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Cho SKS, Darby JRT, Williams GK, Holman SL, Rai A, Van Amerom JFP, Fan CP, Macgowan CK, Selvanayagam JB, Morrison JL, Seed M. Post-Myocardial Infarction Remodeling and Hyperkinetic Remote Myocardium in Sheep Measured by Cardiac MRI Feature Tracking. J Magn Reson Imaging 2024. [PMID: 38940396 DOI: 10.1002/jmri.29496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Cardiac MRI feature tracking (FT) allows objective assessment of segmental left ventricular (LV) function following a myocardial infarction (MI), but its utilization in sheep, where interventions can be tested, is lacking. PURPOSE To apply and validate FT in a sheep model of MI and describe post-MI LV remodeling. STUDY TYPE Animal model, longitudinal. ANIMAL MODEL Eighteen lambs (6 months, male, n = 14; female, n = 4; 25.2 ± 4.5 kg). FIELD STRENGTH/SEQUENCE Two-dimensional balanced steady-state free precession (bSSFP) and 3D inversion recovery fast low angle shot (IR-FLASH) sequences at 3 T. ASSESSMENT Seven lambs underwent test-retest imaging to assess FT interstudy reproducibility. MI was induced in the remaining 11 by coronary ligation with MRI being undertaken before and 15 days post-MI. Injury size was measured by late gadolinium enhancement (LGE) and LV volumes, LV mass, ejection fraction (LVEF), and wall thickness (LVWT) were measured, with FT measures of global and segmental radial, circumferential, and longitudinal strain. STATISTICAL TESTS Sampling variability, inter-study, intra and interobserver reproducibility were assessed using Pearson's correlation, Bland-Altman analyses, and intra-class correlation coefficients (ICC). Diagnostic performance of segmental strain to predict LGE was assessed using receiver operating characteristic curve analysis. Significant differences were considered P < 0.05. RESULTS Inter-study reproducibility of FT was overall good to excellent, with global strain being more reproducible than segmental strain (ICC = 0.89-0.98 vs. 0.77-0.96). MI (4.0 ± 3.7% LV mass) led to LV remodeling, as evident by significantly increased LV volumes and LV mass, and significantly decreased LVWT in injured regions, while LVEF was preserved (54.9 ± 6.9% vs. 55.6 ± 5.7%; P = 0.778). Segmental circumferential strain (CS) correlated most strongly with LGE. Basal and mid- CS increased significantly, while apical CS significantly decreased post-MI. DATA CONCLUSION FT is reproducible and compensation by hyperkinetic remote myocardium may manifest as overall preserved global LV function. EVIDENCE LEVEL N/A TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Steven K S Cho
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jack R T Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Georgia K Williams
- Preclinical, Imaging & Research Laboratories, South Australian Health & Medical Research Institute, Adelaide, South Australia, Australia
| | - Stacey L Holman
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Archana Rai
- Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Imaging, University Medical Imaging Toronto, University of Toronto, Toronto, Ontario, Canada
- Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Joshua F P Van Amerom
- Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chun-Po Fan
- Rogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Christopher K Macgowan
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joseph B Selvanayagam
- Cardiac Imaging Research Group, Department of Heart Health, South Australian Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Janna L Morrison
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mike Seed
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
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2
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Sorolla-Romero JA, Navarrete-Navarro J, Martinez-Sole J, Garcia HMG, Diez-Gil JL, Martinez-Dolz L, Sanz-Sanchez J. Pharmacological Considerations during Percutaneous Treatment of Heart Failure. Curr Pharm Des 2024; 30:565-577. [PMID: 38477207 DOI: 10.2174/0113816128284131240209113009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 03/14/2024]
Abstract
Heart Failure (HF) remains a global health challenge, marked by its widespread prevalence and substantial resource utilization. Although the prognosis has improved in recent decades due to the treatments implemented, it continues to generate high morbidity and mortality in the medium to long term. Interventional cardiology has emerged as a crucial player in HF management, offering a diverse array of percutaneous treatments for both acute and chronic HF. This article aimed to provide a comprehensive review of the role of percutaneous interventions in HF patients, with a primary focus on key features, clinical effectiveness, and safety outcomes. Despite the growing utilization of these interventions, there remain critical gaps in the existing body of evidence. Consequently, the need for high-quality randomized clinical trials and extensive international registries is emphasized to shed light on the specific patient populations and clinical scenarios that stand to benefit most from these innovative devices.
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Affiliation(s)
- Jose Antonio Sorolla-Romero
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
| | - Javier Navarrete-Navarro
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
| | - Julia Martinez-Sole
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
| | - Hector M Garcia Garcia
- Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 20010, United States
| | - Jose Luis Diez-Gil
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
| | - Luis Martinez-Dolz
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
| | - Jorge Sanz-Sanchez
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 116, Valencia, Spain
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Castelvecchio S, Frigelli M, Sturla F, Milani V, Pappalardo OA, Citarella M, Menicanti L, Votta E. Elucidating the mechanisms underlying left ventricular function recovery in patients with ischemic heart failure undergoing surgical remodeling: A 3-dimensional ultrasound analysis. J Thorac Cardiovasc Surg 2023; 165:1418-1429.e4. [PMID: 33781593 DOI: 10.1016/j.jtcvs.2021.02.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study objective was to elucidate the mechanisms of left ventricle functional recovery in terms of endocardial contractility and synchronicity after surgical ventricular reconstruction. METHODS Real-time 3-dimensional transthoracic echocardiography was performed on 20 patients with anterior left ventricle remodeling and ischemic heart failure before surgical ventricular reconstruction and at 6-month follow-up, and on 15 healthy controls matched by age and body surface area. Real-time 3-dimensional transthoracic echocardiography datasets were analyzed through TomTec software (4D LV-Analysis; TomTec Imaging Systems GmbH, Unterschleissheim, Germany): Left ventricle volumes, ejection fraction, and global longitudinal strain were computed; the time-dependent endocardial surface yielded by 3-dimensional speckle-tracking echocardiography was postprocessed through in-house software to quantify local systolic minimum principal strain as a measure of fiber shortening and mechanical dispersion as a measure of fiber synchronicity. RESULTS Compared with controls, patients with heart failure before surgical ventricular reconstruction showed lower ejection fraction (P < .0001) and significantly impaired mechanical dispersion (P < .0001) and minimum principal strain (P < .0001); the latter worsened progressively from left ventricle base to apex. After surgical ventricular reconstruction, global longitudinal strain improved from -6.7% to -11.3% (P < .0001); mechanical dispersion decreased in every left ventricle region (P ≤ .017) and mostly in the basal region, where computed mechanical dispersion values were comparable to physiologic values (P ≥ .046); minimum principal strain improved mostly in the basal region, changing from -16.6% to -22.3% (P = .0027). CONCLUSIONS At 6-month follow-up, surgical ventricular reconstruction was associated with significant recovery in global left ventricle function, improved mechanical dispersion indicating a more synchronous left ventricle contraction, and improved left ventricle fiber shortening mostly in the basal region, suggesting the major role of the remote myocardium in enhancing left ventricle functional recovery.
