The Mechanism of Mitral Regurgitation Influences the Temporal Dynamics of the Vena Contracta Area as Measured with Color Flow Doppler.


BACKGROUND:In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mitral valve disease (DMVD). METHODS:VCA measurements obtained by planimetry of the proximal jet from 3D transesophageal echocardiographic (TEE) color flow Doppler data sets were acquired in 42 cardiac surgical patients, including 22 with FMR and 20 with DMVD. Serial VCAs were measured throughout systole for each patient to evaluate variation in the effective regurgitant orifice area. Tercile averages were compared within and between the FMR and DMVD groups using repeated measures analysis of variance. Pairwise tests were Bonferroni-corrected for the number of comparisons. RESULTS:Normalized average VCA values in patients with FMR revealed a biphasic pattern compared with a monophasic pattern in patients with DMVD. Among FMR patients, normalized average VCA values in early (1.10 ± 0.32 cm2) and late systole (1.11 ± 0.33 cm2) were similar but were both significantly greater compared with mid-systole (0.79 ± 0.22 cm; P = 0.0144 and P = 0.0106, respectively). Among DMVD patients, normalized average VCA values in mid-systole (1.37 ± 0.15 cm2) were significantly greater than those in early (0.53 ± 0.14 cm2) and late systole (1.09 ± 0.18 cm2; P < 0.0001 for both). An analysis of normalized average VCAs also revealed significant differences between the FMR and the DMVD groups during early (1.10 ± 0.32 cm vs 0.53 ± 0.14 cm2) and mid-systole (0.79 ± 0.22 cm2 vs 1.37 ± 0.15 cm2; P < 0.0001 for both). CONCLUSIONS:VCA dynamics are governed by the mechanism of MR and are observed in FMR patients primarily as a biphasic temporal pattern compared with a monophasic temporal pattern in patients with DMVD.


Anesth Analg


Anesthesia and analgesia


Cobey FC,Ashihkmina E,Edrich T,Fox J,Shook D,Bollen B,Breeze JL,Ursprung WW,Shernan SK




Has Abstract


2016-02-01 00:00:00












  • Left ventricular systolic and diastolic function is unaltered during propofol infusion in newborn swine.

    abstract:UNLABELLED:Propofol is a cardiac depressant with minimal diastolic effects in the adult myocardium. Cardiac effects of propofol in the newborn are unknown. We examined hemodynamic variables and systolic and diastolic left ventricular function in 12 newborn pigs exposed to propofol at three different infusion rates (7.5...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Graham MR,Thiessen DB,Mutch WA

    更新日期:1998-04-01 00:00:00

  • Preoperative "fentanyl challenge" as a tool to estimate postoperative opioid dosing in chronic opioid-consuming patients.

    abstract:UNLABELLED:When opioids are used for postoperative pain control, it is useful to define the dose-response relationship for analgesia and respiratory depression. We studied 20 chronically opioid-consuming patients having elective multilevel spine fusion. Preoperatively, each patient received a fentanyl infusion of 2 mic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Davis JJ,Swenson JD,Hall RH,Dillon JD,Johnson KB,Egan TD,Pace NL,Niu SY

    更新日期:2005-08-01 00:00:00

  • Sequencing cases in the operating room: predicting whether one surgical case will last longer than another.

    abstract:UNLABELLED:A microscope will be used for the first case of the day in operating room (OR) 1 and then may be used in the second case of the day by a different surgeon in a different OR, OR 2. Provided that the probability is reasonably high that the first case of the day in OR 2 will last longer than the first case in O...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Dexter F,Traub RD

    更新日期:2000-04-01 00:00:00

  • Cardiovascular effects of sufentanil anesthesia.

    abstract::Sufentanil is a new synthetic opiate analgesic that is 4520 times more potent than morphine in animal experiments. This study evaluated the cardiovascular effects of sufentanil, 15 micrograms/kg, and air/O2 used as a complete anesthetic with 50% inspired oxygen (air/O2 mixture) in 40 adult patients undergoing elective...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Sebel PS,Bovil JG

    更新日期:1982-02-01 00:00:00

  • Comparison of lidocaine and bupivacaine depression of sinoatrial nodal activity during hypoxia and acidosis in adult and neonatal guinea pigs.

