Clinical Physiology and Functional Imaging最新文献

{"title":"The durability of different anchoring points and anchoring types in the left ventricle in an ex vivo porcine model","authors":"Henrik Bjursten,&nbsp;Per Wierup,&nbsp;Sasha Koul,&nbsp;Matthias Götberg,&nbsp;Magnus Dencker","doi":"10.1111/cpf.70099","DOIUrl":"10.1111/cpf.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Surgical mitral valve repair, including anchoring in different parts of the mitral apparatus, is the standard of care for severe mitral regurgitation. Various percutaneous approaches have been developed and are currently under development, but are struggling with durable results. This study investigates the durability of different anatomic anchoring points and anchoring types in the left ventricle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Anchoring was tested with PTFE sutures or a 5 mm helix at three locations: the head of the papillary muscle, the lateral wall of the ventricle, and the apex of the ventricle. An accelerated life test was performed with 300 cycles at 3 N for each anchoring. Durability was assessed by measuring compliance (strain in mm until 3 N is reached), migration (change in strain from the first to the last cycle), and the occurrence of dehiscence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The lowest numerical strain/compliance in the first cycle was observed at the head of the papillary muscle anchoring (both surgical and helix). Migration of strain limits over 300 cycles was seen for all locations. The lowest migration was numerically for helix in the papillary muscle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PTFE in the head of the papillary muscle is standard practice in mitral valve repair and was used as a reference in the present study. The anchoring that yielded the most similar results was a helix in the papillary muscle, whereas other anchoring points showed greater compliance and/or migration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of advancing age on diaphragm thickness and maximal inspiratory pressure: Comparison with peripheral skeletal muscle","authors":"Colton B. Hart,&nbsp;Kylie R. Roozen,&nbsp;Bo A. Warner,&nbsp;Ana P. Freire,&nbsp;Robert C. Pritchett,&nbsp;Leonardo J. D'Acquisto,&nbsp;Jared M. Dickinson","doi":"10.1111/cpf.70100","DOIUrl":"10.1111/cpf.70100","url":null,"abstract":"<p>Aging is associated with deleterious effects on skeletal muscle size and function, known as sarcopenia. Less understood is the impact of advancing age specific to the size and function of the diaphragm. The purpose of this study was to determine the extent to which structural and functional responses of the diaphragm to advancing age are similar or unique to those observed in peripheral muscle. Ten young (22 ± 1 yr, 5 M, 5 F) and ten old (69 ± 3, 4 M, 6 F) healthy individuals volunteered for this study. Diaphragm thickness (end exhalation, end-tidal inhalation, end-maximal inhalation) and thickness of the thigh (vastus lateralis, vastus intermedius) were assessed via ultrasound. Inspiratory muscle strength was evaluated using maximal inspiratory pressure (MIP) and thigh muscle strength was assessed using peak isometric (extension) force. Thigh muscle thickness and peak isometric force were ~35% and 44%, respectively, lower in old compared to young (<i>p</i> &lt; 0.05). All measures of diaphragm thickness were similar between old and young (<i>p</i> &gt; 0.05). Despite similar diaphragm thickness, MIP was ~24% lower in old compared to young (<i>p</i> &lt; 0.05). Linear regression analysis revealed that diaphragm thickness at end exhalation was a predictor of MIP in old (<i>r</i>² = 0.42, <i>p</i> &lt; 0.05). These preliminary data suggest that while aging contributes to reduced respiratory and peripheral muscle function, diaphragm thickness, as assessed via ultrasound, appears less impacted by advancing age compared to peripheral skeletal muscle thickness. These data provide further insight for muscle-specific responses to advancing age and a basis for the development of diaphragm muscle-specific therapeutic strategies.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of exercise PETO2 changes for major adverse cardiovascular events in ischaemic heart disease: An exploratory study","authors":"Yuma Sasaki,&nbsp;Keiji Asada","doi":"10.1111/cpf.70095","DOIUrl":"10.1111/cpf.70095","url":null,"abstract":"<p>The difference in end-tidal oxygen partial pressure (ΔPETO₂) between rest and anaerobic threshold exercise is reportedly a predictor of major adverse cardiovascular events (MACE) in heart disease patients, but its predictive accuracy has not been verified in ischaemic heart disease (IHD). We analyzed the incidence of MACE within 3 years after cardiopulmonary exercise testing (CPET) in IHD patients, and calculated ΔPETO₂ from the CPET data. Receiver operating characteristic analysis identified the ΔPETO₂ cutoff value in predicting MACE occurrence, after which patients were divided into low ΔPETO₂ and high ΔPETO₂ groups. Kaplan-Meier analysis using the log-rank test was performed to compare the incidence of MACE within 3 years, and multiple regression analysis was conducted with