Evaluation Of Cardiac Function Research Articles

The study on estimation of physical activity and evaluation of cardiac function in pulmonary rehabilitation

The study on estimation of physical activity and evaluation of cardiac function in pulmonary rehabilitation

400 Relationship between Cardiac Iron and Altered Myocardial Substrate in Patients With Chronic Kidney Disease – Non-Invasive Assessment With CMR.

Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular complications, and dialysis patients often receive iron supplementation. Cardiac magnetic resonance (CMR) allows evaluation of cardiac function, fibrosis and iron deposition. We used CMR to explore mechanistic links between cardiac iron and abnormal myocardial substrate in patients with CKD. Cardiac function and morphology, tissue characterisation and iron deposition were compared in 24 healthy controls,10 patients with CKD stage 3-5, and 30 patients dialysed for >1 year. There were no between group differences in left ventricular (LV) ejection fraction (65±5 v 62±7 v 61±10%, p=0.908), end diastolic volume (84±16 v 69±13 v 76±22 ml/m2, p=0.532) or left atrial size (21±5 v 22±4 v 23±7m2, p=0.473). LV mass (58±13 v 66±9 v 76±27 g/m2, p=0.005) and global longitudinal strain (-22±3 v -20±4 v -14±4%, p<0.001) were abnormal in the dialysis group, but not the CKD group. Native T1 and T2 times were increased in both CKD and dialysis patients (ShMOLLI 1127±43 v 1189±37 v 1223±61ms, p<0.001; and T2 FLASH 35±2 v42±4 v 39±2ms, p<0.001). No group had significant iron deposition by T2-star. Despite no significant myocardial iron deposition, CMR detects abnormal myocardial structure and function across the spectrum of CKD, with abnormal global longitudinal strain seen only in dialysis patients. CMR may aid in identifying CKD patients at higher risk of adverse cardiac outcomes.

P284 Patients with reduced systolic function benefit most from recanalisation of chronic total occlusion

Abstract Background Percutaneous coronary intervention of chronic total coronary occlusion (PCI of CTO) is proved to reduce symptoms of angina and long term survival. Purpose This study aimed to assess systolic and diastolic left ventricular function with standard echocardiographic indices. Methods We analyzed total of 46 CTO patients (age 58 ± 9, 73% male). Measures were obtained with the transducer in the apical four-chamber view. Doppler time intervals were measured from mitral inflow and left ventricular outflow Doppler tracings by pulsed wave Doppler. The isovolumetric relaxation time (IVRT) was measured from closure of the aortic valve to opening of the mitral valve. The isovolumetric contraction time (IVCT) was measured from closure of the mitral valve to opening of the aortic valve. Ejection time (ET) was measured from the opening to the closure of the aortic valve on the LV outflow velocity profile. Myocardial performance index (MPI) is simple method for evaluation of overall cardiac function and is independent of heart rate and blood pressure. MPI was equal to the sum of the IVRT and IVCT divided by the ET. Velocity of early mitral filling wave (E) was measured and divided by average peak early diastolic annular velocity (e") which was measured as average value between septal and lateral side of the mitral annulus using Doppler tissue imaging. The E/e’ ratio was calculated to estimate the LV filling pressures Results Six months after PCI of CTO patients showed no change in ejection fraction (EF) (55.69 ± 8.56% vs. 54.83 ± 8.44%, p = 0.10). MPI was significantly decreased (0.676 ± 0.99 vs. 0.632 ± 0.96 p &amp;lt; 0.01), E/e" was significantly reduced, (13,10 ± 6.90 vs. 12.05 ± 5.1 p &amp;lt; 0.05), and when we analyzed only patients with baseline EF &amp;lt; 50% (n = 9) improvement of diastolic function (reduction of E/e") was even greater (22.53 ± 5.52 vs. 15.65 ± 4.8 p &amp;lt; 0.01). Conclusion PCI of CTO improves overall cardiac function, particularly diastolic function in patients with reduced ejection fraction.

