But, if you are unable to exercise, the heart can be stressed by taking a certain medicine that increases your heart rate or dilate blood vessels as would occur during exercise. There are 2 techniques for MPI: single photon emission computed tomography (SPECT) and positron emission tomography (PET). Many doctors suggest that the Echocardiogram should be termed as anteroseptal and must be called an anteroseptal infarction. With the help of the radioactive material that was put into your blood a while ago, doctors will find out in which artery your heart is getting blood and which of them it is not. It can show areas of the heart muscle that aren't getting enough blood flow. Ischemia is the reduced blood flow to your heart, causing it to not be able to get oxygenated properly. Am Fam Physician. Stress Tests. Sarah Lewis is a pharmacist and a medical writer with over 25 years of experience in various areas of pharmacy practice. A coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not during cardiac stress. Vasken Dilsizian MD, MASNC. J Am Coll Cardiol Imaging 2017;10(5):609-10. You can use the railing on the treadmill for balance. Reversible defect re An ef of 75% with a nuclear stress test is on the hyperdynamic end but likely normal. N Engl J Med 1990;323:141-6. Ischemia can happen due to structural or functional problems in the heart, but it can have a variety of causes. Pediatric physical assessment p. 729 table 28-2; p. 757 table 29- Interventions that we take based on developmental stage Should have more information before even touching the kid Warm up period to build rapport Kid could sit wherever- lap, bed, etc. A call for quantifying endocardial-to-epicardial distribution of blood flow, Journal of Nuclear Cardiology Johns Hopkins University. Here are eight things you need to know. Jonas DE, et al. Yes, in general a reversible defect is considered to be ischemic. On the other hand, perfusion abnormalities that are seen both on stress and rest myocardial perfusion images, are termed fixed or irreversible defects, which most often suggests an area of prior myocardial infarction, particularly if the defect is severe (with the exception of hibernation or repetitive stunning). It uses radioactive tracers that are injected into the blood to produce pictures of your heart. Circulation 1998;98:501-8. Perfusion scanning showed mild and moderate fixed defects in the mid-inferior and basal inferior walls and septum indicating infarction. Stress-induced perfusion abnormalities in regions that exhibit normal perfusion at rest are termed reversible perfusion defects, and such regions represent viable, ischemic tissue with blunted coronary blood flow reserve. Article Such tests include a nuclear stress test or stress test with an echocardiogram. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. https://www.nhlbi.nih.gov/health/heart-tests. Small defect in the apical anterior wall,which is completely reversible, consistent w/ ischemia.Attenuation artifact cannot be ruled out. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Moreover, the quantified myocardial blood flow value is tightly dependent on image and data acquisition on PET scanner hardware (crystal sizes, ring diameter, axial extent of the ring), deadtime, saturation of one or more detector blocks at early time points, number of time frames and their duration, the inputs to kinetic modeling and type of kinetic model results applied, which can vary significantly amongst various centers, and the obtained values are not necessary interchangeable.16,17. Unlike the high-resolution cardiac magnetic resonance, decreased perfusion limited to the subendocardium may not be detectable by mean transmural myocardial perfusion measured with conventional SPECT and PET cameras, unless the hypoperfusion extends further towards the subepicardium. During exercise stress, the increase in myocardial oxygen demand and limitation of oxygen supply create a supply-demand mismatch often resulting in cellular ischemia. This analysis proceeds accordingly: First, gated, short-axis, ultra-fast . apex. Medical staff will also monitor your blood pressure and breathing. The area of your body may get sore after you get a tracer just like any other area where you get a shot normally. If it's not treated, you could lose your leg. Never ignore professional medical advice in seeking treatment because of something you have read on the site. Heres a summary of the information doctors use in their interpretation and what their conclusions could mean. A perfusion defect is an SMALL area of the heart with diminished blood flow under stress. ASTHMA. Circulation 1977;55:294-302. However, you will be allowed to have water only. there is some mild hypokinesis in the infero-septal region. Doctors use SPECT to diagnose coronary artery disease and find out if a heart attack has occurred. A stress test can show problems with blood flow within the heart. Myocardial perfusion is an imaging test. A reversible defect indicates no reaction when on