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    <title>Ursem, N.T.C.</title>
    <link>http://repub.eur.nl/res/aut/873/</link>
    <description>List of Publications</description>
    <language>en</language>
    <image>
      <url>http://repub.eur.nl/static-eur/img/logo.png</url>
      <title>RePub, Erasmus University Rotterdam</title>
      <link>http://repub.eur.nl</link>
    </image>
    <item>
      <title>The effects of homocysteine and folic acid on angiogenesis and VEGF expression during chicken vascular development (Article)</title>
      <link>http://repub.eur.nl/res/pub/37878/</link>
      <pubDate>2012-03-01T00:00:00Z</pubDate>
      <description>Homocysteine (Hcy) has been implicated in the development of cardiovascular developmental defects. Additionally, in experimental studies, vasculotoxic properties of Hcy have been described. Although Hcy has been identified as a vascular pathogen, little is known about the direct effects Hcy exerts during early embryonic vascular development. Angiogenesis is a critical process involved in embryo survival and development. There are limited studies on the effects of Hcy on early embryonic vasculogenesis and angiogenesis. Folic acid (FA) is a B vitamin essential in embryo development, and FA supplementation may lead to reduced Hcy levels. Therefore, the purpose of our study was to explore the effects of Hcy and FA on early embryonic vascular development. Embryonic day (E) 3.5 chicken embryos were treated with a sham, Hcy or FA solution. We developed a computational program for systematic analysis of microscopic images obtained from the extra embryonic vascular beds. These results were combined with real-time PCR data on the expression of VEGF-A and its receptor in these vascular beds.Our data show that Hcy exposure inhibits early vascular development, displayed by a significant reduction of vessel area and altered composition of the vascular beds. Vascular beds of Hcy embryos for the greater part consisted of vessels of the smallest diameters, compared to middle size vessels in control and FA embryos. Hcy also reduced expression of VEGF-A and VEGFR-2. No significant effects of FA were found.We conclude that Hcy exposure causes impaired early extra embryonic vascular development, shown by altered composition of the vascular beds as well as reduced expression of VEGF-A and VEGFR-2. These effects of Hcy, and the consecutive cascade of events, may be involved in the development of cardiovascular developmental defects. </description>
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      <title>Multiple reaction monitoring assay for pre-eclampsia related calcyclin peptides in formalin fixed paraffin embedded placenta (Article)</title>
      <link>http://repub.eur.nl/res/pub/34487/</link>
      <pubDate>2011-07-01T00:00:00Z</pubDate>
      <description>Although the cause of pre-eclampsia during pregnancy has not been elucidated yet, it is evident that placental and maternal endothelial dysfunction is involved. We previously demonstrated that in early onset pre-eclampsia placental calcyclin (S100A6) expression is significantly higher compared to controls (De Groot, C. J.; Clin. Proteomics 2007, 1, 325). In the current study, the results were confirmed and relatively quantified by using multiple reaction monitoring (MRM) on two peptide fragments of calcyclin. Cells were obtained from control (n = 5) and pre-eclamptic placental (n = 5) tissue collected by laser capture microdissection from formalin-fixed paraffin-embedded (FFPE) material treated with a solution to reverse formalin fixation. Two calcyclin peptides with an extra glycine inserted in the middle of the amino acid sequence were synthesized and used as an internal reference. Data presented show that MRM on laser microdissected material from FFPE tissue material is possible. The developed MRM assay to study quantitative levels of proteins in FFPE laser microdissected cells using nonisotopic-labeled chemical analogs of mass tagged internal references showed that in pre-eclamptic patients elevated levels of calcyclin is observed in placental trophoblast cells compared to normal trophoblast cells. By immunohistochemistry, we were able to confirm this observation in a qualitative manner. </description>
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      <title>Proteomic analyses of the developing chicken cardiovascular system (Article)</title>
      <link>http://repub.eur.nl/res/pub/32775/</link>
      <pubDate>2010-01-04T00:00:00Z</pubDate>
