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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

The Efficacy and Safety of an Intra-articular Dual-Acting Antibacterial Agent (TNP-2092) for Implant Infection–Associated Methicillin-Resistant Staphylococcus aureus

Abstract Owing to the presence of microbial biofilm on the implant, the eradication of biofilm-associated infections poses a challenge for antibiotic therapies. The study aimed to investigate the efficacy and safety of the novel antibiotic agent TNP-2092 in the context of implant infections. In vivo, rats with periprosthetic joint infection (PJI) treated with antibiotics showed an increase in body weight and decrease in swelling, temperature, and width of knee, compared with the control group. Meanwhile, inflammatory markers in synovium and serum were decreased in the TNP-2092 group, consistent with the pathological results. Moreover, TNP-2092 was effective in eliminating bacteria and disruption biofilm formation, and further alleviated the abnormal bone absorption and reactive bone changes around the prosthesis. In conclusion, intra-articular injection of TNP-2092 is safe and effective in treating knee PJI in a rat model. The study provides a foundation for the future utilization of TNP-2092 in the management of implant-related infections.

Dai, Tianyu↗
DOE OSTI2023

Motion Planning Algorithms for Safety and Quantum Computing Efficiency

Motion planning remains a fundamental problem in robotics. Sampling-based algorithms use randomization to allow efficient solutions to this complex problem. As mobile robots and autonomous vehicles become more prevalent in everyday life, motion planning must be applied to increasingly challenging scenarios. Safety has become a paramount concern in motion planning for ensuring robotic applications enrich human lives. To date, many motion planning techniques to increase safety in the face of uncertain and dynamic environments have been developed. This dissertation first addresses distributional safety of Rapidly-Exploring Random Trees (RRT) through our algorithm W-Safe RRT. To acknowledge distributional uncertainty and poor modeling, W-Safe RRT uses the Wasserstein metric to provide a probabilistic bound on the distributional distance between a robot and obstacles. Human-interpretable environmental agent classification allows online safety margin adaptation. We propose and analyze an integrating region method for online classification that increases actor labeling accuracy based on behavioral feature values when compared to state of the art methods. The method performs class assignments based on local maximum likelihood in a created behavioral feature-space, allowing a notion of classification uncertainty. Model-based methods with safety guarantees can quickly become computationally in tractable, especially with multiple agents, higher dimensions, and plentiful unknowns. Sampling based algorithms have been parallelized for computation with multi-core computers and GPUs. We consider the use of quantum algorithms and computers for sampling-based motion planning for the first time. Quantum computing performs operations on superpositions of states and can solve certain problems much more efficiently than classical computers, but introduces previously unseen challenges. With Quantum-RRT, we recast the motion planning problem into a database-search structure and use Quantum Amplitude Amplification to find reachable states in the database with a quadratic performance increase over classical methods. We address two error sources with this method: quantum measurement and quantum oracle errors. We then extend this method to Parallel Quantum-RRT, which uses a manager-worker architecture with multiple parallel quantum workers to increase database search efficiency. We compare algorithm architectures and characterize probabilities of multiple workers finding solutions. Lastly, we test in simulation the quantum algorithms against classical versions in a wide variety of scenarios, concluding that a similar parallelization improvement is to be found in the quantum case as was found in the parallelization of classical RRT.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2026

Optimal CO 2 storage management considering safety constraints in multi-stakeholder multi-site GCS projects: A Markov game perspective

Geological carbon storage (GCS) projects could involve a diverse array of stakeholders or players from public, private, and regulatory sectors, each with different objectives and responsibilities. Given the complexity, scale, and long-term nature of GCS operations, determining whether individual stakeholders can independently optimize their interests — or whether collaborative coalition agreements are needed — remains a central question for effective GCS project planning and management. To access large, high-quality storage resources, future GCS deployment may increasingly occur in geologically connected sites, where shared geological features such as pressure space and reservoir pore capacity can lead to competitive behavior among stakeholders. In this work, we propose a paradigm based on Markov games to quantitatively investigate how different coalition structures affect the goals of stakeholders. We frame this multi-stakeholder multi-site problem as a multi-agent reinforcement learning problem with safety constraints. Our approach enables agents to learn optimal strategies while complying with safety regulations. We present an example where multiple operators are injecting CO 2 into their respective project areas in a geologically connected basin. To address the high computational cost of repeated simulations of high fidelity models, a previously developed surrogate model based on the Embed-to-Control (E2C) framework is employed. Our results demonstrate the effectiveness of the proposed framework in addressing optimal management of CO 2 storage when multiple stakeholders with different objectives and goals are involved.

