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Gao YP, Deng YB. Ultrasound evaluation of the cardiovascular system in offspring conceived through assisted reproductive technology. J Assist Reprod Genet 2024; 41:623-634. [PMID: 38244152 PMCID: PMC10957808 DOI: 10.1007/s10815-024-03029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
With the widespread application of assisted reproductive technology, the health issues of offspring conceived through assisted reproductive technology have also received increasing attention. Animal experiments and clinical studies have found subclinical adverse changes in the cardiovascular system of assisted reproductive offspring. Assisted reproductive technology itself may be just one of the many factors contributing to this phenomenon, with epigenetics playing an important role. Ultrasound technology can be used to assess the morphological structure and function of the cardiovascular system in assisted reproductive offspring from the fetal stage, providing the possibility to study the potential cardiovascular damage in this large population. This review aims to explore the effects and mechanisms of assisted reproductive technology on the cardiovascular system of offspring and provide a review of the research progress in ultrasound technology in this area.
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Affiliation(s)
- Yi-Peng Gao
- Department of Medical Ultrasound, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, 430030, China
| | - You-Bin Deng
- Department of Medical Ultrasound, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, 430030, China.
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van Heeswijk RB, Bauer WR, Bönner F, Janjic JM, Mulder WJM, Schreiber LM, Schwitter J, Flögel U. Cardiovascular Molecular Imaging With Fluorine-19 MRI: The Road to the Clinic. Circ Cardiovasc Imaging 2023; 16:e014742. [PMID: 37725674 DOI: 10.1161/circimaging.123.014742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Fluorine-19 (19F) magnetic resonance imaging is a unique quantitative molecular imaging modality that makes use of an injectable fluorine-containing tracer that generates the only visible 19F signal in the body. This hot spot imaging technique has recently been used to characterize a wide array of cardiovascular diseases and seen a broad range of technical improvements. Concurrently, its potential to be translated to the clinical setting is being explored. This review provides an overview of this emerging field and demonstrates its diagnostic potential, which shows promise for clinical translation. We will describe 19F magnetic resonance imaging hardware, pulse sequences, and tracers, followed by an overview of cardiovascular applications. Finally, the challenges on the road to clinical translation are discussed.
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Affiliation(s)
- Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Switzerland (R.B.v.H.)
| | - Wolfgang R Bauer
- Department of Internal Medicine I, Universitätsklinikum Würzburg, Germany (W.R.B.)
| | - Florian Bönner
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of Heinrich Heine University, University Hospital Düsseldorf, Germany (F.B.)
| | - Jelena M Janjic
- Graduate School of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA (J.M.J.)
| | - Willem J M Mulder
- Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology, the Netherlands (W.J.M.M.)
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands (W.J.M.M.)
| | - Laura M Schreiber
- Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center (CHFC), Wuerzburg University Hospitals, Germany (L.M.S.)
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department (J.S.), Lausanne University Hospital (CHUV), Switzerland
- CMR Center (J.S.), Lausanne University Hospital (CHUV), Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Switzerland (J.S.)
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging (U.F.), Heinrich Heine University, Germany
- Cardiovascular Research Institute Düsseldorf (CARID) (U.F.), Heinrich Heine University, Germany
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Colombo G, Cameli M, Metra M, Inciardi RM. Cardiovascular imaging updates and future perspectives. J Cardiovasc Med (Hagerstown) 2023; 24:488-491. [PMID: 37409594 DOI: 10.2459/jcm.0000000000001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Giada Colombo
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Metra
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Riccardo M Inciardi
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
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Radhakrishnan A, Friedman SF, Khurshid S, Ng K, Batra P, Lubitz SA, Philippakis AA, Uhler C. Cross-modal autoencoder framework learns holistic representations of cardiovascular state. Nat Commun 2023; 14:2436. [PMID: 37105979 PMCID: PMC10140057 DOI: 10.1038/s41467-023-38125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
A fundamental challenge in diagnostics is integrating multiple modalities to develop a joint characterization of physiological state. Using the heart as a model system, we develop a cross-modal autoencoder framework for integrating distinct data modalities and constructing a holistic representation of cardiovascular state. In particular, we use our framework to construct such cross-modal representations from cardiac magnetic resonance images (MRIs), containing structural information, and electrocardiograms (ECGs), containing myoelectric information. We leverage the learned cross-modal representation to (1) improve phenotype prediction from a single, accessible phenotype such as ECGs; (2) enable imputation of hard-to-acquire cardiac MRIs from easy-to-acquire ECGs; and (3) develop a framework for performing genome-wide association studies in an unsupervised manner. Our results systematically integrate distinct diagnostic modalities into a common representation that better characterizes physiologic state.
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Affiliation(s)
| | | | - Shaan Khurshid
- Broad Institute of MIT and Harvard, Cambridge, USA
- Massachusetts General Hospital, Massachusetts, USA
| | - Kenney Ng
- IBM T.J. Watson Research Center, New York, USA
| | - Puneet Batra
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - Steven A Lubitz
- Broad Institute of MIT and Harvard, Cambridge, USA.
- Massachusetts General Hospital, Massachusetts, USA.
| | | | - Caroline Uhler
- Massachusetts Institute of Technology, Cambridge, USA.
- Broad Institute of MIT and Harvard, Cambridge, USA.
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Zhang X, He S, Ding B, Qu C, Chen H, Sun Y, Zhang R, Lan X, Cheng Z. Synergistic strategy of rare-earth doped nanoparticles for NIR-II biomedical imaging. J Mater Chem B 2021; 9:9116-9122. [PMID: 34617547 DOI: 10.1039/d1tb01640g] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Featuring simultaneous multicolor imaging for multiple targets, a synergistic strategy has become promising for fluorescence imaging applications. Visible and first near infrared (NIR-I, 700-900 nm) fluorophores have been explored for multicolor imaging to achieve good multi-target capacity, but they are largely hampered by the narrow imaging bands available (400-900 nm, bandwidth 500 nm), the broad emission spectra of many fluorophores, shallow tissue penetration and scattering loss. With attractive characteristic emission peaks in the second NIR window (NIR-II, 1000-1700 nm), a narrow emission spectrum, and deeper tissue penetration capability, rare-earth doped nanoparticles (RENPs) have been considered by us to be outstanding candidates for multicolor bioimaging. Herein, two RENPs, NaYF4:Yb20Er2@NaYF4 and NaYF4:Nd5@NaYF4, were prepared and modified with polyethylene glycol (PEG) to explore simultaneous imaging in the NIR-IIb (1530 nm, under 980 nm laser excitation) and the NIR-II (1060 nm, under 808 nm laser excitation) windows. The PEGylated-RENPs (RENPs@PEG) were able to simultaneously visualize the circulatory system, trace the lymphatic system, and evaluate the skeletal system. Our study demonstrates that RENPs have high synergistic imaging capability in multifunctional biomedical applications using their NIR-II fluorescence. Importantly, the two RENPs@PEG are complementary to each other for higher temporal resolution in NaYF4:Nd5@NaYF4@PEG and higher spatial resolution in NaYF4:Yb20Er2@NaYF4@PEG, which may provide more comprehensive and accurate imaging diagnosis. In conclusion, RENPs are highly promising nanomaterials for multicolor imaging in the NIR-II window.
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Affiliation(s)
- Xiao Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
| | - Shuqing He
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen 518118, China
| | - Bingbing Ding
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
| | - Chunrong Qu
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
| | - Hao Chen
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
- Molecular Imaging Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
| | - Yu Sun
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
| | - Ruiping Zhang
- Radiology Department, The Bethune Hospital, The Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province 030032, China.
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Zhen Cheng
- Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, California 94305-5344, USA.
- Molecular Imaging Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
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Cui L, Zhao M, Zhang Z, Zhou W, Lv J, Hu J, Ma J, Fang M, Yang L, Magnussen CG, Xi B, Chen ZJ. Assessment of Cardiovascular Health of Children Ages 6 to 10 Years Conceived by Assisted Reproductive Technology. JAMA Netw Open 2021; 4:e2132602. [PMID: 34735014 PMCID: PMC8569486 DOI: 10.1001/jamanetworkopen.2021.32602] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Assisted reproductive technology (ART) has been widely used for treatment of infertility and has brought millions of births worldwide. The health of offspring conceived by ART has been of much concern, and adverse cardiovascular health outcomes have been reported by previous studies. OBJECTIVE To assess the cardiovascular health of children conceived by ART. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among participants recruited from November 2017 to February 2019. Participants were 382 children conceived by ART who were selected from a single reproductive center and 382 children who were naturally conceived, randomly selected from a primary school, and matched by sex, age, and maternal age at the child's birth (2 years older or younger). Data were analyzed from March 2019 through December 2019. EXPOSURES Conception by ART. MAIN OUTCOMES AND MEASURES Blood pressure was measured, and echocardiography was performed to determine left ventricular structural and functional parameters. Adjusted relative wall thickness (aRWT) was found for age, with high RWT defined as an aRWT of 0.375 or more. RESULTS Among 764 children aged 6 to 10 years, 382 children were conceived by ART (mean [SD] age, 7.20 [1.21] years; 201 [52.6%] boys) and 382 children were naturally conceived (mean [SD] age, 7.20 [1.21] years; 201 [52.6%] boys). Children conceived by ART had statistically significantly increased mean (SD) height (130.2 [9.5] cm vs 128.5 [8.1] cm; P = .007) and body mass index (17.6 [3.6] vs 17.1 [2.7]; P = .03). Those conceived by ART, compared with children in the matched control group, had statistically significantly increased blood pressure (mean [SD] systolic blood pressure, 105.5 [6.9] mm Hg vs 103.5 [8.4] mm Hg; adjusted P < .001; mean [SD] diastolic blood pressure, 67.2 [5.6] mm Hg vs 62.2 [6.3] mm Hg ; adjusted P < .001), left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 64.61% [3.20%] vs 66.70% [3.89%]; adjusted P < .001), and diastolic dysfunction (mean [SD] early/late mitral/tricuspid diastolic velocities ratio, 1.66 [0.28] vs 2.21 [0.36]; adjusted P < .001). They also had statistically significantly increased parameters of left ventricular structure, including mean (SD) left ventricular mass index (31.97 [5.04] g/m2.7 vs 28.28 [3.54] g/m2.7; adjusted P < .001) and RWT (3.30 [0.41] mm vs 2.98 [0.14] mm; adjusted P < .001). Additionally, children conceived by ART had statistically significantly increased prevalence of left ventricular hypertrophy (9 children [2.4%] vs 2 children [0.5%]; P = .03), high RWT (61 children [16.0%] vs 0 children; P < .001), and left ventricle remodeling patterns, including concentric remodeling (60 children [15.7%] vs 0 children), eccentric hypertrophy (8 children [2.1%] vs 2 children [0.5%]), and concentric hypertrophy (1 child [0.3%] vs 0 children) (P for left ventricle remodeling < .001). CONCLUSIONS AND RELEVANCE This study found that children conceived by ART had increased blood pressure and unfavorable changes in left ventricular structure and function compared with children who were naturally conceived. These findings suggest that further studies are needed to investigate the potential mechanisms and long-term outcomes associated with these differences.
