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Lv L, Ma X, Xu Y, Zhang Q, Kan S, Chen X, Liu H, Wang H, Wang C, Ma J. The constricting effect of reduced coronary artery compliance on the left ventricle is an important cause of reduced diastolic function in patients with coronary heart disease. BMC Cardiovasc Disord 2022; 22:375. [PMID: 35978296 PMCID: PMC9382726 DOI: 10.1186/s12872-022-02809-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies of left ventricular diastolic function (LVDF) have focused on the decrease in active and passive diastolic function due to ischemic factors but have not investigated if the decrease in compliance of the coronary arteries that bypass the surface of the heart and travel between the myocardium could cause a constricting effect on the ventricular wall like that caused by myocardial fibrosis. Methods and Results 581 patients diagnosed with coronary heart disease (CHD) were divided into A group (patients are the control group), B group (patients with less than 50% coronary artery stenosis), C group (patients with coronary artery stenosis between 50 and 75%), D group (patients with coronary artery stenosis greater than 75%) according to the degree of coronary stenosis. The diastolic function of the ventricle is reflected by applying the relaxation time constant T value, which refers to the time between peak dp/dt and end-diastolic pressure in the left ventricle. It was concluded that there was a statistical difference in Gensini scores between patients in groups B, C and D (P < 0.001). And multiple linear regression analysis showed that T was correlated with Gensini score and C-dp/dtmax (R = 0.711, P < 0.001). Grouping according to the site of stent implantation and the number of stents implanted, it was found out that the changes in T values before and after left anterior descending artery (LAD) stent implantation were greater than left circumflex artery (LCX) and right coronary artery (RCA) (P < 0.001). And multiple linear regression revealed a correlation between T values and stent length, ventricular stiffness, and C-dp/dtmax (P = 0.001). Conclusions The decrease in compliance of the coronary arteries bypassing the surface of the heart and travelling between the myocardium would cause a constricting effect on the ventricular wall like that caused by myocardial fibrosis.
Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02809-0.
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Affiliation(s)
- Liang Lv
- The Third Affiliated Hospital, Southern Medical University or The Third School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xianghe Ma
- Shanghai Maritime University, Shanghai, China
| | - Yannan Xu
- Anhui University of Science and Technology, Huainan, Anhui, China
| | - Qiong Zhang
- Department of Cardiology, Fengxian Branch of Shanghai 6th People's Hospital, Nanfeng Road 6600#, Shanghai, 201400, China
| | - Shanshan Kan
- Anhui University of Science and Technology, Huainan, Anhui, China
| | - Xiaoming Chen
- Anhui University of Science and Technology, Huainan, Anhui, China
| | - Huajin Liu
- Department of Cardiology, Fengxian Branch of Shanghai 6th People's Hospital, Nanfeng Road 6600#, Shanghai, 201400, China
| | - Hongwei Wang
- Department of Cardiology, Fengxian Branch of Shanghai 6th People's Hospital, Nanfeng Road 6600#, Shanghai, 201400, China
| | - Changhua Wang
- TengZhou City Central People Hospital, Affiliated to Jining Medical University, Jining, Shandong, China
| | - Jiangwei Ma
- The Third Affiliated Hospital, Southern Medical University or The Third School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China. .,Anhui University of Science and Technology, Huainan, Anhui, China. .,Department of Cardiology, Fengxian Branch of Shanghai 6th People's Hospital, Nanfeng Road 6600#, Shanghai, 201400, China.
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2
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Manabe O, Oyama-Manabe N, Tamaki N. Positron emission tomography/MRI for cardiac diseases assessment. Br J Radiol 2020; 93:20190836. [PMID: 32023123 DOI: 10.1259/bjr.20190836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Functional imaging tools have emerged in the last few decades and are increasingly used to assess the function of the human heart in vivo. Positron emission tomography (PET) is used to evaluate myocardial metabolism and blood flow. Magnetic resonance imaging (MRI) is an essential tool for morphological and functional evaluation of the heart. In cardiology, PET is successfully combined with CT for hybrid cardiac imaging. The effective integration of two imaging modalities allows simultaneous data acquisition combining functional, structural and molecular imaging. After PET/CT has been successfully accepted for clinical practices, hybrid PET/MRI is launched. This review elaborates the current evidence of PET/MRI in cardiovascular imaging and its expected clinical applications for a comprehensive assessment of cardiovascular diseases while highlighting the advantages and limitations of this hybrid imaging approach.