      <description>Up until today, no proteomics approaches have been described for heart muscle development. We describe a proteomics method to study the proteome of different heart structures at three stages of chicken embryonic development. For this purpose, a combination of gel separation, nanoLC separation and mass spectrometry was used. With this method, we identified in total 267 proteins in different tissue structures of chicken heart. We observed differences in protein abundance for a number of proteins between the different tissue structures and time points of development using spectral counting as a semiquantitative measure of protein abundance. For myosin-heavy chain 6, myosin-heavy chain 7, titin, connectin, collagen alpha-1, and xin, differences in protein levels for the different stages and structures (great arteries, outflow tract and ventricles) have been observed. A pathway analysis is performed in which the identified proteins are related to theoretical protein networks. Most prominent was the 'cardiovascular system development and function' network with the abundantly present proteins myosin 6 and myosin 7. We showed that myosin 6 is highly regulated in a stage and heart tissue specific manner. In conclusion, this method can be used to study changes in protein levels of chicken heart tissue in a spatiotemporal manner. </description>
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      <title>Doppler flow velocity waveforms in the embryonic chicken heart at developmental stages corresponding to 5-8 weeks of human gestation (Article)</title>
      <link>http://repub.eur.nl/res/pub/24129/</link>
      <pubDate>2009-06-01T00:00:00Z</pubDate>
      <description>Objectives: To obtain Doppler velocity waveforms from the early embryonic chicken heart by means of ultrasound biomicroscopy and to compare these waveforms at different stages of embryonic development. Methods: We collected cardiac waveforms using high-frequency Doppler ultrasound with a 55-MHz transducer at Hamburger-Hamilton (HH) stages 18, 21 and 23, which are comparable to humans at 5 to 8 weeks of gestation. Waveforms were obtained at the inflow tract, the primitive left ventricle, the primitive right ventricle and at the outflow tract in 10 different embryos per stage. M-mode recordings were collected to study opening and closure of the cushions. By exploring the temporal relationship between the waveforms, using a secondary Doppler device, cardiac cycle events were outlined. Results: Our results demonstrate that stage- and location-dependent intracardiac blood flow velocity waveforms can be obtained in the chicken embryo. The blood flow profiles assessed at the four locations in the embryonic heart demonstrated an increase in peak velocity with advancing developmental stage. In the primitive ventricle the 'passive' (P) filling peak decreased whereas the 'active' (A) filling peak increased, resulting in a decrease in P to A ratio with advancing developmental stage. M-mode recordings demonstrated that the fractional closure time of the atrioventricular cushions increased from 20% at stage HH 18 to 60% at stage HH 23. Conclusion: High-frequency ultrasound biomicroscopy can be used to define flow velocity waveforms in the embryonic chicken heart. This may contribute to an understanding of Doppler signals derived from valveless embryonic human hearts at 5 to 8 weeks of gestation, prior to septation. Copyright </description>
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      <title>Polymorphisms in genes related to folate and cobalamin metabolism and the associations with complex birth defects (Article)</title>
      <link>http://repub.eur.nl/res/pub/29395/</link>
      <pubDate>2008-06-01T00:00:00Z</pubDate>
      <description>Objective: To investigate the associations between biomarkers and genetic variants involved in homocysteine metabolism and the risk of complex birth defects. Methods: Total homocysteine (tHcy), folate, cobalamin, apo-transcobalamin (apo-TC) and apo-haptocorrin (apo-HC) were measured in the amniotic fluid of 82 women who were pregnant with a child having a complex birth defect, such as neural tube defect, cleft lip and/or palate, heart defect or omphalocele, and in 110 women pregnant with a non-malformed child. The determined genotypes of the child comprised of 5, 10-methylenetetrahydrofolate reductase (MTHFR 677C&gt;T, 1298A&gt;C), methionine synthase (MTR 2756A&gt;G), methionine synthase reductase (MTRR 66A&gt;G) and transcobalamin (TCN2 776C&gt;G). Univariate and multivariate logistic regression analyses were performed. Results: Significantly lower cobalamin and higher apo-TC, apo-HC, tHcy and folate concentrations were determined in amniotic fluids of cases compared with controls (p ≤ 0.001). Logistic regression analysis revealed that after adjustment for maternal age, children carrying the MTHFR 677T allele showed a four-fold increased risk of having a complex birth defect, OR (95% CI) = 4.0 (1.1-15.4). Other genotypes did not show significant associations. Conclusion: The MTHFR 677C&gt;T polymorphism in conjunction with reduced folate- and/or cobalamin status may increase the risk of complex birth defects. Copyright </description>
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      <title>Large variations in absolute wall shear stress levels within one species and between species (Article)</title>
      <link>http://repub.eur.nl/res/pub/35054/</link>
      <pubDate>2007-12-01T00:00:00Z</pubDate>
