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Hume RD, Kanagalingam S, Deshmukh T, Chen S, Mithieux SM, Rashid FN, Roohani I, Lu J, Doan T, Graham D, Clayton ZE, Slaughter E, Kizana E, Stempien-Otero AS, Brown P, Thomas L, Weiss AS, Chong JJ. Tropoelastin Improves Post-Infarct Cardiac Function. Circ Res 2023; 132:72-86. [PMID: 36453283 PMCID: PMC9829044 DOI: 10.1161/circresaha.122.321123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Myocardial infarction (MI) is among the leading causes of death worldwide. Following MI, necrotic cardiomyocytes are replaced by a stiff collagen-rich scar. Compared to collagen, the extracellular matrix protein elastin has high elasticity and may have more favorable properties within the cardiac scar. We sought to improve post-MI healing by introducing tropoelastin, the soluble subunit of elastin, to alter scar mechanics early after MI. METHODS AND RESULTS We developed an ultrasound-guided direct intramyocardial injection method to administer tropoelastin directly into the left ventricular anterior wall of rats subjected to induced MI. Experimental groups included shams and infarcted rats injected with either PBS vehicle control or tropoelastin. Compared to vehicle treated controls, echocardiography assessments showed tropoelastin significantly improved left ventricular ejection fraction (64.7±4.4% versus 46.0±3.1% control) and reduced left ventricular dyssynchrony (11.4±3.5 ms versus 31.1±5.8 ms control) 28 days post-MI. Additionally, tropoelastin reduced post-MI scar size (8.9±1.5% versus 20.9±2.7% control) and increased scar elastin (22±5.8% versus 6.2±1.5% control) as determined by histological assessments. RNA sequencing (RNAseq) analyses of rat infarcts showed that tropoelastin injection increased genes associated with elastic fiber formation 7 days post-MI and reduced genes associated with immune response 11 days post-MI. To show translational relevance, we performed immunohistochemical analyses on human ischemic heart disease cardiac samples and showed an increase in tropoelastin within fibrotic areas. Using RNA-seq we also demonstrated the tropoelastin gene ELN is upregulated in human ischemic heart disease and during human cardiac fibroblast-myofibroblast differentiation. Furthermore, we showed by immunocytochemistry that human cardiac fibroblast synthesize increased elastin in direct response to tropoelastin treatment. CONCLUSIONS We demonstrate for the first time that purified human tropoelastin can significantly repair the infarcted heart in a rodent model of MI and that human cardiac fibroblast synthesize elastin. Since human cardiac fibroblasts are primarily responsible for post-MI scar synthesis, our findings suggest exciting future clinical translation options designed to therapeutically manipulate this synthesis.
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Affiliation(s)
- Robert D. Hume
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Sydney Medical School, University of Sydney, NSW, Australia (R.D.H., T.D., F.R., Z.E.C., E.K., J.J.H.C.)
| | - Shaan Kanagalingam
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.)
| | - Tejas Deshmukh
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.).,Sydney Medical School, University of Sydney, NSW, Australia (R.D.H., T.D., F.R., Z.E.C., E.K., J.J.H.C.)
| | - Siqi Chen
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.)
| | - Suzanne M. Mithieux
- Charles Perkins Centre, University of Sydney, NSW, Australia (S.M.M., A.S.W.).,School of Life and Environmental Sciences, University of Sydney, NSW, Australia (S.M.M., A.S.W.)
| | - Fairooj N. Rashid
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.)
| | - Iman Roohani
- School of Biomedical Engineering, University of Sydney, NSW, Australia (I.R.).,School of Chemistry, University of New South Wales, Australia (I.R.)
| | - Juntang Lu
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.)
| | - Tram Doan
- Centre for Cancer Research, Westmead Institute for Medical Research, NSW, Australia (T.D.‚ D.G.)
| | - Dinny Graham
- Centre for Cancer Research, Westmead Institute for Medical Research, NSW, Australia (T.D.‚ D.G.).,Westmead Breast Cancer Institute, NSW, Australia (D.G.).,Westmead Clinical School, University of Sydney, NSW, Australia (D.G., L.T.)
| | - Zoe E. Clayton
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Sydney Medical School, University of Sydney, NSW, Australia (R.D.H., T.D., F.R., Z.E.C., E.K., J.J.H.C.)
| | | | - Eddy Kizana
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.).,Sydney Medical School, University of Sydney, NSW, Australia (R.D.H., T.D., F.R., Z.E.C., E.K., J.J.H.C.)
| | - April S. Stempien-Otero
- Department of Medicine, Division of Cardiology, University of Washington School of Medicine, Seattle, WA (A.S.S.-O.)
| | - Paula Brown
- Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.)
