It's also known as myocardial perfusion imaging or a nuclear stress test. And they can help your doctor recommend next steps for you. This is typically seen as a "reversible" perfusion defect, in that blood flow is insufficient to meet exercise demand and the defect appears with exercise or some other stress. 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. Of the 11 asynergic regions with normal stress thallium, 10 (91%) demonstrated improved systolic wall thickening after revascularization. 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. William C. Lloyd III, MD, FACS. And why is it dangerous for your heart? You might get a headache. June 21, 2018. Dilsizian, V. Interpretation and clinical management of patients with Fixed myocardial perfusion defects. Show how well heart treatment is working. When stress is induced through perfusion in the region of abnormalities but they show normal behavior it is termed reversible perfusion defects. A heart rhythm problem is called an arrhythmia. U.S. National Library of Medicine. The isotope used for SPECT imaging was thallium in 73% and technetium in 27% of the cases. 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. What Is Hypertensive Heart Disease? Ensure that your doctor knows your condition. The exercise stress comes from walking on a treadmill or pedaling a stationary bike. Wires connect the patches to a computer, which shows or prints the test results. It will easily get mixed in your blood and flows around your heart through arteries. J Am Coll Cardiol Imaging 2009;2:1037-8. People normally do not expose themselves to any reaction after the tracer is injected. The exercise part takes only around 15 minutes. If i had inferior ischemia stress test & echo would've showed something right? These cookies will be stored in your browser only with your consent. Chemical stress tests use heart imaging along with an ECG. Locations in the body this condition can affect include the heart, intestines, brain, and limbs. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. When releasing the applied strain and stress the Ic of the patient should be recovered to its original value. What is a myocardial perfusion scan? Using the medication containing theophylline and caffeine, Intake of the medication containing caffeine and theophylline within the 48 hours of the test, Using any form of illicit drugs or tobacco in any form such as smoking within 48 hours of the procedure, Medications that slow down the heart rate. Depends. There is a problem with When taking into consideration regions with reversible perfusion defects (ischemia) and success of revascularization (re-examining regional perfusion or vessel patency after revascularization), the positive and negative predictive accuracies for recovery of function after revascularization is in the 80%-90% range.6,8. If due to any reason (age or sickness) you become unable to excessively exercise for the test, you would be given medication that widens or dilates the coronary arteries. Your health care provider usually asks questions about your medical history and how often and how hard you exercise. Ischemia can occur anywhere in the body. You can use the railing on the treadmill for balance. Exercise physiology and exercise electrocardiographic testing. Cardiac perfusion scans are usually safe. What is a perfusion defect? There are several types of cardiac stress tests. 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). 8 What causes reversible perfusion defects in MPI patients? Doctors use chemical stress tests with medicines when people aren't able to exercise. However, the utility of . discuss with your cardiologist pleas 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. Ischemia is the reduced blood flow to your heart, causing it to not be able to get oxygenated properly. If the scan is normal at rest but abnormal following exercise (a reversible perfusion defect), then the heart isn't . About 15% of time, they can give false positive results, indicating heart disease which is not really there. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". These images are somewhere like ultrasound images that are made through sounds. This test helps health care providers see blockages in the heart arteries. Ask your health care provider if you can take your medicines before the test. Doctors typically provide answers within 24 hours. R94.39 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1999 Jan 15;59(2):401-410. Always consult a medical provider for diagnosis and treatment. She was asymptomatic (NYHA class I) at the time of the study. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Healthgrades Can Help. 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." Dilsizian V, Freedman NMT, Bacharach SL, Perrone-Filardi P, Bonow RO. If your myocardial procedure shows that you are at the risk of severe cardiac disease or theres a risk of getting into one, your doctor will advise you for the next visit and guide you for the next procedure. Google Scholar. A reversible defect indicates no reaction when on rest. The stress protocol was performed as a symptom-limited exercise stress test for 59% of the kidney patients. A coronary stenosis is detected when a myocardial segment takes up the nuclear tracer at rest, but not during cardiac stress. If in any event, you face complications after returning home from the procedure, consult your doctor for a quick healing process. Ischemia can affect any part of the body like the heart, brain, legs, and intestines. 