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Article ; Online: Nesiritide administration in patients with left ventricular dysfunction undergoing coronary artery bypass surgery.

Belenkie, Israel

Journal of the American College of Cardiology

2007 Volume 49, Issue 6, Page(s) 727–728

MeSH term(s)	Coronary Artery Bypass ; Heart Failure ; Humans ; Kidney/drug effects ; Natriuretic Agents/pharmacology ; Natriuretic Agents/therapeutic use ; Natriuretic Peptide, Brain/pharmacology ; Natriuretic Peptide, Brain/therapeutic use ; Ventricular Dysfunction, Left/drug therapy
Chemical Substances	Natriuretic Agents ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2007-02-13
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2006.11.009
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Article: Diagnosis of lead-induced tricuspid regurgitation.

Wardell, Stephan / Kuriachan, Vikas / Weeks, Sarah G / Belenkie, Israel

HeartRhythm case reports

2016 Volume 2, Issue 2, Page(s) 173–177

Language	English
Publishing date	2016-01-12
Publishing country	United States
Document type	Case Reports
ZDB-ID	2834871-0
ISSN	2214-0271
ISSN	2214-0271
DOI	10.1016/j.hrcr.2016.01.004
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Article ; Online: Comparison of Cardiac Magnetic Resonance Imaging and Echocardiography in Assessment of Left Ventricular Hypertrophy in Fabry Disease.

Hazari, Hassan / Belenkie, Israel / Kryski, Albert / White, James A / Oudit, Gavin Y / Thompson, Richard / Fung, Tak / Dehar, Navdeep / Khan, Aneal

The Canadian journal of cardiology

2018 Volume 34, Issue 8, Page(s) 1041–1047

Abstract: Background: Cardiac hypertrophy in Fabry disease can be assessed using the left ventricular mass index (LVMI) with either echocardiography (LVMI-ECHO) or magnetic resonance imaging (LVMI-CMR).: Methods: A retrospective case series of patients with ... ...

Abstract	Background: Cardiac hypertrophy in Fabry disease can be assessed using the left ventricular mass index (LVMI) with either echocardiography (LVMI-ECHO) or magnetic resonance imaging (LVMI-CMR). Methods: A retrospective case series of patients with Fabry disease in Alberta involved a cross-sectional analysis of 32 patients and a longitudinal analysis of 14 of these patients with at least 4 serial CMR measurements. Results: The cross-sectional analysis showed the mean LVMI-ECHO was 97.8 ± 26.0 g/m Conclusions: We propose the preferred method for measuring LVMI is CMR in patients with Fabry disease.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Echocardiography/methods ; Fabry Disease/complications ; Fabry Disease/diagnosis ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Hypertrophy, Left Ventricular/diagnosis ; Hypertrophy, Left Ventricular/etiology ; Hypertrophy, Left Ventricular/physiopathology ; Magnetic Resonance Imaging, Cine/methods ; Male ; Middle Aged ; Retrospective Studies ; Ventricular Function, Left/physiology
Language	English
Publishing date	2018-03-29
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2018.03.011
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Article ; Online: Wave reflections in the pulmonary arteries analysed with the reservoir-wave model.

Bouwmeester, J Christopher / Belenkie, Israel / Shrive, Nigel G / Tyberg, John V

The Journal of physiology

2014 Volume 592, Issue 14, Page(s) 3053–3062

Abstract: Conventional haemodynamic analysis of pressure and flow in the pulmonary circulation yields incident and reflected waves throughout the cardiac cycle, even during diastole. The reservoir-wave model provides an alternative haemodynamic analysis consistent ...

