Assessment Of Left Ventricular Function Research Articles

Myocardial Performance Index by Pulsed Wave Doppler versus Tissue Doppler Echocardiography in Left Ventricular Systolic Function Assessment

Myocardial Performance Index by Pulsed Wave Doppler versus Tissue Doppler Echocardiography in Left Ventricular Systolic Function Assessment

Resuscitative transesophageal echocardiography in emergency departments in the United States and Canada: A cross-sectional survey

IntroductionOver the past two decades, transesophageal echocardiography (TEE) has been used with increasing frequency to evaluate critically ill patients outside of traditional settings. The purpose of this study was to characterize the number of programs, users, practice characteristics, training and competency requirements and barriers for the current use of resuscitative transesophageal echocardiography (TEE) in Emergency Departments (EDs) in the United States and Canada. MethodsA closed internet-based, cross-sectional, point-prevalence survey was administered via email to 120 program directors of emergency ultrasound fellowships (EUSF) and 43 physicians from EDs without EUSF from the United States and Canada. ResultsNinety-eight percent of surveyed participants responded. Twenty percent of respondents reported having active resuscitative TEE programs. The majority of participating hospitals (70%) were academic centers with residency programs. A total of 33 programs reported using resuscitative TEE in their ED and of those, 82% were programs with EUSF. Most programs performing TEE (79%) had less than five attending physicians performing TEE. Evaluation of patients during resuscitation from cardiac arrest (100%) and post-arrest care (76%) are the two most frequent indications for TEE in the ED. The most common core elements of resuscitative TEE protocols used are: assessment of left ventricular (LV) systolic function (97%), assessment of right ventricular (RV) function (88%), evaluation of pericardial effusion / tamponade (52%). All programs reported using formal didactics in their training programs, 94% reported using high-fidelity simulation, and 79% live scanning of patients. Financial concerns were the most common barrier use of TEE in the ED (58%), followed by maintenance of equipment (30%), and credentialing/privileges (30%). ConclusionsThis study provides a snapshot of the practice of resuscitative TEE in EDs in the United States and Canada revealing the existence of 33 programs using this emerging modality in the care of critically ill patients.

Diagnostic performance of bedside transthoracic echocardiography in the management of patients with suspected myocardial infarction

Abstract Introduction The diagnostic management of patients with symptoms indicative of acute myocardial infarction (MI) is largely based on the clinical assessment of symptoms, ECG and diagnostic algorithms based on high-sensitivity cardiac troponin (hs-cTn). Additionally, guidelines recommend transthoracic echocardiography (TTE) for patients neither eligible for rule-out nor rule-in. Purpose To assess the diagnostic performance of TTE in the diagnostic management of patients with suspected MI. Methods We conducted a prospective, observational cohort study enrolling consecutive patients presenting with symptoms suggestive of MI to the emergency department of a tertiary care hospital. Management was at the discretion of the treating physician. The final diagnosis was adjudicated by two independent cardiologists according to the 4th Universal Definition of MI. Evaluation in the emergency department included TTE with an assessment of left-ventricular (LV) function and regional wall motion abnormalities (WMA). We calculated diagnostic performance parameters (sensitivity, specificity, and negative and positive predictive value [NPV, PPV] with 95% confidence intervals) to rule-out or rule-in MI, respectively, for the presence of WMA. Performance was calculated for patients stratified to the observe and rule-in groups after application the ESC 0/1-hour algorithm using hs-cTnI. Patients without available TTE and those with STEMI were excluded. WMA were only reported if the acoustic window allowed a reasonable evaluation. Variables associated with the conduction of coronary angiography were studied using logistic regression. Results Overall, 2,163 patients with available TTE were included, of those 1,707 (78.9%) patients had data on WMA available, with 360 (21.1%) having any WMA (hypokinesia or akinesia) detected. Median age was 64 (51, 75) years, 1,383 (63.9%) were males and 383 (17.7%) were diagnosed with MI. Application of the ESC 0/1-hour algorithm resulted in assignment of 729 (42.9%) and 308 (18.6%) patients to the rule-out and -in groups, respectively, with 599 (38.5%) patients remaining in the observe group. Of these, 45 (7.5%) had MI. Performance of the ESC 0/1-hour algorithm was good and is shown in Figure 1. In the observe group, detection of WMA poorly identified patients with MI (PPV 12.7%, Figure 1). Absence of WMA resulted in moderate performance to rule-out MI (NPV 94.0%, Figure 1). Adjusted for age, sex, symptoms, baseline hs-cTnI, presence of ischemic signs on ECG and cardiovascular risk factors, the presence of WMA was significantly associated with the conduction of coronary angiography at index presentation (OR 2.7 [1.8, 4.0], p < 0.001). Conclusion The diagnostic value of bedside TTE is limited for the rule-out or -in of MI. Still, patients with prevalent WMA were significantly more likely to undergo coronary angiography.Performance of TTE in ESC 0/1-hour alg.

