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Albertova P, Gram M, Blaimer M, Bauer WR, Jakob PM, Nordbeck P. Rotary excitation of non-sinusoidal pulsed magnetic fields: Towards non-invasive direct detection of cardiac conduction. Magn Reson Med 2024. [PMID: 38934418 DOI: 10.1002/mrm.30190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/09/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE There is a need for high resolution non-invasive imaging methods of physiologic magnetic fields. The purpose of this work is to develop a MRI detection approach for non-sinusoidal magnetic fields based on the rotary excitation (REX) mechanism which was previously successfully applied for the detection of oscillating magnetic fields in the sub-nT range. METHODS The new detection concept was examined by means of Bloch simulations, evaluating the interaction effect of spin-locked magnetization and low-frequency pulsed magnetic fields. The REX detection approach was validated under controlled conditions in phantom experiments at 3 T. Gaussian and sinc-shaped stimuli were investigated. In addition, the detection of artificial fields resembling a cardiac QRS complex, which is the most prominent peak visible on a magnetocardiogram, was tested. RESULTS Bloch simulations demonstrated that the REX method has a high sensitivity to pulsed fields in the resonance case, which is met when the spin-lock frequency coincides with a non-zero Fourier component of the stimulus field. In the experiments, we found that magnetic stimuli of different durations and waveforms can be distinguished by their characteristic REX response spectrum. The detected REX amplitude was proportional to the stimulus peak amplitude (R2 > 0.98) and the lowest field detection was 1 nT. Furthermore, the detection of QRS-like fields with varying QRS durations yielded significant results in a phantom setup (p < 0.001). CONCLUSION REX detection can be transferred to non-sinusoidal pulsed magnetic fields and could provide a non-invasive, quantitative tool for spatially resolved assessment of cardiac biomagnetism. Potential applications include the direct detection and characterization of cardiac conduction.
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Affiliation(s)
- Petra Albertova
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Maximilian Gram
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Martin Blaimer
- Fraunhofer Institute for Integrated Circuits IIS, Würzburg, Germany
| | | | | | - Peter Nordbeck
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
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2
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Marhabaie S, Delcey M, El Hamrani D, Vaillant F, Ginefri JC, Ozenne V, Abell E, Poirier-Quinot M, Quesson B. Remotely detuned receiver coil for high-resolution interventional cardiac magnetic resonance imaging. Front Cardiovasc Med 2023; 10:1249572. [PMID: 38028485 PMCID: PMC10643167 DOI: 10.3389/fcvm.2023.1249572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Interventional cardiac MRI in the context of the treatment of cardiac arrhythmia requires submillimeter image resolution to precisely characterize the cardiac substrate and guide the catheter-based ablation procedure in real-time. Conventional MRI receiver coils positioned on the thorax provide insufficient signal-to-noise ratio (SNR) and spatial selectivity to satisfy these constraints. Methods A small circular MRI receiver coil was developed and evaluated under different experimental conditions, including high-resolution MRI anatomical and thermometric imaging at 1.5 T. From the perspective of developing a therapeutic MR-compatible catheter equipped with a receiver coil, we also propose alternative remote active detuning techniques of the receiver coil using one or two cables. Theoretical details are presented, as well as simulations and experimental validation. Results Anatomical images of the left ventricle at 170 µm in-plane resolution are provided on ex vivo beating heart from swine using a 2 cm circular receiver coil. Taking advantage of the increase of SNR at its vicinity (up to 35 fold compared to conventional receiver coils), real-time MR-temperature imaging can reach an uncertainty below 0.1°C at the submillimetric spatial resolution. Remote active detuning using two cables has similar decoupling efficiency to conventional on-site decoupling, at the cost of an acceptable decrease in the resulting SNR. Discussion This study shows the potential of small dimension surface coils for minimally invasive therapy of cardiac arrhythmia intraoperatively guided by MRI. The proposed remote decoupling approaches may simplify the construction process and reduce the cost of such single-use devices.
