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Doppler Echocardiography in Coronary Artery Disease

  • Ben J. M. Delemarre
  • Cees A. Visser
Chapter
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 80)

Abstract

Doppler echocardiography is based on a principle described by Johann Christian Doppler (1803–1853) [1] according to whom the frequency of ultrasound changes when it interferes with moving blood cells. The change in the ultrasound frequency is proportional with the velocity component of the blood cell motion in direction of the ultrasound beam. When blood cells move toward the ultrasound source, the backscattered frequency increases, and the frequency decreases when blood cells move away. No frequency shift occurs when blood cells move perpendicular to the ultrasound beam [2].

Keywords

Mitral Valve Vortex Ring Doppler Echocardiography Interventricular Septum Left Ventricular Diastolic Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Doppler C. Ueber das farbige Licht der Doppelsterne und einiger anderer Gestirne des Himmels. Abh Bohm Wiss (V) 1843;2:469.Google Scholar
  2. 2.
    Hatle L, Angelsen B. Doppler ultrasound in cardiology: physical principles and clinical applications. Philadelphia: Lea and Febiger, 1985;36, 37 and 39.Google Scholar
  3. 3.
    Franklin DL, Schlegel W, Rushmer RF. Blood flow measured by Doppler frequency shift of back-scattered ultrasound. Science 1961;134:564.PubMedCrossRefGoogle Scholar
  4. 4.
    Baker DW, Rubenstein SA, Lorch GS. Pulsed Doppler echocardiography: principles and applications. Am J Med 1977;63:69.PubMedCrossRefGoogle Scholar
  5. 5.
    Omoto R. Color atlas of real-time two-dimensional Doppler echocardiography. Tokyo: Shindan-To-Chiryo, 1984.Google Scholar
  6. 6.
    Omoto R, Yokoto Y, Takamoto S, Kyo S, Ueda K, Asano H, Namekawa K, Kasai C, Kondo Y, Koyano A. The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular diseases: with special reference to the evaluation of valvular regurgitation. Jpn Heart J 1984;25:325.PubMedCrossRefGoogle Scholar
  7. 7.
    Sahn DJ. Real-time two-dimensional Doppler echocardiographic flow mapping. Circulation 1985;71:849.PubMedCrossRefGoogle Scholar
  8. 8.
    Nishimura RA, Miller FA, Callahan MJ, Benassi C, Seward JB, Tajik AJ. Doppler echocardiography: theory, instrumentation, technique, and application. Mayo Clin Proc 1985;60:321.PubMedGoogle Scholar
  9. 9.
    Pearlman AS, Scoblionko DP, Saal AK. Assessment of valvular heart disease by Doppler echocardiography. Clin Cardiol 1983;6:573.PubMedCrossRefGoogle Scholar
  10. 10.
    Hatle L, Brubakk A, Tromsdal A, Angelsen B. Noninvasive assessment of pressure drop in mitral stenosis by Doppler ultrasound. Br Heart J 1978;40:131.PubMedCrossRefGoogle Scholar
  11. 11.
    Helmcke F, Nanda NC, Hsiung MC, Soto B, Adey CK, Goyal RG, Gatewood RP. Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation 1987;75:175.PubMedCrossRefGoogle Scholar
  12. 12.
    Fioretti P, Brower RW, Meester GT, Serruys PW. Interaction of left ventricular relaxation and filling during early diastole in human subjects. Am J Cardiol 1980;46:197.PubMedCrossRefGoogle Scholar
  13. 13.
    Takenaka K, Dabestani A, Gardin JM, Russell D, Clark S, Allfie A, Henry WL. Pulsed Doppler echocardiographic study of left ventricular filling in dilated cardiomyopathy. Am J Cardiol 1986;58:143.PubMedCrossRefGoogle Scholar
  14. 14.
    Friedman BJ, Drinkovic N, Miles H, Shih W, Mazzoleni A, De Maria AN. Assessment of left ventricular diastolic function: comparison of Doppler echocardiography and gated blood pool scintigraphy. J Am Coll Cardiol 1986;8:1348.PubMedCrossRefGoogle Scholar
  15. 15.