Finasteride effectively attenuates the impairments of left ventricular function and cardiac sympathovagal balance in both aging and obese male rats via reducing systemic oxidative stress

Abstract Background Cardiovascular diseases are commonly found in the elderly and obese population manifested by left ventricular (LV) dysfunction and impaired cardiac sympathovagal balance. Finasteride (FIN), a 5-alpha reductase inhibitor (5-ARI), is a universal prescription for patients with benign prostatic hyperplasia (BPH). Since BPH is commonly found in obesity and aging, it is essential to investigate whether FIN could have an impact on the LV function and cardiac sympathovagal balance in either elderly or obese conditions. Purpose We tested the hypothesis that impaired LV function and cardiac sympathovagal balance are observed in aging and obese conditions, and FIN improves these parameters through a reduction of systemic oxidative stress in both aging and obese male rats. Methods Twenty-four male Wistar rats (aged 8 weeks old) were randomly divided into 3 groups (n=8/group) to receive one of the followings: 1) normal diet (ND) feeding, 2) ND feeding with D-galactose injection (150 mg/kg/day, subcutaneous injection, 18 weeks) for creating an aging model, and 3) HFD feeding for 18 weeks for creating an obesity model. At week 13, rats in each group were divided into 2 subgroups (n=4/subgroup) and received either a vehicle (drinking water) or FIN (5 mg/kg/day) via oral gavage. At the end of treatment, echocardiography was performed to assess LV function, and the heart rate variability (HRV) was determined to quantify cardiac sympathovagal balance. The blood was collected, and serum was used to determine serum malondialdehyde (MDA) levels as a marker of systemic oxidative stress. Results At week 13, D-galactose injection successfully induced aging as indicated by increasing cardiac p53 protein expression. HFD also caused obesity in those rats as indicated by increased body weight and visceral fat weight. LV dysfunction (as indicated by reduced %LVEF and %LVFS) and cardiac sympathovalgal imbalance (as indicated by an increased LF/HF ratio) were observed in both models (Figure 1A-C). This functional impairment was associated with an increased MDA levels (Figure 1D). Treatment with FIN successfully reduced cardiac sympathovagal imbalance in both models (Figure 1C); however, an improvement of LV function was found only in aging rats-treated with FIN (Figure 1A, B). Consistent with a reduction of cardiac sympathovagal imbalance, FIN decreased systemic oxidative stress in both models (Figure 1D). Conclusions FIN effectively improved cardiac sympathovagal balance in rats under both aging and obese conditions. However, FIN reduced LV dysfunction only in aging rats. Interestingly, FIN did not affect these cardiac parameters in normal healthy rats. These findings suggest the cardioprotective potential of FIN in both aging and obese populations.