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.).,Westmead Clinical School, University of Sydney, NSW, Australia (D.G., L.T.)
| | | | - James J.H. Chong
- Centre for Heart Research, Westmead Institute for Medical Research, NSW, Australia (R.D.H., S.K., T.D., S.C., F.N.R., J.L., Z.E.C., E.K., J.J.H.C.).,Department of Cardiology, Westmead Hospital, NSW, Australia (T.D., J.L., E.K., P.B., L.T., J.J.H.C.).,Sydney Medical School, University of Sydney, NSW, Australia (R.D.H., T.D., F.R., Z.E.C., E.K., J.J.H.C.)
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Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease. J Clin Med 2022; 11:jcm11216252. [PMID: 36362481 PMCID: PMC9656271 DOI: 10.3390/jcm11216252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 11/24/2022] Open
Abstract
In this study, we identified several factors related to left ventricular remodeling (LVR) and examined the impact of LVR on the prognosis of patients with ST-elevated myocardial infarction and multivessel disease treated with complete (CR) or incomplete (IR) revascularization. LVR was defined as an LV end-diastolic diameter >55 mm. A total of 262 patients without LVR at presentation were followed up with echocardiography between 1 month and 1 year. The primary outcome was a composite of all-cause death (AD), MI, and heart failure (HF), referred to as a major adverse cardiovascular endpoint (MACE). Then, each variable was analyzed as a secondary outcome. Follow-up echocardiography identified 26 patients (9.9%) with LVR. LVR was associated with an initial LV ejection fraction <50%, Killip 3 disease at presentation, and a peak troponin I level >70 mg/dL. Survival analysis showed an association between LVR and adverse outcomes only in the IR group, in which the adjusted hazard ratio (HR) was increased for the MACE (HR = 3.22, 95% confidence interval (CI) = 1.19−8.71, p = 0.002) and HF (HR = 21.37, 95% CI = 4.47−102.09, p< 0.001), but not for the CR group. In STEMI with MVD, LVR within the first year after percutaneous coronary intervention was associated with worse outcomes in the IR but not the CR group.
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Degtiarova G, Claus P, Duchenne J, Schramm G, Nuyts J, Bogaert J, Vöros G, Willems R, Verberne HJ, Voigt JU, Gheysens O. Can nuclear imaging accurately detect scar in ischemic cardiac resynchronization therapy candidates? Nucl Med Commun 2022; 43:502-509. [PMID: 35045554 DOI: 10.1097/mnm.0000000000001533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Accurate scar assessment is crucial in cardiac resynchronization therapy (CRT) candidates, since its presence is a negative predictor for CRT response. Therefore, we assessed the performance of different PET parameters to detect scar in CRT candidates. METHODS Twenty-nine CRT candidates underwent 18F-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT), resting 13N-NH3-PET/CT and cardiac magnetic resonance (CMR) prior to CRT implantation. Segmental 18F-FDG uptake, late 13N-NH3 uptake and absolute myocardial blood flow (MBF) were evaluated for scar detection using late gadolinium enhancement (LGE) CMR as reference. A receiver operator characteristic (ROC) area under the curve (AUC) ≥0.8 indicated a good accuracy of the methods evaluated. RESULTS Scar was present in 111 of 464 segments. None of the approaches could reliably identify segments with nontransmural scar, except for 18F-FDG uptake in the lateral wall (AUC 0.83). Segmental transmural scars could be detected with all methods (AUC ≥ 0.8), except for septal 18F-FDG uptake and MBF in the inferior wall (AUC < 0.8). Late 13N-NH3 uptake was the best parameter for transmural scar detection, independent of its location, with a sensitivity of 80% and specificity of 92% using a cutoff of 66% of the maximum tracer activity. CONCLUSIONS Late 13N-NH3 uptake is superior to 13N-NH3 MBF and 18F-FDG in detecting transmural scar, independently of its location. However, none of the tested PET parameters was able to accurately detect nontransmural scar.
