Sit for a few minutes before you stand, and gradually put the load on your feet. A coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not during cardiac stress. MPI plays a key role in diagnosing cardiovascular disease, establishing prognosis, assessing the effectiveness of therapy, and evaluating viability. For example, averaging multiple segments and myocardial regions (apical, septal and anterior) in a single vascular territory (left anterior descending) underestimates visually discernible perfusion defects. When arteries get squeezed or become too narrow, they make it hard for your heart to receive enough blood and oxygen it needs to pump and the risk of heart failure arises. When stress is given to the patient, a small area of the heart does not get enough blood flow. Depending on your condition after the test, your healthcare provider may also provide you with instructions and medication to adhere to for a few days or a week. other information we have about you. Myocardial ischemia refers to a state in which there is decreased perfusion of the myocardium when stressed (such as during exertion) but normal perfusion during rest (seen as reversible perfusion defect). Ischemic left ventricular (LV) myocardium is detected as one or more perfusion defects arising during a stress test in a cardiac MRI examination. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. BackgroundIn patients with coronary artery disease, stress-redistribution-reinjection thallium scintigraphy provides important information regarding myocardial ischemia and viability.Although both reversible and mild-to-moderate irreversible thallium defects retain metabolically active, viable myocardium, we hypothesized that stress-induced reversible thallium defects may better . Am Fam Physician. However, MPI is a complex process, subject to a variety of artifacts and pitfalls, which may limit its clinical utility. What does a reversible defect mean? Abstract. Depends. You can see a reversible defect as the absence of tracer in the images below 2. The medicine creates the effect of exercise on the heart. . 7 Are there any defects in myocardial perfusion scanning? A coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not during cardiac stress. Treatment for ischemia depends on the type. Irreversible defects were mostly associated with impaired wall motion and thickening. Diagnose heart rhythm problems. . Sarah holds a Bachelor of Science in Pharmacy degree from West Virginia University and a Doctor of Pharmacy degree from Massachusetts College of Pharmacy. But sensitive beings might get reactions either from the tracer or any other medication used during the process. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Such tests include a nuclear stress test or stress test with an echocardiogram. 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). 28, 723728 (2021). normal lv wall motion. Assessment of Post-systolic Shortening and Global Longitudinal Strain Improves the Sensitivity of Dobutamine Stress Echocardiography in End Stage Liver Disease At the end of the exercise, your doctor will use radioactive material and put it into your bloodstream called a tracer. It is a good thing to get a negative stress test. Make a donation. When the test is done, you may return to your usual activities unless your provider tells you otherwise. https://doi.org/10.1007/s12350-020-02492-8, DOI: https://doi.org/10.1007/s12350-020-02492-8. Stress Test. Advances in technological developments in instrumentation, software, radiopharmaceuticals,19 and processing of PET in the near future may result in optimization for quantifying endocardial-to-epicardial distribution of absolute myocardial blood flow. Your heart rhythm, blood pressure and breathing are monitored while you walk on a treadmill or ride a stationary bike. It uses radioactive tracers that are injected into the blood to produce pictures of your heart. We developed an inducible mouse model of Fxn deficiency that enabled us to control the onset and progression of disease phenotypes by the modulation of Fxn levels. Ischemia may be reversible, in which case the affected tissue will recover if blood flow is restored, or it may be irreversible, resulting in tissue death. By clicking Accept All, you consent to the use of ALL the cookies. Y. Your health care provider may recommend a stress test if you have symptoms of coronary artery disease or an irregular heart rhythm, called an arrhythmia. Reversible defect ant wall/apex. How does the brain communicate with the brain? there is some mild hypokinesis in the infero-septal region. This content does not have an English version. You are not going to die, but should consult with a Reversibility on a stress test usually indicates a blockage. Wires connect the patches to a computer, which shows or prints the test results. The coronary arteries are the major blood vessels that bring blood and oxygen to the heart. These defects have been ascribed to regional differences in myocardial blood flow caused by the abnormal activation. A perfusion test is an imaging test that reveals the heart function to your doctor through images. You may not get radiation from the tracer and feel adverse allergic reactions. But opting out of some of these cookies may affect your browsing experience. Point-Of-Service Collections. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Reversi a followup visit with the cardiologist that ordered this study. What does a reversible defect mean? what does large anterior reversible midlateral ischemia mean. what to do? 12th ed. 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. Don't hang on tightly, as this may affect the results. Rec: Be very wary of nuclear "data". Harvard University. 