Assessment of Left Ventricular Systolic Function after Surgical and Transcatheter Device Closure of Ventricular Septal Defect Using Speckle Tracking Imaging

Assessment of Left Ventricular Systolic Function after Surgical and Transcatheter Device Closure of Ventricular Septal Defect Using Speckle Tracking Imaging

Abstract 12897: Automated Assessment of Left Ventricular Function in Tetralogy of Fallot - A Machine Learning Approach

Introduction: Congenital heart disease (CHD) is associated with significant cardiac anatomic and functional variability. This study tests the implementation and validation of a convolutional neural network algorithm (EchoNet-Dynamic) on a pediatric dataset via a transfer learning approach. We compare the echocardiographic systolic function measure, left ventricular ejection fraction (LVEF), with CMR as the gold standard. Methods: Patients ages 1-18 (44% female) who underwent a transthoracic echocardiographic evaluation and CMR for repaired Tetralogy of Fallot (TOF) were divided into 2 groups of EF < and >40%. 406 (2D-A4C views) videos with LVEF calculated using Bullet and Simpson method were identified. MRI EF as a ground truth label was compared with predicted EF data. Inference weights were derived from EchoNet-Dynamic and the weights from re-training the model on pediatric data. Correlation statistics were computed. The metrics included mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R2). Results: The R2 of actual vs predicted was 0.83 (0.71-0.89) with an MAE of 3.55. The predicted EF vs MRI EF resulted in an R2 of 0.48 and an MAE of 6.39 (Figure 1 a-c). Bland-Altman analysis between actual vs predicted EF estimates LVEF (bias = 1.64%) with 95% limits of agreement of -7.80% to 11.09%. MRI EF vs predicted values, the model estimates LVEF (bias = -3.12%) with 95% limits of agreement of -18.71% to 12.48%. The smaller body surface area and ages correlated with better model performance in both groups. Conclusions: EchoNet-Dynamic trained on a pediatric data set can accurately predict EF and this validates the model’s performance on a distinct CHD population. The predicted EF accurately compares with the MRI assessment. EchoNet Dynamic can be employed via a transfer learning method for automated real-time evaluations of cardiac function in CHD patients with compromised ventricular function and complex anatomical phenotypes.

Abstract 17637: Lacking MicroRNA-1’s Biophysical Action Causes Heart Failure Revealed by a Newly Developed Biplane Echocardiography of Mouse Heart

MicroRNA-1 (miR1) is the most abundant microRNA in the heart and plays a key role in maintaining cardiac homeostasis through a well-known RNAi mechanism. Recently, we found a novel biophysical function of miR1 to physically bind to and modulate cardiac ion channels. A human single nucleotide polymorphism-hSNP14A/G (rs776480338) of miR1, in which the 14th nucleotide “A” is mutated to “G”, specifically abolishes the biophysical modulation while maintaining the RNAi. However, the physiological significance of microRNA’s biophysical action remains unknown. To study this, we created a single-nucleotide 14A/G mutation on miR1-1 and miR1-2 genes by using CRISPR/Cas9 and developed 14G-mutated homozygous (14G-Homo, miR1-1 14G/G:miR1-2 14G/G) transgenic mice. In addition, we also developed a new echocardiography methodology that can consistently record clear 4-chamber views of mouse hearts, allowing integration of 4-chamber and long axis views for the clinically recommended Biplane Simpson’s assessment of left ventricular (LV) function. Validation via Cardiac Magnetic Resonance (CMR) revealed that the Biplane method is more accurate than M-mode analysis for precise assessments of mouse LV functional parameters. These findings were highlighted in practice by monitoring both Wild Type (WT) and 14G-Homo mice at 2, 3, and 4 months of age, in which M-mode consistently overestimated LV parameters. Moreover, the clarity of the 4 chamber images enables many cardiac analyses that were previously not feasible for the mouse heart, such as the mitral valve color doppler that revealed turbulent blood flow into the LV of 14G-Homo mice. With the 4-chamber view methodology, we also studied the right ventricular (RV) function by assessing fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) and found that cardiac functional deterioration of 14G-Homo mice most likely originated in the LV, followed by RV deteriorations and development of heart failure. In conclusion, our study demonstrated that the biophysical action of miR1 is essential to cardiac homeostasis. Additionally, our new imaging methodology enables more clinically comparable analyses which significantly improve translational implications of mouse cardiac research.

