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Kaesler A, Rudawski FL, Zander MO, Hesselmann F, Pinar I, Schmitz-Rode T, Arens J, Steinseifer U, Clauser JC. In-Vitro Visualization of Thrombus Growth in Artificial Lungs Using Real-Time X-Ray Imaging: A Feasibility Study. Cardiovasc Eng Technol 2021; 13:318-330. [PMID: 34532837 PMCID: PMC9114054 DOI: 10.1007/s13239-021-00579-y] [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: 10/27/2020] [Accepted: 09/03/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Extracorporeal membrane oxygenation has gained increasing attention in the treatment of patients with acute and chronic cardiopulmonary and respiratory failure. However, clotting within the oxygenators or other components of the extracorporeal circuit remains a major complication that necessitates at least a device exchange and bears risks of adverse events for the patients. In order to better predict thrombus growth within oxygenators, we present an approach for in-vitro visualization of thrombus growth using real-time X-ray imaging. METHODS An in-vitro test setup was developed using low-dose anticoagulated ovine blood and allowing for thrombus growth within 4 h. The setup was installed in a custom-made X-ray setup that uses phase-contrast for imaging, thus providing enhanced soft-tissue contrast, which improves the differentiation between blood and potential thrombus growth. During experimentation, blood samples were drawn for the analysis of blood count, activated partial thromboplastin time and activated clotting time. Additionally, pressure and flow data was monitored and a full 360° X-ray scan was performed every 15 min. RESULTS Thrombus formation indicated by a pressure drop and changing blood parameters was monitored in all three test devices. Red and white thrombi (higher/lower attenuation, respectively) were successfully segmented in one set of X-ray images. CONCLUSION We showed the feasibility of a new in-vitro method for real-time thrombus growth visualization by means of phase contrast X-ray imaging. In addition, with more blood parameters that are clinically relevant, this approach might contribute to improved oxygenator exchange protocols in the clinical routine.
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Affiliation(s)
- Andreas Kaesler
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Freya Lilli Rudawski
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Mark Oliver Zander
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Felix Hesselmann
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Isaac Pinar
- Monash Institute of Medical Engineering and Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Thomas Schmitz-Rode
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Jutta Arens
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.,Chair of Engineering Organ Support Technologies, Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, The Netherlands
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.,Monash Institute of Medical Engineering and Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Johanna Charlotte Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.
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Izadifar M, Berecz T, Apáti Á, Nagy A. An Optical-Flow-Based Method to Quantify Dynamic Behavior of Human Pluripotent Stem Cell-Derived Cardiomyocytes in Disease Modeling Platforms. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2021; 2454:213-230. [PMID: 33982275 DOI: 10.1007/7651_2021_382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) hold great promise for cardiovascular disease modeling, drug screening and personalized medicine. A crucial requirement to establish an hPSC-CM-based disease model is the availability of a reliable differentiation protocol and a functional assessment of phenotypic properties of CMs in a disease context. Characterization of relative changes in contractile behavior of CMs can provide insight not only about drug effects but into the pathogenesis of cardiovascular diseases. Image-based optical-flow analysis, which applies a speckle tracking algorithm to videomicroscopy of hPSC-CMs, is a noninvasive method to quantitatively assess the dynamics of mechanical contraction of the CMs. This method offers an efficient characterization of contractile cycles. It quantifies contraction velocity field, beat rate, contractile strain and contraction-relaxation strain rate profile, which are important phenotypic characteristics of CMs.
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Affiliation(s)
- Mohammad Izadifar
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
| | - Tünde Berecz
- Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Ágota Apáti
- Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Andras Nagy
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Australian Regenerative Medicine Institute, Monash University, Melbourne, VIC, Australia.,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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