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Affiliation(s)
- Ganna Degtiarova
- Department of Imaging and Pathology, KU Leuven
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven
| | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven
| | - Jürgen Duchenne
- Department of Cardiovascular Sciences, KU Leuven
- Department of Cardiovascular Diseases, University Hospitals Leuven
| | | | - Johan Nuyts
- Department of Imaging and Pathology, KU Leuven
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Gabor Vöros
- Department of Cardiovascular Sciences, KU Leuven
- Department of Cardiovascular Diseases, University Hospitals Leuven
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven
- Department of Cardiovascular Diseases, University Hospitals Leuven
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, University of Amsterdam, The Netherlands
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, KU Leuven
- Department of Cardiovascular Diseases, University Hospitals Leuven
| | - Olivier Gheysens
- Department of Imaging and Pathology, KU Leuven
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussel
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4
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Jáuregui B, Soto-Iglesias D, Penela D, Acosta J, Fernández-Armenta J, Linhart M, Ordóñez A, San Antonio R, Terés C, Chauca A, Carreño JM, Scherer C, Falasconi G, Prat-González S, Perea RJ, Mont L, Bosch X, Ortiz-Pérez JT, Berruezo A. Cardiovascular magnetic resonance determinants of ventricular arrhythmic events after myocardial infarction. Europace 2021; 24:938-947. [PMID: 34849726 DOI: 10.1093/europace/euab275] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/26/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS To non-invasively characterize, by means of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), scar differences, and potential variables associated with ventricular tachycardia (VT) occurrence in chronic post-myocardial infarction (MI) patients. METHODS AND RESULTS A case-control study was designed through retrospective LGE-CMR data analysis of chronic post-MI patients (i) consecutively referred for VT substrate ablation after a first VT episode (n = 66) and (ii) from a control group (n = 84) with no arrhythmia evidence. The myocardium was characterized differentiating core, border zone (BZ), and BZ channels (BZCs) using the ADAS 3D post-processing imaging platform. Clinical and scar characteristics, including a novel parameter, the BZC mass, were compared between both groups. One hundred and fifty post-MI patients were included. Four multivariable Cox proportional hazards regression models were created for total scar mass, BZ mass, core mass, and BZC mass, adjusting them by age, sex, and left ventricular ejection fraction (LVEF). A cut-off of 5.15 g of BZC mass identified the cases with 92.4% sensitivity and 86.9% specificity [area under the ROC curve (AUC) 0.93 (0.89-0.97); P < 0.001], with a significant increase in the AUC compared to other scar parameters (P < 0.001 for all pairwise comparisons). Adding BZC mass to LVEF allowed to reclassify 33.3% of the cases and 39.3% of the controls [net reclassification improvement = 0.73 (0.71-0.74)]. CONCLUSIONS The mass of BZC is the strongest independent variable associated with the occurrence of sustained monomorphic ventricular tachycardia in post-MI patients after adjustment for age, sex, and LVEF. Border zone channel mass measurement could permit a more accurate VT risk stratification than LVEF in chronic post-MI patients.