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Affiliation(s)
| | - Matteo Frigelli
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Francesco Sturla
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
| | - Valentina Milani
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Omar A Pappalardo
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Michele Citarella
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Emiliano Votta
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Nawaz W, Naveed M, Zhang J, Noreen S, Saeed M, Sembatya KR, Ihsan AU, Mohammad IS, Wang G, Zhou X. Cardioprotective effect of silicon-built restraint device (ASD), for left ventricular remodeling in rat heart failure model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:42. [PMID: 35536369 PMCID: PMC9090860 DOI: 10.1007/s10856-022-06663-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
This study aims to evaluate the feasibility and cardio-protective effects of biocompatible silicon-built restraint device (ASD) in the rat's heart failure (HF) model. The performance and compliance characteristics of the ASD device were assessed in vitro by adopting a pneumatic drive and ball burst test. Sprague-Dawley (SD) rats were divided into four groups (n = 6); control, HF, HF + CSD, and HF + ASD groups, respectively. Heart failure was developed by left anterior descending (LAD) coronary artery ligation in all groups except the control group. The ASD and CSD devices were implanted in the heart of HF + ASD and HF + CSD groups, respectively. The ASD's functional and expansion ability was found to be safe and suitable for attenuating ventricular remodeling. ASD-treated rats showed normal heart rhythm, demonstrated by smooth -ST and asymmetrical T-wave. At the same time, hemodynamic parameters of the HF + ASD group improved systolic and diastolic functions, reducing ventricular wall stress, which indicated reverse remodeling. The BNP values were reduced in the HF + ASD group, which confirmed ASD feasibility and reversed remodeling at a molecular level. Furthermore, the HF + ASD group with no fibrosis suggests that ASD has significant curative effects on the heart muscles. In conclusion, ASD was found to be a promising restraint therapy than the previously standard restraint therapies. Stepwise ASD fabrication process (a) 3D computer model of ASD was generated by using Rhinoceros 5.0 software (b) 3D blue wax model of ASD (c) Silicon was prepared by mixing the solutions (as per manufacturer instruction) (d) Blue wax model of ASD was immersed into liquid Silicon (e) ASD model was put into the oven for 3 hours at 50 °C. (f) Blue wax started melting from the ASD model (g) ASD model was built from pure silicon (h) Two access lines were linked to the ASD device, which was connected with an implantable catheter (Port-a-cath), scale bar 100 µm. (Nikon Ldx 2.0).
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Affiliation(s)
- Waqas Nawaz
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Muhammad Naveed
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
- Department of Clinical Pharmacology, School of Pharmacy, Nanjing University, Nanjing, China
| | - Jing Zhang
- Department of Clinical Pharmacology, School of Pharmacy, Nanjing University, Nanjing, China
| | - Sobia Noreen
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Saeed
- The Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
| | - Kiganda Raymond Sembatya
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Awais Ullah Ihsan
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | | | - Gang Wang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xiaohui Zhou
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
- Department of Heart Surgery, Nanjing Shuiximen Hospital, Nanjing, China.
- Department of Cardiothoracic Surgery, Zhongda Hospital affiliated with Southeast University, Nanjing, China.
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5
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Bi W, Xiao Y, Wang X, Cui L, Song G, Yang Z, Zhang Y, Ren W. The association between assisted reproductive technology and cardiac remodeling in fetuses and early infants: a prospective cohort study. BMC Med 2022; 20:104. [PMID: 35361200 PMCID: PMC8973576 DOI: 10.1186/s12916-022-02303-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Limited data exist regarding the potential impact of assisted reproductive technology (ART) on cardiac remodeling. In particular, whether different ART techniques are related to different cardiac alterations remains unclear. We aimed to evaluate cardiac changes in fetuses and infants arising from ART and fetal cardiac alterations in fetuses conceived by specific ART procedures. METHODS This prospective and observational cohort study recruited 111 fetuses conceived by ART and 106 spontaneously conceived controls between December 2017 and April 2019. Echocardiography was performed between 28+0 and 32+6 weeks-of-gestation and at 0-2 and 6 months after birth. RESULTS A total of 88 ART fetuses and 85 controls were included in the final analysis. Compared to controls, ART fetuses demonstrated a globular enlarged left ventricle (LV) (LV sphericity index of mid-section, 2.29 ± 0.34 vs. 2.45 ± 0.39, P = 0.006; LV area, 262.33 ± 45.96 mm2 vs. 244.25 ± 47.13 mm2, P = 0.002), a larger right ventricle (RV) (RV area, 236.10 ± 38.63 mm2 vs. 221.14 ± 42.60 mm2, P = 0.003) and reduced LV systolic deformation (LV global longitudinal strain (GLS), -19.56% ± 1.90% vs. -20.65% ± 1.88%, P = 0.013; LV GLS rate S, -3.32 ± 0.36 s-1 vs. -3.58 ± 0.39 s-1, P = 0.023). There were no significant differences between the ART and control groups at postnatal follow-ups. Furthermore, we found fetal cardiac morphometry and function were comparable between different ART procedures. Compared to controls, the fetuses derived from various ART procedures all exhibited impairments in the LV GLS and the LV GLS rate S. CONCLUSIONS Our analysis demonstrated that subclinical cardiac remodeling and dysfunction were evident in ART fetuses, although these alterations did not persist in early infancy. In addition, various ART procedures may cause the same unfavorable changes in the fetal heart. TRIAL REGISTRATION This trial was registered at the Chinese Clinical Trial Registry ( www.chictr.org.cn ) ( ChiCTR1900021672 ) on March 4, 2019, retrospectively registered.
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Affiliation(s)
- Wenjing Bi
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Yangjie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Xin Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Li Cui
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China.,Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Zeyu Yang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Ying Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Weidong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China.