Abstract	Conventional haemodynamic analysis of pressure and flow in the pulmonary circulation yields incident and reflected waves throughout the cardiac cycle, even during diastole. The reservoir-wave model provides an alternative haemodynamic analysis consistent with minimal wave activity during diastole. Pressure and flow in the main pulmonary artery were measured in anaesthetized dogs and the effects of hypoxia and nitric oxide, volume loading and positive end-expiratory pressure were observed. The reservoir-wave model was used to determine the reservoir contribution to pressure and flow and once subtracted, resulted in 'excess' quantities, which were treated as wave-related. Wave intensity analysis quantified the contributions of waves originating upstream (forward-going waves) and downstream (backward-going waves). In the pulmonary artery, negative reflections of incident waves created by the right ventricle were observed. Overall, the distance from the pulmonary artery valve to this reflection site was calculated to be 5.7 ± 0.2 cm. During 100% O2 ventilation, the strength of these reflections increased 10% with volume loading and decreased 4% with 10 cmH2O positive end-expiratory pressure. In the pulmonary arterial circulation, negative reflections arise from the junction of lobar arteries from the left and right pulmonary arteries. This mechanism serves to reduce peak systolic pressure, while increasing blood flow.
MeSH term(s)	Animals ; Arterial Pressure ; Dogs ; Hypoxia/physiopathology ; Male ; Models, Biological ; Myocardial Contraction ; Nitric Oxide/physiology ; Oxygen/physiology ; Pulmonary Artery/physiology ; Pulmonary Circulation
Chemical Substances	Nitric Oxide (31C4KY9ESH) ; Oxygen (S88TT14065)
Language	English
Publishing date	2014-04-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3115-x
ISSN	1469-7793 ; 0022-3751
ISSN (online)	1469-7793
ISSN	0022-3751
DOI	10.1113/jphysiol.2014.273094
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Article ; Online: Genesis of the characteristic pulmonary venous pressure waveform as described by the reservoir-wave model.

Bouwmeester, J Christopher / Belenkie, Israel / Shrive, Nigel G / Tyberg, John V

The Journal of physiology

2014 Volume 592, Issue 17, Page(s) 3801–3812

Abstract: Conventional haemodynamic analysis of pulmonary venous and left atrial (LA) pressure waveforms yields substantial forward and backward waves throughout the cardiac cycle; the reservoir wave model provides an alternative analysis with minimal waves during ...

Abstract	Conventional haemodynamic analysis of pulmonary venous and left atrial (LA) pressure waveforms yields substantial forward and backward waves throughout the cardiac cycle; the reservoir wave model provides an alternative analysis with minimal waves during diastole. Pressure and flow in a single pulmonary vein (PV) and the main pulmonary artery (PA) were measured in anaesthetized dogs and the effects of hypoxia and nitric oxide, volume loading, and positive-end expiratory pressure (PEEP) were observed. The reservoir wave model was used to determine the reservoir contribution to PV pressure and flow. Subtracting reservoir pressure and flow resulted in 'excess' quantities which were treated as wave-related.Wave intensity analysis of excess pressure and flow quantified the contributions of waves originating upstream (from the PA) and downstream (from the LA and/or left ventricle (LV)).Major features of the characteristic PV waveform are caused by sequential LA and LV contraction and relaxation creating backward compression (i.e.pressure-increasing) waves followed by decompression (i.e. pressure-decreasing) waves. Mitral valve opening is linked to a backwards decompression wave (i.e. diastolic suction). During late systole and early diastole, forward waves originating in the PA are significant. These waves were attenuated less with volume loading and delayed with PEEP. The reservoir wave model shows that the forward and backward waves are negligible during LV diastasis and that the changes in pressure and flow can be accounted for by the discharge of upstream reservoirs. In sharp contrast, conventional analysis posits forward and backward waves such that much of the energy of the forward wave is opposed by the backward wave.
MeSH term(s)	Animals ; Blood Flow Velocity ; Blood Pressure ; Dogs ; Female ; Male ; Mitral Valve/physiology ; Models, Cardiovascular ; Myocardial Contraction ; Nitric Oxide/metabolism ; Oxygen/metabolism ; Pulmonary Artery/metabolism ; Pulmonary Artery/physiology ; Pulmonary Veins/metabolism ; Pulmonary Veins/physiology ; Ventricular Function
Chemical Substances	Nitric Oxide (31C4KY9ESH) ; Oxygen (S88TT14065)
Language	English
Publishing date	2014-07-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3115-x
ISSN	1469-7793 ; 0022-3751
ISSN (online)	1469-7793
ISSN	0022-3751
DOI	10.1113/jphysiol.2014.272963
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Article ; Online: Alternative Approaches to the Assessment of the Systemic Circulation and Left Ventricular Performance: A Proof-of-Concept Study.