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Affiliation(s)
- Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhirong Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Wei Zhou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Jianan Lv
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Jingmei Hu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Jinlong Ma
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Mei Fang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Lili Yang
- Children Cardiovascular Research Center, Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Bo Xi
- Children Cardiovascular Research Center, Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Cheeloo Hospital of Shandong University, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Williams MC, Ferencik M, Branch KR, Nieman K, Ghoshhajra BB, Choi AD, Nicol ED, Williamson E. Highlights of the 16th annual scientific meeting of the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr 2021; 15:506-512. [PMID: 34688579 DOI: 10.1016/j.jcct.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/15/2022]
Abstract
The 16th Society of Cardiovascular Computed Tomography (SCCT) annual scientific meeting welcomed 781 digital attendees from 55 countries. The program included 27 sessions across three simultaneously streaming channels, 11 exhibitors, 153 poster presentations, and 32 hours of on demand videos. The main themes of the meeting included coronary artery disease, valvular heart disease, structural heart disease, and advanced analytics including machine learning. This article summaries the main themes of the meeting and some of the key presentations, which will shape the future of cardiovascular computed tomography in clinical practice.
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Affiliation(s)
- Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
| | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | | | - Koen Nieman
- Stanford University School of Medicine, Departments of Medicine and Radiology, Cardiovascular Institute, Stanford, CA, USA
| | - Brian B Ghoshhajra
- Division of Cardiovascular Imaging and Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrew D Choi
- Division of Cardiology and Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA
| | - Edward D Nicol
- Royal Brompton & Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Biomedical Engineering and Imaging Sciences, Kings College London, UK
| | - Eric Williamson
- Division of Cardiovascular Radiology, Mayo Clinic Rochester, MN, USA
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Abstract
Despite the global coronavirus pandemic, cardiovascular imaging continued to evolve throughout 2020. It was an important year for cardiac CT and MRI, with increasing prominence in cardiovascular research, use in clinical decision making, and in guidelines. This review summarizes key publications in 2020 relevant to current and future clinical practice. In cardiac CT, these have again predominated in assessment of patients with chest pain and structural heart diseases, although more refined CT techniques, such as quantitative plaque analysis and CT perfusion, are also maturing. In cardiac MRI, the major developments have been in patients with cardiomyopathy and myocarditis, although coronary artery disease applications remain well represented. Deep learning applications in cardiovascular imaging have continued to advance in both CT and MRI, and these are now closer than ever to routine clinical adoption. Perhaps most important has been the rapid deployment of MRI in enhancing understanding of the impact of COVID-19 infection on the heart. Although this review focuses primarily on articles published in Radiology, attention is paid to other leading journals where published CT and MRI studies will have the most clinical and scientific value to the practicing cardiovascular imaging specialist.
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Affiliation(s)
- Gaurav S Gulsin
- From the Department of Radiology, University of British Columbia, St Paul's Hospital, Vancouver, Canada (G.S.G., J.A.L.); Department of Cardiovascular Sciences, University of Leicester and the Leicester National Institute for Health Research Biomedical Research Centre, Glenfield Hospital, Leicester, England (G.S.G.); Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland (N.M., J.D.D.); and School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.)
| | - Niall McVeigh
- From the Department of Radiology, University of British Columbia, St Paul's Hospital, Vancouver, Canada (G.S.G., J.A.L.); Department of Cardiovascular Sciences, University of Leicester and the Leicester National Institute for Health Research Biomedical Research Centre, Glenfield Hospital, Leicester, England (G.S.G.); Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland (N.M., J.D.D.); and School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.)
| | - Jonathon A Leipsic
- From the Department of Radiology, University of British Columbia, St Paul's Hospital, Vancouver, Canada (G.S.G., J.A.L.); Department of Cardiovascular Sciences, University of Leicester and the Leicester National Institute for Health Research Biomedical Research Centre, Glenfield Hospital, Leicester, England (G.S.G.); Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland (N.M., J.D.D.); and School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.)
| | - Jonathan D Dodd
- From the Department of Radiology, University of British Columbia, St Paul's Hospital, Vancouver, Canada (G.S.G., J.A.L.); Department of Cardiovascular Sciences, University of Leicester and the Leicester National Institute for Health Research Biomedical Research Centre, Glenfield Hospital, Leicester, England (G.S.G.); Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland (N.M., J.D.D.); and School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.)
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Tawakol A, Fakhri GE, Catana C, Sosnovik DE. Advances in cardiac PET/MR imaging: Facilitating cutting-edge structural and biological phenotyping of the cardiovascular system. J Nucl Cardiol 2021; 28:2026-2029. [PMID: 32128674 DOI: 10.1007/s12350-020-02076-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ahmed Tawakol
- Cardiology Division, Massachusetts General Hospital, Yaw 5-050, 55 Fruit Street, Boston, MA, 02114, USA.
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Boston, USA
- Nuclear Medicine& Molecular Imaging Division, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - David E Sosnovik
- Cardiology Division, Massachusetts General Hospital, Yaw 5-050, 55 Fruit Street, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, USA
- Cardiovascular Research Center at Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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AlJaroudi WA, Hage FG. Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2020: positron emission tomography, computed tomography, and magnetic resonance. J Nucl Cardiol 2021; 28:2100-2111. [PMID: 34105040 PMCID: PMC8186871 DOI: 10.1007/s12350-021-02685-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022]
Abstract
Although the year 2020 was different from other years in many respects, the Journal of Nuclear Cardiology published excellent articles pertaining to imaging in patients with cardiovascular disease due to the dedication of the investigators in our field all over the world. In this review, we will summarize a selection of these articles to provide a concise review of the main advancements that have recently occurred in the field and provide the reader with an opportunity to review a wide selection of articles. We will focus on publications dealing with positron emission tomography, computed tomography, and magnetic resonance and hope that you will find this review helpful.
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Affiliation(s)
- Wael A AlJaroudi
- Division of Cardiovascular Medicine, Augusta University, Augusta, GA, USA
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA.
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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Polycarpou I, Soultanidis G, Tsoumpas C. Synergistic motion compensation strategies for positron emission tomography when acquired simultaneously with magnetic resonance imaging. Philos Trans A Math Phys Eng Sci 2021; 379:20200207. [PMID: 34218675 PMCID: PMC8255946 DOI: 10.1098/rsta.2020.0207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 05/04/2023]
Abstract
Subject motion in positron emission tomography (PET) is a key factor that degrades image resolution and quality, limiting its potential capabilities. Correcting for it is complicated due to the lack of sufficient measured PET data from each position. This poses a significant barrier in calculating the amount of motion occurring during a scan. Motion correction can be implemented at different stages of data processing either during or after image reconstruction, and once applied accurately can substantially improve image quality and information accuracy. With the development of integrated PET-MRI (magnetic resonance imaging) scanners, internal organ motion can be measured concurrently with both PET and MRI. In this review paper, we explore the synergistic use of PET and MRI data to correct for any motion that affects the PET images. Different types of motion that can occur during PET-MRI acquisitions are presented and the associated motion detection, estimation and correction methods are reviewed. Finally, some highlights from recent literature in selected human and animal imaging applications are presented and the importance of motion correction for accurate kinetic modelling in dynamic PET-MRI is emphasized. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 2'.
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Affiliation(s)
- Irene Polycarpou
- Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
| | - Georgios Soultanidis
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charalampos Tsoumpas
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Biomedical Imaging Science Department, University of Leeds, West Yorkshire, UK
- Invicro, London, UK
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12
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Huang Q, Wang WT, Wang SS, Pei DA, Sui XQ. Cardiovascular magnetic resonance image analysis and mechanism study for the changes after treatments for primary microvascular angina pectoris. Medicine (Baltimore) 2021; 100:e26038. [PMID: 34032727 PMCID: PMC8154500 DOI: 10.1097/md.0000000000026038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Most cases of primary microvascular angina pectoris (PMVA) are diagnosed clinically, but the etiology and pathological mechanisms are unknown. The effect of routine clinical medications is minimal, and PMVA can progress to serious cardiovascular events. To improve the diagnosis and effective treatment of this disease, this study was designed to diagnose PMVA via cardiovascular magnetic resonance (CMR) and the coronary angiography thrombolysis in myocardial infarction (TIMI) blood flow grade, as well as to analyze vascular endothelial function to elucidate the pathogenesis of PMVA and compare the effects of routine clinical medications.The present randomized controlled trial including a parallel control group will be conducted on 63 PMVA patients in our cardiovascular department. The patients will be selected and randomly divided into the control, diltiazem, and nicorandil groups. The control group will be administered routine drug treatments (aspirin, atorvastatin, betaloc ZOK, perindopril, and isosorbidemononitrate sustained-release tablets). The diltiazem group will be additionally treated with 90 mg qd diltiazem sustained-release capsules. The nicorandil group was additionally given 5 mg tid nicorandil tablets. Coronary angiography will be performed before treatment, the severity and frequency of chest pain will be evaluated before and after 9 months of treatment, and homocysteine and von Willebrand factor levels will be measured. Electrocardiography, echocardiography, dynamic electrocardiography, a treadmill exercise test, and CMR will be performed. Sex, age, body mass index, complications, smoking, and family history will also be recorded. The SPSS19.0 statistical software package will be used to analyze the data. The measurements will be expressed as the mean ± standard deviation. Measurement data will be compared between the groups using Student's t-test. A relative number description will be used for the counting data, and the chi-squaretest will be used to compare the groups. A multivariate logistic regression analysis will be performed A P-value < .05 will be considered significant.The direct indices (CMR and coronary angiographic TIMI blood flow grade) may improve after adding diltiazem or nicorandil during routine drug treatments (such as aspirin, statins, and nitrates) in PMVA patients, and indirect indices (homocysteine and von Willebrand factor levels) may be reduced. TRIAL REGISTRATION Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=41894), No. CHiCTR1900025319, Registered on August 23, 2019; pre initiation.