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Nakamura M, Yaku H, Ako J, Arai H, Asai T, Chikamori T, Daida H, Doi K, Fukui T, Ito T, Kadota K, Kobayashi J, Komiya T, Kozuma K, Nakagawa Y, Nakao K, Niinami H, Ohno T, Ozaki Y, Sata M, Takanashi S, Takemura H, Ueno T, Yasuda S, Yokoyama H, Fujita T, Kasai T, Kohsaka S, Kubo T, Manabe S, Matsumoto N, Miyagawa S, Mizuno T, Motomura N, Numata S, Nakajima H, Oda H, Otake H, Otsuka F, Sasaki KI, Shimada K, Shimokawa T, Shinke T, Suzuki T, Takahashi M, Tanaka N, Tsuneyoshi H, Tojo T, Une D, Wakasa S, Yamaguchi K, Akasaka T, Hirayama A, Kimura K, Kimura T, Matsui Y, Miyazaki S, Okamura Y, Ono M, Shiomi H, Tanemoto K. JCS 2018 Guideline on Revascularization of Stable Coronary Artery Disease. Circ J 2022; 86:477-588. [DOI: 10.1253/circj.cj-20-1282] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | - Hitoshi Yaku
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine
| | - Kiyoshi Doi
- General and Cardiothoracic Surgery, Gifu University Graduate School of Medicine
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University
| | - Toshiaki Ito
- Department of Cardiovascular Surgery, Japanese Red Cross Nagoya Daiichi Hospital
| | | | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tatsuhiko Komiya
- Department of Cardiovascular Surgery, Kurashiki Central Hospital
| | - Ken Kozuma
- Department of Internal Medicine, Teikyo University Faculty of Medicine
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science
| | - Koichi Nakao
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Hiroshi Niinami
- Department of Cardiovascular Surgery, Tokyo Women’s Medical University
| | - Takayuki Ohno
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University Hospital
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Hirofumi Takemura
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kanazawa University
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hitoshi Yokoyama
- Department of Cardiovascular Surgery, Fukushima Medical University
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Institute of Community Medicine, Niigata University Uonuma Kikan Hospital
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Susumu Manabe
- Department of Cardiovascular Surgery, Tsuchiura Kyodo General Hospital
| | | | - Shigeru Miyagawa
- Frontier of Regenerative Medicine, Graduate School of Medicine, Osaka University
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Noboru Motomura
- Department of Cardiovascular Surgery, Graduate School of Medicine, Toho University
| | - Satoshi Numata
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine
| | - Hiroyuki Nakajima
- Department of Cardiovascular Surgery, Saitama Medical University International Medical Center
| | - Hirotaka Oda
- Department of Cardiology, Niigata City General Hospital
| | - Hiromasa Otake
- Department of Cardiovascular Medicine, Kobe University Graduate School of Medicine
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Ken-ichiro Sasaki
- Division of Cardiovascular Medicine, Kurume University School of Medicine
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine
| | - Tomoki Shimokawa
- Department of Cardiovascular Surgery, Sakakibara Heart Institute
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Tomoaki Suzuki
- Department of Cardiovascular Surgery, Shiga University of Medical Science
| | - Masao Takahashi
- Department of Cardiovascular Surgery, Hiratsuka Kyosai Hospital
| | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | | | - Taiki Tojo
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | - Dai Une
- Department of Cardiovascular Surgery, Okayama Medical Center
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Kazuo Kimura
- Cardiovascular Center, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Yoshiro Matsui
- Department of Cardiovascular and Thoracic Surgery, Graduate School of Medicine, Hokkaido University
| | - Shunichi Miyazaki
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Kindai University
| | | | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School
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Liu N, Ye X, Yao B, Zhao M, Wu P, Liu G, Zhuang D, Jiang H, Chen X, He Y, Huang S, Zhu P. Advances in 3D bioprinting technology for cardiac tissue engineering and regeneration. Bioact Mater 2021; 6:1388-1401. [PMID: 33210031 PMCID: PMC7658327 DOI: 10.1016/j.bioactmat.2020.10.021] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/09/2020] [Accepted: 10/27/2020] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease is still one of the leading causes of death in the world, and heart transplantation is the current major treatment for end-stage cardiovascular diseases. However, because of the shortage of heart donors, new sources of cardiac regenerative medicine are greatly needed. The prominent development of tissue engineering using bioactive materials has creatively laid a direct promising foundation. Whereas, how to precisely pattern a cardiac structure with complete biological function still requires technological breakthroughs. Recently, the emerging three-dimensional (3D) bioprinting technology for tissue engineering has shown great advantages in generating micro-scale cardiac tissues, which has established its impressive potential as a novel foundation for cardiovascular regeneration. Whether 3D bioprinted hearts can replace traditional heart transplantation as a novel strategy for treating cardiovascular diseases in the future is a frontier issue. In this review article, we emphasize the current knowledge and future perspectives regarding available bioinks, bioprinting strategies and the latest outcome progress in cardiac 3D bioprinting to move this promising medical approach towards potential clinical implementation.
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Affiliation(s)
- Nanbo Liu
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
| | - Xing Ye
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
- Department of Cardiac Surgery, Affiliated South China Hospital, Southern Medical University (Guangdong Provincial People's Hospital) and The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Bin Yao
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College, 28 Fu Xing Road, Beijing, 100853, China
| | - Mingyi Zhao
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
| | - Peng Wu
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
- Department of Cardiac Surgery, Affiliated South China Hospital, Southern Medical University (Guangdong Provincial People's Hospital) and The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Guihuan Liu
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China
| | - Donglin Zhuang
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
| | - Haodong Jiang
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China
| | - Xiaowei Chen
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
| | - Yinru He
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
| | - Sha Huang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College, 28 Fu Xing Road, Beijing, 100853, China
| | - Ping Zhu
- Department of Cardiac Surgery, and Department of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510100, China
- Department of Cardiac Surgery, Affiliated South China Hospital, Southern Medical University (Guangdong Provincial People's Hospital) and The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China
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8
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Patel AJ, Mohamed S, Iqbal Y, Kar A, Soppa G. A combined approach to correct posterior left ventricular aneurysm, aortic stenosis and coronary artery disease. J Surg Case Rep 2020; 2020:rjaa356. [PMID: 33072255 PMCID: PMC7550209 DOI: 10.1093/jscr/rjaa356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/13/2022] Open
Abstract
Ischaemic heart disease and aortic stenosis are potentially life-threatening conditions. A post-infarct left ventricular aneurysm, when combined with the above, is particularly hazardous. We present a case where all three conditions occurred simultaneously and describe the surgical approach undertaken to attempt correction. The patient underwent aneurysmectomy together with aortic valve replacement and two-vessel coronary artery bypass grafting. The aneurysm was excised with direct linear closure of the walls using a Teflon-buttressed interrupted mattress suture technique. Post-operatively, ventricular systolic function was good (LVEF 40%) together with a well-seated aortic valve showing no paravalvular leaks. This case highlights the importance of meticulous removal of thrombus from the aneurysm and everting the edges thereby eliminating a thrombogenic surface and the risk of embolic stroke. The restorative procedure itself serves to underline the importance of ventricular shape in the effective functioning of the myocardium for sustaining an adequate stroke volume with normalized physiology.
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Affiliation(s)
- Akshay J Patel
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - Saifullah Mohamed
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
| | - Yassir Iqbal
- Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, Birmingham, UK
| | - Ashok Kar
- Department of Cardiothoracic Surgery, Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Gopal Soppa
- Department of Cardiothoracic Surgery, Bart's Heart Centre, Bart's Health NHS Trust, London, UK
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9
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M H BT, H Z, H P, Sh N, A E, A G. Sex-related Left Ventricle Rotational and Torsional Mechanics by Block Matching Algorithm. J Biomed Phys Eng 2019; 9:541-550. [PMID: 31750268 PMCID: PMC6820028 DOI: 10.31661/jbpe.v0i0.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/25/2015] [Indexed: 11/17/2022]
Abstract
Background: The aim of the present study was to evaluate how left ventricular twist and torsion are associated with sex between sex groups of the same age.
Materials and Methods: In this analytical study, twenty one healthy subjects were scanned in left ventricle basal and apical short axis views to run the block matching algorithm; instantaneous changes in the base and apex rotation angels were estimated by this algorithm and then instantaneous changes of the twist and torsion were calculated over the cardiac cycle.