Howell, Sarah / Burrowes, Lindsay M / Belenkie, Israel / Ter Keurs, Henk E D J / Lei, Lucy / Raj, Satish R / Bouwmeester, J Christopher / Sheldon, Robert S / Shrive, Nigel G / Tyberg, John V

CJC open

2019 Volume 1, Issue 2, Page(s) 84–92

Abstract: Background: The purpose of this article is to examine the systemic circulation and left ventricular (LV) performance by alternative, nonconventional approaches: systemic vascular conductance (: Methods: In 16 open-chest, anaesthetized pigs, we ... ...

Abstract	Background: The purpose of this article is to examine the systemic circulation and left ventricular (LV) performance by alternative, nonconventional approaches: systemic vascular conductance ( Methods: In 16 open-chest, anaesthetized pigs, we measured LV pressure ( Results: Sodium nitroprusside and isoproterenol increased Conclusions: Thus, at a given
Language	English
Publishing date	2019-02-13
Publishing country	United States
Document type	Journal Article
ISSN	2589-790X
ISSN (online)	2589-790X
DOI	10.1016/j.cjco.2019.01.007
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Article ; Online: Systemic vascular effects of acute electrical baroreflex stimulation.

Burgoyne, Steven / Georgakopoulos, Dimitrios / Belenkie, Israel / Tyberg, John V

American journal of physiology. Heart and circulatory physiology

2014 Volume 307, Issue 2, Page(s) H236–41

Abstract: We intended to determine if acute baroreflex activation therapy (BAT) increases venous capacitance and aortic conductance. BAT is effective in resistant hypertension, but its effect on the systemic vasculature is poorly understood. Left ventricular (LV) ... ...

Abstract	We intended to determine if acute baroreflex activation therapy (BAT) increases venous capacitance and aortic conductance. BAT is effective in resistant hypertension, but its effect on the systemic vasculature is poorly understood. Left ventricular (LV) and aortic pressures and subdiaphragmatic aortic and caval flows (ultrasonic) were measured in six anesthetized dogs. Changes in abdominal blood volume (Vabdominal) were estimated as the integrated difference in abdominal aortic inflow and caval outflow. An electrode was implanted on the right carotid sinus. Data were measured during control and BAT. Next, sodium nitroprusside (SNP) was infused and BAT was subsequently added. Finally, angiotensin II (ANG II) was infused, and three increased BAT currents were added. We found that BAT decreased mean aortic pressure (PAo) by 22.5 ± 1.3 mmHg (P < 0.001) and increased aortic conductance by 16.2 ± 4.9% (P < 0.01) and Vabdominal at a rate of 2.2 ± 0.6 ml·kg(-1)·min(-1) (P < 0.01). SNP decreased PAo by 17.4 ± 0.7 mmHg (P < 0.001) and increased Vabdominal at a rate of 2.2 ± 0.7 ml·kg(-1)·min(-1) (P < 0.05). During the SNP infusion, BAT decreased PAo further, by 26.0 ± 2.1 mmHg (P < 0.001). ANG II increased PAo by 40.4 ± 3.5 mmHg (P = 0.001). When an increased BAT current was added, PAo decreased to baseline (P < 0.01) while aortic conductance increased from 62.3 ± 5.2% to 80.2 ± 3.3% (P < 0.05) of control. Vabdominal increased at a rate of 1.8 ± 0.9 ml·kg(-1)·min(-1) (P < 0.01), reversing the ANG II effects. In conclusion, BAT increases arterial conductance, decreases PAo, and increases venous capacitance even in the presence of powerful vasoactive drugs. Increasing venous capacitance may be an important effect of BAT in hypertension.
MeSH term(s)	Animals ; Aorta, Abdominal/physiology ; Arterial Pressure ; Baroreflex/drug effects ; Blood Flow Velocity ; Dogs ; Electric Stimulation ; Female ; Hemodynamics/drug effects ; Male ; Models, Animal ; Pressoreceptors/drug effects ; Pressoreceptors/physiology ; Regional Blood Flow ; Time Factors ; Vascular Capacitance ; Vasoconstrictor Agents/pharmacology ; Vasodilator Agents/pharmacology ; Vena Cava, Inferior/physiology ; Ventricular Function, Left ; Ventricular Pressure
Chemical Substances	Vasoconstrictor Agents ; Vasodilator Agents
Language	English
Publishing date	2014-05-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603838-4
ISSN	1522-1539 ; 0363-6135
ISSN (online)	1522-1539
ISSN	0363-6135
DOI	10.1152/ajpheart.00422.2013
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Article ; Online: Partitioning pulmonary vascular resistance using the reservoir-wave model.