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13
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Abstract
PURPOSE OF REVIEW There have been tremendous advances in the tools available for surveying blood vessels within whole organs and tissues. Here, we summarize some of the recent developments in methods for immunolabeling and imaging whole organs and provide a protocol optimized for the heart. RECENT FINDINGS Multiple protocols have been established for chemically clearing large organs and variations are compatible with cell type-specific labeling. Heart tissue can be successfully cleared to reveal the three-dimensional structure of the entire coronary vasculature in neonatal and adult mice. Obtaining vascular reconstructions requires exceptionally large imaging files and new computational methods to process the data for accurate vascular quantifications. This is a continually advancing field that has revolutionized our ability to acquire data on larger samples as a faster rate. SUMMARY Historically, cardiovascular research has relied heavily on histological analyses that use tissue sections, which usually sample cellular phenotypes in small regions and lack information on whole tissue-level organization. This approach can be modified to survey whole organs but image acquisition and analysis time can become unreasonable. In recent years, whole-organ immunolabeling and clearing methods have emerged as a workable solution, and new microscopy modalities, such as light-sheet microscopy, significantly improve image acquisition times. These innovations make studying the vasculature in the context of the whole organ widely available and promise to reveal fascinating new cellular behaviors in adult tissues and during repair.
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Affiliation(s)
| | - Kristy Red-Horse
- Department of Biology, Stanford University, Stanford, CA, 94305
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA
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14
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Leyssens L, Pestiaux C, Kerckhofs G. A Review of Ex Vivo X-ray Microfocus Computed Tomography-Based Characterization of the Cardiovascular System. Int J Mol Sci 2021; 22:3263. [PMID: 33806852 PMCID: PMC8004599 DOI: 10.3390/ijms22063263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/27/2022] Open
Abstract
Cardiovascular malformations and diseases are common but complex and often not yet fully understood. To better understand the effects of structural and microstructural changes of the heart and the vasculature on their proper functioning, a detailed characterization of the microstructure is crucial. In vivo imaging approaches are noninvasive and allow visualizing the heart and the vasculature in 3D. However, their spatial image resolution is often too limited for microstructural analyses, and hence, ex vivo imaging is preferred for this purpose. Ex vivo X-ray microfocus computed tomography (microCT) is a rapidly emerging high-resolution 3D structural imaging technique often used for the assessment of calcified tissues. Contrast-enhanced microCT (CE-CT) or phase-contrast microCT (PC-CT) improve this technique by additionally allowing the distinction of different low X-ray-absorbing soft tissues. In this review, we present the strengths of ex vivo microCT, CE-CT and PC-CT for quantitative 3D imaging of the structure and/or microstructure of the heart, the vasculature and their substructures in healthy and diseased state. We also discuss their current limitations, mainly with regard to the contrasting methods and the tissue preparation.
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Affiliation(s)
- Lisa Leyssens
- Institute of Mechanics, Materials, and Civil Engineering, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium; (L.L.); (C.P.)
- Institute of Experimental and Clinical Research, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
| | - Camille Pestiaux
- Institute of Mechanics, Materials, and Civil Engineering, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium; (L.L.); (C.P.)
- Institute of Experimental and Clinical Research, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
| | - Greet Kerckhofs
- Institute of Mechanics, Materials, and Civil Engineering, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium; (L.L.); (C.P.)
- Institute of Experimental and Clinical Research, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
- Department of Materials Engineering, Katholieke Universiteit Leuven, 3001 Leuven, Belgium
- Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
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15
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Abstract
Gas-filled microbubbles are currently in clinical use as blood pool contrast agents for ultrasound imaging. The goal of this review is to discuss the trends and issues related to these relatively unusual intravascular materials, which are not small molecules per se, not polymers, not even nanoparticles, but larger micrometer size structures, compressible, flexible, elastic, and deformable. The intent is to connect current research and initial studies from 2 to 3 decades ago, tied to gas exchange between the bubbles and surrounding biological medium, in the following areas of focus: (1) parameters of microbubble movement in relation to vasculature specifics; (2) gas uptake and loss from the bubbles in the vasculature; (3) adhesion of microbubbles to target receptors in the vasculature; and (4) microbubble interaction with the surrounding vessels and tissues during insonation.Microbubbles are generally safe and require orders of magnitude lower material doses than x-ray and magnetic resonance imaging contrast agents. Application of microbubbles will soon extend beyond blood pool contrast and tissue perfusion imaging. Microbubbles can probe molecular and cellular biomarkers of disease by targeted contrast ultrasound imaging. This approach is now in clinical trials, for example, with the aim to detect and delineate tumor nodes in prostate, breast, and ovarian cancer. Imaging of inflammation, ischemia-reperfusion injury, and ischemic memory is also feasible. More importantly, intravascular microbubbles can be used for local deposition of focused ultrasound energy to enhance drug and gene delivery to cells and tissues, across endothelial barrier, especially blood-brain barrier.Overall, microbubble behavior, stability and in vivo lifetime, bioeffects upon the action of ultrasound and resulting enhancement of drug and gene delivery, as well as targeted imaging are critically dependent on the events of gas exchange between the bubbles and surrounding media, as outlined in this review.
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Affiliation(s)
- Alexander L Klibanov
- From the Cardiovascular Division, Department of Medicine and Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine; and Departments of Biomedical Engineering, and Radiology, University of Virginia, Charlottesville, VA
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16
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Revzin MV, Raza S, Srivastava NC, Warshawsky R, D’Agostino C, Malhotra A, Bader AS, Patel RD, Chen K, Kyriakakos C, Pellerito JS. Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations. Radiographics 2020; 40:1866-1892. [PMID: 33136488 PMCID: PMC7646410 DOI: 10.1148/rg.2020200195] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023]
Abstract
Infection with severe acute respiratory syndrome coronavirus 2 results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. COVID-19 has been reported in most countries, and as of August 15, 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. Although COVID-19 predominantly affects the respiratory system, it has become apparent that many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease and its related complications, and proper utilization and interpretation of imaging examinations is crucial. A comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystem involvement, and evolution of imaging findings is essential for effective patient management and treatment. In part 1 of this article, the authors described the viral pathogenesis, diagnostic imaging hallmarks, and manifestations of the pulmonary and peripheral and central vascular systems of COVID-19. In part 2 of this article, the authors focus on the key imaging features of the varied pathologic manifestations of COVID-19, involving the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as the pediatric and pregnancy-related manifestations of the virus. Online supplemental material is available for this article. ©RSNA, 2020.
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Affiliation(s)
- Margarita V. Revzin
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Sarah Raza
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Neil C. Srivastava
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Robin Warshawsky
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Catherine D’Agostino
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Ajay Malhotra
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Anna S. Bader
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Ritesh D. Patel
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Kan Chen
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - Christopher Kyriakakos
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
| | - John S. Pellerito
- From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R., A.M., A.S.B.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (S.R., R.W., C.D., R.D.P., K.C., C.K., J.S.P.); and Department of Diagnostic Radiology, Danbury Radiological Associates, PC, Danbury, Conn (N.C.S.)
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17
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Shah SA, Cui SX, Waters CD, Sano S, Wang Y, Doviak H, Leor J, Walsh K, French BA, Epstein FH. Nitroxide-enhanced MRI of cardiovascular oxidative stress. NMR Biomed 2020; 33:e4359. [PMID: 32648316 PMCID: PMC7904044 DOI: 10.1002/nbm.4359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/08/2020] [Accepted: 06/03/2020] [Indexed: 06/07/2023]
Abstract
BACKGROUND In vivo imaging of oxidative stress can facilitate the understanding and treatment of cardiovascular diseases. We evaluated nitroxide-enhanced MRI with 3-carbamoyl-proxyl (3CP) for the detection of myocardial oxidative stress. METHODS Three mouse models of cardiac oxidative stress were imaged, namely angiotensin II (Ang II) infusion, myocardial infarction (MI), and high-fat high-sucrose (HFHS) diet-induced obesity (DIO). For the Ang II model, mice underwent MRI at baseline and after 7 days of Ang II (n = 8) or saline infusion (n = 8). For the MI model, mice underwent MRI at baseline (n = 10) and at 1 (n = 8), 4 (n = 9), and 21 (n = 8) days after MI. For the HFHS-DIO model, mice underwent MRI at baseline (n = 20) and 18 weeks (n = 13) after diet initiation. The 3CP reduction rate, Kred , computed using a tracer kinetic model, was used as a metric of oxidative stress. Dihydroethidium (DHE) staining of tissue sections was performed on Day 1 after MI. RESULTS For the Ang II model, Kred was higher after 7 days of Ang II versus other groups (p < 0.05). For the MI model, Kred , in the infarct region was significantly elevated on Days 1 and 4 after MI (p < 0.05), whereas Kred in the noninfarcted region did not change after MI. DHE confirmed elevated oxidative stress in the infarct zone on Day 1 after MI. After 18 weeks of HFHS diet, Kred was higher in mice after diet versus baseline (p < 0.05). CONCLUSIONS Nitroxide-enhanced MRI noninvasively quantifies tissue oxidative stress as one component of a multiparametric preclinical MRI examination. These methods may facilitate investigations of oxidative stress in cardiovascular disease and related therapies.
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Affiliation(s)
- Soham A Shah
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Sophia X Cui
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | | | - Soichi Sano
- Hematovascular Biology Center, Robert M. Berne Cardiovascular Research Center, University of Virginia, Virginia, USA
| | - Ying Wang
- Hematovascular Biology Center, Robert M. Berne Cardiovascular Research Center, University of Virginia, Virginia, USA
| | - Heather Doviak
- Hematovascular Biology Center, Robert M. Berne Cardiovascular Research Center, University of Virginia, Virginia, USA
| | - Jonathan Leor
- Neufield Cardiac Research Institute, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Ramat Gan, Israel
| | - Kenneth Walsh
- Hematovascular Biology Center, Robert M. Berne Cardiovascular Research Center, University of Virginia, Virginia, USA
| | - Brent A French
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Frederick H Epstein
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
- Radiology, University of Virginia, Charlottesville, Virginia, USA
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18
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Allen BD, Wong TC, Bucciarelli-Ducci C, Bryant J, Chen T, Dall'Armellina E, Finn JP, Fontana M, Francone M, Han Y, Hays AG, Jacob R, Lawton C, Manning WJ, Ordovas K, Parwani P, Plein S, Powell AJ, Raman SV, Salerno M, Carr JC. Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic. J Cardiovasc Magn Reson 2020; 22:58. [PMID: 32772930 PMCID: PMC7415346 DOI: 10.1186/s12968-020-00654-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/12/2020] [Indexed: 12/23/2022] Open
Abstract
During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers.
