Sample records for left cardiac chambers

  1. Size of Left Cardiac Chambers Correlates with Cerebral Microembolic Load in Open Heart Operations

    PubMed Central

    Golukhova, Elena Z.; Polunina, Anna G.; Zhuravleva, Svetlana V.; Lefterova, Natalia P.; Begachev, Alexey V.

    2010-01-01

    Background. Microemboli are a widely recognized etiological factor of cerebral complications in cardiac surgery patients. The present study was aimed to determine if size of left cardiac chambers relates to cerebral microembolic load in open heart operations. Methods. Thirty patients participated in the study. Echocardiography was performed in 2-3 days before surgery. A transcranial Doppler system was used for registering intraoperative microemboli. Results. Preoperative left atrium and left ventricular end-systolic and end-diastolic sizes significantly correlated with intraoperative microembolic load (rs = 0.48, 0.57 and 0.53, Ps < .01, resp.). The associations between left ventricular diameters and number of cerebral microemboli remained significant when cardiopulmonary bypass time was included as a covariate into the analysis. Conclusions. The present results demonstrate that increased size of left heart chambers is an influential risk factor for elevated cerebral microembolic load during open heart operations. Mini-invasive surgery and carbon dioxide insufflation into wound cavity may be considered as neuroprotective approaches in patients with high risk of cerebral microembolism. PMID:20631826

  2. Measurement of photon attenuation from different cardiac chambers

    SciTech Connect

    Keller, A.M.; Simon, T.R.; Malloy, C.R.; Dehmer, G.J.; Smitherman, T.C.

    1985-05-01

    Accounting for the attenuation (AT) of photons within cardiac chambers is crucial to accurate non-geometric volume determinations from gated blood pool scintigraphy. Previous techniques to determine AT for each patient have assumed an attenuation factor of 0.15/cm for Tc-99m, the value of water. To verify this, the authors determined the AT at various tissue distances (TD) in vivo. As a point source they used the balloon of a 5 French Swan-Ganz catheter which could reproducibly be filled with a constant amount of Tc-99m and could be placed within the left or right cardiac chambers. The exact location of the balloon, once inflated, and the TD from the balloon to the collimator of a small field-of-view Anger camera was determined using biplane orthogonal fluoroscopy. AT was determined by counting the inflated Tc-99m filled balloon in air and dividing that value by the counts of the same balloon within the heart. The authors positioned the balloon in the apex of the right and left ventricle, the ascending aorta and at the junction of the right atrium and inferior vena cava to give a total of 36 simultaneous observations of AT and TD. For our data the slope of the regression of the natural log of AT versus TD, when forced through zero, was 0.102, the calculated attenuation factor. The authors conclude that the attenuation factor that should be used for determining cardiac volumes with gated blood pool scans is 0.102/cm, not the value for water.

  3. Posterior left atrial–esophageal relationship throughout the cardiac cycle

    Microsoft Academic Search

    Jasbir Sra; David Krum; Angela Malloy; Atul Bhatia; Ryan Cooley; Zalmen Blanck; Anwer Dhala; Alfred J. Anderson; Masood Akhtar

    2006-01-01

    Background  Radiofrequency energy delivered throughout the cardiac cycle has the potential to cause thermal injury to the esophagus if the anatomical relationship between the posterior left atrium and the esophagus changes during cardiac motion.Objective  To assess the posterior left atrial–esophageal relationship throughout the cardiac cycle.Methods  In this study, the anatomical relationship between the posterior left atrium and the esophagus was assessed throughout the

  4. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-1 157.4840. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  5. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-2 157.4834. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  6. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-1 157.4833. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  7. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-2 157.4841. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  8. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-2 157.4834. Right (not printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  9. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-1 157.4833. Right (not printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  10. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-1 157.4840. Right (not printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  11. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER LEFT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER LEFT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-2 157.4841. Right (not printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  12. Isolated left ventricular assist as bridge to cardiac transplantation.

    PubMed

    Starnes, V A; Oyer, P E; Portner, P M; Ramasamy, N; Miller, P J; Stinson, E B; Baldwin, J C; Ream, A K; Wyner, J; Shumway, N E

    1988-07-01

    The electrically driven Novacor implantable left ventricular assist device has been implanted in six patients (four men and two women) since Sept. 7, 1984. In four of the six patients (67%) the device was a successful bridge to cardiac transplantation. One patient died of multiple organ failure and Candida sepsis after 16 days of support with the device. One patient died in the operating room of uncontrollable hemorrhage and biventricular failure caused by severe cardiac rejection. Three patients are alive with cardiac transplants 38, 17, and 10 months after transplantation. One patient died after cardiac transplantation of presumed sepsis. The Novacor left ventricular assist device performed in all cases without mechanical or electrical failure. Excluding the intraoperative death, assist duration ranged from 2 to 16 days. The cardiac index (synonymous with device output) ranged from 2.4 to 3.4 L/min/m2. No embolic events (cerebrovascular or systemic) occurred during assistance with the device. Minimal red cell hemolysis was documented during the period of support. The Novacor left ventricular assist device is a safe and effective bridge to cardiac transplantation in patients with refractory cardiogenic shock. PMID:3290589

  13. Hybrid right-left cardiac resynchronization therapy defibrillator implantation in persistent left superior vena cava.

    PubMed

    Anselmino, Matteo; Marocco, Maria Cristina; Amellone, Claudia; Massa, Riccardo

    2009-04-01

    Persistence of the left superior vena cava (PLSVC), observed in 0.3% of the general population as established by autopsy, is an anatomic variation particularly relevant when occurring in patients in need of a transvenous pacing. In this report, we describe a hybrid right-left cardiac resynchronization therapy defibrillator implantation approach in a patient with PLSVC. In our experience, the described approach proved feasible and safe, and may be considered an option in case of complex vein anatomy before referring for cardiac surgical implantation of a left ventricular lead. PMID:19112072

  14. Measurement of photon attenuation from different cardiac chambers

    Microsoft Academic Search

    A. M. Keller; T. R. Simon; C. R. Malloy; G. J. Dehmer; T. C. Smitherman

    1985-01-01

    Accounting for the attenuation (AT) of photons within cardiac chambers is crucial to accurate non-geometric volume determinations from gated blood pool scintigraphy. Previous techniques to determine AT for each patient have assumed an attenuation factor of 0.15\\/cm for Tc-99m, the value of water. To verify this, the authors determined the AT at various tissue distances (TD) in vivo. As a

  15. Left Ventricle Volume Measurements in Cardiac Micro-CT

    PubMed Central

    Badea, Cristian T.; Wetzel, Arthur W.; Mistry, Nilesh; Pomerantz, Stuart; Nave, Demian; Johnson, G. Allan

    2008-01-01

    Micro-CT based cardiac function estimation in small animals requires measurement of left ventricle (LV) volume at multiple time points during the cardiac cycle. Measurement accuracy depends on the image resolution, its signal and noise properties, and the analysis procedure. This work compares the accuracy of the Otsu thresholding and a region sampled binary mixture approach, for live mouse LV volume measurement using 100 micron resolution datasets. We evaluate both analysis methods after varying the volume of injected contrast agent and the number of projections used for CT reconstruction with a goal of permitting reduced levels of both x-ray and contrast agent doses. PMID:18243656

  16. Left ventricular rotation: a neglected aspect of the cardiac cycle

    Microsoft Academic Search

    Stefan Bloechlinger; Wilhelm Grander; Juerg Bryner; Martin W. Dünser

    2011-01-01

    Purpose  To describe the mechanics and possible clinical importance of left ventricular (LV) rotation, exemplify techniques to quantify\\u000a LV rotation and illustrate the temporal relationship of cardiac pressures, electrocardiogram and LV rotation.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Review of the literature combined with selected examples of echocardiographic measurements.\\u000a \\u000a \\u000a \\u000a Results  Rotation of the left ventricle around its longitudinal axis is an important but thus far neglected

  17. Reptilian heart development and the molecular basis of cardiac chamber evolution.

    PubMed

    Koshiba-Takeuchi, Kazuko; Mori, Alessandro D; Kaynak, Bogac L; Cebra-Thomas, Judith; Sukonnik, Tatyana; Georges, Romain O; Latham, Stephany; Beck, Laurel; Beck, Laural; Henkelman, R Mark; Black, Brian L; Olson, Eric N; Wade, Juli; Takeuchi, Jun K; Nemer, Mona; Gilbert, Scott F; Bruneau, Benoit G

    2009-09-01

    The emergence of terrestrial life witnessed the need for more sophisticated circulatory systems. This has evolved in birds, mammals and crocodilians into complete septation of the heart into left and right sides, allowing separate pulmonary and systemic circulatory systems, a key requirement for the evolution of endothermy. However, the evolution of the amniote heart is poorly understood. Reptilian hearts have been the subject of debate in the context of the evolution of cardiac septation: do they possess a single ventricular chamber or two incompletely septated ventricles? Here we examine heart development in the red-eared slider turtle, Trachemys scripta elegans (a chelonian), and the green anole, Anolis carolinensis (a squamate), focusing on gene expression in the developing ventricles. Both reptiles initially form a ventricular chamber that homogenously expresses the T-box transcription factor gene Tbx5. In contrast, in birds and mammals, Tbx5 is restricted to left ventricle precursors. In later stages, Tbx5 expression in the turtle (but not anole) heart is gradually restricted to a distinct left ventricle, forming a left-right gradient. This suggests that Tbx5 expression was refined during evolution to pattern the ventricles. In support of this hypothesis, we show that loss of Tbx5 in the mouse ventricle results in a single chamber lacking distinct identity, indicating a requirement for Tbx5 in septation. Importantly, misexpression of Tbx5 throughout the developing myocardium to mimic the reptilian expression pattern also results in a single mispatterned ventricular chamber lacking septation. Thus ventricular septation is established by a steep and correctly positioned Tbx5 gradient. Our findings provide a molecular mechanism for the evolution of the amniote ventricle, and support the concept that altered expression of developmental regulators is a key mechanism of vertebrate evolution. PMID:19727199

  18. Shape and dimensions of cardiac chambers: Importance of CT section thickness and orientation. [Dogs

    Microsoft Academic Search

    E. A. Hoffman; E. L. Ritman

    1985-01-01

    Three-dimensional (3D) computed tomography (CT) scan data were used to quantitate the geometry of all heart chambers. The Dynamic Spatial Reconstructor (DSR) was used to scan dogs with in situ casts of the cardiac chambers. Chamber volumes estimated from DSR images were accurate within 5% of water displacement volume measurements of the actual casts for chambers greater than 11 ml

  19. Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy

    NASA Astrophysics Data System (ADS)

    Rettmann, M. E.; Holmes, D. R.; Johnson, S. B.; Lehmann, H. I.; Robb, R. A.; Packer, D. L.

    2015-03-01

    Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2+/-1.8 mm in the medial/lateral direction, 4.7+/-4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0+/-5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5+/-1.3 mm in the medial/lateral direction, and 2.1+/-2.0 mm in the anterior/posterior and 1.3+/-1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0+/-1.5mm in the medial/lateral direction, 3.0+/-1.8mm in the anterior/posterior direction, and 1.5+/-1.5 mm in the superior/inferior directions.

  20. Chamber-Specific Cardiac Expression of Tbx5 and Heart Defects in HoltOram Syndrome

    E-print Network

    Tabin, Cliff

    Chamber-Specific Cardiac Expression of Tbx5 and Heart Defects in Holt­Oram Syndrome Benoit G with cardiac defects caused by human TBX5 mutations in Holt­Oram syndrome. Early in the developing heart, Tbx5 is uniformly expressed throughout the entire cardiac crescent. Upon formation of the linear heart tube, Tbx5

  1. Percutaneous cardioscopy of the cardiac chambers in patients with hypertrophic cardiomyopathy

    NASA Astrophysics Data System (ADS)

    Fujimori, Yoshiharu; Uchida, Yasumi; Nakamura, Fumitaka; Tomaru, Takanobu; Miwa, Atsuko; Hirose, Junichi; Sasaki, Michihiko; Oshima, Tomomitsu; Tsubouchi, Hiroyuki

    1993-05-01

    Recent advances in fiberoptic technology enables us to observe the cardiac chambers percutaneously in various categories of heart disease. We applied cardioscopy in 4 patients with HCM. Two of them presented excessive or good left ventricular function and no history of congestive heart failure (CHF). The other two patients showed reduced left ventricular function with a history of CHF. Cardioscopy was successfully performed in all patients. In patients with excessive or good left ventricular function, the color of the endocardial surface was light brown mixed with white. The trabeculae were significantly thick and contracted vigorously. In patients with reduced left ventricular function, the color was whiter, and the thickness and contraction of the trabeculae were reduced obviously. Myocardial biopsy revealed that interstitial fibrosis was prominent in the latters. These results indicate that (1) cardioscopy is safe and useful for evaluation of the internal surface of the ventricle in patients with HCM, and (2) cardioscopic characteristics of the ventricle are closely related to histopathological features.

  2. Left ventricular chamber stiffness at rest as a determinant of exercise capacity in heart failure subjects with decreased ejection fraction.

    PubMed

    Meyer, Timothy E; Karamanoglu, Mustafa; Ehsani, Ali A; Kovács, Sándor J

    2004-11-01

    Impaired exercise tolerance, determined by peak oxygen consumption (VO2 peak), is predictive of mortality and the necessity for cardiac transplantation in patients with chronic heart failure (HF). However, the role of left ventricular (LV) diastolic function at rest, reflected by chamber stiffness assessed echocardiographically, as a determinant of exercise tolerance is unknown. Increased LV chamber stiffness and limitation of VO2 peak are known correlates of HF. Yet, the relationship between chamber stiffness and VO2 peak in subjects with HF has not been fully determined. Forty-one patients with HF New York Heart Association [(NYHA) class 2.4 +/- 0.8, mean +/- SD] had echocardiographic studies and VO2 peak measurements. Transmitral Doppler E waves were analyzed using a previously validated method to determine k, the LV chamber stiffness parameter. Multiple linear regression analysis of VO(2 peak) variance indicated that LV chamber stiffness k (r2 = 0.55) and NYHA classification (r2 = 0.43) were its best independent predictors and when taken together account for 59% of the variability in VO2 peak. We conclude that diastolic function at rest, as manifested by chamber stiffness, is a major determinant of maximal exercise capacity in HF. PMID:15208299

  3. Improvement of cardiac function by increasing stimulus strength during left ventricular pacing in cardiac resynchronization therapy.

    PubMed

    Ishibashi, Kohei; Kubo, Takashi; Kitabata, Hironori; Takarada, Shigeho; Shimamura, Kunihiro; Tanimoto, Takashi; Orii, Makoto; Shiono, Yasutsugu; Yamano, Takashi; Ino, Yasushi; Yamaguchi, Tomoyuki; Hirata, Kumiko; Tanaka, Atsushi; Imanishi, Toshio; Akasaka, Takashi

    2015-01-01

    Cardiac resynchronization therapy (CRT) is an established therapy in patients with severe heart failure due to left ventricular (LV) dyssynchrony. Increasing stimulus strength (SS) of LV pacing could capture an enlarged myocardial area and provide rapid electrical conduction. The aim of the present study was to investigate whether increasing SS of LV pacing improves LV mechanical dyssynchrony and cardiac function in patients treated with CRT.We enrolled 26 patients with CRT and changed the SS of LV pacing: 2.5 V (standard SS) and 5 V (high SS). Electrocardiography and echocardiography were performed to assess QRS duration, LV mechanical dyssynchrony, and cardiac function under each condition.The QRS duration (138.6 ± 21.4 ms versus 126.8 ± 23.1 ms, P < 0.001), septal-posterior wall motion delay (126.5 ± 42.7 ms versus 111.4 ± 55.3 ms, P = 0.012), standard deviation of time from QRS (69.6 ± 21.8 ms versus 55.6 ± 19.4 ms, P < 0.001), LV ejection fraction (29.4 ± 10.6% versus 33.4 ± 11.6%, P = 0.005), and LV stroke volume (50.7 ± 15.5 mL versus 63.8 ± 18.3 mL, P < 0.001) improved significantly in high SS compared with standard SS.Increasing SS of LV pacing in CRT improves LV mechanical dyssynchrony and cardiac function. The capture of an enlarged myocardial area by increasing SS of LV pacing might offer an acute hemodynamic benefit to patients treated with CRT. PMID:25503657

  4. Multiple cerebral mycotic aneurysms due to left atrial myxoma: are there any pitfalls for the cardiac surgeon?

    PubMed

    Baikoussis, Nikolaos G; Siminelakis, Stavros N; Kotsanti, Angeliki; Achenbach, Kerstin; Argyropoulou, Maria; Goudevenos, John

    2011-01-01

    Acute cerebral embolism or cerebral aneurysm formation as a consequence of left atrial myxomas has been well documented, but the formation of multiple cerebral aneurysms resulting from atrial myxoma is a very rare neurological complication. We present the case of a 72-year-old-woman with a cardiac myxoma who suffered multiple cerebral mycotic aneurysms. After experiencing both vertigo and a sudden collapse accompanied by loss of consciousness, she underwent cerebral computed tomography (CT) and magnetic resonance imaging (MRI) examinations, which revealed multiple cerebral mycotic aneurysms of various dimensions and a large cyst, as a result of a previous haemorrhage. Embolisation was performed in large aneurysms of the circle of Willis but not in the one located in the periphery, and re-examination for a cardiac intervention a month later was indicated. The risk of cerebral haemorrhage was considered high; thus she was not operated on. Conservative treatment followed. Two years after the first diagnosis the patient remains healthy, suggesting that in such cases we should also consider conservative treatment. According to the literature, the risk is high when aneurysms are large, multiple and intractable. We propose that cerebral CT or MRI scan should be performed before operation in all patients with a cardiac myxoma, especially in those with left cardiac chamber localisation. PMID:21940297

  5. Technical failure to perform cardiac resynchronization therapy: Use of cardiac magnetic resonance imaging techniques to clarify a left-sided superior vena cava and coronary sinus morphology

    PubMed Central

    Keeble, William; Mohiaddin, Raad

    2008-01-01

    The most common reason for failure to implant a left ventricular lead to deliver cardiac resynchronization therapy is the presence of unfavourable coronary venous anatomy. The present report illustrates the use of cardiac magnetic resonance imaging to delineate the anatomy of a left-sided superior vena cava in two patients in whom permanent cardiac pacing was unattainable. PMID:18612503

  6. Image-Guided Radiotherapy for Cardiac Sparing in Patients with Left-Sided Breast Cancer

    PubMed Central

    Lemanski, Claire; Thariat, Juliette; Ampil, Federico L.; Bose, Satya; Vock, Jacqueline; Davis, Rick; Chi, Alexander; Dutta, Suresh; Woods, William; Desai, Anand; Godinez, Juan; Karlsson, Ulf; Mills, Melissa; Nguyen, Nam Phong; Vinh-Hung, Vincent

    2014-01-01

    Patients with left-sided breast cancer are at risk of cardiac toxicity because of cardiac irradiation during radiotherapy with the conventional 3-dimensional conformal radiotherapy technique. In addition, many patients may receive chemotherapy prior to radiation, which may damage the myocardium and may increase the potential for late cardiac complications. New radiotherapy techniques such as intensity-modulated radiotherapy (IMRT) may decrease the risk of cardiac toxicity because of the steep dose gradient limiting the volume of the heart irradiated to a high dose. Image-guided radiotherapy (IGRT) is a new technique of IMRT delivery with daily imaging, which may further reduce excessive cardiac irradiation. Preliminary results of IGRT for cardiac sparing in patients with left-sided breast cancer are promising and need to be investigated in future prospective clinical studies. PMID:25295227

  7. Scintigraphic Evaluation of Left Ventricular Function and Correlation with Autonomic Cardiac Neuropathy in Diabetic Patients

    Microsoft Academic Search

    Tomris Erbas; Belkis Erbas; Okay Gedik; Sevinc Bïberoglu; Coskun F. Bekdik

    1992-01-01

    Left ventricular function of 20 diabetic patients was investigated at rest and during hand-grip test using radionuclide ventriculography. The aim of the study was to discuss the correlation of cardiac function with autonomic cardiac neuropathy (ACN) in diabetic subjects. ACN was tested using heart rate response to valsalva maneuver, standing up, deep breathing; blood pressure response to standing up, sustained

  8. Construction of Left Ventricle 3D Shape Atlas from Cardiac MRI

    E-print Network

    Huang, Junzhou

    disorders and quantitative analysis of cardiac diseases. Recent developments in Cine MRI further help novel segmentation methods if further developed. The input to our al- gorithm is a cloud of pointsConstruction of Left Ventricle 3D Shape Atlas from Cardiac MRI Shaoting Zhang1 , Mustafa Uzunbas1

  9. Construction of Left Ventricle 3D Shape Atlas from Cardiac MRI

    E-print Network

    disorders and quantitative analysis of cardiac diseases. Recent developments in Cine MRI further help 2D databases and could lead to further novel segmentation methods if further developed. The inputConstruction of Left Ventricle 3D Shape Atlas from Cardiac MRI Shaoting Zhang1 , Mustafa Uzunbas1

  10. A DYNAMIC PROGRAMMING SOLUTION TO TRACKING AND ELASTICALLY MATCHING LEFT VENTRICULAR WALLS IN CARDIAC CINE MRI

    E-print Network

    Tsaftaris, Sotirios

    A DYNAMIC PROGRAMMING SOLUTION TO TRACKING AND ELASTICALLY MATCHING LEFT VENTRICULAR WALLS match the con- tours of the epicardial walls of the left ventricle (LV) in cardiac phase-resolved 2-D among different sets of cine MRI images. Future extensions include comparisons with contours hand

  11. Segmentation of the Left Ventricle from Cardiac MR Images Based on Radial GVF Snake

    Microsoft Academic Search

    Jia Liang; Gangyi Ding; Yuwei Wu

    2008-01-01

    Segmentation of the left ventricle (LV) is a hot topic in cardiac magnetic resonance (MR) images analysis and still remains challenging. In this paper, we propose a novel method, radial gradient vector flow (GVF) snake, to segment LV automatically. Left ventricle centroid and region of interest (ROI) are located using temporal intensity difference along with Hough transform. Taking the centroid

  12. Catheter Location, Tracking, Cardiac Chamber Geometry Creation, and Ablation Using Cutaneous Patches

    Microsoft Academic Search

    David Krum; Anil Goel; John Hauck; Jeff Schweitzer; John Hare; Mehran Attari; Anwer Dhala; Ryan Cooley; Masood Akhtar; Jasbir Sra

    2005-01-01

    Objective: The ability to construct a three-dimensional (3-D) surface model of the endocardium and track the location of catheters within a cardiac chamber, using only cutaneous patches, would be a useful advancement in treating arrhythmias. We tested the feasibility of such a system, Ensite NavX (Endocardial Solutions, Inc., St. Paul, MN, USA), in patients undergoing catheter ablation for SVTs.

  13. Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study

    PubMed Central

    Kou, Seisyou; Caballero, Luis; Dulgheru, Raluca; Voilliot, Damien; De Sousa, Carla; Kacharava, George; Athanassopoulos, George D.; Barone, Daniele; Baroni, Monica; Cardim, Nuno; Gomez De Diego, Jose Juan; Hagendorff, Andreas; Henri, Christine; Hristova, Krasimira; Lopez, Teresa; Magne, Julien; De La Morena, Gonzalo; Popescu, Bogdan A.; Penicka, Martin; Ozyigit, Tolga; Rodrigo Carbonero, Jose David; Salustri, Alessandro; Van De Veire, Nico; Von Bardeleben, Ralph Stephan; Vinereanu, Dragos; Voigt, Jens-Uwe; Zamorano, Jose Luis; Donal, Erwan; Lang, Roberto M.; Badano, Luigi P.; Lancellotti, Patrizio

    2014-01-01

    Aims Availability of normative reference values for cardiac chamber quantitation is a prerequisite for accurate clinical application of echocardiography. In this study, we report normal reference ranges for cardiac chambers size obtained in a large group of healthy volunteers accounting for gender and age. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following chamber quantitation protocols approved by the European Association of Cardiovascular Imaging. Methods A total of 734 (mean age: 45.8 ± 13.3 years) healthy volunteers (320 men and 414 women) were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was performed on all subjects following pre-defined protocols. There were no gender differences in age or cholesterol levels. Compared with men, women had significantly smaller body surface areas, and lower blood pressure. Quality of echocardiographic data sets was good to excellent in the majority of patients. Upper and lower reference limits were higher in men than in women. The reference values varied with age. These age-related changes persisted for most parameters after normalization for the body surface area. Conclusion The NORRE study provides useful two-dimensional echocardiographic reference ranges for cardiac chamber quantification. These data highlight the need for body size normalization that should be performed together with age-and gender-specific assessment for the most echocardiographic parameters. PMID:24451180

  14. Lessons from patient-specific 3D models of the cardiac chambers after the Mustard operation

    PubMed Central

    Chapron, Julien; Hosny, Hatem; Torii, Ryo; Sedky, Yasser; Donya, Mohamed; Yacoub, Magdi H

    2013-01-01

    The recent ability to create detailed 3D models of the atrial and ventricular chambers using CT, MRI and rapid prototyping offers unique opportunities to study the size and shape of the different cardiac chambers both before and following operation for complex cardiac anomalies. We here describe the techniques for creating detailed 3D models of the heart and demonstrate the utility of these techniques in a patient studied after the Mustard operation. This can give important insights into the changes in size and shape of the different chambers and the patterns of blood flow from the pulmonary and systemic veins to the ‘appropriate’ ventricle. This information in turn could be extremely helpful in understanding and optimizing the overall hemodynamic function after the Mustard operation. PMID:24749115

  15. Three-dimensional active shape model matching for left ventricle segmentation in cardiac CT

    Microsoft Academic Search

    Hans C. van Assen; Rob J. van der Geest; Mikhail G. Danilouchkine; Hildo J. Lamb; Johan H. C. Reiber; Boudewijn P. F. Lelieveldt

    2003-01-01

    Manual quantitative analysis of cardiac left ventricular function using multi-slice CT is labor intensive because of the large datasets. We present an automatic, robust and intrinsically three-dimensional segmentation method for cardiac CT images, based on 3D Active Shape Models (ASMs). ASMs describe shape and shape variations over a population as a mean shape and a number of eigenvariations, which can

  16. Left ventricular systolic torsion correlates global cardiac performance during dyssynchrony and cardiac resynchronization therapy

    PubMed Central

    Lamia, Bouchra; Tanabe, Masaki; Tanaka, Hidekazu; Kim, Hyung Kook; Gorcsan, John

    2011-01-01

    Left ventricular (LV) systolic torsion is a primary mechanism contributing to stroke volume (SV). We hypothesized that change in LV torsion parallels changes in global systolic performance during dyssynchrony and cardiac resynchronization therapy (CRT). Seven anesthetized open chest dogs had LV pressure-volume relationship. Apical, basal, and mid-LV cross-sectional echocardiographic images were studied by speckle tracking analysis. Right atrial (RA) pacing served as control. Right ventricular (RV) pacing simulated left bundle branch block. Simultaneous RV-LV free wall and RV-LV apex pacing (CRTfw and CRTa, respectively) modeled CRT. Dyssynchrony was defined as the time difference in peak strain between earliest and latest segments. Torsion was calculated as the maximum difference between the apical and basal rotation. RA pacing had minimal dyssynchrony (52 ± 36 ms). RV pacing induced dyssynchrony (189 ± 61 ms, P < 0.05). CRTa decreased dyssynchrony (46 ± 36 ms, P < 0.05 vs. RV pacing), whereas CRTfw did not (110 ± 96 ms). Torsion during baseline RA was 6.6 ± 3.7°. RV pacing decreased torsion (5.1 ± 3.6°, P < 0.05 vs. control), and reduced SV, stroke work (SW), and dP/dtmax compared with RA (21 ± 5 vs. 17 ± 5 ml, 252 ± 61 vs. 151 ± 64 mJ, and 2,063 ± 456 vs. 1,603 ± 424 mmHg/s, respectively, P < 0.05). CRTa improved torsion, SV, SW, and dP/dtmax compared with RV pacing (7.7 ± 4.7°, 23 ± 3 ml, 240 ± 50 mJ, and 1,947 ± 647 mmHg/s, respectively, P < 0.05), whereas CRTfw did not (5.1 ± 3.6°, 18 ± 5 ml, 175 ± 48 mJ, and 1,699 ± 432 mmHg/s, respectively, P < 0.05). LV torsion changes covaried across conditions with SW (y = 0.94x+12.27, r = 0.81, P < 0.0001) and SV (y = 0.66x+0.91, r = 0.81, P < 0.0001). LV dyssynchrony changes did not correlate with SW or SV (r = ?0.12, P = 0.61 and r = 0.08, P = 0.73, respectively). Thus, we conclude that LV torsion is primarily altered by dyssynchrony, and CRT that restores LV performance also restores torsion. PMID:21169399

  17. Effects of injectable anesthetic combinations on left ventricular function and cardiac morphology in Sprague-Dawley rats.