ΔPETO₂ as the dependent variable. Among 168 cases (mean age 66.2 ± 10.1 years; 143 males), 22 patients (13%) experienced MACE. The optimal ΔPETO₂ cutoff value in predicting MACE was 2.5 mmHg (area under the curve 0.888, sensitivity 77%, specificity 90%). Kaplan-Meier analysis revealed that the MACE incidence rate was significantly higher in the ΔPETO₂ ≤ 2.5 group compared to the ΔPETO₂ &gt; 2.5 group. Multiple regression analysis identified peak oxygen pulse (peak O₂ pulse), ankle-brachial index (ABI), and dyslipidemia (DL) as independent factors associated with ΔPETO₂. ΔPETO₂ may serve as a useful early indicator for predicting high risk of MACE in IHD before the onset of heart failure. Additionally, peak O₂ pulse, ABI, and DL were identified as factors influencing ΔPETO₂, suggesting that blood flow to the lower limbs may impact ΔPETO₂.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effects of volume-matched isometric exercise intensity on vascular function and autonomic regulation in men with elevated blood pressure","authors":"Min Ji Jeong,&nbsp;Jae-Geun Kim,&nbsp;Wonil Park,&nbsp;Jung-Hyun Kim,&nbsp;Hyun Chul Jung","doi":"10.1111/cpf.70093","DOIUrl":"10.1111/cpf.70093","url":null,"abstract":"<p>Isometric exercise (IE) has been introduced as an effective non-pharmacological strategy for blood pressure (BP) management; however, the influence of exercise intensity remains unclear during lower-limb IE. This study investigated the acute effects of volume-matched high-intensity (HIIE) and low-intensity IE (LIIE) on cardiovascular function in men with elevated BP. Seventeen men with prehypertension or stage I hypertension completed three randomized crossover conditions, including HIIE (60% of maximal voluntary contraction (MVC)), LIIE (30% of MVC), and a non-exercise control condition (CON). BP, heart rate variability (HRV), brachial-ankle pulse wave velocity (baPWV) were measured at baseline and three different time points during recovery, while flow-mediated dilation (FMD) was measured at baseline and 30-min post-exercise. No significant BP reduction was observed. However, HIIE induced greater autonomic disturbance with elevated heart rate and reduced HRV indices during recovery (<i>p</i> &lt; 0.05). Right baPWV decreased following HIIE (<i>p</i> &lt; 0.05) while FMD increased after both exercise conditions (<i>p</i> &lt; 0.001). Our findings suggest that volume-matched HIIE induces greater acute autonomic and vascular responses than LIIE in men with elevated BP, despite no immediate changes in BP. HIIE may provide a stronger physiological stimulus associated with vascular adaptation.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar acute increases in muscle size, but discrete perceptual responses to low-load blood flow restriction protocols","authors":"Mason A. Howard,&nbsp;Paola M. Rivera,&nbsp;Sean M. Lubiak,&nbsp;Christopher E. Proppe,&nbsp;Jeffrey T. Schmidt,&nbsp;Thalia L. Fraifer,&nbsp;Ezra D. Shobe,&nbsp;Ethan C. Hill","doi":"10.1111/cpf.70097","DOIUrl":"10.1111/cpf.70097","url":null,"abstract":"<p>The purpose of this investigation was to assess muscle size and perceptual responses following acute bouts of low-load blood flow restriction resistance exercise performed with a 75-repetition (1 × 30, 3 × 15), 3 sets to failure, and a 1 set to failure protocols. Nineteen females randomly performed a 75-repetition, 3 sets to failure, and 1 one set to failure low-load blood flow restriction protocols consisting of unilateral, submaximal (30% of maximal voluntary isometric contraction), isokinetic (90°·s⁻¹), leg extension muscle actions. The minimal difference (MD) was used to determine real changes in each dependent variable from pretest to posttest. There were no significant (<i>p</i> = 0.191–0.567) interactions, main effects of Condition (<i>p</i> = 0.108–0.931), or main effects of Muscle (<i>p</i> = 0.103–0.958) for muscle thickness (MTH), cross-sectional area (CSA), or echo intensity (EI) of the rectus femoris or vastus lateralis. Across the protocols, the changes in MTH, CSA, and EI exceeded the minimal difference for 16–19, 18–19, and 11–19 of the 19 participants, respectively. Following the final set of each protocol, 3 sets to failure (8.94 ± 1.07 au) resulted in a greater rating of perceived exertion compared to the 1 set to failure (8.02 ± 1.08 au) and 75-repetition (8.05 ± 1.35 au) protocols. All three protocols resulted in comparable acute changes in muscle size; however, the 3 sets to failure resulted in the greatest perceptual response. Therefore, comparable acute muscle size responses can be achieved with the 75-repetition protocol or one set performed to failure with a reduced level of exertion.