Abstract 12139: Left Ventricular Myocardial Work in Patients With Chagas Disease From a Quaternary Hospital in Brazil

Background: Left ventricular (LV) function assessment in patients (pts) with Chagas disease (ChD) is challenging. LV ejection fraction (LVEF) as a marker of myocardial contractility in these pts has issues, and alterations in myocardial deformation (MD) may occur in early stages of cardiac disease (CD) before the decline of LVEF. LV global longitudinal strain (GLS) is a good parameter to evaluate LV MD, but is dependent on afterload. LV myocardial work (MW) is a technique which integrates afterload to the calculation of GLS Purpose: To analyze LV function using MW in pts with ChD Methods: 39 pts with positive serology for ChD, (74,4% women, age 68,8 ± 9,7) followed in a quaternary Brazilian hospital, were divided in groups of stages of CD: G1 - normal Echocardiography (Echo) and ECG, G2 - alterations in ECG a/o Echo, normal LVEF, G3 - reduced LVEF. LV MW was measured integrating GLS with non-invasive blood pressure as an afterload index, for generation of pressure-strain loops by specific software(fig.1). Global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were measured. Results: 11 pts (28,2%) were in G1, 14 (35,9%) in G2, and 14 (35,9%) in G3. In overall population median values of MW were within normal ranges: GWI = 1760mmHg% (>968), GCW = 2046mmHg% (>1550), GWW= 178mmHg% (<331), GWE = 92 (>83). Values of GWI, GCW and GWE were significantly lower and GWW was higher in G3, compared to G1 and G2, translating into less LV mechanical efficiency (ME) in these pts with more advanced CD (table 1). Despite LVEF and GLS similar between G1 and G2, values of GCW were 12% lower in G2 compared to G1, which could point to a tendency of early alterations in these pts, although not reaching statistical significance (p > 0,05). Conclusion: In pts with advanced stages with Chagas CD (G3) there were significant alterations in parameters that evaluate ME, with reduced values of GWI, GCW and GWE, with higher GWW

Clinical comparison of a handheld cardiac ultrasound device for the assessment of left ventricular function.

Recently developed handheld ultrasound devices (HHUD) represent a promising method to evaluate the cardiovascular abnormalities at the point of care. However, this technology has not been rigorously evaluated. The aim of this study was to explore the correlation and the agreement between the LVEF (Left Ventricular Ejection Fraction) visually assessed by a moderately experienced sonographer using an HHUD compared to the routine LVEF assessment performed at the Echocardiography Laboratory. This was a prospective single center study which enrolled 120 adult inpatients and outpatients referred for a comprehensive Echocardiography (EC). The mean age of the patients was 69.9 ± 12.5 years. There were 47 females (39.2%). The R-squared was r 0.94 (p < 0.0001) and the ICC was 0.93 (IC 95% 0.91-0.95, p ≤ 0.0001). The Bland-Altman plot showed limits of agreement (LOA): Upper LOA 10.61 and Lower LOA - 8.95. The overall agreement on the LVEF assessment when it was stratified as "normal" or "reduced" was 89.1%, with a kappa of 0.77 (p < 0.0001). When the LVEF was classified as "normal", "mildly reduced", "moderately reduced", or "severely reduced," the kappa was 0.77 (p < 0.0001). The kappa between the HHUD EC and the comprehensive EC for the detection of RWMAs in the territories supplied by the LAD, LCX and RCA was 0.85, 0.73 and 0.85, respectively. With current HHUD, an averagely experienced operator can accurately bedside visual estimate the LVEF. This may facilitate the incorporation of this technology in daily clinical practice improving the management of patients.

Assessment of left ventricular function in subjects with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is the world's third leading cause of death, posing a significant public health challenge. Heart failure is an important milestone in the natural history of this disease's ever-decreasing course. Cor pulmonale alone is sometimes insufficient to explain the scenario, as many heart failures are refractory even after standard treatment. A possible explanation is involvement of the left ventricle (LV). However, there is currently no consensus on a therapeutic approach to LV dysfunction in COPD. Some previous studies were conducted on COPD patients regardless of the presence or absence of other factors influencing LV function. This study attempted to rule out all known confounding factors/co-morbidities that influence LV function. We discovered that LV diastolic dysfunction was common in subjects at all stages of COPD. We believe that all COPD patients, regardless of stage, should have screening echocardiography.