    PubMed

    Sabatini, Carla F; O'Sullivan, M Lynne; Valcour, James E; Sears, William; Johnson, Ron J

    2013-01-01

    Novel anesthetic agents or combinations may provide superior general anesthesia for echocardiography in rodents with the potential for reduced adverse effects. This study sought to characterize the effects of 3 injectable anesthetics on left ventricular (LV) systolic function and cardiac morphology in healthy male and female rats. Rats underwent echocardiographic assessment after general anesthesia via pentobarbital or combinations of ketamine and medetomidine (KME) and ketamine and midazolam (KMI) according to a crossover Latin-square design. Blood samples for serum estradiol measurements were obtained from all females after echocardiography with each anesthetic. Rats given KMI showed superior LV systolic function with the highest values for fractional shortening (FS), ejection fraction (EF) and stroke volume, whereas heart rate was greatest with pentobarbital, followed by KMI and then KME. KME produced the greatest effects on cardiac morphology, most notably during systole, including reduced septal and posterior wall thickness and increased LV chamber dimensions and volumes. In addition, KME had the greatest cardiac-depressing effects on LV systolic function, including reduced FS, EF, and heart rate values. Compared with male rats, female rats had superior LV function with greater EF and FS values, whereas male rats showed higher heart rate. Significant negative correlations were noted between serum estradiol levels and FS and EF values in female rats receiving KME. We conclude that the combination of KMI may be a superior anesthetic for use in male and female rats undergoing echocardiography. PMID:23562031

  18. Effects of Injectable Anesthetic Combinations on Left Ventricular Function and Cardiac Morphology in Sprague–Dawley Rats

    PubMed Central

    Sabatini, Carla F; O'Sullivan, M Lynne; Valcour, James E; Sears, William; Johnson, Ron J

    2013-01-01

    Novel anesthetic agents or combinations may provide superior general anesthesia for echocardiography in rodents with the potential for reduced adverse effects. This study sought to characterize the effects of 3 injectable anesthetics on left ventricular (LV) systolic function and cardiac morphology in healthy male and female rats. Rats underwent echocardiographic assessment after general anesthesia via pentobarbital or combinations of ketamine and medetomidine (KME) and ketamine and midazolam (KMI) according to a crossover Latin-square design. Blood samples for serum estradiol measurements were obtained from all females after echocardiography with each anesthetic. Rats given KMI showed superior LV systolic function with the highest values for fractional shortening (FS), ejection fraction (EF) and stroke volume, whereas heart rate was greatest with pentobarbital, followed by KMI and then KME. KME produced the greatest effects on cardiac morphology, most notably during systole, including reduced septal and posterior wall thickness and increased LV chamber dimensions and volumes. In addition, KME had the greatest cardiac-depressing effects on LV systolic function, including reduced FS, EF, and heart rate values. Compared with male rats, female rats had superior LV function with greater EF and FS values, whereas male rats showed higher heart rate. Significant negative correlations were noted between serum estradiol levels and FS and EF values in female rats receiving KME. We conclude that the combination of KMI may be a superior anesthetic for use in male and female rats undergoing echocardiography. PMID:23562031

  19. Improved GVF Based Left Ventricle Segmentation from Cardiac MR Images Using Radial B-Snake Model

    Microsoft Academic Search

    Jia Liang; Yuanquan Wang

    2008-01-01

    Segmentation of the left ventricle (LV) is a hot topic in cardiac magnetic resonance (MR) images analysis and still remains an open issue. In this paper, we propose a novel method, radial B-Snake model based on improved gradient vector flow (GVF), to segment LV automatically. Due to the left ventriclepsilas circle-like shape prior in short-axis view, the region of interest

  20. Relation Between Cardiac Sympathetic Activity and Hypertensive Left Ventricular Hypertrophy

    Microsoft Academic Search

    Markus P. Schlaich; David M. Kaye; Elisabeth Lambert; Marcus Sommerville; Flora Socratous; Murray D. Esler

    2010-01-01

    Background—Left ventricular (LV) hypertrophy is an independent risk factor for cardiovascular morbidity and mortality in hypertensive subjects. Sympathetic activation has been suggested to contribute to LV hypertrophy, but this has not yet been conclusively validated in humans. Methods and Results—We comprehensively assessed total systemic and regional sympathetic activity by radiotracer dilution methods and microneurography in 15 untreated hypertensive subjects with

  1. Cardiac memory during rather than after termination of left bundle branch block.

    PubMed

    Littmann, Laszlo; Proctor, Patrick A; Givens, Priscilla M

    2014-01-01

    An 83-year-old woman with chronic left bundle branch block and remote history of pacemaker implantation for intermittent AV block was hospitalized for fatigue and leg swelling. She had no cardiac complaints. Routine 12-lead electrocardiogram showed sinus rhythm with left bundle branch block. There were diffuse negative T waves in the inferior and anterolateral leads that were concordant with the QRS complexes. Echocardiogram was normal and nuclear perfusion heart scan showed no abnormality. It was noted that the negative T waves during left bundle branch block were in the exact same leads as were the deep negative QRS complexes during ventricular pacing. The electrocardiographic changes were consistent with cardiac memory. This case is unique because cardiac memory in patients with intermittent left bundle branch block typically occurs when the QRS complexes normalize and not during left bundle branch block itself. Our findings indicate that memory Ts can develop not only after normalization of wide complex rhythms but also with alternating wide complex rhythms as in the presented case where a ventricular paced rhythm was replaced by left bundle branch block. PMID:25172185

  2. Outer contour and radial changes of the cardiac left ventricle

    Microsoft Academic Search

    Kent Emilsson; A. Kähäri; L. Bodin; P. Thunberg

    2007-01-01

    Earlier studies have shown a 5% end-systolic decrease in the volume encompassed by the pericardial sack, manifesting as a\\u000a radial diminution of the pericardial\\/epicardial contour of the left ventricle (LV).\\u000a \\u000a The aim of this study was to measure this radial displacement at different segmental levels of the LV and try to find out\\u000a were it is as greatest and to

  3. Real-time cardiac output estimation of the circulatory system under left ventricular assistance

    Microsoft Academic Search

    Makoto Yoshizawa; Hiroshi Takeda; Makoto Miura; Tomoyuki Yambe; Yoshiaki Katahira; Shin-ichi Nitta

    1993-01-01

    A method for indirect and real-time estimation of the cardiac output of the circulatory system supported by the left ventricular assist device (LVAD) is proposed. This method has low invasiveness and is useful for clinical applications of the LVAD since it needs only two measurements: the rate of blood outflow from the LVAD and the aortic pressure. The method is

  4. Multistage Hybrid Active Appearance Model Matching: Segmentation of Left and Right Ventricles in Cardiac MR Images

    Microsoft Academic Search

    Steven C. Mitchell; Boudewijn P. F. Lelieveldt; Rob J. Van Der Geest; Johan G. Bosch; Johan H. C. Reiber; Milan Sonka

    2001-01-01

    A fully automated approach to segmentation of the left and right cardiac ventricles from magnetic resonance (MR) images is reported. A novel multistage hybrid appearance model methodology is presented in which a hybrid active shape model\\/ac- tive appearance model (AAM) stage helps avoid local minima of the matching function. This yields an overall more favorable matching result. An automated initialization

  5. VDD pacing from the middle cardiac vein via a persistent left superior vena cava

    Microsoft Academic Search

    John A. Chiladakis; Dimitris Siablis; Antonis S. Manolis

    2001-01-01

    We report a combination of unusual features demonstrating a permanent pacemaker implantation of a single-pass VDD lead by way of an anomalous persistent left superior vena cava in the middle cardiac vein. The ventricular stimulation resembled a right bundle branch block QRS morphology and was successfully synchronized by spontaneous atrial activity. This case illustrates an alternative approach of effective VDD

  6. Post-hypothermic cardiac left ventricular systolic dysfunction after rewarming in an intact pig model

    PubMed Central

    2010-01-01

    Introduction We developed a minimally invasive, closed chest pig model with the main aim to describe hemodynamic function during surface cooling, steady state severe hypothermia (one hour at 25°C) and surface rewarming. Methods Twelve anesthetized juvenile pigs were acutely catheterized for measurement of left ventricular (LV) pressure-volume loops (conductance catheter), cardiac output (Swan-Ganz), and for vena cava inferior occlusion. Eight animals were surface cooled to 25°C, while four animals were kept as normothermic time-matched controls. Results During progressive cooling and steady state severe hypothermia (25°C) cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), maximal deceleration of pressure in the cardiac cycle (dP/dtmin), indexes of LV contractility (preload recruitable stroke work, PRSW, and maximal acceleration of pressure in the cardiac cycle, dP/dtmax) and LV end diastolic and systolic volumes (EDV and ESV) were significantly reduced. Systemic vascular resistance (SVR), isovolumetric relaxation time (Tau), and oxygen content in arterial and mixed venous blood increased significantly. LV end diastolic pressure (EDP) remained constant. After rewarming all the above mentioned hemodynamic variables that were depressed during 25°C remained reduced, except for CO that returned to pre-hypothermic values due to an increase in heart rate. Likewise, SVR and EDP were significantly reduced after rewarming, while Tau, EDV, ESV and blood oxygen content normalized. Serum levels of cardiac troponin T (TnT) and tumor necrosis factor-alpha (TNF-?) were significantly increased. Conclusions Progressive cooling to 25°C followed by rewarming resulted in a reduced systolic, but not diastolic left ventricular function. The post-hypothermic increase in heart rate and the reduced systemic vascular resistance are interpreted as adaptive measures by the organism to compensate for a hypothermia-induced mild left ventricular cardiac failure. A post-hypothermic increase in TnT indicates that hypothermia/rewarming may cause degradation of cardiac tissue. There were no signs of inadequate global oxygenation throughout the experiments. PMID:21092272

  7. Left ventricular diastolic dysfunction of the cardiac surgery patient; a point of view for the cardiac surgeon and cardio-anesthesiologist

    Microsoft Academic Search

    Efstratios E Apostolakis; Nikolaos G Baikoussis; Haralabos Parissis; Stavros N Siminelakis; Georgios S Papadopoulos

    2009-01-01

    BACKGROUND: Left ventricular diastolic dysfunction (DD) is defined as the inability of the ventricle to fill to a normal end-diastolic volume, both during exercise as well as at rest, while left atrial pressure does not exceed 12 mm Hg. We examined the concept of left ventricular diastolic dysfunction in a cardiac surgery setting. MATERIALS AND METHODS: Literature review was carried

  8. Turning crocodilian hearts into bird hearts: growth rates are similar for alligators with and without right-to-left cardiac shunt.

    PubMed

    Eme, John; Gwalthney, June; Owerkowicz, Tomasz; Blank, Jason M; Hicks, James W

    2010-08-01

    The functional and possible adaptive significance of non-avian reptiles' dual aortic arch system and the ability of all non-avian reptiles to perform central vascular cardiac shunts have been of great interest to comparative physiologists. The unique cardiac anatomy of crocodilians - a four-chambered heart with the dual aortic arch system - allows for only right-to-left (R-L; pulmonary bypass) cardiac shunt and for surgical elimination of this shunt. Surgical removal of the R-L shunt, by occluding the left aorta (LAo) upstream and downstream of the foramen of Panizza, results in a crocodilian with an obligatory, avian/mammalian central circulation. In this study, R-L cardiac shunt was eliminated in age-matched, female American alligators (Alligator mississippiensis; 5-7 months of age). We tested the hypothesis that surgical elimination of R-L cardiac shunt would impair growth (a readily measured proxy for fitness) compared with sham-operated, age-matched controls, especially in animals subjected to exhaustive exercise. While regular exercise caused a decrease in size (snout-to-vent length, head length and body mass), elimination of the capacity for R-L cardiac shunt did not greatly reduce animal growth, despite a chronic ventricular enlargement in surgically altered juvenile alligators. We speculate that, despite being slightly smaller, alligators with an occluded LAo would have reached sexual maturity in the same breeding season as control alligators. This study suggests that crocodilian R-L cardiac shunt does not provide an adaptive advantage for juvenile alligator growth and supports the logic that cardiac shunts persist in crocodilians because they have not been selected against. PMID:20639429

  9. Body surface mapping of cardiac activity after partial left ventriculectomy.

    PubMed

    Gersak, Borut

    2003-05-01

    MECG measurements were performed using 35 electrodes in 10 patients operated with partial left ventriculectomy (PLV). Body surface ECG signals were recorded and five measurements were done: prior to PLV, second, third, fourth and fifth postoperative day. This work was concentrated on the following mapping methods: average isopotential ST segment maps (STM), QRS interval isointegral maps (QRM) and isochronal activation maps (IAM). STMs of the patients show a great positive area (elevation) over the anterior aspect of the heart and a great negative area (depression) over the lateral and posterior aspect of the heart before the operation. After the operation, the ST elevation over the anterior, lateral and posterior aspect of the heart was reduced. A substantial positive value over the excised area of the heart was present also on the end of the postoperative monitoring interval. Minimal and maximal values of the QRMs were smaller and also show some kind of normalisation. The area of the left ventricle, where PLV was performed, was carefully analysed for any changes of activation time for different heart regions. IAMs indicate that the start of the first activation was quite stable and in accordance with the position of the QRMs minimum. PMID:12726802

  10. Cardiac resynchronization therapy in patients with absent right but persistent left superior vena cava.

    PubMed

    Kortner, A; Keyser, A; Schmid, C

    2009-06-01

    Abnormalities of the vena cava system are usually asymptomatic and are found incidentally during pacemaker implantation or catherization. We report a case of dilative cardiomyopathy requiring cardiac resynchronization defibrillator therapy (CRT-D). During the operation, a persistent left superior vena cava with an absent right vena cava was discovered. During open chest surgery, we implanted a CRT-D with epicardial patches and pacing leads, which is a simple technique for safe and reliable biventricular defibrillator therapy in these patients. PMID:19670119

  11. The right atrium, a forgotten cardiac chamber: An updated review of multimodality imaging.

    PubMed

    Tadic, Marijana

    2015-07-01

    Despite several limitations, two-dimensional echocardiography (2DE) is the standard method for assessing the right atrium (RA) in everyday clinical routine. Cardiac magnetic resonance remains the current "gold standard" for RA visualization and volume quantification. The development of 2DE-derived strain imaging has enabled assessing RA deformation and phasic function in various pathologic conditions. Three-dimensional echocardiography was demonstrated to be more accurate and reproducible than 2DE for cardiac chamber quantification, while also allowing the evaluation of RA phasic function without geometric assumption. The purpose of this review is to summarize currently available data about RA anatomy, phasic function, and mechanics acquired by different imaging modalities. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 43:335-345, 2015. PMID:25732678

  12. Pitx2 regulates cardiac left–right asymmetry by patterning second cardiac lineage-derived myocardium

    Microsoft Academic Search

    Di Ai; Wei Liu; Lijiang Ma; Feiyan Dong; Mei-Fang Lu; Degang Wang; Michael P. Verzi; Chenleng Cai; Philip J. Gage; Sylvia Evans; Brian L. Black; Nigel A. Brown; James F. Martin

    2006-01-01

    Current models of left–right asymmetry hold that an early asymmetric signal is generated at the node and transduced to lateral plate mesoderm in a linear signal transduction cascade through the function of the Nodal signaling molecule. The Pitx2 homeobox gene functions at the final stages of this cascade to direct asymmetric morphogenesis of selected organs including the heart. We previously

  13. Toward standardized mapping for left atrial analysis and cardiac ablation guidance

    NASA Astrophysics Data System (ADS)

    Rettmann, M. E.; Holmes, D. R.; Linte, C. A.; Packer, D. L.; Robb, R. A.

    2014-03-01

    In catheter-based cardiac ablation, the pulmonary vein ostia are important landmarks for guiding the ablation procedure, and for this reason, have been the focus of many studies quantifying their size, structure, and variability. Analysis of pulmonary vein structure, however, has been limited by the lack of a standardized reference space for population based studies. Standardized maps are important tools for characterizing anatomic variability across subjects with the goal of separating normal inter-subject variability from abnormal variability associated with disease. In this work, we describe a novel technique for computing flat maps of left atrial anatomy in a standardized space. A flat map of left atrial anatomy is created by casting a single ray through the volume and systematically rotating the camera viewpoint to obtain the entire field of view. The technique is validated by assessing preservation of relative surface areas and distances between the original 3D geometry and the flat map geometry. The proposed methodology is demonstrated on 10 subjects which are subsequently combined to form a probabilistic map of anatomic location for each of the pulmonary vein ostia and the boundary of the left atrial appendage. The probabilistic map demonstrates that the location of the inferior ostia have higher variability than the superior ostia and the variability of the left atrial appendage is similar to the superior pulmonary veins. This technique could also have potential application in mapping electrophysiology data, radio-frequency ablation burns, or treatment planning in cardiac ablation therapy.

  14. Primary Cardiac Synovial Sarcoma Originating from the Mitral Valve Causing Left Ventricular Outflow Tract Obstruction.

    PubMed

    Veshti, Altin; Prifti, Edvin Mihal; Ikonomi, Majlinda

    2015-01-01

    An 11-year-old boy was admitted due to different episodes of syncope and convulsion. Echocardiogram revealed a mass of 2 × 4 cm originating from the mitral subvalvular apparatus and more precisely from the antero-lateral papillary muscle, protruding in the left ventricle outflow tract causing intermittent obstruction. The patient underwent surgical excision of the left sided mass. Pathology confirmed the diagnosis of primary synovial sarcoma. At 6 months after the operation a small mass in the left ventricle of 1 × 1 cm was detected. The patient underwent reoperation consisting in radical resection of the subvalvular apparatus and mitral valve replacement. Histology confirmed that the mass was a cardiac synovial sarcoma. At 1 year after surgery the patient is doing well. PMID:26115156

  15. Hindlimb unloading results in increased predisposition to cardiac arrhythmias and alters left ventricular connexin 43 expression

    PubMed Central

    Henry, Matthew K.; Welliver, Kathryn C.; Jepson, Amanda J.; Garnett, Emily R.

    2013-01-01

    Hindlimb unloading (HU) is a well-established animal model of cardiovascular deconditioning. Previous data indicate that HU results in cardiac sympathovagal imbalance. It is well established that cardiac sympathovagal imbalance increases the risk for developing cardiac arrhythmias. The cardiac gap junction protein connexin 43 (Cx43) is predominately expressed in the left ventricle (LV) and ensures efficient cell-to-cell electrical coupling. In the current study we wanted to test the hypothesis that HU would result in increased predisposition to cardiac arrhythmias and alter the expression and/or phosphorylation of LV-Cx43. Electrocardiographic data using implantable telemetry were obtained over a 10- to 14-day HU or casted control (CC) condition and in response to a sympathetic stressor using isoproterenol administration and brief restraint. The arrhythmic burden was calculated using a modified scoring system to quantify spontaneous and provoked arrhythmias. In addition, Western blot analysis was used to measure LV-Cx43 expression in lysates probed with antibodies directed against the total and an unphosphorylated form of Cx43 in CC and HU rats. HU resulted in a significantly greater total arrhythmic burden during the sympathetic stressor with significantly more ventricular arrhythmias occurring. In addition, there was increased expression of total LV-Cx43 observed with no difference in the expression of unphosphorylated LV-Cx43. Specifically, the increased expression of LV-Cx43 was consistent with the phosphorylated form. These data taken together indicate that cardiovascular deconditioning produced through HU results in increased predisposition to cardiac arrhythmias and increased expression of phosphorylated LV-Cx43. PMID:23302960

  16. Great vessel, cardiac chamber, and wall growth patterns in normal children.

    PubMed

    Epstein, M L; Goldberg, S J; Allen, H D; Konecke, L; Wood, J

    1975-06-01

    The purpose of this study was to establish normal echocardiographic measurements of valvular motion, cavity dimensions, great vessel diameters, and right, left and septal wall thicknesses of children ranging in size from infants to full growth. The study group was composed of 205 normal, healthy children for whom echocardiograms and subsequent measurements were performed in a standardized manner. The following measurements were performed: left ventricular end-diastolic and end-systolic dimension, right ventricular end-diastolic cavity dimension, right ventricular end-diastolic anterior wall thickness, left ventricular end-diastolic posterior wall thickness, ventricular septal end-diastolic thickness, maximal left atrail dimension, end-diastolic aortic and pulmonary artery diameter, end-diastolic cardiac and septal depth, maximal aortic leaflet separation, and maximal anterior mitral and anterior tricupsid amplitude. Data are grouped into the fifth, fiftieth, and ninety-fifty percentiles according to body surface area. These graphs allow measurements of a single patient to be compared to normal measurements of individuals with similar body surface area. PMID:1132102

  17. A Collaborative Resource to Build Consensus for Automated Left Ventricular Segmentation of Cardiac MR Images

    PubMed Central

    Suinesiaputra, Avan; Cowan, Brett R.; Al-Agamy, Ahmed O.; AlAttar, Mustafa A.; Ayache, Nicholas; Fahmy, Ahmed S.; Khalifa, Ayman M.; Medrano-Gracia, Pau; Jolly, Marie-Pierre; Kadish, Alan H.; Lee, Daniel C.; Margeta, Ján; Warfield, Simon K.; Young, Alistair A.

    2013-01-01

    A collaborative framework was initiated to establish a community resource of ground truth segmentations from cardiac MRI. Multi-site, multi-vendor cardiac MRI datasets comprising 95 patients (73 men, 22 women; mean age 62.73 ± 11.24 years) with coronary artery disease and prior myocardial infarction, were randomly selected from data made available by the Cardiac Atlas Project (Fonseca et al., 2011). Three semi- and two fully-automated raters segmented the left ventricular myocardium from short-axis cardiac MR images as part of a challenge introduced at the STACOM 2011 MICCAI workshop (Suinesiaputra et al., 2012). Consensus myocardium images were generated based on the Expectation-Maximization principle implemented by the STAPLE algorithm (Warfield et al., 2004). The mean sensitivity, specificity, positive predictive and negative predictive values ranged between 0.63-0.85, 0.60-0.98, 0.56-0.94 and 0.83-0.92, respectively, against the STAPLE consensus. Spatial and temporal agreement varied in different amounts for each rater. STAPLE produced high quality consensus images if the region of interest was limited to the area of discrepancy between raters. To maintain the quality of the consensus, an objective measure based on the candidate automated rater performance distribution is proposed. The consensus segmentation based on a combination of manual and automated raters were more consistent than any particular rater, even those with manual input. The consensus is expected to improve with the addition of new automated contributions. This resource is open for future contributions, and is available as a test bed for the evaluation of new segmentation algorithms, through the Cardiac Atlas Project (www.cardiacatlas.org). PMID:24091241

  18. A collaborative resource to build consensus for automated left ventricular segmentation of cardiac MR images.

    PubMed

    Suinesiaputra, Avan; Cowan, Brett R; Al-Agamy, Ahmed O; Elattar, Mustafa A; Ayache, Nicholas; Fahmy, Ahmed S; Khalifa, Ayman M; Medrano-Gracia, Pau; Jolly, Marie-Pierre; Kadish, Alan H; Lee, Daniel C; Margeta, Ján; Warfield, Simon K; Young, Alistair A

    2014-01-01

    A collaborative framework was initiated to establish a community resource of ground truth segmentations from cardiac MRI. Multi-site, multi-vendor cardiac MRI datasets comprising 95 patients (73 men, 22 women; mean age 62.73±11.24years) with coronary artery disease and prior myocardial infarction, were randomly selected from data made available by the Cardiac Atlas Project (Fonseca et al., 2011). Three semi- and two fully-automated raters segmented the left ventricular myocardium from short-axis cardiac MR images as part of a challenge introduced at the STACOM 2011 MICCAI workshop (Suinesiaputra et al., 2012). Consensus myocardium images were generated based on the Expectation-Maximization principle implemented by the STAPLE algorithm (Warfield et al., 2004). The mean sensitivity, specificity, positive predictive and negative predictive values ranged between 0.63 and 0.85, 0.60 and 0.98, 0.56 and 0.94, and 0.83 and 0.92, respectively, against the STAPLE consensus. Spatial and temporal agreement varied in different amounts for each rater. STAPLE produced high quality consensus images if the region of interest was limited to the area of discrepancy between raters. To maintain the quality of the consensus, an objective measure based on the candidate automated rater performance distribution is proposed. The consensus segmentation based on a combination of manual and automated raters were more consistent than any particular rater, even those with manual input. The consensus is expected to improve with the addition of new automated contributions. This resource is open for future contributions, and is available as a test bed for the evaluation of new segmentation algorithms, through the Cardiac Atlas Project (www.cardiacatlas.org). PMID:24091241

  19. Improved noninvasive method for measurement of cardiac output and evaluation of left-sided cardiac valve incompetence

    SciTech Connect

    Kelbaek, H.

    1989-05-01

    A time-saving method was developed to label red blood cells in vitro with /sup 99m/Tc while avoiding centrifugation. After tin incubation, extracellular tin was oxidized by sodium hypochlorite, and EDTA was added for stabilizing the complex prior to /sup 99m/Tc incubation. Labeling yields were 95%, and in vivo decay showed a high stability with a mean biologic half-life of eleven hours. The first-passage radionuclide technique for determination of cardiac output using the above-mentioned tracer was evaluated by using the left ventricle as area-of-interest with individual background correction after complete mixing of the tracer. This technique showed a high level of agreement with invasive methods. By combining this method for measurement of the forward stroke volume with the multigated equilibrium principle for determination of the total left ventricular stroke volume using similar background corrections, an exact evaluation of regurgitation fractions was obtained. In patients with aortic and mitral valve disease the noninvasive radionuclide technique gave similar but probably more accurate results as compared with contrast aortography and ventriculography. The radionuclide technique may be suitable for monitoring and selecting patients for surgical treatment.

  20. Magnetic resonance assessment of left ventricular diastolic dysfunction for detecting cardiac allograft vasculopathy in recipients of heart transplants

    Microsoft Academic Search

    Haruhiko Machida; Shinichi Nunoda; Kiyotaka Okajima; Kazunobu Shitakura; Akihiko Sekikawa; Yutaka Kubo; Kuniaki Otsuka; Masami Hirata; Shinya Kojima; Eiko Ueno

    Cardiac allograft vasculopathy (CAV) is a major late complication in heart transplant recipients, graded based on intravascular\\u000a ultrasound (IVUS), and accelerates left ventricular (LV) diastolic dysfunction. We investigated the clinical feasibility of\\u000a using magnetic resonance (MR) to assess LV diastolic dysfunction noninvasively in transplant recipients. Thirty-eight asymptomatic\\u000a recipients (25 men, 37.2 ± 14.9 years) underwent both IVUS and cardiac MR. Based on IVUS,

  1. Potential Effect of Robust and Simple IMRT Approach for Left-Sided Breast Cancer on Cardiac Mortality

    SciTech Connect

    Lohr, Frank [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany)], E-mail: frank.lohr@radonk.ma.uni-heidelberg.de; El-Haddad, Mostafa [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany); Department of Oncology, Kasr-El-Einy Hospital, Cairo University, Cairo (Egypt); Dobler, Barbara [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany); Department of Radiotherapy, Regensburg University Medical Center, Regensburg (Germany); Grau, Roland; Wertz, Hans-Joerg; Kraus-Tiefenbacher, Uta; Steil, Volker [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany); Madyan, Yasser Abo [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany); Department of Oncology, Kasr-El-Einy Hospital, Cairo University, Cairo (Egypt); Wenz, Frederik [Department of Radiation Oncology, Mannheim University Medical Center, University of Heidelberg, Mannheim (Germany)

    2009-05-01

    Purpose: Three-dimensional (3D) treatment planning has reduced the cardiac dose in postoperative radiotherapy for breast cancer; however, the overall cardiac toxicity is still an issue because of more aggressive adjuvant treatment. Toxicity models have suggested that a reduction of the heart volume treated to high doses might be particularly advantageous. We compared aperture-based multifield intensity-modulated radiotherapy (IMRT) plans to 3D-planned tangent fields using dose-volume histograms, cardiac toxicity risk, and the robustness to positioning errors. Methods and Materials: For 14 computed tomography data sets of patients with left-sided breast cancer (unfavorable thoracic geometry), a 3D treatment plan and an IMRT plan were created. The dose-volume histograms were evaluated for the target and risk organs. Excess risk of cardiac mortality was calculated for both approaches using a relative seriality model. Positioning errors were simulated by moving the isocenter. Results: IMRT reduced the maximal dose to the left ventricle by a mean of 30.9% (49.14 vs. 33.97 Gy). The average heart volume exposed to >30 Gy was reduced from 45 cm{sup 3} to 5.84 cm{sup 3}. The mean dose to the left ventricle was reduced by an average of 10.7% (10.86 vs. 9.7 Gy), and the mean heart dose increased by an average of 24% (from 6.85 to 8.52 Gy). The model-based reduction of the probability for excess therapy-associated cardiac death risk was from 6.03% for the 3D plans to 0.25% for the IMRT plans. Conclusion: Aperture-based IMRT for left-sided breast cancer significantly reduces the maximal dose to the left ventricle, which might translate into reduced cardiac mortality. Biological modeling might aid in deciding to treat with IMRT but has to be validated prospectively.

  2. Natakalim improves post-infarction left ventricular remodeling by restoring the coordinated balance between endothelial function and cardiac hypertrophy

    PubMed Central

    ZHOU, HONG-MIN; ZHONG, MING-LI; ZHANG, YAN-FANG; CUI, WEN-YU; LONG, CHAO-LIANG; WANG, HAI

    2014-01-01

    Endothelial dysfunction can lead to congestive heart failure and the activation of endothelial ATP-sensitive potassium (KATP) channels may contribute to endothelial protection. Therefore, the present study was carried out to investigate the hypothesis that natakalim, a novel KATP channel opener, ameliorates post-infarction left ventricular remodeling and failure by correcting endothelial dysfunction. The effects of myocardial infarction were assessed 8 weeks following left anterior descending coronary artery occlusion in male Wistar rats. Depressed blood pressure, cardiac dysfunction, evidence of left ventricular remodeling and congestive heart failure were observed in the rats with myocardial infarction. Treatment with natakalim at daily oral doses of 1, 3 or 9 mg/kg/day for 8 weeks prevented these changes. Natakalim also prevented the progression to cardiac failure, which was demonstrated by the increase in right ventricular weight/body weight (RVW/BW) and relative lung weight, signs of cardiac dysfunction, as well as the overexpression of atrial and brain natriuretic peptide mRNAs. Our results also demonstrated that natakalim enhanced the downregulation of endothelium-derived nitric oxide, attenuated the upregulation of inducible nitric oxide synthase-derived nitric oxide (NO), inhibited the upregulated endothelin system and corrected the imbalance between prostacyclin and thromboxane A2. Overall, our findings suggest that natakalim prevents post-infarction hypertrophy and cardiac failure by restoring the coordinated balance between endothelial function and cardiac hypertrophy. PMID:25215478

  3. Natakalim improves post-infarction left ventricular remodeling by restoring the coordinated balance between endothelial function and cardiac hypertrophy.

    PubMed

    Zhou, Hong-Min; Zhong, Ming-Li; Zhang, Yan-Fang; Cui, Wen-Yu; Long, Chao-Liang; Wang, Hai

    2014-11-01

    Endothelial dysfunction can lead to congestive heart failure and the activation of endothelial ATP-sensitive potassium (K(ATP)) channels may contribute to endothelial protection. Therefore, the present study was carried out to investigate the hypothesis that natakalim, a novel K(ATP) channel opener, ameliorates post-infarction left ventricular remodeling and failure by correcting endothelial dysfunction. The effects of myocardial infarction were assessed 8 weeks following left anterior descending coronary artery occlusion in male Wistar rats. Depressed blood pressure, cardiac dysfunction, evidence of left ventricular remodeling and congestive heart failure were observed in the rats with myocardial infarction. Treatment with natakalim at daily oral doses of 1, 3 or 9 mg/kg/day for 8 weeks prevented these changes. Natakalim also prevented the progression to cardiac failure, which was demonstrated by the increase in right ventricular weight/body weight (RVW/BW) and relative lung weight, signs of cardiac dysfunction, as well as the overexpression of atrial and brain natriuretic peptide mRNAs. Our results also demonstrated that natakalim enhanced the downregulation of endothelium-derived nitric oxide, attenuated the upregulation of inducible nitric oxide synthase-derived nitric oxide (NO), inhibited the upregulated endothelin system and corrected the imbalance between prostacyclin and thromboxane A(2). Overall, our findings suggest that natakalim prevents post-infarction hypertrophy and cardiac failure by restoring the coordinated balance between endothelial function and cardiac hypertrophy. PMID:25215478

  4. Optimizing the programation of cardiac resynchronization therapy devices in patients with heart failure and left bundle branch block.

    PubMed

    Vidal, Bàrbara; Sitges, Marta; Marigliano, Alba; Delgado, Victoria; Díaz-Infante, Ernesto; Azqueta, Manel; Tamborero, David; Tolosana, José María; Berruezo, Antonio; Pérez-Villa, Félix; Paré, Carles; Mont, Lluís; Brugada, Josep

    2007-09-15

    This study was conducted to investigate the clinical impact of cardiac resynchronization device optimization. A series of 100 consecutive patients received cardiac resynchronization therapy. In the first 49 patients, an empirical atrioventricular delay of 120 ms was set, with simultaneous biventricular stimulation (interventricular [VV] interval=0 ms). In the next 51 patients, systematic atrioventricular optimization was performed. VV optimization was also performed, selecting 1 VV delay: right or left ventricular preactivation (+30 or -30 ms) or simultaneous (VV interval=0 ms), according to the best synchrony obtained by tissue Doppler-derived wall displacement. At follow-up, patients who were alive without cardiac transplantation and showed improvement of >or=10% in the distance walked in the 6-minute walking test were considered responders. There were no differences between the 2 groups at baseline. Left ventricular ejection fraction improved in the 2 groups, but left ventricular cardiac output improved only in the optimized group. At 6 months, patients with optimized devices walked slightly further in the 6-minute walking test (497+/-167 vs 393+/-123 m, p<0.01), with no differences in New York Heart Association functional class or quality of life compared with nonoptimized patients. Overall, the number of nonresponders were similar in the 2 groups (27% vs 23%, p=NS). In conclusion, the echocardiographic optimization of cardiac resynchronization devices provided a slight incremental clinical benefit at midterm follow-up. Simple and rapid methods to routinely optimize the devices are warranted. PMID:17826387

  5. The Effects of Training on the Time Components of the Left Ventricle, and Cardiac Time Components: Sedentary versus Active Individuals.

    ERIC Educational Resources Information Center

    Plowman, Sharon Ann

    A review of previous research was completed to determine (a) the response of the cardiac time components of the left ventricle to varying types and intensities of training programs, (b) the probable physiological explanations for these responses, and (c) the significance of the changes which did or did not occur. It was found that, at rest,…

  6. Left ventricular flow analysis: recent advances in numerical methods and applications in cardiac ultrasound.

    PubMed

    Borazjani, Iman; Westerdale, John; McMahon, Eileen M; Rajaraman, Prathish K; Heys, Jeffrey J; Belohlavek, Marek

    2013-01-01

    The left ventricle (LV) pumps oxygenated blood from the lungs to the rest of the body through systemic circulation. The efficiency of such a pumping function is dependent on blood flow within the LV chamber. It is therefore crucial to accurately characterize LV hemodynamics. Improved understanding of LV hemodynamics is expected to provide important clinical diagnostic and prognostic information. We review the recent advances in numerical and experimental methods for characterizing LV flows and focus on analysis of intraventricular flow fields by echocardiographic particle image velocimetry (echo-PIV), due to its potential for broad and practical utility. Future research directions to advance patient-specific LV simulations include development of methods capable of resolving heart valves, higher temporal resolution, automated generation of three-dimensional (3D) geometry, and incorporating actual flow measurements into the numerical solution of the 3D cardiovascular fluid dynamics. PMID:23690874

  7. Left Ventricular Flow Analysis: Recent Advances in Numerical Methods and Applications in Cardiac Ultrasound

    PubMed Central

    Borazjani, Iman; Westerdale, John; McMahon, Eileen M.; Rajaraman, Prathish K.; Heys, Jeffrey J.