Software for Post-Processing Analysis of Strain Curves: The D-Station.

ResumoFundamento O emprego de Speckle Tracking para estudo da função cardíaca tem grande aplicabilidade em diversos cenários. A expansão do uso deste método requer ferramentas que permitam a extração de dados relevantes das curvas de deformação cardíaca e que sejam adicionais aos parâmetros habitualmente utilizados.Objetivos O presente trabalho visa apresentar e validar um software de uso livre, denominado D-station, para análise das curvas de deformação cardíaca.Métodos A partir de arquivos raw data, o D-Station realiza a separação das fases do ciclo cardíaco, exibe simultaneamente curvas de Strain e Strain Rate de diferentes câmaras cardíacas. Para validação do software utilizamos o parâmetro Global Longitudinal Strain (GLS) avaliando-o: 1) Graficamente, a partir da comparação das Medidas emparelhadas de GLS no EchoPAC e D-Station frente à linha de igualdade; 2) pelo Coeficiente de Correlação dessas medidas; 3) pelo Teste de Hipóteses (p > 0,05); e 4) pelo Método Gráfico de Bland-Altman.Resultados O Coeficiente rho de Spearman apontou forte correlação entre as medidas, o Teste de Hipóteses retornou um p-value = 0.6798 >> 0,05, que também indicou a equivalência entre elas; o Método gráfico de Bland-Altman mostrou um viés ≤ 1% e dispersão ≤ 2% entre as medidas. Os testes mostraram que para valores de GLS inferiores à 10% há a tendência de aumento das diferenças percentuais, mas seus valores absolutos ainda são baixos.Conclusão O D-Station foi validado como uma aplicação suplementar ao EchoPAC que utiliza o raw data das curvas de Strain e Strain Rate obtidos por software proprietário. (Arq Bras Cardiol. 2020; 114(3):496-506)

P1542 Reference values for multilayer longitudinal strain in children: preliminary findings from healthy individuals

Abstract BACKGROUND Strain echocardiography is a reliable echocardiographic modality to measure myocardial mechanical deformation and evaluate regional and global myocardial systolic function, and has been demonstrated to be a useful tool for the evaluation of cardiac function in children with acquired and congenital heart diseases. Recent advancements in echocardiographic technology allow to analyze myocardial strain in multiple layers. To our knowledge, there are no published reference values for echocardiographic multilayer-specific strain measurement. AIM OF THE STUDY Aim of our study was to establish normal reference values for left ventricular (LV) and right ventricular (RV) longitudinal strain (LS) in a wide population of Italian children and to provide normal reference values of layer-specific LS in a healthy pediatric population. METHODS AND RESULT At present we have analyzed data from two-hundred (target: n = 500) healthy, consecutive subjects (age &amp;lt;18 years, mean age 7.5 ± 4yrs; range from 1 month to 17,5 years). All subjects underwent a clinical cardiological evaluation including ECG and physical examination. Subsequently, a complete echo Doppler examination including LS evaluation using speckle-tracking echocardiography was performed. Individuals were excluded if any significant abnormality was found at echocardiography (e.g. valvular regurgitation more than trivial, any structural abnormalities including small ASDs or VSDs; patients with isolated PFO were included). Subendocardial, midwall, subepicardial LS, and strain gradient (LSsubepi - LSsubendo) were also determined. LS% analysis was considered acceptable if missing data were present in no more than one segment per echocardiographic view, according to current consensus. Echocardiographic yield for LS analysis was 98.5 % for 4-chamber views, 82.5% for 2-chamber views and 84.5% for 3-chamber views. Accordingly Global Longitudinal Strain (GLS) was available overall in 82% of the population analyzed so far (n= 164 children) on all layers, with a total of 8,872 echocardiographic available segments analyzed. Normal distribution was found for global subendocardial, midwall and subepicardial LS. As displayed in figure 1 (panels A-B-C), means ± SD were -20.8 ± 1.9% for LSsubendo, -19.2 ± 1.8% for LSsubepi and -19.9 ± 1.8% for LSmidwall. Accordingly higher value (95ile) for normal LS were -17.9%, -16.4% and -17.1% for LSsubepi, LSsubendo and LSmidwall, respectively. A significant subepicardial to subendocardial gradient was found in all children with higher absolute values found at the endocardial level, with a mean difference of 1.6 ± 0.9% (Panel D). CONCLUSIONS We provide preliminary data on 200 children to establish normal reference values for echocardiographic multilayer-specific strain measurement in a wide population of healthy italian children. Abstract P1542 Figure.