    abstract::High blood concentrations of local anesthetics are cardiotoxic. The aim of this study was to compare the effects of lidocaine and bupivacaine on the intrinsic pacemaker activity of in vitro sinoatrial nodal cells of the adult and neonatal guinea pig in the presence and absence of hypoxia and acidosis. Fifteen pairs of...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Bosnjak ZJ,Stowe DF,Kampine JP

    更新日期:1986-09-01 00:00:00

  • Biotransformation of sevoflurane in dogs and rats.

    abstract::Sevoflurane, 3% and 4% in oxygen was administered to four dogs for 3 hours. Sevoflurane was metabolized to inorganic fluoride and hexafluoroisopropanol. Serum fluoride concentrations reached peak values during 2 to 3 hours into anesthesia and averaged 18.5 micrometer/L (n = 2) and 20.0 +/- 4.8 (mean +/- SD) micrometer...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Martis L,Lynch S,Napoli MD,Woods EF

    更新日期:1981-04-01 00:00:00

  • Spine Surgery and Blood Loss: Systematic Review of Clinical Evidence.

    abstract::Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraop...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Willner D,Spennati V,Stohl S,Tosti G,Aloisio S,Bilotta F

    更新日期:2016-11-01 00:00:00

  • Solubility of I-653, sevoflurane, isoflurane, and halothane in plastics and rubber composing a conventional anesthetic circuit.

    abstract::This study defines some characteristics of a standard anesthetic circuit that may impede anesthetic induction and recovery with I-653, sevoflurane, isoflurane, and halothane. Partition coefficients for anesthetic circuit components (masks, bellows, bags, airways, and circuit tubes) consistently ranked halothane greate...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Targ AG,Yasuda N,Eger EI 2nd

    更新日期:1989-08-01 00:00:00

  • Time course of muscle relaxation with a combination of pancuronium and tubocurarine.

    abstract::A combination of pancuronium and d-tubocurarine is associated with potentiation of the neuromuscular blocking effects of each drug used singly. The time to onset of maximum block and the time to 25% recovery after administration of equipotent (ED95) doses of pancuronium (0.07 mg/kg) alone, d-tubocurarine (0.51 mg/kg) ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Mirakhur RK,Pandit SK,Ferres CJ,Gibson FM

    更新日期:1984-04-01 00:00:00

  • Cost-Effectiveness Research in Anesthesiology.

    abstract::Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the E...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Teja BJ,Sutherland TN,Barnett SR,Talmor DS

    更新日期:2018-11-01 00:00:00

  • Comparison of pH-adjusted bupivacaine 0.75% and a mixture of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, in day-case cataract surgery under regional anesthesia.

    abstract::Alkalinized bupivacaine 0.75% (pH 6.8) and a mixture (1:1) of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, were compared in regional ophthalmic anesthesia for day-case cataract surgery. Eighty-two patients were randomized into two groups (n = 39 and 43) to receive one of the two solutions in a double-b...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Sarvela PJ,Paloheimo MP,Nikki PH

    更新日期:1994-07-01 00:00:00

  • Altered response to formalin by L5 spinal nerve ligation in rats: a behavioral and molecular study.

    abstract:BACKGROUND:The status of neuropathic pain alters the responsiveness to formalin injection in rats. However, the mechanism by which this alteration occurs is unknown. METHODS:We used immunocytochemistry to examine the expression of brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Kaku R,Yokoyama M,Kobayashi H,Matsuoka Y,Sato T,Mizobuchi S,Itano Y,Morita K

    更新日期:2007-04-01 00:00:00

  • Epidural labor analgesia is associated with a decreased risk of postpartum depression: a prospective cohort study.

    abstract:BACKGROUND:Postpartum depression is a common psychiatric disorder in parturients after delivery. The etiology remains unclear, and multiple factors may be involved. In this study, we investigated whether epidural labor analgesia was associated with a decreased risk of postpartum depression development. METHODS:Two hun...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Ding T,Wang DX,Qu Y,Chen Q,Zhu SN

    更新日期:2014-08-01 00:00:00

  • The in vivo effects of general and epidural anesthesia on human immune function.

    abstract:UNLABELLED:Impaired in vivo immunity is often observed after major surgery and is multifactorial. We conducted a randomized clinical study to determine the independent effects of general anesthesia (GA) and of lumbar epidural anesthesia (LEA) on human immune function in the absence of surgical trauma. Nineteen healthy ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Procopio MA,Rassias AJ,DeLeo JA,Pahl J,Hildebrandt L,Yeager MP

