Cardiovascular status of the participants was assessed as published previously32 (link)–36 (link). Briefly, echocardiography included standard two-dimensional measurements and continuous and pulse-wave Doppler measurements (iE33 echocardiography system, Philips Electronics, Amsterdam, The Netherlands). Measures for left ventricular systolic function (ejection fraction; LVEF) and diastolic function (E/E’) were determined as described33 (link),34 (link). Flow mediated dilatation (FMD) as a surrogate of endothelial function was measured in the brachial artery under resting conditions and after induction of reactive hyperemia by 5 min upper-arm occlusion as described in detail previously35 (link). Arterial stiffness was assessed by digital volume plethysmography using an EndoPat 2000 device (Itamar Medical, Caesarea, Israel) as described previously36 (link). The resultant augmentation index (AI) is automatically calculated.
Ie33 echocardiography system
Manufactured by Philips
Sourced in United States
The Philips IE33 echocardiography system is a diagnostic medical device used for conducting ultrasound-based cardiac imaging. It provides real-time visualization and analysis of the heart's structure and function.
Automatically generated - may contain errors
Lab products found in correlation
S5 1 transducer, by Philips (2 mentions)
Endopat 2000 device, by Itamar Medical (1 mentions)
Cobas 6000 analyzer series, by Roche (1 mentions)
Cobas e601 immunology analyzer, by Roche (1 mentions)
Xe 2100 hematology analyzer, by Sysmex (1 mentions)
Qlab software, by Philips (1 mentions)
Vivid 7 echocardiography system, by GE Healthcare (1 mentions)
S5 1 sector array transducer, by Philips (1 mentions)
Xcelera, by Philips (1 mentions)
18 protocols using ie33 echocardiography system
1
Comprehensive Cardiovascular Assessment Protocol
2
Quantitative Echocardiographic Assessment of Mitral Regurgitation
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Transthoracic echocardiography studies were obtained using a Philips iE 33 echocardiography system (Philips, Amsterdam, Netherlands). Vena contracta, proximal isovelocity surface area (PISA), EROA, and regurgitant volume for quantitative mitral valve assessment were recorded according to current recommendations (14 (link)). The severity of MR was graded according to a previously reported classification (15 (link)). Left ventricular ejection fraction (LVEF) was determined using the Simpsons method in 4- and 2-chamber view.
Patients in the FMR ≤ 1+ group showed normal LVEF and systolic pulmonary artery pressure (sPAP) compared to the FMR ≥ 2+ group (Figures 2A,B and Table 1 ). The FMR subgroups (FMR 2+, FMR3+ and FMR4+) revealed a decreasing LVEF and increasing sPAP with more advanced FMR (Figures 2A,B ). Quantitative echocardiographic MR assessment was performed only in the FMR ≥ 2+ group. Patients in the FMR ≥ 2+ group were divided into FMR classes according to these parameters. Vena contracta, PISA, EROA, and regurgitant volume were increasing according to the FMR class (Figure 2C ).
Patients in the FMR ≤ 1+ group showed normal LVEF and systolic pulmonary artery pressure (sPAP) compared to the FMR ≥ 2+ group (
3
Cardiac Injury Biomarkers and Outcomes
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The primary outcome was myocardial injury as assessed by serum cardiac troponin I (cTnI) in blood samples collected preoperatively and at 1, 6, 12, 24, and 72 h after the end of the ischemic period. The institutional laboratory quantified cTnI by immunoassay (Cobas 6000 analyzer series, Roche Diagnostic USA). Secondary outcomes were systemic metabolic stress as assessed by blood pH, lactate, and serum creatinine level; mechanical ventilation time; length of intensive care unit/high dependency unit stay; and left ventricular function. Blood samples for measuring lactate and pH were taken before CPB, during CPB (at 20 and 40 min), and at the end of surgery. Blood samples for measuring serum creatinine were taken at 6, 24, 48, and 72 h after surgery. Left ventricular function was assessed preoperatively and between days 4 and 6 postoperatively. Examinations were performed using the Philips Healthcare IE33 echocardiography system, and the biplane method of disks summation (modified Simpson's rule) was applied to quantify left ventricular function.
4
Echocardiographic Evaluation of Cardiac Structure and Function
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All subjects underwent 2D transthoracic echocardiography (iE33 echocardiography system; Philips Medical Systems, Best, The Netherlands) examinations conducted by a single, experienced echocardiographer. To optimize speckle tracking, 2D grayscale harmonic images were obtained at a frame rate of 60 to 80/s. Standard parasternal long-axis and apical chamber views were obtained using a synchronous electrocardiogram in all cases. In each imaging plane, four end-expiratory cardiac cycles were acquired. From the parasternal long-axis view, the end-diastolic dimension of the left ventricle was measured from the left side of the interventricular septum to the left ventricular posterior wall, and the end-systolic dimension of the left atrium was measured from the left atrial anterior wall to the left atrial posterior wall. In apical two- or four-chamber views, the LVEF was assessed according to the modified biplane Simpson's rule (7) (link). Characteristics of subjects and routine echocardiographic data are listed in Table 1 .