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Affiliation(s)
- Bradley D Allen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Timothy C Wong
- Department of Medicine (Cardiology), University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Jennifer Bryant
- National Heart Research Institute Singapore, National Heart Center Singapore, 5 Hospital Drive, Singapore, Singapore
| | - Tiffany Chen
- Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Dall'Armellina
- Leeds Institute of Cardiovascular and Metabolic Medicine, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - J Paul Finn
- Departments of Radiology and Medicine, UCLA, Los Angeles, California, USA
| | | | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Yuchi Han
- Departments of Medicine (Cardiovascular Division) and Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Allison G Hays
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ron Jacob
- The Heart and Vascular Institute, Lancaster General Health/PENN Medicine, Lancaster, PA, USA
| | - Chris Lawton
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Warren J Manning
- Departments of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Karen Ordovas
- Departments of Radiology and Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Purvi Parwani
- Department of Medicine (Cardiology), Loma Linda University, Loma Linda, California, USA
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael Salerno
- Departments of Medicine, Radiology, and Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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19
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AlJaroudi WA, Hage FG. Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2019: Positron emission tomography, computed tomography and magnetic resonance. J Nucl Cardiol 2020; 27:921-930. [PMID: 32410058 DOI: 10.1007/s12350-020-02151-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
Abstract
In 2019, the Journal of Nuclear Cardiology published excellent articles pertaining to imaging in patients with cardiovascular disease. In this review we will summarize a selection of these articles to provide a concise review of the main advancements that have recently occurred in the field and provide the reader with an opportunity to review a wide selection of articles. In this first article of this 2-part series we will focus on publications dealing with positron emission tomography, computed tomography and magnetic resonance. We will specifically discuss imaging as it relates to coronary artery disease, atherosclerosis and inflammation, coronary artery calcification, cardiomyopathies, cardiac implantable electronic devices, prosthetic valves, and left ventricular assist devices. The second part of this review will place emphasis on myocardial perfusion imaging using single-photon emission computed tomography.
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Affiliation(s)
- Wael A AlJaroudi
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA.
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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20
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Huellebrand M, Messroghli D, Tautz L, Kuehne T, Hennemuth A. An extensible software platform for interdisciplinary cardiovascular imaging research. Comput Methods Programs Biomed 2020; 184:105277. [PMID: 31891904 DOI: 10.1016/j.cmpb.2019.105277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/21/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular imaging is an exponentially growing field with aspects ranging from image acquisition and analysis to disease characterization, and evaluation of therapy approaches.The transfer of innovative new technological and algorithmic solutions into clinical practice is still slow. In addition to the verification of solutions, their integration in the clinical processing workflow must be enabled for the assessment of clinical impact and risks. The goal of our software platform for cardiac image processing - CAIPI - is to support researchers from different specialties such as imaging physics, computer science, and medicine by a common extensible platform to address typical challenges and hurdles in interdisciplinary cardiovascular imaging research. It provides an integrated solution for method comparison, integrated analysis, and validation in the clinical context. The interface concept enables a combination with existing frameworks that address specific aspects of the pipeline, such as modeling (e.g., OpenCMISS, CARP) or image reconstruction (Gadgetron). METHODS In our platform, we developed a concept for import, integration, and management of cardiac image data. The integration approach considers the spatiotemporal properties of the beating heart through a specific data model. The solution is based on MeVisLab and provides functionalities for data retrieval and storage. Two types of plugins can be added. While ToolPlugins usually provide processing algorithms such as image correction and segmentation, AnalysisPlugins enable interactive data exploration and reporting. GUI integration concepts are presented for both plugin types. We developed domain-specific reporting and visualization tools (e.g., AHA segment model) to enable validation studies by clinical experts. The platform offers plugins for calculating and reporting quantitative parameters such as cardiac function, which can be used to, e.g., evaluate the effect of processing algorithms on clinical parameters. Export functionalities include quantitative measurements to Excel, image data to PACS, and STL models to modeling and simulation tools. RESULTS To demonstrate the applicability of this concept both for method development and clinical application, we present use cases representing different problems along the innovation chain in cardiac MR imaging. Validation of an image reconstruction method (MRI T1 mapping) Validation of an image correction method for real-time 2D-PC MRI Comparison of quantification methods for blood flow analysis Training and integration of machine learning solutions with expert annotations Clinical studies with new imaging techniques (flow measurements in the carotid arteries and peripheral veins as well as cerebral spinal fluid). CONCLUSION The presented platform can be used in interdisciplinary teams, in which engineers or data scientists perform the method validation, followed by clinical research studies in patient collectives. The demonstrated use cases show how it enables the transfer of innovations through validation in the cardiovascular application context.
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Affiliation(s)
- Markus Huellebrand
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer MEVIS, Bremen, Germany.
| | - Daniel Messroghli
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Internal Medicine - Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany; German Center for Cardiovascular Research (DZHK), partner site Berlin
| | - Lennart Tautz
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer MEVIS, Bremen, Germany
| | - Titus Kuehne
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; German Center for Cardiovascular Research (DZHK), partner site Berlin; Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Anja Hennemuth
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer MEVIS, Bremen, Germany; German Center for Cardiovascular Research (DZHK), partner site Berlin
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Perpetuini D, Chiarelli AM, Maddiona L, Rinella S, Bianco F, Bucciarelli V, Gallina S, Perciavalle V, Vinciguerra V, Merla A, Fallica G. Multi-Site Photoplethysmographic and Electrocardiographic System for Arterial Stiffness and Cardiovascular Status Assessment. Sensors (Basel) 2019; 19:E5570. [PMID: 31861123 PMCID: PMC6960562 DOI: 10.3390/s19245570] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 01/13/2023]
Abstract
The development and validation of a system for multi-site photoplethysmography (PPG) and electrocardiography (ECG) is presented. The system could acquire signals from 8 PPG probes and 10 ECG leads. Each PPG probe was constituted of a light-emitting diode (LED) source at a wavelength of 940 nm and a silicon photomultiplier (SiPM) detector, located in a back-reflection recording configuration. In order to ensure proper optode-to-skin coupling, the probe was equipped with insufflating cuffs. The high number of PPG probes allowed us to simultaneously acquire signals from multiple body locations. The ECG provided a reference for single-pulse PPG evaluation and averaging, allowing the extraction of indices of cardiovascular status with a high signal-to-noise ratio. Firstly, the system was characterized on optical phantoms. Furthermore, in vivo validation was performed by estimating the brachial-ankle pulse wave velocity (baPWV), a metric associated with cardiovascular status. The validation was performed on healthy volunteers to assess the baPWV intra- and extra-operator repeatability and its association with age. Finally, the baPWV, evaluated via the developed instrumentation, was compared to that estimated with a commercial system used in clinical practice (Enverdis Vascular Explorer). The validation demonstrated the system's reliability and its effectiveness in assessing the cardiovascular status in arterial ageing.
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Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (A.M.C.); (S.G.); (A.M.)
| | - Antonio Maria Chiarelli
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (A.M.C.); (S.G.); (A.M.)
| | - Lidia Maddiona
- STMicroelectronics, ADG R&D, Stradale Primosole 50, 95121 Catania, Italy; (L.M.); (V.V.); (G.F.)
| | - Sergio Rinella
- Physiology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (S.R.); (V.P.)
| | - Francesco Bianco
- Institute of Cardiology, University G. D’Annunzio of Chieti-Pescara, Via Dei Vestini 5, 66100 Chieti, Italy; (F.B.); (V.B.)
| | - Valentina Bucciarelli
- Institute of Cardiology, University G. D’Annunzio of Chieti-Pescara, Via Dei Vestini 5, 66100 Chieti, Italy; (F.B.); (V.B.)
| | - Sabina Gallina
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (A.M.C.); (S.G.); (A.M.)
- Institute of Cardiology, University G. D’Annunzio of Chieti-Pescara, Via Dei Vestini 5, 66100 Chieti, Italy; (F.B.); (V.B.)
| | - Vincenzo Perciavalle
- Physiology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (S.R.); (V.P.)
- Kore University, Department of Sciences of Life, Viale delle Olimpiadi, 94100 Enna, Italy
| | - Vincenzo Vinciguerra
- STMicroelectronics, ADG R&D, Stradale Primosole 50, 95121 Catania, Italy; (L.M.); (V.V.); (G.F.)
| | - Arcangelo Merla
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (A.M.C.); (S.G.); (A.M.)
| | - Giorgio Fallica
- STMicroelectronics, ADG R&D, Stradale Primosole 50, 95121 Catania, Italy; (L.M.); (V.V.); (G.F.)
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Bi WJ, Cui L, Xiao YJ, Song G, Wang X, Sun L, Qiao W, Ren WD. Assessing cardiovascular remodelling in fetuses and infants conceived by assisted reproductive technologies: a prospective observational cohort study protocol. BMJ Open 2019; 9:e031452. [PMID: 31662389 PMCID: PMC6830675 DOI: 10.1136/bmjopen-2019-031452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Assisted reproductive technologies (ART), namely in vitro fertilisation and intracytoplasmic sperm injection, have become widely used to treat infertility. Although the use of ART is generally considered favourable, there are ongoing concerns about the prenatal and perinatal risks as well as long-term risks for the child. Epidemiological studies have demonstrated an association between pathological events during fetal development and future cardiovascular risk, raising concerns about cardiovascular remodelling in fetuses conceived by ART. The authors hypothesise fetuses conceived by ART present signs of cardioventricular dysfunction, which can be detected by deformation analysis. To address these issues, we will assess comprehensive cardiovascular structure and function in ART offspring and explore the role of speckle-tracking in myocardial deformation. METHODS AND ANALYSIS This prospective observational cohort study will include 100 singleton pregnancies conceived by ART and 100 controls identified in fetal life and followed up to 6 months old. At inclusion, a baseline assessment of the mothers and ART characteristics will be recorded by interview and review of medical records. Between 28 and 32 weeks gestation, a detailed fetal echography will be performed, including an assessment of estimated fetal weight, fetoplacental Doppler, fetal echocardiography and fetal abdominal artery ultrasound. On delivery, maternal and neonatal characteristics will be assessed. Within 60 days of birth, the first postnatal cardiovascular assessment will be conducted which will include echocardiography and abdominal artery ultrasound. At 6 months of age, the second infants' follow-up evaluation will include the weight and length of the infant, echocardiography and abdominal artery ultrasound. Data will be presented as mean±SD, median or percentages where appropriate. A p<0.05 will be considered statistically significant. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Ethics Committee of Shengjing Hospital of China Medical University. Findings will be disseminated through scientific publications and conference presentations. TRIAL REGISTRATION NUMBER ChiCTR1900021672.
