The ultrasonographic examinations were carried out by an experienced investigator (more than 1000 diaphragm ultrasound examinations performed prior to the beginning of the study) using commercially available ultrasound machine (Vivid S60N, GE Medical System, Milwaukee, Wl, USA) connected to a 1.5–3 MHz transducer array (3Sc probe) for excursion measurements and to a linear vascular transducer (9L probe) for thickness measurements.
Vivid s60n
Manufactured by GE Healthcare
Sourced in United States, Japan
The Vivid S60N is a compact and portable ultrasound system designed for cardiovascular and general imaging applications. It features a high-resolution display and advanced imaging capabilities, providing healthcare professionals with the tools to perform a variety of diagnostic exams.
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10 protocols using vivid s60n
1
Diaphragm Ultrasound Examination Technique
2
Brachial Artery Diameter Measurement
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The brachial artery diameter was measured in the antecubital fossa immediately before its branching using a Doppler ultrasound system with a high-resolution transducer (Vivid S60N, 12 MHz linear-array transducer; GE). For two-dimensional imaging, a segment with clearly identifiable anterior and posterior intimal faces was selected. The brachial artery diameter was measured three times, and the average was recorded as the basal diameter. Measurements of the brachial artery were taken at the end of diastole according to electrocardiography monitoring. The cuff of the blood pressure device was placed in the upper part of the right antecubital fossa to create current impulses in the brachial artery. After baseline measurements were recorded, the cuff pressure was increased to 50 mmHg above the SBP, and the cuff was held in this position for 5 min to allow complete interruption of arterial flow. Anterograde blood flow was cut, and ischemia was induced. Sixty seconds after the cuff was deflated, two-dimensional longitudinal images of the brachial artery were obtained. FMD values were calculated using the baseline and maximum diameters of the brachial artery. FMD was calculated as: FMD = 100 × (maximum diameter after hyperemia − baseline diameter ÷ baseline diameter) [18 (link)].
3
Echocardiographic Evaluation of Mitral Insufficiency
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Two-dimensional, M-mode, pulsed, and color flow Doppler echocardiographic examinations (Vivid S60N, 3-MHz transducer; GE, Horten, Norway) were performed by a pediatric cardiologist. During echocardiography, one-lead electrocardiography was recorded continuously. The systolic function of the left ventricle was evaluated using M-mode echocardiography in the parasternal long-axis view. Mitral insufficiency was detected using color Doppler based on the measurement of jet length (grade 1, jet length ≤ 1.5 cm; grade 2, jet length 1.5–2.9 cm; grade 3, jet length 3.0–4.4 cm; grade 4, jet length > 4.5 cm). Grade 1 was accepted as mild insufficiency, grade 2 as moderate, and grades 3 and 4 as severe insufficiency [17 (link)].
4
Echocardiographic Evaluation Protocol
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All echocardiographic studies were performed within 4 h of catheterization using a commercially available echocardiography system (Vivid S60N; GE Healthcare, Milwaukee, WI, USA) equipped with a 3.0-MHz transducer. Interpretation was blinded from haemodynamic data. All measurements were performed according to the American Society of Echocardiography.11 (link) If the patient was presenting with an irregular rhythm, such as atrial fibrillation, five consecutive cycles and the average of these five E-waves and e′ were registered.
5
Newborn Screening Echocardiography Protocol
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Baseline demographic and clinical data were collected from the medical records of all participants. At the Department of Pediatrics at Chutoen Medical Center, newborn screening is performed using 2-dimensional (2D) and color Doppler echocardiography.18 (link) With subjects at rest, echocardiography was performed using a Vivid S5 or Vivid S60N cardiac ultrasound system (GE Healthcare Japan, Tokyo, Japan) with a 6S or 12S sector array transducer. All newborns underwent routine echocardiography at a mean age of 1.4 days after birth. The stored digital scans were analyzed using a commercially available software package (automated functional imaging; EchoPAC version 204; GE Healthcare) by an expert blinded to the subjects’ details.