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Affiliation(s)
- Beatriz Jáuregui
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain.,Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - David Soto-Iglesias
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain.,Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Diego Penela
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain.,Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Juan Acosta
- Arrhythmia Department, Virgen del Rocío University Hospital, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - Juan Fernández-Armenta
- Arrhythmia Department, Puerta del Mar University Hospital, Avda. Ana de Viya 21, 11009 Cádiz, Spain
| | - Markus Linhart
- Arrhythmia Department, Josep Trueta University Hospital, Avda. de França s/n, 17007 Girona, Spain
| | - Augusto Ordóñez
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Rodolfo San Antonio
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Cheryl Terés
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Alfredo Chauca
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - José M Carreño
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Claudia Scherer
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Giulio Falasconi
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain
| | - Susana Prat-González
- Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Rosario J Perea
- Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Lluís Mont
- Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Xavier Bosch
- Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - José T Ortiz-Pérez
- Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
| | - Antonio Berruezo
- Arrhythmia Department, Heart Institute, Teknon Medical Center, C/Vilana 12, 08022 Barcelona, Spain.,Arrhythmia Department, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08024 Barcelona, Spain
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Gao Y, Xu HY, Guo YK, Wen XL, Shi R, Li Y, Yang ZG. Impact of myocardial scars on left ventricular deformation in type 2 diabetes mellitus after myocardial infarction by contrast-enhanced cardiac magnetic resonance. Cardiovasc Diabetol 2021; 20:215. [PMID: 34696783 PMCID: PMC8547068 DOI: 10.1186/s12933-021-01407-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluate myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of myocardial scar on left ventricular (LV) deformation. Methods Overall, 202 T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI−)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR), were compared among these groups. Correlation and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation. Results Decreases were observed in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Reduced LV deformation (p < 0.017) was observed in the T2DM(MI+) group with anterior wall infarction. The increased total LV infarct extent and infarct mass of LV were related to decreased LV global PS (radial, circumferential, and longitudinal directions; p < 0.01) and LV global PSSR (radial and circumferential directions, p < 0.02). Multivariate analysis demonstrated that NYHA functional class and total LV infarct extent were independently associated with LV global radial PS (β = − 0.400 and β = − 0.446, respectively, all p < 0.01; model R2 = 0.37) and circumferential PS (β = 0.339 and β = 0.530, respectively, all p < 0.01; model R2 = 0.41), LV anterior wall infarction was independently associated with LV global longitudinal PS (β = 0.398, p = 0.006). Conclusions The myocardial scarring size in T2DM patients after MI is negatively correlated with LV global PS and PSSR, particularly in the circumferential direction. Additionally, different MI regions have different effects on the reduction of LV deformation, and relevant clinical evaluations should be strengthened.
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Affiliation(s)
- Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xiao-Ling Wen
- Department of Radiology, West China Fourth Hospital, Sichuan University, 18# Section 3, Renmin South Road, Chengdu, Sichuan Province, China
| | - Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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Wang X, Yang B, Moody JB, Tang J. Improved myocardial perfusion PET imaging using artificial neural networks. Phys Med Biol 2020; 65:145010. [PMID: 32244234 DOI: 10.1088/1361-6560/ab8687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Myocardial perfusion (MP) PET imaging plays a key role in risk assessment and stratification of patients with coronary artery disease. In this work, we proposed a patch-based artificial neural network (ANN) fusion approach that integrates information from the ML and the post-smoothed ML reconstruction to improve MP PET imaging. The proposed method was applied to images reconstructed from different noise levels to enhance quantification and task-based MP defect detection. Using the XCAT phantom, we simulated three MP PET imaging cases, one with normal perfusion and the other two with non-transmural and transmural regionally reduced perfusion of the left ventricular (LV) myocardium. The proposed ANN fusion technique was quantitatively evaluated in terms of the noise versus bias and noise versus contrast tradeoff, and compared with the post-smoothed ML reconstruction. Using the channelized Hotelling observer, we evaluated the detectability of the non-transmural and transmural defects through the receiver operating characteristic analysis. The quantitative results demonstrated that the ANN enhancement method reduced bias and improved contrast while reaching comparable noise to what the post-smoothed ML reconstruction achieved. Moreover, the ANN fusion technique significantly improved the defect detectability of both the non-transmural and transmural defects. In addition to the simulation study, we further evaluated the proposed method using patient data. Compared with the post-smoothed ML reconstruction, the ANN fusion improved the tradeoff between noise and the mean value on the LV myocardium, indicating its potential clinical application in MP PET imaging.