Assessment of Right and Left Ventricular Functions in Patient with Type I Diabetes Mellitus: Strain Imaging Study

Assessment of Right and Left Ventricular Functions in Patient with Type I Diabetes Mellitus: Strain Imaging Study

Assessment of left ventricular function in patients with type 2 diabetes mellitus by non-invasive myocardial work.

Diabetes mellitus (DM) is a chronic disease that poses a serious risk of cardiovascular diseases. Therefore, early detection of impaired cardiac function with non-invasive myocardial imaging is critical for improving the prognosis of patients with DM. This study aimed to assess the left ventricular (LV) function in patients with type 2 diabetes mellitus (T2DM) by non-invasive myocardial work technique. In all, 67 patients with T2DM and 28 healthy controls were included and divided into a DM group and a control group. Two-dimensional dynamic images of apical three-chamber view, apical two-chamber view, and apical four-chamber view were collected from all subjects, consisting of at least three cardiac cycles. LV myocardial strain parameters, including global longitudinal strain (GLS) and peak strain dispersion (PSD), as well as myocardial work parameters, including global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE), were obtained and analyzed. A total of 15 subjects were randomly selected to assess intra-observer and inter-observer consistency of myocardial work parameters and strain parameters, which showed excellent results (intra-class correlation coefficients: 0.856 - 0.983, P<0.001). Compared with the control group, the DM group showed significantly higher PSD (37.59 ± 17.18 ms vs. 27.72 ± 13.52 ms, P<0.05) and GWW (63.98 ± 43.63 mmHg% vs. 39.28 ± 25.67 mmHg%, P<0.05), and lower GWE (96.38 ± 2.02% vs. 97.72 ± 0.98%, P<0.001). Furthermore, the PSD was positively correlated with GWW (r = 0.565, P<0.001) and negatively correlated with GWE (r = -0.569, P<0.001). Uncoordinated LV myocardial strain, higher GWW, and lower GWE in patients with T2DM may serve as indicators for the early assessment of cardiac impairment in T2DM.

Comparison of two echocardiography-based methods for evaluating pediatric left ventricular diastolic dysfunction.

To investigate the consistency between the 2016 America Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guideline-based recommendations and the body surface area (BSA)-transformed Z value-based cut-off for the assessment of left ventricular diastolic function (LVDF) in children. Clinical data of children with heart failure (HF) and those with a high risk of HF and a low risk of HF were collected from the Children's Hospital of Chongqing Medical University between March 2021 and October 2022. The mitral annular e' velocity, lateral E/e' ratio, left atrial volume index, and peak tricuspid regurgitation velocity were detected by Echocardiography. The cut-off values recommended by the 2016 ASE/EACVI guidelines and the cut-off value based on the BSA-transformed Z value were used to evaluate LVDF. The consistencies and differences of the two criteria were compared. A total of 132 children with HF, 189 with a high risk of HF, and 231 with a low risk of HF, were enrolled. The consistency of the two criteria in evaluating LVDF in children with HF and with high risk of HF was moderate, with weighted kappa coefficients of 0.566 and 0.468, respectively (P < 0.001). The positivity rate of left ventricular diastolic dysfunction (LVDD) with Z value-based criteria (HF group, 23.5%; high-risk group, 8.5%) was higher than that with guideline-based criteria (HF group, 15.6%; high-risk group, 3.2%). In children with a low risk of HF, no case with LVDD was found. The consistency between the two criteria for grading the degree of LVDD was moderate, with a kappa coefficient of 0.522 (P = 0.001). The degree of LVDD according to the Z value-based criteria was higher than that of the guideline-based criteria (P = 0.004). The Z value-based criteria used to evaluate LVDD in children with HF and high risk of HF may be more conducive to the early identification of LVDD, thereby permitting the possibility of early treatment intervention.