    2013-01-01

    The left ventricle (LV) pumps oxygenated blood from the lungs to the rest of the body through systemic circulation. The efficiency of such a pumping function is dependent on blood flow within the LV chamber. It is therefore crucial to accurately characterize LV hemodynamics. Improved understanding of LV hemodynamics is expected to provide important clinical diagnostic and prognostic information. We review the recent advances in numerical and experimental methods for characterizing LV flows and focus on analysis of intraventricular flow fields by echocardiographic particle image velocimetry (echo-PIV), due to its potential for broad and practical utility. Future research directions to advance patient-specific LV simulations include development of methods capable of resolving heart valves, higher temporal resolution, automated generation of three-dimensional (3D) geometry, and incorporating actual flow measurements into the numerical solution of the 3D cardiovascular fluid dynamics. PMID:23690874

  8. Left Ventricular Geometric Remodeling in Relation to Non-Ischemic Scar Pattern on Cardiac Magnetic Resonance Imaging

    PubMed Central

    Kim, Jiwon; Kochav, Jonathan D.; Gurevich, Sergey; Afroz, Anika; Petashnick, Maya; Volo, Samuel; Diaz, Belen; Okin, Peter M.; Horn, Evelyn; Devereux, Richard B.; Weinsaft, Jonathan W.

    2014-01-01

    Purpose Left ventricular (LV) remodeling and myocardial fibrosis have been linked to adverse heart failure outcomes. Mid wall late gadolinium enhancement (MW-LGE) on cardiac magnetic resonance (CMR) imaging is well-associated with non-ischemic cardiomyopathy (NICM), but prevalence in ischemic cardiomyopathy (ICM) and association with remodeling are unknown. Methods The population comprised patients with systolic dysfunction (LVEF?40%). CMR was used to identify MW-LGE, conventionally defined as fibrosis of the mid-myocardial or epicardial aspect of the LV septum. Results 285 patients were studied. MW-LGE was present in 12%, and was 10-fold more common with NICM (32%) vs. ICM (3%, p<0.001). However, owing to higher prevalence of ICM, 15% of patients with MW-LGE had ICM. LV wall stress was higher (p=0.02) among patients with, vs. those without, MW-LGE despite similar systolic blood pressure (p=0.24). In multivariate analysis, MW-LGE was associated with CMR-quantified LV end-diastolic volume (p=0.03) independent of LVEF and mass. Incorporation of clinical and imaging variables demonstrated MW-LGE to be associated with higher LV end-diastolic volume (OR=1.13 [CI 1.004–1.27] per 10 ml/m2, p=0.04) after controlling for presence of NICM (OR=16.0 [CI 5.8–44.1], p<0.001). Conclusions While more common in NICM, MW-LGE can occur in ICM and is a marker of LV chamber dilation irrespective of cardiomyopathic etiology. PMID:25008088

  9. Segmentation of left atrial intracardiac ultrasound images for image guided cardiac ablation therapy

    NASA Astrophysics Data System (ADS)

    Rettmann, M. E.; Stephens, T.; Holmes, D. R.; Linte, C.; Packer, D. L.; Robb, R. A.

    2013-03-01

    Intracardiac echocardiography (ICE), a technique in which structures of the heart are imaged using a catheter navigated inside the cardiac chambers, is an important imaging technique for guidance in cardiac ablation therapy. Automatic segmentation of these images is valuable for guidance and targeting of treatment sites. In this paper, we describe an approach to segment ICE images by generating an empirical model of blood pool and tissue intensities. Normal, Weibull, Gamma, and Generalized Extreme Value (GEV) distributions are fit to histograms of tissue and blood pool pixels from a series of ICE scans. A total of 40 images from 4 separate studies were evaluated. The model was trained and tested using two approaches. In the first approach, the model was trained on all images from 3 studies and subsequently tested on the 40 images from the 4th study. This procedure was repeated 4 times using a leave-one-out strategy. This is termed the between-subjects approach. In the second approach, the model was trained on 10 randomly selected images from a single study and tested on the remaining 30 images in that study. This is termed the within-subjects approach. For both approaches, the model was used to automatically segment ICE images into blood and tissue regions. Each pixel is classified using the Generalized Liklihood Ratio Test across neighborhood sizes ranging from 1 to 49. Automatic segmentation results were compared against manual segmentations for all images. In the between-subjects approach, the GEV distribution using a neighborhood size of 17 was found to be the most accurate with a misclassification rate of approximately 17%. In the within-subjects approach, the GEV distribution using a neighborhood size of 19 was found to be the most accurate with a misclassification rate of approximately 15%. As expected, the majority of misclassified pixels were located near the boundaries between tissue and blood pool regions for both methods.

  10. Optimized temporary bi-ventricular pacing improves haemodynamic function after on-pump cardiac surgery in patients with severe left ventricular systolic dysfunction: a two-centre randomized control trial

    PubMed Central

    Russell, Stuart J.; Tan, Christine; O'Keefe, Peter; Ashraf, Saeed; Zaidi, Afzal; Fraser, Alan G.; Yousef, Zaheer R.

    2012-01-01

    OBJECTIVES Optimized temporary bi-ventricular (BiV) pacing may benefit heart failure patients after on-pump cardiac surgery compared with conventional dual-chamber right ventricular (RV) pacing. An improvement in haemodynamic function with BiV pacing may reduce the duration of ‘Level 3’ intensive care. METHODS Thirty-eight patients in sinus rhythm, ejection fraction ?35%, undergoing on-pump surgical revascularization, valve surgery or both were enrolled in this study. Before closing the sternum, temporary epicardial pacing wires were attached to the right atrium, RV outflow tract and basal posterolateral wall of the left ventricle. Patients were randomly assigned to postoperative BiV pacing with the optimization of the atrio- (AV) and inter-ventricular (VV) pacing intervals (Group 1) or conventional dual-chamber right AV pacing (Group 2). The primary end-point was the duration of ‘Level 3’ intensive care. Secondary end-points included cardiac output which was measured by thermodiluation at admission to the intensive care unit and at 6 and 18 h later, in five different pacing modes. RESULTS The duration of ‘Level 3’ care was similar between groups (40 ± 35 vs 54 ± 63 h; Group 1 vs 2; P = 0.43). Cardiac output was similar in all pacing modes at baseline. At 18 h, cardiac output with BiV pacing (5.8 l/min) was 7% higher than atrial inhibited (5.4 l/min) and 9% higher than dual-chamber RV pacing (5.3 l/min; P = 0.02 and 0.001, respectively). Optimization of the VV interval produced a further 4% increase in cardiac output compared with baseline settings (P = 0.005). CONCLUSIONS Postoperative haemodynamic function may be enhanced by temporary BiV pacing of high-risk patients after on-pump cardiac surgery. PMID:23138590

  11. Assessment of left ventricular cardiac output by arterial thermodilution technique via a left atrial catheter in a patient on a right ventricular assist device.

    PubMed

    Wiesenack, Christoph; Prasser, Christopher; Liebold, Andreas; Schmid, Franz X

    2004-01-01

    Following heart transplantation (HTx) in a 49-year old male, the patient's haemodynamic situation deteriorated in the early postoperative period despite increasing doses of catecholamines. When transoesophageal echocardiography (TEE) showed a dilated right ventricle, but adequate left ventricular (LV) function, a right ventricular assist device (RVAD) was implanted to support the right ventricle of the failing graft. Evaluation of the resulting cardiac output (CO) of the left ventricle and, thus, assessment of the remaining right ventricular function in patients supported by a RVAD is of great clinical interest. In this situation, continuous measurement of LV function, enabling assessment of the remaining right ventricular function, can be performed by pulse contour analysis following initial calibration of the system by arterial thermodilution CO measurement via a left atrial catheter. PMID:15072259

  12. Docosahexaenoic Acid Supplementation Alters Key Properties of Cardiac Mitochondria and Modestly Attenuates Development of Left Ventricular Dysfunction in Pressure Overload-Induced Heart Failure

    PubMed Central

    Dabkowski, Erinne R.; O’Connell, Kelly A.; Xu, Wenhong; Ribeiro, Rogerio F.; Hecker, Peter A.; Shekar, Kadambari Chandra; Stanley, William C.; Daneault, Caroline; Rosiers, Christine Des

    2015-01-01

    Purpose Supplementation with the n3 polyunsaturated fatty acid docosahexaenoic acid (DHA) is beneficial in heart failure patients, however the mechanisms are unclear. DHA is incorporated into membrane phospholipids, which may prevent mitochondrial dysfunction. Thus we assessed the effects of DHA supplementation on cardiac mitochondria and the development of heart failure caused by aortic pressure overload. Methods Pathological cardiac hypertrophy was generated in rats by thoracic aortic constriction. Animals were fed either a standard diet or were supplemented with DHA (2.3 % of energy intake). Results After 14 weeks, heart failure was evident by left ventricular hypertrophy and chamber enlargement compared to shams. Left ventricle fractional shortening was unaffected by DHA treatment in sham animals (44.1±1.6 % vs. 43.5±2.2 % for standard diet and DHA, respectively), and decreased with heart failure in both treatment groups, but to a lesser extent in DHA treated animals (34.9±1.7 %) than with the standard diet (29.7±1.5 %, P <0.03). DHA supplementation increased DHA content in mitochondrial phospholipids and decreased membrane viscosity. Myocardial mitochondrial oxidative capacity was decreased by heart failure and unaffected by DHA. DHA treatment enhanced Ca2+ uptake by subsarcolemmal mitochondria in both sham and heart failure groups. Further, DHA lessened Ca2+-induced mitochondria swelling, an index of permeability transition, in heart failure animals. Heart failure increased hydrogen peroxide-induced mitochondrial permeability transition compared to sham, which was partially attenuated in interfibrillar mitochondria by treatment with DHA. Conclusions DHA decreased mitochondrial membrane viscosity and accelerated Ca2+ uptake, and attenuated susceptibility to mitochondrial permeability transition and development of left ventricular dysfunction. PMID:24013804

  13. Cardiac Looping and the Left-Right Axis: Integrating Morphologic, Molecular, and Genetic Analyses of Vertebrate Left-Right Asymmetry

    Microsoft Academic Search

    Ann F. Ramsdell; H. Joseph Yost

    \\u000a Comparative vertebrate anatomy reveals a strikingly diverse complexity of heart structures, ranging from the more familiar\\u000a four-chambered hearts of mammals and avians to the three-chambered forms of reptiles, amphibians, and fish. Yet, despite variations\\u000a in anatomic form, the functionality of all vertebrate hearts is the same: to support and maintain separation of pulmonary\\u000a and systemic blood flow. To this end,

  14. The Value of Myocardial Torsion and Aneurysm Volume for Evaluating Cardiac Function in Rabbit with Left Ventricular Aneurysm

    PubMed Central

    Chunmei, Wang; Xue, Yan

    2015-01-01

    Objective This study aimed to investigate the effect of left ventricular aneurysm (LVA) volume and left ventricular global torsion on cardiac function by real time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging(2D-STI), to determine the accuracy of RT-3DE and 2D-STI in assessing LV function. Methods Thirty New Zealand rabbit models of with LVA were prepared by ligation of the middle segment of the left anterior descending and left circumflex arteries. Four weeks post-procedure, RT-3DE was conducted to obtain data on LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and LVA volume (LVAV), Peak rotation angles at the mitral valve annulus level (MV-ROT), peak rotation angles at the apical level (AP-ROT), and left ventricular global torsion angles (LV-TOR) were measured by 2D-STI. Results Compared with controls, LVEDV and LVESV were significantly increased in the LVA group, while LVEF, MV-ROT, AP-ROT, and LV-TOR were consistently reduced (p<0.01). Moreover, LVEF correlated with LVA volume and LV torsion angle (r= -0.778 and 0.821, p<0.01). LVA volume/LVEDV had the strongest inverse relationship with LVEF (r= -0.911, p<0.01). Conclusion LVA volume, LVA volume/LVEDV, and LV torsion may be used as an indicator for evaluation of cardiac function after LVA. Moreover, LVA volume/LVEDV may be a more sensitive and reliable marker of cardiac function after LVA formation. PMID:25855970

  15. Coronary Sinus Ostial Atresia and Persistent Left-Sided Superior Vena Cava: Clinical Significance and Strategies for Cardiac Resynchronization Therapy

    PubMed Central

    Lim, Paul Chun Yih; Baskaran, Lohendran; Ho, Kah Leng; Teo, Wee Siong; Ching, Chi Keong

    2013-01-01

    A 48-year-old male patient underwent cardiac resynchronization therapy defibrillator implantation, and he was found to have atresia of the coronary sinus ostium with venous drainage occurring via a persistent left-sided superior vena cava, which was connected to the right-sided superior vena cava by the innominate vein. This is a rare benign cardiac anomaly that can pose problems when the coronary sinus needs to be cannulated. To identify the course of the coronary sinus, a coronary angiogram can be performed with attention directed to the venous phase of the angiogram. Although the technical difficulty of coronary sinus cannulation increases, various catheters, wires, and delivery systems can be utilized and this anomaly does not usually prevent successful left ventricular lead placement in cardiac resynchronization therapy via a left-sided superior vena cava approach. There however needs to be consideration regarding caliber of the left-sided superior vena cava being sufficiently large to avoid compromise of venous drainage after lead insertion. PMID:24436612

  16. Tempol prevents cardiac oxidative damage and left ventricular dysfunction in the PPAR-? KO mouse.

    PubMed

    Guellich, Aziz; Damy, Thibaud; Conti, Marc; Claes, Victor; Samuel, Jane-Lise; Pineau, Thierry; Lecarpentier, Yves; Coirault, Catherine

    2013-06-01

    Peroxisome proliferator-activated receptor (PPAR)-? deletion induces a profound decrease in MnSOD activity, leading to oxidative stress and left ventricular (LV) dysfunction. We tested the hypothesis that treatment of PPAR-? knockout (KO) mice with the SOD mimetic tempol prevents the heart from pathological remodelling and preserves LV function. Twenty PPAR-? KO mice and 20 age-matched wild-type mice were randomly treated for 8 wk with vehicle or tempol in the drinking water. LV contractile parameters were determined both in vivo using echocardiography and ex vivo using papillary muscle mechanics. Translational and posttranslational modifications of myosin heavy chain protein as well as the expression and activity of major antioxidant enzymes were measured. Tempol treatment did not affect LV function in wild-type mice; however, in PPAR-? KO mice, tempol prevented the decrease in LV ejection fraction and restored the contractile parameters of papillary muscle, including maximum shortening velocity, maximum extent of shortening, and total tension. Moreover, compared with untreated PPAR-? KO mice, myosin heavy chain tyrosine nitration and anion superoxide production were markedly reduced in PPAR-? KO mice after treatment. Tempol also significantly increased glutathione peroxidase and glutathione reductase activities (~ 50%) in PPAR-? KO mice. In conclusion, these findings demonstrate that treatment with the SOD mimetic tempol can prevent cardiac dysfunction in PPAR-? KO mice by reducing the oxidation of contractile proteins. In addition, we show that the beneficial effects of tempol in PPAR-? KO mice involve activation of the glutathione peroxidase/glutathione reductase system. PMID:23542920

  17. Recommendations for chamber quantification

    Microsoft Academic Search

    Roberto M. Lang; Michelle Bierig; Richard B. Devereux; Frank A. Flachskampf; Elyse Foster; Patricia A. Pellikka; Michael H. Picard; Mary J. Roman; James Seward; Jack Shanewise; Scott Solomon; Kirk T. Spencer; John Sutton; William Stewart

    2006-01-01

    Abstract Quantification of cardiac chamber size, ventricular mass and function ranks among,the most,clinically important,and most,frequently,requested,tasks of echocardiography. Over the last decades, echocardiographic methods and techniques haveimprovedandexpandeddramatically,duetotheintroductionofhigherfrequency transducers, harmonic imaging, fully digital machines, left-sided contrast agents, and other technological advancements. Furthermore, echocardiography due to its porta- bility and versatility is now used in emergency rooms, operating rooms, and intensive care units.

  18. Left phrenic nerve anatomy relative to the coronary venous system: Implications for phrenic nerve stimulation during cardiac resynchronization therapy.

    PubMed

    Spencer, Julianne H; Goff, Ryan P; Iaizzo, Paul A

    2015-07-01

    The objective of this study was to quantitatively characterize anatomy of the human phrenic nerve in relation to the coronary venous system, to reduce undesired phrenic nerve stimulation during left-sided lead implantations. We obtained CT scans while injecting contrast into coronary veins of 15 perfusion-fixed human heart-lung blocs. A radiopaque wire was glued to the phrenic nerve under CT, then we created three-dimensional models of anatomy and measured anatomical parameters. The left phrenic nerve typically coursed over the basal region of the anterior interventricular vein, mid region of left marginal veins, and apical region of inferior and middle cardiac veins. There was large variation associated with the average angle between nerve and veins. Average angle across all coronary sinus tributaries was fairly consistent (101.3°-111.1°). The phrenic nerve coursed closest to the middle cardiac vein and left marginal veins. The phrenic nerve overlapped a left marginal vein in >50% of specimens. Clin. Anat. 28:621-626, 2015. © 2015 Wiley Periodicals, Inc. PMID:25851773

  19. Extracorporeal cardiopulmonary resuscitation for breath-holding spells followed by cardiac arrest due to left main coronary artery stenosis.

    PubMed

    Ozyilmaz, Isa; Altin, Husnu F?rat; Yildiz, Okan; Erek, Ersin; Ergul, Yakup; Guzeltas, Alper

    2015-06-01

    Non-syndromic congenital supravalvular aortic stenosis (SVAS) leads to ventricular hypertrophy and increased oxygen consumption, and when combined with other factors reduces coronary blood flow, potentially resulting in myocardial ischemia and sudden cardiac death. While the anatomic obstruction of coronary circulation is as common in non-syndromic SVAS as in Williams syndrome, it often remains unacknowledged. Extracorporeal membrane oxygenation (ECMO) is an elective procedure that can be used to support patients with cardiac arrest during diagnosis as a way to reduce cardiopulmonary load in preparation for surgery or further treatment. In this report, we describe the rare case of an infant with severe SVAS and mild valvular pulmonary and left main coronary artery stenosis, as well as breath-holding spells. After multiple cardiac arrests, the infant underwent diagnostic catheter angiography on ECMO and had the pathology surgically corrected. PMID:26012561

  20. Cardiac Wound Healing Post-myocardial Infarction: A Novel Method to Target Extracellular Matrix Remodeling in the Left Ventricle

    PubMed Central

    Zamilpa, Rogelio; Zhang, Jianhua; Chiao, Ying Ann; Bras, Lisandra de Castro; Halade, Ganesh; Ma, Yonggang; Hacker, Sander O.; Lindsey, Merry L.

    2014-01-01

    Myocardial infarction (MI) is a leading cause of death worldwide. Permanent ligation of the left anterior descending coronary artery (LAD) is a commonly used surgical model to study post-MI effects in mice. LAD occlusion induces a robust wound healing response that includes extracellular matrix (ECM) remodeling. This chapter provides a detailed guide on the surgical procedure to permanently ligate the LAD. Additionally, we describe a prototype method to enrich cardiac tissue for ECM, which allows one to focus on ECM remodeling in the left ventricle following surgically induced MI in mice. PMID:24029944

  1. Paired pulse pacing increases cardiac O 2 consumption for activation without changing efficiency of contractile machinery in canine left ventricle

    Microsoft Academic Search

    Hiroyuki Suga; Shiho Futaki; Nobuaki Tanaka; Yoshio Yasumura; Takashi Nozawa; Dequan Wu; Yuichi Ohgoshi; Hitoshi Yaku

    1988-01-01

    Summary The relation between cardiac O2 consumption (Vo2) and the total mechanical energy (TME) generated by contraction was studied under paired-pulse (PP) pacing and compared with that under single-pulse pacing at the same basic rate as PP pacing and at the double-pacing rate in ten excised cross-circulated canine left ventricles (LV). TME was assessed by the systolic pressure-volume (P–V) area

  2. Current Management and Risk of Recurrent Stroke in Cerebrovascular Patients with Right-to-Left Cardiac Shunt

    Microsoft Academic Search

    C. Weimar; D. N. Holle; J. Benemann; E. Schmid; U. Schminke; R. L. Haberl; H.-C. Diener; M. Goertler

    2009-01-01

    Background: Right-to-left cardiac shunt (RLS) is considered a risk factor for stroke, especially in patients aged <55 years. We aimed to investigate the current management and prognosis in consecutive patients with RLS and otherwise cryptogenic cerebrovascular events. Methods: In total, 1,126 patients with cryptogenic stroke or TIA were included from 17 German neurology departments. During a mean follow-up of 28.4

  3. Targeted Inactivation of Cerberus Like-2 Leads to Left Ventricular Cardiac Hyperplasia and Systolic Dysfunction in the Mouse

    PubMed Central

    Araújo, Ana Carolina; Marques, Sara; Belo, José António

    2014-01-01

    Previous analysis of the Cerberus like 2 knockout (Cerl2?/?) mouse revealed a significant mortality during the first day after birth, mostly due to cardiac defects apparently associated with randomization of the left-right axis. We have however, identified Cerl2-associated cardiac defects, particularly a large increase in the left ventricular myocardial wall in neonates that cannot be explained by laterality abnormalities. Therefore, in order to access the endogenous role of Cerl2 in cardiogenesis, we analyzed the embryonic and neonatal hearts of Cerl2 null mutants that did not display a laterality phenotype. Neonatal mutants obtained from the compound mouse line Cer2?/?::Mlc1v-nLacZ24+, in which the pulmonary ventricle is genetically marked, revealed a massive enlargement of the ventricular myocardium in animals without laterality defects. Echocardiography analysis in Cerl2?/? neonates showed a left ventricular systolic dysfunction that is incompatible with a long lifespan. We uncovered that the increased ventricular muscle observed in Cerl2?/? mice is caused by a high cardiomyocyte mitotic index in the compact myocardium which is mainly associated with increased Ccnd1 expression levels in the left ventricle at embryonic day (E) 13. Interestingly, at this stage we found augmented left ventricular expression of Cerl2 levels when compared with the right ventricle, which may elucidate the regionalized contribution of Cerl2 to the left ventricular muscle formation. Importantly, we observed an increase of phosphorylated Smad2 (pSmad2) levels in embryonic (E13) and neonatal hearts indicating a prolonged TGF?s/Nodal-signaling activation. Concomitantly, we detected an increase of Baf60c levels, but only in Cerl2?/? embryonic hearts. These results indicate that independently of its well-known role in left-right axis establishment Cerl2 plays an important role during heart development in the mouse, mediating Baf60c levels by exerting an important control of the TGF?s/Nodal-signaling pathway. PMID:25033293

  4. How does the left ventricle work? Ventricular rotation as a new index of cardiac performance.

    PubMed

    Song, Jae-Kwan

    2009-09-01

    Although simple cylindrical or ellipsoidal left ventricular (LV) geometry with transverse or circumferential muscle contraction has been traditionally used to estimate LV performance, the estimated LV ejection fraction (EF) with muscle fiber shortening up to 20% is less than 50% of maximum, which is lower than the normal EF observed in routine clinical practice. Thus, oblique fiber orientation and LV rotation, in addition to radial thickening and longitudinal shortening, is predicted as an essential component of effective LV pumping. This was confirmed by animal experiments using surgically implanted markers or invasive sonomicrometry. Demonstration of the muscle band extending from the pulmonary artery to the aorta, which connects the ventricular myocardium, both right ventricle and LV as a continuous band (muscle band theory) provides an anatomical backbone of helical configuration of the cardiac muscle band with descending and ascending segments wrapping the LV apex. Moreover, sequential, non-simultaneous, activation and contraction of the helicoids muscle band contributes to LV rotation or twist motion. Recently, magnetic resonance imaging and speckle tracking echocardiography (STE) techniques have provided an excellent noninvasive way to measure LV rotation and twist, which is expected to contribute to a more thorough evaluation of both LV systolic and diastolic function. Initial animal experiments showed that quantification of apical rotation or LV twist using STE is more accurate for estimating LV systolic function than conventional EF under a variety of LV inotropic conditions, irrespective of coronary ligation. As de-rotation or the untwisting rate can also be measured by STE, the role of ventricular untwisting as a temporal link between LV relaxation and suction can be addressed. Further clinical investigations are needed to determine the real clinical impact of these new indices of LV mechanical function. PMID:19949617

  5. Effect of mechanical dyssynchrony and cardiac resynchronization therapy on left ventricular rotational mechanics.

    PubMed

    Sade, Leyla Elif; Demir, Ozlem; Atar, Ilyas; Müderrisoglu, Haldun; Ozin, Bülent

    2008-04-15

    Alterations in rotational mechanics can bring new aspects to the understanding of left ventricular (LV) dyssynchrony. The aims of this study were to investigate LV rotational mechanics in candidates for cardiac resynchronization therapy (CRT) and to assess the effect of CRT by speckle-tracking echocardiography. Fifty-four patients with heart failure and 33 healthy controls were studied. Thirty-three underwent CRT. Speckle tracking was applied to short- and long-axis views. Radial and longitudinal dyssynchrony were assessed as previously defined. Apical and basal rotations were measured as the average angular displacement about the LV central axis. LV twist and torsion were then calculated. Peak apical and basal rotation, peak LV twist and torsion, apical and basal rotation at aortic valve closure (AVC), and LV twist and torsion at AVC were significantly lower in patients than controls. Apical-basal rotation delay and AVC-to-peak LV twist interval were longer in patients and associated with decreased peak LV twist and LV twist at AVC, respectively. In patients, rotational indexes, particularly LV twist and torsion, were correlated strongly with radial dyssynchrony. LV torsion (cutoff 0.1 degrees /cm) and twist (cutoff 1 degrees ) at AVC had the highest sensitivity (90%) and specificity (77%) to predict CRT responders among all other parameters, including radial and longitudinal dyssynchrony. In conclusion, LV dyssynchrony is associated with discoordinate rotation of the apical and basal regions, which in turn significantly decreases peak LV twist and torsion and LV twist and torsion at AVC. CRT significantly restored the altered rotational mechanics in responders. These parameters have potential for predicting responders to CRT. PMID:18394452

  6. Nifedipine Inhibits Cardiac Hypertrophy and Left Ventricular Dysfunction in Response to Pressure Overload

    PubMed Central

    Ago, Tetsuro; Yang, Yanfei; Zhai, Peiyong; Sadoshima, Junichi

    2010-01-01

    Pathological hypertrophy is commonly induced by activation of protein kinases phosphorylating class II histone deacetylases (HDACs) and de-suppression of transcription factors, such as NFAT. We hypothesized that nifedipine, an L-type Ca2+ channel blocker, inhibits Ca2+ -calmodulin dependent kinase II (CaMKII) and NFAT, thereby inhibiting pathological hypertrophy. Mice were subjected to sham operation or transverse aortic constriction (TAC) for 2 weeks with or without nifedipine (10 mg/kg/day). Nifedipine did not significantly alter blood pressure or the pressure gradient across the TAC. Nifedipine significantly suppressed TAC-induced increases in left ventricular (LV) weight/body weight (LVW/BW) (5.09 ± 0.80 vs. 4.16 ± 0.29, mg/g, TAC without and with nifedipine, n=6,6, p<0.05), myocyte cross sectional area (1681 ± 285 vs. 1434 ± 197, arbitrary unit, p<0.05), and expression of fetal type genes, including ANF (35. 9 ± 6.4 vs. 8.6 ± 3.3, arbitrary unit, p<0.05). TAC-induced increases in lung weight/BW (7.7 ± 0.9 vs. 5.5 ± 0.5, mg/g, p<0.05) and decreases in LV ejection fraction (65.5 ± 3.1 vs. 75.7 ± 3.3 %, p<0.05) were attenuated by nifedipine. Nifedipine caused significant inhibition of TAC-induced activation of NFAT-mediated transcription, which was accompanied by suppression of Thr 286 phosphorylation in CaMKII. Nifedipine inhibited activation of CaMKII and NFAT by phenylephrine, accompanied by suppression of Ser 632 phosphorylation and nuclear exit of HDAC4 in cardiac myocytes. These results suggest that a subpressor dose of nifedipine inhibits pathological hypertrophy in the heart by inhibiting activation of CaMKII and NFAT, a signaling mechanism commonly activated in pathological hypertrophy. PMID:20559781

  7. Nifedipine inhibits cardiac hypertrophy and left ventricular dysfunction in response to pressure overload.

    PubMed

    Ago, Tetsuro; Yang, Yanfei; Zhai, Peiyong; Sadoshima, Junichi

    2010-08-01

    Pathological hypertrophy is commonly induced by activation of protein kinases phosphorylating class II histone deacetylases (HDACs) and desuppression of transcription factors, such as nuclear factor of activated T cell (NFAT). We hypothesized that nifedipine, an L-type Ca(2+) channel blocker, inhibits Ca(2+) calmodulin-dependent kinase II (CaMKII) and NFAT, thereby inhibiting pathological hypertrophy. Mice were subjected to sham operation or transverse aortic constriction (TAC) for 2 weeks with or without nifedipine (10 mg/kg/day). Nifedipine did not significantly alter blood pressure or the pressure gradient across the TAC. Nifedipine significantly suppressed TAC-induced increases in left ventricular (LV) weight/body weight (BW; 5.09 +/- 0.80 vs. 4.16 +/- 0.29 mg/g, TAC without and with nifedipine, n = 6,6, p < 0.05), myocyte cross-sectional area (1,681 +/- 285 vs. 1,434 +/- 197 arbitrary units, p < 0.05), and expression of fetal-type genes, including atrial natriuretic factor (35. 9 +/- 6.4 vs. 8.6 +/- 3.3 arbitrary units, p < 0.05). TAC-induced increases in lung weight/BW (7.7 +/- 0.9 vs. 5.5 +/- 0.5 mg/g, p < 0.05) and decreases in LV ejection fraction (65.5 +/- 3.1% vs. 75.7 +/- 3.3%, p < 0.05) were attenuated by nifedipine. Nifedipine caused significant inhibition of TAC-induced activation of NFAT-mediated transcription, which was accompanied by suppression of Thr 286 phosphorylation in CaMKII. Nifedipine inhibited activation of CaMKII and NFAT by phenylephrine, accompanied by suppression of Ser 632 phosphorylation and nuclear exit of HDAC4 in cardiac myocytes. These results suggest that a subpressor dose of nifedipine inhibits pathological hypertrophy in the heart by inhibiting activation of CaMKII and NFAT, a signaling mechanism commonly activated in pathological hypertrophy. PMID:20559781

  8. Quantitative analysis of cardiac left ventricular variables obtained by MRI at 3 T: a pre- and post-contrast comparison.

    PubMed

    Matthew, S; Gandy, S J; Nicholas, R S; Waugh, S A; Crowe, E A; Lerski, R A; Dunn, M H; Houston, J G

    2012-07-01

    Short-axis cine images are acquired during cardiac MRI in order to determine variables of cardiac left ventricular (LV) function such as ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and LV mass. In cardiac perfusion assessments this imaging can be performed in the temporal window between first pass perfusion and the acquisition of delayed enhancement images in order to minimise overall scanning time. The objective of this study was to compare pre- and post-contrast short-axis LV variables of 15 healthy volunteers using a two-dimensional cardiac-gated segmented cine true fast imaging with steady state precession sequence and a 3.0 T MRI unit in order to determine the possible effects of contrast agent on the calculated cardiac function variables. Image analysis was carried out using semi-automated software. The calculated mean LV mass was lower when derived from the post-contrast images, relative to those derived pre-contrast (102 vs 108.1 g, p<0.0001). Small but systematic significant differences were also found between the mean pre- and post-contrast values of EF (69.4% vs 68.7%, p<0.05), EDV (142.4 vs 143.7 ml, p<0.05) and ESV (44.2 vs 45.5 ml, p<0.005), but no significant differences in SV were identified. This study has highlighted that contrast agent delivery can influence the numerical outcome of cardiac variables calculated from MRI and this was particularly noticeable for LV mass. This may have important implications for the correct interpretation of patient data in clinical studies where post-contrast images are used to calculate LV variables, since LV normal ranges have been traditionally derived from pre-contrast data sets. PMID:22745212

  9. Hemodynamic Improvement in Cardiac Resynchronization Does Not Require Improvement in Left Ventricular

    E-print Network

    Paris-Sud XI, Université de

    left ventricular (LV) rotation mechanics. Methods and Results--In dogs with left bundle branch block mortality in patients with moderate to severe heart failure associated with an intraventricular conduction

  10. Thoracoscopic Left Cardiac Sympathetic Denervation for a Patient with Catecholaminergic Polymorphic Ventricular Tachycardia and Recurrent Implantable Cardioverter-Defibrillator Shocks

    PubMed Central

    Yu, Woo-Sik; Kim, Tae-Hoon; Suh, Jee won; Song, Seunghwan; Lee, Chang Young; Joung, Boyoung

    2015-01-01

    A patient presented with loss of consciousness and conversion. During an exercise test, catecholaminergic polymorphic ventricular tachycardia (CPVT) resulted in cardiac arrest. He started taking medication (a beta-blocker and flecainide) and an implantable cardioverter defibrillator (ICD) was inserted, but the ventricular tachycardia did not resolve. Left cardiac sympathetic denervation (LCSD) was then performed under general anesthesia, and the patient was discharged on the second postoperative day without complications. One month after the operation, no shock had been administered by the ICD, and an exercise stress test did not induce ventricular tachycardia. Although beta-blockers are the gold standard of therapy in patients with CPVT, thoracoscopic LCSD is safe and can be an effective alternative treatment option for patients with intractable CPVT. PMID:26078933

  11. Transvenous Biventricular Pacing for Cardiac Resynchronization Therapy in Patients with Persistent Left Superior Vena Cava and Right Superior Vena Cava Atresia

    PubMed Central

    Lopez, J. Alberto

    2008-01-01

    Biventricular pacing for cardiac resynchronization therapy is an effective adjunctive therapy for the treatment of symptomatic moderate and severe congestive heart failure. However, experience with transvenous cardiac resynchronization therapy in patients who have both persistent left superior vena cava and right superior vena cava atresia is extremely limited. We successfully performed cardiac resynchronization therapy in 2 patients who had persistent left superior vena cava, right superior vena cava atresia, and congestive heart failure. Our 2 cases demonstrate the possibility of a total transvenous approach for left ventricular pacing despite the presence of serious cardiac venous anomalies. This approach enables clinicians to avoid the riskier epicardial lead placement, which requires a thoracotomy under general anesthesia. PMID:18427654

  12. Transvenous biventricular pacing for cardiac resynchronization therapy in patients with persistent left superior vena cava and right superior vena cava atresia.

