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2012, Number 3

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CorSalud 2012; 4 (3)

Echocardiographic variables for noninvasive assessment of pulmonary hemodynamics

Pérez CD, Alonso HA, Gómez GY, Novo CLE, Cruz EJM

Language: Spanish
References: 90
Page: 201-215
PDF size: 618.33 Kb.


ABSTRACT

The assessment of pulmonary hemodynamics depends on many clinical situations because the pulmonary vascular tree may be affected by various physiological and pathological circumstances. The gold test for assessing these parameters is the right heart catheterization, but its use cannot be routinely justified. Imaging techniques, especiallye chocardiography, have developed rapidly and allow for a full and approximate description, as well as the magnitude of the impact of these parameters on the heart. There are several echo-cardiographic indexes that are of particular interest in the assessment of pulmonary hemodynamics, and multiple variables should be analyzed to ensure proper interpretation of results and an accurate echocardiographic diagnosis. This article presents a review of the different echocardiographic variables involved in assessing pulmonary hemodynamics and their application in the clinical setting.


REFERENCES

  1. Badesch DB, Champion HC, Sanchez MA, Hoeper MM, Loyd JE, Manes A, et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S55-66.

  2. McGoon M, Gutterman D, Steen V, Barst R, Mc-Crory DC, Fortin TA, et al. Screening, early detec-tion, and diagnosis of pulmonary arterial hyperten-sion: ACCP evidence-based clinical practice guide-lines. Chest. 2004;126 (1 Suppl):14S-34S.

  3. McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 expert consensus document on pulmonary hyper-tension a report of the American College of Cardio-logy Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53:1573-619.

  4. Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hyperten-sion.The task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009;34:1219-63.

  5. Lee KS, Abbas AE, Khandheria BK, Lester SJ. Echocardiographic assessment of right heart hemo-dynamic parameters. J Am Soc Echocardiogr. 2007; 20(6):773-82.

  6. Mori S, Nakatani S, Kanzaki H, Yamagata K, Take Y, Matsuura Y, et al. Patterns of the interventricular septal motion can predict conditions of patients with pulmonary hypertension. J Am Soc Echocardiogr. 2008;21(4):386-93.

  7. Horton KD, Meece RW, Hill JC. Assessment of the right ventricle by echocardiography: a primer for cardiac sonographers. J Am Soc Echocardiogr. 2009;22:776-92.

  8. Champion HC, Michelakis ED, Hassoun PM. Com-prehensive invasive and noninvasive approach to the right ventricle-pulmonary circulation unit: state of the art and clinical and research implications. Circu-lation. 2009;120(11):992-1007.

  9. Ristow B, Schiller NB. Stepping away from ritual right heart catheterization into the era of noninva- sively measured pulmonary artery pressure.J Am Soc Echocardiogr 2009;22(7):820-2.

  10. Hatle L, Angelsen BA, Tromsdal A. Non-invasive estimation of pulmonary artery systolic pressure with Doppler ultrasound. Br Heart J. 1981;45(2): 157-65.

  11. Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation.Circulation. 1984;70 (4):657-62.

  12. Berger M, Haimowitz A, Van Tosh A, Berdoff RL, Goldberg E. Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol. 1985;6(2):359-65.

  13. Currie PJ, Seward JB, Chan KL, Fyfe DA, Hagler DJ, Mair DD, et al. Continuous wave Doppler deter-mination of right ventricular pressure: a simulta-neous Doppler-catheterization study in 127 patients. J Am Coll Cardiol. 1985;6(4):750-6.

  14. Skjaerpe T, Hatle L. Noninvasive estimation of sys-tolic pressure in the right ventricle in patients with tricuspid regurgitation. Eur Heart J. 1986;7(8):704-10.

  15. Fisher MR, Forfia PR, Chamera E, Housten-Harris T, Champion HC,Girgis RE, et al. Accuracy of Dop-pler echocardiography in the hemodynamic assess-ment of pulmonary hypertension. Am J Respir Crit Care Med. 2009;179(7):615-21.

  16. Simonneau G, Robbins IM, Beghetti M, Channick RN, Delcroix M, Denton CP, et al. Updated clinical classification of pulmonary hypertension.J Am Coll Cardiol. 2009;54 (1 Suppl):S43-54.

  17. McQuillan BM, Picard MH, Leavitt M, Weyman AE. Clinical correlates and reference intervals for pulmo-nary artery systolic pressure among echocardiogra-phically normal subjects. Circulation 2001;104(23): 2797-802.