    更新日期:2001-08-01 00:00:00

  • Is dexamethasone associated with recurrence of ovarian cancer?

    abstract:BACKGROUND:Basic science studies suggest that perioperative immune impairment may augment the risk of cancer recurrence after otherwise potentially curative surgery. Despite its immunosuppressant properties, dexamethasone is commonly given to oncologic patients in an effort to reduce postoperative nausea and vomiting. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: De Oliveira GS Jr,McCarthy R,Turan A,Schink JC,Fitzgerald PC,Sessler DI

    更新日期:2014-06-01 00:00:00

  • An advanced specialty training program in anesthesiology: a special educational fellowship designed to return community anesthesiologists to clinical practice.

    abstract::We describe a program for community anesthesiologists designed to evaluate clinical skills and provide additional training in the latest technologies in anesthesiology. This educational program was established for previously trained anesthesiologists who require additional training for either remedial purposes or beca...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Larson CP Jr,Steadman RH

    更新日期:2006-07-01 00:00:00

  • Drug infusion system manifold dead-volume impacts the delivery response time to changes in infused medication doses in vitro and also in vivo in anesthetized swine.

    abstract:BACKGROUND:IV infusion systems can be configured with manifolds connecting multiple drug infusion lines to transcutaneous catheters. Prior in vitro studies suggest that there may be significant lag times for drug delivery to reflect changes in infusion rates set at the pump, especially with low drug and carrier flows a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Lovich MA,Wakim MG,Wei A,Parker MJ,Maslov MY,Pezone MJ,Tsukada H,Peterfreund RA

    更新日期:2013-12-01 00:00:00

  • The Physiology of Cardiopulmonary Resuscitation.

    abstract::Outcomes after cardiac arrest remain poor more than a half a century after closed chest cardiopulmonary resuscitation (CPR) was first described. This review article is focused on recent insights into the physiology of blood flow to the heart and brain during CPR. Over the past 20 years, a greater understanding of hear...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Lurie KG,Nemergut EC,Yannopoulos D,Sweeney M

    更新日期:2016-03-01 00:00:00

  • Anesthetic sensitivities to propofol and halothane in mice lacking the R-type (Cav2.3) Ca2+ channel.

    abstract:UNLABELLED:Because inhibition of voltage-dependent Ca(2+) channels can be a mechanism underlying general anesthesia, we examined sensitivities to propofol and halothane in mice lacking the R-type (Ca(v)2.3) channel widely expressed in neurons. Sleep time after propofol injection (26 mg/kg IV) and halothane MAC(RR) and ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Takei T,Saegusa H,Zong S,Murakoshi T,Makita K,Tanabe T

    更新日期:2003-07-01 00:00:00

  • Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety.

    abstract:BACKGROUND:Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reduci...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析


    authors: Eijlers R,Utens EMWJ,Staals LM,de Nijs PFA,Berghmans JM,Wijnen RMH,Hillegers MHJ,Dierckx B,Legerstee JS

    更新日期:2019-11-01 00:00:00

  • The impact of heparin-coated cardiopulmonary bypass circuits on pulmonary function and the release of inflammatory mediators.

    abstract:UNLABELLED:Reduction of the inflammatory reaction with the use of heparin coating has been found during and after cardiopulmonary bypass (CPB). The question remains whether this reduced reaction also decreases the magnitude of CPB-induced pulmonary dysfunction. We therefore evaluated the effects of a heparin-coated cir...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: de Vroege R,van Oeveren W,van Klarenbosch J,Stooker W,Huybregts MA,Hack CE,van Barneveld L,Eijsman L,Wildevuur CR

    更新日期:2004-06-01 00:00:00

  • Selective spinal anesthesia: a comparison of hyperbaric bupivacaine 4 mg versus 6 mg for outpatient knee arthroscopy.

    abstract:IMPLICATIONS:A low-dose (4 mg), low-volume (0.8 mL), low-flow (2 min) technique with hyperbaric bupivacaine toward the dependent side oriented injection and maintenance of the lateral decubitus position for 10 min produced selective spinal anesthesia with rapid recession of motor block and early discharge home. ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Valanne JV,Korhonen AM,Jokela RM,Ravaska P,Korttila KK