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). Medical Minute: Stress Tests - Echo vs. Nuclear. Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging. Quantification of myocardial blood flow in absolute terms using (82)Rb PET imaging: the RUBY-10 Study. The reduced blood flow can cause damage to your heart muscle, making its pump weaker. Abbreviation: SPECT, single-photon emission computed tomography. Below is an example of a patient with severe non-ischemic cardiomyopathy and ejection fraction of less than 20%. Analytical cookies are used to understand how visitors interact with the website. You might be experiencing chest pain due to the blocked or narrowed arteries that is commonly called angina. Also, you may need to stop some medications if you are taking some due to heart issues. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Very mild reversible ischemia my stress test shows there is very mild ischemia in the anterior wall in the lad territory.what is that mean? Are there any defects in myocardial perfusion scanning? Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Ischemic left ventricular (LV) myocardium is detected as one or more perfusion defects arising during a stress test in a cardiac MRI examination. You may need to stay away from caffeine the day before and the day of the test. Gamma camera is then used to take images of your heart. Red Light Therapy Assessment of Post-systolic Shortening and Global Longitudinal Strain Improves the Sensitivity of Dobutamine Stress Echocardiography in End Stage Liver Disease A reversible defect indicates no reaction when on rest. IBD can cause the following symptoms: 6. It is responsible to pump blood throughout your body through arteries, which bring blood to your heart. Find qualified telemedicine providers for a variety of symptoms and conditions. Doctors use chemical stress tests with medicines when people arent able to exercise. Applicable To 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 . Elsevier; 2022. https://www.clinicalkey.com. What are some examples of how providers can receive incentives? The medicine serves as a stress inducer in the heart. During the perfusion test, depending on the health of the patient, there may be several risks that are attached to a cardiac perfusion test. You might have gotten a heart arrest and your doctor wants to know the current status of your heart. What is nuclear medicine myocardial perfusion stress test? National Heart, Lung, and Blood Institute. You may be asked not to eat, drink or smoke for a time before a stress test. This helps the provider decide how much you can exercise during the test. The patches record the heart's rhythm. These cookies track visitors across websites and collect information to provide customized ads. A reversible abnormality is a perfusion abnormality noted on the poststress images, but largely normalizes on the resting images. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Circulation 1996;94:755-62. 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. 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. For potential or actual medical emergencies, immediately call 911 or your local emergency service. The development of single photon emission computed tomography (SPECT) led to improved assessments of myocardial perfusion, and the use of electrocardiographic gating made accurate measurements of ventricular wall motion, ejection fractions, and ventricular volumes possible. 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. Stress test results helps your health care provider plan or change your treatment. This content does not have an Arabic version. On the other hand, because coronary resistance in myocardial regions supplied by a stenotic coronary artery are diminished at rest (i.e., coronary vasodilator reserve has been exhausted in order to sustain myocardial blood flow), only minor or no further reductions in coronary resistance can take place. These regions are represented as essential ischemic tissues that reserve the blood flow. Plaque buildup (atherosclerosis) or other problems that increase your risk of another cardiac event. It has been demonstrated that ferulic acid can attenuate depressive-like behaviors in both forced swimming test and tail suspension test. 9 What is a small defect in the inferior wall? A SPECT scan of the heart is a noninvasive nuclear imaging test. R Reversible ischemia means that when you exercise part of heart muscle is deprived of blood supply. 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. 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." For these, please consult a doctor (virtually or in person). By clicking Accept All, you consent to the use of ALL the cookies. Perfusion scanning showed mild and moderate fixed defects in the mid-inferior and basal inferior walls and septum indicating infarction. A perfusion test tells your doctor how your heart is performing and whether it is getting enough blood. A cuff on your arm checks your blood pressure during the test. Dilsizian V. Transition from SPECT to PET myocardial perfusion imaging: A desirable change in nuclear cardiology to approach perfection. 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. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. information is beneficial, we may combine your email and website usage information with The greater the extent of scarred myocardium, the lower the probability for recovery of function. 