Doppler transthoracic echocardiography is routinely performed to measure peak mitral inflow velocities in the assessment of left ventricular diastolic function. The limitations of echocardiography ...are well documented, but its accuracy in the measurement of transmitral peak velocity in the presence of aortic valve regurgitation has not yet been compared with four-dimensional flow cardiac magnetic resonance imaging. Four-dimensional flow cardiac magnetic resonance imaging offers time-resolved cross-sectional velocity information that can be used to investigate mitral inflow peak velocity. We present a case report demonstrating the potential superior capabilities of four-dimensional flow cardiac magnetic resonance imaging in accurately detecting mitral inflow velocities over Doppler echocardiography in patients with aortic regurgitation.
A 67-year-old Caucasian female presented to our outpatient cardiology clinic with exertional dyspnea. Doppler transthoracic echocardiography identified moderate to severe aortic regurgitation. Mapping of mitral inflow peak velocities proved challenging with Doppler echocardiography. Additionally, four-dimensional flow cardiac magnetic resonance imaging with automated three-dimensional flow streamlines was performed, which allowed for more accurate detection of mitral inflow peak velocities.
Doppler echocardiography has a limited role in mitral inflow assessment where aortic regurgitation is present. In such cases, four-dimensional flow cardiac magnetic resonance imaging is an alternative imaging technique that may circumvent this issue and allow mitral inflow assessment.
Doppler echocardiographic aortic valve peak velocity and peak pressure gradient assessment across the aortic valve (AV) is the mainstay for diagnosing aortic stenosis. Four-dimensional flow ...cardiovascular magnetic resonance (4D flow CMR) is emerging as a valuable diagnostic tool for estimating the peak pressure drop across the aortic valve, but assessment remains cumbersome. We aimed to validate a novel semi-automated pipeline 4D flow CMR method of assessing peak aortic value pressure gradient (AVPG) using the commercially available software solution, CAAS MR Solutions, against invasive angiographic methods.
We enrolled 11 patients with severe AS on echocardiography from the EurValve programme. All patients had pre-intervention doppler echocardiography, invasive cardiac catheterisation with peak pressure drop assessment across the AV and 4D flow CMR. The peak AVPG was 51.9 ± 35.2 mmHg using the invasive pressure drop method and 52.2 ± 29.2 mmHg for the 4D flow CMR method (semi-automated pipeline), with good correlation between the two methods (r = 0.70, p = 0.017). Assessment of AVPG by 4D flow CMR using the novel semi-automated pipeline method shows excellent agreement to invasive assessment when compared to doppler-based methods and advocate for its use as complementary to echocardiography.
•PAHs in waste water discharged into waste pit pose threat to groundwater quality.•PAHs concentration significantly varied across seasons in the study area.•Soil lithology of the study area enhanced ...contaminants’ transport to groundwater.•Innovative and sustainable water treatment approach recommended.
This study evaluates the potential deleterious impact of untreated waste water discharged into an unlined pit by the Nigerian National Petroleum Company (NNPC) on the groundwater quality of Umuakpara community in Osisioma, Abia state. Its overarching objective is to assess potential contaminant sources, distribution in groundwater using diverse techniques. Water samples collected from 14 domestic wells in two contrasting seasons (Rainy and Dry) were analyzed for Polynuclear Aromatic Hydrocarbons (PAHs) using Gas chromatography (GC). Vertical Electric Sounding (VES) technique was employed to determine the depth to water table and soil lithological layers required for good understanding of contaminants behavior along groundwater flow path. Pearson product moment correlation coefficient (r) and One-way ANOVA were used to define the interactions of detected PAHs and spatial variation in means of the PAHs components (p < 0.05) respectively. Five (5) priority PAHs were found in groundwater samples which generally measured above the WHO (2011) maximum permissible limit for PAHs in drinking water (0.001 mg/l). However, the levels of individual PAHs in each borehole were found to be lower than the USEPA permissible limit for each PAH. Phenanthrene recorded the highest mean concentration of 0.011214 (0.00106 ± 0.01650) mg/l, while Fluoranthene had the lowest mean concentration between N.D (Not detected) − 0.00216 (0.0004060 ± 0.00027136) mg/l. Significant spatial variability of PAH existed across sampled boreholes whereas strong correlations were noted among the respective PAH components at P < 0.01. Findings ultimately informed the design of a novel Composite Filter for Treatment of Hydrocarbon Contaminated Waters.