Application of strain echocardiography in valvular heart diseases.

Echocardiographic strain imaging allows new insight into a complex cardiac mechanics and enables more precise evaluation of cardiac function. Hence, it has been shown to have clinical utility in a variety of valvular heart diseases. In particular, global longitudinal strain has been shown to be more sensitive to detect systolic dysfunction than left ventricular ejection fraction. In patients with valvular heart diseases, it provides both diagnostic and prognostic information in addition to standard echocardiographic and clinical parameters. In this review, we summarize current clinical application of strain echocardiography in patients with valvular heart diseases and discuss pathophysiological mechanisms that lead to respective findings in specific diseases.

Echocardiographic evaluation of cardiac function in cynomolgus monkeys over a wide age range.

Various cardiovascular diseases can be detected and diagnosed using echocardiography. The demand for cardiovascular system research using nonhuman primates is increasing, but echocardiographic references for nonhuman primates are limited. This report describes the first comparison of echocardiographic reference values in 247 normal cynomolgus monkeys (135 females, 112 males) over a wide age range. Echocardiography, electrocardiography, blood pressure and chest X-ray images were acquired under immobilization with intramuscular ketamine hydrochloride, then cardiac structure, function, and flow velocity were assessed. Cardiac hormone levels were also tested. We found that cardiac structures positively correlated with weight, that the size of these structures stabilized after reaching maturity and that cardiac output increased according to heart size. In contrast, fractional shortening of the left ventricle, ejection fraction and flow velocity showed no significant correlations with weight or age, and age and E wave correlated negatively. These findings appear sufficiently similar to those in humans to suggest that cynomolgus monkeys can serve as a suitable model of human cardiac disease. Our data should also prove useful for surveying cardiac dysfunction in monkeys.

P662 Synchrony between the right and left heart systems is recovered after TAVI in patients with severe aortic stenosis

Abstract Funding Acknowledgements Young Investigator Grant of Japanese Society of Cardiovascular Anesthesia Background / Introduction Evidences have shown that cardiac function decline and systolic phase change are caused by massive afterload of the stenosed aortic valve in patients with severe aortic valve stenosis. As a result of the reduction of the left ventricular afterload by valve replacement, the cardiac function recovers. However, it has not been clarified yet how the changes in cardiac function affect the relationship between the right and left heart systems, as well as the systole phase. TAPSE and MAPSE are known as indices of simple cardiac function evaluation by measuring the movement distance of the atrioventricular annulus. We obtained these indices (i.e. TAPSE, MAPSE) within the same heartbeat using speckle tracking analysis of the atrioventricular annulus and evaluated the changes in cardiac function and phase between the right and left heart systems. Purpose To reveal the relationship of cardiac function and time phase between the right and left heart systems by evaluating the maximum movement distance and time of the atrioventricular annulus within the same heartbeat and the same view in patients with severe aortic valve stenosis before and after TAVI. Methods A prospective cohort study was conducted. We recruited and analyzed 44 patients with severe aortic valve stenosis who received TAVI treatment, able to record baseline before treatment and follow-up 6 months and 12 months after treatment at our hospital from March 2017 to May 2019. Patients were excluded if more than 2 degree of atrioventricular valve regurgitation or incomplete data. The apical four-chamber view was used for speckle tracking analysis with the origin of the apical extension and region of interest (ROI) of the mitral annulus and tricuspid annulus. For each patient before treatment, at 6 months and 12 months after treatment, the maximum contraction distance (DM), maximum contraction time (TM) of the mitral valve annulus, maximum contraction distance (DT) and maximum contraction time (TT) of the tricuspid annulus were measured. Maximum contraction distance ratio (DM/ DT) and maximum contraction time ratio (TM/ TT) were calculated. For statistical analysis, t-test and ANOVA were used, and a significance threshold of p &amp;lt;0.05 was applied. Results TM/ TT decreased at 12 months after TAVI, and DM/ DT increased significantly at 6 months and 12 months after TAVI when compared to baseline before treatment. Conclusions In patients with severe aortic valve stenosis, the correction of cardiac function difference between the right and left heart systems occurs from 6 months after TAVI. Moreover, the correction of contraction phase difference between the right and left heart systems at 12 months after TAVI. Thus, the synchrony between the right and left heart system is recovered 12 months after TAVI. Abstract P662 Figure.

