Myocardial Oxygen Supply Research Articles

Myocardial injury and anaemia in patients undergoing surgery for fractured neck of femur: An observational study.

Myocardial injury and anaemia in patients undergoing surgery for fractured neck of femur: An observational study.

Clinical effect of BiPAP non-invasive ventilation on acute exacerbation of chronic obstructive pulmonary disease with acute left heart failure

Objective To observe the effect of BiPAP non-invasive assisted ventilation on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with acute left heart failure. Methods From January 2017 to December 2018, 100 AECOPD patients with acute left heart failure admitted to the Central Hospital of Yiwu were randomly divided into observation group and control group according to random number table method, with 50 cases in each group.The control group received routine treatment such as oxygen inhalation, anti-infection, spasmolysis and asthma relief, phlegm resolving, diuresis and cardiotonic therapy.The observation group used BiPAP non-invasive auxiliary ventilation therapy on the basis of routine treatment.The basic vital signs[heart rate(HR), systolic blood pressure(SBP), respiratory rate(RR)] and blood gas analysis[partial pressure of arterial oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), oxygen saturation(SaO2), pH value] before treatment and 48h after treatment were compared between the two groups.The levels of N-terminal pro-brain natriuretic peptide were observed and compared before treatment and 24h, 48h after treatment.The therapeutic effect of the two groups was compared. Results The basic vital signs(HR, SBP, RR) and blood gas analysis (PaO2, PaCO2, SaO2, pH value) of the two groups were improved after treatment, and the improvement degrees of the observation group were better than those of the control group(control group: HR t=12.352, P=0.000; RR t=7.872, P=0.000; SBP t=10.469, P=0.000; observation group: HR t=20.032, P=0.000; RR t=12.319, P=0.000; SBP t=13.911, P=0.000; intergroup comparison after treatment: HR t=6.711, P=0.000; RR t=3.742, P=0.000; SBP t=4.172, P=0.000; the control group: pH t=13.115, P=0.000, SaO2t=3.134, P=0.001; PaO2t=3.812, P=0.000; PaCO2t=5.335, P=0.000; the observation group: pH t=24.980, P=0.000; SaO2t=5.305, P=0.000; PaO2t=7.357, P=0.000; PaCO2t=10.172, P=0.000; intergroup comparison after treatment: pH t=7.394, P=0.000; SaO2t=2.851, P=0.002; PaO2t=3.467, P=0.000; PaCO2t=4.063, P=0.000). The N-terminal pro-brain natriuretic peptide in the observation group decreased significantly after 24 hours of treatment compared with the control group, but the difference was no statistically significant(t=0.996, P=0.161). The N-terminal pro-brain natriuretic peptide levels in the observation group were significantly lower than those in the control group at 48 and 72 hours after treatment(t=6.043, P=0.000; t=12.897, P=0.000). The effective rate in the observation group was 88.00%(44/50), which was higher than 72.00%(36/50) in the control group(χ2=4.000, P=0.046). Conclusion BiPAP noninvasive assisted ventilation can effectively relieve symptoms, lessen the work of respiratory muscles, reduce cardiac load, improve myocardial oxygen supply, improve cardiac function, improve patients' oxygenation, improve hypoxemia and hypercapnia, reduce mortality and improve prognosis of AECOPD patients complicated with acute left heart failure. Key words: Pulmonary disease, chronic obstructive; Ventilators, mechanical; Continuous positive airway pressure; Heart failure; Blood gas analysis; Natriuretic peptide, brain; Prognosis; Comparative effectiveness research

P3597Occurence of type 2 myocardial infarction in patients with coronary artery disease