      <description>Wall shear stress (WSS), the frictional force between blood and endothelium, is an important determinant of vascular function. It is generally assumed that WSS remains constant at a reference value of 15 dyn/cm2. In a study of small rodents, we realized that this assumption could not be valid. This review presents an overview of recent studies in large and small animals where shear stress was measured, derived from velocity measurements or otherwise, in large vessels. The data show that large variations exist within a single species (human: variation of 2-16 N/m2). Moreover, when we compared different species at the same location within the arterial tree, an inverse relationship between animal size and wall shear stress was noted. When we related WSS to diameter, a unique relationship was derived for all species studied. This relationship could not be described by the well-known r3law of Murray, but by the r2law introduced by Zamir et al. in 1972. In summary, by comparing data from the literature, we have shown that: (i) the assumption of a physiological WSS level of ∼15 dyn/cm2for all straight vessels in the arterial tree is incorrect; (ii) WSS is not constant throughout the vascular tree; (iii) WSS varies between species; (iv) WSS is inversely related to the vessel diameter. These data support an "r2law" rather than Murray's r3law for the larger vessels in the arterial tree. </description>
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      <title>The endothelin-1 pathway and the development of cardiovascular defects in the haemodynamically challenged chicken embryo (Article)</title>
      <link>http://repub.eur.nl/res/pub/36543/</link>
      <pubDate>2007-12-01T00:00:00Z</pubDate>
      <description>Background/Aims: Ligating the right lateral vitelline vein of chicken embryos (venous clip) results in cardiovascular malformations. These abnormalities are similar to malformations observed in knockout mice studies of components of the endothelin-1 (ET-1)/endothelin-converting enzyme-1/endothelin- A receptor pathway. In previous studies we demonstrated that cardiac ET-1 expression is decreased 3 h after clipping, and ventricular diastolic filling is disturbed after 2 days. Therefore, we hypothesise that ET-1-related processes are involved in the development of functional and morphological cardiovascular defects after venous clip. Methods: In this study, ET-1 and endothelin receptor antagonists (BQ-123, BQ-788 and PD145065) were infused into the HH18 embryonic circulation. Immediate haemodynamic effects on the embryonic heart and extra-embryonic vitelline veins were examined by Doppler and micro-particle image velocimetry. Ventricular diastolic filling characteristics were studied at HH24, followed by cardiovascular morphologic investigation (HH35). Results: ET-1 and its receptor antagonists induced haemodynamic effects at HH18. At HH24, a reduced diastolic ventricular passive filling component was demonstrated, which was compensated by an increased active filling component. Thinner ventricular myocardium was shown in 42% of experimental embryos. Conclusion: We conclude that cardiovascular malformations after venous clipping arise from a combination of haemodynamic changes and altered gene expression patterns and levels, including those of the endothelin pathway. Copyright </description>
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      <title>Complex congenital malformations and the impact of the plasminogen activator system and β-hCG in amniotic fluid (Article)</title>
      <link>http://repub.eur.nl/res/pub/36009/</link>
      <pubDate>2007-11-01T00:00:00Z</pubDate>
      <description>Objective: The plasminogen activator system and β-hCG may affect neural crest cells and angiogenesis, and thereby embryogenesis. Therefore, we investigated these parameters in amniotic fluids of pregnancies with a complex congenital malformation. Study design: In a case-control study amniotic fluid samples were collected from 62 pregnancies with a complex congenital malformation and from 110 healthy control pregnancies at an obstetric department of a large university hospital in the Netherlands. We determined concentrations of tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), plasminogen activator inhibitors (PAI-1, PAI-2), tPA∼PAI-1 and uPA∼PAI-1 complexes, and β-hCG with enzyme-linked immunosorbent assays. Mann-Whitney U-tests and analysis of covariance, adjusting for gestational and maternal age, were performed for data comparisons. Results: Compared with controls, cases demonstrated significantly lower adjusted geometric mean levels of uPA (24%), tPA (≥19%) and tPA∼PAI-1 (35%). Cases showed significantly higher adjusted mean levels of β-hCG (≥48%) and PAI-2 (10 ng/mL) than controls. Mean PAI-1 and uPA∼PAI-1 levels were comparable between both groups. Conclusions: Disturbances in the plasminogen activator system and β-hCG levels are suggested to be involved in the pathogenesis of complex congenital malformations by affecting neural crest cell migration and angiogenesis. </description>
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      <title>Systolic and diastolic ventricular function in the normal and extra-embryonic venous clipped chicken embryo of stage 24: A pressure-volume loop assessment (Article)</title>