AIUM Practice Parameter for the Performance of Fetal Echocardiography.

AIUM Practice Parameter for the Performance of Fetal Echocardiography.

Machine learning based quantification of ejection and filling parameters by fully automated dynamic measurement of left ventricular volumes from cardiac magnetic resonance images

BackgroundAlthough analysis of cardiac magnetic resonance (CMR) images provides accurate and reproducible measurements of left ventricular (LV) volumes, these measurements are usually not performed throughout the cardiac cycle because of lack of tools that would allow such analysis within a reasonable timeframe. A fully-automated machine-learning (ML) algorithm was recently developed to automatically generate LV volume-time curves. Our aim was to validate ejection and filling parameters calculated from these curves using conventional analysis as a reference. MethodsWe studied 21 patients undergoing clinical CMR examinations. LV volume-time curves were obtained using the ML-based algorithm (Neosoft), and independently using slice-by-slice, frame-by-frame manual tracing of the endocardial boundaries. Ejection and filling parameters derived from these curves were compared between the two techniques. For each parameter, Bland-Altman bias and limits of agreement (LOA) were expressed in percent of the mean measured value. ResultsTime-volume curves were generated using the automated ML analysis within 2.5 ± 0.5 min, considerably faster than the manual analysis (43 ± 14 min per patient, including ~10 slices with 25–32 frames per slice). Time-volume curves were similar between the two techniques in magnitude and shape. Size and function parameters extracted from these curves showed no significant inter-technique differences, reflected by high correlations, small biases (<10%) and mostly reasonably narrow LOA. ConclusionML software for dynamic LV volume measurement allows fast and accurate, fully automated analysis of ejection and filling parameters, compared to manual tracing based analysis. The ability to quickly evaluate time-volume curves is important for a more comprehensive evaluation of the patient's cardiac function.

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology.

Acute heart failure is one of the main diagnostic and therapeutic challenges in clinical practice due to a non-specific clinical manifestation and the urgent need for timely and tailored management at the same time. In this position statement, the Heart Failure Association aims to systematize the use of various imaging methods in accordance with the timeline of acute heart failure care proposed in the recent guidelines of the European Society of Cardiology. During the first hours of admission the point-of-care focused cardiac and lung ultrasound examination is an invaluable tool for rapid differential diagnosis of acute dyspnoea, which is highly feasible and relatively easy to learn. Several portable and stationary imaging modalities are being increasingly used for the evaluation of cardiac structure and function, haemodynamic and volume status, precipitating myocardial ischaemia or valvular abnormalities, and systemic and pulmonary congestion. This paper emphasizes the central role of the full echocardiographic examination in the identification of heart failure aetiology, severity of cardiac dysfunction, indications for specific heart failure therapy, and risk stratification. Correct evaluation of cardiac filling pressures and accurate prognostication may help to prevent unscheduled short-term readmission. Alternative advanced imaging modalities should be considered to assist patient management in the pre- and post-discharge phase, including cardiac magnetic resonance, computed tomography, nuclear studies, and coronary angiography. The Heart Failure Association addresses this paper to the wide spectrum of acute care and heart failure specialists, highlighting the value of all available imaging techniques at specific stages and in common clinical scenarios of acute heart failure.

