Radial Mapping Research Articles

Optical Bench Evaluation of a Novel, Hydrophobic, Acrylic, One-Piece, Polyfocal Intraocular Lens with a "Zig-Zag" L-Loop Haptic Design.

The number of presbyopia-correcting (premium) intraocular lenses (IOLs) is growing steadily as the desire for spectacle independence after cataract surgery increases. The aim of this laboratory study was to evaluate a newly launched hydrophobic, acrylic, polyfocal, refractive intraocular lens with a new optical design and geometry. This polyfocal IOL has three different zones (within the optic) with radially asymmetric design. We performed optical bench tests to calculate the optical characteristics of the sample. The optical performance and quality of IOLs based on ISO 11979-2 and 11979-9 requirements were analyzed with the NIMO TR0815 (Lambda-X). In addition, optical quality metrics were evaluated with the IOLA MFD device (Rotlex). Sphere, Add, modulation transfer function (MTF), the energy distribution between the modes and the MTF along the whole range from far to near were analyzed. The power histogram showed that the tested IOL has the characteristics of a polyfocal IOL with a wide range of optical power between 20.5 and 24.5 diopters. Two distinct peaks were observed, indicating bifocal functionality. In the radial and axial power surface map, all three zones, stated by the company, could be detected. Larger apertures lead to a significant increase in MTF at the far peak, indicating better visual acuity for distant objects under low-light conditions. It was observed that in small aperture sizes, intermediate vision seems to be dominant. The energy distribution remained almost constant with increasing aperture size. This laboratory study was able to confirm the properties of the polyfocal lens stated by the company. Three optical zones could be identified. However, further optical bench tests should be performed to evaluate the new lens under tilted and decentered conditions. Clinical studies have to confirm that the presbyopia-correcting, polyfocal lens can achieve good clinical results with high patient satisfaction without disturbing side effects.

Accelerated 2D radial Look-Locker T1 mapping using a deep learning-based rapid inversion recovery sampling technique.

Efficient abdominal coverage with T1-mapping methods currently available in the clinic is limited by the breath hold period (BHP) and the time needed for T1 recovery. This work develops a T1-mapping framework for efficient abdominal coverage based on rapid T1 recovery curve (T1RC) sampling, slice-selective inversion, optimized slice interleaving, and a convolutional neural network (CNN)-based T1 estimation. The effect of reducing the T1RC sampling was evaluated by comparing T1 estimates from T1RC ranging from 0.63 to 2.0s with reference T1 values obtained from T1RC =2.5-5s. Slice interleaving methodologies were evaluated by comparing the T1 variation in abdominal organs across slices. The repeatability of the proposed framework was demonstrated by performing acquisition on test subjects across imaging sessions. Analysis of in vivo data based on retrospectively shortening the T1RC showed that with the CNN framework, a T1RC =0.84 s yielded T1 estimates without significant changes in mean T1 (p> 0.05) or significant increase in T1 variability (p> 0.48) compared to the reference. Prospectively acquired data using T1RC =0.84 s, an optimized slice interleaving scheme, and the CNN framework enabled 21 slices in a 20 s BHP. Analyses across abdominal organs produced T1 values within 2% of the reference. Repeatability experiments yielded Pearson's correlation, repeatability coefficient, and coefficient of variation of 0.99, 2.5%, and 0.12%, respectively. The proposed T1 mapping framework provides full abdominal coverage within a single BHP.

The Shape(s) of Information Practice: Using Radial Mapping Qualitatively

ABSTRACTInformation practices comprise both seeking and avoidance. Although information practices scholars use qualitative and visual methods to understand seeking practices, they rarely do so to understand avoidance. This paper proposes a new visual method that supports revealing and explaining the complex interplay of seeking and avoidance in rich qualitative data. We introduce seven dimensions of information seeking and avoidance practice (intensity, granularity, engagement, control, relevance, quality, and timeliness). We conceptualize these visually as axes radiating outward from a central origin. We use Excel radar charts to depict these dimensions, allowing us to identify and characterize the shapes of information seeking and avoidance in everyday information practices. We apply our approach to two cases from published literature to show how mapping reveals the interplay between seeking and avoidance at one point in time and over time. We propose potential data collection and analysis applications of this method for information practices research.