Results: The rotation amount between the consecutive frames in basal and apical levels was extracted from short axis views by tracking the speckle pattern of images. The maximum basal rotation angle for men and women were -6.94°±1.84 and 9.85°±2.36 degrees (p-value = 0.054), respectively. Apex maximum rotation for men was -8.89°±2.04 and for women was 12.18°±2.33 (p-value < 0.05). The peak of twist angle for men and women was 16.78 ± 1.83 and 20.95± 2.09 degrees (p-value < 0.05), respectively. In men and women groups, the peak of calculated torsion angle was 5.49°±1.04 and 7.12± 1.38 degrees (p-value < 0.05), respectively.
Conclusion: The conclusion is that although torsion is an efficient parameter for left ventricle function assessment, because it can take in account the heart diameter and length,
statistic evaluation of the results shows that among men and women LV mechanical parameters are significantly different. This study was mainly ascribed to the dependency of the torsion and twist on patient sex.
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Affiliation(s)
- Bahreini Toosi M H
- PhD, Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zarghani H
- PhD, Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Poorzand H
- MD, Atherosclerosis Prevention Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naseri Sh
- PhD, Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Eshraghi A
- MD, Atherosclerosis Prevention Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Golabpour A
- PhD, Biomedical Informatics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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10
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Dziewięcka E, Wiśniowska-Śmiałek S, Khachatryan L, Karabinowska A, Szymonowicz M, Podolec P, Rubiś P. Relationships between left ventricular geometry and remodeling in dilated cardiomyopathy. Minerva Cardioangiol 2019; 67:261-271. [PMID: 31115242 DOI: 10.23736/s0026-4725.19.04856-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Since left ventricular reverse remodeling (LVRR) and sphericity index (SI) are correlated with DCM patients' survival, we attempted to establish the relationship between LVRR, SI and left ventricle (LV) dimensions. METHODS In 70 DCM patients, we measured EF, LV transverse (sLVd) and longitudinal (lLVd) diameters at hospital admission, then after 3 and 12 months. SI was assessed thus: SI=sLVd/lLVd. RESULTS LVRR was present in 32 patients (52%). SI measurements were similar in LVRR-present and -absent groups at baseline (0.71 vs. 0.70) and differed after 3 and 12 months (0.61 vs. 0.72, P<0.005; 0.59 vs. 0.73, P<0.001; respectively). During 12 months, SI and sLVd decreased in the LVRR-present (0.71 vs. 0.61 vs. 0.59, P<0.05; 5.75 vs. 5.00 vs. 4.82 cm, P<0.001; respectively) and increased in the LVRR-absent cohort (0.70 vs. 0.72 vs. 0.73, P<0.001; 6.01 vs. 6.15 vs. 6.67, P<0.001; respectively). lLVd remained stable (8.23 vs. 8.16 vs. 8.38cm; 8.66 vs. 8.85 vs. 9.13 cm; respectively). SI was significantly correlated with sLVd but not with lLVd. At 3-month follow-up, SI (P<0.005, OR=14000 [95% CI: 5 - 3.9*107]) was found to be a significant LVRR predictor via univariate logistic regression. CONCLUSIONS To summarize, changes in sLVd are crucial for changes in LV geometry, whereas lLVd has a negligible effect on this process. The presence of LVRR was not always associated with an improvement in SI and its absence with increase in SI. Since the assessment of SI is less complex than LVRR, SI as a significant LVRR predictor can be useful part of a regular echocardiography examination.
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Affiliation(s)
- Ewa Dziewięcka
- Department of Cardiac and Vascular Diseases, Medical College, John Paul II Hospital, Jagiellonian University, Krakow, Poland -
| | - Sylwia Wiśniowska-Śmiałek
- Department of Cardiac and Vascular Diseases, Medical College, John Paul II Hospital, Jagiellonian University, Krakow, Poland
| | - Lusine Khachatryan
- Department of Cardiac and Vascular Diseases, Medical Collage, Jagiellonian University, Krakow, Poland
| | - Aleksandra Karabinowska
- Department of Cardiac and Vascular Diseases, Medical Collage, Jagiellonian University, Krakow, Poland
| | - Maria Szymonowicz
- Department of Cardiac and Vascular Diseases, Medical Collage, Jagiellonian University, Krakow, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Medical College, John Paul II Hospital, Jagiellonian University, Krakow, Poland
| | - Paweł Rubiś
- Department of Cardiac and Vascular Diseases, Medical College, John Paul II Hospital, Jagiellonian University, Krakow, Poland
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11
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Wei H, Chai S, Liu C, Huang X, Gu C. Left Ventricular Aneurysm Repair: Off-pump Linear Plication versus On-pump Patch Plasty. Braz J Cardiovasc Surg 2019; 34:187-193. [PMID: 30916129 PMCID: PMC6436783 DOI: 10.21470/1678-9741-2018-0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/17/2018] [Indexed: 11/25/2022] Open
Abstract
Objective The study aimed to compare the clinical outcomes of simplified linear
plication and classic patch plasty in patients with left ventricular
aneurysm (LVA). Methods We retrospectively reviewed 282 patients undergoing LVA repair between 2006
and 2016. After propensity score matching, 45 pairs of patients receiving
LVA surgery were divided into either a patch group (on-pump endoventricular
patch plasty) or a plication group (off-pump linear plication). Then, their
early surgical outcomes and long-term survival were compared in two matched
groups. Results The heart function improvement at discharge was similar in the two matched
groups, while patients in the patch group more commonly suffered from low
cardiac output syndrome (P=0.042) with higher proportion of
intra-aortic balloon pumping assistance (P=0.034) than
patients in the plication group. Compared with patients in the patch group,
the patients in the plication group had shorter recovery times, regarding to
mechanical ventilation, intensive care unit stay, and hospital stay
(P<0.001, P<0.001, and
P=0.001, respectively). No significant difference was
found in the long-term survival (P=0.62). Conclusions Off-pump linear plication presented acceptable results in terms of early
outcomes and long-term survival. For high-risk patients, the simplified LVA
repair technique may be an option.
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Affiliation(s)
- Hua Wei
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Shoudong Chai
- Department of Cardiac Surgery, Liaocheng People's Hospital, Clinical School of Taishan Medical University, Shandong, China
| | - Changcheng Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Xinsheng Huang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Chengxiong Gu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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12
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Abstract
Patients with heart failure show myocardial, valvular, and electrical dysfunction, which results in enlarged cardiac chambers and increased intracardiac volume and pressure. Intracardiac flow analysis can provide information regarding the shape and wall properties, chamber dimensions, and flow efficiency throughout the cardiac cycle. There is increasing interest in vortex flow analysis for patients with heart failure to overcome limitations of conventional parameters. In conjunction with the conventional structural and functional parameters, vortex flow analysis-guided treatment in heart failure might be a novel option for cardiac physicians.
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Affiliation(s)
- In-Cheol Kim
- Division of Cardiology, Keimyung University Dongsan Medical Center, 56 Dalsung-ro Jung-gu, Daegu 41931, Republic of Korea
| | - Geu-Ru Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodae mun-gu, Seoul 03722, Republic of Korea.