Rapid Ultrasound Evaluations of Neonatal Cardiac Function by Transport Clinicians.

Rapid Ultrasound Evaluations of Neonatal Cardiac Function by Transport Clinicians.

Quantitative Clinical Cardiac Magnetic Resonance Imaging.

Cardiac magnetic resonance imaging (MRI) represents the established reference standard method for the assessment of cardiac function and non-invasive evaluation of myocardial tissue in a variety of clinical questions, wherein quantification of cardiac parameters gains growing diagnostic and differential-diagnostic importance. This review aims to summarize established and newly emerging quantitative parameters, which are assessed in routine cardiac MRI. Interrelations and interdependencies between metrics are explained, and common factors affecting quantitative results are discussed. The review is based on a PubMed literature research using the search terms "cardiac magnetic resonance" and "quantification", "recommendations", "quantitative evaluation/assessment", "reference method", "reference/normal values", "pitfalls" or "artifacts" published between 2000-2019. Quantitative functional, phase contrast, and perfusion imaging, as well as relaxation time mapping techniques give opportunity for assessment of a large number of quantitative cardiac MRI parameters in clinical routine. Application of these techniques allows for characterization of function, morphology and perfusion of the heart beyond visual analysis of images, either in primary evaluation and comparison to normal values or in patients' follow-up and treatment monitoring. However, with implementation of quantitative parameters in clinical routine, standardization is of particular importance as different acquisition and evaluation strategies and algorithms may substantially influence results, though not always immediately apparent. · Clinical cardiac MRI provides numerous functional and morphological quantitative parameters.. · Quantitative cardiac MRI enables assessment of diffuse and global myocardial alterations.. · Standardized data acquisition/evaluation is the prerequisite for diagnostic use of quantitative cardiac MRI parameters.. · Reiter U, Reiter C, Kräuter C et al. Quantitative Clinical Cardiac Magnetic Resonance Imaging. Fortschr Röntgenstr 2020; 192: 246 - 256.

Evaluation of Agonal Cardiac Function for Sudden Cardiac Death in Forensic Medicine with Postmortem Brain Natriuretic Peptide (BNP) and NT-proBNP: A Meta-analysis.

Sudden cardiac death (SCD) is an unexpected death caused by a sudden loss of cardiac function, which is currently a global public health problem. Evaluation of the agonal cardiac function of the deceased is a quite important task for the diagnosis of SCD in forensic medicine. Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are currently considered as significant biomarkers for the diagnosis of heart failure in both clinical and forensic practices. To investigate the postmortem evaluation roles of postmortem BNP and NT-proBNP levels for SCD, the present study meta-analyzed eight related studies from Embase, Cochrane Library, PubMed, China Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data. Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included literature, and the meta-analysis was performed by RevMan 5.3.5 software. Postmortem NT-proBNP in pericardial fluid showed higher levels in the SCD group than that of the non-SCD group with the weighted mean difference=3665.74, 95% confidence interval: 1812.89-5518.59, and p=0.0001. However, postmortem levels of BNP in pericardial fluid and NT-proBNP in serum revealed no statistical difference between SCD and non-SCD subjects. The results of present meta-analysis demonstrated that postmortem NT-proBNP in the pericardial fluid could be used as an ancillary indicator for evaluation of agonal cardiac function in forensic medicine.

Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta-Analysis.