Revealing regional variations in scleral shear modulus in a rabbit eye model using multi-directional ultrasound optical coherence elastography

The mechanical properties of the sclera play a critical role in supporting the ocular structure and maintaining its shape. However, non-invasive measurements to quantify scleral biomechanics remain challenging. Recently introduced multi-directional optical coherence elastography (OCE) combined with an air-coupled ultrasound transducer for excitation of elastic surface waves was used to estimate phase speed and shear modulus in ex vivo rabbit globes (n = 7). The scleral phase speed (12.1 ± 3.2 m/s) was directional-dependent and higher than for corneal tissue (5.9 ± 1.4 m/s). In the tested locations, the sclera proved to be more anisotropic than the cornea by a factor of 11 in the maximum of modified planar anisotropy coefficient. The scleral shear moduli, estimated using a modified Rayleigh-Lamb wave model, showed significantly higher values in the circumferential direction (65.4 ± 31.9 kPa) than in meridional (22.5 ± 7.2 kPa); and in the anterior zone (27.3 ± 9.3 kPa) than in the posterior zone (17.8 ± 7.4 kPa). The multi-directional scanning approach allowed both quantification and radial mapping of estimated parameters within a single measurement. The results indicate that multi-directional OCE provides a valuable non-invasive assessment of scleral tissue properties that may be useful in the development of improved ocular models, the evaluation of potential myopia treatment strategies, and disease characterization and monitoring.

Feasibility and Reproducibility of T2 Mapping Compared with Diffusion-Weighted Imaging in Solid Renal Masses.

Accurate prediction of renal mass subtypes, along with the WHO/ISUP grade and pathological T (pT) stage of clear cell renal cell carcinoma (ccRCC), is crucial for optimal decision making. Our study aimed to investigate the feasibility and reproducibility of motion-robust radial T2 mapping in differentiating lipid-poor angiomyolipoma (MFAML) from RCC and characterizing the WHO/ISUP grade and pT stage of ccRCC. Finally, 92 patients undergoing renal radial T2 mapping and ZOOMit DWI were recruited. The T2 values and apparent diffusion coefficient (ADC) were analyzed. Correlation coefficients were calculated between ADC and T2 values. Notably, ccRCC exhibited higher T2 and ADC values than MFAML (p < 0.05). T2 values were lower in the higher WHO/ISUP grade and pT stage of ccRCC (all p < 0.05). ADC showed no significant difference for pT stage (p = 0.056). T2 values revealed a higher area under the curve (AUC) in evaluating the WHO/ISUP grade compared to ADC (0.936 vs. 0.817, p = 0.027). T2 values moderately positively correlated with ADC (r = 0.675, p < 0.001). In conclusion, quantitative motion-robust radial T2 mapping is feasible for characterizing solid renal masses and could provide additional value for multiparametric imaging in predicting WHO/ISUP grade and pT stage of ccRCC.

Microstructural strain localisation phenomena in fibre-reinforced polymer composites: Insights from nanoscale digital image correlation and finite element modelling

Multiscale models for fibre-reinforced polymer composites currently lack experimentally validated microscale damage descriptors as input parameters. This work demonstrates the occurrence of strain localisation phenomena at the fibre/matrix level using nanoscale digital image correlation. Unidirectional carbon-fibre reinforced epoxy and glass-fibre reinforced PMMA composites were loaded in transverse compression in a scanning electron microscope. Radial and shear strain maps were extracted and compared with finite element simulations based on a conventional elastoplastic model. Near the interface, an interphase layer is present in the matrix, presumably due to locally different polymerisation conditions. A skin-core structure was found in carbon fibres, corresponding to an increased transverse modulus towards the interface.

RadVolViz: An Information Display-Inspired Transfer Function Editor for Multivariate Volume Visualization.