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13
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Denisova NV, Ansheles AA. A study of false apical defects in myocardial perfusion imaging with SPECT/CT. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Naveed M, Mohammad IS, Xue L, Khan S, Gang W, Cao Y, Cheng Y, Cui X, DingDing C, Feng Y, Zhijie W, Xiaohui Z. The promising future of ventricular restraint therapy for the management of end-stage heart failure. Biomed Pharmacother 2018; 99:25-32. [PMID: 29324309 DOI: 10.1016/j.biopha.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 01/31/2023] Open
Abstract
Complicated pathophysiological syndrome associated with irregular functioning of the heart leading to insufficient blood supply to the organs is linked to congestive heart failure (CHF) which is the leading cause of death in developed countries. Numerous factors can add to heart failure (HF) pathogenesis, including myocardial infarction (MI), genetic factors, coronary artery disease (CAD), ischemia or hypertension. Presently, most of the therapies against CHF cause modest symptom relief but incapable of giving significant recovery for long-term survival outcomes. Unfortunately, there is no effective treatment of HF except cardiac transplantation but genetic variations, tissue mismatch, differences in certain immune response and socioeconomic crisis are some major concern with cardiac transplantation, suggested an alternate bridge to transplant (BTT) or destination therapies (DT). Ventricular restraint therapy (VRT) is a promising, non-transplant surgical treatment wherein the overall goal is to wrap the dilated heart with prosthetic material to mechanically restrain the heart at end-diastole, stop extra remodeling, and thereby ultimately improve patient symptoms, ventricular function and survival. Ventricular restraint devices (VRDs) are developed to treat end-stage HF and BTT, including the CorCap cardiac support device (CSD) (CSD; Acorn Cardiovascular Inc, St Paul, Minn), Paracor HeartNet (Paracor Medical, Sunnyvale, Calif), QVR (Polyzen Inc, Apex, NC) and ASD (ASD, X. Zhou). An overview of 4 restraint devices, with their precise advantages and disadvantages, will be presented. The accessible peer-reviewed literature summarized with an important considerations on the mechanism of restraint therapy and how this acquaintance can be accustomed to optimize and improve its effectiveness.
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Affiliation(s)
- Muhammad Naveed
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Imran Shair Mohammad
- Department of Pharmaceutics, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Li Xue
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Sara Khan
- Department of Pharmaceutical Chemistry, University College of Pharmacy, University of the Punjab, Lahore 5400, Pakistan
| | - Wang Gang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Yanfang Cao
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Yijie Cheng
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Xingxing Cui
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Chen DingDing
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China.
| | - Yu Feng
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China.
| | - Wang Zhijie
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, PR China.
| | - Zhou Xiaohui
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China; Department of Heart Surgery, Nanjing Shuiximen Hospital, Jiangsu Province, Nanjing 210017, PR China; Department of Cardiothoracic Surgery, Zhongda Hospital affiliated to Southeast University, Jiangsu Province, Nanjing 210017, PR China.
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15
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Adhyapak SM, Menon PG, Varghese K, Mehra A, Lohitashwa SB, Fantini F. Improvements in Regional Left Ventricular Function Following Late Percutaneous Coronary Intervention for Anterior Myocardial Infarction. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2017; 11:1179546817746636. [PMID: 29308017 PMCID: PMC5751905 DOI: 10.1177/1179546817746636] [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] [Received: 05/17/2017] [Accepted: 11/07/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Late revascularization following a myocardial infarction has questionable clinical benefit. METHODS We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle. RESULTS Left ventricular end-systolic volume decreased to 42 ± 8 mL/body surface area (P = .034) and LV ejection fraction improved to 52% ± 7% (P = .04). Analysis of LV endocardial CWD demonstrated significant improvements in mid-systolic to late-systolic phases in the apical LV segments, from 3.5 ± 0.32 to 5.89 ± 0.43 mm (P = .019). Improvements in CWD were also observed in the late-diastolic phase of the cardiac cycle, from 1.50 ± 0.42 to 1.76 ± 0.52 mm (P = .04). CONCLUSIONS In our pilot patient cohort, following late establishment of infarct-related artery patency following an anterior wall myocardial infarction, regional improvements were noted in the LV apical segments during systole and late diastole.
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Affiliation(s)
| | - Prahlad G Menon
- Department of Biomedical Engineering, Duquesne University, Pittsburgh, PA, USA
- Department of Biomedical Engineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
- QuantMD LLC, Pittsburgh, PA, USA
| | - Kiron Varghese
- Department of Cardiology, St. John’s Medical College Hospital, Bangalore, India
| | | | - SB Lohitashwa
- Department of Cardiology, St. John’s Medical College Hospital, Bangalore, India
| | - Fabio Fantini
- Department of Cardiology, University of Florence, Florence, Italy
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16
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Kinno M, Nagpal P, Horgan S, Waller AH. Comparison of Echocardiography, Cardiac Magnetic Resonance, and Computed Tomographic Imaging for the Evaluation of Left Ventricular Myocardial Function: Part 2 (Diastolic and Regional Assessment). Curr Cardiol Rep 2017; 19:6. [PMID: 28116679 DOI: 10.1007/s11886-017-0816-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Assessing left ventricular diastolic and regional function is a crucial part of the cardiovascular evaluation. Diastolic function is as important as systolic function for left ventricular performance because it is the determinant of the ability of the left atrium and ventricle to fill at relatively low pressures. Additionally, diastolic function plays an important role in the management and prognosis of patients with symptoms and signs of heart failure. Technical advances in the imaging modalities have allowed a comprehensive noninvasive assessment of global and regional cardiac mechanics and precise estimation of cardiovascular hemodynamics. In this review, we will discuss and compare clinically available techniques and novel approaches using echocardiography, cardiac magnetic resonance, and computed tomography for the assessment of diastolic and regional left ventricular function.
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Affiliation(s)
- Menhel Kinno
- Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Prashant Nagpal
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Stephen Horgan
- Department of Cardiovascular Medicine, Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, NJ, USA
| | - Alfonso H Waller
- Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA. .,Department of Radiology, Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, 185 South Orange Avenue, Newark, NJ, 07103, USA.
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17
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Rajan NK, Song Z, Hoffmann KR, Belohlavek M, McMahon EM, Borazjani I. Automated Three-Dimensional Reconstruction of the Left Ventricle From Multiple-Axis Echocardiography. J Biomech Eng 2016; 138:2469751. [PMID: 26548948 DOI: 10.1115/1.4031977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Indexed: 01/08/2023]
Abstract
Two-dimensional echocardiography (echo) is the method of choice for noninvasive evaluation of the left ventricle (LV) function owing to its low cost, fast acquisition time, and high temporal resolution. However, it only provides the LV boundaries in discrete 2D planes, and the 3D LV geometry needs to be reconstructed from those planes to quantify LV wall motion, acceleration, and strain, or to carry out flow simulations. An automated method is developed for the reconstruction of the 3D LV endocardial surface using echo from a few standard cross sections, in contrast with the previous work that has used a series of 2D scans in a linear or rotational manner for 3D reconstruction. The concept is based on a generalized approach so that the number or type (long-axis (LA) or short-axis (SA)) of sectional data is not constrained. The location of the cross sections is optimized to minimize the difference between the reconstructed and measured cross sections, and the reconstructed LV surface is meshed in a standard format. Temporal smoothing is implemented to smooth the motion of the LV and the flow rate. This software tool can be used with existing clinical 2D echo systems to reconstruct the 3D LV geometry and motion to quantify the regional akinesis/dyskinesis, 3D strain, acceleration, and velocities, or to be used in ventricular flow simulations.