    PubMed

    Lopez, J Alberto

    2008-01-01

    Biventricular pacing for cardiac resynchronization therapy is an effective adjunctive therapy for the treatment of symptomatic moderate and severe congestive heart failure. However, experience with transvenous cardiac resynchronization therapy in patients who have both persistent left superior vena cava and right superior vena cava atresia is extremely limited. We successfully performed cardiac resynchronization therapy in 2 patients who had persistent left superior vena cava, right superior vena cava atresia, and congestive heart failure. Our 2 cases demonstrate the possibility of a total transvenous approach for left ventricular pacing despite the presence of serious cardiac venous anomalies. This approach enables clinicians to avoid the riskier epicardial lead placement, which requires a thoracotomy under general anesthesia. PMID:18427654

  13. Deterioration of left ventricular chamber performance after bed rest : "cardiovascular deconditioning" or hypovolemia?

    NASA Technical Reports Server (NTRS)

    Perhonen, M. A.; Zuckerman, J. H.; Levine, B. D.; Blomqvist, C. G. (Principal Investigator)

    2001-01-01

    BACKGROUND: Orthostatic intolerance after bed rest is characterized by hypovolemia and an excessive reduction in stroke volume (SV) in the upright position. We studied whether the reduction in SV is due to a specific adaptation of the heart to head-down tilt bed rest (HDTBR) or acute hypovolemia alone. METHODS AND RESULTS: We constructed left ventricular (LV) pressure-volume curves from pulmonary capillary wedge pressure and LV end-diastolic volume and Starling curves from pulmonary capillary wedge pressure and SV during lower body negative pressure and saline loading in 7 men (25+/-2 years) before and after 2 weeks of -6 degrees HDTBR and after the acute administration of intravenous furosemide. Both HDTBR and hypovolemia led to a similar reduction in plasma volume. However, baseline LV end-diastolic volume decreased by 20+/-4% after HDTBR and by 7+/-2% after hypovolemia (interaction P<0.001). Moreover, SV was reduced more and the Starling curve was steeper during orthostatic stress after HDTBR than after hypovolemia. The pressure-volume curve showed a leftward shift and the equilibrium volume of the left ventricle was decreased after HDTBR; however, after hypovolemia alone, the curve was identical, with no change in equilibrium volume. Lower body negative pressure tolerance was reduced after both conditions; it decreased by 27+/-7% (P<0.05) after HDTBR and by 18+/-8% (P<0.05) after hypovolemia. CONCLUSIONS: Chronic HDTBR leads to ventricular remodeling, which is not seen with equivalent degrees of acute hypovolemia. This remodeling leads to a greater decrease in SV during orthostatic stress after bed rest than hypovolemia alone, potentially contributing to orthostatic intolerance.

  14. Cardiac through-plane motion: comparison of long- and short-axis MR images of the left ventricle

    Microsoft Academic Search

    N. A. A. Matheijssen; E. E. Wall; B. M. Pluim; J. Doornbos; A. Roos

    1995-01-01

    Left ventricular (LV) long-axis shortening produces cardiac motion through fixed short-axis sections, complicating accurate quantification of myocardial and wall-motion parameters with MRI. Therefore, LV long-axis length and shortening was studied in both long- and short-axis end-diastolic (ED) and end-systolic (ES) MRI scans. A group of 38 male volunteers underwent gradient-echo cine-MRI: single-slice long-axis and multi-slice short-axis. The LV dimensions were

  15. Left ventricular diastolic function in workers occupationally exposed to mercury vapour without clinical presentation of cardiac involvement

    SciTech Connect

    Por?ba, Rafa?, E-mail: sogood@poczta.onet.pl; Skoczy?ska, Anna; Ga?, Pawe?; Turczyn, Barbara; Wojakowska, Anna

    2012-09-15

    The aim of the study was to evaluate left ventricular diastolic function in workers occupationally exposed to mercury vapour without clinical presentation of cardiac involvement. The studies included 115 workers (92 men and 23 women) occupationally exposed to mercury vapour without clinical presentation of cardiac involvement (mean age: 47.83 ± 8.29). Blood samples were taken to determine blood lipid profile, urine was collected to estimate mercury concentration (Hg-U) and echocardiographic examination was performed to evaluate diastolic function of the left ventricle. In the entire group of workers occupationally exposed to mercury vapour without clinical presentation of cardiac involvement, Spearman correlations analysis demonstrated the following significant linear relationships: between body mass index (BMI) and ratio of maximal early diastolic mitral flow velocity/early diastolic mitral annular velocity (E/E') (r = 0.32, p < 0.05), between serum HDL concentration and E/E' (r = ? 0.22, p < 0.05), between Hg-U and E/E' (r = 0.35, p < 0.05), between Hg-U and isovolumetric relaxation time (IVRT') (r = 0.41, p < 0.05), between Hg-U and ratio of maximal early diastolic mitral flow velocity/maximal late diastolic mitral flow velocity (E/A) (r = ? 0.31, p < 0.05) and between serum HDL concentration and E/A (r = 0.43, p < 0,05). In logistic regression analysis it as shown that independent factors of left ventricular diastolic dysfunction risk in the study group included a higher urine mercury concentration, a higher value of BMI and a lower serum HDL concentration (OR{sub Hg}-{sub U} = 1.071, OR{sub BMI} = 1.200, OR{sub HDL} = 0.896, p < 0.05). Summing up, occupational exposure to mercury vapour may be linked to impaired left ventricular diastolic function in workers without clinical presentation of cardiac involvement. -- Highlights: ? Study aimed at evaluation of LVDD in workers occupationally exposed to Hg. ? There was significant linear relationships between Hg-U and E/E'. ? Independent risk factor of LVDD in study group included higher Hg-U. ? Independent risk factor of LVDD in study group included higher BMI and lower HDL. ? Occupational exposure to Hg may be linked to LVDD.

  16. Effects of conversion from cyclosporine to tacrolimus on left ventricular structure in cardiac allograft recipients.

    PubMed

    Peura, Jennifer L; Zile, Michael R; Feldman, David S; VanBakel, Adrian B; McClure, Catherine; Uber, Walter; Haynes, Hwajoo; Pereira, Naveen L

    2005-11-01

    Twelve heart transplant recipients selected for conversion from cyclosporine to tacrolimus because of adverse effects of cyclosporine therapy underwent echocardiography at baseline and 6 months after conversion. Left ventricular mass decreased by 24% and left ventricular geometry returned toward normal at 6 months after conversion, without significant changes in blood pressure. PMID:16297806

  17. Maternal hyperoxygenation and foetal cardiac MRI in the assessment of the borderline left ventricle.

    PubMed

    Borik, Sharon; Macgowan, Christopher K; Seed, Mike

    2015-08-01

    Using phase-contrast MRI in a foetus with borderline left ventricular hypoplasia at 37 weeks' gestation we showed an increase in pulmonary blood flow during maternal hyperoxygenation. The associated increase in venous return to the left atrium, however, resulted in reversal of the atrial shunt, with no improvement in left ventricular output. The child initially underwent single ventricle palliation with a neonatal hybrid procedure, but following postnatal growth of the left ventricle tolerated conversion to a biventricular circulation at 5 months of age. We conclude that when there is significant restriction of filling or outflow obstruction across the left heart, neither prenatal nor postnatal acute pulmonary vasodilation can augment left ventricular output enough to support a biventricular circulation. Chronic pulmonary vasodilation may stimulate the growth of the left-sided structures allowing biventricular repair, raising the intriguing question of whether chronic maternal oxygen therapy might obviate the need for neonatal single ventricle pallation in the setting of borderline left ventricular hypoplasia. PMID:25275342

  18. [Tumor in the right cardiac chambers. Regression after antitubercular treatment. Apropos of a case].

    PubMed

    Mesbahi, R; Aouad, A; Benabdeslam, A; Lebbar, M; Benomar, M

    1996-11-01

    The authors report the case of a young patient with a tumour of the right atrium and right ventricular outflow tract without visceral complications but with multiple muscular and skin localisations. The diagnosis of tuberculosis was made on biopsy of a suppurating skin lesion. The diagnosis of tuberculosis was made on biopsy of a suppurating skin lesion. Anti-tuberculosis treatment resulted in regression of these tumours, especially the cardiac lesions, confirmed by transoesophageal echocardiography. PMID:9092402

  19. Full neurologic recovery and return of spontaneous circulation following prolonged cardiac arrest facilitated by percutaneous left ventricular assist device.

    PubMed

    Heidlebaugh, Michael; Kurz, Michael C; Turkelson, Carman L; Sawyer, Kelly N

    2014-12-01

    Sudden cardiac arrest is associated with high early mortality, which is largely related to postcardiac arrest syndrome characterized by an acute but often transient decrease in left ventricular (LV) function. The stunned LV provides poor cardiac output, which compounds the initial global insult from hypoperfusion. If employed early, an LV assist device (LVAD) may improve survival and neurologic outcome; however, traditional methods of augmenting LV function have significant drawbacks, limiting their usefulness in the periarrest period. Full cardiac support with cardiopulmonary bypass is not always readily available but is increasingly being studied as a tool to intensify resuscitation. There have been no controlled trials studying the early use of percutaneous LVADs (pLVADs) in pericardiac arrest patients or intra-arrest as a bridge to return of spontaneous circulation. This article presents a case study and discussion of a patient who arrested while undergoing an elective coronary angioplasty and suffered prolonged cardiopulmonary resuscitation. During resuscitation, treatment included placement of a pLVAD and initiation of therapeutic hypothermia. The patient made a rapid and full recovery. PMID:25184627

  20. Electrical Wave Propagation in an Anisotropic Model of the Left Ventricle Based on Analytical Description of Cardiac Architecture

    PubMed Central

    Pravdin, Sergey F.; Dierckx, Hans; Katsnelson, Leonid B.; Solovyova, Olga; Markhasin, Vladimir S.; Panfilov, Alexander V.

    2014-01-01

    We develop a numerical approach based on our recent analytical model of fiber structure in the left ventricle of the human heart. A special curvilinear coordinate system is proposed to analytically include realistic ventricular shape and myofiber directions. With this anatomical model, electrophysiological simulations can be performed on a rectangular coordinate grid. We apply our method to study the effect of fiber rotation and electrical anisotropy of cardiac tissue (i.e., the ratio of the conductivity coefficients along and across the myocardial fibers) on wave propagation using the ten Tusscher–Panfilov (2006) ionic model for human ventricular cells. We show that fiber rotation increases the speed of cardiac activation and attenuates the effects of anisotropy. Our results show that the fiber rotation in the heart is an important factor underlying cardiac excitation. We also study scroll wave dynamics in our model and show the drift of a scroll wave filament whose velocity depends non-monotonically on the fiber rotation angle; the period of scroll wave rotation decreases with an increase of the fiber rotation angle; an increase in anisotropy may cause the breakup of a scroll wave, similar to the mother rotor mechanism of ventricular fibrillation. PMID:24817308

  1. Cardiac resynchronization therapy in heart failure patients with less severe left ventricular dysfunction.

    PubMed

    Hai, Ofek Y; Mentz, Robert J; Zannad, Faiez; Gasparini, Maurizio; De Ferrari, Gaetano M; Daubert, Jean-Claude; Holzmeister, Johannes; Lam, Carolyn S P; Pochet, Thierry; Vincent, Alphons; Linde, Cecilia

    2015-02-01

    Cardiac resynchronization therapy is beneficial in heart failure patients with LVEF ?35% and electrical dyssynchrony. However, its effects among patients with less severe LV dysfunction have not been established. Recent post-hoc analyses of landmark CRT trials suggest that CRT benefit may be present in patients with LVEF >35% and is associated with improvement in cardiac reverse remodelling, all-cause mortality, and need for heart failure hospitalizations. This review summarizes the currently available literature regarding the potential impact of CRT in patients with more modest reductions in LVEF. PMID:25469668

  2. Left Atrial Intramural Hematoma after Removal of Atrial Myxoma: Cardiac Magnetic Resonance in the Differential Diagnosis of Intra-Cardiac Mass

    PubMed Central

    Lee, Hee-Sun; Park, Eun-Ah; Kim, Kyung-Hwan; Kim, Yong-Jin; Sohn, Dae-Won

    2014-01-01

    Left atrial (LA) dissection is a rare entity, which is, in most cases, observed after valvular intervention. Transesophageal echocardiography (TEE) is considered to be a modality of choice in the diagnosis of LA dissection. However, LA dissection might be missed clinically in the absence of significant hemodynamic changes, and moreover physicians are occasionally reluctant to perform TEE due to its semi-invasiveness. Recently, cardiac magnetic resonance (CMR) has been introduced as a modality to perform different roles to existing imaging modalities, such as echocardiography. Given that CMR can provide information on tissue characteristics, it may give incremental information to TEE. We here present a rare case of LA dissection following LA myxoma removal, where CMR can make a correct diagnosis and guide management strategy. PMID:25580195

  3. Cardiac energy metabolic alterations in pressure overload–induced left and right heart failure (2013 Grover Conference Series)

    PubMed Central

    Lopaschuk, Gary D.

    2015-01-01

    Abstract Pressure overload of the heart, such as seen with pulmonary hypertension and/or systemic hypertension, can result in cardiac hypertrophy and the eventual development of heart failure. The development of hypertrophy and heart failure is accompanied by numerous molecular changes in the heart, including alterations in cardiac energy metabolism. Under normal conditions, the high energy (adenosine triphosphate [ATP]) demands of the heart are primarily provided by the mitochondrial oxidation of fatty acids, carbohydrates (glucose and lactate), and ketones. In contrast, the hypertrophied failing heart is energy deficient because of its inability to produce adequate amounts of ATP. This can be attributed to a reduction in mitochondrial oxidative metabolism, with the heart becoming more reliant on glycolysis as a source of ATP production. If glycolysis is uncoupled from glucose oxidation, a decrease in cardiac efficiency can occur, which can contribute to the severity of heart failure due to pressure-overload hypertrophy. These metabolic changes are accompanied by alterations in the enzymes that are involved in the regulation of fatty acid and carbohydrate metabolism. It is now becoming clear that optimizing both energy production and the source of energy production are potential targets for pharmacological intervention aimed at improving cardiac function in the hypertrophied failing heart. In this review, we will focus on what alterations in energy metabolism occur in pressure overload induced left and right heart failure. We will also discuss potential targets and pharmacological approaches that can be used to treat heart failure occurring secondary to pulmonary hypertension and/or systemic hypertension. PMID:25992268

  4. Contrast-enhanced cardiac C-arm CT evaluation of radiofrequency ablation lesions in the left ventricle

    PubMed Central

    Girard, Erin E; Al-Ahmad, Amin A; Rosenberg, Jarrett; Luong, Richard; Moore, Teri; Lauritsch, Günter; Boese, Jan; Fahrig, Rebecca

    2011-01-01

    Objectives The purpose of this study was to evaluate use of cardiac C-arm computed tomography (CT) in the assessment of the dimensions and temporal characteristics of radiofrequency ablation (RFA) lesions. This imaging modality uses a standard C-arm fluoroscopy system rotating around the patient, providing CT-like images during the RFA procedure. Background Both magnetic resonance imaging (MRI) and CT can be used to assess myocardial necrotic tissue. Several studies have reported visualizing cardiac RF ablation lesions with MRI, however obtaining MR images during interventional procedures is not common practice. Direct visualization of RFA lesions using C-arm CT during the procedure may improve outcomes and circumvent complications associated with cardiac ablation procedures. Methods RFA lesions were created on the endocardial surface of the left ventricle of 9 swine using a 7-F RF ablation catheter. An ECG-gated C-arm CT imaging protocol was used to acquire projection images during iodine contrast injection and following the injection every 5 min for up to 30 min, with no additional contrast. Reconstructed images were analyzed offline. The mean and standard deviation of the signal intensity of the lesion and normal myocardium were measured in all images in each time series. Lesion dimensions and area were measured and compared in pathologic specimens and C-arm CT images. Results All ablation lesions (n=29) were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements (1D dimensions : concordance correlation = 0.87; area : concordance correlation = 0.90). Lesions were visualized as a perfusion defect on first-pass C-arm CT images with a signal intensity 95 HU lower than normal myocardium (95% confidence interval: -111 to -79 HU). Images acquired at 1 and 5 minutes exhibited an enhancing ring surrounding the perfusion defect in 24 (83%) lesions. Conclusions RFA lesion size, including transmurality, can be assessed using ECG-gated cardiac C-arm CT in the interventional suite. Visualization of RFA lesions using cardiac C-arm CT may facilitate the assessment of adequate lesion delivery and provide valuable feedback during cardiac ablation procedures. PMID:21414574

  5. Reduced Ventricular Volumes and Improved Systolic Function With Cardiac Resynchronization Therapy A Randomized Trial Comparing Simultaneous Biventricular Pacing, Sequential Biventricular Pacing, and Left Ventricular Pacing

    Microsoft Academic Search

    Rajni K. Rao; Uday N. Kumar; Jill Schafer; Esperanza Viloria; David De Lurgio; Elyse Foster

    2010-01-01

    Background—Cardiac resynchronization therapy has emerged as an important therapy for advanced systolic heart failure. Among available cardiac resynchronization therapy pacing modes that restore ventricular synchrony, it is uncertain whether simultaneous biventricular (BiV), sequential BiV, or left ventricular (LV) pacing is superior. The Device Evaluation of CONTAK RENEWAL 2 and EASYTRAK 2: Assessment of Safety and Effectiveness in Heart Failure (DECREASE-HF)

  6. The deep inspiration breath hold technique using Abches reduces cardiac dose in patients undergoing left-sided breast irradiation

    PubMed Central

    Lee, Ha Yoon; Chang, Jee Suk; Lee, Ik Jae; Park, Kwangwoo; Kim, Yong Bae; Suh, Chang Ok; Kim, Jun Won

    2013-01-01

    Purpose We explored whether the deep inspiration breath hold (DIBH) technique using Abches during left-sided breast irradiation was effective for minimizing the amount of radiation to the heart and lung compared to free breathing (FB). Materials and Methods Between February and July 2012, a total of 25 patients with left-sided breast cancer underwent two computed tomography scans each with the DIBH using Abches and using FB after breast-conserving surgery. The scans were retrospectively replanned using standardized criteria for the purpose of this study. The DIBH plans for each patient were compared with FB plans using dosimetric parameters. Results All patients were successfully treated with the DIBH technique using Abches. Significant differences were found between the DIBH and FB plans for mean heart dose (2.52 vs. 4.53 Gy), heart V30 (16.48 vs. 45.13 cm3), V20 (21.35 vs. 54.55 cm3), mean left anterior descending coronary artery (LAD) dose (16.01 vs. 26.26 Gy, all p < 0.001), and maximal dose to 0.2 cm3 of the LAD (41.65 vs. 47.27 Gy, p = 0.017). The mean left lung dose (7.53 vs. 8.03 Gy, p = 0.073) and lung V20 (14.63% vs. 15.72%, p = 0.060) of DIBH using Abches were not different significantly compared with FB. Conclusion We report that the use of a DIBH technique using Abches in breathing adapted radiotherapy for left-sided breast cancer is easily feasible in daily practice and significantly reduces the radiation doses to the heart and LAD, therefore potentially reducing cardiac risk. PMID:24501713

  7. Congenital giant cardiac tumor with severe left-ventricular inflow and outflow obstruction and arrhythmia treated with pulmonary artery banding and long-term amiodarone infusion

    PubMed Central

    Takeuchi, Daiji; Hiramatsu, Takeshi; Nakanishi, Toshio

    2012-01-01

    We report a congenital giant cardiac tumor that occupied the majority of left ventricular cavity with severe left ventricular inflow and outflow obstruction. The hemodynamics were similar to univentricular physiology. He was treated with prostaglandins and bilateral pulmonary artery banding. He had frequent supraventricular tachycardia associated with ventricular pre-excitation that was controlled by long-term administration of intravenous amiodarone. The patient died due to sepsis after 3 months. PMID:22529609

  8. Fatal delayed cardiac tamponade due to rupture of micropseudoaneurysm of left anterior descending coronary artery following stab to the chest.

    PubMed

    Xing, Jingjun; Li, Shangxun; Zhang, Lin; Yang, Yi; Duan, Yijie; Li, Wenhe; Zhou, Yiwu

    2015-01-01

    Traumatic coronary pseudoaneurysm has been described to be mainly associated to iatrogenic lesion of the coronary arteries. However, chest-stab-wound-related coronary pseudoaneurysm caused by isolated partial incision of a coronary artery giving rise to fatal delayed cardiac tamponade is very rare. We describe an autopsy case in which this potentially fatal complication developed 8 days later after a thoracic stab wound. Unfortunately, the imaging examination failed to detect this defect during hospitalization. Postmortem examination revealed that the posterior wall of the left anterior descending coronary artery was intact but that the anterior wall was incised, forming a micropseudoaneurysm which had ruptured. This case highlights that isolated coronary artery injuries must be considered in any patient with a penetrating wound to the thorax, and coronary pseudoaneurysms should not be missed in these patients. PMID:25541181

  9. A model-based time-reversal of left ventricular motion improves cardiac motion analysis using tagged MRI data

    PubMed Central

    Alrefae, Tareq; Smirnova, Irina V; Cook, Larry T; Bilgen, Mehmet

    2008-01-01

    Background Myocardial motion is an important observable for the assessment of heart condition. Accurate estimates of ventricular (LV) wall motion are required for quantifying myocardial deformation and assessing local tissue function and viability. Harmonic Phase (HARP) analysis was developed for measuring regional LV motion using tagged magnetic resonance imaging (tMRI) data. With current computer-aided postprocessing tools including HARP analysis, large motions experienced by myocardial tissue are, however, often intractable to measure. This paper addresses this issue and provides a solution to make such measurements possible. Methods To improve the estimation performance of large cardiac motions while analyzing tMRI data sets, we propose a two-step solution. The first step involves constructing a model to describe average systolic motion of the LV wall within a subject group. The second step involves time-reversal of the model applied as a spatial coordinate transformation to digitally relax the contracted LV wall in the experimental data of a single subject to the beginning of systole. Cardiac tMRI scans were performed on four healthy rats and used for developing the forward LV model. Algorithms were implemented for preprocessing the tMRI data, optimizing the model parameters and performing the HARP analysis. Slices from the midventricular level were then analyzed for all systolic phases. Results The time-reversal operation derived from the LV model accounted for the bulk portion of the myocardial motion, which was the average motion experienced within the overall subject population. In analyzing the individual tMRI data sets, removing this average with the time-reversal operation left small magnitude residual motion unique to the case. This remaining residual portion of the motion was estimated robustly using the HARP analysis. Conclusion Utilizing a combination of the forward LV model and its time reversal improves the performance of motion estimation in evaluating the cardiac function. PMID:18489766

  10. Two-domain mechanics of a spherical, single chamber heart with applications to specific cardiac pathologies.

    PubMed

    Puwal, Steffan

    2013-12-01

    Continuum approximations of tissue consider responses averaged over many cells in a region. This simplified approach allows consideration of macroscopic effects, such as deformation or action potential propagation. A bidomain (sometimes known as biphasic) approach retains the macroscopic character of a continuum approximation while allowing one to consider microscopic effects; novel behavior arising from interactions between the intracellular and extracellular spaces can also be noted. I consider a spherical, single chamber heart with the new mechanical bidomain model in four separate pathologies: hypertension, hypovolemic hypotension, and hypertrophic and dilational cardiomyopathies. Analytic solutions of intracellular and extracellular displacements and hydrostatic pressures are presented; the distributions describe elastic deformation and hydrostatic fluid pressure buildup of the extracellular collagen matrix and the intracellular muscle under simplified spherical geometry. Potential applications, such as stretch activated membrane channels, are also noted. PMID:23875126

  11. The role of cardiac biomarkers for predicting left ventricular dysfunction and cardiovascular mortality in acute exacerbations of COPD

    PubMed Central

    Bennett, Ruth; Coad, Anna; Barnes, Simon; Russell, Richard; Manuel, Ari R

    2015-01-01

    The presence of cardiovascular comorbidities is frequently associated with poor outcomes in chronic obstructive pulmonary disease (COPD). No clear role has been defined for cardiac biomarkers in acute exacerbations of COPD (AECOPD). The aim of this systematic review was to examine the prognostic value of brain natriuretic peptide (BNP) and troponins in patients with AECOPD. Two independent authors searched the PubMed and Cochrane Library to collect clinical trials, observational studies and meta-analyses studying the prognostic value of cardiac biomarkers in AECOPD. The reference lists of all the included studies were also reviewed. A total of 14 studies were included in the review, of which 10 measured troponins, 7 measured BNP or NT-proBNP, and 3 measured both. Of the studies that used mortality in AECOPD as an end point, some but not all found that elevated BNP and/or troponins were associated with increased mortality. Of the studies that used left ventricular (LV) dysfunction in AECOPD as an end point, all found a significant association between elevated BNP and troponins in the diagnosis of LV dysfunction. In summary, it appears that there may be a link between an elevated level of BNP or NT-proBNP and increased cardiovascular mortality in AECOPD, although the data currently available are not conclusive. The inconsistencies in biomarkers measured, time points of measurements and the variability in outcome measured preclude more robust analysis. PMID:25852947

  12. Quantification of left ventricular volumes from cardiac cine MRI using active contour model combined with gradient vector flow.

    PubMed

    Tanki, Nobuyoshi; Murase, Kenya; Kumashiro, Masayuki; Momoi, Risa; Yang, Xiaomei; Tabuchi, Takashi; Nagayama, Masako; Watanabe, Yuji

    2005-12-31

    We investigated the feasibility of combining the active contour model with gradient vector flow (Snakes-GVF) to estimate left ventricular (LV) volumes from cardiac cine magnetic resonance imaging (MRI). MRI data were acquired from 27 patients, including 14 adults (9 men, 5 women, 55.0+/-23.3 years) and 13 children (10 boys, 3 girls, 2.7+/-2.1 years) using Gyroscan Intera (1.5 Tesla, Philips Medical Systems). LV volumes were calculated by adding the areas surrounded by the contour extracted by Snakes-GVF and compared with volumes estimated by manual tracing. Those estimated by Snakes-GVF [y (mL)] correlated well with those estimated by manual tracing [x (mL)]. In adult cases, the regression equation and correlation coefficient were y=1.008x - 0.517 and 0.996, respectively. In pediatric cases, they were y=1.174x - 2.542 and 0.992, respectively. In conclusion, Snakes-GVF is a powerful and useful tool for quantifying LV volumes using cardiac MRI. PMID:16543704

  13. Beat-to-beat estimation of the continuous left and right cardiac elastance from metrics commonly available in clinical settings

    PubMed Central

    2012-01-01

    Introduction Functional time-varying cardiac elastances (FTVE) contain a rich amount of information about the specific cardiac state of a patient. However, a FTVE waveform is very invasive to directly measure, and is thus currently not used in clinical practice. This paper presents a method for the estimation of a patient specific FTVE, using only metrics that are currently available in a clinical setting. Method Correlations are defined between invasively measured FTVE waveforms and the aortic and pulmonary artery pressures from 2 cohorts of porcine subjects, 1 induced with pulmonary embolism, the other with septic shock. These correlations are then used to estimate the FTVE waveform based on the individual aortic and pulmonary artery pressure waveforms, using the “other” dysfunction’s correlations as a cross validation. Results The cross validation resulted in 1.26% and 2.51% median errors for the left and right FTVE respectively on pulmonary embolism, while the septic shock cohort had 2.54% and 2.90% median errors. Conclusions The presented method accurately and reliably estimated a patient specific FTVE, with no added risk to the patient. The cross validation shows that the method is not dependent on dysfunction and thus has the potential for generalisation beyond pulmonary embolism and septic shock. PMID:22998792

  14. Oxidative and proteolytic profiles of the right and left heart in a model of cancer-induced cardiac cachexia.

    PubMed

    Borges, F H; Marinello, P C; Cecchini, A L; Blegniski, F P; Guarnier, F A; Cecchini, R

    2014-11-01

    Cardiac cachexia is a syndrome that has received increased attention in recent years. Although an association between proteolysis and cardiac cachexia has been proposed, the direct influence of oxidative stress on the process has not been demonstrated. In the present study, the right (RH) and left (LH) hearts (atrium and ventricle of each side of the heart) were collected from rats at the 5th and 10th days after phosphate buffer (control) orWalker-256 solid tumour implantation. Immediately after sacrifice, cachexia was determined in tumour-bearing animals by the formula: [(inicial body weight-final body weight+tumour weight+weight gain of control group)/(initial body weight+body mass gain of control group)]×100%; RH and LH were stored until use. Oxidative stress and proteolysis were determined in each collected sample. In addition, heart samples were collected from a separate set of animals to determine the thickness of the left and right ventricles. Cachexia values increased over time after tumour implantation from 6.85% at the 5th day to 17.76% at the 10th day. There was no significant difference in LH wet weight and ventricle thickness compared with the control, where as RH wet weight (0.109±0.09g at the 5th day and 0.093±0.09g at the 10th day) and thickness (420±16?m at the 5th day and 279±08?m at the 10th day) were significantly decreased at both time points when compared with control values (0.153±0.06g and 607±21?m, respectively). tert-Butyl-stimulated chemiluminescence analysis revealed a significant increase in the LH and decrease in the RH oxidative stress profiles. Carbonylated proteins increased in the LH (140%, p<0.05) and RH (100%, p<0.05) at the 5th day, and significantly decreased in both sides on the 10th day compared to controls. Chemotrypsin-like, caspase-like, and calpain-like activities were evaluated by chemiluminescence, and only calpain-like activity was found to increase at the 5th day in the RH. In the LH, all proteolytic activities systems were decreased when compared with controls. Together, these results demonstrate that oxidative stress appears to play a different role in mass modulation on the LH and RH. The proteolytic systems evaluated herein also appear to have different effects on the responses developed during cardiac cachexia in the two sides of the heart. PMID:24996969

  15. Effects of Dobutamine on Left Ventricular Performance, Coronary Dynamics, and Distribution of Cardiac Output in Conscious Dogs

    PubMed Central

    Vatner, Stephen F.; McRitchie, Robert J.; Braunwald, Eugene

    1974-01-01

    The effects of dobutamine ([±]-4-[2-[[3-(p-hydroxyphenyl)-1-methyl propyl] amino] ethyl] pyrocatechol hydrochloride), a new synthetic cardioactive sympathomimetic amine, were examined on direct and continuous measurements of left ventricular (LV) diameter (D), pressures (P), velocity of shortening (V), dP/dt, dP/dt/P, arterial pressure, cardiac output, and regional blood flows in the left circumflex coronary, mesenteric, renal, and iliac beds in healthy, conscious dogs. At the highest dose of dobutamine examined, 40 ?g/kg/min, the drug increased dP/dt/P from 65±3 to 128±4 s-1 and isolength velocity from 72±4 to 120±7 mm/s without affecting LV end diastolic D significantly. Mean arterial P rose from 92±2 to 104±3 mm Hg and heart rate from 78±3 to 111±7 beats/min, while LV end systolic D fell from 24.1±1.4 to 19.9±1.8 mm, reflecting a rise in stroke volume from 30±4 to 42±3 ml. Cardiac output rose from 2.41±0.23 to 4.35±0.28 liter/min, while calculated total peripheral resistance declined from 0.042±0.005 to 0.028±0.003 mm Hg/ml/min. The greatest increases in flow and decreases in calculated resistance occurred in the iliac and coronary beds, and the least occurred in the renal bed. Propranolol blocked the inotropic and beta2 dilator responses while vasoconstricting effects mediated by alpha adrenergic stimulation remained in each of the beds studied. When dobutamine was infused after a combination of practolol and phentolamine, dilatation occurred in each of the beds studied. These observations indicate that dobutamine is a potent positive inotropic agent with relatively slight effects on preload, afterload, or heart rate, and thus may be a potentially useful clinical agent. The one property of this drug which is not ideal is its tendency to cause a redistribution of cardiac output favoring the muscular beds at the expense of the kidney and visceral beds. Images PMID:4825224

  16. Management of high-risk patients with hypertension and left ventricular hypertrophy in Germany: differences between cardiac specialists in the inpatient and outpatient setting

    Microsoft Academic Search

    Heinz Völler; Frank J Sonntag; Joachim Thiery; Karl Wegscheider; Friedrich C Luft; Kurt Bestehorn

    2006-01-01

    BACKGROUND: Among patients with hypertension, those with established left ventricular hypertrophy (LVH) represent a high risk cohort with poor prognosis. We aimed to investigate differences in characteristics and health care management of such patients treated as inpatients or outpatients by cardiac specialists. METHODS: Prospective cross-sectional study in patients with hypertension and LVH who were referred to either inpatient care (rehabilitation

  17. Non-sustained ventricular tachycardia as a predictor of sudden cardiac death in patients with left ventricular dysfunction: A meta-analysis

    Microsoft Academic Search

    Marcos R. de Sousa; Carlos A. Morillo; Fábio T. Rabelo; Antônio M. Nogueira Filho; Antonio L. P. Ribeiro

    Background: Identifying patients at risk of sudden cardiac death (SCD) remains a challenge. Aim: To evaluate the performance of non-sustained ventricular tachycardia (NSVT) from 24 hour ambulatory electrocardiography as a predictor of SCD in patients with heart failure or non-ischaemic dilated cardiomyopathy with left ventricular systolic dysfunction (LVSD). Methods and results: Study search and selection were performed by independent reviewers

  18. The application of the principle of conserved myocardium volume in guiding automated chamber estimation in mouse cardiac imaging

    NASA Astrophysics Data System (ADS)

    Garson, Christopher D.; Li, Bing; Hossack, John A.