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Affiliation(s)
- Osamu Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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3
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Wu D, Zhang Z, Ma R, Guo F, Wang L, Fang W. Comparison of CZT SPECT and conventional SPECT for assessment of contractile function, mechanical synchrony and myocardial scar in patients with heart failure. J Nucl Cardiol 2019; 26:443-452. [PMID: 28623525 DOI: 10.1007/s12350-017-0952-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
AIM The aim of this study was to compare CZT-SPECT (CZT SPECT) to conventional SPECT (C-SPECT) in the assessment of left ventricular myocardial scar, contractile function, and mechanical synchrony in patients with heart failure (HF). METHODS Fifty-nine patients with HF who were referred for myocardial perfusion/metabolism imaging were enrolled. All patients underwent resting 99mTc-MIBI gated myocardial perfusion imaging using a CZT SPECT camera and a C-SPECT camera, respectively, and 18F-FDG PET myocardial metabolism imaging within three days. Summed rest score (SRS) and total perfusion defect (TPD) (as indices of perfusion abnormality), left ventricular (LV), end diastolic volume (EDV), end systolic volume (ESV), and ejection fraction (EF) (as indices of LV systolic function), and histogram band width (BW) and standard deviation (SD) (as indices of mechanical synchrony) were analyzed by automated software while the perfusion/metabolism patterns were analyzed visually. RESULTS There was a good correlation between CZT SPECT and C-SPECT for SRS and TPD. CZT SPECT tended to underestimate SRS and TPD compared to C-SPECT. CZT-SPECT and C-SPECT showed excellent agreement in assessing the perfusion/metabolism pattern though a small proportion of normal segments (6.6%) identified by CZT/PET exhibited mismatch pattern on C-SPECT/PET. CZT SPECT also showed excellent correlation with C-SPECT in measuring EDV, ESV, and EF. Finally, BW and SD measured by CZT SPECT correlated well with C-SPECT but CZT SPECT tended to overestimate BW and SD compared to C-SPECT. CONCLUSION CZT SPECT provided comparable data to C-SPECT for measuring LV scar, function and synchrony at a considerable reduction in imaging time. CZT SPECT holds a promise for comprehensive evaluation of myocardial performance in patients with HF.
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Affiliation(s)
- Dayong Wu
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Zongyao Zhang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongzheng Ma
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Guo
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Wang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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4
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Nummi A, Nieminen T, Pätilä T, Lampinen M, Lehtinen ML, Kivistö S, Holmström M, Wilkman E, Teittinen K, Laine M, Sinisalo J, Kupari M, Kankuri E, Juvonen T, Vento A, Suojaranta R, Harjula A. Epicardial delivery of autologous atrial appendage micrografts during coronary artery bypass surgery-safety and feasibility study. Pilot Feasibility Stud 2017; 3:74. [PMID: 29276625 PMCID: PMC5738681 DOI: 10.1186/s40814-017-0217-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/01/2017] [Indexed: 12/14/2022] Open
Abstract
Background The atrial appendages are a tissue reservoir for cardiac stem cells. During on-pump coronary artery bypass graft (CABG) surgery, part of the right atrial appendage can be excised upon insertion of the right atrial cannula of the heart-lung machine. In the operating room, the removed tissue can be easily cut into micrografts for transplantation. This trial aims to assess the safety and feasibility of epicardial transplantation of atrial appendage micrografts in patients undergoing CABG surgery. Methods/design Autologous cardiac micrografts are made from leftover right atrial appendage during CABG of 6 patients. Atrial appendage is mechanically processed to micrografts consisting of atrial appendage-derived cells (AADCs) and their extracellular matrix (ECM). The micrografts are epicardially transplanted in a fibrin gel and covered with a tissue-engineered ECM sheet. Parameters including echocardiography—reflecting cardiac insufficiency—are studied pre- and post-operatively as well as at 3 and 6 months of the follow-up. Cardiac functional magnetic resonance imaging is performed preoperatively and at 6-month follow-up. The primary outcome measures are patient safety in terms of hemodynamic and cardiac function over time and feasibility of therapy administration in a clinical setting. Secondary outcome measures are left ventricular wall thickness, change in the amount of myocardial scar tissue, changes in left ventricular ejection fraction, plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, New York Heart Association class, days in hospital, and changes in the quality of life. Twenty patients undergoing routine CAGB surgery will be recruited to serve as a control group. Discussion This study aims to address the surgical feasibility and patient safety of epicardially delivered atrial appendage micrografts during CABG surgery. Delivery of autologous micrografts and AADCs has potential applications for cell and cell-based gene therapies. Trial registration ClinicalTrials.gov Identifier: NCT02672163. Date of registration: 02.02.2016
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Affiliation(s)
- Annu Nummi
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomo Nieminen
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Tommi Pätilä
- Pediatric Cardiac Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Milla Lampinen
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Miia L Lehtinen
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Kivistö
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Miia Holmström
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Erika Wilkman
- Department of Anesthesiology and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kari Teittinen
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mika Laine
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Sinisalo
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Kupari
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Esko Kankuri
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tatu Juvonen
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Vento
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Raili Suojaranta
- Department of Anesthesiology and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ari Harjula
- Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Fassina L, Rozzi G, Rossi S, Scacchi S, Galetti M, Lo Muzio FP, Del Bianco F, Colli Franzone P, Petrilli G, Faggian G, Miragoli M. Cardiac kinematic parameters computed from video of in situ beating heart. Sci Rep 2017; 7:46143. [PMID: 28397830 PMCID: PMC5387404 DOI: 10.1038/srep46143,10.1038/srep46143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/13/2017] [Indexed: 04/01/2024] Open
Abstract
Mechanical function of the heart during open-chest cardiac surgery is exclusively monitored by echocardiographic techniques. However, little is known about local kinematics, particularly for the reperfused regions after ischemic events. We report a novel imaging modality, which extracts local and global kinematic parameters from videos of in situ beating hearts, displaying live video cardiograms of the contraction events. A custom algorithm tracked the movement of a video marker positioned ad hoc onto a selected area and analyzed, during the entire recording, the contraction trajectory, displacement, velocity, acceleration, kinetic energy and force. Moreover, global epicardial velocity and vorticity were analyzed by means of Particle Image Velocimetry tool. We validated our new technique by i) computational modeling of cardiac ischemia, ii) video recordings of ischemic/reperfused rat hearts, iii) videos of beating human hearts before and after coronary artery bypass graft, and iv) local Frank-Starling effect. In rats, we observed a decrement of kinematic parameters during acute ischemia and a significant increment in the same region after reperfusion. We detected similar behavior in operated patients. This modality adds important functional values on cardiac outcomes and supports the intervention in a contact-free and non-invasive mode. Moreover, it does not require particular operator-dependent skills.