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18
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Cirillo M, Campana M, Brunelli F, Dalla Tomba M, Mhagna Z, Messina A, Villa E, Natalini G, Troise G. Time series analysis of physiologic left ventricular reconstruction in ischemic cardiomyopathy. J Thorac Cardiovasc Surg 2016; 152:382-91. [PMID: 27167021 DOI: 10.1016/j.jtcvs.2016.03.087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/14/2016] [Accepted: 03/17/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The history of left ventricular reconstruction has demonstrated that the full spectrum of recoverable physiologic parameters is essential for a good functional result. We report the long-term outcome of a new surgical technique that arranges myocardial fibers in a near-normal disposition, also recovering left ventricular twisting. METHODS Between May 2006 and October 2013, 29 consecutive patients with previous anterior myocardial infarction and heart failure symptoms underwent physiologic left ventricular reconstruction surgery and coronary revascularization. Patients were examined by means of standard echocardiography and 2-dimensional speckle tracking at 8 time steps until 7 years after surgery. Ten geometric and functional parameters were evaluated at each step and analyzed by the linear mixed model test. RESULTS Hospital mortality was 0%. The mean percentage of indexed end-diastolic and end-systolic volume reduction was 45.7% and 50.9%, respectively. Ejection fraction and all of the volumes were significantly different in the postoperative period with a steady correction during time. Diastolic parameters were not worsened by surgical reconstruction. Ejection fraction and deceleration time showed a significant improvement during time. Left ventricular torsion increased immediately after the surgical correction from 2.8 ± 4.4 degrees to 8.7 ± 3.9 degrees (P = .02) and was still present 4 years after surgery. CONCLUSIONS Surgical conduction of ventricular reconstruction should be standardized to achieve the full spectrum of recoverable physiologic parameters. The renewal of ventricular torsion should be pursued as an adjunctive element of ventricular efficiency, mainly in ventricles that work at a critical level in the Frank-Starling relationship and pressure-volume loop.
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Affiliation(s)
- Marco Cirillo
- Heart Failure Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy.
| | - Marco Campana
- Echocardiography Laboratory, Cardiology Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Federico Brunelli
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Margherita Dalla Tomba
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Zean Mhagna
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Antonio Messina
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Emmanuel Villa
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giuseppe Natalini
- Intensive Care Unit, Emergency Department, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giovanni Troise
- Cardiac Surgery Unit, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy
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19
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Measurement of ventricular three-dimensional torsion. J Echocardiogr 2015; 13:59-65. [PMID: 26184639 DOI: 10.1007/s12574-015-0241-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/30/2015] [Accepted: 02/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND In this study, three-dimensional torsion angle of myocardium was extracted by two-dimensional images of the left ventricle at three levels of base, mid, and apex of interventricular septum wall. METHODS Two-dimensional echocardiography images of long- and short-axis views of healthy men were synchronized using an electrocardiogram of each individual and processed. Interventricular septum wall motion at three levels of base, mid, and apex were measured using a motion-detection algorithm throughout three cardiac cycles. Considering position vectors in long and short-axis views, the three-dimensional torsion angle is extracted throughout the cardiac cycle. RESULTS The average and standard deviation of Φ(M) during three cardiac cycles for interventricular septal wall in healthy individuals in this study are estimated as 16.3 ± 3.0° at base level, 22.8 ± 5.0° at mid level, and 14.6 ± 5.8° at apex level of septum wall, respectively. CONCLUSIONS This angle suggested for examination of regional and global biomechanical behavior of myocardium in different pathologic conditions.
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20
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Collins JD. Global and regional functional assessment of ischemic heart disease with cardiac MR imaging. Radiol Clin North Am 2015; 53:369-95. [PMID: 25727001 DOI: 10.1016/j.rcl.2014.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiac MR imaging (CMR) combines assessment of myocardial function and tissue characterization, and is therefore ideally suited to evaluating patients with ischemic heart disease (IHD). This article discusses evaluation of left ventricular global function at CMR, reviewing the literature supporting global parameters in risk stratification and assessment of treatment response in IHD. Techniques for assessment of regional myocardial function are reviewed, and normal myocardial motion and fiber arrangement discussed. Despite barriers to clinical adoption, integration of this assessment into clinical routine should improve the ability to detect functional consequences of early myocardial structural alterations in patients with IHD.
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Affiliation(s)
- Jeremy D Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611, USA.
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Adhyapak SM, Menon PG, Parachuri VR, Gadabanahalli K, Bhat VR, Shetty V, Shetty D. Restoration of optimal left ventricular apical geometry and rotation following surgical ventricular restoration using rectangular patch plasty technique: a pilot study using cardiac magnetic resonance. Interact Cardiovasc Thorac Surg 2014; 19:398-405. [PMID: 24899591 DOI: 10.1093/icvts/ivu173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Clinical outcomes of surgical ventricular restoration (SVR) have been confirmed by Registry data. Accurate assessment of left ventricular (LV) morphology and function can help optimize these outcomes. METHODS LV remodelling in 7 patients (NYHA class 3 ± 1.2) with post-myocardial infarction LV aneurysms was characterized by the regional LV volume (RLVV) computed by dividing the LV in cine steady-state free precession cardiac magnetic resonance imaging (CMR) at each slice level into six radial segments. Rotation of the LV apex and base was analysed using tagged CMR. The apical conicity ratio was used to characterize the restored apical geometry. RESULTS The mean end-diastolic volume (EDV) was 174.8 ± 100.3 ml and the mean ejection fraction (EF) was 18.8 ± 7.8%. Following SVR, all patients had significant clinical improvements (NYHA Class I), and significant increases in the left ventricular ejection fraction (LVEF) to 38.8 ± 4.4%. The LV volumes and regional volumes at the base and apex decreased with a trend towards significance. The mean preoperative apical conicity ratio (ACR) was 1.90 ± 0.43 and, following SVR by endoventricular linear patch plasty (EVLPP), was 1.35 ± 0.3 (P = 0.02). The percent decrease in the ACR following SVR from baseline was 28.68 ± 10.98%. The apical EF increased from 1.19 ± 13.9 to 15.8 ± 8.2% (P = 0.028). The basal rotations improved from 3.13 ± 2.1 to 4.69 ± 2.94° (P = 0.04). The apical rotations also improved significantly from 2.48 ± 1.23 to 3.93 ± 2.45° (P = 0.05) and reversed to the normal anticlockwise direction. CONCLUSIONS SVR by geometric repair using a rectangular intracavitary patch helps restoration of a physiological apex with normalization of apical rotation reflecting a near-physiological LV function.