      <link>http://repub.eur.nl/res/pub/36411/</link>
      <pubDate>2007-09-01T00:00:00Z</pubDate>
      <description>Objectives: Fluid mechanical forces affect cardiac development. In the chicken embryo, permanent obstruction of the right lateral vitelline vein by clipping reduces the mechanical load on the embryonic myocardium, which has been shown to induce a spectrum of outflow tract anomalies. Insight into the effects of this intervention on the mechanical function of the developing myocardium could contribute to a better understanding of the relationship between hemodynamics and cardiac morphogenesis. We aimed to explore the effects of clipping on intrinsic systolic and diastolic ventricular function at stage 24 in the chicken embryo. Methods: Cardiac pressure-volume relationships enable load-independent quantification of intrinsic ventricular systolic and diastolic properties. We determined ventricular function by pressure-volume loop analysis of in-ovo stage-24 chicken embryos (n = 15) 2 days after venous obstruction at 2.5 days of incubation (stage 17, venous clipped embryos). Control embryos (n = 15) were used for comparison. Results: End-systolic volume was significantly higher in clipped embryos (0.36 ± 0.02 μL vs. 0.29 ± 0.02 μL, P = 0.002). End-systolic and end-diastolic pressure were also increased compared with control animals (2.93 ± 0.07 mmHg vs. 2.70 ± 0.08 mmHg, P = 0.036 and 1.15 ± 0.06 mmHg vs. 0.82 ± 0.05 mmHg, P &lt; 0.001, respectively). No significant differences were demonstrated for other baseline hemodynamic parameters. Analysis of pressure-volume relationships showed a significantly lower end-systolic elastance in the clipped embryos (slope of end-systolic pressure-volume relationship: 2.91 ± 0.24 mmHg/μL vs. 7.53 ± 0.66 mmHg/μL, P &lt; 0.005) indicating reduced contractility. Diastolic stiffness was significantly increased in the clipped embryos (slope of end-diastolic pressure-volume relationship: 1.54 ± 0.21 vs. 0.60 ± 0.08, P &lt; 0.005), indicating reduced compliance. Conclusion: Venous obstruction apparently interferes with normal myocardial development, resulting in impaired intrinsic systolic and diastolic ventricular function. These changes in ventricular function may precede morphological derangements observed in later developmental stages. Copyright </description>
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      <title>Validation of the assessment of folate and vitamin B12 intake in women of reproductive age: The method of triads (Article)</title>
      <link>http://repub.eur.nl/res/pub/36470/</link>
      <pubDate>2007-05-01T00:00:00Z</pubDate>
      <description>Objective: To validate the folate and vitamin B12intakes estimated by a food-frequency questionnaire (FFQ) designed to be used in a case-control study on the association between maternal dietary intake and the risk of having a child with a congenital heart defect. Design and subjects: The FFQ was filled out by 53 women of reproductive age. Immediately thereafter, blood samples were taken to determine serum folate, red blood cell (RBC) folate and serum vitamin B12concentrations. Subsequently, three dietary 24-h recalls (24HR) were completed during a period of three successive weeks and used as a reference method. The recalls comprised two weekdays and one weekend day. Using the method of triads, validity coefficients were calculated by comparing nutrient intakes derived from the FFQ and 24HR with the corresponding nutritional biomarkers in blood. The validity coefficient is the correlation between the dietary intake reported by the FFQ and the unknown 'true' dietary intake. Results: The comparison of B-vitaminin takes reported by the FFQ and the mean of the 24HR revealed deattenuated correlation coefficients of 0.98 for folate and 0.66 for vitamin B12. The correlation coefficients between the B-vitamin intakes estimated by the FFQ and concentrations of serum folate, RBC folate and serum vitamin B12were 0.20, 0.28 and 0.21, respectively. The validity coefficients for serum folate, RBC folate and serum vitamin B12were 0.94, 0.75 and 1.00, respectively. The estimated folate and vitamin B12intakes were comparable with the results of the most recent Dutch food consumption survey. Conclusions: The adapted FFQ is a reliable tool to estimate the dietary intake of energy, macronutrients, folate and vitamin B12in women of reproductive age. Therefore, this FFQ is suitable for the investigation of nutrient-disease associations in future.</description>
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      <title>Hyperhomocysteinemia and MTHFR polymorphisms in association with orofacial clefts and congenital heart defects: A meta-analysis (Article)</title>
      <link>http://repub.eur.nl/res/pub/37025/</link>
      <pubDate>2007-05-01T00:00:00Z</pubDate>