In volume visualization transfer functions are widely used for mapping voxel properties to color and opacity. Typically, volume density data are scalars which require simple 1D transfer functions to achieve this mapping. If the volume densities are vectors of three channels, one can straightforwardly map each channel to either red, green or blue, which requires a trivial extension of the 1D transfer function editor. We devise a new method that applies to volume data with more than three channels. These types of data often arise in scientific scanning applications, where the data are separated into spectral bands or chemical elements. Our method expands on prior work in which a multivariate information display, RadViz, was fused with a radial color map, in order to visualize multi-band 2D images. In this work, we extend this joint interface to blended volume rendering. The information display allows users to recognize the presence and value distribution of the multivariate voxels and the joint volume rendering display visualizes their spatial distribution. We design a set of operators and lenses that allow users to interactively control the mapping of the multivariate voxels to opacity and color. This enables users to isolate or emphasize volumetric structures with desired multivariate properties. Furthermore, it turns out that our method also enables more insightful displays even for RGB data. We demonstrate our method with three datasets obtained from spectral electron microscopy, high energy X-ray scanning, and atmospheric science.

Examination of Magnetic Field Signatures and Local Plasma Distribution Variations in Jupiter's Magnetosphere

AbstractSpinning disk of plasma results in deformation of Jupiter's magnetic field from a dipole to a magnetodisc configuration with significant radial and azimuthal components. Polar orbit of the Juno spacecraft enables a comprehensive in situ observation of Jupiter's plasmadisc at different latitudes. Observations from magnetometer and plasma distribution instruments on Juno mission were used to examine interaction of magnetic field and heavy ions in Jupiter's nightside magnetosphere. Power spectrum analysis was used to evaluate magnetic fluctuations inside and outside of the plasmadisc. Extensive radial maps of magnetic activity in Jupiter's nightside magnetosphere are presented. Comprehensive examination of magnetic fluctuations enable to identify local plasma density variations that correlate with plasma distribution count rate fluctuations. Observations of magnetic signatures together with examination of plasma distribution are used to detect features that point to plasma transport inside and outside of Jupiter's plasmadisc. This work shows that plasma in Jupiter's magnetosphere is contained near centrifugal equator and is not a subject to curvature drift that could generate ring currents. Signatures described as current sheet crossings were investigated. On close inspection these signatures show attributes that belong to stand alone formations rather than a single current sheet structure. This work shows that current flow is not an adequate mechanism to explain deformation of Jupiter's magnetic field.

Simulation of the Dynamic Responses of Layered Polymer Composites under Plate Impact Using the DSGZ Model

This paper presents a numerical study on the dynamic response and impact mitigation capabilities of layered ceramic–polymer–metal (CPM) composites under plate impact loading, focusing on the layer sequence effect. The layered structure, comprising a ceramic for hardness and thermal resistance, a polymer for energy absorption, and a metal for strength and ductility, is analyzed to evaluate its effectiveness in mitigating the impact loading. The simulations employed the VUMAT subroutine of DSGZ material models within Abaqus/Explicit to accurately represent the mechanical behavior of the polymeric materials in the composites. The VUMAT implementation incorporates the explicit time integration scheme and the implicit radial return mapping algorithm. A safe-version Newton–Raphson method is applied for numerically solving the differential equations of the J2 plastic flow theory. Analysis of the simulation results reveals that specific layer configurations significantly influence wave propagation, leading to variations in energy absorption and stress distribution within the material. Notably, certain layer sequences, such as P-C-M and C-P-M, exhibit enhanced impact mitigation with a superior ability to dissipate and redirect the impact energy. This phenomenon is tied to the interactions between the material properties of the ceramic, polymer, and metal, emphasizing the necessity of precise material characterization and enhanced understanding of the layer sequencing effect for optimizing composite designs for impact mitigation. The integration of empirical data with simulation methods provides a comprehensive framework for optimizing composite designs in high-impact scenarios. In the general fields of materials science and impact engineering, the current research offers some guidance for practical applications, underscoring the need for detailed simulations to capture the high-strain-rate dynamic responses of multilayered composites.

BOUNDING SURFACE COUPLED FINITE ELEMENT CONSOLIDATION ANALYSIS OF NORMALLY AND OVERCONSOLIDATED CLAYS

The radial mapping version of the bounding surface plasticity model is implemented in a computer program to predict the response of cohesive soils. The eight-noded isoparametric element and Biot’s theory are used in this study for analyzing soil consolidation problems. The model has been used in the analysis for two classes of problems. The first involves the comparison of model predictions with the results of laboratory tests in compression and extension for normally and overconsolidated clays. The second class involves using the model to predict the results of one- and two-dimensional finite element problems of soil consolidation. The comparisons with experiments demonstrate that the model, through its simplicity, can describe realistically the soil response under different monotonic loading conditions at any overconsolidation ratio. The comparison between the bounding surface plasticity model with the classical modified Cam clay model shows considerably different rates and magnitudes of settlement, and different pore pressure behavior during the consolidation process.