    Bellhouse BJ. Fluid mechanics of a model mitral valve and left ventricle. Cardiovasc Res 1972;6:199.PubMedCrossRefGoogle Scholar
  16. 16.
    Lee CSF, Talbot L. A fluid-mechanical study of the closure of heart valves. J Fluid Mech 1979;91:41.CrossRefGoogle Scholar
  17. 17.
    Nolan SP, Dixon SH, Fisher RD, Morrow AG. The influence of atrial contraction and mitral valve mechanics on ventricular filling. Am Heart J 1969;77:784.PubMedCrossRefGoogle Scholar
  18. 18.
    Yellin EL, Peskin C, Yoran C, Koenigsberg M, Matsumoto M, Laniado S, McQueen D, Shore D, Frater RWM. Mechanisms of mitral valve motion during diastole. Am J Physiol 1981;241:389.Google Scholar
  19. 19.
    Taylor DEM, Wade JD. Pattern of blood flow within the heart: a stable system. Cardiovasc Res 1973;7:14.PubMedCrossRefGoogle Scholar
  20. 20.
    Laiken SL, Johnson AD, Bhargava V, Rigo P. Instantaneous transmitral blood flow and anterior mitral leaflet motion in man. Circulation 1979;59:476.PubMedGoogle Scholar
  21. 21.
    Kalmanson D, Toutain G, Novikoff N, Derai C. Retrograde catheterization of left heart cavities in dogs by mans of an orientable directional Doppler catheter-tip flowmeter: a preliminary report. Cardiovasc Res 1972;6:309.PubMedCrossRefGoogle Scholar
  22. 22.
    Taylor DEM, Wade JD. Flow through the mitral valve during diastolic filling of the left ventricle. J Physiol 1969;200:73–P.Google Scholar
  23. 23.
    Johnson SL, Baker DW, Lute RA, Dodge HT. Doppler echocardiography: the localization of cardiac murmurs. Circulation 1973;48:810.PubMedGoogle Scholar
  24. 24.
    Lorch G, Rubenstein S, Baker D, Dooley T, Dodge H. Doppler echocardiography: use of a graphical display system. Circulation 1977;56:576.PubMedGoogle Scholar
  25. 25.
    Rokey R, Kuo LC, Zoghbi WA, Limacher MC, Quinones MA. Determination of parameters of left ventricular diastolic filling with pulsed Doppler echocardiography: comparison with cineangiography. Circulation 1985;71:543.PubMedCrossRefGoogle Scholar
  26. 26.
    Friedman B, Drinkovic N, Miles H, Stipp V, Mazzoleni A, De Maria AN. Assessment of left ventricular diastolic function: comparison of Doppler and blood pool scintigraphy [abstr]. Circulation 1985;72:1713.Google Scholar
  27. 27.
    Spirito P, Maron BJ, Bonow RO. Noninvasive assessment of left ventricular diastolic function: comparative analysis of Doppler echocardiographic and radionuclide angiographic techniques. J Am Coll Cardiol 1986;7:518.PubMedCrossRefGoogle Scholar
  28. 28.
    Spirito P, Maron BJ, Bellotti P, Chiarella F, Vecchio C. Noninvasive assessment of left ventricular diastolic function: comparative analysis of pulsed Doppler ultrasound and digitized M-mode echocardiography. Am J Cardiol 1986;58:837.PubMedCrossRefGoogle Scholar
  29. 29.
    Kitabatake A, Tanouchi J, Inoue M, Asao M, Morita T, Masuyama T, Ito H, Yasui K, Shimazu T, Hori M, Abe H. Relations between transmitral flow and ventricular relaxation: a study by pulsed Doppler flowmetry. In Spenser MP (ed) Cardiac doppler diagnosis. Boston: Martinus Nijhoff, 1983.Google Scholar
  30. 30.
    Kitabatake A, Inoue M, Asao M, Tanouchi J, Masuyama T, Abe H, Morita H, Senda S, Matsuo H. Transmitral bloodflow reflecting diastolic behavior of the left ventricle in health and disease: a study by pulsed Doppler technique. Jpn Circ J 1982;46:92.PubMedCrossRefGoogle Scholar
  31. 31.