58 GEOSCIENCES↗
DOE OSTI2018

Characterization of the effects of immunomodulatory drug fingolimod (FTY720) on human T cell receptor signaling pathways

Immune responses against gene therapy products limit its therapeutic efcacy and present a safety risk. Identification of agents that blunt immune reactions may aid in developing novel immunomodulatory therapies. Fingolimod (FTY720) is an FDA approved immunomodulatory drug for treating multiple sclerosis that inhibits lymphocyte egress from lymphoid tissues by down regulating sphingosine-1 phosphate receptor (S1PR). Recent studies found that FTY720 inhibits T cell activation (TCA) in a S1PRindependent manner; however, the mechanism is incompletely understood. Here we characterized the effects of FTY720 on human T cell receptor (TCR) signaling pathways. FTY720 inhibited both the TCR-dependent and independent activation of primary human T cells. FTY720 did not affect proximal TCR signaling events as measured by phosphorylation of Lck, ZAP-70 and LAT; however, inhibited PMA/Ionomycin induced distal TCR signaling as measured by IL-2, IFN-γ release and CD25 expression. FTY720 induced aberrant NFAT1, AP1 and NFκB activation which were associated with increased acetylation of histone (H3K9). Phosphorylated FTY720 did not inhibit TCA, and arachidonic acid did not rescue FTY720 mediated inhibition of TCA. These data suggest that FTY720 mediated inhibition of TCA is due to inhibition of distal TCR signaling. Understanding FTY720-mediated inhibition of TCA may aid in developing novel FTY720-based immunomodulatory agents.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2023

Application of multi-criteria decision analysis techniques and decision support framework for informing select agent designation for agricultural animal pathogens

The United States Department of Agriculture (USDA), Division of Agricultural Select Agents and Toxins (DASAT) established a list of biological agents and toxins (Select Agent List) that potentially threaten agricultural health and safety, the procedures governing the transfer of those agents, and training requirements for entities working with them. Every 2 years the USDA DASAT reviews the Select Agent List, using subject matter experts (SMEs) to perform an assessment and rank the agents. To assist the USDA DASAT biennial review process, we explored the applicability of multi-criteria decision analysis (MCDA) techniques and a Decision Support Framework (DSF) in a logic tree format to identify pathogens for consideration as select agents, applying the approach broadly to include non-select agents to evaluate its robustness and generality. We conducted a literature review of 41 pathogens against 21 criteria for assessing agricultural threat, economic impact, and bioterrorism risk and documented the findings to support this assessment. The most prominent data gaps were those for aerosol stability and animal infectious dose by inhalation and ingestion routes. Technical review of published data and associated scoring recommendations by pathogen-specific SMEs was found to be critical for accuracy, particularly for pathogens with very few known cases, or where proxy data (e.g., from animal models or similar organisms) were used to address data gaps. The MCDA analysis supported the intuitive sense that select agents should rank high on the relative risk scale when considering agricultural health consequences of a bioterrorism attack. However, comparing select agents with non-select agents indicated that there was not a clean break in scores to suggest thresholds for designating select agents, requiring subject matter expertise collectively to establish which analytical results were in good agreement to support the intended purpose in designating select agents. The DSF utilized a logic tree approach to identify pathogens that are of sufficiently low concern that they can be ruled out from consideration as a select agent. In contrast to the MCDA approach, the DSF rules out a pathogen if it fails to meet even one criteria threshold. Both the MCDA and DSF approaches arrived at similar conclusions, suggesting the value of employing the two analytical approaches to add robustness for decision making.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2026

A Physics-Informed Reinforcement Learning Framework for Economic-Thermal Co-Optimization of Crypto Mining Data Centers: Preprint