6
Echocardiographic Assessment of Aortic Elasticity
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Following routine echocardiography, the patients were placed on their left sides on their backs, and ascending aorta recordings were obtained in M-mode under two-dimensional guidance (Vivid S60N, 3-MHz transducer; GE). M-mode ascending aortic recordings were obtained 3 cm above the aortic valve. Aortic diameters were calculated by measuring the distance between the inner edges of the anterior and posterior walls in systole and diastole. The systolic aortic diameter (AoS) was measured with the aortic valve in the open position. The diastolic aortic diameter (AoD) was measured from the area corresponding to the QRS peak on simultaneous electrocardiographic recordings (Fig. 1 ). The following formulae were used to assess arterial elasticity: pulse pressure (PP) = SBP − DBP, aortic strain (%) = [(AoS – AoD) ÷ AoD] × 100, and aortic distensibility = 2 × [AoS – AoD ÷ AoD] × PP [18 (link)].
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Aortic systolic diameter and aortic diastolic diameter measurements
7
Echocardiographic Evaluation of Mice
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The mice were anesthetized with 2% isoflurane in pure medical oxygen. Two-dimensional images and M-mode tracings were recorded on the short axis at the left ventricular papillary muscle level using a 14.0 MHz transducer to determine the percentage of fractional shortening and ventricular dimensions (Vivid S60N; GE HealthCare, Chicago, IL, USA). Measurements were performed at least three times for each mouse and the average of the measurements was used.
8
Ultrasound Assessment of Diaphragmatic Function
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The ultrasonographic examinations were carried out by two experienced investigators (AB and JF), both of whom had performed more than 500 ultrasound examinations of the diaphragm before the beginning of the study. The investigator performing the ultrasound was blinded to the results of the medical consultation and the PFT results. Diaphragmatic function was assessed as both the motion and the thickness of the two hemidiaphragms. The ultrasound examinations were performed using a commercially available ultrasound machine (Vivid S60N, GE Medical System, Milwaukee, WI, United States) equipped with a cardiac probe (3Sc probe) for the diaphragm excursion measurements and a linear vascular transducer (9L probe) for the diaphragm thickness measurements. The examinations were performed with the patients in a seated position.
9
Echocardiographic Assessment of SEATAK
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Transthoracic echocardiograms were performed within 24 hours after admission to the ward by an experienced sonographer cardiologist (JW) using commercially available echocardiographic systems of Vivid S60N or Vivid S6 (General Electric Company, Boston, MA, US) according to the same protocol. The measurements were made based on the current guidelines with real-time electrocardiographic recording to precisely define the phases of the heart cycle. The estimation of SEATAK was utilized according to the method by Díaz-Gómez and colleagues from the Mayo Clinic. Briefly, the subcostal four-chamber view was obtained with an average depth of 20 to 24 cm. Then a counterclockwise rotation was applied to acquire the subcostal short-axis view upon which the right atrium, RV, tricuspid annulus, and inferior vena cava could be identified. Subsequently, the cursor was aligned in real-time with M-mode echocardiographic imaging with the tricuspid annulus to obtain a linear measurement from end-diastole to end-systole i.e. SEATAK [9, (link)12] . The average values of every single echocardiographic parameter were calculated from 3 cardiac cycles using the incorporated sonography software.
10
Echocardiography Assessment of GDM Infants
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Baseline demographic and clinical data were collected from the medical records of all participants. In GDM, HbA1c is measured as an indicator of the degree of blood glucose level during pregnancy. In this study, the highest HbA1c level during pregnancy was used.
For the infants with GDM, echocardiography was performed using a Vivid S5 or Vivid S60N cardiac ultrasound system (GE Healthcare Japan, Tokyo, Japan) with a 6S or 12S sector array transducer while the infant was at rest. All infants underwent routine echocardiography at an average age of 1 day after birth to confirm the closing of a patent ductus arteriosus. The stored digital scans were analyzed using a commercially available software package (automated functional imaging; EchoPAC version 204, GE Healthcare) by an expert blinded to the subjects' details.
For the infants with GDM, echocardiography was performed using a Vivid S5 or Vivid S60N cardiac ultrasound system (GE Healthcare Japan, Tokyo, Japan) with a 6S or 12S sector array transducer while the infant was at rest. All infants underwent routine echocardiography at an average age of 1 day after birth to confirm the closing of a patent ductus arteriosus. The stored digital scans were analyzed using a commercially available software package (automated functional imaging; EchoPAC version 204, GE Healthcare) by an expert blinded to the subjects' details.
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