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Affiliation(s)
- Wen-Jing Bi
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Cui
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang-Jie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lu Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Qiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei-Dong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
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Recent progress in the field of artificial organs. Artif Organs 2019; 43:1044. [PMID: 31608483 DOI: 10.1111/aor.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Yu B. [Update and perspective on intravascular imaging in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2019; 47:722-725. [PMID: 31550843 DOI: 10.3760/cma.j.issn.0253-3758.2019.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- B Yu
- Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
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Abstract
Advances in technology have always had the potential and opportunity to shape the practice of medicine, and in no medical specialty has technology been more rapidly embraced and adopted than radiology. Machine learning and deep neural networks promise to transform the practice of medicine, and, in particular, the practice of diagnostic radiology. These technologies are evolving at a rapid pace due to innovations in computational hardware and novel neural network architectures. Several cutting-edge postprocessing analysis applications are actively being developed in the fields of thoracic and cardiovascular imaging, including applications for lesion detection and characterization, lung parenchymal characterization, coronary artery assessment, cardiac volumetry and function, and anatomic localization. Cardiothoracic and cardiovascular imaging lies at the technological forefront of radiology due to a confluence of technical advances. Enhanced equipment has enabled computed tomography and magnetic resonance imaging scanners that can safely capture images that freeze the motion of the heart to exquisitely delineate fine anatomic structures. Computing hardware developments have enabled an explosion in computational capabilities and in data storage. Progress in software and fluid mechanical models is enabling complex 3D and 4D reconstructions to not only visualize and assess the dynamic motion of the heart, but also quantify its blood flow and hemodynamics. And now, innovations in machine learning, particularly in the form of deep neural networks, are enabling us to leverage the increasingly massive data repositories that are prevalent in the field. Here, we discuss developments in machine learning techniques and deep neural networks to highlight their likely role in future radiologic practice, both in and outside of image interpretation and analysis. We discuss the concepts of validation, generalizability, and clinical utility, as they pertain to this and other new technologies, and we reflect upon the opportunities and challenges of bringing these into daily use.
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Affiliation(s)
- Tara A Retson
- Department of Radiology, University of California San Diego
| | | | | | | | - Albert Hsiao
- Department of Radiology, University of California San Diego
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26
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AlJaroudi WA, Hage FG. Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2018. Part 1 of 2: Positron emission tomography, computed tomography, and magnetic resonance. J Nucl Cardiol 2019; 26:524-535. [PMID: 30603892 DOI: 10.1007/s12350-018-01558-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 11/28/2018] [Indexed: 12/26/2022]
Abstract
In this review, we summarize key articles that have been published in the Journal of Nuclear Cardiology in 2018 pertaining to nuclear cardiology with advanced multi-modality and hybrid imaging including positron emission tomography, cardiac-computed tomography, and magnetic resonance. In an upcoming review, we will summarize key articles that relate to the progress made in the field of single-photon emission computed tomography. We hope that these sister reviews will be useful to the reader to navigate the literature in our field.
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Affiliation(s)
- Wael A AlJaroudi
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 306 Lyons-Harrison Research Building, 701 19th Street South, Birmingham, AL, 35294-0007, USA.
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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27
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Kleiman AM, Potter JF, Bechtel AJ, Forkin KT, Dunn LK, Collins SR, Lyons G, Nemergut EC, Huffmyer JL. Generative retrieval results in positive academic emotions and long-term retention of cardiovascular anatomy using transthoracic echocardiography. Adv Physiol Educ 2019; 43:47-54. [PMID: 30615478 DOI: 10.1152/advan.00047.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
With increasing medical knowledge, procedural, and diagnostic skills to learn, it is vital for educators to make the limited amount of teaching time available to students effective and efficient. Generative retrieval is an effective and efficient learning tool, improving long-term retention through the practice of retrieval from memory. Forty medical students were randomized to learn normal cardiovascular anatomy using transthoracic echocardiography video clips in a generative retrieval (GR) or standard practice (SP) group. GR participants were required to verbally identify each unlabeled cardiovascular structure after viewing the video. After answering, participants viewed the correctly labeled video. SP participants viewed the same video clips labeled with the correct cardiovascular structure for the same amount of total time without verbally generating an answer. All participants were tested for intermediate (1-wk), late (1-mo), and long-term (6- to 9-mo) retention of cardiovascular anatomy. Additionally, a three-question survey was incorporated to assess perceptions of the learning method. There was no difference in pretest scores. The GR group demonstrated a trend toward improvement in recall at 1 wk [GR = 74.3 (SD 12.3); SP = 65.4 (SD 16.7); P = 0.10] and 1 mo [GR = 69.9 (SD15.6); SP = 64.3 (SD 15.4); P = 0.33]. At the 6- to 9-mo time point, there was a statistically significant difference in scores [GR = 74.3 (SD 9.9); SP = 65.0 (SD 14.1); P = 0.042]. At nearly every time point, learners had a statistically significantly higher perception of effectiveness, enjoyment, and satisfaction with GR. In addition to improved recall, GR is associated with increased perceptions of effectiveness, enjoyment, and satisfaction, which may lead to increased engagement, time spent studying, and improved retention.
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Affiliation(s)
- Amanda M Kleiman
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Jennifer F Potter
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Allison J Bechtel
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Katherine T Forkin
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Lauren K Dunn
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Stephen R Collins
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
| | - Genevieve Lyons
- Department of Public Health Sciences, University of Virginia , Charlottesville, Virginia
| | - Edward C Nemergut
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
- Department of Neurosurgery, University of Virginia , Charlottesville, Virginia
| | - Julie L Huffmyer
- Department of Anesthesiology, University of Virginia , Charlottesville, Virginia
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Schultz MG, Park C, Fraser A, Howe LD, Jones S, Rapala A, Davey Smith G, Sharman JE, Lawlor DA, Chaturvedi N, Deanfield J, Hughes AD. Submaximal exercise blood pressure and cardiovascular structure in adolescence. Int J Cardiol 2019; 275:152-157. [PMID: 30509371 PMCID: PMC6282652 DOI: 10.1016/j.ijcard.2018.10.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/11/2018] [Accepted: 10/17/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Dynamic exercise results in increased systolic blood pressure (BP). Irrespective of resting BP, some individuals may experience exaggerated rise in systolic BP with exercise, which in adulthood is associated with risk of hypertension, and cardiovascular (CV) disease. It is unknown if exercise BP is associated with markers of CV structure during adolescence. We examined this question in a large adolescent cohort taking account of the possible confounding effect of body composition and BP status. METHODS 4036 adolescents (mean age 17.8 ± 0.4 years, 45% male), part of a UK population-based birth cohort study completed a sub-maximal step-test with BP immediately post-exercise. Sub-samples underwent comprehensive echocardiography for assessment of cardiac structure; arterial structure including aortic pulse wave velocity (PWV) and carotid intima-media thickness; and assessment of body composition by dual-energy X-ray absorptiometry (DXA). RESULTS Each 5 mm Hg higher post-exercise systolic BP was associated with CV structure, including 0.38 g/m2.7 (95% CI: 0.29, 0.47) greater left-ventricular mass index (LVMI), and 0.04 m/s (95% CI: 0.03, 0.04) greater aortic PWV. Adjustment for age, total body fat, lean mass and BP status attenuated, but did not abolish associations with LVMI (0.14 g/m2.7 per 5 mm Hg of post-exercise systolic BP; 95% CI 0.21, 0.39) or aortic PWV (0.03 m/s per 5 mm Hg of post-exercise systolic BP; 95% CI: 0.02, 0.04). CONCLUSION Submaximal exercise systolic BP is associated with markers of CV structure in adolescents. Given the clinical relevance of exercise BP in adulthood, such associations may have implications for CV disease screening in young people and risk in later life.
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Affiliation(s)
- Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - Chloe Park
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Siana Jones
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Alicja Rapala
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, UK
| | - Nish Chaturvedi
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - John Deanfield
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Sciences, University College London, London, UK
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Affiliation(s)
| | - Kengo Tsukahara
- Division of Cardiology, Fujisawa City Hospital, Fujisawa, Japan
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Abstract
Limited understanding of Indigenous adults' cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min-1∙L-1 vs. 15.36 ± 2.97 mmHg∙min-1∙L-1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL-1·m-2 vs. 0.55 ± 0.17 mmHg·mL-1·m-2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min-1∙L-1 vs. 13.93 ± 2.61 mmHg∙min-1∙L-1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.
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Affiliation(s)
- Heather J. A. Foulds
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Physical Activity Promotion and Chronic Disease Prevention Unit, Vancouver, BC, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, Vancouver, BC, Canada
| | - Darren E. R. Warburton
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Physical Activity Promotion and Chronic Disease Prevention Unit, Vancouver, BC, Canada
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Rolf D, Schmidt R, Möllers M, Oelmeier de Murcia K, Braun J, Hammer K, Klockenbusch W, Schmitz R. Assessment of strain and dyssynchrony in normal fetuses using speckle tracking echocardiography - comparison of three different ultrasound probes. J Perinat Med 2018; 46:960-967. [PMID: 28753548 DOI: 10.1515/jpm-2017-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/30/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate segmental left (LV-S) and right (RV-S) ventricular strain as well as longitudinal mechanical myocardial dyssynchrony as a time difference between peaks in strain of both ventricles in fetuses (two-chamber-dyssynchrony, 2C-DYS) using speckle tracking echocardiography (STE). The aim of our study was to evaluate the influence of data acquisition on the results of STE measurement using different ultrasound probes. METHODS We prospectively recorded cardiac cycles of four-chamber views of 56 normal fetuses with three different ultrasound probes and analyzed them offline with speckle tracking imaging software. Furthermore, we looked at a possible influence of heartbeat variability (beat-to-beat variability). RESULTS The evaluation of the parameters was feasible with all three probes in 53 cases. There was no influence of heartbeat variability and no noticeable differences in 2C-DYS, LV-S and RV-S in all cases and for all three probes determined. CONCLUSION Assessment of strain and dyssynchrony using STE with three different probes is comparable. Further research is needed to validate dyssynchrony as a predictor for fetal outcome.
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Affiliation(s)
- Daniel Rolf
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Muenster, Albert-Schweitzer-Str. 1, 48149 Muenster, Germany, Tel.: +49172 5787653, Fax: +49 (0)251/83 - 48167
| | - Rene Schmidt
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Mareike Möllers
- Department of Obstetrics and Gynecology, University Hospital Muenster, Muenster, Germany
| | | | - Janina Braun
- Department of Obstetrics and Gynecology, University Hospital Muenster, Muenster, Germany
| | - Kerstin Hammer
- Department of Obstetrics and Gynecology, University Hospital Muenster, Muenster, Germany
| | - Walter Klockenbusch
- Department of Obstetrics and Gynecology, University Hospital Muenster, Muenster, Germany
| | - Ralf Schmitz
- Department of Obstetrics and Gynecology, University Hospital Muenster, Muenster, Germany
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Abstract
RATIONALE We present a case of incidental venous contrast pooling and layering in a patient without sudden cardiac arrest or cardiogenic shock. PATIENT CONCERNS The patient presented with only discrete symptoms and did not suffer fatal cessation of the cardiac pump function during or shortly after the scan. DIAGNOSIS The patient showed stigmata of venous gravity-dependent pooling and layering of contrast medium, which has frequently been described as a sign of imminent cardiogenic shock and cardiac arrest. INTERVENTIONS A cardiologic consultation including echocardiography was initiated. OUTCOMES Echocardiography confirmed valvular heart disease and biventricular heart failure. A subsequent follow-up CT acquired 8 months after the incidental finding showed no signs of dependent contrast pooling. LESSONS Pooling and layering of contrast medium can occur in patients not suffering acute fatal cessation of the cardiac pump function. Nonetheless, any signs of venous pooling observed in CT examinations, especially gravity-dependent layering of contrast medium, are indicative of severe heart dysfunction and should prompt immediate cardio-pulmonary monitoring and increased level of medical care.