The rapid expansion of cryptocurrency mining has created a new class of high-density data centers characterized by extreme thermal flux and high sensitivity to volatile economic markets. Traditional thermal management strategies, typically reliant on rule-based control, maintain static setpoints that fail to account for fluctuating electricity prices and cryptocurrency values - factors critical to mining profitability. To address this, we present a physics-informed reinforcement learning (PIRL) framework for economic-thermal co-optimization in crypto mining data centers. This framework consists of a proximal policy optimization (PPO) agent, a virtual testbed powered by high-fidelity physics-based models, and an interactive frontend dashboard. The PPO agent is trained using the virtual testbed and strict hardware safety limits. This physics-informed approach allows the agent to learn a stochastic policy that dynamically balances mining revenue against operational costs by co-optimizing HVAC cooling setpoints and IT computational hashrate. The simulation results demonstrate that the integrated framework achieved an 8.62% increase in net operational profit compared to traditional baseline strategies while strictly adhering to safety-critical temperature constraints (coolant supply temperature < 32 degrees C). This work provides a scalable template for the deployment of reinforcement learning in mission critical facilities where economic volatility and physical safety must be managed simultaneously.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2017

Polypyrrole-Coated Perfluorocarbon Nanoemulsions as a Sono-Photoacoustic Contrast Agent

A new contrast agent for combined photoacoustic and ultrasound imaging is presented here. It has a liquid perfluorocarbon (PFC) core of about 250 nm diameter coated by a 30 nm thin polypyrrole (PPy) doped polymer shell emulsion that represents a broadband absorber covering the visible and near-infrared ranges (peak optical extinction at 1050 nm). When exposed to a sufficiently high intensity optical or acoustic pulse, the droplets vaporize to form microbubbles providing a strong increase in imaging sensitivity and specificity. The threshold for contrast agent activation can further drastically be reduced by up to 2 orders of magnitude if simultaneously exposing them with optical and acoustic pulses. The selection of PFC core liquids with low boiling points (i.e., perfluorohexane (56 °C), perfluoropentane (29 °C), and perfluorobutane (–2 °C)) facilitates activation and reduces the activation threshold of PPy-coated emulsion contrast agents to levels well within clinical safety limits (as low as 0.2 MPa at 1 mJ/cm 2 ). Finally, the potential use of these nanoemulsions as a contrast agent is demonstrated in a series of phantom imaging studies.

42 ENGINEERING↗
DOE OSTI2016

Chronic preclinical safety evaluation of EPO-018B, a pegylated peptidic erythropoiesis-stimulating agent in monkeys and rats

EPO-018B, a synthetic peptide-based erythropoiesis stimulating agent (ESA), is mainly designed for treatment of anemia caused by chronic renal failure and chemotherapy against cancer. It overcomes the deficiencies of currently approved ESA, including the frequent administration of temperature-sensitive recombinant protein and anti-EPO antibody-mediated pure red cell aplasia (PRCA). This study was designed to evaluate the potential chronic toxicity of EPO-018B. Subcutaneous administration doses were designed as 0, 0.2, 1 and 10 mg/kg for six months for 160 rats (20/gender/group) and 0, 0.3, 3 and 20 mg/kg for nine months for 32 monkeys (4/gender/group) once every three weeks. The vehicles received the same volume of physiological saline injection. All animals survived to the scheduled necropsies after six weeks (for rats) and fourteen weeks (for monkeys) recovery period, except for the two high-dose female rats and two high-dose male monkeys, which were considered related to the increased RBCs, chronic blood hyperviscosity and chronic cardiac injury. EPO-018B is supposed to be subcutaneously injected once every month and the intended human therapeutic dose is 0.025 mg/kg. The study findings at 0.2 mg/kg for rats and 0.3 mg/kg for monkeys were considered to be the study NOAEL (the no observed adverse effect level), which were more than ten times the intended human therapeutic dose. Higher doses caused adverse effects related to the liver toxicity, cardiotoxicity, appearance of neutralizing antibodies of EPO-018B and the decrease of serum glucose and cholesterol. Most treatment-induced effects were reversible or revealed ongoing recovery upon the discontinuation of treatment. The sequelae occurred in rats and monkeys were considered secondary to exaggerated pharmacology and would less likely occur in the intended patient population. As to the differences between human beings and animals, the safety of EPO-018B need to be further confirmed in the future clinical studies. - Highlights: • EPO-018B is a newly developed synthetic peptide-based ESA. • The evaluation contained studies of 6 months in rats and 9 months in monkeys. • The safety studies provided further evidences in future clinical trials. • Most toxic effects were reversible and need more evidences in clinical studies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Application of Multi-Criteria Decision Analysis Techniques for Informing Select Agent Designation and Decision Making