Abstract Background Type 2 myocardial infarction (T2MI) is an emerging entity defined by a myocardial oxygen supply and demand mismatch, in the absence of coronary thrombosis. The prevalence of T2MI is high in patients admitted for an acute MI, but is unknown in patients with coronary artery disease (CAD). Purpose We aimed to address the comparative prevalence and characteristics of T2 and Type 1 MI in CAD patients. Patients We conducted a single-center retrospective study among 33 669 consecutive patients admitted from January 2014 to December 2016 in a university hospital emergency or intensive care unit (ICU). Patients admitted for acute MI, diagnosed by troponin elevation associated with symptoms or signs of myocardial ischemia (typical chest pain and/or ECG changes) and with history of CAD were included. They were systematically adjudicated as T1MI or T2MI according to 4th MI universal definition. Result Among the 619 patients included, 254 (41%) had T2MI and 365 (59%) had T1MI. T2MI patients were characterized by an older age (median age [IQR]: 82 [71–87] vs 72 [62–81] y, respectively, p<0.001) and more frequent comorbidities than T1MI patients. In contrast, T2MI patients had similar rates of cardioprotective chronic treatments than T1MI. Only 41% of T2MI patients admitted in ICU underwent a coronary angiography, of whom most (56%) had three-vessels disease. Percutaneous coronary intervention was much less performed in T2MI than in T1MI (28% vs 67%, respectively p<0.001). Median (IQR) time from first CAD diagnosis to index MI was similar for both groups (83 [27–151] months vs 94 [30–179] for T1MI, respectively p=0.22). In-hospital mortality were 2 fold higher in T2MI than in T1MI (15.0% vs 6.6%, respectively, p<0.001). Moreover, in the first year following CAD diagnosis, T2MI had similar rate of occurrence than T1MI (17% vs 14%, respectively p=0.389). Conclusion This large real-life study in CAD patients with a recurrence of MI highlights the high frequency of T2MI. Furthermore, almost 1 out of 5 patients had an acute MI, either T1 or T2MI, within the first year after CAD diagnosis. These findings may have implications for prevention and management strategies of T2MI. Acknowledgement/Funding University Hospital Center Dijon Bourgogne, Agence Régionale de Santé Bourgogne Franche Comté, France

Extracorporeal Life Support Enhances the Forward Pressure Wave to Cause a Mismatch between Cardiac Oxygen Demand and Supply

Extracorporeal life support (ECLS) is a world-famous life-saving method. Until now, changes in arterial wave properties due to ECLS have remained unexamined. In this study, we determined the effects of ECLS on arterial wave properties and ventricular/arterial coupling in male Wistar rats with the measured aortic pressure alone. Ascending aortic pressure signals were measured before ECLS and at 30, 60, and 90 min after weaned off. The aortic pressure signal then calculated by fourth-order derivative to obtain an assumed triangular flow wave. The ratio of mean systolic pressure to mean diastolic pressure (Pms/Pmd), a parameter for evaluating the matching condition between myocardial oxygen demand and supply, was significantly higher after ECLS. The magnitude of forward pressure (|Pf|) augmented by ECLS prevailed over the backward pressure (|Pb|), leading to a decline in wave reflection factor. Pms/Pmd was positively linearly correlated with |Pf| (Pms/Pmd = 0.9177 + 0.0078 × |Pf|, r = 0.8677; P < 0.0001). These findings suggest that |Pf| was a predominant factor responsible for the mismatch between the myocardial oxygen demand and supply in rats after ECLS phase of experiment.

Yohimbine Induced Type II Myocardial Injury: An Underrecognized and Dangerous Adverse Effect

Yohimbine is an Indoloquinolizidine alkaloid derived from the bark of the African tree Pausinystalia johimbe, as well as from the bark of the unrelated South American tree Aspidosperma quebracho-blanco. It is commonly sold as a dietary supplement for the purpose of enhancing libido, weight loss and natural bodybuilding aids. Yohimbine has high affinity for the α2-adrenergic receptor, moderate affinity for the α1 receptor, dopamine D2 receptor, and weak affinity for the dopamine D3 receptors and some of the serotonin receptors. Depending on dosage, Yohimbine can either increase or decrease systemic blood pressure (through vasoconstriction or vasodilation, respectively). We present a 51-year-old male who presented with substernal chest pressure and the sensation of a “pounding heart” after starting Yohimbine as a dietary supplement. He was found to have type II myocardial injury characterized by elevated troponin levels. We propose that the mechanism for this was 1) elevation of blood pressure and sinus tachycardia causing myocardial ischemia due to increased myocardial oxygen demand and supply mismatch, 2) cardiac norepinephrine release causing direct non-ischemic norepinephrine mediated myocardial injury and 3) increased sympathetic outflow mediated coronary vasoconstriction and spasm causing ischemia.