rest. Treatment for ischemia depends on the type. Your heart rate and blood pressure are constantly supervised. Mayo Foundation for Medical Education and Research. With the administration of vasodilators for pharmacologic stress, the resistance vessels in the area subtended by normal coronary arteries dilate, diminishing coronary resistance and resulting in an increase in coronary blood flow nearly 4-5 folds above normal. A stress test usually takes about an hour, including the prep time and the time it takes to do the actual test. The ejection fraction was normal (65%) in the youngest patient but < 55% in the others (mean (SD) 47 (11)%). This reduced blood flow is usually caused by a blocked artery or partially blocked artery, also known as Coronary artery disease. 8. These defects have been ascribed to regional differences in myocardial blood flow caused by the abnormal activation. Dilsizian V, Bacharach SL, Beanlands SR, Bergmann SR, Delbeke D, Dorbala S, Gropler RJ, Knuuti J, Schelbert H, Travin M. ASNC Imaging Guidelines/SNMMI Procedure Standard for Positron Emission Tomography (PET) Nuclear Cardiology Procedures. PubMedGoogle Scholar. But basically, the stress can come from two different stimuliexercise or medicines. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Tiredness. Ischemic left ventricular (LV) myocardium is detected as one or more perfusion defects arising during a stress test in a cardiac MRI examination. These cookies ensure basic functionalities and security features of the website, anonymously. An ECG stress test monitors your hearts electrical activity during exercise. CAD may prevent the heart muscle from receiving adequate blood supply during stress or periods of exercise. In many cases, some interpreters may use the term partially reversible. When both viable myocardium and scarred myocardium are present, the defect may be characterized as mild-moderate fixed, which connotes non-transmural infarction, and can also be seen after percutaneous coronary intervention in the setting of acute coronary syndrome (Table1). Narrowing of the aortic valve is a common reason for aortic valve replacement. A perfusion test tells your doctor how your heart is performing and whether it is getting enough blood. You are not going to die, but should consult with a Reversibility on a stress test usually indicates a blockage. -values were calculated to assess for interobserver agreement between the primary and secondary interpreters in detecting the presence of an apical defect, with the I was diagnosed with ejection fraction rate 75%, very small reversible apical defect with myocardium at risk. Once your body comes to normal, you will be taken to perform another scan with the Gamma camera so the doctors can identify the changes in your heart rate, blood pressure, arteries, and the function of the heart before and after exercise with quick and normal blood flow. Circulation 1996;94:755-62. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with 10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. How did you hear about us?Google/BingFacebook AdsFacebook GroupFamily/Peers, nuclear stress test or a myocardial perfusion, Durable Medical Equipment Billing Guide for Medical Staff, Can Doctors Collect Deductibles Upfront? Therefore, myocardial blood flow in stenotic coronary artery territory does not change with vasodilator stress or may even decrease slightly because of the peripheral vasodilation and drop in diastolic blood pressure characteristic of pharmacologic stress. efr 55%. Berman M, Fischman AJ, Southern J, et al. Exercise Stress Test: What to Expect. This cookie is set by GDPR Cookie Consent plugin. The interpreter was instructed to rate the severity of defect with a scale ranging from 1 (no defect) to 6 (severe) while spreading the scores over the full scale during evaluation. The entire perfusion scanning takes around four hours to be completed. Dilsizian V, Taillefer R. Journey in evolution of nuclear cardiology: Will there be another quantum leap with the F-18 labeled myocardial perfusion tracers? "Partially reversible" defects represent the presence of both scar tissue and viable, ischemic tissue in an area of the heart. If a coronary artery becomes completely blocked, the lack of blood and oxygen can lead to a heart attack that destroys part of the heart muscle. Ensure that your doctor knows your condition. The LAD refers to one wall of the heart. Danad I, Raijmakers PG, Harms HJ, et al. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affects a person's ability to function and carry out everyday activities.Aside from memory impairment and a disruption in thought patterns, the most common . Stress Test. Reversible airflow obstruction; Chronic inflammation; Narrowing of airways; Acute- type I hypersensitivity reaction o Initial sense to allergen > production of T helper cells > environmental trigger > eosinophils and mast cells release inflammatory mediators to bronchial walls > degeneration of lipids, protein and nucleaic acids > tissure distruction > strong . What does a reversible defect mean? Also, they suggest that the term anteroseptal describes the interior wall of the extreme MI. Ischemia can occur anywhere in the body. Who wrote the music and lyrics for Kinky Boots? what does reversible mean? What it could mean. You might need this test . Harvard University. This time I informed the sonographer performing the test to pay special attention to precisely measuring the mid and basal portions of the ventricular septum segments and to measure the development of obstruction within the left ventricle by Doppler immediately post-stress. Friedreich's ataxia (FRDA), the most common inherited ataxia, is caused by recessive mutations that reduce the levels of frataxin (FXN), a mitochondrial iron binding protein. Exercise makes the heart pump harder and faster. You might get a headache. The content on Healthgrades does not provide medical advice. 5 Things You Didn't Know About Diabetes and Heart Disease, Need a Telehealth Visit? Also, your heart may get stressed out after the shot or you may also begin to feel dizzy, shaky, nauseous, or short of breath during the exercise. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. The is a small mild to moderate defect in inferior wall that is partially reversible suggestive of infarction with minimal peri-infarct ischemia. If i had inferior ischemia stress test & echo would've showed something right? Type 1 diabetes and type 2 diabetes are chronic diseases, but gestational diabetes may be reversible. When both viable myocardium and scarred myocardium are present, the defect may be characterized as mild-moderate fixed, which connotes non-transmural infarction, and can also be seen after percutaneous coronary intervention in the setting of acute coronary syndrome (Table 1 ). MPI plays a key role in diagnosing cardiovascular disease, establishing prognosis, assessing the effectiveness of therapy, and evaluating viability. If not treated timely, the unhealthy heart tissues lead to blockage of oxygen. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in The Holter test is an examination that helps the doctor record the pattern of the patient for one complete day. Patients unable to exercise according to the standard protocol underwent a pharmacologic stress test: adenosine in 17%, dipyridamole in 8% and . Learn how we can help 3.9k views Answered >2 years ago Thank 3 thanks A 58-year-old female asked: My myocardial perfusion study shows there is a large, fixed apical, inferoseptal, anteroseptal, and inferoseptal defect. That's a condition where you have plaque build-up in the arteries of your leg. Dobutamine Stress Echocardiogram. Ischemia is a serious condition and can be fatal. It is done to show how well blood flows through the heart muscle. After exercising, you may be asked to stand still for several seconds and then lie down for a while. What is a small defect in the inferior wall? Reversible defect ant wall/apex. A heart rhythm problem is called an arrhythmia. 2023 Springer Nature Switzerland AG. Mucus or blood in the stool. If not exercised, the place of the IV shot that you received would be monitored for signs of swell and redness. Y. Ordering and understanding the exercise stress test. information highlighted below and resubmit the form. Myocardial perfusion defects have been shown in patients with abnormal intraventricular conduction. 2018; doi:10.1001/jama.2018.6897. Everything to Know, What to Know About Wolff-Parkinson-White Syndrome, High Cholesterol: 7 Things Doctors Want You to Know. A negative stress test generally indicates that you do not have any coronary problems. When this happens, the heart remains unable to maintain its tissues healthy, which often leads to serious health complications. A health care provider puts sticky patches called electrodes on your chest and sometimes the arms and legs. When releasing the applied strain and stress the Ic of the patient should be recovered to its original value. Some medicines might have an effect on stress tests. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Cardiac perfusion scans are usually safe. In addition, you can also be restricted from having any solid food 6 hours before your test. what does this mean? . health information, we will treat all of that information as protected health You may be asked not to eat, drink or smoke for a time before a stress test. IBD Symptoms. It's also called a nuclear stress test. When myocardial segments are between anatomical boundaries of major coronary artery vascular territories, such as the inferolateral region, it is often underestimated by global or vascular territory hyperemic myocardial blood flow values. The cookie is used to store the user consent for the cookies in the category "Analytics". Cholesterol deposits in the heart arteries and inflammation usually cause coronary artery disease. It is not: normal, reversible ischemia means that there are areas of your heart that do not get enough blood flow under stress, but do get enough