    Takagi S, Yokota M, Iwase M, Koide M, Jing H, Hayashi H, Sotobata I. Evaluation of left ventricular diastolic filling by a pulsed Doppler flowmeter in patients with coronary artery disease. In Spenser MP (ed) Cardiac doppler diagnosis II. Boston: Martinus Nijhoff, 1986.Google Scholar
  32. 32.
    Miyatake K, Okamoto M, Kinoshita N, Owa M, Nakasone I, Sakakibara H, Nimura Y. Augmentation of atrial contribution to left ventricular inflow with aging as assessed by intracardiac Doppler flowmetry. Am J Cardiol 1984;53:586.PubMedCrossRefGoogle Scholar
  33. 33.
    Fujii J, Yazaki Y, Sawada H, Aizawa T, Watanabe H, Kato K. Noninvasive assessment of left and right ventricular filling in myocardial infarction with a two-dimensional Doppler echocardiographic method. J Am Coll Cardiol 1985;5:1155.PubMedCrossRefGoogle Scholar
  34. 34.
    Bonow RO, Bacharach SL, Green MV, Kent KM, Rosing DR, Lipson LC, Leon MB, Epstein SE. Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography. Circulation 1981;64:315.PubMedCrossRefGoogle Scholar
  35. 35.
    Ryan T, Armstrong WF, Feigenbaum H. Doppler assessment of left ventricular filling during experimental myocardial ischemia [abstr]. Circulation 1985;72:235.Google Scholar
  36. 36.
    Wind BE, Dilworth LR, Buda AJ, Snider AR. Doppler evaluation of left ventricular diastolic filling in ischemic heart disease [abstr]. Circulation 1985;72(suppl III):III–234.Google Scholar
  37. 37.
    Delemarre BJM, Bot H, Visser CA, Dunning AJ. Intra-ventricular flow characteristics in acute myocardial infarction. In: Manger Cats V, Visser CA (eds) The first 24 hours of acute myocardial infarction. Amsterdam: Rodopi, 1986.Google Scholar
  38. 38.
    Visser CA, De Koning H, Delemarre BJM, Koolen JJ, Dunning AJ. Pulsed Doppler-derived mitral in-flow velocity in acute myocardial infarction: an early prognostic indicator [abstr]. J Am Coll Cardiol 1986;7:136A.Google Scholar
  39. 39.
    Hayakawa M, Yokota Y, Kumaki T, Fujitani K, Kurogane K, Takeuchi M, Kawanishi H, Inoh T, Fukuzaki H. Intracardiac flow pattern in dilated cardiomyopathy studied with pulsed Doppler echocardiography. J Cardiogr 1983;13:317.PubMedGoogle Scholar
  40. 40.
    Tanouchi J, Kitabatake A, Asao M, Ishihara K, Morita T, Fujii K, Ito H, Inoue M, Abe H. Intraventricular systolic flow velocity as a sensitive indicator of left ventricular dysfunction: a Doppler echocardiographic study [abstr]. Circulation 1984;70(suppl II):II–1175.Google Scholar
  41. 41.
    Kitabatake A, Ito H, Asao M, Tanouchi J, Morita T, Ishihara K, Fujii K, Inoue M, Abe H. A new approach to assess left ventricular regional pump function: Doppler determination of dynamic pressure distribution [abstr]. Circulation 1984;70(suppl II):II–946.Google Scholar
  42. 42.
    Ito H, Kitabatake A, Asao M, Tanouchi J, Ishihara K, Morita T, Fujii K. Noninvasive assessment of left ventricular regional pump function by duplex Doppler echocardiography [abstr]. Circulation 1984;70(suppl II):II–1569.Google Scholar
  43. 43.
    Rushmer RF. Initial ventricular impulse: a potential key to cardiac evaluation. Circulation 1964;29:268.PubMedGoogle Scholar
  44. 44.
    Nobel MIM, Trenchard D, Guz A. Left ventricular ejection in conscious dogs. I. Measurement and significance of the maximum acceleration of blood from the left ventricle. Circ Res 1966;19:139.Google Scholar
  45. 45.
    Noble MIM, Trenchard D, Guz A. Left ventricular ejection in conscious dogs. II. Determinants of stroke volume. Circ. Res 1966;19:148.Google Scholar
  46. 46.