The Centers for Disease Control and Prevention (CDC) Select Agent Program establishes a list of biological agents and toxins that potentially threaten public health and safety, the procedures governing the possession, utilization, and transfer of those agents, and training requirements for entities working with them. Every 2 years the Program reviews the select agent list, utilizing subject matter expert (SME) assessments to rank the agents. In this study, we explore the applicability of multi-criteria decision analysis (MCDA) techniques and logic tree analysis to support the CDC Select Agent Program biennial review process, applying the approach broadly to include non-select agents to evaluate its generality. We conducted a literature search for over 70 pathogens against 15 criteria for assessing public health and bioterrorism risk and documented the findings for archiving. The most prominent data gaps were found for aerosol stability and human infectious dose by inhalation and ingestion routes. Technical review of published data and associated scoring recommendations by pathogen-specific SMEs was found to be critical for accuracy, particularly for pathogens with very few known cases, or where proxy data (e.g., from animal models or similar organisms) were used to address data gaps. Analysis of results obtained from a two-dimensional plot of weighted scores for difficulty of attack (i.e., exposure and production criteria) vs. consequences of an attack (i.e., consequence and mitigation criteria) provided greater fidelity for understanding agent placement compared to a 1-to-n ranking and was used to define a region in the upper right-hand quadrant for identifying pathogens for consideration as select agents. A sensitivity analysis varied the numerical weights attributed to various properties of the pathogens to identify potential quantitative (x and y) thresholds for classifying select agents. The results indicate while there is some clustering of agent scores to suggest thresholds, there are still pathogens that score close to any threshold, suggesting that thresholding “by eye” may not be sufficient. The sensitivity analysis indicates quantitative thresholds are plausible, and there is good agreement of the analytical results with select agent designations. A second analytical approach that applied the data using a logic tree format to rule out pathogens for consideration as select agents arrived at similar conclusions.

60 APPLIED LIFE SCIENCES↗
NASA NTRS1992

Occupational safety considerations with hydrazine

Hydrazine is a reducing agent that is most commonly used as a propellant and as an oxygen scavenger in boilers. Hydrazine is extremely irritating and has been demonstrated to produce both acute and chronic toxicity. As a result, the established permissible inhalation exposure limits are very low, and respiration protection is required whenever vapors are present. Liquid hydrazine penetrates the skin and produces a chemical burn; therefore, some protective measures must also be taken to protect the skin from liquid contact. Often, however, a cumbersome, whole-body protective suit is worn to protect against skin contact with vapor as well. To what extent it is actually necessary to protect skin from vapor penetration had not previously been demonstrated. In an attempt to answer this question, we conducted a study with rats to compare the dermal penetration of hydrazine vapor with inhalation. Pharmacokinetic modeling was used to compare body burdens resulting from these different routes of exposure. The analysis concluded that the vapor concentration during a skin-only exposure would have to be at least 200 times higher than that during inhalation to achieve the same body burden. This type of estimation illustrates the use of predictive toxicology in occupational exposures.

Clewell, Harvey J., III↗
NASA NTRS1990

Critical safety assurance factors for manned spacecraft - A fire safety perspective

Safety assurance factors for manned spacecraft are discussed with a focus on the Space Station Freedom. A hazard scenario is provided to demonstrate a process commonly used by safety engineers and other analysts to identify onboard safety risks. Fire strategies are described, including a review of fire extinguishing agents being considered for the Space Station. Lessons learned about fire safety technology in other areas are also noted. NASA and industry research on fire safety applications is discussed. NASA's approach to ensuring safety for manned spacecraft is addressed in the context of its multidiscipline program.

Rodney, George A.↗
DOE OSTI2019

Aryl azide-sulfonamide hybrids induce cellular apoptosis: synthesis and preliminary screening of their cytotoxicity in human HCT116 and A549 cancer cell lines