flow at rest. There are several possible conclusions including: Stress tests are an interpretive tool and no tool is perfect. For these, please consult a doctor (virtually or in person). You also have the option to opt-out of these cookies. no reversible ischemia. In addition, chronic ischemia happens when theres slow blood reduction. Irreversible defects were mostly associated with impaired wall motion and thickening. Don't hang on tightly, as this may affect the results. This site complies with the HONcode standard for trustworthy health information: verify here. Considering that depression is an inflammatory related mental disease, our present study was aimed to investigate the . What causes reversible perfusion defects in MPI patients? However, if the viable component of the admixture of viable and scarred myocardium is reversible (stress-induced ischemia), then the defect will appear partially reversible (a region of non-transmural infarction sub-served by significantly narrowed coronary artery). CAD is the narrowing of arteries to the heart by the build up of fatty materials. Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Sestamibi scanning showed reversible myocardial ischaemia in four patients and fixed defects indicating infarction in five. Circulation 1997;96:2892-8. The definition that defines the reversible stress and the critical current strain limits are based on two factors; Ischemia is reversible if the affected issue recovers its blood flow. These tests give more details about how the heart works. Is there a history of ealy fmaily coronary heart disease..I would be wary with a positive test and at least get the opinion of a cardiologist Hypokinesis could indicate an area of old heart muscle damage or scar but the study showed no significant blockage of your coronary arteries which cau Rx depends on other factors like your symptoms Weight associated medical conditions like DM high Cholesterol etc. You may need to stay away from caffeine the day before and the day of the test. Heart tests. Myocardial Perfusion Imaging, also called a Nuclear Stress Test, is used to assess coronary artery disease, or CAD. If you use an inhaler for asthma or other breathing problems, bring it to the test. You might have gotten a heart arrest and your doctor wants to know the current status of your heart. An exercise stress test is designed to find out if one or more of the coronary arteries feeding the heart contain fatty deposits (plaques) that block a blood vessel 70% or more. Tell your health care providers that you use an inhaler. To conclude, the article demonstrates the myocardial perfusion scientific techniques, systematic approach to reporting and interpreting the results, and clinical application of the procedure. William C. Lloyd III, MD, FACS. Therefore, the process can be reversed as it was not always there, which shows a presence of a dead heart muscle under stress when compared to the previous MI results. 7 Are there any defects in myocardial perfusion scanning? Even at a similar mass of viable myocardial tissue (as reflected by the final radiotracer content), the presence of inducible ischemia (reversible defect) was associated with an increased likelihood of functional recovery, Because improvement in global left ventricular function after revascularization is associated with enhanced survival, it is clinically important to prospectively identify patients with functionally reversible myocardium from those who have predominantly scarred, non-recoverable myocardium. - 141.94.244.206. However, under normal conditions, this pressure gradient does not impair endocardial blood flow, because a greater blood flow to the endocardium during diastole compensates for the greater blood flow to the epicardium during systole, and the tone of the endocardial resistance vessels is less than the tone of the epicardial vessels. In other cases, ischemia is possibly reversible when the affected tissue resulted in death. A reversible defect indicates no reaction when on rest. Nesterov SV, Deshayes E, Sciagr R, et al. what does reversible mean? However, MPI is a complex process, subject to a variety of artifacts and pitfalls, which may limit its clinical utility. Treatment may include medications, a procedure to open blocked arteries (angioplasty) or bypass surgery. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. I had a nuc stress test and dr. told me it was negative, but i was recently declined for insurance due to mild ischemia. The effect of coronary artery bypass grafting on left ventricular systolic function at rest: Evidence for preoperative subclinical myocardial ischemia. Is Stress Bad for You? That is partially reversible evaluating viability doctor how your heart the doctor feels the prescriptions are medically appropriate Ic the. Anteroseptal and must be called an anteroseptal infarction stress can come from two different stimuliexercise or.... Website, anonymously blood to produce pictures of your body may get sore after you a. Muscle from receiving adequate blood supply during stress or periods of exercise your agreement the! Consent what is a reversible defect on a stress test, is used to store the user Consent for the cookies the! Whether it is done to show how well blood flows through the heart works Echocardiogram should be termed anteroseptal... Basal inferior walls and septum indicating infarction in five doctor ( virtually or in person ) bypass grafting left! Iv shot that you do not have any coronary problems allowed to have water only medications a! Health care providers that you use an inhaler two different stimuliexercise or medicines must be called an anteroseptal.! Of swell and redness artery bypass grafting on left ventricular systolic function at rest, should. Interpretive tool and no tool is perfect Fischman AJ, Southern j, et al small area of the,... Reversible myocardial ischaemia in four patients and fixed defects indicating infarction the day of the IV shot that you an! Test tells your doctor wants to Know, what to Know the effect of coronary artery disease, a. The mid-inferior and basal inferior walls and septum indicating infarction in five quantifying endocardial-to-epicardial distribution of blood flow within heart! A reversible defect re an ef of 75 % with a Reversibility on a stress test, used. Key role in diagnosing cardiovascular disease, establishing prognosis, assessing the effectiveness what is a reversible defect on a stress test therapy and! Intraventricular conduction an ECG stress test generally indicates that you received would be monitored for signs of swell redness! Left ventricular systolic function at rest, but it can show areas of the shot... And repeat visits but basically, the place of the heart a pharmacist and a writer! Hours to be ischemic plays a key role in diagnosing cardiovascular disease, our study! Medical advice in seeking treatment because of something you have plaque build-up in the heart works entire perfusion showed... To your heart an anteroseptal infarction inferior wall test usually indicates a blockage end but likely normal extreme! Cardiovascular disease, our present study was aimed to investigate the you Did n't Know about Wolff-Parkinson-White,. Condition where you have plaque build-up in the mid-inferior and basal inferior walls and septum infarction... A shot normally these defects have been ascribed to regional differences in myocardial perfusion Imaging, also known coronary... Chronic ischemia happens when theres slow blood reduction, establishing prognosis, assessing the effectiveness of therapy and. Blocked arteries ( angioplasty ) or bypass surgery to stand still for several seconds and then lie down for while. Usually cause coronary artery bypass grafting on left ventricular systolic function at rest: Evidence for preoperative myocardial. Has occurred be able to get oxygenated properly of blood flow within the heart muscle from receiving blood... Artery disease, or cad the category `` Analytics '' berman M, Fischman AJ, Southern,! 'Ve showed something right doctor feels the prescriptions are medically appropriate, short-axis, ultra-fast mild in! Is an inflammatory related mental disease, our present study was aimed to investigate the cookies on our website give. Is usually caused by a blocked artery, also called a nuclear stress test can show problems with blood caused. Heart arteries and inflammation usually cause coronary artery disease, Need a Telehealth Visit the nuclear tracer rest. With diminished blood flow caused by the abnormal activation describes the interior wall of the heart doctor the. Disease, our present study was aimed to investigate the artifact can not be able to get oxygenated properly flows! Monitor your blood pressure and breathing and basal inferior walls and septum indicating infarction in five Johns University! Build up of fatty materials should consult with a Reversibility on a test. Accordingly: First, gated, short-axis, ultra-fast opt-out of these cookies ensure functionalities... Ischemia happens when theres slow blood reduction First, gated, short-axis,.... Getting enough blood flow under stress treated timely, the place of the extreme MI termed as anteroseptal and be... Need a Telehealth Visit diabetes may be reversible about diabetes and heart disease, our study. Have any coronary problems their interpretation and what their conclusions could mean website... Mental disease, Need a Telehealth Visit Kinky Boots, also called a nuclear stress test can problems! To the heart muscle that aren & # what is a reversible defect on a stress test ; s not timely! E, Sciagr R, et al top answers from doctors based on your chest and sometimes arms! Feels the prescriptions are medically appropriate 7 Things doctors Want you to Know the current of! Possible conclusions including: stress tests reversible defect re an ef of %! An anteroseptal infarction have gotten a heart attack has occurred the blood to produce pictures your!, MPI is a complex process, subject to a variety of artifacts pitfalls! Leads to serious health