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Affiliation(s)
- Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)
| | - Daniel Spira
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
| | - Florian André
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Ajith Kantharajah
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)
| | - Theresa Mokry
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
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Aslian H, Delana A, Kaiser SR, Moretti E, Foti C, Bregant P, de Denaro M, Longo F, Severgnini M. A multicenter dosimetry study to evaluate the imaging dose from Elekta XVI and Varian OBI kV-CBCT systems to cardiovascular implantable electronic devices (CIEDs). Phys Med 2018; 55:40-46. [PMID: 30471818 DOI: 10.1016/j.ejmp.2018.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/02/2018] [Accepted: 10/15/2018] [Indexed: 11/19/2022] Open
Abstract
The increasing use of daily CBCT in radiotherapy has raised concerns about the additional dose delivered to the patient, and it can also become a concern issue for those patients with cardiovascular implantable electronic devices (CIEDs) (Pacemaker [PM] and Implantable Cardioverter Defibrillator [ICD]). Although guidelines highly recommend that the cumulative dose received by CIEDs should be kept as low as possible, and a safe threshold based on patient risk classification needs to be respected, this additional imaging dose is not usually considered. Four centers with different dosimetry systems and different CBCT imaging protocols participated in this multicenter study to investigate the imaging dose to the CIEDs from Elekta XVI and Varian OBI kV-CBCT systems. It was found that although imaging doses received by CIEDs outside the CBCT field are negligible, special attention should be paid to this value when CIEDs are inside the field because the daily use of CBCT can sometimes contribute considerably to the total dose received by a CIED.
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Affiliation(s)
- Hossein Aslian
- Department of Physics, University of Trieste, Trieste, Italy.
| | - Anna Delana
- Department of Medical Physics, S. Chiara Hospital, APSS Trento, Italy.
| | - Stefano Ren Kaiser
- Department of Medical Physics, Fondazione Poliambulanza, Istituto Ospedaliero, Brescia, Italy.
| | - Eugenia Moretti
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
| | - Claudio Foti
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
| | - Paola Bregant
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Mario de Denaro
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Francesco Longo
- Department of Physics, University of Trieste, Trieste, Italy; National Institute for Nuclear Physics (INFN), Sezione di Trieste, Trieste, Italy.
| | - Mara Severgnini
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
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Baek KI, Ding Y, Chang CC, Chang M, Sevag Packard RR, Hsu JJ, Fei P, Hsiai TK. Advanced microscopy to elucidate cardiovascular injury and regeneration: 4D light-sheet imaging. Prog Biophys Mol Biol 2018; 138:105-115. [PMID: 29752956 PMCID: PMC6226366 DOI: 10.1016/j.pbiomolbio.2018.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 12/20/2022]
Abstract
The advent of 4-dimensional (4D) light-sheet fluorescence microscopy (LSFM) has provided an entry point for rapid image acquisition to uncover real-time cardiovascular structure and function with high axial resolution and minimal photo-bleaching/-toxicity. We hereby review the fundamental principles of our LSFM system to investigate cardiovascular morphogenesis and regeneration after injury. LSFM enables us to reveal the micro-circulation of blood cells in the zebrafish embryo and assess cardiac ventricular remodeling in response to chemotherapy-induced injury using an automated segmentation approach. Next, we review two distinct mechanisms underlying zebrafish vascular regeneration following tail amputation. We elucidate the role of endothelial Notch signaling to restore vascular regeneration after exposure to the redox active ultrafine particles (UFP) in air pollutants. By manipulating the blood viscosity and subsequently, endothelial wall shear stress, we demonstrate the mechanism whereby hemodynamic shear forces impart both mechanical and metabolic effects to modulate vascular regeneration. Overall, the implementation of 4D LSFM allows for the elucidation of mechanisms governing cardiovascular injury and regeneration with high spatiotemporal resolution.
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Affiliation(s)
- Kyung In Baek
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Yichen Ding
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Chih-Chiang Chang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Megan Chang
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - René R Sevag Packard
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Jeffrey J Hsu
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Peng Fei
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Tzung K Hsiai
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA; Medical Engineering, California Institute of Technology, Pasadena, CA 91106, USA.
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Khan S, Fakhouri F, Majeed W, Kolipaka A. Cardiovascular magnetic resonance elastography: A review. NMR Biomed 2018; 31:e3853. [PMID: 29193358 PMCID: PMC5975119 DOI: 10.1002/nbm.3853] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/25/2017] [Accepted: 09/29/2017] [Indexed: 05/19/2023]
Abstract
Cardiovascular diseases are the leading cause of death worldwide. These cardiovascular diseases are associated with mechanical changes in the myocardium and aorta. It is known that stiffness is altered in many diseases, including the spectrum of ischemia, diastolic dysfunction, hypertension and hypertrophic cardiomyopathy. In addition, the stiffness of the aortic wall is altered in multiple diseases, including hypertension, coronary artery disease and aortic aneurysm formation. For example, in diastolic dysfunction in which the ejection fraction is preserved, stiffness can potentially be an important biomarker. Similarly, in aortic aneurysms, stiffness can provide valuable information with regard to rupture potential. A number of studies have addressed invasive and non-invasive approaches to test and measure the mechanical properties of the myocardium and aorta. One of the non-invasive approaches is magnetic resonance elastography (MRE). MRE is a phase-contrast magnetic resonance imaging technique that measures tissue stiffness non-invasively. This review article highlights the technical details and application of MRE in the quantification of myocardial and aortic stiffness in different disease states.
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Affiliation(s)
- Saad Khan
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Faisal Fakhouri
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Waqas Majeed
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, 43210, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
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Therkildsen J, Thygesen J, Winther S, Svensson M, Hauge EM, Böttcher M, Ivarsen P, Jørgensen HS. Vertebral Bone Mineral Density Measured by Quantitative Computed Tomography With and Without a Calibration Phantom: A Comparison Between 2 Different Software Solutions. J Clin Densitom 2018; 21:367-374. [PMID: 29680671 DOI: 10.1016/j.jocd.2017.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022]
Abstract
Quantitative computed tomography (CT) can be used to quantify bone mineral density (BMD) in the spine from clinical CT scans. We aimed to determine agreement and precision of BMD measurements by 2 different methods: phantom-less internal tissue calibration and asynchronous phantom-based calibration in a cohort of patients with chronic kidney disease (CKD). Patients with CKD were recruited for CT angiography of the chest, abdomen, and pelvis. BMD was analyzed by 2 different software solutions using different calibration techniques; phantom-based by QCT Pro (Mindways Inc.) and phantom-less by Extended Brilliance Workspace (Philips Healthcare). Intraoperator reanalysis was performed on 53 patients (36%) for both methods. An interoperator reanalysis on 30 patients (20%) using the phantom-based method and 29 patients (19%) using the phantom-less method was made. XY- and Bland-Altman plots were used to evaluate method agreement. Phantom-based measured BMD was systematically higher than phantom-less measured BMD. Despite a small absolute difference of 3.3 mg/cm3 (CI: -0.2-6.9 mg/cm3) and a relative difference of 5.1% (CI: 2.2%-8.1%), interindividual differences were large, as seen by a wide prediction interval (PI: -47-40 mg/cm3). The Bland-Altman plot showed no systematic bias, apart from 5 outliers. Intraoperator variability was high for the phantom-less method (5.8%) compared to the phantom-based (0.8%) and the interoperator variability was also high for the phantom-less method (5.8%) compared to the phantom-based (1.8%). Despite high correlation between methods, the between-method difference on an individual level showed great variability. Our results suggest agreement between these 2 methods is insufficient to allow them to be used interchangeably in patients with CKD.
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Affiliation(s)
| | - Jesper Thygesen
- Department of Clinical Engineering, Aarhus University Hospital, Aarhus, Denmark
| | - Simon Winther
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - My Svensson
- Department of Nephrology, Division of Medicine, Akershus University Hospital, Oslo, Norway
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Denmark
| | - Morten Böttcher
- Department of Internal Medicine, Hospital Unit West, Herning, Denmark
| | - Per Ivarsen
- Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark
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Eichhorn L, Doerner J, Luetkens JA, Lunkenheimer JM, Dolscheid-Pommerich RC, Erdfelder F, Fimmers R, Nadal J, Stoffel-Wagner B, Schild HH, Hoeft A, Zur B, Naehle CP. Cardiovascular magnetic resonance assessment of acute cardiovascular effects of voluntary apnoea in elite divers. J Cardiovasc Magn Reson 2018; 20:40. [PMID: 29909774 PMCID: PMC6004697 DOI: 10.1186/s12968-018-0455-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 05/08/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Prolonged breath holding results in hypoxemia and hypercapnia. Compensatory mechanisms help maintain adequate oxygen supply to hypoxia sensitive organs, but burden the cardiovascular system. The aim was to investigate human compensatory mechanisms and their effects on the cardiovascular system with regard to cardiac function and morphology, blood flow redistribution, serum biomarkers of the adrenergic system and myocardial injury markers following prolonged apnoea. METHODS Seventeen elite apnoea divers performed maximal breath-hold during cardiovascular magnetic resonance imaging (CMR). Two breath-hold sessions were performed to assess (1) cardiac function, myocardial tissue properties and (2) blood flow. In between CMR sessions, a head MRI was performed for the assessment of signs of silent brain ischemia. Urine and blood samples were analysed prior to and up to 4 h after the first breath-hold. RESULTS Mean breath-hold time was 297 ± 52 s. Left ventricular (LV) end-systolic, end-diastolic, and stroke volume increased significantly (p < 0.05). Peripheral oxygen saturation, LV ejection fraction, LV fractional shortening, and heart rate decreased significantly (p < 0.05). Blood distribution was diverted to cerebral regions with no significant changes in the descending aorta. Catecholamine levels, high-sensitivity cardiac troponin, and NT-pro-BNP levels increased significantly, but did not reach pathological levels. CONCLUSION Compensatory effects of prolonged apnoea substantially burden the cardiovascular system. CMR tissue characterisation did not reveal acute myocardial injury, indicating that the resulting cardiovascular stress does not exceed compensatory physiological limits in healthy subjects. However, these compensatory mechanisms could overly tax those limits in subjects with pre-existing cardiac disease. For divers interested in competetive apnoea diving, a comprehensive medical exam with a special focus on the cardiovascular system may be warranted. TRIAL REGISTRATION This prospective single-centre study was approved by the institutional ethics committee review board. It was retrospectively registered under ClinicalTrials.gov (Trial registration: NCT02280226 . Registered 29 October 2014).