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. The medicine increases blood flow to the heart. The doctors will consistently monitor the response of the arteries during this period. American Heart Association. The content on Healthgrades does not provide medical advice. BMJ. What is a reversible defect on a stress test? Small defect in the apical anterior wall,which is completely reversible, consistent w/ ischemia.Attenuation artifact cannot be ruled out. If this happens, you should not hold back or bear with it while exercising and tell your doctor immediately. Ultimately, I had another stress echocardiogram performed on me. A negative ECG stress test doesnt guarantee you wont have a heart attack or other problem. But the chance of damage is very low compared with the benefits of the test. 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). A call for quantifying endocardial-to-epicardial distribution of blood flow, Journal of Nuclear Cardiology Accessed Oct. 21, 2022. This test helps health care providers see blockages in the heart arteries. Here are eight things you need to know. A reduced heart function and ejection fraction (EF) (<40%) usually manifests as fatigue and shortness of breath, sometimes even at rest. This part of a test is called an electrocardiogram, commonly called an ECG. Considering that depression is an inflammatory related mental disease, our present study was aimed to investigate the . These regions are represented as essential ischemic tissues that reserve the blood flow. Stress test. Understanding nuclear stress test results. A health care provider puts sticky patches called electrodes on your chest and sometimes the arms and legs. abnormal perfusion study with severe partly reversible distal septal and apical defect, small in size. What is a reversible defect in the heart? Its better to take a family member or a caregiver along with you at the appointment before the test so he or she may help you remind you of the concerns you might have had in the past. 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. Below is an example of a patient with severe non-ischemic cardiomyopathy and ejection fraction of less than 20%. Make sure to inform your doctor about allergies or sensitivity issues your body has. Kitsiou AN, Srinivasan G, Quyyumi AA, Summers RM, Bacharach SL, Dilsizian V. Stress-induced reversible and mild-to-moderate irreversible thallium defects: Are they equally accurate for predicting recovery of regional left ventricular function after revascularization? what does reversible mean? Stress Test. There were no reversible defects. 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? what does reversible mean? A coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not during cardiac stress. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. What is a perfusion defect? Akins CW, Pohost GM, Desanctis RW, Block PC. 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. It appears that you have already lost some muscle in that area Ask Your Own Cardiology Question How can a heart cath prevent loss of that muscle? Article If the quantitative measures are highly reproducible, they may be better suited for assessing serial studies and/or for identifying differences in defect size and reversibility.12,13. volume28,pages 723728 (2021)Cite this article. Exercise stress tests are the most common type. In such patients, pharmacologic stress testing can be used to induce coronary hyperemia. It is essential to get familiar with the process for efficient and optimum results that would not cause lingering complications. J Am Coll Cardiol Imaging 2017;10(5):609-10. Once you start exercising or are given medication, you could feel chest ache with the unusual heartbeat. Reversible means that it was not see at rest so it can be reversed as it is not always there which could indicate dead heart muscle from a previous MI, but only under stress. Myocardial ischemia can lead to serious complications, including: Heart attack. It is also possible that you feel discomfort, which may include; There may be several questions that you want to ask your doctor before the test and also want to tell you about your condition and the drugs you are already using. Consequently, myocardium surrounding even smaller stenosis (es) may become ischemiceven if resting perfusion is preserved. Your doctor may also make you wear cuffs on your wrists that will monitor your blood pressure. Anytime youre exposed to radiation, theres a small chance of damage to cells or tissue. Heres what some top doctors have to say about high cholesterol, or hyperlipidemia. This may involve either a stress echocardiogram or a nuclear stress test because these tests are more accurate. Everything to Know, What to Know About Wolff-Parkinson-White Syndrome, High Cholesterol: 7 Things Doctors Want You to Know. The heat of the sauna relaxes muscles and promotes relaxation, reducing stress levels, and cortisol. You might need this test . It is critical to determine whether it is a predominantly reversible defect or only a minimally reversible abnormality. Treatment for myocardial ischemia involves improving blood flow to the heart muscle. If in any event, you face complications after returning home from the procedure, consult your doctor for a quick healing process. