in lateral forefoot pressure loading when sagittal plane displacements are controlled. Plantar displacement increases medial loading, and dorsal displacement increases lateral loading. The clinician must consider metatarsal head position post-osteotomy, as decrease in medial loading and subsequent increase in lateral loading may lead to lateral forefoot pain and transfer metatarsalgia.

Decreased clinical performance in TGA-ASO patients after RVOT interventions; a multicenter European collaboration

BackgroundIn patients with transposition of the great arteries and an arterial switch operation (TGA-ASO) right ventricular outflow tract (RVOT) obstruction is a common complication requiring one or more RVOT interventions. ObjectivesWe aimed to assess cardiopulmonary exercise capacity and right ventricular function in patients stratified for type of RVOT intervention. MethodsTGA-ASO patients (≥16 years) were stratified by type of RVOT intervention. The following outcome parameters were included: predicted (%) peak oxygen uptake (peak VO2), tricuspid annular plane systolic excursion (TAPSE), tricuspid Lateral Annular Systolic Velocity (TV S′), right ventricle (RV)-arterial coupling (defined as TAPSE/RV systolic pressure ratio), and N-terminal proBNP (NT-proBNP). Results447 TGA patients with a mean age of 25.0 (interquartile range (IQR) 21–29) years were included. Patients without previous RVOT intervention (n = 338, 76%) had a significantly higher predicted peak VO2 (78.0 ± 17.4%) compared to patients with single approach catheter-based RVOT intervention (73.7 ± 12.7%), single approach surgical RVOT intervention (73.8 ± 28.1%), and patients with multiple approach RVOT intervention (66.2 ± 14.0%, p = 0.021). RV-arterial coupling was found to be significantly lower in patients with prior catheter-based and/or surgical RVOT intervention compared to patients without any RVOT intervention (p = 0.029). ConclusionsTGA patients after a successful arterial switch repair have a decreased exercise capacity. A considerable amount of TGA patients with either catheter or surgical RVOT intervention perform significantly worse compared to patients without RVOT interventions.

Fluid-filled versus sensor-tipped pressure guidewires for FFR and Pd/Pa measurement; PW-COMPARE study

BackgroundFluid-filled pressure guidewires are unaffected by the previously inevitable hydrostatic pressure gradient (HPG). This study aimed to compare simultaneous pressure measurements with fluid-filled and sensor-tipped pressure guidewires. MethodsFifty patients underwent fractional flow reserve (FFR) and Pd/Pa measurement with a fluid-filled and a sensor-tipped pressure guidewire simultaneously. To assess maneuverability, patients were randomized with respect to which pressure guidewire was used to cross the lesion first. Lateral fluoroscopy was used to estimate height difference between catheter tip and distal wire position (and thus HPG). Agreement between pressure measurements was studied. ResultsMeasurements were performed in LM (4% (n = 2)), LAD (44% (n = 22)), LCX (26% (n = 13)), and RCA (26% (n = 13)). Simultaneous pressure measurements showed excellent agreement (mean FFR difference − 0.01 ± 0.03 (r = 0.959, p < 0.001), mean Pd/Pa difference − 0.01 ± 0.04 (r = 0.929, p < 0.001)). FFR was ≤0.80 in 42.6% (n = 20) with fluid-filled FFR measurements versus 46.8% (n = 22) by sensor-tipped FFR measurements. Mean height difference was 15 ± 34 mm, and strongly dependent on the coronary artery (LAD 45 ± 10 mm, LCX −23 ± 16 mm, RCA −13 ± 17 mm). There was a strong correlation between height difference and difference in pressure ratios between sensor-tipped and fluid-filled pressure guidewires (FFR r = −0.850, p < 0.001; Pd/Par = −0.641, p < 0.001). Largest FFR differences were present in the LAD (−0.04 ± 0.02). After HPG correction, mean difference between HPG-corrected sensor-tipped FFR and fluid-filled FFR was 0.00 ± 0.02, mean Pd/Pa difference was 0.01 ± 0.03. ConclusionsThis study shows excellent overall correlation between FFR and Pd/Pa measurements with both pressure guidewires. Differences measured with fluid-filled and sensor-tipped pressure guidewires are vessel-specific and attributable to hydrostatic pressure gradients (NCT04802681).