Intra-Aortic Balloon Pump for Patients with Cardiac Conditions: An Update on Available Techniques and Clinical Applications

In this paper, we present a review of the intra-aortic balloon pump, as well as the usage of it in the medical field today. An intra-aortic balloon pump (IABP) is a biomedical device that can assist the heart during unstable angina or after a heart attack. This pump is typically used in patients who suffer from ischemia of the heart tissue, due to an unbalanced level of myocardial oxygen supply or demand. Through counterpulsation, which is a technique to synchronize the external pumping of blood with the heart’s cycle, the device can balance the supply and demand of blood that is necessary for the heart to pump properly. The IABP is comprised of the following four components: a polyurethane balloon, a polyethylene or fiber-optic catheter, a transducer, and the intra-aortic balloon pump console. In the past, researchers have used other materials that have low biocompatibility and can cause complications within the body. This analysis will explain the complications and state changes that occurred due to them. Limitations of past designs and advantages of current designs will be acknowledged, for they can be used by researchers to enhance designs for the future. Consequently, the analysis of this device may lead to improved designs and treatment in the future for patients with cardiac conditions.

NADPH oxidase 4 and its role in the cardiovascular system.

The heart relies on complex mechanisms that provide adequate myocardial oxygen supply in order to maintain its contractile function. At the cellular level, oxygen undergoes one electron reduction to superoxide through the action of different types of oxidases (e.g. xanthine oxidases, uncoupled nitric oxide synthases, NADPH oxidases or NOX). Locally generated oxygen-derived reactive species (ROS) are involved in various signaling pathways including cardiac adaptation to different types of physiological and pathophysiological stresses (e.g. hypoxia or overload). The specific effects of ROS and their regulation by oxidases are dependent on the amount of ROS generated and their specific subcellular localization. The NOX family of NADPH oxidases is a main source of ROS in the heart. Seven distinct Nox isoforms (NOX1–NOX5 and DUOX1 and 2) have been identified, of which NOX1, 2, 4 and 5 have been characterized in the cardiovascular system. For the purposes of this review, we will focus on the effects of NADPH oxidase 4 (NOX4) in the heart.

Safety of Continuous Postextrasystolic Pacing in the Human

Continuous postextrasystolic pacing is a potential positive inotropic treatment for several depressed myocardial states. The safety of this pacing, however, has been questioned since the mid‐1960's because the pacing markedly raises the myocardial oxygen consumption, thereby increasing the potential for proarrhythmia. To understand the actual safety of continuous postextrasystolic pacing, six clinical studies and case reports were reviewed involving a wide range of cardiovascular maladies (atrial or ventricular septal defect, congestive cardiomyopathy, heart failure, mitral or pulmonary stenosis, mitral, tricuspid, or aortic regurgitation, patent ductus arteriosis, mitral valve prolapse, coronary arterial‐arteriosclerotic heart disease, and pulmonary arterial hypertension): Braunwald E., et al. Amer. J. Med. 37: 700–711, 1964. Meijler, F. L. and D. Durrer. Bull. N. Y. Acad. Med. 41: 575–591, 1965. Lister, J. W., et al. Am. Heart J. 73: 362–368, 1967. Resnekov, L. Med. Clin. N. Amer. 54: 247–259, 1970. Gerschwind, H., et al. J. Am. Coll. Cardiol. 4: 216–225, 1984. Freudenberger, R., et al. J. Cardiac Fail. 14: 35–40, 2008. Patients received paired or coupled atrial, ventricular, or dual‐chamber pacing. Continuous postextrasystolic pacing in 63 of 63 patients resulted in zero incidences of ventricular tachyarrhythmia induction, including in 7 with a compromised coronary circulation. Only when a seventh clinical study was reviewed, involving myocardial infarction‐associated cardiogenic shock, did any arrhythmia occur, and only in 1 of 5 cases: Gourgon, R., et al. Paired Pulse Stimulation of the Heart. Proceedings of the Second Conference on Paired Pulse Stimulation and Postextrasystolic Potentiation in the Heart. 1968. pp. 36–51. Hence, when coronary arterial blood flow and myocardial oxygen supply are not compromised, and in the vast majority of cases where it is, continuous postextrasystolic potentiation pacing is a safe positive inotropic technique.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