Assessment of Left Ventricular Function Using Two- And Three-Dimensional Speckle Tracking Echocardiography among Healthy Egyptian Pediatric-Aged Children

Abstract Background Accurate measurements of left ventricular volumes and function are important in the management of patients with various cardiac abnormalities. Speckle tracking echocardiography has shown to be accurate in detecting subclinical myocardial dysfunction when most of the conventional echocardiograph parameters were normal or reported inconsistent results Aim of the Study To establish normal values for the LV systolic function among healthy Egyptian pediatric population using 2D and 3D speckle tracking Echocardiography. Patients and Methods the study included 200 subjects who attended cardiology department Ain Shams University for elective echocardiology below 6 years of age with unremarkable history and no chronic illness affecting LV function with normal 2D echocardiography. Results The study involved 200 subjects with age ranged from 0.1 to 5.9 years and its mean was 3.8±1.5 years. 104 were males representing 52% of subjects of the study while females were 96 representing 48%. Their weight ranged from 3.5 to 28 Kg and its mean was 17.14±4.9 Kg. Their height ranged from 0.11 to 1.24 M and its mean was 1.012±0.178 M. Body surface area ranged from 0.22 to 1.1 Kg/m2 and its mean was 0.695±0.151 Kg/m2. Regarding the 2D speckle tracking parameters: longitudinal strain ranged from -18.6% to -24.6% with its mean was -21.314±1.57%. Circumferential strain was from -16.7% to 23.4% and its mean -19.02±1.23%. And radial strain ranged from 36.4% to 52.6% with mean 42.392±2.794%. Regarding the 3D speckle tracking data: longitudinal strain ranged from -17% to -30% with its mean was -20.73±2.039%. Circumferential strain was from -11% to -21% with its mean -13.259±4.670%. And radial strain ranged from 41% to 61% with its mean 47.511±4.82%.

Echocardiography Assessment of Left Ventricular Function in Extremely Preterm Infants, Born at Less Than 28 Weeks’ Gestation, With Bronchopulmonary Dysplasia and Systemic Hypertension

The survival of smaller and more immature premature infants has been associated with lifelong cardiorespiratory comorbidities. Infants with bronchopulmonary dysplasia (BPD) undergo routine screening echocardiography to evaluate for development of chronic pulmonary hypertension, a late manifestation of pulmonary vascular disease. Our aim was to evaluate left ventricular (LV) performance in infants with BPD and pulmonary vascular disease who developed systemic hypertension. We hypothesized that infants with hypertension were more likely to have impaired LV performance. We present a single-center cross-sectional study of premature infants born at less than 28 0/7weeks'gestational age with a clinical diagnosis of BPD. Infants were categorized by the systolic arterial pressure (SAP) at time of echocardiography as hypertensive (SAP ≥90mm Hg) or normotensive (SAP <90mm Hg). Sixty-four patients were included. Infants with hypertension showed altered LV diastolic function with prolonged tissue Doppler imaging-derived isovolumic relaxation time (54.2±5.1 vs 42.9±8.2, P<.001), lower E:A, and higher E:e'. Indices of left heart volume/pressure loading (left atrium:aorta and LV end-diastolic volume [6.1±2 vs 4.2±1.2, P<.001]) were also higher in the hypertensive group. Finally, infants in the hypertensive group had higher pulmonary vascular resistance index (4.42±1.1 vs 3.69±0.8, P=.004). We conclude that extremely preterm infants with BPD who develop systemic hypertension are at risk of abnormal LV diastolic dysfunction. Increased pulmonary vascular resistance index in the hypertensive group may relate to pulmonary venous hypertension secondary to LV dysfunction. This is an important consideration in this cohort when selecting the physiologically most appropriate treatment.

Accuracy of Rapid Cardiovascular Magnetic Resonance Assessment of Left Ventricular Function During Community Cancer Cardiotoxicity Surveillance (WF98213)

Accuracy of Rapid Cardiovascular Magnetic Resonance Assessment of Left Ventricular Function During Community Cancer Cardiotoxicity Surveillance (WF98213)

The assessment of left ventricular volume and function in gated small animal 18F-FDG PET/CT imaging: a comparative study of three commercially available software tools