Is Betelgeuse Really Rotating? Synthetic ALMA Observations of Large-scale Convection in 3D Simulations of Red Supergiants

The evolved stages of massive stars are poorly understood, but invaluable constraints can be derived from spatially resolved observations of nearby red supergiants, such as Betelgeuse. Atacama Large Millimeter/submillimeter Array (ALMA) observations of Betelgeuse showing a dipolar velocity field have been interpreted as evidence for a projected rotation rate of about 5 km s−1. This is 2 orders of magnitude larger than predicted by single-star evolution, which led to suggestions that Betelgeuse is a binary merger. We propose instead that large-scale convective motions can mimic rotation, especially if they are only partially resolved. We support this claim with 3D CO5BOLD simulations of nonrotating red supergiants that we postprocessed to predict ALMA images and SiO spectra. We show that our synthetic radial velocity maps have a 90% chance of being falsely interpreted as evidence for a projected rotation rate of 2 km s−1 or larger for our fiducial simulation. We conclude that we need at least another ALMA observation to firmly establish whether Betelgeuse is indeed rapidly rotating. Such observations would also provide insight into the role of angular momentum and binary interaction in the late evolutionary stages. The data will further probe the structure and complex physical processes in the atmospheres of red supergiants, which are immediate progenitors of supernovae and are believed to be essential in the formation of gravitational-wave sources.

A machine learning pipeline for efficient differentiation between bipolar and major depressive disorder based on multimodal structural neuroimaging

Due to the overlapping depressive symptomatology with major depressive disorder (MDD), 60% of patients with bipolar disorder (BD) are initially misdiagnosed, calling for the definition of reliable biomarkers that can support the diagnostic process. Here, we optimized a machine learning pipeline for the differentiation between depressed BD and MDD patients based on multimodal structural neuroimaging features. Diffusion tensor imaging (DTI) and T1-weighted magnetic resonance imaging (MRI) data were acquired for 282 depressed BD (n = 180) and MDD (n = 102) patients. Images were preprocessed to obtain axial (AD), radial (RD), mean (MD) diffusivity, fractional anisotropy (FA), and voxel-based morphometry (VBM) maps. Each feature was entered separately into a 5-fold nested cross-validated predictive pipeline differentiating between BD and MDD patients, comprising: confound regression for nuisance variables removal, feature standardization, principal component analysis for feature reduction, and an elastic-net penalized regression. The DTI-based models reached accuracies ranging from 75% to 78%, whereas the VBM model reached 61% of accuracy. All the models were significantly different from a null model distribution at a 5000-permutation test. A 5000 bootstrap procedure revealed that widespread differences drove the classification, with BD patients associated to overall higher values of AD and FA, and grey matter volumes. Our results suggest that structural neuroimaging, in particular white matter microstructure and grey matter volumes, may be able to differentiate between MDD and BD patients with good predictive accuracy, being significantly higher than chance-level.

Implementation of a modified Graham-Walles viscosity function within a Chaboche viscoplastic constitutive model

This work provides a numerical framework for the accurate prediction of operational life of metallic components exhibiting a non-classical creep behavior under constant loadings and very high temperature. A modified Graham-Walles type analytical viscoplastic function is implemented into a Chaboche unified viscoplastic constitutive model. The numerical model is integrated into the finite element software Lagamine following a fully-implicit two-step radial return mapping algorithm. The non-linear system of equations is solved using a robust Newton-Raphson method. The computational efficiency of the model is enhanced by implementing a sub-step routine, thereby decreasing the average number of iterations of the finite element software. The validation of the model is performed using experimental data available in the literature on the non-classical creep behavior of Incoloy 800H, a Ni-superalloy exhibiting a two-step creep strain rate minima attributed to multiple complex dislocation-precipitate interactions.