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Affiliation(s)
- Sina Marhabaie
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Marylène Delcey
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
- Siemens Healthineers, Saint-Denis, France
| | | | - Fanny Vaillant
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
| | - Jean-Christophe Ginefri
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Valéry Ozenne
- Univ. Bordeaux, CNRS, CRMSB, UMR 5536, IHU Liryc, Bordeaux, France
| | - Emma Abell
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
| | - Marie Poirier-Quinot
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Bruno Quesson
- Univ. Bordeaux, CNRS, CRMSB, UMR 5536, IHU Liryc, Bordeaux, France
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3
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Schreiber LM, Lohr D, Baltes S, Vogel U, Elabyad IA, Bille M, Reiter T, Kosmala A, Gassenmaier T, Stefanescu MR, Kollmann A, Aures J, Schnitter F, Pali M, Ueda Y, Williams T, Christa M, Hofmann U, Bauer W, Gerull B, Zernecke A, Ergün S, Terekhov M. Ultra-high field cardiac MRI in large animals and humans for translational cardiovascular research. Front Cardiovasc Med 2023; 10:1068390. [PMID: 37255709 PMCID: PMC10225557 DOI: 10.3389/fcvm.2023.1068390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/04/2023] [Indexed: 06/01/2023] Open
Abstract
A key step in translational cardiovascular research is the use of large animal models to better understand normal and abnormal physiology, to test drugs or interventions, or to perform studies which would be considered unethical in human subjects. Ultrahigh field magnetic resonance imaging (UHF-MRI) at 7 T field strength is becoming increasingly available for imaging of the heart and, when compared to clinically established field strengths, promises better image quality and image information content, more precise functional analysis, potentially new image contrasts, and as all in-vivo imaging techniques, a reduction of the number of animals per study because of the possibility to scan every animal repeatedly. We present here a solution to the dual use problem of whole-body UHF-MRI systems, which are typically installed in clinical environments, to both UHF-MRI in large animals and humans. Moreover, we provide evidence that in such a research infrastructure UHF-MRI, and ideally combined with a standard small-bore UHF-MRI system, can contribute to a variety of spatial scales in translational cardiovascular research: from cardiac organoids, Zebra fish and rodent hearts to large animal models such as pigs and humans. We present pilot data from serial CINE, late gadolinium enhancement, and susceptibility weighted UHF-MRI in a myocardial infarction model over eight weeks. In 14 pigs which were delivered from a breeding facility in a national SARS-CoV-2 hotspot, we found no infection in the incoming pigs. Human scanning using CINE and phase contrast flow measurements provided good image quality of the left and right ventricle. Agreement of functional analysis between CINE and phase contrast MRI was excellent. MRI in arrested hearts or excised vascular tissue for MRI-based histologic imaging, structural imaging of myofiber and vascular smooth muscle cell architecture using high-resolution diffusion tensor imaging, and UHF-MRI for monitoring free radicals as a surrogate for MRI of reactive oxygen species in studies of oxidative stress are demonstrated. We conclude that UHF-MRI has the potential to become an important precision imaging modality in translational cardiovascular research.