  18. Lopes LR, Loureiro MJ, Miranda R, Almeida S, Al-meida AR, Cordeiro A, Cotrim C, Carrageta M. The usefulness of contrast during exercise echocardio-graphy for the assessment of systolic pulmonary pressure. Cardiovasc Ultrasound. 200813;6:51.

  19. Jeon DS, Luo H, Iwami T, Miyamoto T, Brasch AV, Mirocha J, et al. The usefulness of a 10% air-10% blood-80% saline mixture for contrast echocardio-graphy: Doppler measurement of pulmonary artery systolic pressure. J Am Coll Cardiol. 2002;39(8) (1):124-9.

  20. Jeon DS, Luo H, Brasch AV, Nagai T, Miyamoto T, Mohsenifar Z, et al. Superiority of 10% air-10% blood-saline mixture for measuring the velocity of tricuspid regurgitation in patients with severe em-physema. J Am Soc Echocardiogr. 2003;16(8):867-70.

  21. Tan HC, Fung KC, Kritharides L. Agitated colloid is superior to saline and equivalent to levovist in en-hancing tricuspid regurgitation Doppler envelope and in the opacification of right heart chambers: a quantitative, qualitative, and cost-effectiveness stu-dy. J Am Soc Echocardiogr. 2002;15(4):309-15.

  22. Tokushima T, Utsunomiya T, Yoshida K, Ogawa T, Kido K, Ohtsubo Y, et al. Estimation of the systolic pulmonary arterial pressure using contrast-enhanced continuous-wave Doppler in patients with trivial tricuspid regurgitation. Jpn Heart J. 1999; 40(3):311-20.

  23. Aduen JF, Castello R, Lozano MM, Hepler GN, Ke-ller CA, Alvarez F, et al. An alternative echocardio-graphic method to estimate mean pulmonary artery pressure: diagnostic and clinical implications. J Am Soc Echocardiogr. 2009;22(7):814-9.

  24. Ristow B, Schiller NB. Stepping away from ritual right heart catheterization into the era of noninvasively measured pulmonary artery pressure. J Am Soc Echocardiogr 2009;22(7):820-2.

  25. Beard JT, Byrd BF. Saline contrast enhancement of trivial Doppler tricuspid regurgitation signals for es-timating pulmonary artery pressure. Am J Cardiol. 1988;62(7):486-8.

  26. Bréchot N, Gambotti L, Lafitte S, Roudaut R. Usefulness of right ventricular isovolumic relaxation time in predicting systolic pulmonary artery pressure. Eur J Echocardiogr. 2008;9(4):547-54.

  27. Lindqvist P, Waldenstrom A, Wikstrom G, Kazzam E. Right ventricular myocardial isovolumic relaxation time and pulmonary pressure: pulsed Doppler tissue imaging in resurrection of Burstin’s nomogram. Clin Physiol. 2006;26(1):1-8.

  28. Elnoamany MF, Dawood AA. Right ventricular myocardial isovolumic relaxation time as novel method for evaluation of pulmonary hypertension: correlation with endothelin-1 levels. J Am Soc Echocardiogr. 2007;20(5):462-9.

  29. Dambrauskaite V, Delcroix M, Claus P, Herbots L, Palecek T, D’hooge J, et al. The evaluation of pul-monary hypertension using right ventricular myo-cardial isovolumic relaxation time. J Am Soc Echo-cardiogr. 2005;18(11):1113-20.

  30. Abbas A, Lester S, Moreno FC, Srivathsan K, Fortuin D, Appleton C. Noninvasive assessment of right atrial pressure using Doppler tissue imaging. J Am Soc Echocardiogr. 2004;17(11):1155-60 .

  31. Naeije R, Torbicki A. More on the noninvasive diagnosis of pulmonary hypertension: Doppler echo-cardiography revisited. Eur Respir J. 1995;8(9): 1445-9.

  32. Kitabatake A, Inoue M, Asao M, Masuyama T, Mo-rita T, Mishima M, et al. Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler tech-nique. Circulation. 1983;68(2):302-9.

  33. Dabestani A, Mahan G, Gardin JM, Takenaka K, Burn C, Allfie A, et al. Evaluation of pulmonary artery pressure and resistance by pulsed Doppler echocardiography. Am J Cardiol. 1987;59(6):662-8.

  34. Lanzarini L, Fontana A, Campana C, Klersy C. Two simple echo-Doppler measurements can accurately identify pulmonary hypertension in the large majority of patients with chronic heart failure. J Heart Lung Transplant. 2005;24(6):745-54.