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Affiliation(s)
| | - Prahlad G Menon
- Department of Electrical and Computer Engineering, SYSU-CMU Joint Institute of Engineering, Pittsburgh, USA Shunde International Research Institute, Guangdong, China QuantMD LLC, Pittsburgh, USA
| | - V Rao Parachuri
- Department of Cardiac Surgery, Narayana Hrudayalya Institute of Medical Sciences, Bangalore, India
| | - Karthik Gadabanahalli
- Department of Cardiac Surgery, Narayana Hrudayalya Institute of Medical Sciences, Bangalore, India
| | - Venkat Ramana Bhat
- Department of Cardiac Surgery, Narayana Hrudayalya Institute of Medical Sciences, Bangalore, India
| | - Varun Shetty
- Department of Cardiac Surgery, Narayana Hrudayalya Institute of Medical Sciences, Bangalore, India
| | - Devi Shetty
- Department of Cardiac Surgery, Narayana Hrudayalya Institute of Medical Sciences, Bangalore, India
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Pedrizzetti G, La Canna G, Alfieri O, Tonti G. The vortex—an early predictor of cardiovascular outcome? Nat Rev Cardiol 2014; 11:545-53. [DOI: 10.1038/nrcardio.2014.75] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schilling T, Brandes G, Tudorache I, Cebotari S, Hilfiker A, Meyer T, Biskup C, Bauer M, Waldmann KH, Bach FW, Haverich A, Hassel T. In vivo degradation of magnesium alloy LA63 scaffolds for temporary stabilization of biological myocardial grafts in a swine model. ACTA ACUST UNITED AC 2014; 58:407-16. [PMID: 23989110 DOI: 10.1515/bmt-2012-0047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/19/2013] [Indexed: 11/15/2022]
Abstract
Synthetic or biological patch materials used for surgical myocardial reconstruction are often fragile. Therefore, a transient support by degradable magnesium scaffolds can reduce the risk of dilation or rupture of the patch until physiological remodeling has led to a sufficient mechanical durability. However, there is evidence that magnesium implants can influence the growth and physiological behavior of the host's cells and tissue. Hence, we epicardially implanted scaffolds of the magnesium fluoride-coated magnesium alloy LA63 in a swine model to assess biocompatibility and degradation kinetics. Chemical analysis of the pigs' organs revealed no toxic accumulation of magnesium ions in the skeletal muscle, myocardium, liver, kidney, and bone of the pigs 1, 3, and 6 months postimplantation. The implants were surrounded by a fibrous granulation tissue, but no signs of necrosis were histologically evaluable. A sufficiently slow degradation rate of the magnesium alloy scaffold can be demonstrated via micro-computed tomography investigation. We conclude that stabilizing scaffolds of the magnesium fluoride-coated magnesium alloy LA63 can be used for epicardial application because no significant adverse effects to myocardial tissue were noted. Thus, degradable stabilizing scaffolds of this magnesium alloy with a slow degradation rate can extend the indication of innovative biological and synthetic patch materials.
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Bauer M, Schilling T, Weidling M, Hartung D, Biskup C, Wriggers P, Wacker F, Bach FW, Haverich A, Hassel T. Geometric adaption of biodegradable magnesium alloy scaffolds to stabilise biological myocardial grafts. Part I. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:909-916. [PMID: 24264726 DOI: 10.1007/s10856-013-5100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 11/14/2013] [Indexed: 06/02/2023]
Abstract
Synthetic patch materials currently in use have major limitations, such as high susceptibility to infections and lack of contractility. Biological grafts are a novel approach to overcome these limitations, but do not always offer sufficient mechanical durability in early stages after implantation. Therefore, a stabilising structure based on resorbable magnesium alloys could support the biological graft until its physiologic remodelling. To prevent early breakage in vivo due to stress of non-determined forming, these scaffolds should be preformed according to the geometry of the targeted myocardial region. Thus, the left ventricular geometry of 28 patients was assessed via standard cardiac magnetic resonance imaging (MRI). The resulting data served as a basis for a finite element simulation (FEM). Calculated stresses and strains of flat and preformed scaffolds were evaluated. Afterwards, the structures were manufactured by abrasive waterjet cutting and preformed according to the MRI data. Finally, the mechanical durability of the preformed and flat structures was compared in an in vitro test rig. The FEM predicted higher durability of the preformed scaffolds, which was proven in the in vitro test. In conclusion, preformed scaffolds provide extended durability and will facilitate more widespread use of regenerative biological grafts for surgical left ventricular reconstruction.
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Affiliation(s)
- M Bauer
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Lise-Meitner-Str. 1, 30823, Garbsen, Germany,
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Hashizume R, Fujimoto KL, Hong Y, Guan J, Toma C, Tobita K, Wagner WR. Biodegradable elastic patch plasty ameliorates left ventricular adverse remodeling after ischemia-reperfusion injury: a preclinical study of a porous polyurethane material in a porcine model. J Thorac Cardiovasc Surg 2012; 146:391-9.e1. [PMID: 23219497 DOI: 10.1016/j.jtcvs.2012.11.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 10/06/2012] [Accepted: 11/06/2012] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Myocardial infarction (MI) can lead to irreversible adverse left ventricular remodeling resulting in subsequent severe dysfunction. The objective of this study was to investigate the potential for biodegradable, elastomeric patch implantation to positively alter the remodeling process after MI in a porcine model. METHODS Yorkshire pigs underwent a 60-minute catheter balloon occlusion of the left circumflex artery. Two weeks after MI animals underwent epicardial placement of a biodegradable, porous polyurethane (poly(ester urethane)urea; PEUU) patch (MI+PEUU, n = 7) or sham surgery (MI+sham, n = 8). Echocardiography before surgery and at 4 and 8 weeks after surgery measured the end-diastolic area (EDA) and fractional area change (%FAC). All animals were humanely killed 8 weeks after surgery and hearts were histologically assessed. RESULTS At 8 weeks, echocardiography revealed greater EDA values in the MI+sham group (23.6 ± 6.6 cm(2), mean ± standard deviaation) than in the MI+PEUU group (15.9 ± 2.5 cm(2)) (P < .05) and a lower %FAC in the MI+sham group (24.8 ± 7.6) than in the MI+PEUU group (35.9 ± 7.8) (P < .05). The infarcted ventricular wall was thicker in the MI+PEUU group (1.56 ± 0.5 cm) than in the MI+sham group (0.91 ± 0.24 cm) (P < .01). CONCLUSIONS Biodegradable elastomeric PEUU patch implantation onto the porcine heart 2 weeks post-MI attenuated left ventricular adverse remodeling and functional deterioration and was accompanied by increased neovascularization. These findings, although limited to a 2-month follow-up, may suggest an attractive clinical option to moderate post-MI cardiac failure.