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Affiliation(s)
- Laura M. Schreiber
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - David Lohr
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Steffen Baltes
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ulrich Vogel
- Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany
| | - Ibrahim A. Elabyad
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Maya Bille
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Theresa Reiter
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Aleksander Kosmala
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Tobias Gassenmaier
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Maria R. Stefanescu
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Alena Kollmann
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Julia Aures
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Florian Schnitter
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Mihaela Pali
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Yuichiro Ueda
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Wuerzburg, Germany
| | - Tatiana Williams
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center Wuerzburg, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Martin Christa
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ulrich Hofmann
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Wolfgang Bauer
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Brenda Gerull
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center Wuerzburg, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Alma Zernecke
- Institute of Experimental Biomedicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Wuerzburg, Germany
| | - Maxim Terekhov
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
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Scott AD, Jackson T, Khalique Z, Gorodezky M, Pardoe B, Begum L, Bruno VD, Chowdhury RA, Ferreira PF, Nielles‐Vallespin S, Roehl M, McCarthy KP, Sarathchandra P, Rose JN, Doorly DJ, Pennell DJ, Ascione R, de Silva R, Firmin DN. Development of a cardiovascular magnetic resonance-compatible large animal isolated heart model for direct comparison of beating and arrested hearts. NMR IN BIOMEDICINE 2022; 35:e4692. [PMID: 35040195 PMCID: PMC9286060 DOI: 10.1002/nbm.4692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/21/2021] [Accepted: 01/07/2022] [Indexed: 06/02/2023]
Abstract
Cardiac motion results in image artefacts and quantification errors in many cardiovascular magnetic resonance (CMR) techniques, including microstructural assessment using diffusion tensor cardiovascular magnetic resonance (DT-CMR). Here, we develop a CMR-compatible isolated perfused porcine heart model that allows comparison of data obtained in beating and arrested states. Ten porcine hearts (8/10 for protocol optimisation) were harvested using a donor heart retrieval protocol and transported to the remote CMR facility. Langendorff perfusion in a 3D-printed chamber and perfusion circuit re-established contraction. Hearts were imaged using cine, parametric mapping and STEAM DT-CMR at cardiac phases with the minimum and maximum wall thickness. High potassium and lithium perfusates were then used to arrest the heart in a slack and contracted state, respectively. Imaging was repeated in both arrested states. After imaging, tissue was removed for subsequent histology in a location matched to the DT-CMR data using fiducial markers. Regular sustained contraction was successfully established in six out of 10 hearts, including the final five hearts. Imaging was performed in four hearts and one underwent the full protocol, including colocalised histology. The image quality was good and there was good agreement between DT-CMR data in equivalent beating and arrested states. Despite the use of autologous blood and dextran within the perfusate, T2 mapping results, DT-CMR measures and an increase in mass were consistent with development of myocardial oedema, resulting in failure to achieve a true diastolic-like state. A contiguous stack of 313 5-μm histological sections at and a 100-μm thick section showing cell morphology on 3D fluorescent confocal microscopy colocalised to DT-CMR data were obtained. A CMR-compatible isolated perfused beating heart setup for large animal hearts allows direct comparisons of beating and arrested heart data with subsequent colocalised histology, without the need for onsite preclinical facilities.
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Affiliation(s)
- Andrew D. Scott
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Tim Jackson
- Department of PerfusionRoyal Brompton HospitalLondonUK
| | - Zohya Khalique
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Margarita Gorodezky
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Ben Pardoe
- Department of PerfusionRoyal Brompton HospitalLondonUK
| | - Lale Begum
- Department of PerfusionRoyal Brompton HospitalLondonUK
| | - V. Domenico Bruno
- Translational Biomedical Research CentreUniversity of BristolBristolUK
- Bristol Heart InstituteUniversity Hospital Bristol NHS Foundation TrustBristolUK
| | - Rasheda A. Chowdhury
- National Heart and Lung InstituteImperial CollegeLondonUK
- Imperial Centre for Cardiac EngineeringImperial CollegeLondonUK
