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Sirac: A Simplified Iec Risk Assessment Calculator for Electrical Systems



doi: 10.1016/j.esctr.2018.04.009 the content is solely the responsibility of the authors and does not necessarily represent the official views of the national institutes of health or the national institute of general medical sciences. citation: rosenmund s, mahajan rp, von der weid m, kümmer t, albrecht h, vogl t, et al. (2018) systemic amyloidosis: the use of novel echocardiographic markers for risk stratification and outcome prediction in clinical routine. esc heart failure. doi: 10.1002/ehf2.12275 a series of 50 consecutive patients with biopsy-proven al amyloidosis were included in this study. systemic al amyloidosis is a plasma cell dyscrasia characterized by the extracellular deposition of monoclonal immunoglobulin light chains in different organs and tissues. standard echocardiographic parameters, including ef, fs, e/e', dt, and mvo, were not able to risk stratify the prognosis of al patients. las and mcf, novel quantitative parameters based on tissue doppler imaging and speckle-tracking echocardiography, respectively, accurately predicted the outcome of al amyloidosis patients. we performed a retrospective analysis of 50 consecutive patients with biopsy-proven al amyloidosis who were included in the cohort and followed up. patients were divided into two groups according to the median las (8.0%) and mcf (50.3%) values. las and mcf significantly correlated with e/e' ratio (las: r = 0.902, p




Simplified Iec Risk Assessment Calculator Sirac


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second, mitral annular calcification was not associated with outcome, contrary to previous data [ 41 ]. it has been hypothesized that calcification may cause diastolic dysfunction, and consequently mitral annular calcification may represent a compensatory mechanism in advanced amyloidosis. mitral annular calcification may be a compensatory mechanism to amyloid deposition in the left ventricle, as the myocardial mass increases with amyloid deposition in cardiac amyloidosis [ 42 ]. however, it is not always possible to detect mitral annular calcification in every single patient due to the fact that it may be seen in up to 40% of the general population, especially in the elderly and in patients with diabetes mellitus [ 43, 44 ]. in addition, among patients with cardiac amyloidosis, mitral annular calcification was found to be more frequent in al than in attr type, and the presence of mitral annular calcification was significantly associated with a poor prognosis in cardiac amyloidosis [ 41, 45 ]. there is a need for a marker that can identify patients with cardiac amyloidosis with increased mortality risk. thus, mitral annular calcification may represent an additional but potentially unappreciated marker, which could be useful to identify patients with cardiac amyloidosis with high mortality risk. in addition, it should be noted that our study included only patients with confirmed cardiac amyloidosis and excluded patients with al cardiac amyloidosis. thus, mitral annular calcification may represent a non-specific marker in patients with cardiac amyloidosis, including those with attr.


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