Image segmentation
Template:Multiple issues In cardiovascular physiology, ejection fraction (EF) represents the volumetric fraction of blood pumped out of the ventricle (heart) with each heartbeat or cardiac cycle. In finite mathematics allowed by medical imaging, EF is applied to both the right ventricle, which ejects blood via the pulmonary valve into the pulmonary circulation, or the left ventricle, which ejects blood via the aortic valve into the cerebral and systemic circulation.
Imaging of the physiology of the mammalian heart is the art that allows meaningful mathematical expression defining EF. Noninvasive cardiac imaging has become a worldwide utility enabling study of cardiac performance reproducibly and inexpensively. Simplified, Ejection fraction is a mathematical product allowed by cardiac imaging. As a volumetric mathematical term, Ejection Fraction is an extension of the work of Adolph Fick in cardiac output. Dedicated technology such as echocardiography, computed tomography (CT Scan), magnetic resonance imaging (MRI) and Radionuclide angiography (MUGA) scanning have definitively allowed clinically relevant mathematics regarding ischemia, congenital heart disease, and heart failure.
Overview
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By definition, the volume of blood within a ventricle immediately before a contraction is known as the end-diastolic volume (EDV). Likewise, the volume of blood left in a ventricle at the end of contraction is end-systolic volume (ESV). The difference between EDV and ESV represents many variables such as stroke volume (SV). SV describes a dated volumetric of blood ejected from the right and left ventricles with each heartbeat. Ejection fraction (Ef) is the fraction of the end-diastolic volume that is ejected with each beat; that is, it is stroke volume (SV) divided by end-diastolic volume (EDV):[1]
Where the stroke volume is given by:
Normal values
In a healthy Template:Convert man, the SV is approximately 70 mL and the left ventricular EDV is 120 mL, giving an ejection fraction of Template:Frac, or 0.58 (58%).
Right ventricular volumes being roughly equal to those of the left ventricle, the ejection fraction of the right ventricle physiologically matches that of the left ventricle within mathematically narrow beat-to-beat limits.
Healthy individuals typically have ejection fractions between 50% and 65%.[2] However, normal values depend upon the modality being used to calculate the ejection fraction, and some sources consider an ejection fraction of 55–75% to be normal. Damage to the muscle of the heart (myocardium), such as that sustained during myocardial infarction or in atrial fibrillation or a plurality of etiologies of cardiomyopathy, compromises the heart's ability to perform as an efficient pump (ejecting blood) and, therefore, reduces ejection fraction. This reduction in the ejection fraction can manifest itself clinically as heart failure. A low ejection fraction has its cutoff below 40% with symptomatic manifestations constant at 25%.[3] In the USA, a chronically low ejection fraction less than 30% is qualifying support for eligibility of disability benefits from the Social Security Administration.[4]
Healthy older adults favorably adapt as the ventricles become less compliant and are routinely echocardiographically proven to have an EF from 55–85% with the help of good genetics and a healthy lifestyle. Compliance changevolume /changepressure is a property of the heart that allows contractility. Encyclopedic documentation of the commonly documented "Hyperdynamic" ventricle remains sparse.
The ejection fraction is one of the most important predictors of prognosis; those with significantly reduced ejection fractions typically have poorer prognoses. However, recent studies have indicated that a preserved ejection fraction does not mean freedom from risk.[5]Template:Primary source-inline[6]Template:Primary source-inline
The QT interval as recorded on a standard electrocardiogram or "EKG" represents ventricular depolarazation and ventricular repolarazation and is rate-dependent.[7]Template:Primary source-inline
Measurement
Before you choose any particular company it is vital to understand in full how the different plans can vary. There is no other better method than to create a message board so that people can relax and "chill" on your website and check out your articles more. You should read the HostGator review, even before registering with a web hosting company. but Hostgator in addition considers the surroundings. You can even use a Hostgator reseller coupon for unlimited web hosting at HostGator! Most of individuals by no means go for yearly subscription and choose month to month subscription. Several users commented that this was the deciding factor in picking HostGator but in any case there is a 45 day Money Back Guarantee and there is no contract so you can cancel at any time. GatorBill is able to send you an email notice about the new invoice. In certain cases a dedicated server can offer less overhead and a bigger revenue in investments. With the plan come a Free Billing Executive, Free sellers account and Free Hosting Templates.
This is one of the only things that require you to spend a little money to make money. Just go make an account, get a paypal account, and start selling. To go one step beyond just affiliating products and services is to create your own and sell it through your blog. Not great if you really enjoy trying out all the themes. Talking in real time having a real person causes it to be personal helping me personally to sort out how to proceed. The first step I took was search for a discount code, as I did with HostGator. Using a HostGator coupon is a beneficial method to get started. As long as the necessities are able to preserve the horizontal functionality of your site, you would pretty much be fine.
Ejection fraction is commonly measured by echocardiography, in which the volumes of the heart's chambers are measured during the cardiac cycle. Ejection fraction can then be obtained by dividing stroke volume by end-diastolic volume as described above.
Accurate volumetric measurement of performance of the right and left ventricles of the heart is inexpensively and routinely echocardiographically interpreted worldwide as a ratio of dimension between the ventricles in systole and diastole. For example, a ventricle in greatest dimension could measure 6 cm while in least dimension 4 cm. Measured and easily reproduced beat to beat for ten or more cycles, this ratio may represent a physiologically normal EF of 50-60%. Mathematical expression of this Time-dependent ratio can then be interpreted as the greater half as cardiac output and the lesser half as cardiac input.