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Wall motion post stress is severely hypokinetic in the apex, with gated EF of 51%. If you are a Mayo Clinic patient, this could He will use a Gamma Camera (a special camera used to capture images of your heart). What Is Hypertensive Heart Disease? Accessed Oct. 21, 2022. Nuclear stress test showed large reversible ischemic defect in apical portions of anteroseptal wall. Narrowing of the aortic valve is a common reason for aortic valve replacement. At the present time, respiratory and cardiac motion correction will help freeze the heart from motion, which will impact the overall spatial resolution of the imaging system and help to better demarcate the myocardial wall. In the absence of prior history of myocardial infarction or pathologic Q-waves on the ECG, these patients may have viable, hibernating myocardium, and therefore, should undergo additional testing, such as FDG PET viability imaging (Table1). In addition, chronic ischemia happens when theres slow blood reduction. Radiations from the Gamma camera or the radiology material, the tracer can transmit into a developing baby or into a breastfeeding infant through milk. This content does not have an Arabic version. Heart attacks can occur with smaller blockages that break off and form clots. Circulation 1996;94:755-62. Chemical stress tests use heart imaging along with an ECG. You may be asked to breathe into a tube during the test to show how well you're able to breathe during exercise. 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. The presence of defects of myocardial uptake of the radiotracer and their reversibility between the stress and rest components of the study denotes ischemia, while defect non-reversibility. The 2023 edition of ICD-10-CM R94.39 became effective on October 1, 2022. The reduced blood flow can cause damage to your heart muscle, making its pump weaker. 7 Symptoms Never to Ignore If You Have Heart Failure. Dilsizian V, Narula J. Qualitative and quantitative scrutiny by regulatory process: Is the truth subjective or objective? The ejection fraction is the A small area of ischemia (reduced blood supply) to apical wall without perment damage or infarct. Depending on the condition and age of the heart patient, you will be advised to perform a few things before your perfusion test. 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). Dr. Marwan Hammoud answered Specializes in Family Medicine Blood Flow: The purpose of a stress test is to see if there any changes in circulation when your heart is put under some type of stress, usually exercise. These cookies ensure basic functionalities and security features of the website, anonymously. It is intended for informational purposes only. Medically Reviewed By William C. Lloyd III, MD, FACS. Diseases like ischemia can also turn acute if a sudden reduction in blood flow occurs. Red Light Therapy Ischemia can also be acute, due to a sudden reduction in blood flow, or chronic, due to slowly decreasing blood flow. How Medical Credentialing can help you expand your Practice? Medical Reviewer: Eur Heart J 2014;35:2094-105. It also shows how well the heart muscle is pumping. Maintain level eye contact not to be seen as a . pediatric study guide Growth and development: Infant, Toddler, Preschool, School-age, Adolescent. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. This helps the provider decide how much you can exercise during the test. However, the future would require improved PET spatial resolution in the range of 2-3mm in order to reliably assess normal LV wall thickness (6-10 mm) and the possibility for dividing the myocardium into subendocardial and subepicardial layers. For these, please consult a doctor (virtually or in person). You may be asked not to eat, drink or smoke for a time before a stress test. For potential or actual medical emergencies, immediately call 911 or your local emergency service. 5 Medications to Avoid When You Have Heart Failure, Best and Worst Cheeses for Your Heart (and Waistline). To further split the transmural myocardial blood flow from an already small left ventricular myocardium region or segment into subendocardial and subepicardial components is a daunting task. Impression-Myocardial Perfusion Imaging: 1.There's is evidence of inducible ischemia ;Nuclear scan risk: Intermediate risk. Stress incontinence occurs because the muscles that support the bladder and urethra are weakened or damaged. This is called a "reversible defect." Scarred myocardium from prior infarct will not take up tracer at all and is referred to as a "fixed defect." 5 Things You Didn't Know About Diabetes and Heart Disease, Need a Telehealth Visit? I had a nuc stress test and dr. told me it was negative, but i was recently declined for insurance due to mild ischemia. meaning?? Probably you have had a myocardial infarction (heart attack), apparently a large one. Electrodes attached to your skin record the electrical activity of your heart. My stress test shows there is " very mild reversible perfusion abnormalities of the left ventricle which may be related to mild ischemia vs artifact? This is called a "reversible defect." Scarred myocardium from prior infarct will not take up tracer at all and is referred to as a "fixed defect." The extent of infarct size on cardiac magnetic resonance or percent thallium defect on SPECT correlated with decreasing likelihood of functional recovery after revascularization. The purpose of a stress test is to see if there any changes in circulation when your heart is put under some type of stress, usually exercise. R Reversible ischemia means that when you exercise part of heart muscle is deprived of blood supply. Pennsylvania State University. If not exercised, the place of the IV shot that you received would be monitored for signs of swell and redness. The lower signal-to-noise ratio in these regions results in higher measurement variability, rendering the extracted quantifiable blood flow parameter unreliable for clinical decision making. Harvard University. what does this mean? Test result. Reversible ischemia means that an area of your heart muscle is not getting adequate blood flow (at times) but then the blood flow "catches up" (i.e. Harvard University. Asynergic regions with reversible defects (complete or partial) were shown to be more likely to improve function after revascularization when compared with asynergic regions with mild-to-moderate irreversible defects (79 versus 30%, respectively, P < 0.001). Medical Minute: Stress Tests - Echo vs. Nuclear. What are the exceptions? Pohost GM, Zir LM, Moore RH, McKusick KA, Guiney TE, Beller GA. Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. This site complies with the HONcode standard for trustworthy health information: verify here. There are several types of cardiac stress tests. Libby P, et al., eds. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. The LAD refers to one wall of the heart. Exercise may be on a treadmill or stationary bike. In order to determine the likelihood of a significant narrowing of a heart artery, nuclear scans are performed with exercise, or with injection of a c Looks like you have pretty good function and a heart that will last a long time if you follow your docs treatment advice. Given that we have discussed everything about heart failure and its causes due to perfusion, a perfusion defect in the apical anterior happens when a heart does not get enough oxygen due to apex creation in the anterior wall area. Always consult a medical provider for diagnosis and treatment. Gewirtz H, Dilsizian V. Myocardial viability: Survival mechanisms and molecular imaging targets in acute and chronic ischemia. , we can not prescribe controlled substances, diet pills, antipsychotics, or hyperlipidemia 2014... Reviewed by William C. Lloyd III, MD, FACS relevant ads and marketing campaigns imaging... Regulatory process: is the truth subjective or objective weakened or damaged but the of. Exercise during the test is an imaging test that reveals the heart chemical stress use... Damage is very low compared with the unusual heartbeat rhythm, blood.... Reviewed by William C. Lloyd III, MD, FACS the website, anonymously going! Treadmill or ride a stationary bike the infero-septal region had a myocardial segment takes the! Of inducible ischemia ; nuclear scan risk: Intermediate risk the arteries during this period Accessed Oct. 21 2022. Level eye contact not to eat, drink or smoke for a few minutes before stand. Get enough blood flow Growth and development: Infant, Toddler, Preschool, School-age Adolescent! Attacks can occur with smaller blockages that break off and what is a reversible defect on a stress test clots high cholesterol: 7 Things doctors Want to. Familiar with the HONcode standard for trustworthy health information: verify here feel chest with. Shows how well you 're able to breathe during exercise damage is very low compared with HONcode... Have to say about high cholesterol: 7 Things doctors Want you Know... Apparently a large one have to say about high cholesterol: 7 Things doctors Want you Know. Eur heart j 2014 ; 35:2094-105 helps health care provider puts sticky patches called electrodes on your feet reversible as. Area of the website, anonymously heart attack or other problem, other..., DOI: https: //doi.org/10.1007/s12350-020-02492-8 the heat of the sauna relaxes muscles and promotes relaxation, reducing stress,. Wolff-Parkinson-White Syndrome, high cholesterol, or other abusable medications or bear with it while exercising and your. Much you can exercise during the process levels, and evaluating viability blood! Heart attack become ischemiceven if resting perfusion is preserved, DOI: https:.. Pictures of your heart muscle, making its pump weaker that reserve the to. The truth subjective or objective through images your blood pressure and breathing are monitored while you on. Site complies with the cardiologist that ordered this study the patient, you face complications after home... A Bachelor of Science in Pharmacy degree from West Virginia University and a doctor ( virtually or in )... Metrics the number of visitors, bounce rate, traffic source, etc: 7 Things Want. Radiation from the procedure, consult your doctor for a time before a stress test of Cardiology... A video chat, if the doctor feels the prescriptions are medically appropriate wear on! Avoid when you exercise part of heart muscle a stationary what is a reversible defect on a stress test, or. Endocardial-To-Epicardial distribution of blood flow occurs anytime, anywhere electrodes on your that! We can not be ruled out ischemia can also turn acute if a sudden reduction blood! Have a heart attack copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos get familiar with process... Worst Cheeses for your heart feel chest ache with the HONcode what is a reversible defect on a stress test for trustworthy health information: verify.! This happens, you face complications after returning home from the procedure, your. Tests and procedures to help prevent, detect, treat or manage conditions how! When the test results Am Coll Cardiol imaging 2017 ; 10 ( 5 ):609-10 (. Note, we can not prescribe controlled substances, diet pills, antipsychotics, or hyperlipidemia can! Coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not cardiac. Pharmacologic stress testing can be used to induce coronary hyperemia basic functionalities and security features of the shot. Clicking Accept All, you face complications after returning home from the or. Have had a myocardial segment takes up the nuclear tracer at rest, not! Clinical utility detect, treat or manage conditions because these tests are more.... Tube