    2007-03-01

    Active contours have been used in a wide variety of image processing applications due to their ability to effectively distinguish image boundaries with limited user input. In this paper, we consider 3D gradient vector field (GVF) active surfaces and their application in the determination of the volume of the mouse heart left ventricle. The accuracy and efficacy of a 3D active surface is strongly dependent upon the selection of several parameters, corresponding to the tension and rigidity of the active surface and the weight of the GVF. However, selection of these parameters is often subjective and iterative. We observe that the volume of the cardiac muscle is, to a good approximation, conserved through the cardiac cycle. Therefore, we propose using the degree of conservation of heart muscle volume as a metric for assessing optimality of a particular set of active surface parameters. A synthetic dataset consisting of nested ellipsoids of known volume was constructed. The outer ellipsoid contracted over time to imitate a heart cycle, and the inner ellipsoid compensated to maintain constant volume. The segmentation algorithm was also investigated in vivo using B-mode data sets obtained by scanning the hearts of three separate mice. Active surfaces were initialized using a broad range of values for each of the parameters under consideration. Conservation of volume was a useful predictor of the efficacy of the model for the range of values tested for the GVF weighting parameter, though it was less effective at predicting the efficacy of the active surface tension and rigidity parameters.

  19. [Determination of the optimal atrioventricular timing by impedance plethysmography in patients with cardiac pacing; correlations with left ventricular filling].

    PubMed

    Rey, J L; Deschamps-Berger, P H; Tribouilloy, C; Hermida, J S; Kugener, H; Jarry, G; Marek, A

    1994-06-01

    The stroke volume (SV) was measured by the change in the impedance in thirteen patients with dual chamber pacemakers at different atrioventricular delay (AVD) intervals: 31 to 219 ms or 75 to 220 ms. The mitral inflow was also recorded by Doppler echocardiography at each AVD with measurement of the duration of mitral flow (MFD) and the velocity time integral (VTI). All thirteen patients were studied in the DDD mode; in addition, 5 patients were studied in the atrial sensing ventricular stimulation VDD mode. The SV measurement by impedance plethysmography was reproducible with an average variability of 3.5%: the optimal AVD was determined by this method in 11 patients with DDD and 4 patients with VDD pacing: in 3 patients (2 in DDD and 1 in VDD mode) 2 optimal AVD were obtained. The optimal AVD was 123 +/- 31 ms (63 to 156 ms) in DDD mode and 91 +/- 17 ms (63 to 110 ms) in VDD mode. The analysis of left ventricular filling showed that changes in AVD led to similar changes in mitral VTI. The MFD increased as the AVD was shortened to a constant value at the optimal AVD. In all patients, the optimal AVD was obtained when the MFD became maximal and constant. Measurement of MFD is a simple and rapid means of assessing optimal AVD at rest in patients with dual chamber pacing systems. PMID:7702416

  20. Diacerein Improves Left Ventricular Remodeling and Cardiac Function by Reducing the Inflammatory Response after Myocardial Infarction

    PubMed Central

    Torina, Anali Galluce; Reichert, Karla; Lima, Fany; de Souza Vilarinho, Karlos Alexandre; de Oliveira, Pedro Paulo Martins; do Carmo, Helison Rafael Pereira; de Carvalho, Daniela Diógenes; Saad, Mário José Abdalla; Sposito, Andrei Carvalho; Petrucci, Orlando

    2015-01-01

    Background The inflammatory response has been implicated in the pathogenesis of left ventricular (LV) remodeling after myocardial infarction (MI). An anthraquinone compound with anti-inflammatory properties, diacerein inhibits the synthesis and activity of pro-inflammatory cytokines, such as tumor necrosis factor and interleukins 1 and 6. The purpose of this study was to investigate the effects of diacerein on ventricular remodeling in vivo. Methods and Results Ligation of the left anterior descending artery was used to induce MI in an experimental rat model. Rats were divided into two groups: a control group that received saline solution (n = 16) and a group that received diacerein (80 mg/kg) daily (n = 10). After 4 weeks, the LV volume, cellular signaling, caspase 3 activity, and nuclear factor kappa B (NF-?B) transcription were compared between the two groups. After 4 weeks, end-diastolic and end-systolic LV volumes were reduced in the treatment group compared to the control group (p < .01 and p < .01, respectively). Compared to control rats, diacerein-treated rats exhibited less fibrosis in the LV (14.65%± 7.27% vs. 22.57%± 8.94%; p < .01), lower levels of caspase-3 activity, and lower levels of NF-?B p65 transcription. Conclusions Treatment with diacerein once a day for 4 weeks after MI improved ventricular remodeling by promoting lower end-systolic and end-diastolic LV volumes. Diacerein also reduced fibrosis in the LV. These effects might be associated with partial blockage of the NF-?B pathway. PMID:25816098

  1. The impact of infarct size on regional and global left ventricular systolic function: a cardiac magnetic resonance imaging study.

    PubMed

    Palazzuoli, Alberto; Beltrami, Matteo; Gennari, Luigi; Dastidar, A Ghosh; Nuti, Ranuccio; McAlindon, Elisa; Angelini, Gianni D; Bucciarelli-Ducci, Chiara

    2015-06-01

    Myocardial infarction (MI) results in myocardial scarring which can have an impact on left ventricular (LV) stiffness and contractile function, ultimately leading to reduced LV systolic function and LV remodelling, However some concerns about the relation between scar extension and segmental wall motion contractility is not enough clear. Thus, the association between myocardial scar, LV regional and global function and LV remodeling should be investigated. We studied the relationship between scar extension, wall motion score index (WMSI), LV dimensions and systolic function in a group of patients with previous MI by cardiac magnetic resonance (CMR). 133 patients with previous (>6 month) MI were retrospectively enrolled in the study. Indexed end-systolic volume (ESVi), indexed end-diastolic volume (EDVi), LV ejection fraction (EF), stroke volume (SV), LV mass were measured using CMR. WMSI and sum scar score (SSS) were also measured following AHA\\ACC criteria giving an arbitrary cut-off to distinguish larger from restricted late gadolinium enhancement (LGE) area. A total of 2261 segments were studied: regional wall motion abnormalities were present in 1032 segments (45 %) and 724 (32 %) showed presence of MI (LGE). WMSI correlated significantly with EF (r = -0.87, p < 0.0001) in all patients and in both patients with EF ? 40 % (r = -0.77, p < 0.0001) and EF < 40 % (r = -0.68, p < 0.0001). WMSI also correlated significantly with SSS (r = 0.57, p < 0.0001). The correlation between WMSI and SSS was more significant in patients with transmural MI (WMSI 2.1 ± 0.5 and SSS 17 ± 8; r = 0.55, p < 0.0001) than with non transmural MI (WMSI 1.6 ± 0.7 and SSS 6 ± 4; r = 0.34 and p = 0.02). A significant correlation was also found between EF and SSS (r = -0.55 and p < 0.0001) and between SSS and LV indexed volumes (EDVi; r = 0.44, p < 0.0001 and ESVi; r = 0.51, p < 0.0001). Infarct transmurality and extension as expressed as SSS assessed with cardiac MRI has an impact on global and regional systolic function. A multi-parametric score measuring WMSI scar transmurality and extension, could better identify an increased cardiac remodeling after coronary event. PMID:25863669

  2. Vulnerable Myocardial Interstitium in Patients With Isolated Left Ventricular Hypertrophy and Sudden Cardiac Death: A Postmortem Histological Evaluation

    PubMed Central

    Tamarappoo, Balaji K.; John, Benjamin T.; Reinier, Kyndaron; Teodorescu, Carmen; Uy-Evanado, Audrey; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.

    2012-01-01

    Background Concentric left ventricular hypertrophy (LVH) is independently associated with increased risk of sudden cardiac death (SCD). Some animal models of LVH display specific alterations of the myocardial interstitium that could increase myocardial vulnerability to ventricular arrhythmias, but these merit evaluation in humans with LVH and SCD. Methods and Results Twelve consecutive patients with isolated LVH and SCD (LVH+SCD) in the absence of hypertrophic cardiomyopathy, coronary disease, or other cardiac structural abnormality were ascertained in the Oregon Sudden Unexpected Death Study. Detailed postmortem comparisons were conducted with 18 controls who had isolated LVH and unnatural deaths (Control Group A) and 6 controls who had structurally normal hearts and unnatural deaths (Control Group B). Postmortem left ventricular myocardial sections were obtained for measurement of collagen volume fraction, characterization of gap junctions, and quantification of collagen subtypes. Heart weight normalized to body weight was higher in LVH+SCD cases (6.9±1.2 g/kg) than in Control Group A (5.3±1.4 g/kg) and Control Group B (4.2±0.3 g/kg); P=0.001. Collagen volume fraction was also higher in LVH+SCD cases (3.1±0.4) than in Control Group A (2.3±0.4) and Control Group B (1.6±0.3); P=0.0002. The relative amount of collagen III was significantly higher in LVH+SCD cases (33.0±4.4%) than in Control Group A (20.9±4.3%) and Control Group B (13.4±3.5%); P=0.0001. There was an overall increase in the number of connexin 43–labeled gap junctions with increasing myocyte size. No subject was found to have high-risk hypertrophic cardiomyopathy mutations. Conclusions In addition to the expected increase in myocardial mass and overall collagen content, SCD with isolated LVH was associated with relative abundance of type III collagen, a novel finding that warrants further mechanistic evaluation. (J Am Heart Assoc. 2012;1:e001511 doi: 10.1161/JAHA.111.001511.) PMID:23130141

  3. Cardiac chamber volumes by echocardiography using a new mathematical method: A promising technique for zero-G use

    NASA Technical Reports Server (NTRS)

    Buckey, J. C.; Beattie, J. M.; Gaffney, F. A.; Nixon, J. V.; Blomqvist, C. G.

    1984-01-01

    Accurate, reproducible, and non-invasive means for ventricular volume determination are needed for evaluating cardiovascular function zero-gravity. Current echocardiographic methods, particularly for the right ventricle, suffer from a large standard error. A new mathematical approach, recently described by Watanabe et al., was tested on 1 normal formalin-fixed human hearts suspended in a mineral oil bath. Volumes are estimated from multiple two-dimensional echocardiographic views recorded from a single point at sequential angles. The product of sectional cavity area and center of mass for each view summed over the range of angles (using a trapezoidal rule) gives volume. Multiple (8-14) short axis right ventricle and left ventricle views at 5.0 deg intervals were videotaped. The images were digitized by two independent observers (leading-edge to leading-edge technique) and analyzed using a graphics tablet and microcomputer. Actual volumes were determined by filling the chambers with water. These data were compared to the mean of the two echo measurements.

  4. Relation of mitral valve prolapse to basal left ventricular hypertrophy as determined by cardiac magnetic resonance imaging.

    PubMed

    Zia, Mohammad Imran; Valenti, Valentina; Cherston, Caroline; Criscito, Maressa; Uretsky, Seth; Wolff, Steven

    2012-05-01

    We aimed to characterize the extent and distribution of focal basal left ventricular (LV) hypertrophy in patients with mitral valve prolapse (MVP). Sixty-three patients (mean age: 58 ± 14 years) with MVP and 20 age-matched normal volunteers (mean age: 53 ± 11 years) were assessed using cardiac magnetic resonance imaging. We compared the ratio of basal to mid end-diastolic wall thickness in both groups and correlated it with clinical and imaging parameters. Of the 63 patients, 44 (70%) had posterior leaflet prolapse, 2 (3%) had anterior leaflet prolapse, and 17 (27%) had bileaflet prolapse. There was a significantly increased ratio of basal to mid-ventricular end-diastolic wall thickness in all segments of the left ventricle in those with MVP compared to the controls. The inferolateral (2.1 vs 1.0, p <0.01) and anterolateral (2.1 vs 1.1) ratios (p <0.01) were the greatest compared to the other myocardial segments. The degree of mitral annular excursion had a strong positive correlation with the degree of hypertrophy (r(2) = 0.81, p <0.01) and was an independent predictor in adjusted multivariate analysis (p <0.0001). Age, body mass index, LV end-diastolic volume index, LV end -systolic volume index, LV stroke volume index, degree of prolapse, and mitral regurgitation volume did not have any significant correlation with the degree of hypertrophy. In conclusion, MVP is associated with concentric basal LV hypertrophy and good correlation between the excursion of the mitral valve annulus and the degree of relative LV hypertrophy suggests that locally increased myocardial function could be responsible for this remodeling. PMID:22335854

  5. Dynamic left ventricular elastance: a model for integrating cardiac muscle contraction into ventricular pressure-volume relationships.

    PubMed

    Campbell, Kenneth B; Simpson, Amy M; Campbell, Stuart G; Granzier, Henk L; Slinker, Bryan K

    2008-04-01

    To integrate myocardial contractile processes into left ventricular (LV) function, a mathematical model was built. Muscle fiber force was set equal to the product of stiffness and elastic distortion of stiffness elements, i.e., force-bearing cross bridges (XB). Stiffness dynamics arose from recruitment of XB according to the kinetics of myofilament activation and fiber-length changes. Elastic distortion dynamics arose from XB cycling and the rate-of-change of fiber length. Muscle fiber stiffness and distortion dynamics were transformed into LV chamber elastance and volumetric distortion dynamics. LV pressure equaled the product of chamber elastance and volumetric distortion, just as muscle-fiber force equaled the product of muscle-fiber stiffness and lineal elastic distortion. Model validation was in terms of its ability to reproduce cycle-time-dependent LV pressure response, DeltaP(t), to incremental step-like volume changes, DeltaV, in the isolated rat heart. All DeltaP(t), regardless of the time in the cycle at which DeltaP(t) was elicited, consisted of three phases: phase 1, concurrent with the leading edge of DeltaV; phase 2, a brief transient recovery from phase 1; and phase 3, sustained for the duration of systole. Each phase varied with the time in the cycle at which DeltaP(t) was elicited. When the model was fit to the data, cooperative activation was required to sustain systole for longer periods than was possible with Ca(2+) activation alone. The model successfully reproduced all major features of the measured DeltaP(t) responses, and thus serves as a credible indicator of the role of underlying contractile processes in LV function. PMID:18048589

  6. Isolation of the left atrial surface from cardiac multi-detector CT images based on marker controlled watershed segmentation.

    PubMed

    Cristoforetti, Alessandro; Faes, Luca; Ravelli, Flavia; Centonze, Maurizio; Del Greco, Maurizio; Antolini, Renzo; Nollo, Giandomenico

    2008-01-01

    The delineation of left atrium (LA) and pulmonary veins (PVs) anatomy from high resolution images holds importance for atrial fibrillation (AF) investigation and treatment. In this study, a semiautomatic segmentation procedure for LA and PVs inner surface from contrast enhanced CT data was developed. The procedure consists of a three dimensional marker controlled watershed segmentation applied to the external morphological gradient, followed by variable threshold surface extraction from the original intensity image. A preliminary anisotropic non-linear filtering was implemented to improve the S/N ratio of CT images. The performance of segmentation was evaluated on cardiac CT scans of 12 AF patients both qualitatively and quantitatively. The qualitative evaluation by expert radiologist assessed the segmentation as overall successful in all patients and capable of extracting both the LA body and the connected vascular trees. The quantitative validation, by computing discrepancy measures with respect to a manually segmented gold standard, indicated an average of about 90% of voxels correctly classified and an average border mismatch lower than 1.5 voxels (1.2 mm). The accurate extraction of the inner LA-PVs walls provided by this method, along with the minimal required human intervention, should facilitate the use of anatomical atrial models for the non-pharmacological treatment of AF. PMID:17392015

  7. Videoscopic Left Cardiac Sympathetic Denervation for Patients With Recurrent Ventricular Fibrillation/Malignant Ventricular Arrhythmia Syndromes Besides Congenital Long-QT Syndrome

    PubMed Central

    Coleman, Mira A.; Bos, J. Martijn; Johnson, Jonathan N.; Owen, Heidi J.; Deschamps, Claude; Moir, Christopher; Ackerman, Michael J.

    2014-01-01

    Background Treatment options for patients with recurrent ventricular arrhythmias refractory to pharmacotherapy and ablation are minimal. Although left cardiac sympathetic denervation (LCSD) is well established in long-QT syndrome, its role in non-long-QT syndrome arrhythmogenic channelopathies and cardiomyopathies is less clear. Here, we report our single-center experience in performing LCSD in this setting. Methods and Results In this institutional review board-approved study, we retrospectively reviewed the electronic medical records of all patients (N=91) who had videoscopic LCSD at our institution from 2005 to 2011. Data were analyzed for the subset (n=27) who were denervated for an underlying diagnosis other than autosomal dominant or sporadic long-QT syndrome. The spectrum of arrhythmogenic disease included catecholaminergic polymorphic ventricular tachycardia (n=13), Jervell and Lange-Nielsen syndrome (n=5), idiopathic ventricular fibrillation (n=4), left ventricular noncompaction (n=2), hypertrophic cardiomyopathy (n=1), ischemic cardiomyopathy (n=1), and arrhythmogenic right ventricular cardiomyopathy (n=1). Five patients had LCSD because of high-risk assessment and ?-blocker intolerance, none of whom had a sentinel breakthrough cardiac event at early follow-up. Among the remaining 22 previously symptomatic patients who had LCSD as secondary prevention, all had an attenuation in cardiac events, with 18 having no breakthrough cardiac events so far and 4 having experienced ?1 post-LCSD breakthrough cardiac event. Conclusions LCSD may represent a substrate-independent antifibrillatory treatment option for patients with life-threatening ventricular arrhythmia syndromes other than long-QT syndrome. The early follow-up seems promising, with a marked reduction in the frequency of cardiac events postdenervation. PMID:22787014

  8. Passive external cardiac constraint improves segmental left ventricular wall motion and reduces akinetic area in patients with non-ischemic dilated cardiomyopathy

    Microsoft Academic Search

    Alexander Lembcke; Simon Dushe; Christian N. H. Enzweiler; Christian Kloeters; Till H. Wiese; Kay-Geert A. Hermann; Bernd Hamm; Wolfgang F. Konertz

    2004-01-01

    Objective: To verify changes in left ventricular (LV) volumes and regional myocardial wall motion after implantation of a textile cardiac support device (CSD) for passive external constraint in non-ischemic dilated cardiomyopathy. Methods: In nine male patients participating in a non-randomized clinical trial LV volumes were determined and the segmental LV wall motion was studied by contrast-enhanced electron-beam CT in a

  9. Passive external cardiac constraint improves segmental left ventricular wall motion and reduces akinetic area in patients with non-ischemic dilated cardiomyopathy

    Microsoft Academic Search

    Alexander Lembcke; Simon Dushe; Christian N. H. Enzweiler; Kay-Geert A. Hermann; Bernd Hamma; Wolfgang F. Konertz

    Objective: To verify changes in left ventricular (LV) volumes and regional myocardial wall motion after implantation of a textile cardiac support device (CSD) for passive external constraint in non-ischemic dilated cardiomyopathy. Methods: In nine male patients participating in a non-randomized clinical trial LV volumes were determined and the segmental LV wall motion was studied by contrast-enhanced electron-beam CT in a

  10. Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation.

    PubMed

    Nishimoto, M; Nakamae, H; Koh, H; Nakane, T; Nakamae, M; Hirose, A; Hagihara, K; Nakao, Y; Terada, Y; Ohsawa, M; Hino, M

    2013-04-01

    Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for >1 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient=-5.550, P=0.02 and coefficient=-0.268, P=0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P=0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT. PMID:23528643

  11. Evaluation of Cardiac Function Index as Measured by Transpulmonary Thermodilution as an Indicator of Left Ventricular Ejection Fraction in Cardiogenic Shock

    PubMed Central

    Perny, Jessica; Perez, Pierre; Levy, Bruno

    2014-01-01

    Introduction. The PiCCO transpulmonary thermodilution technique provides two indices of cardiac systolic function, the cardiac function index (CFI) and the global ejection fraction (GEF). Both appear to be correlated with left ventricular ejection fraction (LVEF) measured by echocardiography in patients with circulatory failure, especially in septic shock. The aim of the present study was to test the reliability of CFI as an indicator of LVEF in patients with cardiogenic shock. Methods. In thirty-five patients with cardiogenic shock, we performed (i) simultaneous measurements of echocardiography LVEF and cardiac function index assessed by transpulmonary thermodilution (n = 72) and (ii) transpulmonary thermodilution before/after increasing inotropic agents (n = 18). Results. Mean LVEF was 31% (+/?11.7), CFI 3/min (+/?1), and GEF 14.2% (+/?6). CFI and GEF were both positively correlated with LVEF (P < 0.0001, r2 = 0.27). CFI and GEF were significantly increased with inotropic infusion (resp., P = 0.005, P = 0.007). A cardiac function index <3.47/min predicted a left ventricular ejection fraction ?35% (sensitivity 81.1% and specificity 63%). In patients with right ventricular dysfunction, CFI was not correlated with LVEF. Conclusion. CFI is correlated with LVEF provided that patient does not present severe right ventricular dysfunction. Thus, the PiCCO transpulmonary thermodilution technique is useful for the monitoring of inotropic therapy during cardiogenic shock. PMID:25013790

  12. Left ventricular filling patterns in patients with previous myocardial infarction measured by conventional cine cardiac magnetic resonance.

    PubMed

    Rodríguez-Granillo, Gastón A; Mejía-Campillo, Marlon; Rosales, Miguel A; Bolzán, Gabriel; Ingino, Carlos; López, Federico; Degrossi, Elina; Lylyk, Pedro

    2012-04-01

    To explore left ventricular filling patterns in patients with a history of previous myocardial infarction (MI) using time-volume curves obtained from conventional cine-cardiac magnetic resonance (CMR) examinations. Consecutive patients with a history of previous MI who were referred for CMR evaluation constituted the study population, and a consecutive cohort of sex and age-matched patients with a normal CMR constituted the control group. The following CMR diastolic parameters were evaluated: peak filling rate (PFR), time to PFR (tPFR), normalised PFR adjusted for diastolic volume at PFR (nPFR), and percent RR interval between end systole and PFR. Fifty patients were included, 25 with a history of previous MI and 25 control. The mean age was 59.6 ± 13.9 years and 27 (54%) were male. Within the control group, age was significantly related to PFR (r = -0.53, p = 0.007), whereas among patients with previous MI age was not related to PFR (r = -0.16, p = 0.44). PFR (252.4 ± 96.7 ml/s vs. 316.0 ± 126.4 ml/s, p = 0.05) and nPFR (1.6 ± 1.2 vs. 3.3 ± 1.5, p < 0.001) were significantly lower in patients with previous MI, whereas no significant differences were detected regarding tPFR (143.0 ± 67.5 ms vs. 176.2 ± 83.9 ms, p = 0.13) and % RR to PFR (18.1 ± 9.7% vs. 20.6 ± 12.2%, p = 0.44). MI size was related to LV ejection fraction (r = -0.76, p < 0.001), PFR (r = -0.40, p = 0.004), nPFR (r = -0.52, p < 0.001) and left atrium area (r = 0.40, p = 0.004). Patients at the lowest PFR quartile (<200 ml/s) showed a larger MI size (Q1 26.5 ± 25.5%, Q2 15.5 ± 20.9%, Q3 6.3 ± 12.4%, Q4 8.8 ± 14.1%, p = 0.04). At multivariate analysis, MI size was the only independent predictor of the lowest PFR (p = 0.017). Infarct size has an impact on LV filling profiles, as assessed by conventional cine CMR without additional specific pulse sequences. PMID:21553076

  13. Electrocardiographic features of ventricular pacing lead in the middle cardiac vein vs. right ventricular apex in a patient with persistent left superior vena cava

    Microsoft Academic Search

    Tien-En Chen; Chun-Chieh Wang; Oruganti Sai Satish; Delon Wu

    2007-01-01

    A 53-year-old woman with sinus node dysfunction underwent dual-chamber pacemaker implantation through a persistent left superior vena cava draining into the coronary sinus, which was detected at the time of implantation. We managed to fix the ventricular lead in the right ventricular (RV) apex by forming a clockwise loop in the right atrium. Inadvertently, the lead was placed in the

  14. Towards a re-definition of 'cardiac hypertrophy' through a rational characterization of left ventricular phenotypes: a position paper of the Working Group 'Myocardial Function' of the ESC.

    PubMed

    Knöll, Ralph; Iaccarino, Guido; Tarone, Guido; Hilfiker-Kleiner, Denise; Bauersachs, Johann; Leite-Moreira, Adelino F; Sugden, Peter H; Balligand, Jean-Luc

    2011-08-01

    Many primary or secondary diseases of the myocardium are accompanied with complex remodelling of the cardiac tissue that results in increased heart mass, often identified as cardiac 'hypertrophy'. Although there have been numerous attempts at defining such 'hypertrophy', the present paper delineates the reasons as to why current definitions of cardiac hypertrophy remain unsatisfying. Based on a brief review of the underlying pathophysiology and tissue and cellular events driving myocardial remodelling with or without changes in heart dimensions, as well as current techniques to detect such changes, we propose to restrict the use of the currently popular term 'hypertrophy' to cardiac myocytes that may or may not accompany the more complex tissue rearrangements leading to changes in shape or size of the ventricles, more broadly referred to as 'remodelling'. We also discuss the great potential of genetically modified (mouse) models as tools to define the molecular pathways leading to the different forms of left ventricle remodelling. Finally, we present an algorithm for the stepwise assessment of myocardial phenotypes applicable to animal models using well-established imaging techniques and propose a list of parameters most suited for a critical evaluation of such pathophysiological phenomena in mouse models. We believe that this effort is the first step towards a much auspicated unification of the terminology between the experimental and the clinical cardiologists. PMID:21708908

  15. Delineation of the cardiac substructures based on PET-CT and contrast-enhanced CT in patients with left breast cancer treated with postoperative radiotherapy.

    PubMed

    Yu, X-L; Zhang, Q; Chen, J-Y; Zhang, Z; Wang, J-Z; Hu, W-G; Pan, Z-Q; Hu, S-L; Zhang, Y-J; Feng, Y; Shao, Z-M; Orecchia, R; Guo, X-M

    2013-04-01

    The aim of this study is to evaluate the volume differences between contrast-enhanced CT-based left ventricle (LV) and PET-CT-based LV and assess the impact of dose on the substructure volume differences in patients with left breast cancer treated with adjuvant radiotherapy. From October 2008 to February 2009, 14 patients with post-operatively confirmed left breast cancer were enrolled in the current study. The patients were scanned using contrast-enhanced CT for simulation, and (18)F-FDG PET-CT was employed to display the structure of the left ventricle of each before radiotherapy (RT). The LV was delineated based on both contrast-enhanced CT and PET-CT. And other substructures, such as the left anterior descending coronary artery (LAD), were contoured in each patient, with the six-field simple intensity modulated radiotherapy (sIMRT) technique created for all. The mean volumes of the left ventricle based on contrast-enhanced CT (LV-CT) and PET-CT (LV-PET) were found to be 107.296 cm(3) and 112.931 cm(3), respectively (p = 0.06). The volume of LV receiving ? 50% prescription dose was significantly correlated with the volume of the heart receiving the same dosage (? = 0.869). There was less correlation between the volume of LAD and that of the heart under the same condition (? = 0.22). As a conclusion, the left ventricle can be delineated effectively based on the image of PET-CT, the contrast-enhanced CT based LV can serve as an appropriate alternative. Moreover, the volume of LV receiving high dose in RT closely correlated with the volume of the heart using sIMRT technique, which may pave the way for further exploring radiation-induced cardiac injuries in patients with left breast cancer. PMID:22974330

  16. Treatment with a copper-selective chelator causes substantive improvement in cardiac function of diabetic rats with left-ventricular impairment

    PubMed Central

    2013-01-01

    Background Defective copper regulation is implicated as a causative mechanism of organ damage in diabetes. Treatment with trientine, a divalent-copper-selective chelator, improves arterial and renal structure/function in diabetes, wherein it also ameliorates left-ventricular (LV) hypertrophy. However, direct in vivo evidence that trientine can improve cardiac function in heart failure has hitherto been lacking. Methods To determine whether trientine treatment could improve in vivo outcome, we measured cardiac function in groups of trientine-treated diabetic (TETA-DIA), non-drug-treated diabetic (DIA) and sham-treated control (SHAM) rats, by using in vivo high-field cardiac magnetic-resonance imaging (cMRI) and an ex vivo isolated-perfused working heart method. Forty age-matched animals underwent a cMRI scan after which 12 were randomized to the SHAM group and 28 underwent streptozotocin-injection; of these, 25 developed stable diabetes, and 12 were then randomized to receive no treatment for 16 weeks (DIA) and the other 13 to undergo 8-weeks’ untreated diabetes followed by 8-weeks’ drug treatment (TETA-DIA). Animals were studied again by cMRI at 8 and 16 weeks following disease induction, and finally by measurement of ex vivo cardiac function. Results After eight weeks diabetes, rats (DIA/TETA-DIA) had developed significant impairment of LV function, as judged by impairment of ejection fraction (LVEF), cardiac output (CO), and LV mass (LVM)/body-mass (all P?cardiac function by elevating LVEF and CO (both P?cardiac function in diabetic rats with substantive LV impairment. These results implicate impaired copper regulation in the pathogenesis of impaired cardiac function caused by diabetic cardiomyopathy, and support ongoing studies of trientine treatment in patients with heart failure. PMID:23368770

  17. Geometric and Dosimetric Approach to Determine Probability of Late Cardiac Mortality in Left Tangential Breast Irradiation: Comparison Between Wedged Beams and Field-in-Field Technique

    SciTech Connect

    Pili, Giorgio; Grimaldi, Luca; Fidanza, Christian; Florio, Elena T. [Department of Medical Physics, 'A. Perrino' Hospital, Brindisi (Italy); Petruzzelli, Maria F. [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); D'Errico, Maria P. [Department of Laboratory Medicine, 'A. Perrino' Hospital, Brindisi (Italy); De Tommaso, Cristina; Tramacere, Francesco [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); Musaio, Francesca [Department of Medical Physics, 'A. Perrino' Hospital, Brindisi (Italy); Castagna, Roberta; Francavilla, Maria C. [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); Gianicolo, Emilio A.L. [National Research Council-Clinical Physiology Institute, Pisa-Lecce (Italy); Portaluri, Maurizio, E-mail: portaluri@hotmail.com [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); National Research Council-Clinical Physiology Institute, Pisa-Lecce (Italy)

    2011-11-01

    Purpose: To evaluate the probability of late cardiac mortality resulting from left breast irradiation planned with tangential fields and to compare this probability between the wedged beam and field-in-field (FIF) techniques and to investigate whether some geometric/dosimetric indicators can be determined to estimate the cardiac mortality probability before treatment begins. Methods and Materials: For 30 patients, differential dose-volume histograms were calculated for the wedged beam and FIF plans, and the corresponding cardiac mortality probabilities were determined using the relative seriality model. As a comparative index of the dose distribution uniformity, the planning target volume (PTV) percentages involved in 97-103% of prescribed dose were determined for the two techniques. Three geometric parameters were measured for each patient: the maximal length, indicates how much the heart contours were displaced toward the PTV, the angle subtended at the center of the computed tomography slice by the PTV contour, and the thorax width/thickness ratio. Results: Evaluating the differential dose-volume histograms showed that the gain in uniformity between the two techniques was about 1.5. With the FIF technique, the mean dose sparing for the heart, the left anterior descending coronary artery, and the lung was 15% (2.5 Gy vs. 2.2 Gy), 21% (11.3 Gy vs. 9.0 Gy), and 42% (8.0 Gy vs. 4.6 Gy) respectively, compared with the wedged beam technique. Also, the cardiac mortality probability decreased by 40% (from 0.9% to 0.5%). Three geometric parameters, the maximal length, angle subtended at the center of the computed tomography slice by the PTV contour, and thorax width/thickness ratio, were the determining factors (p = .06 for FIF, and p = .10 for wedged beam) for evaluating the cardiac mortality probability. Conclusion: The FIF technique seemed to yield a lower cardiac mortality probability than the conventional wedged beam technique. However, although our study demonstrated that FIF technique improved the dose coverage of the PTV, the restricted number of patients enrolled and the short follow-up did not allow us to evaluate and compare the breast cancer survival rates of the patients.