TREATMENT AND OUTCOMES OF TYPE 2 MYOCARDIAL INFARCTION COMPARED WITH TYPE 1 MYOCARDIAL INFARCTION

Type 2 myocardial infarction (MI) is defined by elevated cardiac biomarkers and evidence of ischemia due to a mismatch in myocardial oxygen supply and demand. Type 2 MI patients are usually misclassified under the diagnosis of non-ST-segment-elevation myocardial infarction (NSTEMI) despite the

Diagnosis and management of acute myocardial infarction: An overview

Acute myocardial infarction (AMI) occurs when there is acute disruption of coronary blood flow, resulting in a sudden imbalance between myocardial oxygen demand and supply, which causes ischemia and necrosis. AMI accounts for the highest mortality rate of approximately 15% worldwide. The acute complications of AMI, including cardiac arrhythmias, tolls almost 50% deaths, which may occur on the way to the hospital. The effective treatment modalities for AMI include antianginal medications and reperfusion with thrombolytics (tissue plasminogen activator) or percutaneous coronary intervention (PCI). PCI is the established and widely used reperfusion technique in the management of AMI as thrombolytics are contraindicated in many patients. PCI is superior to thrombolytics with a higher reperfusion rate of approximately 90%, shorter hospital stay, and lowering the mortality rate. The intervention performed within 90 min of hospital arrival improves the clinical outcomes significantly. In this article, major updates in diagnosis and treatment modalities of AMI have been summarized, mainly focusing on the efficacy of PCI in improving the clinical outcomes.

Modulation of Myocardial Oxygen Delivery in Response to Isovolemic Hemodilution

Background and Hypothesis: Prior studies have established that progressive increases in coronary blood flow are sufficient to maintain myocardial oxygen delivery in response to reductions in arterial oxygenation. However, the precise mechanisms responsible for anemic coronary vasodilation remain poorly understood. This investigation tested the hypothesis that autonomic neural pathways contribute to the maintenance of myocardial oxygen delivery in response to graded reductions in arterial hematocrit. &#x0D; Experimental Design: Experiments were conducted in open-chest anesthetized swine while assessing coronary blood flow and coronary arterial and venous blood gases in response to progressive hemodilution. Isovolemic hemodilution was achieved via simultaneous removal of 250mL of arterial blood and addition of 250mL of a synthetic plasma expander (Hespan) in swine that received either vehicle or a combination of atropine (0.5mg/kg) and propranolol (1mg/kg) (Atro/Pro). &#x0D; Results: Relative to vehicle control swine, treatment with Atro/Pro increased heart rate by ~50±4 beats/min and arterial pressure by ~10±1 mmHg. However, Atro/Pro did not significantly alter increases in coronary blood flow in response to isovolemic hemodilution (hematocrits ranging from ~35±1% to ~15±1%). Coronary venous PO2, an index of myocardial oxygenation, was also unchanged by hemodilution in both vehicle and Atro/Pro treated swine. &#x0D; Conclusion and Potential Impact: These data suggest that autonomic neural pathways do not play a significant role in the maintenance of myocardial oxygen delivery in response to graded reduction in arterial oxygen content. Understanding of how myocardial oxygen supply is ultimately sensed and regulated in response to reductions in tissue oxygenation remains elusive.

Different Effects of Vascular Aging on Ischemic Predisposition in Healthy Men and Women.

Invasive studies of the twentieth century showed the value of aortic pressure-time integrals as markers of myocardial oxygen demand and supply. More recent studies have used these concepts to evaluate the mechanisms of ischemic predisposition using noninvasive arterial tonometry in cardiology outpatients. We sought to evaluate the spectrum of myocardial oxygen demand and supply in a large cross-sectional community sample of healthy volunteers and identify the roles of age, sex, and wave reflection. Arterial tonometry was performed in 3682 healthy volunteers. Measures of systolic and diastolic pressure-time integrals and their ratio in addition to cardiac ejection duration were determined and analyzed by age and sex. Multiple regression analyses were performed to identify the mechanisms underlying observations, while controlling for confounders (heart rate, height, weight, and mean pressure). In a healthy cohort, older women more than men ( P<0.001) had unfavorable myocardial oxygen supply:demand ratios because of differing effects of vascular aging.