5
Echocardiographic Evaluation of Cardiac Function
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Conventional echocardiographic studies using standard views and echo techniques, as recommended by the American Society of Echocardiography, were performed for all patients by experienced investigators using an iE33 Echocardiography System (Philips, NL) [11 (link), 12 (link)]. From four-chamber and two-chamber views, left ventricular end-diastolic and end-systolic volumes and ejection fraction (LVEF) were measured by the modified Simpson disk method. Additionally, for measurement of the right ventricular (RV) function, we used the tricuspid annular plane systolic excursion (TAPSE), which is an excellent surrogate parameter for the RV systolic function [13 (link)]. Left ventricular (LV) diastolic function was assessed by Doppler analysis.
6
Cardiac and Metabolic Profiles in Patients
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The clinical and demographic profiles of all patients were collected. Fasting blood samples were collected from all subjects for the detection of hemoglobin (HGB), C-reactive protein (CRP), albumin (ALB), creatinine, blood urea nitrogen, calcium (Ca), phosphorus (P), fasting blood glucose (FBG), PTH, 25 hydroxyvitamin D (25(OH)D), N-terminal peptide of type 1 procollagen (P1NP), β-cross-linked C-telopeptide of type 1 collagen (β-CTx), and N-terminal/midregion osteocalcin (N-MID) using AU5821 Clinical Chemistry Analyzer (Beckman Coulter, Inc., Brea, USA), XE-2100 Hematology Analyzer (Sysmex, Kobe, Japan), and Cobas E601 Immunology Analyzer (Roche, Basel, Switzerland). When the serum ALB level was less than 40 g/L, the measured serum Ca was corrected for ALB concentration (g/L) as follows: corrected Ca (mmol/L) = measured Ca (mmol/L) + 0.02 × (40-ALB concentration). The IE33 echocardiography system (Philips, Amsterdam, Netherlands) was used to measure the indicators of cardiac structure and function, including the left atrial diameter, right atrial diameter, left ventricular (LV) diameter, right ventricular diameter, and LV ejection fraction.
7
Echocardiographic Assessment of LV Function
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One week after the MI model establishment, and 4 weeks after ECP transplantation, the left ventricular (LV) functions of the rats were evaluated using the IE33 echocardiography system (Philips Medical Systems, Nederland B.V.). M-mode and B-mode were recorded to monitor LV anterior wall morphology and beating activity. The cardiac function parameters were measured based on the 3 consecutive cardiac cycles, including LV internal dimensions at both diastole and systole (LVIDd and LVIDs), FS, and EF. All the echocardiography data were acquired and analyzed in a blinded manner by 2 investigators.
8
Evaluating Left Atrial Appendage Flow in TAVI
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During the procedure, left atrial appendagepeak antegrade flow velocity (LAA-PAFV) with TEE (IE33 echocardiography system, X7-2t probe, 7 MHz, Philips Medical Systems, Eindhoven, the Netherlands) was measured and recorded. TEE was performed just before the intervention and it was repeated few minutes after the valve deployment (4.8 ± 1.7 min) to compare between TEE results before and after TAVI. PW spectral Doppler was recorded in mid-esophageal basal short-axis view at aortic valve level (30-60°) to assess the LAA-PAFV which was calculated by placing PW Doppler cursor in the LAA 2 mm from its orifice (Fig. 1). In sinus rhythm, LAA-PAFV was calculated as the average of the 3 highest velocities, whereas in patients with AF, the average of 5 cardiac cycles was used.
After the valve implantation, the presence of complications like cardiac effusion or tamponade, aortic regurgitation, valve displacement, LV wall motion abnormalities, and mitral valve injury were described [17] . Data expected to interfere with diastolic function parameters like systolic or diastolic blood pressure, heart rate, and hemoglobin level were assessed before the procedure and few minutes after the valve deployment.
After the valve implantation, the presence of complications like cardiac effusion or tamponade, aortic regurgitation, valve displacement, LV wall motion abnormalities, and mitral valve injury were described [17] . Data expected to interfere with diastolic function parameters like systolic or diastolic blood pressure, heart rate, and hemoglobin level were assessed before the procedure and few minutes after the valve deployment.
9
Echocardiographic Assessment of Cardiac Function
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Echocardiography was performed according to current standards in a left lateral position using Philips iE33 echocardiography system equipped with an S5-1 transducer (Philips Healthcare, Best, The Netherlands). Image acqusition was performed according to current recommendations.12 (link) Measurements were performed offline using the QLAB software (Philips Healthcare). Left ventricular end-systolic and end-diastolic volumes were measured, and EF was calculated by the biplane Simpson method.12 (link)
10
Comprehensive Echocardiographic Evaluation
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Resting two‐dimensional transthoracic echocardiograms were performed according to recommendations of the American and European Society of Echocardiography using an iE33 echocardiography system (Royal Philips Electronics, Amsterdam, The Netherlands).16 The mitral inflow velocity pattern was recorded from the apical four‐chamber view with the pulsed‐wave Doppler sample volume positioned at the tips of the mitral valve leaflets during diastole in expiration. Peak early (E‐wave) and late (A‐wave) diastolic filling velocities were measured, and their ratio (E/A) was calculated. The lateral mitral annular early diastolic velocity (E') was measured by spectral tissue Doppler imaging, and the E/E' ratio determined. LVEF was calculated by measurement according to Simpson from the apical four‐chamber view.
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