  18. Left Ventricle: Fully Automated Segmentation Based on Spatiotemporal Continuity and Myocardium Information in Cine Cardiac Magnetic Resonance Imaging (LV-FAST)

    PubMed Central

    Wang, Lijia; Pei, Mengchao; Codella, Noel C. F.; Kochar, Minisha; Weinsaft, Jonathan W.; Li, Jianqi; Prince, Martin R.

    2015-01-01

    CMR quantification of LV chamber volumes typically and manually defines the basal-most LV, which adds processing time and user-dependence. This study developed an LV segmentation method that is fully automated based on the spatiotemporal continuity of the LV (LV-FAST). An iteratively decreasing threshold region growing approach was used first from the midventricle to the apex, until the LV area and shape discontinued, and then from midventricle to the base, until less than 50% of the myocardium circumference was observable. Region growth was constrained by LV spatiotemporal continuity to improve robustness of apical and basal segmentations. The LV-FAST method was compared with manual tracing on cardiac cine MRI data of 45 consecutive patients. Of the 45 patients, LV-FAST and manual selection identified the same apical slices at both ED and ES and the same basal slices at both ED and ES in 38, 38, 38, and 41 cases, respectively, and their measurements agreed within ?1.6 ± 8.7?mL, ?1.4 ± 7.8?mL, and 1.0 ± 5.8% for EDV, ESV, and EF, respectively. LV-FAST allowed LV volume-time course quantitatively measured within 3 seconds on a standard desktop computer, which is fast and accurate for processing the cine volumetric cardiac MRI data, and enables LV filling course quantification over the cardiac cycle. PMID:25738153

  19. Left ventricle: fully automated segmentation based on spatiotemporal continuity and myocardium information in cine cardiac magnetic resonance imaging (LV-FAST).

    PubMed

    Wang, Lijia; Pei, Mengchao; Codella, Noel C F; Kochar, Minisha; Weinsaft, Jonathan W; Li, Jianqi; Prince, Martin R; Wang, Yi

    2015-01-01

    CMR quantification of LV chamber volumes typically and manually defines the basal-most LV, which adds processing time and user-dependence. This study developed an LV segmentation method that is fully automated based on the spatiotemporal continuity of the LV (LV-FAST). An iteratively decreasing threshold region growing approach was used first from the midventricle to the apex, until the LV area and shape discontinued, and then from midventricle to the base, until less than 50% of the myocardium circumference was observable. Region growth was constrained by LV spatiotemporal continuity to improve robustness of apical and basal segmentations. The LV-FAST method was compared with manual tracing on cardiac cine MRI data of 45 consecutive patients. Of the 45 patients, LV-FAST and manual selection identified the same apical slices at both ED and ES and the same basal slices at both ED and ES in 38, 38, 38, and 41 cases, respectively, and their measurements agreed within -1.6 ± 8.7?mL, -1.4 ± 7.8?mL, and 1.0 ± 5.8% for EDV, ESV, and EF, respectively. LV-FAST allowed LV volume-time course quantitatively measured within 3 seconds on a standard desktop computer, which is fast and accurate for processing the cine volumetric cardiac MRI data, and enables LV filling course quantification over the cardiac cycle. PMID:25738153

  20. A novel cardiac muscle-derived biomaterial reduces dyskinesia and postinfarct left ventricular remodeling in a mouse model of myocardial infarction

    PubMed Central

    O'Connor, Daniel M; Naresh, Nivedita K; Piras, Bryan A; Xu, Yaqin; Smith, Robert S; Epstein, Frederick H; Hossack, John A; Ogle, Roy C; French, Brent A

    2015-01-01

    Extracellular matrix (ECM) degradation after myocardial infarction (MI) leaves the myocardium structurally weakened and, as a result, susceptible to early infarct zone dyskinesia and left ventricular (LV) remodeling. While various cellular and biomaterial preparations have been transplanted into the infarct zone in hopes of improving post-MI LV remodeling, an allogeneic cardiac muscle-derived ECM extract has yet to be developed and tested in the setting of reperfused MI. We sought to determine the effects of injecting a novel cardiac muscle-derived ECM into the infarct zone on early dyskinesia and LV remodeling in a mouse model of MI. Cardiac muscle ECM was extracted from frozen mouse heart tissue by a protocol that enriches for basement membrane constituents. The extract was injected into the infarct zone immediately after ischemia/reperfusion injury (n = 6). Echocardiography was performed at baseline and at days 2, 7, 14, and 28 post-MI to assess 3D LV volumes and cardiac function, as compared to infarcted controls (n = 9). Early infarct zone dyskinesia was measured on day 2 post-MI using a novel metric, the dyskinesia index. End-systolic volume was significantly reduced in the ECM-treated group compared to controls by day 14. Ejection fraction and stroke volume were also significantly improved in the ECM-treated group. ECM-treated hearts showed a significant (P < 0.005) reduction in dyskinetic motion on day 2. Thus, using high-frequency ultrasound, it was shown that treatment with a cardiac-derived ECM preparation reduced early infarct zone dyskinesia and post-MI LV remodeling in a mouse model of reperfused MI. PMID:25825543

  1. Supracardiac total anomalous pulmonary venous connection with bilateral (right and left) vertical veins and bilateral obstruction.

    PubMed

    Gavali, Seema A; Phadke, Milind S; Kerkar, Prafulla G

    2013-10-01

    This report describes a rare form of obstructed supracardiac total anomalous pulmonary venous connection with two vertical veins (right and left) draining the right- and the left-sided pulmonary veins respectively without formation of a common chamber and with bilateral obstruction. Surgery for these patients is technically challenging due to the absence of a common chamber, and the prognosis is worse than for patients with a common chamber. Also, it is important to be aware of this entity so that an accurate noninvasive preoperative diagnosis by echocardiography alone without invasive cardiac catheterization is possible. This facilitates emergency surgical repair without delay, which is crucial to improvement of the outcome. PMID:23354149

  2. Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: A novel cardiac syndrome mimicking acute myocardial infarction

    Microsoft Academic Search

    Satoshi Kurisu; Hikaru Sato; Takuji Kawagoe; Masaharu Ishihara; Yuji Shimatani; Kenji Nishioka; Yasuyuki Kono; Takashi Umemura; Suji Nakamura

    2002-01-01

    Background Peculiar asynergy, which consists of hypokinesis or akinesis from the mid portion to the apical area and hyperkinesis of the basal area on contrast left ventriculogram, is rare. Because the end-systolic left ventriculogram looks like a “tako-tsubo,” which was used for trapping octopuses in Japan, we proposed the term “tako-tsubo-like left ventricular dysfunction.” Our aim was to evaluate its

  3. Association of high-sensitivity cardiac troponin T and N-terminal pro-brain-type natriuretic peptide with left ventricular structure: J-HOP study.

    PubMed

    Hoshide, Satoshi; Nagai, Michiaki; Yano, Yuichiro; Ishikawa, Joji; Eguchi, Kazuo; Kario, Kazuomi

    2014-05-01

    Although both high-sensitivity cardiac troponin T (Hs-cTnT) and N-terminal pro-brain-type natriuretic peptide (NT-proBNP) levels are higher among patients with cardiac structural abnormalities than among those with apparently normal hearts, there is considerable overlap between the groups. The authors evaluated 1336 patients who had ?1 cardiovascular risk factors, underwent echocardiography, and had Hs-cTnT and NT-proBNP measured and excluded patients with left ventricular (LV) dysfunction. The patients in the highest Hs-cTnT category in quintiles had an increased likelihood of abnormal relative wall thickness compared with those in the lowest category (odds ratio, 1.66; 95% confidence interval, 1.17-2.36; P<.01). However, no such association was found in the category of NT-proBNP. The patients in the highest NT-proBNP category had an increased likelihood of abnormal LV diastolic dimension/body surface area compared with those in the lowest category (odds ratio, 2.11; 95% confidence interval, 1.17-3.79; P<.05). However, no such association was found in the category of Hs-cTnT. The data suggest that the measurement of Hs-cTnT and NT-proBNP might provide information on cardiac structural abnormalities. PMID:24811391

  4. Cardiac magnetic resonance imaging assessment of regional and global left atrial function before and after catheter ablation for atrial fibrillation

    Microsoft Academic Search

    David Nori; Gilbert Raff; Vikesh Gupta; Ralph Gentry; Judith Boura; David E. Haines

    2009-01-01

    Background  Ablation of the left atrium and pulmonary veins antrum (PVAI) can be an effective treatment of atrial fibrillation (AF). However,\\u000a there is discrepancy in the literature regarding the effect extensive ablation has on left atrial (LA) function. We sought\\u000a to evaluate the effect that AF ablation procedures has on global and regional wall motion as assessed by cardiovascular magnetic\\u000a resonance

  5. Combined score using clinical, electrocardiographic, and echocardiographic parameters to predict left ventricular remodeling in patients having had cardiac resynchronization therapy six months earlier.

    PubMed

    Brunet-Bernard, Anne; Maréchaux, Sylvestre; Fauchier, Laurent; Guiot, Aurélie; Fournet, Maxime; Reynaud, Amélie; Schnell, Frédéric; Leclercq, Christophe; Mabo, Philippe; Donal, Erwan

    2014-06-15

    The aim of this study was to evaluate whether a scoring system integrating clinical, electrocardiographic, and echocardiographic measurements can predict left ventricular reverse remodeling after cardiac resynchronization therapy (CRT). The derivation cohort consisted of 162 patients with heart failure implanted with a CRT device. Baseline clinical, electrocardiographic, and echocardiographic characteristics were entered into univariate and multivariate models to predict reverse remodeling as defined by a ?15% reduction in left ventricular end-systolic volume at 6 months (60%). Combinations of predictors were then tested under different scoring systems. A new 7-point CRT response score termed L2ANDS2: Left bundle branch block (2 points), Age >70 years, Nonischemic origin, left ventricular end-diastolic Diameter <40 mm/m(2), and Septal flash (2 points) was calculated for these patients. This score was then validated against a validation cohort of 45 patients from another academic center. A highly significant incremental predictive value was noted when septal flash was added to an initial 4-factor model including left bundle branch block (difference between area under the curve C statistics = 0.125, p <0.001). The predictive accuracy using the L2ANDS2 score was then 0.79 for the C statistic. Application of the new score to the validation cohort (71% of responders) gave a similar C statistic (0.75). A score >5 had a high positive likelihood ratio (+LR = 5.64), whereas a score <2 had a high negative likelihood ratio (-LR = 0.19). In conclusion, this L2ANDS2 score provides an easy-to-use tool for the clinician to assess the pretest probability of a patient being a CRT responder. PMID:24793667

  6. Validation of an evaluation routine for left ventricular volumes, ejection fraction and wall motion from gated cardiac FDG PET: a comparison with cardiac magnetic resonance imaging

    Microsoft Academic Search

    Wolfgang M. Schaefer; Claudia S. A. Lipke; Bernd Nowak; Hans Juergen Kaiser; Arno Buecker; Gabriele A. Krombach; Udalrich Buell; Harald P. Kühl

    2003-01-01

    The aim of this study was to validate the estimation of left ventricular end-diastolic and end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) as well as wall motion analysis from gated fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in patients with severe coronary artery disease (CAD) using software originally designed for gated single-photon emission tomography (SPET). Thirty patients with severe

  7. Comparison of Echocardiographic Markers of Cardiac Dyssynchrony and Latest Left Ventricular Activation Site in Heart Failure Patients with and without Left Bundle Branch Block

    PubMed Central

    Lotfi-Tokaldany, Masoumeh; Roomi, Zahra Savand; Kasemisaeid, Ali; Sadeghian, Hakimeh

    2013-01-01

    Background: Several echocardiographic markers have been introduced to assess the left ventricular (LV) mechanical dyssynchrony. We studied dyssynchrony markers and the latest LV activation site in heart failure patients with and without left bundle branch block (LBBB). Methods: Conventional echocardiography and tissue velocity imaging were performed for 78 patients (LV ejection fraction ? 35%), who were divided into two groups: LBBB (n = 37) and non-LBBB (n = 41). Time-to-peak systolic velocity (Ts) was measured in 12 LV segments in the mid and basal levels. Seven dyssynchrony markers were defined: delay and standard deviation (SD) of Ts in all and basal segments, septal-lateral and anteroseptal-posterior wall delay (at the basal level), and interventricular mechanical delay (IVMD). Results: The LBBB patients had significantly higher QRS duration and IVMD. The posterior wall was the latest activated site in the LBBB and the inferior wall was the latest in the non-LBBB patients. The most common dyssynchrony marker in the LBBB group was the SD of Ts in all segments (73%), whereas it was Ts delay in the basal segments in the non-LBBB group (48.8%). Ts delay and SD of all LV segments, septal lateral delay, septal-to-posterior wall delay by M-mode, pre-ejection period of the aortic valve, and IVMD were significantly higher in the LBBB group than in the non-LBBB group. Also, 29.3% of the non-LBBB and 10.8% of the LBBB patients did not show dyssynchrony by any marker. The number of patients showing dyssynchrony by ? 3 markers was remarkably higher in the LBBB patients (73% vs. 43.9%, respectively; p value = 0.044). Conclusion: The LBBB patients presented with a higher prevalence of dyssynchrony according to the frequently used echocardiographic markers. The latest activation site was different between the groups. PMID:23967031

  8. N-Terminal Pro-B-Type Natriuretic Peptide Plasma Levels as a Potential Biomarker for Cardiac Damage After Radiotherapy in Patients With Left-Sided Breast Cancer

    SciTech Connect

    D'Errico, Maria P., E-mail: patderrico@libero.it [Department of Laboratory Medicine, 'A. Perrino' Hospital, Brindisi (Italy); Grimaldi, Luca [Department of Medical Physics, 'A. Perrino' Hospital, Brindisi (Italy); Petruzzelli, Maria F. [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); Gianicolo, Emilio A.L. [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Tramacere, Francesco [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); Monetti, Antonio; Placella, Roberto [Department of Laboratory Medicine, 'A. Perrino' Hospital, Brindisi (Italy); Pili, Giorgio [Department of Medical Physics, 'A. Perrino' Hospital, Brindisi (Italy); Andreassi, Maria Grazia; Sicari, Rosa; Picano, Eugenio [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Portaluri, Maurizio [Department of Radiation Oncology, 'A. Perrino' Hospital, Brindisi (Italy); Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy)

    2012-02-01

    Purpose: Adjuvant radiotherapy (RT) after breast-conserving surgery has been associated with increased cardiovascular mortality. Cardiac biomarkers may aid in identifying patients with radiation-mediated cardiac dysfunction. We evaluated the correlation between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin (TnI) and the dose of radiation to the heart in patients with left-sided breast cancer. Methods and Materials: NT-proBNP and TnI plasma concentrations were measured in 30 left-sided breast cancer patients (median age, 55.0 years) 5 to 22 months after RT (Group I) and in 30 left-sided breast cancer patients (median age, 57.0 years) before RT as control group (Group II). Dosimetric and geometric parameters of heart and left ventricle were determined in all patients of Group I. Seventeen patients underwent complete two-dimensional echocardiography. Results: NT-proBNP levels were significantly higher (p = 0.03) in Group I (median, 90.0 pg/ml; range, 16.7-333.1 pg/ml) than in Group II (median, 63.2 pg/ml; range, 11.0-172.5 pg/ml). TnI levels remained below the cutoff threshold of 0.07 ng/ml in both groups. In patients with NT-proBNP values above the upper limit of 125 pg/ml, there were significant correlations between plasma levels and V{sub 3Gy}(%) (p = 0.001), the ratios D{sub 15cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.01), the ratios D{sub 15cm}{sup 3}/D{sub 50%} (Gy) (p = 0.008) for the heart and correlations between plasma levels and V{sub 2Gy} (%) (p = 0.002), the ratios D{sub 1cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.03), and the ratios D{sub 0.5cm{sup 3}}(Gy)/D{sub 50%}(Gy) (p = 0.05) for the ventricle. Conclusions: Patients with left-sided breast cancer show higher values of NT-pro BNP after RT when compared with non-RT-treated matched patients, increasing in correlation with high doses in small volumes of heart and ventricle. The findings of this study show that the most important parameters are not the mean doses but instead the small percentage of organ volumes (heart or ventricle) receiving high dose levels, supporting the notion that the heart behaves as a serial organ.

  9. [Effects of Shenmai injection on afterdepolarization and triggered activities in left ventricular papillary muscle in rat cardiac hypertrophy].

    PubMed

    Jiao, Hong; Wang, Xiao-Ling; Chen, Yan-Jing; Xiang, Li-Hua; Zhang, Sheng-Nan

    2014-08-01

    This study is to evaluate the effects of Shenmai injection on the temporal alterations of action potential (AP), early afterdepolarization (EAD) and delayed afterdepolarization (DAD) in papillary muscles. The action potentials were recorded by a glass electrode. APD at 90% repolarization (APD9 ) was measured, and spontaneous EAD and DAD were observed. The results show APD90 was significantly prolonged in model group compared with sham-operated group, whereas it was remained unchanged in Shenmai injec- tion treatment group and amiodarone group. The spontaneous EADs and DADs were frequently visible in model group. In conclusion, EAD, DAD and trigger activities increase gradually during pathological progression of rat cardiac hypertrophy, and Shenmai injection could improve the action potential change in rat cardiac hypertrophy. PMID:25423840

  10. Identification of Left Ventricular Myocardial Ischemia and Cardiac Prognosis with Cardiovascular Magnetic Resonance: Updates from 2008 to 2010

    Microsoft Academic Search

    Runyawan Chotenimitkhun; W. Gregory Hundley

    2011-01-01

    Noninvasive imaging modalities are often used to manage patients with cardiovascular disease. Cardiovascular magnetic resonance\\u000a (CMR) is increasingly used for diagnosing and evaluating myocardial ischemia and viability; moreover, stress CMR study results\\u000a can be used to determine cardiac prognosis. In this article, we review recently published material regarding the performance\\u000a of stress testing with CMR including a brief update regarding

  11. Comparison of different segmentation approaches without using gold standard. Application to the estimation of the left ventricle ejection fraction from cardiac cine MRI sequences

    PubMed Central

    Lebenberg, Jessica; Buvat, Irène; Garreau, Mireille; Casta, Christopher; Constantinidès, Constantin; Cousty, Jean; Cochet, Alexandre; Jehan-Besson, Stéphanie; Tilmant, Christophe; Lefort, Muriel; Roullot, Elodie; Najman, Laurent; Sarry, Laurent; Clarysse, Patrick; De Cesare, Alain; Lalande, Alain; Frouin, Frédérique

    2011-01-01

    A statistical method is proposed to compare several estimates of a relevant clinical parameter when no gold standard is available. The method is illustrated by considering the left ventricle ejection fraction derived from cardiac magnetic resonance images and computed using seven approaches with different degrees of automation. The proposed method did not use any a priori regarding with the reliability of each method and its degree of automation. The results showed that the most accurate estimates of the ejection fraction were obtained using manual segmentations, followed by the semi-automatic methods, while the methods with the least user input yielded the least accurate ejection fraction estimates. These results were consistent with the expected performance of the estimation methods, suggesting that the proposed statistical approach might be helpful to assess the performance of estimation methods on clinical data for which no gold standard is available. PMID:22254889

  12. LVEDGE: A Knowledge-Based Heuristic Program For Border Finding Of The Left Ventricular Cavity In Cardiac Digital X-Ray Images

    NASA Astrophysics Data System (ADS)

    Fozzard, Richard; Gustafson, David

    1988-07-01

    Traditional edge-detection methods have involved grey-level thresholding and pixel neighborhood operations, as well as tracking algorithms. These purely mathematical aroaches have a tendency to generate many extra edges not relevant to the desired edge and are often fooled by artifacts such as catheters or rib boundaries. LVEDGE utilizes several techniques from artificial intelligence to deal with these difficulties. It has a user trainable knowledge-base to constrain the search to an expected left ventricular (LV) shape. A structure likelihood matrix is created based onprobabilities that pixels are on the actual edge. This matrix is then dynamically searched incorporating both local and global information to generate the most likely continuous single edge of the ventricle. The program has been run on digital LV images (some quite poor) and has compared favorably to human generated edges. The generated edges can be input to standard cardiac function analysis software (ejection fraction, regional wall motion, etc.)

  13. Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs.

    PubMed

    Xu, Da; Olivier, N Bari; Mukkamala, Ramakrishna

    2009-02-01

    We developed a technique to continuously (i.e., automatically) monitor cardiac output (CO) and left atrial pressure (LAP) by mathematical analysis of the pulmonary artery pressure (PAP) waveform. The technique is unique to the few previous related techniques in that it jointly estimates the two hemodynamic variables and analyzes the PAP waveform over time scales greater than a cardiac cycle wherein wave reflections and inertial effects cease to be major factors. First, a 6-min PAP waveform segment is analyzed so as to determine the pure exponential decay and equilibrium pressure that would eventually result if cardiac activity suddenly ceased (i.e., after the confounding wave reflections and inertial effects vanish). Then, the time constant of this exponential decay is computed and assumed to be proportional to the average pulmonary arterial resistance according to a Windkessel model, while the equilibrium pressure is regarded as average LAP. Finally, average proportional CO is determined similar to invoking Ohm's law and readily calibrated with one thermodilution measurement. To evaluate the technique, we performed experiments in five dogs in which the PAP waveform and accurate, but highly invasive, aortic flow probe CO and LAP catheter measurements were simultaneously recorded during common hemodynamic interventions. Our results showed overall calibrated CO and absolute LAP root-mean-squared errors of 15.2% and 1.7 mmHg, respectively. For comparison, the root-mean-squared error of classic end-diastolic PAP estimates of LAP was 4.7 mmHg. On future successful human testing, the technique may potentially be employed for continuous hemodynamic monitoring in critically ill patients with pulmonary artery catheters. PMID:19057003

  14. Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs

    PubMed Central

    Xu, Da; Olivier, N. Bari; Mukkamala, Ramakrishna

    2009-01-01

    We developed a technique to continuously (i.e., automatically) monitor cardiac output (CO) and left atrial pressure (LAP) by mathematical analysis of the pulmonary artery pressure (PAP) waveform. The technique is unique to the few previous related techniques in that it jointly estimates the two hemodynamic variables and analyzes the PAP waveform over time scales greater than a cardiac cycle wherein wave reflections and inertial effects cease to be major factors. First, a 6-min PAP waveform segment is analyzed so as to determine the pure exponential decay and equilibrium pressure that would eventually result if cardiac activity suddenly ceased (i.e., after the confounding wave reflections and inertial effects vanish). Then, the time constant of this exponential decay is computed and assumed to be proportional to the average pulmonary arterial resistance according to a Windkessel model, while the equilibrium pressure is regarded as average LAP. Finally, average proportional CO is determined similar to invoking Ohm's law and readily calibrated with one thermodilution measurement. To evaluate the technique, we performed experiments in five dogs in which the PAP waveform and accurate, but highly invasive, aortic flow probe CO and LAP catheter measurements were simultaneously recorded during common hemodynamic interventions. Our results showed overall calibrated CO and absolute LAP root-mean-squared errors of 15.2% and 1.7 mmHg, respectively. For comparison, the root-mean-squared error of classic end-diastolic PAP estimates of LAP was 4.7 mmHg. On future successful human testing, the technique may potentially be employed for continuous hemodynamic monitoring in critically ill patients with pulmonary artery catheters. PMID:19057003

  15. Association of the Frontal QRS-T Angle with Adverse Cardiac Remodeling, Impaired Left and Right Ventricular Function, and Worse Outcomes in Heart Failure with Preserved Ejection Fraction

    PubMed Central

    Selvaraj, Senthil; Ilkhanoff, Leonard; Burke, Michael A.; Freed, Benjamin H.; Lang, Roberto M.; Martinez, Eva E.; Shah, Sanjiv J.

    2013-01-01

    Background No prior studies have investigated the association of QRS-T angle with cardiac structure/function and outcomes in heart failure with preserved ejection fraction (HFpEF). We hypothesized that increased frontal QRS-T angle is associated with worse cardiac function/remodeling and adverse outcomes in HFpEF. Methods We prospectively studied 376 patients with HFpEF (i.e. symptomatic HF with left ventricular [LV] ejection fraction >50%.) The frontal QRS-T angle was calculated from the 12-lead electrocardiogram. Patients were divided into tertiles by frontal QRS-T angle (0–26°, 27–75°, and 76–179°), and clinical, laboratory, and echocardiographic data were compared among groups. Cox proportional hazards analyses were performed to determine the association between QRS-T angle and outcomes. Results The mean age of the cohort was 64±13 years, 65% were women, and the mean QRS-T angle was 61±51°. Patients with increased QRS-T angle were older, had a lower body-mass index, more frequently had coronary artery disease, diabetes, chronic kidney disease, and atrial fibrillation, and had higher B-type natriuretic peptide (BNP) levels (P<0.05 for all comparisons). After multivariable adjustment, patients with increased QRS-T angle had higher BNP levels in addition to higher LV mass index, worse diastolic function parameters, more right ventricular (RV) remodeling, and worse RV systolic function (P<0.05 for all associations). QRS-T angle was independently associated with the composite outcome of cardiovascular hospitalization or death on multivariable analysis, even after adjusting for BNP (HR for the highest QRS-T tertile = 2.0, 95% CI 1.2–3.4; P=0.008). Conclusions In HFpEF, increased QRS-T angle is independently associated with worse left and right ventricular function/remodeling and adverse outcomes. PMID:24075945

  16. Cardiogenic Shock Associated with Acute Left-Heart Failure

    Microsoft Academic Search

    Jina Sohn; Steven M. Hollenberg

    \\u000a When cardiogenic shock is suspected, echocardiography should be performed at the bedside as soon as possible. This simple\\u000a and noninvasive tool can assess the anatomy of the cardiac chambers, ventricular function, valve structure, and function and\\u000a anatomy of the pericardial space. Echocardiography allows for expeditious evaluation of overall and regional left ventricular\\u000a performance, and it can rule out other etiologies

  17. Simplified intensity-modulated radiotherapy using pre-defined segments to reduce cardiac complications in left-sided breast cancer

    Microsoft Academic Search

    B. C. John Cho; Marco Schwarz; Ben J. Mijnheer; Harry Bartelink

    2004-01-01

    Background and purposeLeft-sided breast cancer patients pose a difficult clinical challenge when significant heart and contralateral breast irradiation are present, particularly with tangential uniform beams. The aims of the study are: (1) to design and evaluate a simplified intensity-modulated radiotherapy (IMRT) (SI) solution using pre-defined segments, (2) to compare the SI technique with a conformal (CN) and a full fluence

  18. Correlation of heart rate variability with cardiac functional and metabolic variables in cyclists with training induced left ventricular hypertrophy

    Microsoft Academic Search

    B M Pluim; C A Swenne; A H Zwinderman; A C Maan; A van der Laarse; J Doornbos; E E Van der Wall

    1999-01-01

    OBJECTIVETo examine the correlation between heart rate variability and left ventricular mass in cyclists with an athlete’s heart.METHODSLeft ventricular mass and diastolic function were determined at rest and myocardial high energy phosphates were quantified at rest and during atropine–dobutamine stress in 12 male cyclists and 10 control subjects, using magnetic resonance techniques. Ambulatory 24 hour ECG recordings were obtained, and

  19. Right and left ventricular volume measurements in an animal heart model in vitro: first experiences with cardiac MRI at 1.0 T.

    PubMed

    Koch, J A; Poll, L W; Godehardt, E; Korbmacher, B; Mödder, U

    2000-01-01

    The aim of this study was to determine the accuracy in quantifying right and left ventricular volumes using a 1.0-T system and commercially available, standard equipment. For exact comparison of MRI measurements and real volumes we used an animal heart model ex vivo. Eight pig hearts were explanted and prepared by removal of the atria. Aorta and pulmonary truncus were cannulated. Definable volumes were injected into the ventricles. Magnetic resonance imaging was performed at 1.0 T (Gyroscan T10 NT, Philips, Eindhoven, The Netherlands); sequence: fast field echo-echo planar (multishot EPI); body coil; MR software: Cardiac Application Package (Philips). Statistical analysis correlated the real volumes and MR measurements separately for both ventricles and two investigators (SAS, ANOVA). For both ventricles and both investigators the correlation between real volumes and MR measurements was greater than 0.99. There was no significant systematic false estimation for both ventricles. Magnetic resonance imaging at 1.0 T using standard hardware and software equipment enables the quantification of right and left ventricular volumes with high approximation to the real volumes in vitro. There is a clear restriction in translating these data into a clinical application because under experimental conditions no motion-induced artifacts existed. PMID:10756995

  20. Longstanding Hyperthyroidism Is Associated with Normal or Enhanced Intrinsic Cardiomyocyte Function despite Decline in Global Cardiac Function

    PubMed Central

    Redetzke, Rebecca A.; Gerdes, A. Martin

    2012-01-01

    Thyroid hormones (THs) play a pivotal role in cardiac homeostasis. TH imbalances alter cardiac performance and ultimately cause cardiac dysfunction. Although short-term hyperthyroidism typically leads to heightened left ventricular (LV) contractility and improved hemodynamic parameters, chronic hyperthyroidism is associated with deleterious cardiac consequences including increased risk of arrhythmia, impaired cardiac reserve and exercise capacity, myocardial remodeling, and occasionally heart failure. To evaluate the long-term consequences of chronic hyperthyroidism on LV remodeling and function, we examined LV isolated myocyte function, chamber function, and whole tissue remodeling in a hamster model. Three-month-old F1b hamsters were randomized to control or 10 months TH treatment (0.1% grade I desiccated TH). LV chamber remodeling and function was assessed by echocardiography at 1, 2, 4, 6, 8, and 10 months of treatment. After 10 months, terminal cardiac function was assessed by echocardiography and LV hemodynamics. Hyperthyroid hamsters exhibited significant cardiac hypertrophy and deleterious cardiac remodeling characterized by myocyte lengthening, chamber dilatation, decreased relative wall thickness, increased wall stress, and increased LV interstitial fibrotic deposition. Importantly, hyperthyroid hamsters demonstrated significant LV systolic and diastolic dysfunction. Despite the aforementioned remodeling and global cardiac decline, individual isolated cardiac myocytes from chronically hyperthyroid hamsters had enhanced function when compared with myocytes from untreated age-matched controls. Thus, it appears that long-term hyperthyroidism may impair global LV function, at least in part by increasing interstitial ventricular fibrosis, in spite of normal or enhanced intrinsic cardiomyocyte function. PMID:23056390

  1. Cardiac amyloidosis.

    PubMed

    Kingman, A; Pereira, N L

    2001-05-01

    Cardiac amyloidosis should be considered in a patient with heart failure, who is normotensive with decreased left ventricular systolic function and marked left ventricular hypertrophy by echocardiogram and has decreased voltage by ECG. Furthermore, when the diagnosis of cardiac amyloid is made, it is important to classify the subtype of disease to be able to offer appropriate treatment. Contrary to traditional belief that the prognosis for patients with amyloidosis is dismal, some forms of this disease are curable and other forms are characterized by slow progression of disease. PMID:11381776

  2. Downregulation of cardiac guanosine 5'-triphosphate-binding proteins in right atrium and left ventricle in pacing-induced congestive heart failure.