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Affiliation(s)
- Lorenzo Fassina
- Dipartimento di Ingegneria Industriale e dell’Informazione, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
- Centre for Health Technologies (C.H.T.), Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Giacomo Rozzi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
- Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Stefano Rossi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
- CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Simone Scacchi
- Dipartimento di Matematica, Università degli Studi di Milano, Via Saldini 50, 20133 Milano, Italy
| | - Maricla Galetti
- CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Francesco Paolo Lo Muzio
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Fabrizio Del Bianco
- Dipartimento di Ingegneria Industriale e dell’Informazione, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
- Centre for Health Technologies (C.H.T.), Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Piero Colli Franzone
- Dipartimento di Matematica, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Giuseppe Petrilli
- Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Giuseppe Faggian
- Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Michele Miragoli
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
- CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
- Humanitas Clinical and Research Center, Via Manzoni 56, 20090 Rozzano, Italy
- Institute of Genetic and Biomedical Research, National Research Council, Via Manzoni 56, 20090 Rozzano, Italy
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6
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Fassina L, Rozzi G, Rossi S, Scacchi S, Galetti M, Lo Muzio FP, Del Bianco F, Colli Franzone P, Petrilli G, Faggian G, Miragoli M. Cardiac kinematic parameters computed from video of in situ beating heart. Sci Rep 2017; 7:46143. [PMID: 28397830 PMCID: PMC5387404 DOI: 10.1038/srep46143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/13/2017] [Indexed: 12/21/2022] Open
Abstract
Mechanical function of the heart during open-chest cardiac surgery is exclusively monitored by echocardiographic techniques. However, little is known about local kinematics, particularly for the reperfused regions after ischemic events. We report a novel imaging modality, which extracts local and global kinematic parameters from videos of in situ beating hearts, displaying live video cardiograms of the contraction events. A custom algorithm tracked the movement of a video marker positioned ad hoc onto a selected area and analyzed, during the entire recording, the contraction trajectory, displacement, velocity, acceleration, kinetic energy and force. Moreover, global epicardial velocity and vorticity were analyzed by means of Particle Image Velocimetry tool. We validated our new technique by i) computational modeling of cardiac ischemia, ii) video recordings of ischemic/reperfused rat hearts, iii) videos of beating human hearts before and after coronary artery bypass graft, and iv) local Frank-Starling effect. In rats, we observed a decrement of kinematic parameters during acute ischemia and a significant increment in the same region after reperfusion. We detected similar behavior in operated patients. This modality adds important functional values on cardiac outcomes and supports the intervention in a contact-free and non-invasive mode. Moreover, it does not require particular operator-dependent skills.
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Affiliation(s)
- Lorenzo Fassina
- Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy.,Centre for Health Technologies (C.H.T.), Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Giacomo Rozzi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy.,Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Stefano Rossi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy.,CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Simone Scacchi
- Dipartimento di Matematica, Università degli Studi di Milano, Via Saldini 50, 20133 Milano, Italy
| | - Maricla Galetti
- CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Francesco Paolo Lo Muzio
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy
| | - Fabrizio Del Bianco
- Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy.,Centre for Health Technologies (C.H.T.), Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Piero Colli Franzone
- Dipartimento di Matematica, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
| | - Giuseppe Petrilli
- Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Giuseppe Faggian
- Dipartimento di Cardiochirurgia, Università degli Studi di Verona, Ospedale Borgo Trento, P.le Stefani 1, 37126 Verona, Italy
| | - Michele Miragoli
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy.,CERT, Centro di Eccellenza per la Ricerca Tossicologica, INAIL-exISPESL, Università degli Studi di Parma, Via Gramsci 14, 43124 Parma, Italy.,Humanitas Clinical and Research Center, Via Manzoni 56, 20090 Rozzano, Italy.,Institute of Genetic and Biomedical Research, National Research Council, Via Manzoni 56, 20090 Rozzano, Italy
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