BackgroundSeveral software tools have been developed for gated PET imaging that use distinct algorithms to analyze tracer uptake, myocardial perfusion, and left ventricle volumes and function. Studies suggest that different software tools cannot be used interchangeably in humans. In this study, we sought to compare the left ventricular parameters in gated 18F-FDG PET/CT imaging in mice by three commercially available software tools: PMOD, MIM, and QGS.Methods and resultsHealthy mice underwent ECG-gated 18F-FDG imaging using a small-animal nanoPET/CT (Mediso) under isoflurane narcosis. Reconstructed gates PET images were subsequently analyzed in three different software tools, and cardiac volume and function (end-diastolic (EDV), end-systolic volumes (ESV), stroke volume (SV), and ejection fraction (EF)) were evaluated. While cardiac volumes correlated well between PMOD, MIM, and QGS, the left ventricular parameters and cardiac function differed in agreement using Bland–Altman analysis. EDV in PMOD vs. QGS: r = 0.85; p < 0.001, MIM vs. QGS: r = 0.92; p < 0.001, and MIM vs. PMOD: r = 0.88; p < 0.001, showed good correlations. Correlation was also found in ESV: PMOD vs. QGS: r = 0.48; p = 0.07, MIM vs QGS: r = 0.79; p < 0.001, and MIM vs. PMOD: r = 0.69; p < 0.01. SV showed good correlations in: PMOD vs. QGS: r = 0.73; p < 0.01, MIM vs. QGS: r = 0.86; p < 0.001, and MIM vs. PMOD: r = 0.92; p < 0.001. However, EF among correlated poorly: PMOD vs. QGS: r = −0.31; p = 0.26, MIM vs. QGS: r = 0.48; p = 0.07, and MIM vs. PMOD: r = 0.23; p = 0.41. Inter-class and intra-class correlation coefficient were > 0.9 underlining repeatability in using PMOD, MIM, and QGS for cardiac volume and function assessment.ConclusionsAll three commercially available software tools are feasible in small animal cardiac volume assessment in gated 18F-FDG PET/CT imaging. However, due to software-related differences in agreement analysis for cardiac volumes and function, PMOD, MIM, and QGS cannot be used interchangeably in murine research.

Role of collateral circulation in the recovery of left ventricular function after recanalization of chronic coronary total occlusion

Aim. To obtain extended data on the impact of collateral circulation on the recovery of left ventricular (LV) function after recanalization of chronic coronary total occlusion (CTO), especially in patients with reduced left ventricle ejection fraction (LVEF).Material and methods. This single-center, prospective, non-randomized study included 20 patients with single-vessel CTO with reduced LVEF (&lt;50%), confirmed by magnetic resonance imaging (MRI), who underwent successful recanalization. All patients were divided into 2 groups depending on the severity of collateral circulation. After 1, 3 and 6 months, MRI was repeated to assess LV function recovery.Results. All patients had prior myocardial infarction, while in 70% of cases — in the area of the occluded artery. A previous attempt to recanalize CTO was noted in 30%. The mean baseline LVEF according to echocardiography was 38,80±6,72%. The most common target vessel was the right coronary artery (n=17, 85%), followed by the circumflex and anterior descending arteries — 1 (5%) and 2 (10%) patients, respectively. In the group with high collateral circulation, the initial LVEF according to MRI was higher compared to the group with mild collateral circulation (35,8±7,33% vs 30,7±8,82%, p=0,17). After 6 months, MRI showed significant changes in end-diastolic volume (from 226±71,1 ml to 203±55,2 ml) and LV endsystolic volume (from 153±72,8 ml to 118±57,6 ml), as well as mean increase in LVEF by 3,3%, 4,8% and 5,2% at 1, 3 and 6 months, respectively (p=0,01 compared with baseline). The predictors of LVEF recovery in multivariate regression analysis were the initial LVEF according to MRI, and the filling rate of distal CTO bed on coronary angiography (R2=0,63).Conclusion. Successful percutaneous coronary intervention with CTO improves LV function in patients with ischemic cardiomyopathy, regardless of the degree of collateral circulation. LV function recovery generally occurs within 3 months after revascularization.