    PubMed Central

    Roth, D A; Urasawa, K; Helmer, G A; Hammond, H K

    1993-01-01

    The extent to which congestive heart failure (CHF) is dependent upon increased levels of the cardiac inhibitory GTP-binding protein (Gi), and the impact of CHF on the cardiac stimulatory GTP-binding protein (Gs) and mechanisms by which Gs may change remain unexplored. We have addressed these unsettled issues using pacing-induced CHF in pigs to examine physiological, biochemical, and molecular features of the right atrium (RA) and left ventricle (LV). CHF was associated with an 85 +/- 20% decrease in LV segment shortening (P < 0.001) and a 3.5-fold increase (P = 0.006) in the ED50 for isoproterenol-stimulated heart rate responsiveness. Myocardial beta-adrenergic receptor number was decreased 54% in RA (P = 0.004) and 57% in LV (P < 0.001), and multiple measures of adenylyl cyclase activity were depressed 49 +/- 8% in RA (P < 0.005), and 44 +/- 9% in LV (P < 0.001). Quantitative immunoblotting established that Gi and Gs were decreased in RA (Gi: 59% reduction; P < 0.0001; Gs: 28% reduction; P < 0.007) and LV (Gi: 35% reduction; P < 0.008; Gs: 28% reduction; P < 0.01) after onset of CHF. Reduced levels of Gi and Gs were confirmed by ADP ribosylation studies, and diminished function of Gs was established in reconstitution studies. Steady state levels for Gs alpha mRNA were increased in RA and unchanged in LV, and significantly more GS alpha was found in the supernatant (presumably cytosolic) fraction in RA and LV membrane homogenates after CHF, suggesting that increased Gs degradation, rather than decreased Gs synthesis, is the mechanism by which Gs is downregulated. We conclude that cardiac Gi content poorly predicts adrenergic responsiveness or contractile function, that decreased Gs is caused by increased degradation rather than decreased synthesis, and that alterations in beta-adrenergic receptors, adenylyl cyclase, and GTP-binding proteins are uniform in RA and LV in this model of congestive heart failure. Images PMID:8383705

  3. Local electrogram delay recorded from left ventricular lead at implant predicts response to cardiac resynchronization therapy: Retrospective study with 1 year follow up

    PubMed Central

    2012-01-01

    Background Considerable proportion of patients does not respond to the cardiac resynchronization therapy (CRT). This study investigated clinical relevance of left ventricular electrode local electrogram delay from the beginning of QRS (QLV). We hypothesized that longer QLV indicating more optimal lead placement in the late activated regions is associated with the higher probability of positive CRT response. Methods We conducted a retrospective, single–centre analysis of 161 consecutive patients with heart failure and LBBB or nonspecific intraventricular conduction delay (IVCD) treated with CRT. We routinely intend to implant the LV lead in a region with long QLV. Clinical response to CRT, left ventricular (LV) reverse remodelling (i.e. decrease in LV end-systolic diameter - LVESD ?10%) and reduction in plasma level of NT-proBNP >30% at 12-month post-implant were the study endpoints. We analyzed association between pre-implant variables and the study endpoints. Results Clinical CRT response rate reached 58%, 84% and 92% in the lowest (?105?ms), middle (106-130?ms) and the highest (>130?ms) QLV tertile (p?

  4. Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course : Case report and review of the literature.

    PubMed

    Nguyen, A L; Haas, F; Evens, J; Breur, J M P J

    2012-11-01

    Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised. PMID:23055055

  5. Sudden cardiac death and left ventricular ejection fraction during long-term follow-up after acute myocardial infarction in the primary percutaneous coronary intervention era: results from the HIJAMI-II registry

    Microsoft Academic Search

    T Shiga; N Hagiwara; H Ogawa; A Takagi; M Nagashima; T Yamauchi; Y Tsurumi; R Koyanagi; H Kasanuki

    2009-01-01

    Objective:To determine the incidence of sudden cardiac death (SCD) according to left ventricular ejection fraction (LVEF) in survivors of myocardial infarction (MI) in the primary percutaneous coronary intervention (PCI) era.Design:A multicentre observational prospective registered cohort study.Setting:18 medical centres in Japan.Patients:4122 consecutive patients (mean age 66 (SD 12) years, 73.7% male) with acute MI, who were discharged alive.Main outcome measures:The primary

  6. Magnitude and Time Course of Changes Induced by Continuous-Flow Left Ventricular Assist Device Unloading in Chronic Heart Failure: Insights into Cardiac Recovery

    PubMed Central

    Drakos, Stavros G.; Wever-Pinzon, Omar; Selzman, Craig H.; Gilbert, Edward M.; Alharethi, Rami; Reid, Bruce B.; Saidi, Abdulfattah; Diakos, Nikolaos A.; Stoker, Sandi; Davis, Erin S.; Movsesian, Matthew; Li, Dean Y.; Stehlik, Josef; Kfoury, Abdallah G.

    2013-01-01

    Objective To prospectively investigate the longitudinal effects of continuous-flow left ventricular assist device (LVAD) unloading on myocardial structure and systolic and diastolic function. Background The magnitude, timeline and sustainability of changes induced by continuous-flow LVAD on the structure and function of the failing human heart are unknown. Methods Eighty consecutive patients with clinical characteristics consistent with chronic heart failure requiring implantation of a continuous-flow LVAD were prospectively enrolled. Serial echocardiograms (1, 2, 3, 4, 6, 9 and 12 months) and right heart catheterizations were performed after LVAD implant. Cardiac recovery was assessed on the basis of improvement in systolic and diastolic function indices on echocardiography that were sustained during LVAD turn-down studies. Results After 6 months of LVAD unloading, 34% of patients had a relative LVEF increase above 50% and 19% of patients, both ischemic and nonischemic, achieved an LVEF?40%. LV systolic function improved as early as 30 days, the greatest degree of improvement was achieved by 6 months of mechanical unloading and persisted over the 1- year follow up. LV diastolic function parameters also improved as early as 30 days post LVAD unloading and this improvement persisted over time. LV end-diastolic and end-systolic volumes decreased as early as 30 days post LVAD unloading (113 vs. 77ml/m2, p<0.01 and 92 vs. 60ml/m2, p<0.01, respectively). LV mass decreased as early as 30 days post LVAD unloading (114 vs. 95g/m2, p<0.05) and continued to do so over the 1-year follow-up but did not reach values below the normal reference range suggesting no atrophic remodeling after prolonged LVAD unloading. Conclusion Continuous-flow LVAD unloading induced in a subset of patients, both ischemic and nonischemic, early improvement in myocardial structure and systolic and diastolic function that was largely completed within 6 months, with no evidence of subsequent regression. PMID:23500219

  7. Effect of Smaller Left Ventricular Capture Threshold Safety Margins to Improve Device Longevity in Recipients of Cardiac Resynchronization-Defibrillation Therapy

    PubMed Central

    Steinhaus, Daniel A.; Waks, Jonathan W.; Collins, Robert; Kleckner, Karen; Kramer, Daniel B.; Zimetbaum, Peter J.

    2015-01-01

    Device longevity in cardiac resynchronization therapy (CRT) is affected by the pacing capture threshold (PCT) and programmed pacing amplitude of the left ventricular (LV) pacing lead. The aims of this study were to evaluate the stability of LV pacing thresholds in a nationwide sample of CRT defibrillator recipients and to determine potential longevity improvements associated with a decrease in the LV safety margin while maintaining effective delivery of CRT. CRT defibrillator patients in the Medtronic CareLink database were eligible for inclusion. LV PCT stability was evaluated using ?2 measurements over a 14-day period. Separately, a random sample of 7,250 patients with programmed right atrial and right ventricular amplitudes ?2.5 V, LV thresholds ? 2.5 V, and LV pacing ?90% were evaluated to estimate theoretical battery longevity improvement using LV safety margins of 0.5 and 1.5 V. Threshold stability analysis in 43,256 patients demonstrated LV PCT stability of <0.5 V in 77% of patients and <1 V in 95%. Device longevity analysis showed that the use of a 0.5-V safety margin increased average battery longevity by 0.62 years (95% confidence interval 0.61 to 0.63) compared with a safety margin of 1.5 V. Patients with LV PCTs >1 V had the greatest increases in battery life (mean increase 0.86 years, 95% confidence interval 0.85 to 0.87). In conclusion, nearly all CRT defibrillator patients had LV PCT stability <1.0 V. Decreasing the LV safety margin from 1.5 to 0.5 V provided consistent delivery of CRT for most patients and significantly improved battery longevity. PMID:25933732

  8. Effect of Smaller Left Ventricular Capture Threshold Safety Margins to Improve Device Longevity in Recipients of Cardiac Resynchronization-Defibrillation Therapy.

    PubMed

    Steinhaus, Daniel A; Waks, Jonathan W; Collins, Robert; Kleckner, Karen; Kramer, Daniel B; Zimetbaum, Peter J

    2015-07-01

    Device longevity in cardiac resynchronization therapy (CRT) is affected by the pacing capture threshold (PCT) and programmed pacing amplitude of the left ventricular (LV) pacing lead. The aims of this study were to evaluate the stability of LV pacing thresholds in a nationwide sample of CRT defibrillator recipients and to determine potential longevity improvements associated with a decrease in the LV safety margin while maintaining effective delivery of CRT. CRT defibrillator patients in the Medtronic CareLink database were eligible for inclusion. LV PCT stability was evaluated using ?2 measurements over a 14-day period. Separately, a random sample of 7,250 patients with programmed right atrial and right ventricular amplitudes ?2.5 V, LV thresholds ? 2.5 V, and LV pacing ?90% were evaluated to estimate theoretical battery longevity improvement using LV safety margins of 0.5 and 1.5 V. Threshold stability analysis in 43,256 patients demonstrated LV PCT stability of <0.5 V in 77% of patients and <1 V in 95%. Device longevity analysis showed that the use of a 0.5-V safety margin increased average battery longevity by 0.62 years (95% confidence interval 0.61 to 0.63) compared with a safety margin of 1.5 V. Patients with LV PCTs >1 V had the greatest increases in battery life (mean increase 0.86 years, 95% confidence interval 0.85 to 0.87). In conclusion, nearly all CRT defibrillator patients had LV PCT stability <1.0 V. Decreasing the LV safety margin from 1.5 to 0.5 V provided consistent delivery of CRT for most patients and significantly improved battery longevity. PMID:25933732

  9. Flow chamber

    DOEpatents

    Morozov, Victor (Manassas, VA)

    2011-01-18

    A flow chamber having a vacuum chamber and a specimen chamber. The specimen chamber may have an opening through which a fluid may be introduced and an opening through which the fluid may exit. The vacuum chamber may have an opening through which contents of the vacuum chamber may be evacuated. A portion of the flow chamber may be flexible, and a vacuum may be used to hold the components of the flow chamber together.

  10. Coronary fistula between the left anterior descending coronary artery and the pulmonary artery: Two case reports

    PubMed Central

    Ibrahim, Mohamed F.; Sayed, Sameh; Elasfar, Abdelfatah; Sallam, Ayman; Fadl, Mazin; Al Baradai, Abdulaziz

    2012-01-01

    Coronary artery fistulae are rare congenital or acquired connections between the coronary vessels and the cardiac chambers or other vascular structures. We present two consecutive cases of coronary fistulae between the proximal left anterior descending artery (LAD) and the main pulmonary artery. Both cases where admitted with history of acute coronary syndromes and had multivessel coronary disease along with coronary pulmonary fistulae. The two cases were managed by coronary artery bypass grafting (CABG) and repair of the fistulae. PMID:24174833

  11. Registration-based segmentation of murine 4D cardiac micro-CT data using symmetric normalization

    PubMed Central

    Clark, Darin; Badea, Alexandra; Liu, Yilin; Johnson, G. Allan; Badea, Cristian T.

    2013-01-01

    Micro-CT can play an important role in preclinical studies of cardiovascular disease because of its high spatial and temporal resolution. Quantitative analysis of 4D cardiac images requires segmentation of the cardiac chambers at each time point, an extremely time consuming process if done manually. To improve throughput this study proposes a pipeline for registration-based segmentation and functional analysis of 4D cardiac micro-CT data in the mouse. Following optimization and validation using simulations, the pipeline was applied to in vivo cardiac micro-CT data corresponding to 10 cardiac phases acquired in C57BL/6 mice (n = 5). After edge-preserving smoothing with a novel adaptation of 4D bilateral filtration, one phase within each cardiac sequence was manually segmented. Deformable registration was used to propagate these labels to all other cardiac phases for segmentation. The volumes of each cardiac chamber were calculated and used to derive stroke volume, ejection fraction, cardiac output, and cardiac index. Dice coefficients and volume accuracies were used to compare manual segmentations of two additional phases with their corresponding propagated labels. Both measures were, on average, >0.90 for the left ventricle and >0.80 for the myocardium, the right ventricle, and the right atrium, consistent with trends in inter- and intra-segmenter variability. Segmentation of the left atrium was less reliable. On average, the functional metrics of interest were underestimated by 6.76% or more due to systematic label propagation errors around atrioventricular valves; however, execution of the pipeline was 80% faster than performing analogous manual segmentation of each phase. PMID:22971564

  12. Characterization of Respiratory and Cardiac Motion from Electro-Anatomical Mapping Data for Improved Fusion of MRI to Left Ventricular Electrograms

    PubMed Central

    Roujol, Sébastien; Anter, Elad; Josephson, Mark E.; Nezafat, Reza

    2013-01-01

    Accurate fusion of late gadolinium enhancement magnetic resonance imaging (MRI) and electro-anatomical voltage mapping (EAM) is required to evaluate the potential of MRI to identify the substrate of ventricular tachycardia. However, both datasets are not acquired at the same cardiac phase and EAM data is corrupted with respiratory motion limiting the accuracy of current rigid fusion techniques. Knowledge of cardiac and respiratory motion during EAM is thus required to enhance the fusion process. In this study, we propose a novel approach to characterize both cardiac and respiratory motion from EAM data using the temporal evolution of the 3D catheter location recorded from clinical EAM systems. Cardiac and respiratory motion components are extracted from the recorded catheter location using multi-band filters. Filters are calibrated for each EAM point using estimates of heart rate and respiratory rate. The method was first evaluated in numerical simulations using 3D models of cardiac and respiratory motions of the heart generated from real time MRI data acquired in 5 healthy subjects. An accuracy of 0.6–0.7 mm was found for both cardiac and respiratory motion estimates in numerical simulations. Cardiac and respiratory motions were then characterized in 27 patients who underwent LV mapping for treatment of ventricular tachycardia. Mean maximum amplitude of cardiac and respiratory motion was 10.2±2.7 mm (min?=?5.5, max?=?16.9) and 8.8±2.3 mm (min?=?4.3, max?=?14.8), respectively. 3D Cardiac and respiratory motions could be estimated from the recorded catheter location and the method does not rely on additional imaging modality such as X-ray fluoroscopy and can be used in conventional electrophysiology laboratory setting. PMID:24250815

  13. Right coronary artery fistula to left ventricle treated by transcatheter coil embolization: a case report and literature review.

    PubMed

    Jiang, Zhenni; Chen, Han; Wang, Jian'an

    2012-01-01

    A coronary artery fistula between a coronary artery and a cardiac chamber is a rare condition. We reported a case of right coronary artery fistula to the left ventricle in a 57-year-old man who had 2-year history of chest pain and exercise dyspnea without significant coronary atherosclerosis with abnormal left ventricular size and function. It was important to recognize this anomaly and our experience showed that transcatheter occlusion of coronary artery fistula was a safe and effective procedure in the presence of symptoms of congestive heart failure, significant left-to-right shunt or refractory to medical treatment. PMID:22687840

  14. Nicardipine Intravenous Bolus Dosing for Acutely Decreasing Arterial Blood Pressure During General Anesthesia for Cardiac Operations: Pharmacokinetics, Pharmacodynamics, and Associated Effects on Left Ventricular Function

    Microsoft Academic Search

    Albert T. Cheung; Dmitri V. Guvakov; Stuart J. Weiss; Joseph S. Savino; Ivan S. Salgo; Qing C. Meng

    1999-01-01

    The objective of this study was to evaluate the efficacy of nicardipine, a dihydropyridine calcium channel an- tagonist, administered as an IV bolus dose to acutely decrease arterial pressure in anesthetized cardiac surgi- cal patients. We performed a double-blind, random- ized, self-controlled, dose-ranging study in 40 adult cardiac surgical patients to determine the pharmacoki- netics and pharmacodynamics of nicardipine 0.25

  15. Giant left atrial myxoma mimicking severe mitral valve stenosis and severe pulmonary hypertension.

    PubMed

    Mouine, Najat N; Asfalou, Ilyass I; Raissouni, Maha M; Benyass, Aatif A; Zbir, El Mehdi E

    2013-01-01

    Myxoma is the most common primary tumor of the heart and can arise in any of the cardiac chambers. This paper reports A 50 -year-old woman without medical history and any cardiovascular risk factors was hospitalized for exertional dyspnea and palpitations from three months and signifiant weight loss. Transthoracic echocardiogram showed a giant left atrial myxoma mobile confined to the left atrium in systole, in diastole the tumor was seen prolapsing across the mitral valve into the left ventricle and partially obstructing it and causing severe functional mitral stenosis with a mean gradient of 21,3 mmHg. Severe pulmonary hypertension was confirmed by Doppler PAPs =137 mmHg. The patient was scheduled for cardiac surgery with good outcome. PMID:23601991

  16. Giant left atrial myxoma mimicking severe mitral valve stenosis and severe pulmonary hypertension

    PubMed Central

    2013-01-01

    Myxoma is the most common primary tumor of the heart and can arise in any of the cardiac chambers. This paper reports A 50 -year-old woman without medical history and any cardiovascular risk factors was hospitalized for exertional dyspnea and palpitations from three months and signifiant weight loss. Transthoracic echocardiogram showed a giant left atrial myxoma mobile confined to the left atrium in systole, in diastole the tumor was seen prolapsing across the mitral valve into the left ventricle and partially obstructing it and causing severe functional mitral stenosis with a mean gradient of 21,3 mmHg. Severe pulmonary hypertension was confirmed by Doppler PAPs =137 mmHg. The patient was scheduled for cardiac surgery with good outcome. PMID:23601991

  17. Doppler echocardiographic description of double-inlet left ventricle in an Arabian horse.

    PubMed

    Sedacca, Cassidy D; Bright, Janice M; Boon, June

    2010-08-01

    Univentricular atrioventricular (AV) connections are rare and complex congenital cardiac anomalies in which both AV valves communicate into a large, common (single) receiving chamber. The common chamber can be of left, right, or mixed ventricular morphology. Although well documented in people, reports of the double-inlet ventricle malformation are rare in the veterinary literature. This report provides description of an Arabian horse with a double-inlet univentricular connection of left ventricular type, a hypoplastic subpulmonary right ventricle, two muscular ventricular septal defects, and a stenotic mitral valve. Transthoracic Doppler echocardiography enabled antemortem diagnosis, and provided an assessment of intracardiac hemodynamics. The findings indicate that Doppler echocardiography is a useful, noninvasive tool for evaluating equine patients with congenital univentricular AV connections, such as a double-inlet left ventricle. PMID:20634162

  18. Immunoglobulin G3 cardiac myosin autoantibodies correlate with left ventricular dysfunction in patients with dilated cardiomyopathy: Immunoglobulin G3 and clinical correlates

    Microsoft Academic Search

    Rahat S. Warraich; Michel Noutsias; Ilkay Kasac; Bettina Seeberg; Micheal J. Dunn; Heinz-Peter Schultheiss; Magdi H. Yacoub; Uwe Kuhl

    2002-01-01

    Background Effector functions of an aberrant immune response have been implicated in the pathogenesis of idiopathic dilated cardiomyopathy (DCM). The immunologic determinants of myocardial dysfunction, however, remain poorly understood. This study sought to determine the relation of different immunologic responses to hemodynamic dysfunction in DCM. Methods Immunoglobulin (Ig) G class\\/subclass response ELISA (enzyme-linked immunosorbent assay) against cardiac myosin heavy chain,

  19. Cardiac-Specific Inhibition of Kinase Activity in Calcium/Calmodulin-Dependent Protein Kinase Kinase-? Leads to Accelerated Left Ventricular Remodeling and Heart Failure after Transverse Aortic Constriction in Mice

    PubMed Central

    Watanabe, Shin; Horie, Takahiro; Nagao, Kazuya; Kuwabara, Yasuhide; Baba, Osamu; Nishi, Hitoo; Sowa, Naoya; Narazaki, Michiko; Matsuda, Tetsuya; Takemura, Genzou; Wada, Hiromichi; Hasegawa, Koji; Kimura, Takeshi; Ono, Koh

    2014-01-01

    Background The mechanism of cardiac energy production against sustained pressure overload remains to be elucidated. Methods and Results We generated cardiac-specific kinase-dead (kd) calcium/calmodulin-dependent protein kinase kinase-? (CaMKK?) transgenic (?-MHC CaMKK?kd TG) mice using ?-myosin heavy chain (?-MHC) promoter. Although CaMKK? activity was significantly reduced, these mice had normal cardiac function and morphology at baseline. Here, we show that transverse aortic binding (TAC) in ?-MHC CaMKK?kd TG mice led to accelerated death and left ventricular (LV) dilatation and dysfunction, which was accompanied by significant clinical signs of heart failure. CaMKK? downstream signaling molecules, including adenosine monophosphate-activated protein kinase (AMPK), were also suppressed in ?-MHC CaMKK?kd TG mice compared with wild-type (WT) mice. The expression levels of peroxisome proliferator-activated receptor-? coactivator (PGC)-1?, which is a downstream target of both of CaMKK? and calcium/calmodulin kinases, were also significantly reduced in ?-MHC CaMKK?kd TG mice compared with WT mice after TAC. In accordance with these findings, mitochondrial morphogenesis was damaged and creatine phosphate/?-ATP ratios assessed by magnetic resonance spectroscopy were suppressed in ?-MHC CaMKK?kd TG mice compared with WT mice after TAC. Conclusions These data indicate that CaMKK? exerts protective effects on cardiac adaptive energy pooling against pressure-overload possibly through phosphorylation of AMPK and by upregulation of PGC-1?. Thus, CaMKK? may be a therapeutic target for the treatment of heart failure. PMID:25255457

  20. A Rare Case of Left Ventricular Intramural Hemangioma Diagnosed Using 1.5-T Cardiac MRI with Histopathological Correlation and Successfully Treated by Surgery

    SciTech Connect

    Marrone, Gianluca, E-mail: gmarrone@ismett.ed [Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT), Diagnostic and Interventional Radiology (Italy); Sciacca, Sergio, E-mail: ssciacca@ismett.edu; D'Ancona, Giuseppe, E-mail: gdancona@ismett.edu; Pilato, Michele, E-mail: mpilato@ismett.ed [Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT), Division of Cardiac Surgery (Italy); Luca, Angelo, E-mail: aluca@ismett.ed [Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT), Diagnostic and Interventional Radiology (Italy); Gridelli, Bruno, E-mail: bgridelli@ismett.ed [Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT), Division of Surgery (Italy)

    2010-02-15

    Hemangiomas are vascular tumors composed of blood vessels, frequently localized in the skin and subcutaneous muscles; their localization in the heart is exceptional. The most common localizations are the lateral walls of the left ventricle, the anterior wall, and the septum. Mostly, these tumors grow intracavitarily, rarely intramurally. We describe a singular case of left ventricular intramural hemangioma, detected and diagnosed using newer magnetic resonance imaging (MRI) modalities, confirmed by histopathological results, and treated successfully by surgery.

  1. Time Components of the Left Ventricle.

    ERIC Educational Resources Information Center

    Franks, B. Don

    The purpose of this study was to examine the relationship of the time components of the left ventricle. Since one of the ways to investigate cardiac function is to analyze the time intervals between particular events of the cardiac cycle, various time intervals of systole and diastole of the left ventricle were measured from simultaneous…

  2. Action potential morphology of human induced pluripotent stem cell-derived cardiomyocytes does not predict cardiac chamber specificity and is dependent on cell density.

    PubMed

    Du, David T M; Hellen, Nicola; Kane, Christopher; Terracciano, Cesare M N

    2015-01-01

    Previous studies investigating human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have proposed the distinction of heart chamber-specific (atrial, ventricular, pacemaker) electrophysiological phenotypes based on action potential (AP) morphology. This suggestion has been based on data acquired using techniques that allow measurements from only a small number of cells and at low seeding densities. It has also been observed that density of culture affects the properties of iPSC-CMs. Here we systematically analyze AP morphology from iPSC-CMs at two seeding densities: 60,000 cells/well (confluent monolayer) and 15,000 cells/well (sparsely-seeded) using a noninvasive optical method. The confluent cells (n = 360) demonstrate a series of AP morphologies on a normally distributed spectrum with no evidence for specific subpopulations. The AP morphologies of sparsely seeded cells (n = 32) displayed a significantly different distribution, but even in this case there is no clear evidence of chamber-specificity. Reduction in gap junction conductance using carbenoxolone only minimally affected APD distribution in confluent cells. These data suggest that iPSC-CMs possess a sui generis AP morphology, and when observed in different seeding densities may encompass any shape including those resembling chamber-specific subtypes. These results may be explained by different functional maturation due to culture conditions. PMID:25564842

  3. A Giant Left Atrial Myxoma

    PubMed Central

    Zaher, Medhat F.; Bajaj, Sharad; Habib, Mirette; Doss, Emile; Habib, Michael; Bikkina, Mahesh; Hoyek, Wissam N.

    2014-01-01

    Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma. PMID:25587285

  4. Augmented Cardiac Hypertrophy in Response to Pressure Overload in Mice Lacking ELTD1

    PubMed Central

    Xiao, Jinfeng; Jiang, Hong; Zhang, Rui; Fan, Guangpu; Zhang, Yan; Jiang, Dingsheng; Li, Hongliang

    2012-01-01

    Background Epidermal growth factor (EGF), latrophilin and seven transmembrane domain-containing protein 1 (ELTD1) is developmentally upregulated in the heart. Little is known about the relationship between ELTD1 and cardiac diseases. Therefore, we aimed to clarify the role of ELTD1 in pressure overload–induced cardiac hypertrophy. Methods and Results C57BL/6J wild-type (WT) mice and ELTD1-knockout (KO) mice were subjected to left ventricular pressure overload by descending aortic banding (AB). KO mice exhibited more unfavorable cardiac remodeling than WT mice 28 days post AB; this remodeling was characterized by aggravated cardiomyocyte hypertrophy, thickening of the ventricular walls, dilated chambers, increased fibrosis, and blunted systolic and diastolic cardiac function. Analysis of signaling pathways revealed enhanced extracellular signal-regulated kinase (ERK) and the c-Jun amino-terminal kinase (JNK) phosphorylation in response to ELTD1 deletion. Conclusions ELTD1 deficiency exacerbates cardiac hypertrophy and cardiac function induced by AB-induced pressure overload by promoting both cardiomyocyte hypertrophy and cardiac fibrosis. These effects are suggested to originate from the activation of the ERK and JNK pathways, suggesting that ELTD1 is a potential target for therapies that prevent the development of cardiac disease. PMID:22606234

  5. CARDIAC COUNTERCLOCKWISE ROTATION IS A RISK FACTOR FOR HIGH-DOSE IRRADIATION TO THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN PATIENTS WITH LEFT-SIDED BREAST CANCER WHO RECEIVING ADJUVANT RADIOTHERAPY AFTER BREAST-CONSERVING SURGERY

    PubMed Central

    TANAKA, HIDEKAZU; HAYASHI, SHINYA; HOSHI, HIROAKI

    2014-01-01

    ABSTRACT Patients irradiated for left-sided breast cancer have higher incidence of cardiovascular disease than those receiving irradiation for right-sided breast cancer. Most abnormalities were in the left anterior descending (LAD) coronary artery territory. We analyzed the relationships between preoperative examination results and irradiation dose to the LAD artery in patients with left-sided breast cancer. Seventy-one patients receiving breast radiotherapy were analyzed. The heart may rotate around longitudinal axis, showing either clockwise or counterclockwise rotation (CCWR). On electrocardiography, the transition zone (TZ) was judged in precordial leads. CCWR was considered to be present if TZ was at or to the right of V3. The prescribed dose was 50 Gy in 25 fractions. The maximum (Dmax) and mean (Dmean) doses to the LAD artery and the volumes of the LAD artery receiving at least 20 Gy, 30 Gy and 40 Gy (V20Gy, V30Gy and V40Gy, respectively) were significantly higher in CCWR than in the non-CCWR patients. On multivariate analysis, TZ was significantly associated with Dmax, Dmean, V20Gy, V30Gy, and V40Gy. CCWR is a risk factor for high-dose irradiation to the LAD artery. Electrocardiography is useful for evaluating the cardiovascular risk of high-dose irradiation to the LAD artery. PMID:25741035

  6. Echocardiography of the normal camel (Camelus dromedaries) heart: technique and cardiac dimensions

    PubMed Central

    2012-01-01

    Background Echocardiography and intra-cardiac dimensions have not previously been reported in adult camels despite its potential application for medical purpose. The aim of this study was to describe the results of a prospective study, aiming to report normal cardiac appearance and normal chamber dimensions in adult camels (Camelus dromedarius). Results On the right side, when the probe was placed in the 5th or 4th intercostal space (ICS), the caudal long-axis four-chamber view of the ventricles, atria, and the interventricular septum was obtained. Placing the probe slightly more cranially in the 4th ICS, the caudal long-axis four-chamber view and the caudal long-axis view of the left ventricular outflow tract (LVOT) were imaged. In 7 camels, a hybrid view between a “four-chamber” and “LVOT view” was imaged from the same position. The short-axis view of the ventricles was obtained in the 4th ICS where the transducer was rotated between 0° and 25°. Placement of the transducer in the 3rd ICS allowed visualisation of the right ventricular outflow tract (RVOT). On the left side, when the probe was placed in the 5th or 4th ICS, a four-chamber view was obtained. The LVOT is imaged in the 4th ICS and the RVOT was seen from the 3rd ICS. Conclusions This study showed that it is possible to obtain good-quality echocardiograms in adult camels and provide normal cardiac dimensions. This study could be used as a reference for further studies concerning camels with cardiac diseases. PMID:22862855

  7. Dietary saturated fat and docosahexaenoic acid differentially effect cardiac mitochondrial phospholipid fatty acyl composition and Ca2+ uptake, without altering permeability transition or left ventricular function

    PubMed Central

    O'Connell, Kelly A; Dabkowski, Erinne R; de Fatima Galvao, Tatiana; Xu, Wenhong; Daneault, Caroline; de Rosiers, Christine; Stanley, William C

    2013-01-01

    High saturated fat diets improve cardiac function and survival in rodent models of heart failure, which may be mediated by changes in mitochondrial function. Dietary supplementation with the n3-polyunsaturated fatty acid docosahexaenoic acid (DHA, 22:6n3) is also beneficial in heart failure and can affect mitochondrial function. Saturated fatty acids and DHA likely have opposing effects on mitochondrial phospholipid fatty acyl side chain composition and mitochondrial membrane function, though a direct comparison has not been previously reported. We fed healthy adult rats a standard low-fat diet (11% of energy intake from fat), a low-fat diet supplemented with DHA (2.3% of energy intake) or a high-fat diet comprised of long chain saturated fatty acids (45% fat) for 6 weeks. There were no differences among the three diets in cardiac mass or function, mitochondrial respiration, or Ca2+-induced mitochondrial permeability transition. On the other hand, there were dramatic differences in mitochondrial phospholipid fatty acyl side chains. Dietary supplementation with DHA increased DHA from 7% to ?25% of total phospholipid fatty acids in mitochondrial membranes, and caused a proportional depletion of arachidonic acid (20:4n6). The saturated fat diet increased saturated fat and DHA in mitochondria and decreased linoleate (18:2n6), which corresponded to a decrease in Ca2+ uptake by isolated mitochondria compared to the other diet groups. In conclusion, despite dramatic changes in mitochondrial phospholipid fatty acyl side chain composition by both the DHA and high saturated fat diets, there were no effects on mitochondrial respiration, permeability transition, or cardiac function. PMID:24303101

  8. [Obesity and cardiac failure].