Bouwmeester, J Christopher / Belenkie, Israel / Shrive, Nigel G / Tyberg, John V

Journal of applied physiology (Bethesda, Md. : 1985)

2013 Volume 115, Issue 12, Page(s) 1838–1845

Abstract: The conventional determination of pulmonary vascular resistance does not indicate which vascular segments contribute to the total resistance of the pulmonary circulation. Using measurements of pressure and flow, the reservoir-wave model can be used to ... ...

Abstract	The conventional determination of pulmonary vascular resistance does not indicate which vascular segments contribute to the total resistance of the pulmonary circulation. Using measurements of pressure and flow, the reservoir-wave model can be used to partition total pulmonary vascular resistance into arterial, microcirculation, and venous components. Changes to these resistance components are investigated during hypoxia and inhaled nitric oxide, volume loading, and positive end-expiratory pressure. The reservoir-wave model defines the pressure of a volume-related reservoir and the asymptotic pressure. The mean values of arterial and venous reservoir pressures and arterial and venous asymptotic pressures define a series of resistances between the main pulmonary artery and the pulmonary veins: the resistance of large and small arteries, the microcirculation, and veins. In 11 anaesthetized, open-chest dogs, pressure and flow were measured in the main pulmonary artery and a single pulmonary vein. Volume loading reduced each vascular resistance component, whereas positive end-expiratory pressure only increased microcirculation resistance. Hypoxia increased the resistance of small arteries and veins, whereas nitric oxide only decreased small-artery resistance significantly. The reservoir-wave model provides a novel method to deconstruct total pulmonary vascular resistance. The results are consistent with the expected physiological responses of the pulmonary circulation and provide additional information regarding which segments of the pulmonary circulation react to hypoxia and nitric oxide.
MeSH term(s)	Animals ; Blood Pressure/physiology ; Dogs ; Female ; Hypoxia/metabolism ; Hypoxia/physiopathology ; Male ; Microcirculation/physiology ; Nitric Oxide/metabolism ; Positive-Pressure Respiration/methods ; Pulmonary Artery/metabolism ; Pulmonary Artery/physiology ; Pulmonary Circulation/physiology ; Pulmonary Veins/metabolism ; Pulmonary Veins/physiology ; Vascular Resistance/physiology
Chemical Substances	Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2013-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00750.2013
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Article: High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart.

Smailys, Andrea / Mitchell, Jamie R / Doig, Christopher J / Tyberg, John V / Belenkie, Israel

Physiological reports

2014 Volume 2, Issue 3, Page(s) e00259

Abstract: Abstract High-frequency oscillatory ventilation (HFOV) may improve gas exchange in patients who are inadequately ventilated by conventional mechanical ventilation (CV); however, the hemodynamic consequences of switching to HFOV remain unclear. We ... ...