Simple, small, drug-like molecules bearing aryl azide and aryl sulfonamide moieties were designed and synthesized. The cytotoxic activity of these compounds was measured on colon cancer HCT116, lung cancer A549, and normal fibroblast cells F180 cell lines. All the synthesized compounds showed a significant cytotoxic activity below 100 µM in both HCT116 and A549 cells. Compounds 10e and 10f exhibited the most potent activity with IC{sub 50} values of 2.20 and 6.27 µM on A549 and HCT116 cells, respectively. Also, compounds 10e and 10f showed significant tumor selectivity on HCT116 and A549 cell lines when compared with the reference cytotoxic agent staurosporine. This indicated the promising safety of these compounds on normal cells. In addition, flow cytometry studies showed that HCT116 cell lines treated with the most active compound 10f were arrested in the G2/M phase of the cell cycle. 10f boosted both early and late apoptosis at HCT116 cells. A hypothetical pharmacophore model was built using 14 reported potent carbonic anhydrase I inhibitors. The pharmacophoric study revealed that the tested sulfonamide derivatives 10e and 10f showed significant fitting on the pharmacophore query with reasonable RMSD values. Molecular docking study showed a chelation reaction with the key Zn atom, in addition to different hydrogen bonding, and van der Waals interactions with several important amino acids inside the CA Ι active site. .

60 APPLIED LIFE SCIENCES↗
NASA NTRS2001

The Conference Proceedings of the 2001 Air Transport Research Society (ATRS) of the WCTR Society

The ATRS held its Annual conference at Jeju Island, Korea in July 2001. The conference was a success with nearly 140 participants including 70 presenters. This report contains presentations from Volume 1 on the following: Airline and Travel Agent Relationships in Asia;Benchmarking Aviation Safety in the Commercial Airline Industry;Impact of Frequent Flyer Program on the Demand for Air Travel; Application of Genetic Algorithm on Airline Schedule;The Effects of Dual Carrier Designation and Partial Liberalization: The Case of Canada;Defense of Air Carriers and Air Agencies in FAA Enforcement proceedin gs - Damage Control Before the Case Arises; Cost Incentives for Airline Mergers? - An examination on the cost impact of U.S. airline mergers and acquisitions;Airport Regulation, Airline Competition and Canada's Airport System; Airline Competition: The Case of Israel's Domestic Doupoly; Non-Financial Indicators of Airline Distress: A Conceptual Approach;and Airport Privatization: An Empirical Analysis of Financial and Operational Efficiency.

Lee, Yeong-Heok↗
NASA NTRSDate not supplied

Human Factors Research Considerations for Terminal Area Urban Air Mobility Operations

In this presentation, we discuss the human factors research challenges from introducing greater levels of automation in a future air transportation concept called Urban Air Mobility (UAM). UAM is an air transportation concept that aims to provide air transportation services to the daily commuter, as well as emergency response and package delivery. The principal innovation over current day large air transport system is the greater distribution of important safety functions to automated and human agents; these functions include air traffic management, traditionally an air traffic controller responsibility. A central aspect of UAM is the development of an automated air traffic manager, whose primary responsibility is to approve airspace access for vehicle operators. Vehicle operator roles may include onboard and remote pilots, as well as a human manager who will supervise an entire fleet. Alternatively, both fleet manager and vehicle operators can be merged into a single role – a feasible option if UAM aircraft are autonomous. In lieu of tower controllers, vertiport managers, with the assistance of automation, will manage arrival and departure schedules between vertiports, as well as supervise surface operations. Our approach here will be to introduce use cases currently being developed by NASA, and then provide preliminary definitions for each of the roles introduced above and how coordination between them can be configured to support the operations within the use cases described. Subsequently, we review the tools and interfaces being developed to support the various roles. To conclude, we present current human factors work related to defining the roles above and suggest future work to advance the UAM concept.

trial planning↗
DOE OSTI2015

Double-Blind, Placebo-Controlled Pilot Study of Processed Ultra Emu Oil Versus Placebo in the Prevention of Radiation Dermatitis