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular reserve as an integrative physiological construct: Current evidence, emerging technologies and future directions","authors":"Uri Gabbay,&nbsp;Shai Fein,&nbsp;Michael J. Drescher","doi":"10.1111/cpf.70094","DOIUrl":"10.1111/cpf.70094","url":null,"abstract":"<p>Cardiovascular reserve represents the integrated physiological capacity of the cardiovascular system to maintain tissue perfusion during increasing physiological stress. Although reserve has long been recognized conceptually, its direct assessment remains challenging. No universally accepted definition or gold-standard measure of cardiovascular reserve currently exists. Nevertheless, if cardiovascular reserve can be estimated reliably, reserve-based monitoring could permit earlier recognition of impending circulatory deterioration before conventional physiological indicators become abnormal. Among the reserve-monitoring technologies currently under investigation, the Compensatory Reserve Metric (CRM) and the Cardiovascular Reserve Index (CVRI) represent two distinct approaches to estimating remaining cardiovascular reserve. This review examines the physiological basis of reserve-based monitoring, critically evaluates the available experimental and clinical evidence supporting CRM and CVRI, assesses their strengths and limitations and outlines priorities for future research and potential clinical applications. CRM has demonstrated strong performance in experimental haemorrhage models and remains the most extensively studied reserve-monitoring technology in low output conditions. Although evidence supporting CVRI is more limited, findings from cardiopulmonary exercise testing, haemorrhage and heat stress suggest that it may reflect progressive depletion of cardiovascular reserve across diverse forms of circulatory and physiological stress. Although seemingly promising, current evidence remains limited by small clinical cohorts, heterogeneous study designs and limited independent validation.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusely impaired myocardial perfusion in patients with suspected coronary artery disease: Clinical utility of relative perfusion","authors":"Niklas Vartiainen,&nbsp;Antti-Pekka E. Rissanen,&nbsp;Suvi Hartikainen,&nbsp;Svantte Halttunen,&nbsp;Aleksi J. Leikas,&nbsp;Elina Kariniemi,&nbsp;Eero Strengell,&nbsp;Paavo-Ilari Kuikka,&nbsp;Juha E. K. Hartikainen,&nbsp;Tomi P. Laitinen","doi":"10.1111/cpf.70096","DOIUrl":"https://doi.org/10.1111/cpf.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In patients with suspected coronary artery disease (CAD), diffusely impaired hyperaemic myocardial blood flow (MBF) may indicate a multivessel epicardial CAD but also impaired coronary microcirculation. We assessed whether relative hyperaemic MBF—that is, the ratio of the lowest to the highest regional hyperaemic MBF—predicts obstructive CAD in patients with diffusely impaired hyperaemic MBF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 874 patients who underwent coronary computed tomography angiography and [¹⁵O]H₂O myocardial perfusion imaging with positron emission tomography at Kuopio University Hospital, Finland, in 2017–2023. The final analyses included 64 patients who had diffusely impaired hyperaemic MBF and were subsequently referred to invasive coronary angiography (ICA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In ICA, 34/64 (53%) patients had obstructive CAD. Compared to patients with non-obstructive CAD, those with obstructive CAD had lower relative hyperaemic MBF: 66% (95% CI 62–69%) versus 52% (95% CI 47–57%), respectively (<i>p</i> &lt; 0.001). When relative hyperaemic MBF was used to predict the presence of obstructive CAD in ICA, the receiver operating characteristic analysis showed an area under the curve of 0.778 (95% CI 0.666–0.891). In binary logistic regression analysis, relative hyperaemic MBF independently predicted obstructive CAD (OR = 0.92 [95% CI 0.86–0.97], <i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Obstructive CAD is more likely in patients with lower relative hyperaemic MBF. Consequently, relative hyperaemic MBF may have clinical utility in patients with suspected CAD and diffusely impaired hyperaemic MBF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular dysfunction in chronic kidney disease: A feasibility study","authors":"Eli Bok,&nbsp;Natasha Wiebe,&nbsp;Michael D. Nelson,&nbsp;Michael K. Stickland,&nbsp;Aminu K. Bello,&nbsp;Branko Braam,&nbsp;Stephanie E. Thompson","doi":"10.1111/cpf.70092","DOIUrl":"https://doi.org/10.1111/cpf.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Microvascular dysfunction contributes to PAD progression, and its detection may facilitate earlier recognition and risk stratification. People with advanced chronic kidney disease (CKD) have a high burden of PAD, yet early detection is limited by disease-related changes, such as medial calcification. Near-infrared spectroscopy (NIRS) is a candidate microvascular tool for early PAD detection, but its feasibility in CKD is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate NIRS feasibility for assessing lower limb microvascular function in participants with CKD Stage 5 (dialysis and non-dialysis) versus controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using an ischaemic challenge, lower limb reperfusion kinetics of the tibialis anterior were assessed by NIRS in CKD participants and controls. Feasibility was defined as acceptability, technical limitations, interpretability, and safety; a priori analyses examined associations between participant characteristics and feasibility within CKD. NIRS indices were