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Affiliation(s)
- Ryotaro Hashizume
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pa, USA
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Yoneyama K, Gjesdal O, Choi EY, Wu CO, Hundley WG, Gomes AS, Liu CY, McClelland RL, Bluemke DA, Lima JAC. Age, sex, and hypertension-related remodeling influences left ventricular torsion assessed by tagged cardiac magnetic resonance in asymptomatic individuals: the multi-ethnic study of atherosclerosis. Circulation 2012; 126:2481-90. [PMID: 23147172 DOI: 10.1161/circulationaha.112.093146] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The aim of the present study was to evaluate how torsion is influenced by left ventricular (LV) remodeling associated with age, sex, and hypertension in a large community-based population. METHODS AND RESULTS Myocardial shortening and torsion were assessed by tagged cardiac magnetic resonance in 1478 participants without clinically apparent cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Torsion was defined as the difference between apical and basal rotation divided by slice distance. In multivariable linear regression models, older age was associated with lower stroke volume (-3.6 mL per decade; P<0.001) and higher LV mass-to-volume ratio (0.03 g/mL per decade; P<0.001), along with lower circumferential shortening (-0.17% per decade; P<0.05). Torsion, however, was greater at older ages (0.14° per decade; P<0.001) and in women (0.37°/cm versus men; P<0.001). Hypertensive participants had higher LV mass and LV mass-to-volume ratio (15.5 g and 0.07 g/mL, respectively; P<0.001 for both). Circumferential shortening was lower in hypertensive (-0.42%; P<0.01), whereas torsion was higher after adjustment for age and sex (0.17°/cm; P<0.05). CONCLUSIONS Older age is associated with lower LV volumes and greater relative wall thickness and is accompanied by lower circumferential myocardial shortening, whereas torsion is greater with older age. Hypertensive individuals have greater LV volumes and relative wall thickness and lower circumferential shortening. Torsion, however, is greater in hypertension independently of age and sex. Torsion may therefore represent a compensatory mechanism to maintain an adequate stroke volume and cardiac output in the face of the progressively reduced LV volumes and myocardial shortening associated with hypertension and aging.
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Affiliation(s)
- Kihei Yoneyama
- Johns Hopkins University, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287, USA
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Grimaldi A, Castiglioni A, De Bonis M, Alfieri O. Large left ventricular aneurysm. J Thorac Cardiovasc Surg 2011; 142:940-1. [PMID: 21924150 DOI: 10.1016/j.jtcvs.2011.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 05/20/2011] [Indexed: 11/27/2022]
Affiliation(s)
- Antonio Grimaldi
- Cardiovascular and Thoracic Department, San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy.
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Stöhr EJ, González-Alonso J, Shave R. Left ventricular mechanical limitations to stroke volume in healthy humans during incremental exercise. Am J Physiol Heart Circ Physiol 2011; 301:H478-87. [DOI: 10.1152/ajpheart.00314.2011] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During incremental exercise, stroke volume (SV) plateaus at 40–50% of maximal exercise capacity. In healthy individuals, left ventricular (LV) twist and untwisting (“LV twist mechanics”) contribute to the generation of SV at rest, but whether the plateau in SV during incremental exercise is related to a blunting in LV twist mechanics remains unknown. To test this hypothesis, nine healthy young males performed continuous and discontinuous incremental supine cycling exercise up to 90% peak power in a randomized order. During both exercise protocols, end-diastolic volume (EDV), end-systolic volume (ESV), and SV reached a plateau at submaximal exercise intensities while heart rate increased continuously. Similar to LV volumes, two-dimensional speckle tracking-derived LV twist and untwisting velocity increased gradually from rest (all P < 0.001) and then leveled off at submaximal intensities. During continuous exercise, LV twist mechanics were linearly related to ESV, SV, heart rate, and cardiac output (all P < 0.01) while the relationship with EDV was exponential. In diastole, the increase in apical untwisting was significantly larger than that of basal untwisting ( P < 0.01), emphasizing the importance of dynamic apical function. In conclusion, during incremental exercise, the plateau in LV twist mechanics and their close relationship with SV and cardiac output indicate a mechanical limitation in maximizing LV output during high exercise intensities. However, LV twist mechanics do not appear to be the sole factor limiting LV output, since EDV reaches its maximum before the plateau in LV twist mechanics, suggesting additional limitations in diastolic filling to the heart.
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Affiliation(s)
- Eric J. Stöhr
- Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge; and
| | - José González-Alonso
- Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge; and
| | - Rob Shave
- Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge; and
- Cardiff School of Sport, University of Wales Institute Cardiff, Cardiff, United Kingdom
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Lessons from a mathematical hypothesis — modification of the endoventricular circular patch plasty. Eur J Cardiothorac Surg 2011; 39:945-51. [DOI: 10.1016/j.ejcts.2010.09.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 09/10/2010] [Accepted: 09/15/2010] [Indexed: 11/19/2022] Open
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Sublethal exposure to crude oil during embryonic development alters cardiac morphology and reduces aerobic capacity in adult fish. Proc Natl Acad Sci U S A 2011; 108:7086-90. [PMID: 21482755 DOI: 10.1073/pnas.1019031108] [Citation(s) in RCA: 234] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Exposure to high concentrations of crude oil produces a lethal syndrome of heart failure in fish embryos. Mortality is caused by cardiotoxic polycyclic aromatic hydrocarbons (PAHs), ubiquitous components of petroleum. Here, we show that transient embryonic exposure to very low concentrations of oil causes toxicity that is sublethal, delayed, and not counteracted by the protective effects of cytochrome P450 induction. Nearly a year after embryonic oil exposure, adult zebrafish showed subtle changes in heart shape and a significant reduction in swimming performance, indicative of reduced cardiac output. These delayed physiological impacts on cardiovascular performance at later life stages provide a potential mechanism linking reduced individual survival to population-level ecosystem responses of fish species to chronic, low-level oil pollution.
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Meyer T, Stuerz K, Guenther E, Edamura M, Kraushaar U. Cardiac slices as a predictive tool for arrhythmogenic potential of drugs and chemicals. Expert Opin Drug Metab Toxicol 2010; 6:1461-75. [PMID: 21067457 DOI: 10.1517/17425255.2010.526601] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE OF THE FIELD cardiac arrhythmia represents one of the primary safety pharmacological concerns in drug development. The most prominent example is drug induced ventricular tachycardia of the Torsade des Pointes type. The mechanism how this type of arrhythmia develops is a complex multi-cellular phenomenon. It can only be insufficiently reflected by cellular or molecular assays. However, organ models - such as Langendorff hearts - or in vivo experiments are expensive and time consuming and not suitable for assays requiring an increased throughput. AREAS COVERED IN THIS REVIEW here, we describe and review an assay bridging the gap between cardiomyocyte based assays and organ based systems - cardiac slices. This assay is reviewed in direct comparison with established safety pharmacological assays. WHAT THE READER WILL GAIN while slices have played an important role in brain research for > 2 decades, cardiac slices are experiencing a renaissance due to the novel challenges in safety pharmacology just in the last few years. Cardiac slices can be cultured and recorded over several days. It is possible to access electrophysiological data with a high number of electrodes - up to 256 electrodes - embedded in the surface of a microelectrode array. TAKE HOME MESSAGE cardiac slices close the gap between cellular and organ based assays in cardiac safety pharmacology. The tissue properties of a functional cardiac syncytium are more accurately reflected by a slice rather than a single cell.
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Affiliation(s)
- Thomas Meyer
- Multi Channel Systems MCS GmbH, Aspenhaustr. 21, 72770 Reutlingen, Germany.
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