| | - Pedro F. Ferreira
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Sonia Nielles‐Vallespin
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Malte Roehl
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | | | - Padmini Sarathchandra
- National Heart and Lung InstituteImperial CollegeLondonUK
- Magdi Yacoub Institute, National Heart and Lung InstituteImperial CollegeLondonUK
| | - Jan N. Rose
- Department of AeronauticsImperial CollegeLondonUK
| | | | - Dudley J. Pennell
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Raimondo Ascione
- Translational Biomedical Research CentreUniversity of BristolBristolUK
- Bristol Heart InstituteUniversity Hospital Bristol NHS Foundation TrustBristolUK
| | - Ranil de Silva
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - David N. Firmin
- Cardiovascular Magnetic Resonance UnitRoyal Brompton HospitalLondonUK
- National Heart and Lung InstituteImperial CollegeLondonUK
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5
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Robert J, Bessiere F, Cao E, Loyer V, Abell E, Vaillant F, Quesson B, Catheline S, Lafon C. Spectral Analysis of Tissue Displacement for Cardiac Activation Mapping: Ex Vivo Working Heart and In Vivo Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:942-956. [PMID: 34941506 DOI: 10.1109/tuffc.2021.3137989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Characterizing myocardial activation is of major interest for understanding the underlying mechanism of cardiac arrhythmias. Electromechanical wave imaging (EWI) is an ultrafast ultrasound-based method used to map the propagation of the local contraction triggered by electrical activation of the heart. This study introduces a novel way to characterize cardiac activation based on the time evolution of the instantaneous frequency content of the cardiac tissue displacement curves. The first validation of this method was performed on an ex vivo dataset of 36 acquisitions acquired from two working heart models in paced rhythms. It was shown that the activation mapping described by spectral analysis of interframe displacement is similar to the standard EWI method based on zero-crossing of interframe strain. An average median error of 3.3 ms was found in the ex vivo dataset between the activation maps obtained with the two methods. The feasibility of mapping cardiac activation by EWI was then investigated on two open-chest pigs during sinus and paced rhythms in a pilot trial of cardiac mapping with an intracardiac probe. Seventy-five acquisitions were performed with reasonable stability and analyzed with the novel algorithm to map cardiac contraction propagation in the left ventricle (LV). Sixty-one qualitatively continuous isochrones were successfully computed based on this method. The region of contraction onset was coherently described while pacing in the imaging plane. These findings highlight the potential of implementing EWI acquisition on intracardiac probes and emphasize the benefit of performing short time-frequency analysis of displacement data to characterize cardiac activation in vivo.
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6
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Gottlieb LA, Vaillant F, Abell E, Belterman C, Loyer V, El Hamrani D, Naulin J, Constantin M, Quesson B, Boukens BJ, Coronel R, Dekker LRC. Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure. Front Physiol 2021; 12:709844. [PMID: 34512384 PMCID: PMC8424033 DOI: 10.3389/fphys.2021.709844] [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: 05/14/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background Pulmonary vein (PV) ablation is unsuccessful in atrial fibrillation (AF) patients with high left atrial (LA) pressure. Increased atrial stretch by increased pressure is proarrhythmic for AF, and myocardial scar alters wall deformation. We hypothesized that localized PV scar is proarrhythmic for AF in high LA pressure. Methods Radiofrequency energy was delivered locally in the right PV of healthy sheep. The sheep recovered for 4 months. Explanted hearts (n = 9 PV scar, n = 9 controls) were perfused with 1:4 blood:Tyrode's solution in a four-chamber working heart setup. Programmed PV stimulation was performed during low (∼12 mmHg) and high (∼25 mmHg) LA pressure. An AF inducibility index was calculated based on the number of induction attempts and the number of attempts causing AF (run of ≥ 20 premature atrial complexes). Results In high LA pressure, the presence of PV scar increased the AF inducibility index compared with control hearts (0.83 ± 0.20 vs. 0.38 ± 0.40 arb. unit, respectively, p = 0.014). The diastolic stimulation threshold in high LA pressure was higher (108 ± 23 vs. 77 ± 16 mA, respectively, p = 0.006), and its heterogeneity was increased in hearts with PV scar compared with controls. In high LA pressure, the refractory period was shorter in PV scar than in control hearts (178 ± 39 vs. 235 ± 48 ms, p = 0.011). Conclusion Localized PV scar only in combination with increased LA pressure facilitated the inducibility of AF. This was associated with changes in tissue excitability remote from the PV scar. Localized PV ablation is potentially proarrhythmic in patients with increased LA pressure.