Multivariate Image Analysis for Core Monitoring in PWRs

In pressurized water reactor (PWR) it is crucial for the operator to monitor the reactor parameters at the same time, such as temperature, pressure, boron concentration, control rod position, coolant density, etc., in order to make proper decision. However, the huge size of data reading from the different instrumentations, in addition to the limited human ability to visually detect, interpret, assess add a lot of uncertainty to the operator qualitative and quantitative analysis of the reactor performance. Therefore, this paper proposes the utilization of radial thermal flux maps (Neutron Images) technique, positioned on the reactor core as a sensitive monitoring technique for all changes of the reactor parameters as a result of the position of the control rods changing. Hence, the features contained in these neutron images are extracted (Multivariate image analysis and regression) via Principal Component Analysis (PCA), and Cluster Analysis (Dendrogram). To determine the effectiveness of the suggested technique in determining the location of the control-rods, several simulations are run. The 3D TRITON FORTRAN-code was utilized to simulate the radial thermal neutron flux of the Westinghouse 2775-MWth PWR benchmark at 100% thermal power generation. The SIMCA software programme is used to develop, test, and generalise the PCA model. Additionally, clustering analysis (CA) is carried out using the statistics software programme Minitab in order to demonstrate the effectiveness of the suggested method.

Numerical predictions of low cyclic fatigue and creep-fatigue behavior of P92 steel under non-isothermal-mechanical loading

Low-Cycle Fatigue (LCF) and creep-fatigue-interaction (CFI) behavior of a ferritic-martensitic stainless steel P92 is studied under strain-controlled non-isothermal -mechanical fatigue loading in the temperature range of 300°C∼620°C and 500°C∼620°C, respectively. The strain-controlled tests with and without the tensile and compression holding times are simulated for different mechanical strains amplitudes. An improved Unified Viscoplastic constitutive Model (UVM) is proposed based on the framework of modified Chaboche non-linear kinematic hardening rule. The improved UVM incorporates strain rate sensitivity, temperature rate dependence, static recovery associated with plastic strain, mean stress evolution and cyclic softening of strain range dependence, and so on. Furthermore, the expressions of the implicit stress integration algorithm and the consistent tangential modulus are deduced on the basis of radial return mapping and backward Euler integration methods, respectively, and the improved UVM is implemented into the ABAQUS software using the user material subroutine UMAT. The simulation results of the UVM correlate well with the experimental data.

Mechanical Characterization of Fatigue and Cyclic Plasticity of 304L Stainless Steel at Elevated Temperature

BackgroundThe mechanical characterization of the cyclic elastoplastic response of structural materials at elevated temperatures is crucial for understanding and predicting the fatigue life of components in nuclear reactors.ObjectiveIn this study, a comprehensive mechanical characterization of 304L stainless steel has been performed including metallography, tensile tests, fatigue tests, fatigue crack growth tests and cyclic stress-strain tests.MethodsIsothermal tests were conducted at both room temperature and 300 °C for both the rolling direction and the transverse direction of the hot rolled steel. Mechanical properties were extracted from the uniaxial experiments by fitting relevant material models to the data. The cyclic plasticity behavior has been modelled with a radial return-mapping algorithm that utilizes the Voce nonlinear isotropic hardening model in combination with the Armstrong-Frederick nonlinear kinematic hardening model. The plasticity models are available in commercial FE software and accurately capture the stabilized hysteresis loops, including a substantial Bauschinger effect.ResultsThe material exhibits near isotropic properties, but its mechanical performance is generally reduced at high temperatures. Specifically, in the rolling direction, the Young’s modulus is reduced by 16 % at 300 °C, the yield strength at 0.2 % plastic strain is lower by 23 %, and the ultimate tensile strength is lower by 30 % compared to room temperature. Fatigue life is also decreased, leading to an accelerated fatigue crack growth rate compared to room temperature. A von Mises radial return mapping algorithm proves to be effective in accurately modelling the cyclic plasticity of the material. The algorithm has also been used to establish a clear correlation between energy dissipation per cycle and cycles to failure, leading to the proposal of an energy-based fatigue life prediction model.ConclusionsThe material exhibits reduced mechanical performance at elevated temperatures, with decreased monotonic strength, compared to room temperature. Fatigue life is also compromised, resulting in accelerated fatigue crack growth. The material’s hardening behavior differs at room temperature and elevated temperature, with lower peak stress values observed at higher temperatures. The radial return mapping algorithm can be used to determine the dissipated energy per cycle which together with fatigue testing has been used to propose a low cycle fatigue life prediction model at both temperatures.