BackgroundWomen with a history of preeclampsia are at increased risk of cardiovascular morbidity and mortality. However, the underlying mechanisms of disease association, and the ideal method of monitoring this high‐risk group, remains unclear. This review aims to determine whether women with a history of preeclampsia show clinical or subclinical cardiac changes when evaluated with an echocardiogram.Methods and ResultsA systematic search of MEDLINE, EMBASE, and CINAHL databases was performed to identify studies that examined cardiac function in women with a history of preeclampsia, in comparison with those with normotensive pregnancies. In the 27 included studies, we found no significant differences between preeclampsia and nonpreeclampsia women with regard to left ventricular ejection fraction, isovolumetric relaxation time, or deceleration time. Women with a history of preeclampsia demonstrated a higher left ventricular mass index and relative wall thickness with a mean difference of 4.25 g/m2 (95% CI, 2.08, 6.42) and 0.03 (95% CI, 0.01, 0.05), respectively. In comparison with the nonpreeclampsia population, they also demonstrated a lower E/A and a higher E/e′ ratio with a mean difference of −0.08 (95% CI, −0.15, −0.01) and 0.84 (95% CI, 0.41, 1.27), respectively.ConclusionsIn comparison with women who had a normotensive pregnancy, women with a history of preeclampsia demonstrated a trend toward altered cardiac structure and function. Further studies with larger sample sizes and consistent echocardiogram reporting with the use of sensitive preclinical markers are required to assess the role of echocardiography in monitoring this high‐risk population group.

Preoperative echocardiographic evaluation of cardiac systolic and diastolic function in liver transplant recipients with diabetes mellitus: a propensity-score matched analysis.

BackgroundDiabetes mellitus (DM) increases risk of heart failure. It has been shown that diabetes leads to DM-cardiomyopathy, characterized by systolic and diastolic dysfunction. Pre-transplant diastolic dysfunction, has been associated with poor graft outcome and mortality. We assessed the hypothesis that end-stage liver disease (ESLD) patients with diabetes (DM-ESLD), have more advanced cardiac systolic and diastolic dysfunction, compared to ESLD patients without diabetes (Non DM-ESLD).MethodsWe retrospectively evaluated preoperative echocardiography of 1,319 consecutive liver transplant recipients (1,007 Non DM-ESLD vs. 312 DM-ESLD [23.7%]) January 2012–May 2016. Systolic and diastolic indices, such as left ventricular ejection fraction, transmital E/A ratio, tissue doppler s’, e’ velocity, and E/e’ ratio (index of left ventricular end-diastolic pressure), were compared using 1:2 propensity-score matching.ResultsDM-ESLD patients showed no differences in systolic indices of left ventricular ejection fraction and s’ velocity, whereas diastolic indices of E/A ratio ≤ 1 (49.0% vs. 40.2% P = 0.014), e’ velocity (median = 7.0 vs. 7.4 cm/s, P < 0.001) and E/e’ ratio (10.9 ± 3.2 vs. 10.1 ± 3.0, P < 0.001), showed worse diastolic function compare with Non DM-ESLD patients, respectively.ConclusionsDM-ESLD patients suffer higher degree of diastolic dysfunction compared with Non DM-ESLD patients. Based on this, careful preoperative screening for diastolic dysfunction in DM-ESLD patients is encouraged, because poor transplant outcomes have been noted in patients with preoperative diastolic dysfunction.

Clinical indications for cardiovascular magnetic resonance

### Learning objectives Cardiovascular magnetic resonance (CMR) is a highly versatile non-invasive and non-ionising multi-parametric imaging technique. Within the multimodality imaging setting of current clinical practice, CMR provides relative strengths...