    Stein PD, Sabbah HN. Comparison of the acceleration and velocity of shortening of the ventricular radius: their potential applicability for noninvasive measurements of ventricular performance. Chest 1976;70:57.PubMedCrossRefGoogle Scholar
  47. 47.
    Wallmeyer K, Wann LS, Sagar KB, Kalbfleisch J, Klopfenstein HS. The influence of preload and heart rate on Doppler echocardiographic indexes of left ventricular performance: comparison with invasive indexes in an experimental preparation. Circulation 1986;74:181.PubMedCrossRefGoogle Scholar
  48. 48.
    Bennett ED, Barclay SA, Davis AL, Mannering D, Mehta N. Ascending aortic blood velocity and acceleration using Doppler ultrasound in the assessment of left ventricular function. Cardiovasc Res 1984;18:632.PubMedCrossRefGoogle Scholar
  49. 49.
    Bennett ED, Else W, Miller GA, Sutton GC, Miller HC, Noble MI. Maximum acceleration of blood from the left ventricle in patients with ischaemic heart disease. Clin Sci Mol Med 1974;46:49.PubMedGoogle Scholar
  50. 50.
    Kolettis M, Jenkins BS, Webb-Peploe MM. Assessment of left ventricular function by indices derived from aortic flow velocity. Br Heart J 1976;38:18.PubMedCrossRefGoogle Scholar
  51. 51.
    Warbasse JR, Hellman BH, Gillilan RE, Hawley RR, Babitt HI. Physiologic evaluation of a catheter tip electromagnetic velocity probe. Am J Cardiol 1969;23:424.PubMedCrossRefGoogle Scholar
  52. 52.
    Mason DT, Gabe IT, Mills CJ, Gault JH, Ross J, Braunwald E. Applications of the catheter-tip electromagnetic velocity probe in the study of the central circulation in man. Am J Med 1970;49:465.PubMedCrossRefGoogle Scholar
  53. 53.
    Benchimol A, Stegall HF, Maroko PR, Gartlan JL, Brener L. Aortic flow velocity in man during cardiac arrhythmias measured with the Doppler catheter-flowmeter system. Am Heart J 1969;78:649.PubMedCrossRefGoogle Scholar
  54. 54.
    Light LH. Non-injurious ultrasonic technique for observing flow in the human aorta. Nature 1969;224:1119.PubMedCrossRefGoogle Scholar
  55. 55.
    Sequeira RF, Light LH, Cross G, Raftery EB. Transcutaneous aortovelography: a quantitative evaluation. Br Heart J 1976;38:443.PubMedCrossRefGoogle Scholar
  56. 56.
    Buchtal A, Hanson GC, Peisach AR. Transcutaneous aortovelography: potentially useful technique in management of critically ill patients. Br Heart J 1976;38:451.PubMedCrossRefGoogle Scholar
  57. 57.
    Huntsman LL, Stewart DK, Barnes SR, Franklin SB, Colocousis JS, Hessel EA. Noninvasive Doppler determination of cardiac output in man. Circulation 1983;67:593.PubMedCrossRefGoogle Scholar
  58. 58.
    Light LH, Sequeira RF, Cross G, Bilton A, Hanson GC. Flow-orientated circulatory patients’ assessment and management using transcutaneous aortovelography, a non-invasive Doppler technique. J Nucl Med Allied Sci 1979;23:137.PubMedGoogle Scholar
  59. 59.
    Louie EK, Maron BJ, Green KJ. Variations in flow-velocity waveforms obtained by pulsed Doppler echocardiography in the normal human aorta. Am J Cardiol 1986;58:821.PubMedCrossRefGoogle Scholar
  60. 60.
    Levy B, Targett RC, Bardou A, Mcllroy MB. Quantitative ascending aortic Doppler blood velocity in normal human subjects. Cardiovasc Res 1985;19:383.PubMedCrossRefGoogle Scholar
  61. 61.
    Schuster AH, Nanda NC. Doppler echocardiographic measurement of cardiac output: comparison with a non-golden standard. Am J Cardiol 1984;53:257.PubMedCrossRefGoogle Scholar
  62. 62.