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Affiliation(s)
- Lisa A Gottlieb
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France.,AUMC, Academic Medical Center, Department of Experimental Cardiology, Amsterdam, Netherlands
| | - Fanny Vaillant
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Emma Abell
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Charly Belterman
- AUMC, Academic Medical Center, Department of Experimental Cardiology, Amsterdam, Netherlands
| | - Virginie Loyer
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Dounia El Hamrani
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Jérôme Naulin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Marion Constantin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France
| | - Bastiaan J Boukens
- AUMC, Academic Medical Center, Department of Experimental Cardiology, Amsterdam, Netherlands.,AUMC, Academic Medical Center, Department of Medical Biology, Amsterdam, Netherlands
| | - Ruben Coronel
- IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France.,AUMC, Academic Medical Center, Department of Experimental Cardiology, Amsterdam, Netherlands
| | - Lukas R C Dekker
- Department of Electrical Engineering, University of Technology, Eindhoven, Netherlands.,Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands
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7
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Mariager CØ, Hansen ESS, Bech SK, Eiskjaer H, Nielsen PF, Ringgaard S, Kimose HH, Laustsen C. Development of a human heart-sized perfusion system for metabolic imaging studies using hyperpolarized [1- 13 C]pyruvate MRI. Magn Reson Med 2020; 85:3510-3521. [PMID: 33368597 DOI: 10.1002/mrm.28639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE Increasing worldwide demand for cardiac transplantation has spurred new developments to increase the donor pool. Normothermic preservation of heart grafts for transplantation is an emerging strategy to improve the utilization of marginal grafts. Hyperpolarized MR using metabolic tracers such as [1-13 C]pyruvate, provide a novel means of investigating metabolic status without the use of ionizing radiation. We demonstrate the use of this methodology to examine ex vivo perfused porcine heart grafts. METHODS Hearts from three 40-kg Danish domestic pigs were harvested and subsequently perfused in Langendorff mode under normothermic conditions, using an MR-compatible perfusion system adapted to the heart. Proton MRI and hyperpolarized [1-13 C]pyruvate were used to investigate and quantify the functional and metabolic status of the grafts. RESULTS Hearts were perfused with whole blood for 120 min, using a dynamic contrast-enhanced perfusion experiment to verify successful myocardial perfusion. Hyperpolarized [1-13 C]pyruvate MRI was used to assess the metabolic state of the myocardium. Functional assessment was performed using CINE imaging and ventricular pressure data. High lactate and modest alanine levels were observed in the hyperpolarized experiment. The functional assessment produced reduced functional parameters. This suggests an altered functional and metabolic profile compared with corresponding in vivo values. CONCLUSION We investigated the metabolic and functional status of machine-perfused porcine hearts. Utilizing hyperpolarized methodology to acquire detailed myocardial metabolic information-in combination with already established MR methods for cardiac investigation-provides a powerful tool to aid the progress of donor heart preservation.
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Affiliation(s)
| | | | - Sabrina Kahina Bech
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Hans Eiskjaer
- Department of Clinical Medicine, Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Fast Nielsen
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Steffen Ringgaard
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Hans-Henrik Kimose
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
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8
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Bessière F, Zorgani A, Robert J, Daunizeau L, Cao E, Vaillant F, Abell E, Quesson B, Catheline S, Chevalier P, Lafon C. High Frame Rate Ultrasound for Electromechanical Wave Imaging to Differentiate Endocardial From Epicardial Myocardial Activation. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:405-414. [PMID: 31767455 DOI: 10.1016/j.ultrasmedbio.2019.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/04/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
Differentiation between epicardial and endocardial ventricular activation remains a challenge despite the latest technologies available. The aim of the present study was to develop a new tool method, based on electromechanical wave imaging (EWI), to improve arrhythmogenic substrate activation analysis. Experiments were conducted on left ventricles (LVs) of four isolated working mode swine hearts. The protocol aimed at demonstrating that different patterns of mechanical activation could be observed whether the ventricle was in sinus rhythm, paced from the epicardium or from the endocardium. A total of 72 EWI acquisitions were recorded on the anterior, lateral and posterior segments of the LV. A total of 54 loop records were blindly assigned to two readers. EWI sequences interpretations were correct in 89% of cases. The overall agreement rate between the two readers was 83%. When in a paced ventricle, the origin of the wave front was focal and originated from the endocardium or the epicardium. In sinus rhythm, wave front was global and activated within the entire endocardium toward the epicardium at a speed of 1.7 ± 0.28 m·s-1. Wave front speeds were respectively measured when the endocardium or the epicardium were paced at a speed of 1.1 ± 0.35 m·s-1 versus 1.3 ± 0.34 m·s-1 (p = NS). EWI activation mapping allows activation localization within the LV wall and calculation of the wave front propagation speed through the muscle. In the future, this technology could help localize activation within the LV thickness during complex ablation procedures.