    更新日期:2001-12-01 00:00:00

  • Anesthesia Capacity of District-Level Hospitals in Malawi, Tanzania, and Zambia: A Mixed-Methods Study.

    abstract:BACKGROUND:District-level hospitals (DLHs) are the main providers of surgical services for rural populations in Sub-Saharan Africa (SSA). Skilled teams are essential for surgical care, and gaps in anesthesia impact negatively on surgical capacity and outcomes. This study, from a baseline of a project scaling-up access ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Gajewski J,Pittalis C,Lavy C,Borgstein E,Bijlmakers L,Mwapasa G,Cheelo M,Le G,Juma A,Kachimba J,Marealle P,Mkandawire N,Chilonga K,Brugha R

    更新日期:2020-04-01 00:00:00

  • Estimation of optimal modeling weights for a Bayesian-based closed-loop system for propofol administration using the bispectral index as a controlled variable: a simulation study.

    abstract:BACKGROUND:Implementing Bayesian methods in a model-based closed-loop system requires the integration of a standard response model with a patient-specific response model. This process makes use of specific modeling weights, called Bayesian variances, which determine how the specific model can deviate from the standard ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: De Smet T,Struys MM,Greenwald S,Mortier EP,Shafer SL

    更新日期:2007-12-01 00:00:00

  • Studies of desflurane in outpatient anesthesia.

    abstract::The low solubility of desflurane contributes to rapid emergence after outpatient anesthesia. Compared with isoflurane, recovery times to eye opening, response to verbal commands, and orientation to person, place, and time have been significantly shorter. Even when compared with the rapid, short-acting intravenous anes...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: White PF

    更新日期:1992-10-01 00:00:00

  • Ketamine potentiates nondepolarizing neuromuscular relaxants in a primate.

    abstract::Ketamine has many neuromuscular effects in vitro. Its neuromuscular effects in vivo have been controversial and inconsistent. To systematically examine its neuromuscular effects over a wide dose range and its interaction with all popular nondepolarizing neuromuscular relaxants, the effects of ketamine 2, 5, and 10 mg/...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tsai SK,Lee C

    更新日期:1989-01-01 00:00:00

  • The effects of maternal position during induction of combined spinal-epidural anesthesia for cesarean delivery.

    abstract:UNLABELLED:Combined spinal-epidural anesthesia (CSE) is a popular technique for cesarean delivery. Regional blocks in obstetrics are often performed with the parturient in the sitting position because the midline may be recognized more easily than in the lateral decubitus position. When conventional spinal anesthesia i...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Yun EM,Marx GF,Santos AC

    更新日期:1998-09-01 00:00:00

  • Transesophageal echocardiography in myocardial revascularization: I. Accuracy of intraoperative real-time interpretation.

    abstract::Transesophageal echocardiography (TEE) is increasingly used intraoperatively as a monitor of ventricular function and volume. Despite its increasing use, whether data from TEE monitoring can be interpreted accurately on-line in real-time is unknown. We studied the performance of five community-based, full-time cardiac...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Bergquist BD,Leung JM,Bellows WH

    更新日期:1996-06-01 00:00:00

  • Heparin induces release of phospholipase A(2) into the splanchnic circulation.

    abstract:UNLABELLED:Cardiopulmonary bypass results in increased plasma activity of phospholipase A(2) (PLA(2)) that appears to be caused by the administration of heparin. High PLA(2) activity may be responsible for increased production of eicosanoids and, thus, may be implicated in various pathophysiologic events associated wit...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Kern H,Johnen W,Braun J,Frey B,Rüstow B,Kox WJ,Schlame M

    更新日期:2000-09-01 00:00:00

  • Intraoperative management of patients with carcinoid heart disease having valvular surgery: a review of one hundred consecutive cases.

    abstract:BACKGROUND:Cardiac surgery for carcinoid heart disease is complicated by hemodynamic instability secondary to carcinoid crises, cardiovascular dysfunction, and blood loss. The safety of vasopressors and the benefit of aprotinin during concomitant octreotide administration are uncertain. METHODS:We reviewed the effects...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Weingarten TN,Abel MD,Connolly HM,Schroeder DR,Schaff HV

    更新日期:2007-11-01 00:00:00