    Gardin JM, Kozlowski J, Dabestani A, Murphy M, Kusnick C, Allfie A, Russell D, Henry WL. Studies of Doppler aortic flow velocity during supine bicycle exercise. Am J Cardiol 1986;57:327.PubMedCrossRefGoogle Scholar
  63. 63.
    Daley PJ, Sagar KB, Kalbfleisch JH, Collier DB, Wann LS. Doppler echocardiographic evaluation of left ventricular function at rest and during exercise: comparison with radionuclide ventriculography [abstr]. Circulation 1985;72(suppl III):III–1791.Google Scholar
  64. 64.
    Daley PJ, Sagar KB, Wann LS. Doppler echocardiographic measurement of flow velocity in the ascending aorta during supine and upright exercise. Br Heart J 1985;54:562.PubMedCrossRefGoogle Scholar
  65. 65.
    Sabbah HN, Khaja F, Brymer JF, McFarland ThM, Albert DE, Snyder JE, Goldstein S, Stein PD. Noninvasive evaluation of left ventricular performance based on peak aortic blood acceleration measured with continuous-wave Doppler velocity meter. Circulation 1986;74:323.PubMedCrossRefGoogle Scholar
  66. 66.
    Chandraratna PAN, Silveira B, Aronow WS. Assessment of left ventricular function by determination of maximum acceleration of blood flow in the aorta using continuous Doppler ultrasound [abstr]. Am J Cardiol 1980;45:398.CrossRefGoogle Scholar
  67. 67.
    Gardin JM, Iseri LT, Elkayam U, Tobis J, Childs W, Burn CS, Henry WL. Evaluation of dilated cardiomyopathy by pulsed Doppler echocardiography. Am Heart J 1983;106:1057.PubMedCrossRefGoogle Scholar
  68. 68.
    Mehta N, Bennett DE. Impaired left ventricular function in acute myocardial infarction assessed by Doppler measurement of ascending aortic blood velocity and maximum acceleration. Am J Cardiol 1986;57:1052.PubMedCrossRefGoogle Scholar
  69. 69.
    Mehta N, Bennett D, Mannering D, Dawkins K, Ward DE. Usefulness of noninvasive Doppler measurement of ascending aortic blood velocity and acceleration in detecting impairment of the left ventricular functional response to exercise three weeks after acute myocardial infarction. Am J Cardiol 1986;58:879.PubMedCrossRefGoogle Scholar
  70. 70.
    Itoh K. Main systolic blood flow patterns in the left and right ventricular outflow tracts determined by Doppler echocardiography. Angiol J Vase Dis 1985;143.Google Scholar
  71. 71.
    Miyatake K, Park Y-D, Kinoshita N, Okamoto M, Beppu S, Izumi S, Takao S, Sakakibara H, Nimura Y. Analysis of left ventricular blood flow in cases of myocardial infarction: a preliminary report. J Cardiogr 1984;14:665.PubMedGoogle Scholar
  72. 72.
    Makihata S, Tanimoto M, Yamamoto T, Konishiike A, Ohyanagi M, Ohgami T, Yamazaki K, Yasutomi N, Kawai Y, Iwasaki T. Pulsed Doppler echocardiographic evaluation of so-called “moyamoya” echoes in left ventricular aneurysms. J Cardiogr 1984;14:267.PubMedGoogle Scholar
  73. 73.
    Wieting DW, Stripling TE, Kennedy JH, Hwang NHC. Vortices in the heart. In Yjaffrin, M (ed) Digest of the 10th international conference on medical and biological engineering. Dresden, 1973:44.Google Scholar
  74. 74.
    Oddou C, Brun P, Dantan P, Beraldo E, Kulas A, Devernejul F: the fluid mechanics in the human left ventricle during cardiac filling phase. In: Cardiovascular and pulmonary dynamics. Inserm, Paris, 1977;71:321.Google Scholar
  75. 75.
    Little RC. The mechanism of closure of the mitral valve: a continuing controversy. Circulation 1979;59:615.PubMedGoogle Scholar
  76. 76.