Remodeling and diastolic dysfunction of the left ventricle in patients with arterial hypertension and polymorphism rs5918 of the &lt;i&gt;ITGB3&lt;/i&gt; gene: cross-sectional study

OBJECTIVE: To identify diastolic myocardial function features in late postmenopausal women with polymorphic variants of the integrin beta-3 (ITGB3) gene and arterial hypertension.&#x0D; MATERIALS AND METHODS: This cross-sectional study enrolled 97 postmenopausal women, with a median age of 67 (6570) years. The duration of menopause was 18 (1621) years. Molecular genetic studies to assess ITGB3 (rs5918) T1565C polymorphism were performed. The study participants with the homozygous TT ITGB3 polymorphic variant comprised group 1, whereas group 2 included patients with the C allele (TC and CC genotypes). All patients underwent standard transthoracic echocardiography and assessment of left ventricular (LV) diastolic function by transmitral flow. LV diastolic dysfunction was classified into rigid, pseudonormal, and restrictive.&#x0D; RESULTS: Homozygous allelic variant TT was detected in 65 (67%) patients, heterozygous TC in 29 (30%), and homozygous polymorphic variant CC in 3 (3%). LVDD occurred in all patients included in the study. Among patients with the TT allelic variant of ITGB3, rigid LVDD was diagnosed in 34 (52%), and its pseudo-normal variant was detected in 31 (48%). Among TC and CC genotypes of C allele carriers, a pseudo-normal variant of LVDD (p 0.01), which occurred in 20 (62%) patients, was statistically significantly more frequently recorded, and 12 (38%) patients had a rigid type of LVDD. In addition, a rigid type LVDD was not detected in any case. Calcification of the mitral and aortic valve leaflets was detected in 24 (37%) cases in group 1 and in 9 (28%) patients in group 2 (p=0.68). In fibrous rings, calcifications were found in 34 (52%) patients in group 1 and 16 (50%) in group 2 (p=0.31), and the differences were not statistically significant.&#x0D; CONCLUSION: This study presents a significant contribution of the rs5918 polymorphism of ITGB3 in the development of myocardial remodeling and LVDD in postmenopausal women.

Characterizing stenosis severity of coronary heart disease by myocardial work measurement in patients with preserved ejection fraction.

The novel echocardiographic parameter of myocardial work incorporates left ventricular pressure into the assessment of left ventricular systolic function and thereby corrects for afterload. We sought to investigate the diagnostic value of myocardial work to identify different grades of stenosis severity in coronary heart disease (CHD) patients with preserved left ventricular ejection fraction and without regional wall motion abnormalities. One hundred and seventeen consecutive subjects with preserved ejection fraction referred for coronary angiography were randomized and prospectively included in this study. Forty-six in the control group, and 25, 24, and 22 in each of the grade-1, grade-2, and grade-3 CHD groups as classified by the Gensini score. The following indices of myocardial work were assessed with a Vivid E95 Version 203 instrument: global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE). Both GWI (P<0.001) and GCW (P<0.001) decreased significantly in CHD grade-1, increased slightly in CHD grade-2 compared with CHD grade-1, and decreased significantly in CHD grade-3. GWW (P<0.001) increased significantly from CHD grade-1 to CHD grade-3, while GWE (P<0.001) decreased significantly from CHD grade-1 to CHD grade-3. Receiver operating characteristic curves analysis revealed good discrimination between the control group and CHD grade-3 for GWI [area under the curve (AUC): 0.810; 95% confidence interval (CI): 0.691-0.930], GCW (AUC: 0.758; 95% CI: 0.631-0.885), GWW (AUC: 0.754; 95% CI: 0.624-0.885) and GWE (AUC: 0.817; 95% CI: 0.709-0.926). The assessment of intraobserver and interobserver variability in the MW echocardiographic data documented good interclass correlation coefficients (all >0.85). Myocardial work incorporates left ventricular pressure into the assessment of left ventricular systolic function and thereby corrects for afterload. It identifies patients with incipient left ventricular dysfunction caused by chronic ischemia due to CHD. A gradual worsening of myocardial work parameters was observed when comparing patients with higher degrees of stenosis severity. Therefore, adding myocardial work when evaluating patients with suspected CHD may help increase diagnostic accuracy.