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Affiliation(s)
- Xinhui Wang
- Department of Electrical and Computer Engineering, Oakland University, Rochester, MI, United States of America
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Achilli F, Pontone G, Bassetti B, Squadroni L, Campodonico J, Corrada E, Facchini C, Mircoli L, Esposito G, Scarpa D, Pidello S, Righetti S, Di Gennaro F, Guglielmo M, Muscogiuri G, Baggiano A, Limido A, Lenatti L, Di Tano G, Malafronte C, Soffici F, Ceseri M, Maggiolini S, Colombo GI, Pompilio G. G-CSF for Extensive STEMI. Circ Res 2019; 125:295-306. [PMID: 31138020 DOI: 10.1161/circresaha.118.314617] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
RATIONALE In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term. OBJECTIVE The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. METHODS AND RESULTS Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/m2 in the change of indexed LV end-systolic volume in favor of G-CSF group (P=0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only (P=0.04). Moreover, over time improvement of global longitudinal strain was 2.4% higher in G-CSF patients versus SOC (P=0.04). Global circumferential strain significantly improved in G-CSF group only (P=0.006). CONCLUSIONS Early administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment-elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01969890.
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Affiliation(s)
- Felice Achilli
- From the Departments of Cardiology (F.A., S.R., C.M., F.S.), ASST-Monza, San Gerardo Hospital, Monza, Italy
| | - Gianluca Pontone
- Cardiovascular Imaging (G. Pontone, M.G., G.M., A.B.), Centro Cardiologico Monzino IRCCS, Milano, Italy.,Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Italy (G.P.)
| | - Beatrice Bassetti
- Vascular Biology and Regenerative Medicine Unit (B.B., G. Pompilio), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Lidia Squadroni
- Department of Cardiology, San Carlo Borromeo Hospital, Milano, Italy (L.S.)
| | - Jeness Campodonico
- Intensive Cardiac Care Unit (J.C.), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Elena Corrada
- Cardiovascular Department, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy (E.C.)
| | | | - Luca Mircoli
- Cardiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy (L.M.)
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy (G.E.)
| | - Daniele Scarpa
- Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (D.S.)
| | - Stefano Pidello
- Cardiology, Città della Salute e della Scienza University Hospital of Torino, Italy (S.P.)
| | - Stefano Righetti
- From the Departments of Cardiology (F.A., S.R., C.M., F.S.), ASST-Monza, San Gerardo Hospital, Monza, Italy
| | | | - Marco Guglielmo
- Cardiovascular Imaging (G. Pontone, M.G., G.M., A.B.), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Giuseppe Muscogiuri
- Cardiovascular Imaging (G. Pontone, M.G., G.M., A.B.), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Andrea Baggiano
- Cardiovascular Imaging (G. Pontone, M.G., G.M., A.B.), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Alberto Limido
- Coronary Intensive Care Unit, ASST-Settelaghi, Ospedale di Circolo-Fondazione Macchi, Varese, Italy (A.L.)
| | - Laura Lenatti
- Cardiology, Alessandro Manzoni Hospital, Lecco, Italy (L.L.)
| | | | - Cristina Malafronte
- From the Departments of Cardiology (F.A., S.R., C.M., F.S.), ASST-Monza, San Gerardo Hospital, Monza, Italy
| | - Federica Soffici
- From the Departments of Cardiology (F.A., S.R., C.M., F.S.), ASST-Monza, San Gerardo Hospital, Monza, Italy
| | - Martina Ceseri
- ANMCO Research Center, Heart Care Foundation, Firenze, Italy (M.C.)