    Gardin JM, Debestani A, Takenaka K, Rohan MK, Knoll M, Russell D, Henry WL. Effect of imaging view and sample volume location on evaluation of mitral flow velocity by pulsed Doppler echocardiography. Am J Cardiol 1986;57:1335.PubMedCrossRefGoogle Scholar
  77. 77.
    Zhang Y, Nitter-Hauge S, Ihlen H, Myhre E. Doppler echocardiographic measurement of cardiac output using the mitral orifice method. Br Heart J 1985;53:130.PubMedCrossRefGoogle Scholar
  78. 78.
    Holen J, Waag RC, Gramiak R, Violante MR, Roe SA. Doppler ultrasound in orifice flow: in vitro studies of the relationship between pressure difference and fluid velocity. Ultrasound Med Biol 1985;11:261.PubMedCrossRefGoogle Scholar
  79. 79.
    Vasko SD, Goldberg SJ, Requarth JA, Allen HD. Factors affecting accuracy of in vitro valvar pressure gradient estimates by Doppler ultrasound. Am J Cardiol 1984;54:893.PubMedCrossRefGoogle Scholar
  80. 80.
    Jawad IA, Taylor ML, Pruitt-Hudson F, Sohn YH. Range ambiguity in pulsed Doppler ultrasound: the ambiguity clarified? J Clin Ultrasound 1985;13:475PubMedCrossRefGoogle Scholar
  81. 81.
    Delemarre BJM, Bot H, Pearlman AS, Visser CA, Dunning AJ. Diastolic flow characteristics of severely impaired left ventricles: a pulsed Doppler ultrasound study. J Clin Ultrasound 1987;15:115.PubMedCrossRefGoogle Scholar
  82. 82.
    Rushmer RF, Crystal DK. Changes in configuration of the ventricular chambers during the cardiac cycle. Circulation 1951;4:211.PubMedGoogle Scholar
  83. 83.
    Rushmer RF, Thal N. The mechanics of ventricular contraction: a cinefluorographic study. Circulation 1951;4:219.PubMedGoogle Scholar
  84. 84.
    Sasson Z, Hatle LK, Appleton CP, Alderman EL, Jewett M, Popp RL. Intraventricular flow during isovolumic relaxation: description and characterization by Doppler [abstr]. Circulation 1986;74(suppl II):II–190.Google Scholar
  85. 85.
    Kostucki W, Van den Bossche J-L, Friart A, Englert M. Pulsed Doppler regurgitant flow patterns of normal valves. Am J Cardiol 1986;58:309.PubMedCrossRefGoogle Scholar
  86. 86.
    Sanada J, Nakamura K, Minami Y, Kuroiwa N, Ohshige T, Hashimoto S. Assessment of left ventricular isovolumetric contraction flow by the use of pulsed Doppler echocardiography. Respir Circ 1983;31:81.Google Scholar
  87. 87.
    Mizushige K, Matsuo H, Morita H, Wada S, Senda S, Nakajima S, Fukada H, Hirabayashi K. Elucidation of pre-ejection flow in the left ventricular outflow tract by pulsed Doppler flowmetery [abstr]. Circulation 1986;74(suppl II):II–191.Google Scholar
  88. 88.
    Okabe J, Inoue S. The generation of vortex rings. Rep Res Inst Appl Mech Kyushu Univ 1961;8:90.Google Scholar
  89. 89.
    Mikell FL, Asinger RW, Elsperger KJ, Anderson WR, Hodges M. Regional stasis of blood in the dysfunctional left ventricle: echocardiographic defection and differentiation from early thrombosis. Circulation 1982;66:755.PubMedCrossRefGoogle Scholar
  90. 90.
    Abinader EG, Kuo LC, Rokey R, Quinones MA. Mitral-septal angle: a new two-dimensional echocardiographic index of left ventricular performance. Am Heart J 1985;110:381.PubMedCrossRefGoogle Scholar
  91. 91.
    Perloff JK, Roberts WC. The mitral apparatus: functional anatomy of mitral regurgitation. Circulation 1972;46:227.PubMedGoogle Scholar

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© Kluwer Academic Publishers. Boston/Dordrecht/Lancaster 1988

Authors and Affiliations

  • Ben J. M. Delemarre
  • Cees A. Visser

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