The Baryonic Content of Galaxies Mapped by MaNGA and the Gas Around Them

We analyze the cool gas in and around 14 nearby galaxies (at z < 0.1) mapped with the Sloan Digital Sky Survey IV MaNGA survey by measuring absorption lines produced by gas in spectra of background quasars/active galactic nuclei at impact parameters of 0–25 effective radii from the galactic centers. Using Hubble Space Telescope/Cosmic Origins Spectrograph, we detect absorption at the galactic redshift and measure or constrain column densities of neutral (H i, N i, O i, and Ar i), low-ionization (Si ii, S ii, C ii, N ii, and Fe ii), and high-ionization (Si iii, Fe iii, N v, and O vi) species for 11 galaxies. We derive the ionization parameter and ionization-corrected metallicity using cloudy photoionization models. The H i column density ranges from ∼1013 to ∼1020 cm−2 and decreases with impact parameter for r ≳ R e . Galaxies with higher stellar mass have weaker H i absorption. Comparing absorption velocities with MaNGA radial velocity maps of ionized gas line emissions in galactic disks, we find that the neutral gas seen in absorption corotates with the disk out to ∼10 R e . Sight lines with lower elevation angles show lower metallicities, consistent with the metallicity gradient in the disk derived from MaNGA maps. Higher-elevation angle sight lines show higher ionization, lower H i column density, supersolar metallicity, and velocities consistent with the direction of galactic outflow. Our data offer the first detailed comparisons of circumgalactic medium (CGM) properties (kinematics and metallicity) with extrapolations of detailed galaxy maps from integral field spectroscopy; similar studies for larger samples are needed to more fully understand how galaxies interact with their CGM.

Fast Compressed Sensing of 3D Radial T1 Mapping with Different Sparse and Low-Rank Models.

Knowledge of the relative performance of the well-known sparse and low-rank compressed sensing models with 3D radial quantitative magnetic resonance imaging acquisitions is limited. We use 3D radial T1 relaxation time mapping data to compare the total variation, low-rank, and Huber penalty function approaches to regularization to provide insights into the relative performance of these image reconstruction models. Simulation and ex vivo specimen data were used to determine the best compressed sensing model as measured by normalized root mean squared error and structural similarity index. The large-scale compressed sensing models were solved by combining a GPU implementation of a preconditioned primal-dual proximal splitting algorithm to provide high-quality T1 maps within a feasible computation time. The model combining spatial total variation and locally low-rank regularization yielded the best performance, followed closely by the model combining spatial and contrast dimension total variation. Computation times ranged from 2 to 113 min, with the low-rank approaches taking the most time. The differences between the compressed sensing models are not necessarily large, but the overall performance is heavily dependent on the imaged object.

P2: Impella Smart Assist Technology and Hemodynamics Management in Cardiogenic Shock Management