| | | | - Gualtiero I Colombo
- Immunology and Functional Genomics Unit (G.I.C.), Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - Giulio Pompilio
- Vascular Biology and Regenerative Medicine Unit (B.B., G. Pompilio), Centro Cardiologico Monzino IRCCS, Milano, Italy
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8
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Molecular Imaging to Monitor Left Ventricular Remodeling in Heart Failure. CURRENT CARDIOVASCULAR IMAGING REPORTS 2019. [DOI: 10.1007/s12410-019-9487-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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9
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Iliopoulou I, Mourouzis I, Lambrou GI, Iliopoulou D, Koutsouris DD, Pantos C. Time‑dependent and independent effects of thyroid hormone administration following myocardial infarction in rats. Mol Med Rep 2018; 18:864-876. [PMID: 29767239 PMCID: PMC6059718 DOI: 10.3892/mmr.2018.9008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/12/2018] [Indexed: 01/12/2023] Open
Abstract
Cardiac function is reduced following myocardial infarction (MI) due to myocardial injury and alterations in the viable non-ischemic myocardium, a process known as cardiac remodeling. The current treatments available for patients with acute MI (AMI) reduce infarct size, preserve left ventricular (LV) function and improve survival; however, these treatments do not prevent remodeling, which can lead to heart failure. The aim of the present study was to investigate the effects of thyroid hormone (TH) treatment following MI in an in vivo rat model. A total of 199 rats were separated into 3 groups: Sham operated and 2 different coronary artery ligation (CAL) groups. Rats subjected to CAL were randomly divided into a further 2 groups 24 h following surgery. The first group received standard rat chow (designated the CAL group), while the second group received food containing 0.05% thyroid powder (designated the CALTH group). The mean daily intake of TH per rat was estimated at 3.0 µg T3 and 12 µg T4. Echocardiography was used to monitor the rats. Large-scale analysis confirmed the favorable effects of TH treatment following CAL on various parameters of cardiac function. TH treatment reduced LV dilation, and increased global and regional LV function. The development of cardiac hypertrophy was induced and, thus, wall stress was limited. Furthermore, TH treatment improved cardiac geometry, which manifested as an increased sphericity index. Myocardial function, as well as LV dilatation, following CAL and TH treatment was not closely associated with the extent of injury, indicating a novel therapeutic intervention that may alter the course of LV remodeling that typically leads to post-MI heart failure. Data modelling and regressions may be developed to enable the simulation of the pathophysiological processes that occur following MI, and to predict with accuracy the effects of novel or current treatments that act via the modulation of tissue injury, LV dilation, LV geometry and hypertrophy.
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Affiliation(s)
- Ioanna Iliopoulou
- Department of Pharmacology, National and Kapodistrian University of Athens, Medical School, 11527 Athens, Greece
| | - Iordanis Mourouzis
- Department of Pharmacology, National and Kapodistrian University of Athens, Medical School, 11527 Athens, Greece
| | - George I Lambrou
- Biomedical Engineering Laboratory, Department of Information Transmission Systems and Material Technology, National Technical University of Athens, School of Electrical and Computer Engineering, 15780 Athens, Greece
| | - Dimitra Iliopoulou
- Biomedical Engineering Laboratory, Department of Information Transmission Systems and Material Technology, National Technical University of Athens, School of Electrical and Computer Engineering, 15780 Athens, Greece
| | - Dimitrios-Dionysios Koutsouris
- Biomedical Engineering Laboratory, Department of Information Transmission Systems and Material Technology, National Technical University of Athens, School of Electrical and Computer Engineering, 15780 Athens, Greece
| | - Constantinos Pantos
- Department of Pharmacology, National and Kapodistrian University of Athens, Medical School, 11527 Athens, Greece
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10
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Pahlm U, Seemann F, Engblom H, Gyllenhammar T, Halvorsen S, Hansen HS, Erlinge D, Atar D, Heiberg E, Arheden H, Carlsson M. Longitudinal left ventricular function is globally depressed within a week of STEMI. Clin Physiol Funct Imaging 2018; 38:1029-1037. [PMID: 29701310 DOI: 10.1111/cpf.12521] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
Abstract
Sixty percent of stroke volume (SV) is generated by atrioventricular plane displacement (AVPD) in a healthy left ventricle (LV). The aims were to determine the effect of ST-elevation myocardial infarction (STEMI) on AVPD and contribution of AVPD to SV and to study the relationship between AVPD and infarct size (IS) and location. Patients from CHILL-MI and MITOCARE studies with cardiovascular magnetic resonance within a week of STEMI (n = 177, 59 ± 11 years) and healthy controls (n = 20, 62 ± 11 years) were included. Left ventricular volumes were quantified in short-axis images. AVPD was measured in six locations in long-axis images. Longitudinal contribution to SV was calculated as AVPD multiplied by the short-axis epicardial area. Patients (IS 17 ± 10% of LV) had decreased ejection fraction (48 ± 8%) compared to controls (60 ± 5%, P<0·001). Global AVPD was decreased in patients (11 ± 2 mm versus 15 ± 2 mm in controls, P<0·001) and this held true for both infarcted and remote segments. AVPD contribution to SV was lower in patients (58 ± 9%) than in controls (64 ± 8%) (P<0·001). There was a weak negative correlation between IS and AVPD (r2 =0·06) but no differences in global AVPD linked to infarct location. Decrease in global and regional AVPD occur even in remote myocardium within 1 week of STEMI. Global AVPD decrease is independent of MI location, and MI size has only minor effect. Longitudinal pumping is slightly lower compared to controls but remains to be the main component to SV even after STEMI. These results highlight the difficulty in determining infarct location and size from longitudinal measures of LV function.