Other methods of measuring ejection fraction include cardiac MRI, fast-scan cardiac computed axial tomography (CT) imaging, ventriculography, Gated SPECT, and the MUGA scan. A MUGA scan involves the injection of a radioisotope into the blood and detecting its flow through the left ventricle. The historical gold standard for the measurement of ejection fraction is ventriculography.
Improving EF
Depending on the burden of systolic heart failure, a physician may make recommendations to help improve EF. Medication for systolic heart failure is commonly prescribed under several ongoing protocols. Other things that could be done to improve how well the heart pumps include: Limiting Salt – Limiting salt (sodium) to 2,000 mg a day is an important part of maintaining a healthy heart and treating heart failure. With a low EF, the kidneys get less blood than they should. This makes them unable to rid the body of excess water and salt. Eating too much salt can lead to even more fluid buildup. It also increases blood pressure, which makes an already-weakened heart work harder.[8] Fluid Management – With a low EF, blood can back up in the lungs and force fluid into the breathing spaces. The fluid then builds up, making it difficult to breathe. Excess fluid can also cause weight gain and swelling. Depending on the EF, a doctor may limit the amount of daily fluid intake. Physical Activity – Exercise can help strengthen the heart and improve how well it pumps blood to the rest of the body. All it takes is 30 minutes a day of activity, even if that activity is walking. It is always recommended that patients consult their doctors about an exercise program that is right for them.[9]
Treating Low EF
Many people having survived a heart attack can benefit from a medical device called an implantable cardiac defibrillator (ICD). An ICD is a pacemaker-like device that treats ventricular fibrillation (VF), the deadly heart rhythm that causes sudden cardiac arrest (SCA).[10] Several large clinical studies have been conducted in recent years to see whether ICDs could help prevent SCA in those people whose heart muscle, and its pumping ability, is damaged by a heart attack. People in the studies had an ejection fraction (EF) of 40 or below.[10] In these studies, survival rates were significantly higher for people with ICDs compared to those that received traditional medical care.[10]
Medication Intervention
Certain medications help reduce the heart's workload, increase blood flow, widen vessels or eliminate excess water from the body, all of which may help treating low ejection fraction. Prescribed medications may include:
- Inotropes (such as digoxin): Helps the heart to contract more vigorously and effectively, and helps to reduce symptoms.[11]
- Angiotensin II receptor blockers: Similar to ACE inhibitors, these medications reduce the stress on the heart muscle and may benefit patients with diabetes and heart disease. The medication protects the kidneys from diabetes-related complications.[11]
- Betablockers: These medications may improve symptoms by slowing the heart's contraction rate and reducing its pumping action, thus lessening the heart's workload.[11]
See also
References
43 year old Petroleum Engineer Harry from Deep River, usually spends time with hobbies and interests like renting movies, property developers in singapore new condominium and vehicle racing. Constantly enjoys going to destinations like Camino Real de Tierra Adentro.
Template:Cardiovascular physiology
- ↑ Morton Kern 5th edition page 180
- ↑ 20 year-old Real Estate Agent Rusty from Saint-Paul, has hobbies and interests which includes monopoly, property developers in singapore and poker. Will soon undertake a contiki trip that may include going to the Lower Valley of the Omo.
My blog: http://www.primaboinca.com/view_profile.php?userid=5889534 - ↑ Template:Cite web
- ↑ Template:Cite web
- ↑ One of the biggest reasons investing in a Singapore new launch is an effective things is as a result of it is doable to be lent massive quantities of money at very low interest rates that you should utilize to purchase it. Then, if property values continue to go up, then you'll get a really high return on funding (ROI). Simply make sure you purchase one of the higher properties, reminiscent of the ones at Fernvale the Riverbank or any Singapore landed property Get Earnings by means of Renting
In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang
Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules
Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.
A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running
The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more
There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang - ↑ One of the biggest reasons investing in a Singapore new launch is an effective things is as a result of it is doable to be lent massive quantities of money at very low interest rates that you should utilize to purchase it. Then, if property values continue to go up, then you'll get a really high return on funding (ROI). Simply make sure you purchase one of the higher properties, reminiscent of the ones at Fernvale the Riverbank or any Singapore landed property Get Earnings by means of Renting
In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang
Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules
Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.
A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running
The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more
There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang - ↑ One of the biggest reasons investing in a Singapore new launch is an effective things is as a result of it is doable to be lent massive quantities of money at very low interest rates that you should utilize to purchase it. Then, if property values continue to go up, then you'll get a really high return on funding (ROI). Simply make sure you purchase one of the higher properties, reminiscent of the ones at Fernvale the Riverbank or any Singapore landed property Get Earnings by means of Renting
In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang
Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules
Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.
A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running
The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more
There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang - ↑ "Heart failure with preserved ejection fraction: is this diastolic heart failure?". Retrieved February 16, 2012.
- ↑ Template:Cite web
- ↑ 10.0 10.1 10.2 http://www.medterms.com/script/main/art.asp?articlekey=7520
- ↑ 11.0 11.1 11.2 http://www.cpmc.org/services/heart/tx/ejtreatment.html