Prophylactic Use of an Intra-Aortic Balloon Pump in a High-risk Patient With Peripartum Cardiomyopathy Requiring Cesarean Delivery

(Int J Obstet Anesth. 2018;33:67–71) The most commonly used mechanical-assist device for the management of heart failure is the intra-aortic balloon pump (IABP). The balance between myocardial oxygen supply and demand is improved via the device’s counter-pulsation. Although some case reports have mentioned the use of IABP counter-pulsation for circulatory support in pregnant women with cardiac failure, few publications have discussed its use during delivery. This case report described the successful management of a patient with peripartum cardiomyopathy who underwent cesarean delivery using preemptive IABP counter-pulsation.

Nurses' recognition and response to clinical deterioration in the cardiac catheterisation laboratory

BackgroundPatients presenting to the cardiac catheter laboratory for treatment of unstable acute coronary syndromes (ACS) experience a mismatch in myocardial oxygen supply and demand, causing vital sign abnormalities prior to neurological, cardiac and respiratory deterioration. Delays in detecting clinical deterioration and escalating care increases risk of adverse events, unplanned intensive care (ICU) admission, cardiac arrest, and in-hospital mortality. ObjectivesThe objective of the study was to explore how nurses in the cardiac catheter laboratory (CCL) recognise and respond to clinical deterioration in patients with unstable ACS undergoing primary percutaneous coronary intervention (PCI). MethodsA prospective exploratory descriptive design was used with 30 participants completing 10 written clinical scenarios. Participants scored their level of concern for each physiological cue and then then ranked their preferred immediate response based on the deterioration identified. ResultsHypotension and the presence of pain were the physiological cues of highest concern. The most common responses to clinical deterioration were to increase vital sign assessment to 5-minutely intervals, administer pain relief or provide reassurance. Despite the presence of clinical deterioration fulfilling organisational escalation of care criteria, calling cardiac arrest or rapid response team (RRT) were not commonly selected responses. ConclusionNurses most commonly use hypotension and the presence of pain to recognise clinical deterioration in patients presenting to the CCL with an unstable ACS. Once clinical deterioration is identified, interventional cardiac nurses delay the escalation of care to the RRT or cardiac arrest team, preferring to implement local nurse initiated interventions.

Cardioprotective effects of alternagin-C (ALT-C), a disintegrin-like protein from Rhinocerophis alternatus snake venom, on hypoxia-reoxygenation-induced injury in fish

Alternagin-C (ALT-C) is a disintegrin-like peptide purified from Rhinocerophis alternatus snake venom with the property of inducing vascular endothelial growth factor (VEGF) expression, endothelial cell proliferation and migration, and angiogenesis. Therefore, this protein could be interesting as a new approach for ischemic heart diseases, an imbalance between myocardial oxygen supply and demand, leading to cardiac dysfunction. We investigated the effects of a single dose of alternagin-C (0.5 mg kg−1, via intra-arterial), after 7 days, on hypoxia/reoxygenation challenge in isolated ventricle strips and on morphological changes and density of blood vessels of the heart, using fish as an alternative experimental model. ALT-C treatment provided protection of cardiomyocytes against hypoxia/reoxygenation-induced negative inotropism. ALT-C also stimulated angiogenesis and improved excitation-contraction coupling during hypoxic conditions. Our results provide a new insight into a functional role of ALT-C against hypoxia/reoxygenation-induced cardiomyocyte injury pointing out to a potential therapeutic strategy for ischemia-related diseases.