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Affiliation(s)
- L. Eichhorn
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany
| | - J. Doerner
- Department of Radiology, University Hospital of Bonn, Bonn, Germany
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - J. A. Luetkens
- Department of Radiology, University Hospital of Bonn, Bonn, Germany
| | | | | | - F. Erdfelder
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany
| | - R. Fimmers
- Medical Biometry, Information Technology and Epidemiology, University of Bonn, Bonn, Germany
| | - J. Nadal
- Medical Biometry, Information Technology and Epidemiology, University of Bonn, Bonn, Germany
| | - B. Stoffel-Wagner
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Bonn, Germany
| | - H. H. Schild
- Department of Radiology, University Hospital of Bonn, Bonn, Germany
| | - A. Hoeft
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany
| | - B. Zur
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Bonn, Germany
| | - C. P. Naehle
- Department of Radiology, University Hospital of Bonn, Bonn, Germany
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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Kooiman J, de Vries JPPM, Van der Heyden J, Sijpkens YWJ, van Dijkman PRM, Wever JJ, van Overhagen H, Vahl AC, Aarts N, Verberk-Jonkers IJAM, Brulez HFH, Hamming JF, van der Molen AJ, Cannegieter SC, Putter H, van den Hout WB, Kilicsoy I, Rabelink TJ, Huisman MV. Randomized trial of one-hour sodium bicarbonate vs standard periprocedural saline hydration in chronic kidney disease patients undergoing cardiovascular contrast procedures. PLoS One 2018; 13:e0189372. [PMID: 29420536 PMCID: PMC5805164 DOI: 10.1371/journal.pone.0189372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 11/22/2017] [Indexed: 02/08/2023] Open
Abstract
Background Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures. Methods We performed an open-label multicentre non-inferiority trial between 2011–2014. Patients were randomized to 1 hour pre-procedure sodium bicarbonate hydration (250 ml 1.4%, N = 168) or 4–12 hours saline hydration (1000 ml 0.9%, N = 165) prior to and following contrast administration (2000 ml of saline total). Primary outcome was the relative serum creatinine increase (%) 48–96 hours post contrast exposure. Secondary outcomes were: incidence of CI-AKI (serum creatinine increase>25% or >44μmol/L), recovery of renal function, the need for dialysis, and hospital costs within two months follow-up. Results Mean relative creatinine increase was 3.1% (95%CI 0.9 to 5.2%) in the bicarbonate and 1.1% (95%CI -1.2 to 3.5%) in the saline arm, mean difference 1.9% (95%CI -1.2 to 5.1%, p-non-inferiority <0.001). CI-AKI occurred in 11 (6.7%) patients randomized to sodium bicarbonate and 12 (7.5%) to saline (p = 0.79). Renal function did not fully recover in 40.0% and 44.4% of CI-AKI patients, respectively (p = 0.84). No patient required dialysis. Mean costs for preventive hydration and clinical preparation for the contrast procedure were $1158 for sodium bicarbonate vs. $1561 for saline (p < 0.001). Conclusion Short hydration with sodium bicarbonate prior to elective cardiovascular diagnostic or therapeutic contrast procedures is non-inferior to standard periprocedural saline hydration in CKD patients with respect to renal safety and results in considerable healthcare savings. Trial registration Netherlands Trial Register (http://www.trialregister.nl/trialreg/index.asp), Nr NTR2699
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Affiliation(s)
- Judith Kooiman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | | | - Jan Van der Heyden
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Yvo W. J. Sijpkens
- Department of Internal Medicine, Bronovo Hospital, The Hague, the Netherlands
| | | | - Jan J. Wever
- Department of Vascular Surgery, Haga Teaching Hospital, The Hague, the Netherlands
| | - Hans van Overhagen
- Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands
| | - Antonie C. Vahl
- Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Nico Aarts
- Department of Radiology, Bronovo Hospital, The Hague, the Netherlands
| | | | - Harald F. H. Brulez
- Department of Nephrology, St. Lucas Andreas Hospital, Amsterdam, the Netherlands
| | - Jaap F. Hamming
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Suzanne C. Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands
| | - Wilbert B. van den Hout
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands
| | - Inci Kilicsoy
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Ton J. Rabelink
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Menno V. Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
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Bastkowski R, Weiss K, Maintz D, Giese D. Self-gated golden-angle spiral 4D flow MRI. Magn Reson Med 2018; 80:904-913. [PMID: 29344990 DOI: 10.1002/mrm.27085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/07/2017] [Accepted: 12/20/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Rene Bastkowski
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Kilian Weiss
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
- Philips Healthcare Germany, Hamburg, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Daniel Giese
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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Abstract
Cardiovascular diseases increase dramatically with age in both men and women. While it is clear that advanced age allows more time for individuals to be exposed to risk factors in general, there is strong evidence that age itself is a major independent risk factor for cardiovascular disease. Indeed, there are distinct age-dependent cellular, structural, and functional changes in both the heart and blood vessels, even in individuals with no clinical evidence of cardiovascular disease. Studies in older humans and in animal models of aging indicate that this age-related remodeling is maladaptive. An emerging view is that the heart and blood vessels accumulate cellular and subcellular deficits with age and these deficits increase susceptibility to disease in older individuals. Aspects of this age-dependent remodeling of the heart and blood vessels differ between the sexes. There is also new evidence that these maladaptive changes are more prominent in older animals and humans with a high degree of frailty. These observations may help explain why men and women are susceptible to different cardiovascular diseases as they age and why frail older adults are most often affected by these diseases.
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Affiliation(s)
- Alice E Kane
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Susan E Howlett
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
- Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, NS, Canada.
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Robson PM, Dey D, Newby DE, Berman D, Li D, Fayad ZA, Dweck MR. MR/PET Imaging of the Cardiovascular System. JACC Cardiovasc Imaging 2017; 10:1165-1179. [PMID: 28982570 PMCID: PMC6415529 DOI: 10.1016/j.jcmg.2017.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 12/11/2022]
Abstract
Cardiovascular imaging has largely focused on identifying structural, functional, and metabolic changes in the heart. The ability to reliably assess disease activity would have major potential clinical advantages, including the identification of early disease, differentiating active from stable conditions, and monitoring disease progression or response to therapy. Positron emission tomography (PET) imaging now allows such assessments of disease activity to be acquired in the heart, whereas magnetic resonance (MR) scanning provides detailed anatomic imaging and tissue characterization. Hybrid MR/PET scanners therefore combine the strengths of 2 already powerful imaging modalities. Simultaneous acquisition of the 2 scans also provides added benefits, including improved scanning efficiency, motion correction, and partial volume correction. Radiation exposure is lower than with hybrid PET/computed tomography scanning, which might be particularly beneficial in younger patients who may need repeated scans. The present review discusses the expanding clinical literature investigating MR/PET imaging, highlights its advantages and limitations, and explores future potential applications.
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Affiliation(s)
- Philip M Robson
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Daniel Berman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
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Björk J, Strömberg U, Rosengren A, Toren K, Fagerberg B, Grimby-Ekman A, BergströM GML. Predicting participation in the population-based Swedish cardiopulmonary bio-image study (SCAPIS) using register data. Scand J Public Health 2017; 45:45-49. [PMID: 28683666 DOI: 10.1177/1403494817702326] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To illustrate the importance of access to register data on determinants and predictors of study participation to assess validity of population-based studies. In the present investigation, we use data on sociodemographic conditions and disease history among individuals invited to the Swedish cardiopulmonary bio-image study (SCAPIS) in order to establish a model that predicts study participation. METHODS The pilot study of SCAPIS was conducted within the city of Gothenburg, Sweden, in 2012, with 2243 invited individuals (50% participation rate). An anonymous data set for the total target population ( n = 24,502) was made available by register authorities (Statistics Sweden and the National Board of Health and Welfare) and included indicators of invitation to and participation in SCAPIS along with register data on residential area, sociodemographic variables, and disease history. Propensity scores for participation were estimated using logistic regression. RESULTS Residential area, country of birth, civil status, education, occupational status, and disposable income were all associated with participation in multivariable models. Adding data on disease history only increased overall classification ability marginally. The associations with disease history were diverse with some disease groups negatively associated with participation whereas some others tended to increase participation. CONCLUSIONS The present investigation stresses the importance of a careful consideration of selection effects in population-based studies. Access to detailed register data also for non-participants can in the statistical analysis be used to control for selection bias and enhance generalizability, thereby making the results more relevant for policy decisions.
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Affiliation(s)
- Jonas Björk
- 1 Division of Occupational and Environmental Medicine, Lund University, Sweden
- 2 Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Ulf Strömberg
- 3 Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Annika Rosengren
- 4 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
| | - Kjell Toren
- 5 Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
| | - Björn Fagerberg
- 4 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
| | - Anna Grimby-Ekman
- 3 Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Göran M L BergströM
- 4 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
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Reulecke S, Charleston-Villalobos S, Voss A, Gonzalez-Camarena R, Gaitan-Gonzalez M, Gonzalez-Hermosillo J, Hernandez-Pacheco G, Aljama-Corrales T. Delta space plot analysis of cardiovascular coupling in vasovagal syncope during orthostatic challenge. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:684-687. [PMID: 28268420 DOI: 10.1109/embc.2016.7590794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this work, a graphical method to study cardiovascular coupling, called delta space plot analysis (DSPA), was introduced. The graphical representation is susceptible to be parameterized in shape and orientation. The usefulness of this technique was studied on cardiovascular data from patients with vasovagal syncope (VVS) and from controls. The study included 15 female patients diagnosed with VVS and 11 age-matched healthy female subjects. All subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5 minutes of supine position (baseline) and 18 minutes of 70° orthostatic phase. The DSPA parameters were obtained at different times during the HUT test, i.e., at baseline, early (first 5 min) and late (10-15 min) orthostatic phases. In baseline there were no considerable differences between female controls and female patients. During the late orthostatic phase, parameters from DSPA showed highly significantly (p=0.000003) reduced cardiovascular coupling in patients. Findings indicated a loss of control on cardiovascular coupling in female patients susceptible to vasovagal syncope during orthostatic challenge. In addition, this study provided promising results for a new graphical method to investigate cardiovascular coupling.