Purpose: The purpose of this single-institution pilot study was to evaluate the feasibility and safety of an oil-based skin agent, Ultra Emu Oil, on skin-related toxicity in patients undergoing radiation therapy to the breast or chest wall. Methods and Materials: Patients were randomized 2:1 in a double-blind fashion and were instructed to apply processed Ultra Emu Oil or placebo (cottonseed oil) twice daily during the course of radiation therapy. The oils were applied before the third fraction and continued for 6 weeks after completion of treatment. The primary endpoint was the area under the curve (AUC) of Skindex-16 scale scores over time. Secondary outcomes included maximum grade of radiation dermatitis using the Common Terminology Criteria (CTC) for Adverse Events (CTCAE 3.0), the Skin Toxicity Assessment Tool, quality of life (QOL) measured by Linear Analogue Self-Assessment, and a symptom experience diary (SED). Results: In all, 42 of 45 patients completed the study and were evaluable. The median times to peak rash, skin redness, peeling, and skin swelling were weeks 6, 6, 7, and 7, respectively as measured by the SED. The Skindex AUC scores tended to be lower in emu oil patients than in placebo patients (mean total AUC 7.2 vs 10.4, respectively). This trend was also seen in all the Skindex subdomains. The overall QOL was slightly better in the emu oil group but remained stable throughout the study for both arms. Peak CTC toxicity occurred at week 6. Patients using emu oil appeared slightly worse on maximum CTC grade, but the difference was not significant. Conclusions: This pilot study confirmed the safety of oil-based skin treatments during radiation therapy and suggests a trend for reduced skin toxicity for patients receiving emu oil. A larger study is needed to evaluate the efficacy of emu oil in reducing radiation dermatitis in patients receiving breast radiation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Mathematical modeling in cancer nanomedicine: a review

Cancer continues to be among the leading healthcare problems worldwide, and efforts continue not just to find better drugs, but also better drug delivery methods. The need for delivering cytotoxic agents selectively to cancerous cells, for improved safety and efficacy, has triggered the application of nanotechnology in medicine. This effort has provided drug delivery systems that can potentially revolutionize cancer treatment. Nanocarriers, due to their capacity for targeted drug delivery, can shift the balance of cytotoxicity from healthy to cancerous cells. The field of cancer nanomedicine has made significant progress, but challenges remain that impede its clinical translation. Several biophysical barriers to the transport of nanocarriers to the tumor exist, and a much deeper understanding of nano-bio interactions is necessary to change the status quo. Mathematical modeling has been instrumental in improving our understanding of the physicochemical and physiological underpinnings of nanomaterial behavior in biological systems. Here, we present a comprehensive review of literature on mathematical modeling works that have been and are being employed towards a better understanding of nano-bio interactions for improved tumor delivery efficacy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2017

An assessment of the safety, hemodynamic response, and diagnostic accuracy of commonly used vasodilator stressors in patients with severe aortic stenosis

Background: Increasing numbers of patients are undergoing transcatheter aortic valve replacement, which often involves assessment of coronary artery disease ischemic burden. The safety and diagnostic accuracy of vasodilator stress agents in patients with severe aortic stenosis (AS) undergoing SPECT myocardial perfusion imaging (MPI) has not been established. Methods: Patients with severe AS (valve area <1 cm{sup 2}) on echocardiography who underwent vasodilator stress SPECT MPI at two centers were identified. Patients with aortic valve intervention prior to MPI or who underwent concurrent exercise during stress testing were excluded. AS patients were matched to controls without AS based on age, gender, BMI, ejection fraction, and stress agent. Symptoms, serious adverse events, hemodynamic response, and correlation to invasive angiography were assessed. Results: A total of 95 cases were identified with 45% undergoing regadenoson, 31% dipyridamole, and 24% adenosine stress. A significant change in systolic blood pressure (BP), cases vs controls, was observed with adenosine [−17.9 ± 20.1 vs −2.6 ± 24.9 P = .03)], with a trend toward significance with regadenoson [−16.8 ± 20.3 vs −9.4 ± 17.9 (P = .08)] and dipyridamole [−17.8 ± 20.6 vs -9.0 ± 12.1 (P = .05)]. The change in heart rate was significantly different only for adenosine [5.3 ± 16.8 vs 14.2 ± 10.8 (P = .04)]. Overall, 45% of cases vs 24% of controls (P = .004) had a >20 mmHg decrease in systolic BP. Age, BMI, and resting systolic BP were related to a >20 mmHg decrease in systolic BP on univariate analysis, although only higher resting systolic BP was a predictor on multivariate analysis. In 33 patients who underwent angiography, the sensitivity, specificity, and diagnostic accuracy of vasodilator stress MPI was 77%, 69%, and 73%, respectively. No serious adverse events occurred in the severe AS patients. Conclusion: Severe AS patients are more likely to have a hemodynamically significant decrease in systolic BP with vasodilator stress. There were no serious adverse events in this severe AS cohort with good diagnostic performance of MPI compared to angiography.

62 RADIOLOGY AND NUCLEAR MEDICINE↗