TCT-785 Misclassification of Type 2 Myocardial Infarction and its Implication on Outcomes

Cardiovascular specialists are aware of the different mechanisms of myocardial infarction (MI); type 1 MI being plaque rupture mediated and type 2 MI caused by a mismatch in myocardial oxygen supply and demand. However, type 2 MI patients are often misclassified under the diagnosis of non–ST-

I.V. NIRS off-pump coronary artery ischemia monitoring bypass surgery

Background: Spectroscopic data were compared with hemodynamic parameters, electrocardiogram, transesophageal echocardiography and laboratory findings. A conversion to extracorporeal circulation was not necessary. The mean number of grafts per patient was 3.1±0.6. An intraoperative myocardial ischemia was not evident, as indicated by electrocardiogram and transesophageal echocardiography.Methods: Continuous spectroscopic analysis showed reproducible absorption spectra of coronary sinus blood. Due to uneventful intraoperative courses, clear ischemia-related changes could be detected in none of the patients. Present initial results show that intravascular near-infrared spectroscopy can reliably be used for an online intraoperative ischemia monitoring in off-pump coronary artery bypass surgery.Results: In 15 elective patients undergoing off-pump myocardial revascularization, intravascular near-infrared spectroscopic analysis of coronary venous blood was performed. NIR signals were transferred through a fiberoptic catheter for signal emission and collection. For data analysis and processing, a miniature spectrophotometer with multivariate statistical package was used. Signal acquisition and analysis were performed before and after revascularization. However, the method has to be further evaluated and standardized to determine the role of spectroscopy in off-pump coronary artery bypass surgery. In off-pump coronary artery bypass surgery, manipulations on the beating heart can lead to transient interruptions of myocardial oxygen supply, which can generate an accumulation of oxygen-dependent metabolites in coronary venous blood.Conclusions: The objective of this study was to evaluate the reliability of intravascular near-infrared spectroscopy as a monitoring method to detect possible ischemic events in off-pump coronary artery bypass procedures.

Myocardial Injury and Cardiac Reserve in Patients With Heart Failure and Preserved Ejection Fraction

BackgroundCardiac reserve is depressed in patients with heart failure and preserved ejection fraction (HFpEF). The mechanisms causing this are poorly understood. ObjectivesThe authors hypothesized that myocardial injury might contribute to the hemodynamic derangements and cardiac reserve limitations that are present in HFpEF. Markers of cardiomyocyte injury, central hemodynamics, ventricular function, and determinants of cardiac oxygen supply–demand balance were measured. MethodsSubjects with HFpEF (n = 38) and control subjects without heart failure (n = 20) underwent cardiac catheterization, echocardiography, and expired gas analysis at rest and during exercise. Central venous blood was sampled to measure plasma high-sensitivity troponin T levels as an index of cardiomyocyte injury. ResultsCompared with control subjects, troponins were more than 2-fold higher in subjects with HFpEF at rest and during exercise (p < 0.0001). Troponin levels were directly correlated with left ventricular (LV) filling pressures (r = 0.52; p < 0.0001) and diastolic dysfunction (r = −0.43; p = 0.002). Although myocardial oxygen demand was similar, myocardial oxygen supply was depressed in HFpEF, particularly during exercise (coronary perfusion pressure–time integral; 44 ± 9 mm Hg × s × min−1 × l × dl−1 vs. 30 ± 9 mm Hg × s × min−1 × l × dl−1; p < 0.0001), and reduced indices of supply were correlated with greater myocyte injury during exercise (r = −0.44; p = 0.0008). Elevation in troponin with exercise was directly correlated with an inability to augment LV diastolic (r = −0.40; p = 0.02) and systolic reserve (r = −0.57; p = 0.0003), greater increases in LV filling pressures (r = 0.55; p < 0.0001), blunted cardiac output response (r = −0.44; p = 0.002), and more severely depressed aerobic capacity in HFpEF. ConclusionsLimitations in LV functional reserve and the hemodynamic derangements that develop secondary to these limitations during exercise in HFpEF are correlated with the severity of cardiac injury, assessed by plasma levels of troponin T. Further study is warranted to determine the mechanisms causing myocyte injury in HFpEF and the potential role of ischemia, and to identify and test novel interventions targeted to these mechanisms. (EXEC [Study of Exercise and Heart Function in Patients With Heart Failure and Pulmonary Vascular Disease]; NCT01418248)

Oxygenation-sensitive cardiovascular magnetic resonance in hypertensive heart disease with left ventricular myocardial hypertrophy and non-left ventricular myocardial hypertrophy: Insight from altered mechanics and cardiac BOLD imaging.