  35. Kojonazarov BK, Imanov BZ, Amatov TA, Mirra-khimov MM, Naeije R, Wilkins MR, et al. Nonin-vasive and invasive evaluation of pulmonary arterial pressure in highlanders. Eur Respir J. 2007;29(2): 352-6.

  36. Melek M, Esen O, Esen AM, Barutcu I, Fidan F, Onrat E, et al. Tissue Doppler evaluation of tricuspid annulus for estimation of pulmonary artery pressure in patients with COPD. Lung 2006;184(3):121-31.

  37. Masuyama T, Kodama K, Kitabatake A, Sato H, Nanto S, Inoue M. Continuous-wave Doppler echo-cardiographic detection of pulmonary regurgitation and its application to noninvasive estimation of pulmonary artery pressure. Circulation. 1986;74(3): 484-92.

  38. Abbas AE, Fortuin FD, Schiller NB, Appleton CP, Moreno CA, Lester SJ. Echocardiographic determi-nation of mean pulmonary artery pressure. Am J Cardiol. 2003;92(11):1373-6.

  39. Pyxaras SA, Pinamonti B, Barbati G, Santangelo S, Valentincic M, Cettolo F, et al. Echocardiographic evaluation of systolic and mean pulmonary artery pressure in the follow-up of patients with pulmonary hypertension. Eur J Echocardiogr. 2011;12(9):696-701.

  40. Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation. 1984;70:657-62.

  41. Bech-Hanssen O, Lindgren F, Selimovic N, Rundqvist B. Echocardiography can identify patients with increased pulmonary vascular resistance by assessing pressure reflection in the pulmonary cir-culation. Circ Cardiovasc Imaging. 2010;3(4):424-32.

  42. Dyer KL, Pauliks LB, Das B, Shandas R, Ivy D, Shaffer EM, et al. Use of myocardial performance index in pediatric patients with idiopathic pulmonary arterial hypertension. J Am Soc Echocardiogr. 2006; 19(1):21-7.

  43. Vonk MC, Sander MH, van der Hoogen FH, van Riel PL, Verheugt FW, van Dijk AP. Right ventricle Tei-index: a tool to increase the accuracy of non-invasive detection of pulmonary arterial hyperten-sion in connective tissue diseases. Eur J Echocar-diogr. 2007;8(5):317-21.

  44. Eidem BW, O’Leary PW, Tei C, Seward JB. Use-fulness of the myocardial performance index for assessing right ventricular function in congenital heart disease. Am J Cardiol. 2000;86(6):654-8.

  45. Chemla D, Castelain V, Humbert M, Hébert J, Simonneau G, Lecarpentier Y, et al. New formula for predicting mean pulmonary artery pressure using systolic pulmonary artery pressure. Chest. 2004;126(4):1313-7.

  46. Friedberg MK, Feinstein JA, Rosenthal DN. A novel echocardiographic Doppler method for estimation of pulmonary arterial pressures. J Am Soc Echocar-diogr. 2006;19(5):559-62.

  47. Syyed R, Reeves JT, Welsh D, Raeside D, Johnson MK, Peacock AJ. The relationship between the components of pulmonary artery pressure remains constant under all conditions in both health and disease. Chest. 2008;133(3):633-9.

  48. Chemla D, Castelain V, Provencher S, Humbert M, Simonneau G, Hervé P. Evaluation of various em-pirical formulae for estimating mean pulmonary artery pressure by using systolic pulmonary artery pressure in adults. Chest. 2009;135 (3):760-8.

  49. Lee RT, Lord CP, Plappert T, Sutton MS. Prospec-tive Doppler echocardiographic evaluation of pulmo-nary artery diastolic pressure in the medical inten-sive care unit. Am J Cardiol. 1989;64(19):1366-70.

  50. Ge Z, Zhang Y, Ji X, Fan D, Duran CM. Pulmonary artery diastolic pressure: a simultaneous Doppler echocardiography and catheterization study. Clin Cardiol 1992;15(11):818-24.

  51. Ristow B, Ahmed S, Wang L, Liu H, Angeja BG, Whooley MA, et al.Pulmonary regurgitation end-diastolic gradient is a Doppler marker of cardiac status: data from the Heart and Soul Study. J Am Soc Echocardiogr. 2005;18(9):885-91.

  52. Reynolds DW, Bartelt N, Taepke R, Bennett TD. Measurement of pulmonary artery diastolic pressure from the right ventricle. J Am Coll Cardiol. 1995; 25(5):1176-82.

  53. Stephen B, Dalal P, Berger M, Schweitzer P, Hecht S. Noninvasive estimation of pulmonary artery dias- tolic pressure in patients with tricuspid regurgitation by Doppler echocardiography. Chest. 1999;116(6): 73-7.