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Affiliation(s)
- Francis Bessière
- Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France; LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France.
| | - Ali Zorgani
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Jade Robert
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Loïc Daunizeau
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Elodie Cao
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Fanny Vaillant
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, 33000 Bordeaux, France
| | - Emma Abell
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, 33000 Bordeaux, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, 33000 Bordeaux, France
| | - Stéphane Catheline
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Philippe Chevalier
- Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France
| | - Cyril Lafon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France; Université de Lyon, Lyon, France
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9
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Peper ES, Leopaldi AM, van Tuijl S, Coolen BF, Strijkers GJ, Baan J, Planken RN, de Weger A, Nederveen AJ, Marquering HA, van Ooij P. An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI: a feasibility study. Eur Radiol Exp 2019; 3:40. [PMID: 31650367 PMCID: PMC6813403 DOI: 10.1186/s41747-019-0114-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
Background Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function. Electronic supplementary material The online version of this article (10.1186/s41747-019-0114-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | - Bram F Coolen
- Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Baan
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arend de Weger
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk A Marquering
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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10
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Kappler B, van Tuijl S, Ergin B, Fixsen L, Stijnen M, Ince C, de Mol BA. Attenuated cardiac function degradation in ex vivo pig hearts. Int J Artif Organs 2019; 43:173-179. [PMID: 31621467 DOI: 10.1177/0391398819879706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Isolated hearts offer the opportunity to evaluate heart function, treatments, and diagnostic tools without in vivo factor interference. However, the early loss of cardiac function and edema occur over time and do limit the duration of the experiment. This research focuses on delaying these limitations using optimal blood control. This study examines whether blood conditioning by means of the combination of blood predilution and hemodialysis can significantly reduce cardiac function degradation. Slaughterhouse porcine hearts were revived in the PhysioHeart™ platform to restore physiological cardiac performance. Twelve hearts were divided into a control group and a dialysis group; in the latter group, hemodialysis was attached to the blood reservoir. Cardiac hemodynamics and blood parameters were recorded and evaluated. Blood conditioning significantly reduced the loss of cardiac pump function (control group vs dialysis group, -14.9 ± 6.3%/h vs -9.7 ± 2.7%/h) and loss of cardiac output (control group vs dialysis group, -11.8 ± 3.4%/h vs -5.9 ± 2.0%/h). Hemodialysis resulted in physiological and stable blood parameters, whereas in the control group ions reached pathological values, while interstitial edema still occurred. The combination of blood predilution and hemodialysis significantly attenuated ex vivo cardiac function degradation and delayed the loss of cardiac hemodynamics. We hypothesized that besides electrolyte and metabolic control, the hemodialysis-accompanied increase in hematocrit resulted in improved oxygen transport. This could have temporarily compensated the deleterious effect of an increased oxygen-diffusion distance due to edema in the dialysis group and resulted in less progression of cell decay. Clinically validated measures delaying edema might improve the effectiveness of the PhysioHeart™ platform.