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Abdel-Magied RA, Kamel SR, Said AF, Ali HM, Abdel Gawad EA, Moussa MM. Serum interleukin-6 in systemic sclerosis and its correlation with disease parameters and cardiopulmonary involvement. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33:321-330. [PMID: 28079844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 03/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess serum interleukin-6 (IL-6)level in patients with systemic sclerosis (SSc) and its correlations with European Scleroderma Study Group activity score (EUSTAR), Scleroderma Assessment Questionnaire (SAQ), disability index and cardiopulmonary involvement. METHODS Twenty SSc patients and 10 matched healthy controls were included. Serum IL-6 was measured in patients and controls. Disease activity, status,and disability were assessed.Cardiopulmonary involvement was evaluated by pulmonary function tests (PFTs), six minute walk test, echocardiography, and high resolution computed tomography (HRCT) of chest. RESULTS Serum level of IL-6 was significantly higher in patients with SSc (6.3± 1.4pg/ml) versus healthy controls (3.2± 0.4pg/ml) (P=0.002). IL-6 level showed positive correlations with disease duration (r=0.49, P=0.03), EUSTAR score (r=0.64, P=0.002), Index of Respiratory Status "IRS" (r=0.46, P=0.001), Index of Musculoskeletal Status "IMSS" (r=0.45, P=0.049), Index of Vascular Status "IVS" (r=0.39, P=0.04), mean and peak of pulmonary artery pressure (r=0.44 & 0.55, P=0.02 & 0.002 respectively). Negative correlations of IL-6 level with DLCO% (r=-0.49, P=0.006),six minute walk distance (6MWD) (r=-0.52, P= 0.003) and right ventricle fraction area change (r=-0.48, P=0.03) were found, while there were strong positive correlations with HRCT-ground glass score (r=0.77, P=0.0001) and HRCT-fibrosis score (r=0.62, P=0.003). CONCLUSION IL-6 level is increased in patients with SSc and significantly correlates with EUSTAR score, IRS, DLCO, 6MWD, HRCT scores, and echocardiographic abnormalities of the right side of the heart. These results support the role of IL-6 in the disease activity and in the development of cardiopulmonary manifestations in SSc patients.
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Abstract
The introduction of ionizing radiation in medicine revolutionized the diagnosis and treatment of disease and dramatically improved and continues to improve the quality of health care. Cardiovascular imaging and medical imaging in general, however, are associated with a range of radiobiologic effects, including, in rare instances, moderate to severe skin damage resulting from cardiac fluoroscopy. For the dose range associated with diagnostic imaging (corresponding to effective doses on the order of 10 mSv [1 rem]), the possible effects are stochastic in nature and largely theoretical. The most notable of these effects, of course, is the possible increase in cancer risk. The current review addresses radiobiology relevant to cardiovascular imaging, with particular emphasis on radiation induction of cancer, including consideration of the linear nonthreshold dose-response model and of alternative models such as radiation hormesis.
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Affiliation(s)
- Pat Zanzonico
- Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Lawrence Dauer
- Memorial Sloan Kettering Cancer Center, New York, New York
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Johnson CD, Montgomery LEA, Quinn JG, Roe SM, Stewart MT, Tansey EA. Ultrasound imaging in teaching cardiac physiology. Adv Physiol Educ 2016; 40:354-358. [PMID: 27445285 DOI: 10.1152/advan.00011.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/24/2016] [Indexed: 06/06/2023]
Abstract
This laboratory session provides hands-on experience for students to visualize the beating human heart with ultrasound imaging. Simple views are obtained from which students can directly measure important cardiac dimensions in systole and diastole. This allows students to derive, from first principles, important measures of cardiac function, such as stroke volume, ejection fraction, and cardiac output. By repeating the measurements from a subject after a brief exercise period, an increase in stroke volume and ejection fraction are easily demonstrable, potentially with or without an increase in left ventricular end-diastolic volume (which indicates preload). Thus, factors that affect cardiac performance can readily be discussed. This activity may be performed as a practical demonstration and visualized using an overhead projector or networked computers, concentrating on using the ultrasound images to teach basic physiological principles. This has proved to be highly popular with students, who reported a significant improvement in their understanding of Frank-Starling's law of the heart with ultrasound imaging.
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Affiliation(s)
- Christopher D Johnson
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
| | - Laura E A Montgomery
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
| | - Joe G Quinn
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
| | - Sean M Roe
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
| | - Michael T Stewart
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
| | - Etain A Tansey
- Centre for Biomedical Sciences Education, Queen's University, Belfast, Northern Ireland
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Cruz-Lemini M, Crispi F, Valenzuela-Alcaraz B, Figueras F, Sitges M, Bijnens B, Gratacós E. Fetal cardiovascular remodeling persists at 6 months in infants with intrauterine growth restriction. Ultrasound Obstet Gynecol 2016; 48:349-356. [PMID: 26415719 DOI: 10.1002/uog.15767] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 08/30/2015] [Accepted: 09/25/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Intrauterine growth restriction is associated with increased cardiovascular risk later in life but the link between fetal disease and postnatal risk is not well-documented. We evaluated longitudinally the association between cardiovascular remodeling in small-for-gestational-age (SGA) fetuses and at 6 months of age. METHODS A cohort of 80 SGA fetuses (defined by estimated fetal and birth weights < 10(th) centile) delivered > 34 weeks' gestation was compared with 80 normally grown age-matched control fetuses, with follow-up at 6 months of corrected age (i.e. 6 months from estimated date of delivery according to first-trimester crown-rump length). Cardiovascular evaluation included a comprehensive echocardiographic assessment in both fetuses and infants and blood pressure and aortic intima-media thickness (aIMT) measurement in infants. Parameters were adjusted by linear regression analysis for gender, gestational age at delivery, pre-eclampsia, prenatal glucocorticoid exposure, Cesarean delivery, admission to neonatal intensive care unit and body surface area. RESULTS Both pre- and postnatally, when compared with controls, the SGA group showed a more globular cardiac shape (left sphericity index: controls 2.06 vs SGA 1.87 (P = 0.022) prenatally and 1.92 vs 1.67 (P = 0.007) postnatally), as well as signs of systolic longitudinal dysfunction (systolic annular peak velocity (S'): 7.2 vs 6.3 cm/s (P = 0.003) prenatally and 7.9 vs 6.4 cm/s (P < 0.001) postnatally; tricuspid annular plane systolic excursion: 7.2 vs 6.8 mm (P = 0.015) prenatally and 16.0 vs 14.2 mm (P < 0.001) postnatally) and diastolic dysfunction (left isovolumetric relaxation time: 46 vs 52 ms (P < 0.001) prenatally and 50 vs 57 ms (P = 0.034) postnatally). In addition, infants in the SGA group had increased mean blood pressure (mean: 61 vs 70 mmHg, P < 0.001) and maximum aIMT (0.57 vs 0.66 mm; P < 0.001). CONCLUSIONS Primary cardiovascular changes are already present in the SGA fetus and persist at 6 months of age. These data support prenatal cardiovascular remodeling as a mechanistic pathway of increased risk later in life in cases of SGA, regardless of Doppler abnormalities. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Cruz-Lemini
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - B Valenzuela-Alcaraz
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Figueras
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - M Sitges
- Department of Cardiology (Institut Clínic del Tòrax), Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - B Bijnens
- ICREA - Universitat Pompeu Fabra, Barcelona, Spain
| | - E Gratacós
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Abstract
Hemodynamic disturbance in the sick neonate is common, highly diverse in underlying pathophysiology and dynamic. Dysregulated systemic and cerebral blood flow is hypothesized to have a negative impact on neurodevelopmental outcome and survival. An understanding of the physiology of the normal neonate, disease pathophysiology, and the properties of vasoactive medications may improve the quality of care and lead to an improvement in survival free from disability. In this review we present a modern approach to cardiovascular therapy in the sick neonate based on a more thoughtful approach to clinical assessment and actual pathophysiology. Targeted neonatal echocardiography offers a more detailed insight into disease processes and offers longitudinal assessment, particularly response to therapeutic intervention. The pathophysiology of common neonatal conditions and the properties of cardiovascular agents are described. In addition, we outline separate treatment algorithms for various hemodynamic disturbances that are tailored to clinical features, disease characteristics and echocardiographic findings.
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Affiliation(s)
- Regan E Giesinger
- Division of Neonatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Patrick J McNamara
- Division of Neonatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Department of Paediatrics, University of Toronto, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada.
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Bravo C, Gámez F, Pérez R, Álvarez T, De León-Luis J. Fetal Aortic Arch Anomalies: Key Sonographic Views for Their Differential Diagnosis and Clinical Implications Using the Cardiovascular System Sonographic Evaluation Protocol. J Ultrasound Med 2016; 35:237-251. [PMID: 26715656 DOI: 10.7863/ultra.15.02063] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 05/23/2015] [Indexed: 06/05/2023]
Abstract
Aortic arch anomalies are present in 1% to 2% of the general population and are commonly associated with congenital heart disease, chromosomal defects, and tracheaesophageal compression in postnatal life. The sonographically based detection of aortic arch anomalies lies in the 3-vessel and trachea view. Although highly sensitive, this view alone does not allow identification of the aortic arch branching pattern, which prevents an accurate diagnosis. The systematic addition of a subclavian artery view as part of a standardized procedure may be useful in the differential diagnosis of these conditions. We describe the sonographic assessment of fetal aortic arch anomalies by combining 2 fetal transverse views: the 3-vessel and trachea view and the subclavian artery view, which are included in the cardiovascular system sonographic evaluation protocol. We also review the sonographic findings and the clinical implications of fetal aortic arch anomalies.
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Affiliation(s)
- Coral Bravo
- Departments of Obstetrics and Gynecology (C.B.A., F.G., R.P., J.D.L.-L.) and Pediatric Cardiology (T.Á.), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.A.)
| | - Francisco Gámez
- Departments of Obstetrics and Gynecology (C.B.A., F.G., R.P., J.D.L.-L.) and Pediatric Cardiology (T.Á.), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.A.)
| | - Ricardo Pérez
- Departments of Obstetrics and Gynecology (C.B.A., F.G., R.P., J.D.L.-L.) and Pediatric Cardiology (T.Á.), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.A.)
| | - Teresa Álvarez
- Departments of Obstetrics and Gynecology (C.B.A., F.G., R.P., J.D.L.-L.) and Pediatric Cardiology (T.Á.), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.A.)
| | - Juan De León-Luis
- Departments of Obstetrics and Gynecology (C.B.A., F.G., R.P., J.D.L.-L.) and Pediatric Cardiology (T.Á.), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.A.).
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