  54. Lanzarini L, Fontana A, Lucca E, Campana C, Kler-sy C. Noninvasive estimation of both systolic and diastolic pulmonary artery pressure from Doppler analysis of tricuspid regurgitant velocity spectrum in patients with chronic heart failure. Am Heart J. 2002;144(6):1087-94.

  55. Selimovic N, Rundqvist B, Bergh C, Andersson B, Petersson S, Johansson L, et al. Assessment of pulmonary vascular resistance by Doppler echocar-diography in patients with pulmonary arterial hyper-tension. J Heart Lung Transplant. 2007;26 (9):927-34.

  56. Lorsomradee S, Lorsomradee S, Cromheecke S, ten Broecke PW, De Hert SG. Inferior vena cava diameter and central venous pressure correlation during cardiac surgery. J Cardiothorac Vasc Anesth. 2007;21(4):492-6.

  57. Nakao S, Come PC, McKay RG, Ransil BJ. Effects of positional changes on inferior vena caval size and dynamics and correlations with right-sided car-diac pressure. Am J Cardiol 1987;59(1):125-32.

  58. Bendjelid K, Romand JA, Walder B, Suter PM, Fournier G. Correlation between measured inferior vena cava diameter and right atrial pressure de-pends on the echocardiographic method used in patients who are mechanically ventilated. J Am Soc Echocardiogr. 2002;15(9):944-9.

  59. Mitaka C, Nagura T, Sakanishi N, Tsunoda Y, Amaha K. Two-dimensional echocardiographic eva-luation of inferior vena cava, right ventricle, and left ventricle during positive-pressure ventilation with varying levels of positive end-expiratory pressure. Crit Care Med. 1989;17(3):205-10.

  60. Jue J, Chung W, Schiller NB. Does inferior vena cava size predict right atrial pressures in patients receiving mechanical ventilation? J Am Soc Echo-cardiogr. 1992;5(6):613-9.

  61. Rudski LG, Lai WW, Afilalo J, Hua L, Handschu-macher MD, Chandrasekaran K, et al. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685-713.

  62. Brennan JM, Blair JE, Goonewardena S, Ronan A, Shah D, Vasaiwala S, et al. Reappraisal of the use of inferior vena cava for estimating right atrial pressure. J Am Soc Echocardiogr. 2007;20(7):857-61.

  63. Appleton CP, Hatle LK, Popp RL. Superior vena ca-va and hepatic vein Doppler echocardiography in healthy adults. J Am Coll Cardiol. 1987;10(5):1032-9.

  64. Shapiro RS, Winsberg F, Maldjian C, Stancato-Pa-sik A. Variability of hepatic vein Doppler tracings in normal subjects. J Ultrasound Med. 1993;12(12): 701-3.

  65. Nagueh SF, Kopelen HA, Zoghbi WA. Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventri-cular function. Circulation. 1996;93(6):1160-9.

  66. Ommen SR, Nishimura RA, Hurrell DG, Klarich KW. Assessment of right atrial pressure with 2-dimen-sional and Doppler echocardiography: a simulta-neous catheterization and echocardiographic study. Mayo Clin Proc. 2000;75(1):24-9.

  67. Menon SC, Gray R, Tani LY. Evaluation of ventri-cular filling pressures and ventricular function by Doppler echocardiography in patients with func-tional single ventricle: correlation with simultaneous cardiac catheterization. J Am Soc Echocardiogr. 2011;24(11):1220-5.

  68. Nageh MF, Kopelen HA, Zoghbi WA, Quiñones MA, Nagueh SF. Estimation of mean right atrial pressure using tissue Doppler imaging. Am J Cardiol. 1999; 84(12):1448-51.

  69. Michaux I, Filipovic M, Skarvan K, Schneiter S, Seeberger MD. Accuracy of tissue Doppler estima-tion of the right atrial pressure in anesthetized, paralyzed, and mechanically ventilated patients. Am J Cardiol. 2006;97(11):1654-6.

  70. Galié N, Torbicki A, Barst R, Dartevelle P, Haworth S, Higenbottam T, et al. Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. Eur Heart J. 2004;25(24):2243-78

  71. National Pulmonary Hypertension Centres of the UK and Ireland. Consensus statement on the manage-ment of pulmonary hypertension in clinical practice in the UK and Ireland. Thorax. 2008;63 Suppl 2:ii1-41.

  72. Appleton CP, Hatle LK, Popp RL. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined he-modynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988;12(2):426-40.