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Affiliation(s)
- Benjamin Kappler
- Department of Cardiothoracic Surgery, AMC Heart Center, Amsterdam University Medical Center-Location AMC, Amsterdam, The Netherlands.,LifeTec Group BV, Eindhoven, The Netherlands
| | | | - Bülent Ergin
- Department of Translational Physiology, Amsterdam University Medical Center-Location AMC, Amsterdam, The Netherlands
| | - Louis Fixsen
- Cardiovascular Biomechanics Group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Can Ince
- Department of Translational Physiology, Amsterdam University Medical Center-Location AMC, Amsterdam, The Netherlands
| | - Bas Ajm de Mol
- Department of Cardiothoracic Surgery, AMC Heart Center, Amsterdam University Medical Center-Location AMC, Amsterdam, The Netherlands.,LifeTec Group BV, Eindhoven, The Netherlands
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11
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Jalal Z, Seguela PE, Baruteau AE, Benoist D, Bernus O, Villemain O, Boudjemline Y, Iriart X, Thambo JB. Role of animal models for percutaneous atrial septal defect closure. J Thorac Dis 2018; 10:S2966-S2974. [PMID: 30305957 DOI: 10.21037/jtd.2018.07.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As for any preclinical development of new implantable device, bench testing has been followed by experimental studies on large animal models for the development of atrial septal defect closure devices. Various models have been used according to studied species (porcine, ovine or canine model) and whether the septal defect was percutaneously or surgically created. Animal models of percutaneous atrial septal defect closure aim to assess the healing process and device endothelialisation, as well as the development of magnetic resonance imaging guided procedures, the short-term effects of volume overload on right ventricular contractility through haemodynamic studies and the understanding of other complications such as nickel hypersensitivity. Each technique has its own advantages and drawbacks, and leads to different punch-related, acute septal injuries that could have an effect on the healing process after device implantation. It has been suggested that some long-term, major device-related complications such as thrombosis or infective endocarditis may be associated with an inappropriate healing process or insufficient endothelialisation of the device, leading industrial companies to pay a great deal of attention to the healing process. Tissue reactions in animal models were shown to adequately reproduce the healing response after device implantation in humans, with an endothelial device coverage observed as early as 30 days after implantation and complete after 3 to 6 months. Research perspectives may evaluate both animal models and in-vitro studies in parallel with a view to clarify the endothelialisation process using human endothelial cells through in-vitro experiments. Self-sensing device for detecting the presence of endothelial cells on the surface of intracardiac occluders and high-resolution imaging techniques that could non-invasively assess the complete endothelialisation of a device would also be promising tools which would need large animal models studies before their clinical application.
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Affiliation(s)
- Zakaria Jalal
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), F-33600 Pessac, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | - Pierre-Emmanuel Seguela
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Alban-Elouen Baruteau
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,CHU Nantes, Fédération de Cardiologie Pédiatrique et Congénitale, Nantes, France.,L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France.,Department of Congenital Cardiology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - David Benoist
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | - Olivier Bernus
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | - Olivier Villemain
- M3C-Necker Enfants malades, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Younes Boudjemline
- Cardiac Catheterization Laboratories, Sidra Cardiac Program, Sidra Medical & Research Center, Doha, Qatar
| | - Xavier Iriart
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), F-33600 Pessac, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | - Jean-Benoit Thambo
- Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), F-33600 Pessac, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France.,Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
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12
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Yeo JM, Tse V, Kung J, Lin HY, Lee YT, Kwan J, Yan BP, Tse G. Isolated heart models for studying cardiac electrophysiology: a historical perspective and recent advances. J Basic Clin Physiol Pharmacol 2018; 28:191-200. [PMID: 28063261 DOI: 10.1515/jbcpp-2016-0110] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/12/2016] [Indexed: 01/25/2023]
Abstract
Experimental models used in cardiovascular research range from cellular to whole heart preparations. Isolated whole hearts show higher levels of structural and functional integration than lower level models such as tissues or cellular fragments. Cardiovascular diseases are multi-factorial problems that are dependent on highly organized structures rather than on molecular or cellular components alone. This article first provides a general introduction on the animal models of cardiovascular diseases. It is followed by a detailed overview and a historical perspective of the different isolated heart systems with a particular focus on the Langendorff perfusion method for the study of cardiac arrhythmias. The choice of species, perfusion method, and perfusate composition are discussed in further detail with particular considerations of the theoretical and practical aspects of experimental settings.
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Affiliation(s)
- Jie Ming Yeo
- School of Medicine, Imperial College London, London
| | - Vivian Tse
- Department of Physiology, McGill University, Montreal, Quebec
| | - Judy Kung
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, P.R
| | - Hiu Yu Lin
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, P.R
| | - Yee Ting Lee
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, P.R
| | - Joseph Kwan
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, P.R
| | - Bryan P Yan
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne
| | - Gary Tse
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, P.R
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