This study investigated the impact of abattoir waste on the soil quality in Ukwunwangwu, Uturu, Abia State. The aim of this study was to assess the impact of abattoir wastes on soil quality at ...Ukwunwangwu, Uturu, Abia State. Experimental research design was used and it was carried out at Uturu, Abia State, Nigeria. Three sampling locations were chosen, the bone, dung and slurry sections respectively and two control points labeled A and B respectively. The first set of samples were collected in the morning to ensure freshness and the second set of samples were collected after two weeks making it a total of eight samples used for this study. These samples were collected at different sections so as to know the variations in concentrations of the following important physico-chemical parameters: pH, Temperature, Moisture Content, Soil Organic Carbon, Cation Exchangeable Capacity and Soil Exchangeable Acidity. The temperature was taken in-situ using a mercury-in-glass thermometer. Results of analyses revealed that UK3A had the highest temperature of 35.00C in the first week and also 35.20C after two weeks, control A had the highest pH value of 8.2mg/l in the first week while UK2B had the highest pH of 8.5mg/l after two weeks. Control A had the higher moisture content value of 58.08% in the first week while UK3B had the highest value of 54.81% after two weeks. UK1A had the highest soil organic carbon 30.5 in the first week and also after two weeks. UK3A had the highest soil exchangeable capacity of 0.6 in the first week while UK3B had the highest value of 0.5 after two weeks. UK3A had the highest cation exchangeable capacity of 5.0 in the first week while UK2B had the highest value of 4.8 after two weeks. The correlation between the results was done using the Pearsons Correlation Moment. The experiment will help reduce the impact of abattoir waste on the environment by reducing the effect of global Climate Change and other environmental hazards. The study therefore recommended that strict environmental laws that can help curb the effects of abattoir wastes on the environment be enforced.
We aim to validate four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) peak velocity tracking methods for measuring the peak velocity of mitral inflow against Doppler ...echocardiography.
Fifty patients were recruited who had 4D flow CMR and Doppler Echocardiography. After transvalvular flow segmentation using established valve tracking methods, peak velocity was automatically derived using three-dimensional streamlines of transvalvular flow. In addition, a static-planar method was used at the tip of mitral valve to mimic Doppler technique.
Peak E-wave mitral inflow velocity was comparable between TTE and the novel 4D flow automated dynamic method (0.9 ± 0.5 vs 0.94 ± 0.6 m/s; p = 0.29) however there was a statistically significant difference when compared with the static planar method (0.85 ± 0.5 m/s; p = 0.01). Median A-wave peak velocity was also comparable across TTE and the automated dynamic streamline (0.77 ± 0.4 vs 0.76 ± 0.4 m/s; p = 0.77). A significant difference was seen with the static planar method (0.68 ± 0.5 m/s; p = 0.04). E/A ratio was comparable between TTE and both the automated dynamic and static planar method (1.1 ± 0.7 vs 1.15 ± 0.5 m/s; p = 0.74 and 1.15 ± 0.5 m/s; p = 0.5 respectively). Both novel 4D flow methods showed good correlation with TTE for E-wave (dynamic method; r = 0.70; P < 0.001 and static-planar method; r = 0.67; P < 0.001) and A-wave velocity measurements (dynamic method; r = 0.83; P < 0.001 and static method; r = 0.71; P < 0.001). The automated dynamic method demonstrated excellent intra/inter-observer reproducibility for all parameters.
Automated dynamic peak velocity tracing method using 4D flow CMR is comparable to Doppler echocardiography for mitral inflow assessment and has excellent reproducibility for clinical use.
•4D flow CMR shows good agreement with doppler echocardiography for mitral inflow peak velocity measurement.•This study suggests that 4D flow CMR is highly reproducible in mitral inflow peak velocity measurement.•4D flow CMR is an accurate and reliable non-invasive imaging method for left ventricular diastolic assessment.
Presence of psychological distress and poor quality of life (QoL) may affect the outcome of HIV/AIDS. One hundred and seventeen consecutive and consenting participants were interviewed using a ...Socio-demographic questionnaire, Kessler Psychological Distress Scale (K10) and World Health Organization Quality of Life-HIV Bref. Fifty-six (47.9%) participants scored 20 and above on K10 Scale. QoL was significantly higher in married participants, those who perceived their state of health as being good, asymptomatic participants and those who scored well-mild on K10. The older age group scored higher on QoL Scale than the younger age group in the physical health domain while the married participants scored higher in the domains of physical health, psychological health, environment and spiritual/religion. The participants who perceived their state of health as being good scored higher than those who perceived their health as poor in all domains. There is a high level of psychological distress and poor QoL in people living with HIV/AIDS.
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