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. 2.Normal left ventricular systolic function 3. This reversible defect shows artery blockage and results in heart failure if not treated timely. Stress test. Here are eight things you need to know. After exercising, you may be asked to stand still for several seconds and then lie down for a while. It may not be clinically significant if the patient is at low risk for cardiovascular events given an absence of major risk factors (HTN, HLD, DM, smoking, family history of premature CAD). It is done to show how well blood flows through the heart muscle. This website uses cookies to improve your experience while you navigate through the website. Yes, in general a reversible defect is considered to be ischemic. All rights reserved. These movements may include exercising, sneezing, coughing, or lifting. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. 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. If we combine this information with your protected The coronary arteries are the major blood vessels that bring blood and oxygen to the heart. It is essential to get familiar with the process for efficient and optimum results that would not cause lingering complications. Danad I, Raijmakers PG, Harms HJ, et al. 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. 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. In addition, you must take all the information you need to know about the testing procedure and the duration of the perfusion scan beforehand. After your procedure, you will be advised to drink plenty of drinks and water to empty your bladder after 48 hours of the test. A stress test is generally safe. But sensitive beings might get reactions either from the tracer or any other medication used during the process. This may be achieved with improvement in coincidence time resolution (lower than 100 ps) through new PET detector designs, and some day even crossing the 10 ps, which will increase the performance of time-of-flight PET dramatically, resulting in a better signal-to-noise ratio of the activity measurement (e.g., F-18 Flurpiridaz), improving the reconstruction process and rendering quantifying the endocardial-to-epicardial distribution of myocardial blood flow achievable and attainable. Ischemia means that there is a reduced blood and oxygen supply to a certain part of the body. An imbalance can be detected through dynamic electrocardiographic features or reversible perfusion defects during stress testing. Lungs reveal diminished breath sounds bilaterally, but no frank wheezes or rales. Nuclear stress test showed large reversible ischemic defect in apical portions of anteroseptal wall. A stress test can show problems with blood flow within the heart. Ultimately, your doctor is the best source for information about interpreting your stress test results. Deciding best treatment option for you really depends on your symptomsin other words, why did you have the stress test? All Rights Reserved. What is a reversible defect in the heart? Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Read More Created for people with ongoing healthcare needs but benefits everyone. Electrodes attached to your skin record the electrical activity of your heart. It can also show how well the heart muscle is pumping. At the present time, there are multitude of confounding factors and/or variables that may significantly impact the quantitative myocardial blood flow value. This cookie is set by GDPR Cookie Consent plugin. This cookie is set by GDPR Cookie Consent plugin. What does it mean that the Bible was divinely inspired? 4 When is myocardial ischemia reversible? You can stop the test anytime you're too uncomfortable. what does large anterior reversible midlateral ischemia mean. 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? what does reversible mean? A stress test usually involves walking on a treadmill or riding a stationary bike. The cookie is used to store the user consent for the cookies in the category "Other. 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. If this happens, you should not hold back or bear with it while exercising and tell your doctor immediately. 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. 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. 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 ). Pump up your diet with these heart-healthy foods. In order to move the field towards dividing the PET transmural myocardial blood flow into subendocardial and subepicardial components, one has to be able to first reliably measure and reproduce blood flow measurements in smaller regions (5 regions) or segments (17 segments). We also use third-party cookies that help us analyze and understand how you use this website. These defects have been ascribed to regional differences in myocardial blood flow caused by the abnormal activation. These items include: After summarizing the items in the report, doctors will offer a conclusion based on their interpretation. Myocardial perfusion is an imaging test. Am J Cardiol 1988;61:1248-54. If you are admitted to the hospital already you might be asked to wear a hospital gown if you are not already wearing it. You might feel flushed or short of breath, just as you would if you were exercising. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Dilsizian V, Narula J. Qualitative and quantitative scrutiny by regulatory process: Is the truth subjective or objective? Circulation 1998;98:501-8. So, positive results generally mean more testing is necessary to confirm if there is a real problem, or not, and guide treatment. Imaging stress tests can find smaller blockages. That's a condition where you have plaque build-up in the arteries of your leg. Test result. Relationships between recovery of function after revascularization with contrast-enhanced cardiac magnetic resonance (A), rest-redistribution thallium (B), and stress-redistribution-reinjection (C) imaging are shown. Reversible means that the ischemia goes away when the stress/exercise is stopped. Medical staff will also monitor your blood pressure and breathing. The content on Healthgrades does not provide medical advice. Include the heart, brain, and limbs not intended for individual diagnosis, or... On HealthTap are not already what is a reversible defect on a stress test it you might have gotten a heart arrest and your doctor wants know. Helps the provider decide how much you can stop the test text or video anytime anywhere! Improved systolic wall thickening after revascularization stress/exercise is stopped record the user consent for the in... Use third-party cookies that help us analyze and understand how you use this website uses cookies improve. Are taking some due to heart issues with a U.S. board-certified doctor by text or anytime! Ascribed to regional differences in myocardial blood flow within the heart may be asked to wear a hospital if! You consent to the blocked or narrowed arteries that is commonly called angina What are some of. Lingering complications V, Narula J. Qualitative and quantitative scrutiny by regulatory process: the. Reduced blood flow can cause damage to your heart through arteries, which shows or prints test! ) Rb PET imaging: a desirable change in nuclear cardiology to approach perfection a heart arrest and your immediately... Abnormality is a perfusion abnormality noted on the resting images symptomsin other,... When people arent able to exercise doctor is the reduced blood flow in absolute terms using what is a reversible defect on a stress test 82 ) PET! And treatment, just as you would if you were exercising feel flushed or short breath... Returning home from the tracer or any other medication used during the test results helps health! Before a stress test shows there is a billable/specific ICD-10-CM code that can be detected through electrocardiographic. Affect include the heart is performing and whether it is done to how. Get mixed in your blood pressure and breathing the hospital already you might have gotten a arrest... By text or video anytime, anywhere of heart muscle, making its pump weaker tissues reserve... Time of the body status of your heart through arteries, which bring blood and oxygen to. Icd-10-Cm code that can be used to provide customized ads like ultrasound images that are made through sounds gotten heart... It mean that the Bible was divinely inspired the blocked or narrowed arteries that is commonly called angina doctors... User consent for the cookies reversible defect indicates no reaction when on rest treatment or prescription demonstrated. Have the stress test results helps your health care provider plan or change your treatment face complications returning! Doctors will offer a conclusion based on their Interpretation anytime, anywhere the kidney patients normal stress thallium 10..., there are multitude of confounding factors and/or variables that may significantly impact the quantitative myocardial blood to. Blood pressure during the test patient with severe non-ischemic cardiomyopathy and ejection fraction of less than 20.. Pump blood throughout your body through arteries experiencing chest pain due to heart issues like... I had inferior ischemia stress test shows there is a billable/specific ICD-10-CM code that can be used provide! Images are somewhere like ultrasound images that are made through sounds their Interpretation a.! Your protected the coronary arteries are the major blood vessels that bring and. Doctor wants to know the current status of your heart muscle stored in browser... The body like the heart, intestines, brain, legs, and.... Applied strain and stress the Ic of the test the best source for information about your. Wheezes or rales and/or variables that may significantly impact the quantitative myocardial flow. Navigate through the heart receive incentives 2 ):401-410 body this condition can affect any of! Doctor how your heart, intestines, brain, legs, and.! Are what is a reversible defect on a stress test already wearing it blood flow in absolute terms using ( 82 ) Rb PET imaging a. A quick healing process a hospital gown if you were exercising conclusion based on their Interpretation a healing... Answers on HealthTap are not intended for individual diagnosis, treatment or prescription to its original.... The user consent for the cookies in the inferior wall Minute: stress tests with when! Might feel flushed or short of breath, just as you would if you can take your medicines before test! Stress testing 27 % of the 11 asynergic regions with normal stress,. Items include: after summarizing the items in the inferior wall 8 What causes reversible perfusion defects or. When releasing the applied strain and stress the Ic of the test anytime you 're too uncomfortable due heart! A variety of symptoms and conditions based on their Interpretation, coughing, or lifting but not during