Implications of serial measurements of natriuretic peptides in heart failure: insights from BIOSTAT‐CHF

No abstract available

Cardiopoietic cell therapy for advanced ischemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort

Expert system based on ontological model to support the detailed project of products in the context of agricultural mechinery

The large amount of available design information from different areas has become common in most organizations. Under these conditions, there are difficulties in sharing and reusing knowledge, especially by the fact that this knowledge is available within the company in different formats and locations. Due to this, design engineers often fail to use such information. To ensure a better use, it is important to organize and integrate the available knowledge in a collaborative manner. In this context, the Knowledge-based Engineering (KBE) approach can be associated. Through KBE concepts, the current study aims to develop an expert system based on an ontology model for assisting decision making, by storing and providing useful information in a timely manner. Such solution should meet the needs of its users (i.e. designers), as well as improve the quality of design activities along the Product Development Process (PDP). For this study, the following steps have been adopted: (a) delimitation of action scope (i.e. steps of PDP to be focused); (b) knowledge capture; (c) standardization; (d) knowledge structuring through ontologies; (e) building of queries; (f) evaluation of solution performance. The application of the present proposal aims to facilitate the access to information, significantly reduce the appearance of failures along the PDP, as well as allow acquired knowledge to be used in subsequent projects (e.g. lessons learned).Uma grande quantidade de informações de projeto, provenientes de diferentes áreas, tornou-se comum na maioria das organizações. Nessas condições, há dificuldades no compartilhamento e reutilização de conhecimento, especialmente pelo fato de que este conhecimento está disponível dentro da empresa em diferentes formatos e em diferentes locais. Devido a isso, os engenheiros de projeto muitas vezes não conseguem utilizar essas informações. Assim, é importante que as empresas possam organizar e integrar o conhecimento disponível de forma colaborativa, a fim de garantir seu melhor aproveitamento. Nesse contexto, a abordagem chamada Engenharia Baseada em Conhecimento (KBE) pode ser associada. Através de conceitos KBE, a presente dissertação tem como objetivo desenvolver um sistema especialista baseado em um modelo de ontologia, que permita o armazenamento e fornecimento de informações úteis no momento certo do desenvolvimento de produtos. Tal solução deve atender às necessidades de seus usuários (i.e. projetistas), bem como melhorar a qualidade de atividades de projeto ao longo do Processo de Desenvolvimento de Produto (PDP). Para este estudo os seguintes passos foram adotados: (a) a delimitação do escopo de ação (i.e. etapas do PDP a serem definidas como foco); (b) captura do conhecimento; (c) normalização; (d) estruturação do conhecimento através de ontologias; (e) elaboração de buscas; e (f) avaliação de desempenho da solução. A presente proposta tem como finalidade facilitar o acesso à informações, reduzir o aparecimento de falhas ao longo do PDP, bem como permitir que o conhecimento adquirido possa ser utilizado em projetos subsequentes (e.g. lições aprendidas)

Diagnostic accuracy of coronary CT angiography performed in 100 consecutive patients with coronary stents using a whole-organ high-definition CT scanner

Aims: To evaluate image quality, interpretability, diagnostic accuracy and radiation exposure of coronary CT angiography (CCTA) performed with a new scanner equipped with 0.23-mm spatial resolution, new generation iterative reconstruction, 0.28-second gantry rotation time and intra-cycle motion-correction algorithm in consecutive patients with coronary stents, including those with high heart rate (HR) and atrial fibrillation (AF). Materials and methods: We enrolled 100 consecutive patients (85 males, mean age 65 \ub1 10 years) with previous coronary stent implantation scheduled for clinically indicated non-emergent invasive coronary angiography (ICA). Image quality, coronary interpretability and diagnostic accuracy vs. ICA were evaluated and the effective dose (ED) was recorded. Results: Mean HR during the scan was 67 \ub1 13 bpm. Twenty-six patients had >65 bpm HR during scanning and 13 patients had AF. Overall, image quality was high (Likert = 3.2 \ub1 0.9). Stent interpretability was 95.8% (184/192 stents). Among 192 stented segments, CCTA correctly identified 22 out of 24 with >50% in-stent restenosis (ISR) (sensitivity 92%). In a stent-based analysis, specificity, positive and negative predictive values and diagnostic accuracy for ISR detection were 91%, 99%, 60% and 91%, respectively. In a patient-based analysis, CCTA diagnostic accuracy was 85%. Overall, mean ED of CCTA was 2.4 \ub1 1.2 mSv. Conclusions: A whole-organ CT scanner was able to evaluate coronary stents with good diagnostic performance and low radiation exposure, also in presence of unfavorable HR and heart rhythm. Translational aspect: The present study is the first to evaluate the CCTA capability of detecting in-stent restenosis in consecutive patients, including those with high HR and AF, using a recent scanner generation that combines improved spatial and temporal resolution with wide coverage. Using the whole-organ high-definition CT scanner we obtained high quality images of coronary stents with good interpretability and diagnostic accuracy combined with low radiation exposure, even in patients with unfavorable HR or heart rhythm for CCTA evaluation

Low-Dose Coronary CT Angiography in Patients with Atrial Fibrillation: Comparison of Image Quality and Radiation Exposure with Two Different Approaches

Rationale and Objectives: To evaluate image quality, coronary interpretability and radiation exposure of coronary CT angiography (CCTA)performed in patients with atrial fibrillation (AF)with the latest scanner generation, comparing two different technical approaches. A new scanner that combines a 0.23 mm spatial resolution, a new generation of iterative reconstruction, fast gantry rotation time and the intracycle motion-correction algorithm to improve the temporal resolution was recently introduced in the clinical field. Materials and Methods: We enrolled 105 consecutive patients with chronic AF who performed CCTA with a whole-heart coverage high-definition CT scanner (16-cm z-axis coverage with 256 detector rows, 0.28 s gantry rotation time). Five of them were excluded for impaired renal function. Patients were randomized between a double acquisition protocol (50 patients, group 1)or a single acquisition protocol (50 patients, group 2). The image quality, coronary segment interpretability and effective dose (ED)of CCTA were assessed. Results: The mean HR during the scan was 85.6\ub121 bpm in group 1 vs. 83.7\ub123 bpm in Group 2, respectively (p < ns). In group 2, overall image quality was high and comparable with that of group 1 (Likert scale =3.2 \ub1 1.4 vs. 3.3 \ub1 1.2, p = ns, in group 1 and 2, respectively). Coronary interpretability was high and similar between the two groups (97.5% and 97.1% in group 1 and 2, p = ns, respectively). Mean ED was significantly higher in group 1 than in group 2 (5.3 \ub1 1.8 mSv vs. 2.7 \ub1 0.7 mSv, p < 0.001). Conclusion: The novel whole-heart coverage CT scanner allows to perform CCTA with a single-acquisition protocol with high image quality and low radiation exposure in AF patients