Abstract	Abstract High-frequency oscillatory ventilation (HFOV) may improve gas exchange in patients who are inadequately ventilated by conventional mechanical ventilation (CV); however, the hemodynamic consequences of switching to HFOV remain unclear. We compared the effects of CV and HFOV on pulmonary vascular conductance and left ventricular (LV) preload and performance at different airway and filling pressures. In anesthetized dogs, we measured LV dimensions, aortic and pulmonary artery (PA) flow, and mean airway ( AW) and pericardial pressures. Catheter-tip pressure manometers measured aortic, LV, left atrial, and PA pressures. The pericardium and chest were closed. At LV end-diastolic pressure (PLVED) = 5 mmHg and 12 mmHg, PEEP was varied (6 cm H2O, 12 cm H2O, and 18 cm H2O) during CV. Then, at airway pressures equal to those during CV, HFOV was applied at 4 Hz, 10 Hz, and 15 Hz. Increased AW decreased pulmonary vascular conductance. As cardiac output increased, conductance increased. At PLVED = 12 mmHg, conductance was greatest during HFOV at 4 Hz. LV preload (i.e., ALV, our index of end-diastolic volume) was similar during HFOV and CV for all conditions. At PLVED = 12 mmHg, SWLV was similar during CV and HFOV, but, at PLVED = 5 mmHg and AW 10 cm H2O, SWLV was lower during HFOV than CV. Compared to pulmonary vascular conductance at higher frequencies, at PLVED = 12 mmHg, conductance was greater at HFOV of 4 Hz. Effects of CV and HFOV on LV preload and performance were similar except for decreased SWLV at PLVED = 5 mmHg. These observations suggest the need for further studies to assess their potential clinical relevance.
Language	English
Publishing date	2014-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2724325-4
ISSN	2051-817X
ISSN	2051-817X
DOI	10.1002/phy2.259
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Article ; Online: Toward zero: deep sternal wound infection after 1001 consecutive coronary artery bypass procedures using arterial grafts: implications for diabetic patients.

Kieser, Teresa M / Rose, M Sarah / Aluthman, Uthman / Montgomery, Marlene / Louie, Thomas / Belenkie, Israel

The Journal of thoracic and cardiovascular surgery

2014 Volume 148, Issue 5, Page(s) 1887–1895

Abstract: Objective: Coronary artery bypass graft (CABG) surgery with arterial conduits is considered optimal. A deterrent to bilateral internal thoracic artery (BITA) grafting is the risk of deep sternal wound infection (DSWI). We introduced infection prevention ...

Abstract	Objective: Coronary artery bypass graft (CABG) surgery with arterial conduits is considered optimal. A deterrent to bilateral internal thoracic artery (BITA) grafting is the risk of deep sternal wound infection (DSWI). We introduced infection prevention measures sequentially, attempting to reduce DSWIs. The aim was to determine (1) if the absence of DSWIs in the last 469 of 1001 consecutive operations was significant; (2) which measures explained the change; and (3) the impact of diabetes. Methods: The measures included internal thoracic artery (ITA) skeletonization, no bone wax, wound irrigation, 1 observer per case, harmonic scalpel harvest of ITAs, vancomycin paste on sternal marrow, iodine-impregnated skin drapes, chlorhexidine-alcohol skin preparation, no BITA grafts in obese, diabetic women, more off-pump procedures, aseptic wound care, and marrow irrigation before sternal approximation. Results: Mean age was 65±10.4 years, 78% were male, 34% had diabetes, and 34% were obese. The first 532 patients had 16 DSWIs (3%) and the subsequent 469 had none (P<.001). Analysis of the data suggested that the first 11 measures likely contributed to the absence of DSWI and less likely, the twelfth. Key measures were likely chlorhexidine-alcohol use and avoidance of BITAs in obese diabetic women who had a 10-fold higher DSWI rate than the other patients (21.4% vs 2.0%). Other diabetics, including obese men, had no increased risk of DSWI. Conclusions: The measures applied caused a substantial reduction in DSWIs. Key measures included the use of chlorhexidine-alcohol and avoidance of BITA grafting in obese diabetic females. These measures reduced DSWIs after BITA grafting in most diabetics.
MeSH term(s)	Aged ; Anti-Infective Agents, Local/therapeutic use ; Decision Support Techniques ; Diabetes Complications/etiology ; Diabetes Complications/prevention & control ; Female ; Humans ; Infection Control/methods ; Internal Mammary-Coronary Artery Anastomosis/adverse effects ; Male ; Mammary Arteries/surgery ; Middle Aged ; Obesity/complications ; Patient Selection ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sex Factors ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control ; Time Factors ; Tissue and Organ Harvesting/adverse effects ; Treatment Outcome
Chemical Substances	Anti-Infective Agents, Local
Language	English
Publishing date	2014-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2014.02.022
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