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Affiliation(s)
- Ulrika Pahlm
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
- Department of Emergency Medicine, Skåne University Hospital, Lund, Sweden
| | - Felicia Seemann
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
- Faculty of Engineering, Department of Biomedical Engineering, Lund University, Lund, Sweden
- Faculty of Engineering, Department of Numerical Analysis, Lund University, Lund, Sweden
| | - Henrik Engblom
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Tom Gyllenhammar
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Sigrun Halvorsen
- Div. of Medicine, and Faculty of Medicine, Dept. of Cardiology B, Oslo University Hospital, University of Oslo, Oslo, Norway
| | | | - David Erlinge
- Cardiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Dan Atar
- Div. of Medicine, and Faculty of Medicine, Dept. of Cardiology B, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Einar Heiberg
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
- Faculty of Engineering, Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Håkan Arheden
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Marcus Carlsson
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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11
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Pöyhönen P, Kylmälä M, Vesterinen P, Kivistö S, Holmström M, Lauerma K, Väänänen H, Toivonen L, Hänninen H. Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural myocardial infarction - a prospective CMR study. BMC Cardiovasc Disord 2018; 18:27. [PMID: 29422025 PMCID: PMC5806273 DOI: 10.1186/s12872-018-0767-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/01/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Large myocardial infarction (MI) is associated with adverse left ventricular (LV) remodeling (LVR). We studied the nature of LVR, with specific attention to non-transmural MIs, and the association of peak CK-MB with recovery and chronic phase scar size and LVR. METHODS Altogether 41 patients underwent prospectively repeated cardiovascular magnetic resonance at a median of 22 (interquartile range 9-29) days and 10 (8-16) months after the first revascularized MI. Transmural MI was defined as ≥75% enhancement in at least one myocardial segment. RESULTS Peak CK-MB was 86 (40-216) μg/L in median, while recovery and chronic phase scar size were 13 (3-23) % and 8 (2-19) %. Altogether 33 patients (81%) had a non-transmural MI. Peak CK-MB had a strong correlation with recovery and chronic scar size (r ≥ 0.80 for all, r ≥ 0.74 for non-transmural MIs; p < 0.001). Peak CK-MB, recovery scar size, and chronic scar size, were all strongly correlated with chronic wall motion abnormality index (WMAi) (r ≥ 0.75 for all, r ≥ 0.73 for non-transmural MIs; p < 0.001). There was proportional scar size and LV mass resorption of 26% (0-50%) and 6% (- 2-14%) in median. Young age (< 60 years, median) was associated with greater LV mass resorption (median 9%vs.1%, p = 0.007). CONCLUSIONS Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural MI. Considerable infarct resorption happens after the first-month recovery phase. LV mass resorption is related to age, being more common in younger patients.
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Affiliation(s)
- Pauli Pöyhönen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Minna Kylmälä
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Paula Vesterinen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Sari Kivistö
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Miia Holmström
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Lauerma
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Heikki Väänänen
- Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
| | - Lauri Toivonen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Helena Hänninen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
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12
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Acute and long-term cardioprotective effects of the Traditional Chinese Medicine MLC901 against myocardial ischemia-reperfusion injury in mice. Sci Rep 2017; 7:14701. [PMID: 29089640 PMCID: PMC5665902 DOI: 10.1038/s41598-017-14822-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/16/2017] [Indexed: 12/20/2022] Open
Abstract
MLC901, a traditional Chinese medicine containing a cocktail of active molecules, both reduces cerebral infarction and improves recovery in patients with ischemic stroke. The aim of this study was to evaluate the acute and long-term benefits of MLC901 in ischemic and reperfused mouse hearts. Ex vivo, under physiological conditions, MLC901 did not show any modification in heart rate and contraction amplitude. However, upon an ischemic insult, MLC901 administration during reperfusion, improved coronary flow in perfused hearts. In vivo, MLC901 (4 µg/kg) intravenous injection 5 minutes before reperfusion provided a decrease in both infarct size (49.8%) and apoptosis (49.9%) after 1 hour of reperfusion. Akt and ERK1/2 survival pathways were significantly activated in the myocardium of those mice. In the 4-month clinical follow-up upon an additional continuous per os administration, MLC901 treatment decreased cardiac injury as revealed by a 45%-decrease in cTnI plasmatic concentrations and an improved cardiac performance assessed by echocardiography. A histological analysis revealed a 64%-decreased residual scar fibrosis and a 44%-increased vascular density in the infarct region. This paper demonstrates that MLC901 treatment was able to provide acute and long-term cardioprotective effects in a murine model of myocardial ischemia-reperfusion injury in vivo.