Liver disease and heart failure

Several systemic conditions, inflammatory disease, infections and alcoholism, may affect both the heart and the liver. Common conditions, such as the non-alcoholic fatty liver disease (NAFLD), may increase the risk of cardiac dysfunction. Patients with acute decompensated HF (ADHF) may develop acute ischemic hepatitis and, chronic HF patients may develop congestive hepatopathy (CH). Laboratory anomalies of hepatic function may predict the outcome of patients with advanced HF and the evaluation of both cardiac and hepatic function is very important in the management of these patients. In clinically apparent ischemic hepatitis more than 90% of patients have some right-sided HF. There are systemic disorders characterized by the accumulation of metals or by metabolism defects that may affect primarily the liver but also the heart leading to symptomatic hypertrophic cardiomyopathy (HCM). Abnormal LFTs indicate the mechanism of liver injury: liver congestion or liver ischemia. In AHF, it's important an adequate evaluation of heart and liver function in order to choose the treatment in order to ensure stable hemodynamic as well as optimal liver function. Measurements of LFTs should be recommended in the early phase of ADHF management. Physicians with interest in HF should be trained in the evaluation of LFTs. It's very important for cardiologists to know the systemic diseases affecting both heart and liver and the first imaging or laboratory findings useful for a diagnosis. it is very important for internists, nephrologists, cardiologists, primary physicians and any physicians with interest in treating HF to recognize such signs and symptoms belong to rare diseases and liver diseases that could be mistaken for HF.

Global Tracking of Myocardial Motion in Ultrasound Sequence Images: A Feasibility Study.

The assessment of myocardial motion plays a promising role in the evaluation of cardiac function. This study aims to propose a novel framework of global estimation of the myocardial motion using radio-frequency (RF) data. The framework consists of B-mode image reconstruction, displacement estimation, myocardium extraction, and image fusion. The RF data of murine heart in parasternal long-axis (PLAX) view were collected for B-mode image reconstruction and displacement estimation. The vectorized normalized cross-correlation (VNCC) approach was proposed to globally estimate the displacements of the RF frames, while a sum-table based normalized cross-correlation (STNCC) was performed as reference algorithm. The bimodal fusion images were obtained to visualize the motion and anatomical structure of myocardium by an improved fast mapping algorithm (IFMA). In comparison with STNCC, the computation time of displacement using VNCC reduced by approximate 10s. The myocardial motions of anterior wall and posterior wall during one cardiac cycle were similarly tracked by VNCC as that of STNCC. The averaged absolute error in displacement between the two methods ranges from 1 to 3μm. The obtained myocardial elastographic images using VNCC intuitively present the morphological and mechanical changes during the contraction period of left ventricle. The results demonstrate that the proposed framework is an efficient tool for the estimation of myocardial motion reflecting cardiac systolic function. This approach has potentials to provide visualized information of myocardium for diagnosis and prognosis of cardiovascular diseases (CVDs).

Synergistic effects of adipose-derived stem cells combined with decellularized myocardial matrix on the treatment of myocardial infarction in rats

AimsThe aims of the study are to investigate whether the combination of adipose-derived stem cells (ADSCs) with decellularized extracellular matrix (dECM) of myocardium can exert synergistic therapeutic effects on acute MI and the underlying mechanism. Main methodsMyocardial dECM from fresh porcine myocardium was prepared in an injectable gel, ADSCs were seeded into the myocardial dECM gels, and then the mixture was injected into the myocardium of the infarct border zone after acute MI, which was induced by ligating the left anterior descending coronary artery in male SD rats, to assess the therapeutic potential. The degree of fibrosis was detected by Masson's trichrome. The evaluation of cardiac function was performed by Electrocardiography. Key findingsMyocardial dECM (2.0%) had a suitable aperture and arrangement for cell growth, and also exhibited suitable biomechanical properties. Four-weeks after treatment in vivo, the combination of ADSCs and myocardial dECM could obviously increase angiogenesis, reduce the degree of fibrosis, and decrease infarct size. Furthermore, the combination treatment exerted significant functional improvement. Compared with ADSCs or dECM group alone, the left ventricular ejection fraction (LVEF) in the combination group was 13.4% and 21.8% elevated, respectively. SignificanceThe combination of ADSCs and myocardial dECM has synergistic effects on cardiac repair in acute MI.