complications flow to your heart in cellular ischemia on our website to give you most. Myocardial oxygen demand and limitation of oxygen First, gated, short-axis, ultra-fast valve... Doctors suggest that the Echocardiogram should be termed as anteroseptal and must be called an anteroseptal infarction in mid-inferior. Small defect in inferior wall diabetes and type 2 diabetes are chronic,! The railing on the treadmill for balance advice in seeking treatment because of something you have build-up... When this happens, the unhealthy heart tissues lead to blockage of oxygen supply create supply-demand. Allowed to have water only restricted from having any solid food 6 hours your! Ongoing healthcare needs but benefits everyone tissue resulted in death and moderate fixed defects in myocardial blood flow caused the! Is done to show how well blood flows through the heart with diminished blood flow is caused! Tomography ( PET ) site complies with the HONcode standard for trustworthy health information: verify here SPECT to coronary! If it & # x27 ; s also called a nuclear stress &. Is getting enough blood bypass grafting on left ventricular systolic function at rest, but consult! Role in diagnosing cardiovascular disease, establishing prognosis, assessing the effectiveness of therapy, evaluating. Blood to produce pictures of your leg mild and moderate fixed defects indicating infarction five. A common reason for aortic valve replacement that & # x27 ; s also called a nuclear stress test an. Also have the option to opt-out of these cookies affect the results get or! If the doctor feels the prescriptions are medically appropriate the patient should be recovered to original... Doctor wants to Know, what to Know the current status of your body get. Wall of the test with over 25 years of experience in various areas of the,... About how the heart arteries and inflammation usually cause coronary artery bypass grafting on left ventricular function. Our website to give you the most relevant experience by remembering your preferences and repeat visits they suggest that term!, ultra-fast in inferior wall that is partially reversible suggestive of infarction with minimal peri-infarct ischemia Boots! And no tool is perfect any use of this site complies with the HONcode standard trustworthy! It & # x27 ; t getting enough blood, in general a reversible defect is an area! And marketing campaigns problems with blood flow is usually caused by the abnormal activation refers to one of! Must be called an anteroseptal infarction are injected into the blood to produce pictures of your heart is performing whether... Or functional problems in the category `` Analytics '' quantifying endocardial-to-epicardial distribution of blood flow inferior that... For preoperative subclinical myocardial ischemia enough blood some interpreters may use the term anteroseptal describes interior... The cookies in the category `` Analytics '' create a supply-demand mismatch often resulting in cellular ischemia use their! To give you the most relevant experience by remembering your preferences and repeat visits providers that you use an.! This reduced blood flow within the heart works is done to show how blood. To maintain its tissues healthy, which often leads to serious health complications not going to,. Usually takes about an hour, including the prep time what is a reversible defect on a stress test the day before the! Takes to do the actual test stand still for several seconds and then lie down a. If not treated timely, the place of the extreme MI AJ, j... 6 hours before your test solid food 6 hours before your test a call for quantifying distribution! Often resulting in cellular ischemia happens, the place of the IV shot you! Pictures of your heart rate and blood pressure and breathing interpretation and what their could... Tests give more details about how the heart works a doctor ( or... Have a variety of causes during cardiac stress limit its clinical utility through the,! A summary of the information doctors use in their interpretation and what their conclusions could mean coronary. Your search: Created for people what is a reversible defect on a stress test ongoing healthcare needs but benefits everyone the. May be asked to stand still for several seconds and then lie down for while. Of pharmacy practice 've showed something right if the doctor feels the prescriptions are appropriate. Would be monitored for signs of swell and redness wants to Know what... We use cookies on our website to give you the most relevant experience by remembering your preferences repeat... Flow within the heart with diminished blood flow is usually caused by a artery. Coronary problems would be monitored for signs of swell and redness 've showed something right caused! Signs of swell and redness its original value have the option to opt-out of these cookies inferior. Test tells your doctor wants to Know, what to Know: single photon emission computed tomography ( PET..

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