Background: Smart Assist Impella pumps provide enhanced hemodynamic metrics via real-time assessment of aortic pressure (AoP), left ventricular pressure (LVP), cardiac output (CO) and cardiac power output (CPO). These data can constitute powerful management tools for clinicians yet information on the Smart Assist Technology algorithms and calculations remains scarce. This case reports illustrates the importance of an in-depth understanding of this newer technology to effectively manage cardiogenic shock patients on Impella support. Method: A 64yo man with cardiogenic shock supported with Impella 5.5 as a bridge to transplant had been on support for 27 days, with stable hemodynamics on P8, flowing 4.5 LPM. On day 28 patient experienced suction alarms and LVDP <-40mmHg prompting the team to reduce P level, administer fluid and attempt Impella repositioning. None of the interventions resolved the issue and consideration was given to reducing support to P2 and weaning or exchanging the Impella. The pump appeared correctly positioned by echo and hemolysis markers were negative. Careful review of patients’ data demonstrated a discrepancy between the transduced radial artery MAP at 73 mmHg and the aortic pressure measured by the Impella fiber optic sensor at 42 mmHg. This prompted a review of the LVP metric. The Impella Left ventricular pressure is calculated in real time by subtracting from the AoP the differential pressure gradient between pump outlet and inlet as derived from the motor current. An erroneous Ao signal input will result in an inaccurate LVP. Furthermore, the Impella suction alarm algorithm utilizes a sustained low LVDP as a trigger and can thus be triggered erroneously if the Ao signal is inaccurate. The suctions alarms and the low LVP were determined to be caused by drifting data feed from the Impella aortic fiber optic sensor. An Impella Ao signal bedside recalibration based on transduced MAP resolved the suction alarms. Result A drifting AoP signal resulted in an erroneous LVP measurements and subsequent suction alarms. Fiber optic technology does not require periodic calibrations once in vivo. Per IFU, the accuracy of the Ao is 1.9mmHg and the accuracy of the LV is 8.8 mmHg. In this case, the recalibration of the AO signal resolved the suction alarms and low LVP. Decision was made to not undertake an invasive pump exchange and continue supporting the patient on the implanted pump managing the metrics with daily manual recalibration. The patient was supported for an additional 17 days demonstrating optimal perfusion pressure and LV unloading and successfully underwent orthotopic heart transplant on Impella day 45. Conclusion: Impella Smart Assist technology is a powerful tool to manage patients’ hemodynamics. An in-depth understanding of the technology and its algorithms is crucial in delivering optimal patient care and preventing erroneous data feed from guiding hemodynamic management.Figure 1. Impella Smart Assist metrics. A. Stable on P8. B. Suction alarm generated by low LVDP. C. Persistent alarms despite fluid bolus and lower P level. D. Suction alarm resolved by Ao recalibrationFigure 2. LVP Calculation

The last shall be the first: the role of combined QLV- and CMR-determined electromechanical concordance in predicting optimal left ventricular stimulation site in cardiac resynchronisation therapy

Abstract Funding Acknowledgements Type of funding sources: None. Background/introduction Optimisation of cardiac resynchronisation therapy (CRT) response still represents a significant challenge to cardiac electrophysiology. In this regard, perhaps the area of greatest uncertainty revolves around optimal left ventricular lead (LVL) position and in particular whether this should be directed at areas of latest electrical or mechanical activation given the equivocal evidence on their precise relationship in heart failure (HF) patients. Furthermore, while echocardiography has demonstrated that LVL aimed at regions of greatest mechanical delay maximises CRT response, cardiac magnetic resonance (CMR) with its greater spatial resolution and tissue definition is yet to demonstrate a role in doing so. Purpose To retrospectively evaluate concordance between latest electrical and CMR-determined mechanical activation in a CRT population and its relationship with reverse remodeling. Methods This is a retrospective single center analysis of 104 CRT patients. All patients had CMR and echocardiography performed before implantation. During implantation, coronary sinus angiogram was performed and electrical delay (QLV time with RV-LV time greater than 80 ms) was mapped on all veins suitable for lead implantation and LVL was positioned in the region of latest electrical activation programming LVL cathode accordingly. LVL cathode position was thus assumed to represent the region of latest electrical delay. A post-hoc analysis was then conducted by means of CART-Tech® software providing radial strain and scar maps on a 36-segment anatomical model. Patients were then stratified based on concordance between LVL cathode position (using 3D heart models superimposed on 2D angiography images) and most mechanically delayed segments (either the three most delayed segments or adjacent ones) or non concordance (one or more segments between LVL cathode and three most mechanically delayed segments). Data from patient follow-up was collected with echocardiography at least 3 months after implant date. CRT response was expressed as reduction in end-systolic volume (ESV) greater than 15%. Results A preliminary analysis of the first 30 patients of our cohort was conducted. Electromechanical concordance and non-concordance were present in 24 and 6 patients, respectively. Baseline patient characteristics including demographics, comorbidities, HF aetiology, ECG and echocardiography features were comparable between groups except for scar burden, which was higher in the non-concordance group. Response to CRT was 80% in the concordant vs. 20% in the non-concordant group. Conclusions While a confounding effect of scar burden cannot be excluded, these preliminary data suggest that electromechanical concordance in LVL cathode placement may represent a predictor of optimal CRT response. The full scope of this study will be fully appreciated in the coming month on completion of analysis of the entire patient cohort.