BOLD (blood oxygen level dependent) MRI can detect regional condition of myocardial oxygen supply and demand by means of paramagnetic properties. Noninvasive assessment of myocardial oxygenation by BOLD MRI in hypertensive patients with hypertension (HTN) left ventricular myocardial hypertrophy (LVMH) and HTN non-LVMH and its correlation with myocardial mechanics were performed. Prospective. Twenty patients with HTN LVMH, 21 patients with HTN non-LVMH, and 23 normotensive controls were enrolled. Cine imaging, T2* and T1 mapping sequences were achieved at 3.0T. Dedicated T1 mapping, T2*, and cine imaging analysis were performed by two radiologists using cvi42. One-way analysis of variance, Kruskal-Wallis test, Bland-Altman analysis, Pearson's correlation coefficient, Spearman's rank correlation. T2* values of HTN LVMH group were significantly lower versus the controls (23.78 ± 3.09 versus 30.77 ± 2.71; P < 0.001) and HTN non-LVMH group (23.78 ± 3.09 versus 28.64 ± 4.23; P < 0.001). Left ventricular peak circumferential strain were reduced in HTN LVMH patients compared with other two groups (-11.32 [-15.64, -10.3], -16.78 [-19.35, -15.34], and -19.73 [-20.57, -18.73]; P < 0.05); and longitudinal strain of HTN LVMH patients were lower than other two groups (-11.31 ± 2.91, -15.1 ± 3.06, and -18.85 ± 1.85; P < 0.05); radial strain of HTN LVMH patients were also lower than other two groups (25.03 ± 16, 40.95 ± 17.5 and 47.9 ± 10.23; P < 0.05). Extracellular volume correlated with peak circumferential, longitudinal, and radial strain (spearman rho = 0.6, 0.64, and -0.69; P < 0.05), respectively; T2* negatively correlated with peak circumferential and longitudinal strain (spearman rho = -0.43 and -0.49; P < 0.05), respectively. Patients with lower T2* values had significant decreases in myocardial mechanics (P < 0.05). HTN LVMH patients have both impaired myocardial mechanics and decreased T2* values compared with HTN non-LVMH and normotensive groups. BOLD MRI could provide a feasible assessment modality for detecting altered T2* due to the change of de-oxygenated hemoglobin and hence to the change of signal intensity in oxygenation-sensitive images. 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1297-1306.

Abstract 644: Some Perspectives of Preventive Cardiology Development

Background: The role of preventive cardiology becomes more significant in solving heart problems. The analysis of our research results allows making assumptions, promising for prevention of coronary atherosclerosis (CA). Material and Methods: The studies were carried out on: hearts of humans died from accidents, from acute myocardial infarction; myocardial biopsies, heart surgical material of patients; hearts of animals; insects flying muscles; placentas of human and animals. The methods were used: autopsy, planimetry of atherosclerotic lesions of aorta and main coronary arteries, heart biopsy, microangio-x-ray, histology, stereology, experimental modeling, measuring of hemodynamic parameters, micromechanography, electron microscopy, cytochemistry, mathematical modeling, statistics. Aim: To show that existing data may serve as a basis for further development of new ways to prevent CA. Results: Huge differences of myocardial arterial bed (MAB) density exist. The richness of MAB correlates directly with life expectancy of people. In hearts with scant MAB CA develops earlier and atherosclerotic lesions are more severe. Therefore scant MAB is considered as an intracardial risk factor (IRF) for IHD. Large individual differences exist in human hearts also for values for the duration of myocardial fibers oxygen supply. The long time is another IRF for IHD. The density of intraorganic arterial bed in human placentas varies widely. There is a positive correlation between placental arterialization density and newborn weigh. The following morphological multifactorial systemic measurement methods are developed: a) for heart muscle oxygen supply; b) for contractility of cardiomyocyte using small heart muscle biopsies (patented); c) for gas exchangeability of placenta. The efficiency and exactness of each method were examined. Conclusion: The received data allow assuming that atherosclerotic profile of human heart CA will be possible to foretell on the next day of born. In cases of bad prognosis a plan of enrichment of MAB, a plan for spatial improvement of the “capillary - myocardial fiber” system may be composed and undertaken. The received data allow in advanced future to draw up a project of new heart with necessary preset structural parameters.