compared with brachial and popliteal hyperaemic velocity–time integral (VTI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight CKD and 20 controls were included. Among CKD participants, 79% of tests were acceptable versus 100% of controls, linked to higher ankle systolic blood pressure and BMI. Interpretability was reduced in 39% of CKD tests, unrelated to these characteristics. Popliteal VTI correlated moderately with NIRS reperfusion time from nadir to baseline (<i>r</i> = −0.64) and hyperemic AUC (<i>r</i> = 0.63); brachial VTI did not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NIRS was feasible when tolerated, but acceptability and interpretability limited its use in advanced CKD. Acceptability, but not interpretability, was limited by markers of vascular severity consistent with a calcified, poorly compressible vasculature. Moderate correlations with popliteal VTI support the potential utility of NIRS in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic cardiovascular changes during reactive hyperemia","authors":"Erislandis López-Galán,&nbsp;Arquímedes Montoya-Pedrón,&nbsp;Rafael Barrio-Deler,&nbsp;Alexander Alexeis Suárez-León,&nbsp;Dania Barzaga-Saborit,&nbsp;Miguel Sánchez-Hechavarría","doi":"10.1111/cpf.70091","DOIUrl":"10.1111/cpf.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The objective of this study was to assess the variations in cardiovascular autonomic modulation during reactive hyperemia in diabetic patients with and without cardiovascular autonomic neuropathy (CAN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study subjects were 35 patients with T2DM without macrovascular complications of diabetes and 40 age and sex matched healthy subjects as the control group. Electrocardiogram and photoplethysmography recordings were performed at rest and during a reactive hyperemia test, which consisted of a 5-min arterial occlusion followed by release. Autonomic nervous system function was evaluated using heart rate variability analysis (time-frequency methods) and the sympathetic skin response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Healthy subjects showed a significant increase in low-frequency (LF) power immediately after vascular release, with an average latency of 339.64 ± 53.86 ms and amplitude of 3467.41 ± 2333.68 ms². In diabetic patients with CAN, the response was faster but less intense (latency: 300.00 ± 20.22 ms, amplitude: 907.15 ± 2688.0 ms²). Diabetic patients without CAN showed a similar latency (300.06 ± 37.64 ms) but the amplitude is overall the lowest (505.73 ± 489.37 ms²).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The reactive hyperemia test reveals an alteration in the temporal dynamics of autonomic activity, as reflected by the low-frequency component in heart rate variability analysis, in diabetic patients. These patients exhibit a reduced response amplitude and a faster or reactive response, especially those with cardiovascular autonomic neuropathy, suggesting altered autonomic modulation that could serve as an early marker of autonomic dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-isotope subtraction scintigraphy and SPECT-CT for preoperative localization of parathyroid adenomas","authors":"Patricia M. Udholm,&nbsp;Christian S. Eriksen,&nbsp;Sabrina H. d'Este,&nbsp;Pernille Bach-Mortensen,&nbsp;Søren Møller","doi":"10.1111/cpf.70089","DOIUrl":"10.1111/cpf.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Primary hyperparathyroidism (PHPT) is often caused by a parathyroid adenoma (PTA). Subtraction scintigraphy with ¹²³I and ^99mTc –MIBI SPECT-CT, and neck ultrasound examination as a hybrid scan (HS) can be used to localize the PTA in order to promote minimally invasive surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated patients referred for HS, the ability of the HS to correctly localize PTA(s), as well as the diagnostic performance of HS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data was retrospectively analyzed for 300 patients with PHPT referred for HS from 2019 to 2023 in a single-centre hospital. We used Begg and Greenes' correction method to calculate diagnostic accuracy, as well as calculated percentage of adenoma(s) correctly localized per patient who underwent PTX or bilateral neck exploration (BNE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 282 patients with PHPT undergoing HS for PTA localization, the HS was positive in 71%. Only 65% of these patients were referred to PTX. Using correction methods, we found a sensitivity and specificity of the HS of 73% and 78%, respectively. The positive predictive value was 99%, while the negative predictive value was 9%. The HS correctly localized PTA in 90% of the patients. Scintigraphy correctly localized 86% of the PTAs, SPECT-CT 85%, and ultrasound 76%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A positive HS was very likely to localize the PTA correctly, whereas a negative HS had limited diagnostic value. Surprisingly, a large proportion of patients undergoing HS were never considered for surgery, resulting in partial reference bias in the evaluation of the diagnostic accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}