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13
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Asgeirsson D, Hedström E, Jögi J, Pahlm U, Steding-Ehrenborg K, Engblom H, Arheden H, Carlsson M. Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic myocardial infarction even when the absolute atrioventricular plane displacement is decreased. BMC Cardiovasc Disord 2017; 17:208. [PMID: 28754098 PMCID: PMC5534092 DOI: 10.1186/s12872-017-0641-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/21/2017] [Indexed: 11/21/2022] Open
Abstract
Background The majority (60%) of left ventricular (LV) stroke volume (SV) is generated by longitudinal shortening causing apical atrioventricular plane displacement (AVPD) in systole. The remaining SV is caused by radial inward motion of the epicardium both in the septal and the lateral wall. We aimed to determine if these longitudinal, septal and lateral contributions to LVSV are changed in patients with chronic myocardial infarction (MI). Methods Patients with a chronic (>3 months) ST-elevation MI in the left anterior descending (LAD, n = 20) or right coronary artery (RCA, n = 16) and healthy controls (n = 20) were examined with cardiovascular magnetic resonance (CMR). AVPD was quantified in long axis cine CMR images and LV volumes and dimensions in short axis cine images. Results AVPD was decreased both in patients with LAD-MI (11 ± 1 mm, p < 0.001) and RCA-MI (13 ± 1 mm, p < 0.05) compared to controls (15 ± 0 mm). However, the longitudinal contribution to SV was unchanged for both LAD-MI (58 ± 3%, p = 0.08) and RCA-MI (59 ± 3%, p = 0.09) compared to controls (64 ± 2%). The preserved longitudinal contribution despite decreased absolute AVPD was a results of increased epicardial dimensions (p < 0.01 for LAD-MI and p = 0.06 for RCA-MI). In LAD-MI the septal contribution to LVSV was decreased (5 ± 1%) compared to both controls (10 ± 1%, p < 0.01) and patients with RCA-MIs (10 ± 1%, p < 0.01). The lateral contribution was increased in LAD-MI patients (44 ± 3%) compared to both RCA-MI (35 ± 2%, p < 0.05) and controls (29 ± 2%, p < 0.001). Conclusion Longitudinal shortening remains the principal component of left ventricular pumping in patients with chronic MI even when the absolute AVPD is decreased.
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Affiliation(s)
- Daniel Asgeirsson
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Erik Hedström
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Ulrika Pahlm
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Katarina Steding-Ehrenborg
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden
| | - Henrik Engblom
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Håkan Arheden
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Marcus Carlsson
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.
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14
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La Grutta L, Toia P, Maffei E, Cademartiri F, Lagalla R, Midiri M. Infarct characterization using CT. Cardiovasc Diagn Ther 2017; 7:171-188. [PMID: 28540212 DOI: 10.21037/cdt.2017.03.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.
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Affiliation(s)
| | - Patrizia Toia
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Erica Maffei
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada
| | - Filippo Cademartiri
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Roberto Lagalla
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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15
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Cardiovascular imaging 2015 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2016; 32:697-709. [DOI: 10.1007/s10554-016-0877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Dastidar AG, Rodrigues JCL, Baritussio A, Bucciarelli-Ducci C. MRI in the assessment of ischaemic heart disease. Heart 2015; 102:239-52. [DOI: 10.1136/heartjnl-2014-306963] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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