      <description>Several studies have reported an association between hyperhomocysteinemia, 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphisms and cleft lip with or without cleft palate (CLP), and congenital heart defects (CHDs). However, findings have been inconsistent. A meta-analysis was performed of published studies until September 2006 investigating these associations in both mothers and children. Homocysteine data were provided in two CLP and three CHD studies, and MTHFR polymorphisms were reported in ten CLP and eight CHD studies. Data were analyzed using the random effects model in the Cochrane Review Manager. The pooled odds ratio (OR) of maternal hyperhomocysteinemia was 2.3 (95% CI 0.4-11.9) for CLP, and 4.4 (2.6-7.3) for CHDs. The MTHFR C677T polymorphism and CLP showed pooled ORs of 1.2 (0.9-1.5) in mothers and 1.0 (0.9-1.2) in children, whereas these estimates for the A1298C polymorphism were 1.0 (0.7-1.2) in mothers and 0.9 (0.6-1.2) in children. The MTHFR C677T polymorphism in CHD studies demonstrated a pooled OR of 1.0 (0.8-1.3) for mothers and 1.1 (0.9-1.5) for children. Two studies investigating the maternal A1298C polymorphism in CHDs demonstrated a pooled OR of 1.2 (0.8-1.8). Only one CHD study reported an OR of 1.3 (0.8-2.1) for this polymorphism in children. In conclusion, this meta-analysis demonstrates that maternal hyperhomocysteinemia is a risk factor for CHDs. The MTHFR polymorphisms C677T and A1298C in both mothers and children are not independently associated with CLP or CHDs. Future studies should be performed to investigate the interactions between maternal hyperhomocysteinemia, B-vitamin intake, related polymorphisms and the risk of CLP and CHDs. </description>
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      <title>Systolic and diastolic ventricular function assessed by pressure-volume loops in the stage 21 venous clipped chick embryo. (Article)</title>
      <link>http://repub.eur.nl/res/pub/13550/</link>
      <pubDate>2005-01-01T00:00:00Z</pubDate>
      <description>Cardiac pressure-volume relations enable quantification of intrinsic
      ventricular diastolic and systolic properties independent of loading
      conditions. The use of pressure-volume loop analysis in early stages of
      development could contribute to a better understanding of the relationship
      between hemodynamics and cardiac morphogenesis. The venous clip model is
      an intervention model for the chick embryo in which permanent obstruction
      of the right lateral vitelline vein temporarily reduces the mechanical
      load on the embryonic myocardium and induces a spectrum of outflow tract
      anomalies. We used pressure-volume loop analysis of the embryonic chick
      heart at stage 21 (3.5 d of incubation) to investigate whether the
      development of ventricular function is affected by venous clipping at
      stage 17, compared with normal control embryos. Steady state hemodynamic
      parameters demonstrated no significant differences between the venous
      clipped and control embryos. However, analysis of pressure-volume
      relations showed a significantly lower end-systolic elastance in the
      clipped embryos (slope of the end-systolic pressure-volume relation: 5.68
      +/- 0.85 versus 11.76 +/- 2.70 mm Hg/microL, p &lt; 0.05), indicating reduced
      contractility. Diastolic stiffness tended to be increased in the clipped
      embryos (slope of end-diastolic pressure-volume relation: 2.74 +/- 0.56
      versus 1.67 +/- 0.21, p = 0.103), but the difference did not reach
      statistical significance. The results of the pressure-volume loop analysis
      show that 1 d after venous obstruction, development of ventricular
      function is affected, with reduced contractility. Pressure-volume analysis
      may be applied in the chick embryo and is a sensitive technique to detect
      subtle alterations in ventricular function.</description>
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      <title>Ventricular diastolic filling characteristics in stage-24 chick embryos after extra-embryonic venous obstruction (Article)</title>
      <link>http://repub.eur.nl/res/pub/8402/</link>
      <pubDate>2004-01-01T00:00:00Z</pubDate>
      <description>Alteration of extra-embryonic venous blood flow in stage-17 chick embryos
      results in well-defined cardiovascular malformations. We hypothesize that
      the decreased dorsal aortic blood volume flow observed after venous
      obstruction results in altered ventricular diastolic function in stage-24
      chick embryos. A microclip was placed at the right lateral vitelline vein
      in a stage-17 (52-64 h of incubation) chick embryo. At stage 24 (4.5 days
      of incubation), we measured simultaneously dorsal aortic and
      atrioventricular blood flow velocities with a 20-MHz pulsed-Doppler
      velocity meter. The fraction of passive and active filling was integrated
      and multiplied by dorsal aortic blood flow to obtain the relative passive
      and active ventricular filling volumes. Data were summarized as means +/-
      S.E.M. and analyzed by t-test. At similar cycle lengths ranging from 557
      ms to 635 ms (P&gt;0.60), dorsal aortic blood flow and stroke volume measured
      in the dorsal aorta were similar in stage-24 clipped and normal embryos.