  73. García Fernández MA, Zamorano JL. Valores de referencia. En: Procedimientos en Ecocardiografía. 3er curso de ecocardiografía. España: McGraw-Hill Interamericana; 2006. p. 345.

  74. Feigenbaum H, Armstorng WF, Ryan T. Hemodinamica. En: Feingenbaum´s Echocardiogra-phy. 6ta ed. España: Médica Panamericana; 2007. p. 243-4.

  75. Yamamoto K, Nishimura RA, Chaliki HP, Appleton CP, Holmes DR Jr,Redfield MM. Determination of left ventricular filling pressure by Doppler echocar-diography in patients with coronary artery disease: critical role of left ventricular systolic function. J Am Coll Cardiol. 1997;30(7):1819-26.

  76. Nishimura RA, Appleton CP, Redfield MM, Ilstrup DM, Holmes DR Jr,Tajik AJ. Noninvasive Doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: a simultaneous Doppler echocardiographic and car-diac catheterization study. J Am Coll Cardiol. 1996; 28(5):1226-33.

  77. Nagueh SF, Lakkis NM, Middleton KJ, Spencer WH III, Zoghbi WA,Quinones MA. Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation. 1999; 99(2):254-61.

  78. Renard S, Habib G. Echocardiography: interest and border for screening and monitoring of pulmonary arterial hypertension. Presse Med. 2011;40(Suppl 1):14-20.

  79. Canter CE, Shaddy RE, Bernstein D, Hsu DT, Chrisant MR, Kirklin JK, et al. Indications for heart transplantation in pediatric heart disease: a scien-tific statement from the American Heart Association Council on Cardiovascular Disease in the Young; the Councils on Clinical Cardiology, Cardiovascular Nursing, and Cardiovascular Surgery and Anes-thesia; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circula-tion. 2007;115(5):658-76.

  80. Farzaneh-Far R, Na B,Whooley MA, Schiller NB. Usefulness of non-invasive estimate of pulmonary vascular resistance to predict mortality, heart failure, and adverse cardiovascular events in patients with stable coronary artery disease (from the Heart and Soul Study). Am J Cardiol 2008;101(6):762-6.

  81. Martín-Duran R, Larman M, Trugeda A, Vázquez de Prada JA, Ruano J, Torres A, et al. Comparison of Doppler-determined elevated pulmonary arterial pressure with pressure measured at cardiac cathe-terization. Am J Cardiol.1986;57(10):859-63.

  82. Scapellato F, Temporelli PL, Eleuteri E, Corrá U, Imparato A, Giannuzzi P. Accurate noninvasive esti-mation of pulmonary vascular resistance by Doppler echocardiography in patients with chronic failure heart failure. J Am Coll Cardiol. 2001;37(7):1813-9.

  83. Abbas AE, Fortuin FD, Schiller NB, Appleton CP, Moreno CA, Lester SJ. A simple method for non-invasive estimation of pulmonary vascular resis-tance. J Am Coll Cardiol. 2003;41(6):1021-7.

  84. Roule V, Labombarda F, Pellissier A, Sabatier R, Lognone T, Gomes S, et al. Echocardiographic assessment of pulmonary vascular resistance in pul-monary arterial hypertension. Cardiovascular Ultra-sound. 2010;8:21.

  85. Gurudevan SV, Malouf PJ, Kahn AM, Auger WR, Waltman TJ, Madani M, et al. Noninvasive assess-ment of pulmonary vascular resistance using Dop-pler tissue imaging of the tricuspid annulus. J Am Soc Echocardiogr. 2007;20(10):1167-71.

  86. McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol. 1996;78(4): 469-73.

  87. Kurzyna M, Torbicki A, Pruszczyk P, Burakowska B, Fijałkowska A, Kober J, et al. Disturbed right ven-tricular ejection pattern as a new Doppler echocar-diographic sign of acute pulmonary embolism. Am J Cardiol. 2002;90(5):507-11.

  88. Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventri-cular dysfunction. Circulation. 2000;101(24):2817-22.

  89. Azarian R, Wartski M, Collignon MA, Parent F, Herve´ P, Sors H, et al. Lung perfusion scans and hemodynamics in acute and chronic pulmonary embolism. J Nucl Med .1997;38(6):980-3.

  90. Ghio S, Raineri C, Scelsi L, Recusani F, D’armini AM, Piovella F, et al. Usefulness and limits of transthoracic echocardiography in the evaluation of patients with primary and chronic thromboembolic pulmonary hypertension. J Am Soc Echocardiogr. 2002;15(11):1374-80.




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