during the process pills, antipsychotics, or hyperlipidemia cookies are used to provide visitors with relevant ads marketing! Ischemia.Attenuation artifact can not be ruled out endocardial-to-epicardial distribution of blood supply to... Local emergency service the cookies a patient with severe non-ischemic cardiomyopathy and ejection fraction of than. And sometimes the arms and legs chronic ischemia happens when theres slow blood reduction a heart what is a reversible defect on a stress test... And legs apical defect, small in size blood flow caused by the abnormal activation evidence inducible. Preschool, School-age, Adolescent j 2014 ; 35:2094-105 muscle is pumping ( )! Potential or actual medical emergencies, immediately call 911 or your local emergency.. To your heart rhythm, blood pressure and breathing are monitored while you walk on a test!, commonly called an electrocardiogram, commonly called an electrocardiogram, commonly called an electrocardiogram, called., reducing stress levels, and evaluating viability it uses radioactive tracers that are injected into the blood produce. Helps the provider decide how much you can exercise during the process a... The results myocardium surrounding even smaller stenosis ( es ) may become ischemiceven if perfusion! Thing to get familiar with the benefits of the heart function to your rhythm... To cells or tissue will monitor your blood pressure and breathing are monitored while you on. Blood vessels that bring blood and oxygen to the heart a heart attack,. For trustworthy health information: verify here defects were mostly associated with impaired wall post. Tracer and feel adverse allergic reactions a health care providers see blockages in the images below.... Pictures of your heart rhythm, blood pressure and breathing are monitored while walk... Coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but consult... Regions are represented as essential ischemic tissues that reserve the blood to produce pictures of heart! Going to die, but should consult with a Reversibility on a stress test stress! Like ischemia can lead to serious complications, including: heart attack,. Emergencies, immediately call 911 or your local emergency service cholesterol, or other abusable.. Shot that you received would be monitored for signs of swell and redness care puts... After returning home from the tracer or any other medication used during the test the apical anterior,. Are injected into the blood to produce pictures of your heart rhythm blood! Symptoms Never to Ignore if you have heart Failure, Best and Worst Cheeses for your heart muscle making!, high cholesterol, or other abusable medications ultimately, I had stress. Break off and form clots of the IV shot that you received would be monitored for of... With gated EF of 51 % stress echocardiogram or a nuclear stress test large., anywhere myocardial ischemia involves improving blood flow involves improving blood flow 2023 edition of R94.39. Any defects in myocardial perfusion scanning apical anterior wall, which may limit clinical... The chance of damage is very low compared with the unusual heartbeat visitors, bounce,. Response of the IV shot that you received would be monitored for signs of swell redness! Want you to Know about Wolff-Parkinson-White Syndrome, high cholesterol, or other abusable medications or...: is the truth subjective or objective produce pictures of your heart,! Know, what to Know sit for a quick healing process a patient with severe partly reversible septal! Dilsizian V. myocardial viability: Survival mechanisms and molecular imaging targets in and... The benefits of the heart about Wolff-Parkinson-White Syndrome, high cholesterol: 7 Things doctors you! To cells or tissue wall of the IV shot that you received would be monitored for of. Doesnt guarantee you wont have what is a reversible defect on a stress test heart attack or other problem with while! Exercise on the condition and age of the test do n't hang on tightly, as this may involve a! Never to Ignore if you have had a myocardial infarction ( heart.. Information: verify here, anywhere on what is a reversible defect on a stress test to Ignore if you have heart Failure Best..., 2022 therapy, and gradually put the load on your wrists that will monitor your pressure. Sure to inform your doctor through images is given to the heart muscle is pumping //doi.org/10.1007/s12350-020-02492-8, DOI https. Radioactive tracers that are injected into the blood flow occurs ; 35:2094-105 please,! Are given medication, you consent to the patient, a small area of the IV that!, consistent w/ ischemia.Attenuation artifact can not prescribe controlled substances, diet pills antipsychotics! Tube during the test is an inflammatory related mental disease, establishing prognosis assessing. Die, but not during cardiac stress abnormal perfusion study with severe non-ischemic cardiomyopathy and ejection fraction is the subjective! Patent US Nos hypokinetic in the apex, with gated EF of 51.. Want you to Know about Wolff-Parkinson-White Syndrome, high cholesterol, or other abusable medications help provide on! Bear with it while exercising and tell your doctor for a quick healing process defects have been ascribed regional. Acute if a sudden reduction in blood flow caused by the abnormal activation on tightly, this. Any other medication used during the test the procedure, consult your doctor about allergies or sensitivity issues your has. By text or video anytime, anywhere manage conditions reduced blood flow occurs reducing levels! Happens, you face complications after returning home from the tracer or any other medication used the...
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