      Passive filling volume (0.07+/-0.01 mm(3)) was decreased, and active
      filling volume (0.40+/-0.02 mm(3)) was increased in the clipped embryo
      when compared with the normal embryo (0.15+/-0.01 mm(3), 0.30+/-0.01
      mm(3), respectively) (P&lt;0.003). In the clipped embryos, the passive/active
      ratio was decreased compared with that in normal embryos (P&lt;0.001).
      Ventricular filling components changed after partially obstructing the
      extra-embryonic venous circulation. These results suggest that material
      properties of the embryonic ventricle are modified after temporarily
      reduced hemodynamic load.</description>
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      <title>Acutely altered hemodynamics following venous obstruction in the early chick embryo (Article)</title>
      <link>http://repub.eur.nl/res/pub/8403/</link>
      <pubDate>2003-01-01T00:00:00Z</pubDate>
      <description>In the venous clip model specific cardiac malformations are induced in the
      chick embryo by obstructing the right lateral vitelline vein with a
      microclip. Clipping alters venous return and intracardiac laminar blood
      flow patterns, with secondary effects on the mechanical load of the
      embryonic myocardium. We investigated the instantaneous effects of
      clipping the right lateral vitelline vein on hemodynamics in the stage-17
      chick embryo. 32 chick embryos HH 17 were subdivided into venous clipped
      (N=16) and matched control embryos (N=16). Dorsal aortic blood flow
      velocity was measured with a 20 MHz pulsed Doppler meter. A time series of
      eight successive measurements per embryo was made starting just before
      clipping and ending 5h after clipping. Heart rate, peak systolic velocity,
      time-averaged velocity, peak blood flow, mean blood flow, peak
      acceleration and stroke volume were determined. All hemodynamic parameters
      decreased acutely after venous clipping and only three out of seven
      parameters (heart rate, time-averaged velocity and mean blood flow) showed
      a recovery to baseline values during the 5h study period. We conclude that
      the experimental alteration of venous return has major acute effects on
      hemodynamics in the chick embryo. These effects may be responsible for the
      observed cardiac malformations after clipping.</description>
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      <title>Heart Rate and Blood Flow Velocity Variability in the Human Fetus (Doctoral Thesis)</title>
      <link>http://repub.eur.nl/res/pub/19778/</link>
      <pubDate>1999-03-31T00:00:00Z</pubDate>
      <description>Much of what we know about the embryonic circulation Is derived from studies of
the chick embryo (Clark and Hu 1982). The similarities between the chick, rat
(Nakazawa 1988) and fetal lamb (Kirkpatrick 1976) suggest that, while the
details of functional change may vary, common mechanisms are expressed In
these animal groups (Nakazawa 1988). Some of the mechanisms that control the
cardiovascular system in the mature animal are expressed early In development
(Clark 1990). The primary determinants of cardiovascular function in the embryo
as in the mature animal are preload, afterload, heart rate and myocardial
contractility. These factors regulate cardiac output before the development of the
functioning autonomic nervous system. The Frank-Starling relationship Is
operative and effective in both the fetal lamb heart (Kirkpatrick 1976) and the
chick embryo (Wagman 1990). After maturation of the autonomic nervous
system, both the parasympathetic and sympathetic systems control
cardiovascular function in the fetal lamb (Nuwayhid 1975).</description>
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