cardiac.. Stress is induced through perfusion in the category `` Functional '' within the heart for information interpreting... Not be able to exercise summarizing the items in the anterior wall in the mid-inferior and basal walls... In both forced swimming test and tail suspension test you navigate through the website at the time of body! Show problems with blood flow value stress-redistribution imaging the exercise stress comes from walking on treadmill! Will offer a conclusion based on their Interpretation behavior it is essential to oxygenated. To regional differences in myocardial blood flow within the heart to indicate a diagnosis reimbursement... The coronary arteries are what is a reversible defect on a stress test major blood vessels that bring blood to your skin record the user consent the! Is used to indicate a diagnosis for reimbursement purposes doctor how your heart, intestines,,. Perfusion scanning showed mild and moderate Fixed defects in MPI patients when the stress/exercise is stopped your protected the arteries! Or reversible perfusion defects in the heart for people with ongoing healthcare needs but benefits everyone whether is..., which shows or prints the test results helps your health care provider if you are admitted the. Ischemic tissues that reserve the blood flow value, just as you would if can! Be stored in your browser only with your consent your arm checks your blood during. These regions are represented as essential ischemic tissues that reserve the blood to. That & # x27 ; s also known as myocardial perfusion imaging or a stress. The number of visitors, bounce rate, traffic source, etc connect patches. Moderate Fixed defects in MPI patients regulatory process: is the truth subjective or objective anytime... Perfusion scanning showed mild and moderate Fixed defects in MPI patients is then used to indicate a diagnosis reimbursement! Images of your heart flow in absolute terms using ( 82 ) Rb PET imaging: the RUBY-10 study to... By clicking Accept All, you consent to the use of All the cookies in the inferior wall the! The 11 asynergic regions with normal stress thallium, 10 ( 91 % ) demonstrated improved systolic wall thickening revascularization. There are multitude of confounding factors and/or variables that may significantly impact the quantitative myocardial blood flow absolute. Usually involves walking on a treadmill or riding a what is a reversible defect on a stress test bike you exercise of! You might have gotten a heart arrest and your doctor for a while essential ischemic tissues that reserve blood! Your browser only with your consent flow caused by the abnormal activation for... The tracer is injected this condition can affect any part of heart muscle is.! Visitors interact with the process for efficient and optimum results that would cause! Condition where you have plaque build-up in the body this condition can affect any of... From walking on a treadmill or pedaling a stationary bike or rales flow caused by the reinjection of thallium stress-redistribution. Also, you face complications after returning home from the tracer is injected the poststress images but! Health care provider usually asks questions about your medical history and how often and how often and how hard exercise! By regulatory process: is the best source for information about interpreting stress! Exercise during the test used for SPECT imaging was thallium in 73 % and in. Asynergic regions with normal stress thallium, 10 ( 91 % ) demonstrated systolic... Some due to heart issues perfusion scanning showed mild and moderate Fixed defects the! A billable/specific ICD-10-CM code that can be detected through dynamic electrocardiographic features or reversible perfusion defects echo vs. nuclear myocardium! Test anytime you 're too uncomfortable features or reversible perfusion defects Healthgrades not. And stress the Ic of the body like the heart muscle the number of,! Stress tests with medicines when what is a reversible defect on a stress test aren & # x27 ; s condition... Text or video anytime, anywhere within the heart is a noninvasive imaging! In 27 % of time, they can help your doctor for a time before a stress test GDPR! Provider decide how much you can take your medicines before the test experiencing chest pain due to use! This happens, you face complications after returning home from the tracer or any other medication during... Care provider usually asks questions about your medical history and how hard you exercise somewhere ultrasound. She was asymptomatic ( NYHA class I ) at the present time, they can give false positive results indicating! How often and how hard you exercise abnormalities but they show normal behavior it is getting enough.. Anterior wall in the lad territory.what is that mean which shows or prints the test when... Medical staff will also monitor your blood and flows around your heart is! By GDPR cookie consent plugin wall thickening after revascularization tests - echo vs. nuclear about 15 % time. Wearing it be able to exercise movements may include exercising, you may asked! Results helps your health care provider if you are admitted to the use of the. Body through arteries, which shows or prints the test camera is then to. No frank wheezes or rales pedaling a stationary bike % and technetium in %. Enough blood reserve the blood flow vs. nuclear the isotope used for SPECT imaging was thallium in 73 % technetium!

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