    PubMed

    Galinier, M; Pathak, A; Roncalli, J; Massabuau, P

    2005-01-01

    Obesity alone is the cause of 11% of cases of cardiac failure in men and 14% of cases in women in the United States. The frequency of obesity continues to rise in our country, 41% of our compatriots being obese or overweight. It is expected that obesity will become an important cause of cardiac failure in the coming years. The Framingham study showed that, after correction for other risk factors, for every point increase in body mass index, the increase in risk of developing cardiac failure was 5% in men and 7% in women. There are three physiopathological mechanisms to explain the adverse effects of obesity on left ventricular function: an increase in ventricular preload secondary to increased plasma volume induced by the high fatty mass; an increase in left ventricular afterload due to the common association of hypertension generated by activation of the sympathetic nervous system by hyperinsulinism; and systolic and diastolic dysfunction due to changes in the myocardial genome and coronary artery disease induced by risk factors of atherosclerosis aggravated by obesity. The adipocyte also secretes a number of hormones which act directly or indirectly on the myocardium: angiotensin II, leptin, resistin, adrenomedulin, cytokines. These haemodynamic and hormonal changes profoundly modify the genetic expression of the myocardium in obesity, favourising hypertrophy of the myocyte and the development of interstitial fibrosis. Whether it be eccentric in the absence of hypertension or concentric when hypertension is associated with obesity, left ventricular hypertrophy, although normalising left ventricular wall stress, has adverse consequences causing abnormal relaxation and decreased left ventricular compliance. Therefore, in obese patients, two forms of cardiac failure may be observed. The more common is due to diastolic dysfunction, obesity being one of the principal causes of cardiac failure with preserved systolic function. Cardiac failure due to systolic dysfunction is less common and may be observed in cases with inappropriate left ventricular hypertrophy which does not normalise abnormal left ventricular wall stress leading to cardiomyopathy, and in cases with associated coronary artery disease. Whatever the underlying mechanism, the diagnosis of cardiac failure is made more difficult by obesity. From the prognostic point of view, in the global population of patients with cardiac failure, obesity improves survival because it counteracts the adverse effect of cachexia; however, obesity increases the risk of sudden death. In fact, obesity is associated with dynamic change in QT interval. In cases of cardiac failure secondary to obesity-related cardiomyopathy, loss of weight leads to an improved functional status and a reduction of left ventricular remodelling and an increase of the ejection fraction. PMID:15724418

  9. Cardiac Rehabilitation

    MedlinePLUS

    ... from the NHLBI on Twitter. What Is Cardiac Rehabilitation? Cardiac rehabilitation (rehab) is a medically supervised program ... be designed to meet your needs. The Cardiac Rehabilitation Team Cardiac rehab involves a long-term commitment ...

  10. Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study

    Microsoft Academic Search

    E Wu; J T Ortiz; P Tejedor; D C Lee; C Bucciarelli-Ducci; P Kansal; J C Carr; T A Holly; D Lloyd-Jones; F J Klocke; R O Bonow

    2008-01-01

    Objectives:Ejection fraction (EF) and end-systolic volume index (ESVI) are established predictors of outcomes following ST-segment elevation myocardial infarction (STEMI). We sought to assess the relative impact of infarct size, EF and ESVI on clinical outcomes and left ventricular (LV) remodelling.Design:Prospective cohort study.Setting:Academic hospital in Chicago, USA.Patients:122 patients with STEMI following acute percutaneous reperfusion.Main outcome measures:Death, recurrent myocardial infarction (MI) and

  11. Cardiac sympathetic denervation does not change the load dependence of the left ventricular end-systolic pressure\\/volume relationship in dogs

    Microsoft Academic Search

    Inger B. Schipper; Paul Steendijk; Robert J. M. Klautz; Enno T. van der Velde; Jan Baan

    1993-01-01

    It has been shown that in the intact canine heart the left-ventricular end-systolic pressure\\/volume relation (ESPVR) depends on loading conditions: an increase in arterial vascular resistance causes a leftwards shift and a steeper slope of the ESPVR, suggesting an increased inotropic state. Our purpose was to investigate the possible contribution of the sympathetic nervous system to this load sensitivity of

  12. Bioptic Study of Left and Right Atrial Interstitium in Cardiac Patients with and without Atrial Fibrillation: Interatrial but Not Rhythm-Based Differences

    PubMed Central

    Smorodinova, Natalia; Lantová, Lucie; Bláha, Martin; Melenovský, Vojt?ch; Hanzelka, Jan; Pirk, Jan; Kautzner, Josef; Ku?era, Tomáš

    2015-01-01

    One of the generally recognized factors contributing to the initiation and maintenance of atrial fibrillation (AF) is structural remodeling of the myocardium that affects both atrial cardiomyocytes as well as interstitium. The goal of this study was to characterize morphologically and functionally interstitium of atria in patients with AF or in sinus rhythm (SR) who were indicated to heart surgery. Patient population consisted of 46 subjects (19 with long-term persistent AF, and 27 in SR) undergoing coronary bypass or valve surgery. Peroperative bioptic samples of the left and the right atria were examined using immunohistochemistry to visualize and quantify collagen I, collagen III, elastin, desmin, smooth muscle actin, endothelium and Vascular Endothelial Growth Factor (VEGF). The content of interstitial elastin, collagen I, and collagen III in atrial tissue was similar in AF and SR groups. However, the right atrium was more than twofold more abundant in elastin as compared with the left atrium and similar difference was found for collagen I and III. The right atrium showed also higher VEGF expression and lower microvascular density as compared to the left atrium. No significant changes in atrial extracellular matrix fiber content, microvascular density and angiogenic signaling, attributable to AF, were found in this cohort of patients with structural heart disease. This finding suggests that interstitial fibrosis and other morphological changes in atrial tissue are rather linked to structural heart disease than to AF per se. Significant regional differences in interstitial structure between right and left atrium is a novel observation that deserves further investigation. PMID:26067062

  13. A biplane roentgen videometry system for dynamic /60 per second/ studies of the shape and size of circulatory structures, particularly the left ventricle.

    NASA Technical Reports Server (NTRS)

    Ritman, E. L.; Sturm, E.; Wood, E. H.; Heintzen, P. H.

    1971-01-01

    A roentgen-television digital-computer technique and a display system developed for dynamic circulatory structure studies are described. Details are given for a videoroentgenographic setup which is used for obtaining biplane roentgen silhouettes of a left ventricle. A 60 per sec measurement of the shape and volume of angiographically outlined cardiac chambers can be made by this technique along with simultaneous ECG, pressure, and flow measurements accessible for real-time digital computer processing and analysis.

  14. Genetic and Physiologic Dissection of the Vertebrate Cardiac Conduction System

    Microsoft Academic Search

    Neil C Chi; Robin M Shaw; Benno Jungblut; Jan Huisken; Tania Ferrer; Rima Arnaout; Ian Scott; Dimitris Beis; Tong Xiao; Herwig Baier; Lily Y Jan; Martin Tristani-Firouzi; Didier Y. R Stainier

    2008-01-01

    Vertebrate hearts depend on highly specialized cardiomyocytes that form the cardiac conduction system (CCS) to coordinate chamber contraction and drive blood efficiently and unidirectionally throughout the organism. Defects in this specialized wiring system can lead to syncope and sudden cardiac death. Thus, a greater understanding of cardiac conduction development may help to prevent these devastating clinical outcomes. Utilizing a cardiac-specific

  15. L-Arginine ameliorates cardiac left ventricular oxidative stress by upregulating eNOS and Nrf2 target genes in alloxan-induced hyperglycemic rats

    SciTech Connect

    Ramprasath, Tharmarajan; Hamenth Kumar, Palani; Syed Mohamed Puhari, Shanavas; Senthil Murugan, Ponniah; Vasudevan, Varadaraj [Molecular Cardiology Unit, Department of Biochemistry, Center for Excellence in Genomic Sciences, School of Biological Sciences, Madurai Kamaraj University, Madurai 625 021, Tamilnadu (India)] [Molecular Cardiology Unit, Department of Biochemistry, Center for Excellence in Genomic Sciences, School of Biological Sciences, Madurai Kamaraj University, Madurai 625 021, Tamilnadu (India); Selvam, Govindan Sadasivam, E-mail: drselvamgsbiochem@rediffmail.com [Molecular Cardiology Unit, Department of Biochemistry, Center for Excellence in Genomic Sciences, School of Biological Sciences, Madurai Kamaraj University, Madurai 625 021, Tamilnadu (India)

    2012-11-23

    Highlights: Black-Right-Pointing-Pointer L-Arginine treatment reduced the metabolic disturbances in diabetic animals. Black-Right-Pointing-Pointer Antioxidant marker proteins were found high in myocardium by L-arginine treatment. Black-Right-Pointing-Pointer Elevated antioxidant status, mediates the reduced TBA-reactivity in left ventricle. Black-Right-Pointing-Pointer L-Arginine treatment enhanced the Nrf2 and eNOS signaling in left ventricle. Black-Right-Pointing-Pointer Improved cell survival signaling by arginine, offers a novel tactic for targeting. -- Abstract: Hyperglycemia is independently related with excessive morbidity and mortality in cardiovascular disorders. L-Arginine-nitric oxide (NO) pathway and the involvement of NO in modulating nuclear factor-E2-related factor-2 (Nrf2) signaling were well established. In the present study we investigated, whether L-arginine supplementation would improve the myocardial antioxidant defense under hyperglycemia through activation of Nrf2 signaling. Diabetes was induced by alloxan monohydrate (90 mg kg{sup -1} body weight) in rats. Both non-diabetic and diabetic group of rats were divided into three subgroups and they were administered either with L-arginine (2.25%) or L-NAME (0.01%) in drinking water for 12 days. Results showed that L-arginine treatment reduced the metabolic disturbances in diabetic rats. Antioxidant enzymes and glutathione levels were found to be increased in heart left ventricles, thereby reduction of lipid peroxidation by L-arginine treatment. Heart histopathological analysis further validates the reversal of typical diabetic characteristics consisting of alterations in myofibers and myofibrillary degeneration. qRT-PCR studies revealed that L-arginine treatment upregulated the transcription of Akt and downregulated NF-{kappa}B. Notably, transcription of eNOS and Nrf2 target genes was also upregulated, which were accompanied by enhanced expression of Nrf2 in left ventricular tissue from diabetic and control rats. Under these findings, we suggest that targeting of eNOS and Nrf2 signaling by L-arginine supplementation could be used as a potential treatment method to alleviate the late diabetic complications.

  16. Hypoplastic left heart syndrome

    PubMed Central

    Connor, Jean Anne; Thiagarajan, Ravi

    2007-01-01

    Hypoplastic left heart syndrome(HLHS) refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch). Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision relative to treatment, and long-term prognosis as information on long-term survival and quality of life for those born with the syndrome is limited. PMID:17498282

  17. Improved Left Ventricular Mass Quantification with Partial Voxel Interpolation – In-Vivo and Necropsy Validation of a Novel Cardiac MRI Segmentation Algorithm

    PubMed Central

    Codella, Noel C.F.; Lee, Hae Yeoun; Fieno, David S.; Chen, Debbie W.; Hurtado-Rua, Sandra; Kochar, Minisha; Finn, John Paul; Judd, Robert; Goyal, Parag; Schenendorf, Jesse; Cham, Matthew D.; Devereux, Richard B.; Prince, Martin; Wang, Yi; Weinsaft, Jonathan W.

    2013-01-01

    Background CMR typically quantifies LV mass (LVM) via manual planimetry (MP), but this approach is time consuming and does not account for partial voxel components - myocardium admixed with blood in a single voxel. Automated segmentation (AS) can account for partial voxels, but this has not been used for LVM quantification. This study used automated CMR segmentation to test the influence of partial voxels on quantification of LVM. Methods and Results LVM was quantified by AS and MP in 126 consecutive patients and 10 laboratory animals undergoing CMR. AS yielded both partial voxel (ASPV) and full voxel (ASFV) measurements. Methods were independently compared to LVM quantified on echocardiography (echo) and an ex-vivo standard of LVM at necropsy. AS quantified LVM in all patients, yielding a 12-fold decrease in processing time vs. MP (0:21±0:04 vs. 4:18±1:02 min; p<0.001). ASFV mass (136±35gm) was slightly lower than MP (139±35; ?=3±9gm, p<0.001). Both methods yielded similar proportions of patients with LV remodeling (p=0.73) and hypertrophy (p=1.00). Regarding partial voxel segmentation, ASPV yielded higher LVM (159±38gm) than MP (?=20±10gm) and ASFV (?=23±6gm, both p<0.001), corresponding to relative increases of 14% and 17%. In multivariable analysis, magnitude of difference between ASPV and ASFV correlated with larger voxel size (partial r=0.37, p<0.001) even after controlling for LV chamber volume (r=.28, p=0.002) and total LVM (r=0.19, p=0.03). Among patients, ASPV yielded better agreement with echo (?=20±25gm) than did ASFV (?=43±24gm) or MP (?=40±22gm, both p<0.001). Among laboratory animals, ASPV and ex-vivo results were similar (?=1±3gm, p=0.3), whereas ASFV (6±3gm, p<0.001) and MP (4±5gm, p=0.02) yielded small but significant differences with LVM at necropsy. Conclusions Automated segmentation of myocardial partial voxels yields a 14-17% increase in LVM vs. full voxel segmentation, with increased differences correlated with lower spatial resolution. Partial voxel segmentation yields improved CMR agreement with echo and necropsy-verified LVM. PMID:22104165

  18. 4D Cardiac Segmentation of the Epicardium and Left Ventricle G. Pons Moll1, G. Tadmor2, R.S. MacLeod3, B. Rosenhahn1 and D.H. Brooks2

    E-print Network

    (TNT),Hannover, Germany 2 Northeastern University/Department of Electrical and Computer Engineering slices and frames, providing spatial and temporal consistency. In a given cardiac phase, the stacking stages of cardiac surgery makes segmentation of cardiac structures from magnetic resonance (MRI) images

  19. Separation of afterload reduction and a direct beneficial cardiac effect of nifedipine in congestive cardiomyopathy.

    PubMed

    Percy, R F; Bass, T A; Conetta, D A; Miller, A B

    1989-08-01

    To assess whether the calcium antagonist nifedipine has a specific, direct effect on left ventricular diastolic function separate from its vasodilatory action, we studied 10 patients with idiopathic congestive cardiomyopathy (ages 28-69, New York Heart Association Class III or IV) at 30 min, 2 h, and 6 h after administration of 10 mg of sublingual nifedipine. Hemodynamic parameters were assessed with Swan-Ganz catheter and two-dimensional echo images were processed with computer-assisted analysis (Quantic 1200) to obtain left ventricular chamber areas and an index of rapid diastolic filling. Indices of left ventricular systolic performance (cardiac index and left ventricular area change fraction) improved during the early (30 min and 2 h) observation periods as afterload (estimated by systolic blood pressure and systemic vascular resistance) was reduced (p less than .05 vs. baseline). Pulmonary capillary wedge pressure fell from 17 mmHg to 11 mmHg and rapid diastolic filling index increased from .28 (% area change/ms) to .37 (% area change/ms) (p less than .05 vs. baseline) during the early observation periods. Indices of left ventricular systolic performance and afterload had returned to baseline at the late (6 h) observation period. However, pulmonary capillary wedge pressure remained reduced significantly at 10 mmHg after 6 h (p less than .05 vs. baseline). Preload (estimated by left ventricular end-diastolic chamber area) did not vary throughout the study period. Reduction of pulmonary capillary wedge pressure at 6 h, despite return of afterload reduction to baseline and no change in preload, suggests improved left ventricular chamber compliance after sublingual nifedipine, not related to alteration of left ventricular loading conditions. PMID:2766589

  20. Chronic intermittent hypobaric hypoxia prevents cardiac dysfunction through enhancing antioxidation in fructose-fed rats.

    PubMed

    Zhou, Jing-Jing; Wei, Yan; Zhang, Li; Zhang, Jiao; Guo, Lan-Ying; Gao, Chao; Li, De-Pei; Zhang, Yi

    2013-05-01

    High-fructose intake induces metabolic syndrome and cardiac dysfunction. Chronic intermittent hypobaric hypoxia (CIHH) preserves cardiac function during ischemia. We hypothesized that CIHH restores the impaired cardiac function in fructose-fed rats. Sprague-Dawley rats were randomly subject to treatment with fructose (10% fructose in drinking water for 6 weeks), CIHH (simulated 5000 m altitude, 6 h/day for 6 weeks in a hypobaric chamber), and CIHH plus fructose groups. In addition to an increase in blood pressure, fructose feeding caused elevated serum levels of glucose, fasting insulin and insulin C peptide, triglyceride, cholesterol, and mass ratio of heart to body. CIHH treatment decreased the arterial blood pressure, serum levels of biochemical markers, and cardiac hypertrophy in fructose-fed rats. Furthermore, CIHH treatment improved the recovery of left ventricular function after ischemia-reperfusion procedure (30 min global no-flow ischemia followed by 60 min of reperfusion) in rats with or without fructose feeding. In addition, CIHH treatment caused a significant increase in superoxide dismutase (SOD) activity and decrease in malondialdehyde level in cardiac myocardium experiencing ischemia-reperfusion in control and fructose-fed rats. Collectively, these data suggest that CIHH improve impaired cardiac function in fructose-fed rats through enhancing antioxidation in the myocardium. PMID:23656204

  1. Cardiac Magnetic Resonance Imaging Findings in 20-year Survivors of Mediastinal Radiotherapy for Hodgkin's Disease

    SciTech Connect

    Machann, Wolfram; Beer, Meinrad [Department of Radiology, University of Wuerzburg (Germany); Breunig, Margret; Stoerk, Stefan; Angermann, Christiane [Department of Cardiology, University of Wuerzburg (Germany); Seufert, Ines; Schwab, Franz; Koelbl, Oliver; Flentje, Michael [Department of Radiation Oncology, University of Wuerzburg (Germany); Vordermark, Dirk, E-mail: dirk.vordermark@medizin.uni-halle.d [Department of Radiation Oncology, University of Wuerzburg (Germany); Department of Radiation Oncology, Martin Luther University Halle-Wittenberg (Germany)

    2011-03-15

    Purpose: The recognition of the true prevalence of cardiac toxicity after mediastinal radiotherapy requires very long follow-up and a precise diagnostic procedure. Cardiac magnetic resonance imaging (MRI) permits excellent quantification of cardiac function and identification of localized myocardial defects and has now been applied to a group of 20-year Hodgkin's disease survivors. Methods and materials: Of 143 patients treated with anterior mediastinal radiotherapy (cobalt-60, median prescribed dose 40 Gy) for Hodgkin's disease between 1978 and 1985, all 53 survivors were invited for cardiac MRI. Of those, 36 patients (68%) presented for MRI, and in 31 patients (58%) MRI could be performed 20-28 years (median, 24) after radiotherapy. The following sequences were acquired on a 1.5-T MRI: transversal T1-weighted TSE and T2-weighted half-fourier acquisition single-shot turbo-spin-echo sequences, a steady-state free precession (SSFP) cine sequence in the short heart axis and in the four-chamber view, SSFP perfusion sequences under rest and adenosine stress, and a SSFP inversion recovery sequence for late enhancement. The MRI findings were correlated with previously reconstructed doses to cardiac structures. Results: Clinical characteristics and reconstructed doses were not significantly different between survivors undergoing and not undergoing MRI. Pathologic findings were reduced left ventricular function (ejection fraction <55%) in 7 (23%) patients, hemodynamically relevant valvular dysfunction in 13 (42%), late myocardial enhancement in 9 (29%), and any perfusion deficit in 21 (68%). An association of regional pathologic changes and reconstructed dose to cardiac structures could not be established. Conclusions: In 20-year survivors of Hodgkin's disease, cardiac MRI detects pathologic findings in approximately 70% of patients. Cardiac MRI has a potential role in cardiac imaging of Hodgkin's disease patients after mediastinal radiotherapy.

  2. Cardiac mechanics: Physiological, clinical, and mathematical considerations

    NASA Technical Reports Server (NTRS)

    Mirsky, I. (editor); Ghista, D. N.; Sandler, H.

    1974-01-01

    Recent studies concerning the basic physiological and biochemical principles underlying cardiac muscle contraction, methods for the assessment of cardiac function in the clinical situation, and mathematical approaches to cardiac mechanics are presented. Some of the topics covered include: cardiac ultrastructure and function in the normal and failing heart, myocardial energetics, clinical applications of angiocardiography, use of echocardiography for evaluating cardiac performance, systolic time intervals in the noninvasive assessment of left ventricular performance in man, evaluation of passive elastic stiffness for the left ventricle and isolated heart muscle, a conceptual model of myocardial infarction and cardiogenic shock, application of Huxley's sliding-filament theory to the mechanics of normal and hypertrophied cardiac muscle, and a rheological modeling of the intact left ventricle. Individual items are announced in this issue.

  3. Sudden cardiac death and obesity.

    PubMed

    Plourde, Benoit; Sarrazin, Jean-François; Nault, Isabelle; Poirier, Paul

    2014-09-01

    For individuals and the society as a whole, the increased risk of sudden cardiac death in obese patients is becoming a major challenge, especially since obesity prevalence has been increasing steadily around the globe. Traditional risk factors and obesity often coexist. Hypertension, diabetes, obstructive sleep apnea and metabolic syndrome are well-known risk factors for CV disease and are often present in the obese patient. Although the bulk of evidence is circumstantial, sudden cardiac death and obesity share common traditional CV risk factors. Structural, functional and metabolic factors modulate and influence the risk of sudden cardiac death in the obese population. Other risk factors such as left ventricular hypertrophy, increased number of premature ventricular complexes, altered QT interval and reduced heart rate variability are all documented in both obese and sudden cardiac death populations. The present review focuses on out-of-hospital sudden cardiac death and potential mechanisms leading to sudden cardiac death in this population. PMID:25160995

  4. Beat?to?Beat Spatiotemporal Variability in the T Vector Is Associated With Sudden Cardiac Death in Participants Without Left Ventricular Hypertrophy: The Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Waks, Jonathan W.; Soliman, Elsayed Z.; Henrikson, Charles A.; Sotoodehnia, Nona; Han, Lichy; Agarwal, Sunil K.; Arking, Dan E.; Siscovick, David S.; Solomon, Scott D.; Post, Wendy S.; Josephson, Mark E.; Coresh, Josef; Tereshchenko, Larisa G.

    2015-01-01

    Background Despite advances in prevention and treatment of cardiovascular disease, sudden cardiac death (SCD) remains a clinical challenge. Risk stratification in the general population is needed. Methods and Results Beat?to?beat spatiotemporal variability in the T vector was measured as the mean angle between consecutive T?wave vectors (mean TT? angle) on standard 12?lead ECGs in 14 024 participants in the Atherosclerosis Risk in Communities (ARIC) study. Subjects with left ventricular hypertrophy, atrial arrhythmias, frequent ectopy, ventricular pacing, or QRS duration ?120 ms were excluded. The mean spatial TT? angle was 5.21±3.55°. During a median of 14 years of follow?up, 235 SCDs occurred (1.24 per 1000 person?years). After adjustment for demographics, coronary heart disease risk factors, and known ECG markers for SCD, mean TT? angle was independently associated with SCD (hazard ratio 1.089; 95% CI 1.044 to 1.137; P<0.0001). A mean TT? angle >90th percentile (>9.57°) was associated with a 2?fold increase in the hazard for SCD (hazard ratio 2.01; 95% CI 1.28 to 3.16; P=0.002). In a subgroup of patients with T?vector amplitude ?0.2 mV, the association with SCD was almost twice as strong (hazard ratio 3.92; 95% CI 1.91 to 8.05; P<0.0001). A significant interaction between mean TT? angle and age was found: TT? angle was associated with SCD in participants aged <55 years (hazard ratio 1.096; 95% CI 0.043 to 1.152; P<0.0001) but not in participants aged ?55 years (Pinteraction=0.009). Conclusions In a large, prospective, community?based cohort of left ventricular hypertrophy–free participants, increased beat?to?beat spatiotemporal variability in the T vector, as assessed by increasing TT? angle, was associated with SCD. PMID:25600143

  5. Normal Human Left and Right Ventricular and Left Atrial Dimensions Using Steady State Free Precession Magnetic Resonance Imaging

    Microsoft Academic Search

    LUCY E. HUDSMITH; STEFFEN E. PETERSEN; JANE M. FRANCIS; MATTHEW D. ROBSON; Stefan Neubauer

    2005-01-01

    Purpose. The aim of this project was to establish a database of left and right ventricular and left atrial dimensions in healthy volunteers using steady-state free precession cardiac magnetic resonance imaging, the clinical technique of choice, across a wide age range. Methods. 108 healthy volunteers (63 male, 45 female) underwent cardiac magnetic resonance imaging using steady-state free precession sequences. Manual

  6. Minimally invasive video-assisted thoracoscopic left ventricular epicardial lead implantation for biventricular pacing in a patient with persistent left superior vena cava.

    PubMed

    Matsuno, Yukihiro; Mori, Yoshio; Umeda, Yukio; Imaizumi, Matsuhisa; Takiya, Hiroshi

    2008-07-01

    Cardiac resynchronization therapy (CRT) by biventricular pacing reduces symptoms and improves left ventricular function in many patients with heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony. Implantation of the biventricular pacing lead in association with persistent left superior vena cava is technically challenging. We report a successful case of minimally invasive video-assisted thoracoscopic left ventricular epicardial lead implantation for biventricular pacing in a patient with persistent left superior vena cava. PMID:18649062

  7. Left ventricular wall stress compendium.

    PubMed

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models. PMID:21547783

  8. Fetal cardiac hypertrophy and cardiac function in diabetic pregnancies

    Microsoft Academic Search

    Jyotsna A. Gandhi; Xiao Yang Zhang; Jack E. Maidman

    1995-01-01

    OBJECTIVE: Our purpose was to evaluate the relationship between fetal cardiac wall hypertrophy and ventricular function in fetuses of metabolically controlled, insulin-requiring diabetics.STUDY DESIGN: M-mode directed fetal echocardiography included measurements of left and right ventricular free wall and interventricular septal thickness and ventricular diastolic and systolic dimensions. Fetal measurements included biparietal diameter, estimation of fetal weight, and cardiac area\\/thoracic area.

  9. Time course of reverse remodeling of the left ventricle during support with a left ventricular assist device

    Microsoft Academic Search

    John D. Madigan; Alessandro Barbone; Asim F. Choudhri; David L. S. Morales; Bolin Cai; Mehmet C. Oz; Daniel Burkhoff

    2001-01-01

    Background: Support with a left ventricular assist device leads to normalization of left ventricular chamber geometry, regression of myocyte hypertrophy, alterations in left ventricular collagen content, and normalized expression of genes involved with excitation-contraction coupling in patients with heart failure. The objective of this study was to investigate the time course of these processes. Methods: Passive left ventricular pressure-volume relationships

  10. Sudden cardiac death.

    PubMed

    Kuriachan, Vikas P; Sumner, Glen L; Mitchell, L Brent

    2015-04-01

    Sudden death accounts for 300,000-400,000 deaths annually in the United States. Most sudden deaths are cardiac, and most sudden cardiac deaths are related to arrhythmias secondary to structural heart disease or primary electrical abnormalities of the heart. The most common structural disease leading to sudden death is ischemic heart disease. Nonischemic cardiomyopathy and other structural abnormalities such as arrhythmogenic ventricular dysplasia and hypertrophic cardiomyopathy may also be causative. Patients without structural disease have a primary electrical abnormality, such as long-QT syndrome or Brugada syndrome. Severe left ventricular systolic dysfunction is the main marker for sudden death in patients with ischemic or nonischemic cardiomyopathy. In other conditions, other markers for structural heart disease and electrical abnormalities need to be considered. It is seen that ?-blocker therapy is associated with a reduction in sudden cardiac death across a broad range of disorders. Nevertheless, the implantable cardioverter defibrillator remains the most effective treatment strategy in selected patients. PMID:25813838

  11. A model-based system for assessing ventricular chamber pressure-volume-dimension relationship: regional and global deformation.

    PubMed

    Kresh, J Y; Brockman, S K

    1986-01-01

    A system has been developed for measuring and relating in a non-beating isolated canine left ventricle dynamic changes in chamber pressure, volume, diameter, regional segment length, and wall thickness. The measurement system consists of a pulsatile blood pump whose stroke-volume and frequency can be adjusted selectively. The external pump system is used as a primary means for controlling instantaneous intraventricular volume. The relationship between left ventricular volume change, intraventricular pressure, minor axis diameter, and regional dimensions were studied as a function of pump rate. In addition to the basic constitutive properties, this system provided the means for measuring and comparing regional and global pressure-strain relationship including the effect of strain rate and its relationship to viscoelastic myocardial muscle model. The dynamic relationship between global dimensions and regional dimensions, circumferential segment length, and wall thickness were also investigated. The instantaneous relationship between intraventricular pressure resulting from periodic oscillations of chamber volume, including minor equator diameter, wall thickness, and regional segment dimensions were plotted and fitted to an exponential pressure-strain model, assuming a quasi-static large deformation. The observed difference between global and regional pressure-dimension strain stiffness coefficients can be attributed in part to basic constitutive and geometric considerations and not necessarily to the complex anisotropic or heterogeneous nature of cardiac muscle properties. This methodology provides indices which appropriately characterize the regional and global left ventricular chamber deformation and stiffness. PMID:3706853

  12. Performance Analysis of a Cardiac Assist Device in Counterpulsation

    Microsoft Academic Search

    N. C. Chesler; R. D. Kamm

    2009-01-01

    Performance of a cardiac assist device pumping chamber in counterpulsat ion was evaluated using numerical simulations of the unsteady, three-dimensional flow inside the chamber and an analytical model of the force required to eject and fill the chamber. The wall shear stress within the device was similarly computed and modeled. The analytical model was scaled to match the numerical results

  13. Videoscope-assisted cardiac surgery

    PubMed Central

    Chen, Robert Jeen-Chen

    2014-01-01

    Videoscope-assisted cardiac surgery (VACS) offers a minimally invasive platform for most cardiac operations such as coronary and valve procedures. It includes robotic and thoracoscopic approaches and each has strengths and weaknesses. The success depends on appropriate hardware setup, staff training, and troubleshooting efficiency. In our institution, we often use VACS for robotic left-internal-mammary-artery takedown, mitral valve repair, and various intra-cardiac operations such as tricuspid valve repair, combined Maze procedure, atrial septal defect repair, ventricular septal defect repair, etc. Hands-on reminders and updated references are provided for reader’s further understanding of the topic. PMID:24455172

  14. Cardiac abnormalities in young women with anorexia nervosa.

    PubMed Central

    de Simone, G.; Scalfi, L.; Galderisi, M.; Celentano, A.; Di Biase, G.; Tammaro, P.; Garofalo, M.; Mureddu, G. F.; de Divitiis, O.; Contaldo, F.

    1994-01-01

    OBJECTIVE--To identify the characteristics of cardiac involvement in the self-induced starvation phase of anorexia nervosa. METHODS--Doppler echocardiographic indices of left ventricular geometry, function, and filling were examined in 21 white women (mean (SD) 22 (5) years) with anorexia nervosa according to the DSMIII (Diagnostic and Statistical Manual of Mental Disorders) criteria, 19 women (23 (2) years) of normal weight, and 22 constitutionally thin women (21 (4) years) with body mass index < 20. RESULTS--13 patients (62%) had abnormalities of mitral valve motion compared with one normal weight woman and two thin women (p < 0.001) v both control groups). Left ventricular chamber dimension and mass were significantly less in women with anorexia nervosa than in either the women of normal weight or the thin women, even after standardisation for body size or after controlling for blood pressure. There were no substantial changes in left ventricular shape. Midwall shortening as a percentage of the values predicted from end systolic stress was significantly lower in the starving patients than in women of normal weight: when endocardial shortening was used as the index this difference was overestimated. The cardiac index was also significantly reduced in anorexia nervosa because of a low stroke index and heart rate. The total peripheral resistance was significantly higher in starving patients than in both control groups. The left atrial dimension was significantly smaller in anorexia than in the women of normal weight and the thin women, independently of body size. The transmitral flow velocity E/A ratio was significantly higher in anorexia than in both the control groups because of the reduction of peak velocity A. When data from all three groups were pooled the flow velocity E/A ratio was inversely related to left atrial dimension (r = -0.43, p < 0.0001) and cardiac output (r = -0.64, p < 0.0001) independently of body size. CONCLUSIONS--Anorexia nervosa caused demonstrable abnormalities of mitral valve motion and reduced left ventricular mass and filling associated with systolic dysfunction. PMID:8142200

  15. Cardiac CT Angiography in Congestive Heart Failure.

    PubMed

    Levine, Avi; Hecht, Harvey S

    2015-06-01

    Cardiac CT angiography has become an important tool for the diagnosis and treatment of congestive heart failure. Differentiation of ischemic from nonischemic cardiomyopathy; evaluation of myocardial perfusion; characterization of hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia; and delineation of congenital heart defects and valvular abnormalities are the primary diagnostic applications. Therapeutic use includes visualization of the coronary venous anatomy for optimal implementation of cardiac resynchronization therapy and evaluation of left ventricular assist devices and transplant vasculopathy. PMID:26033904

  16. Pseudoaneurysm of the left ventricle.

    PubMed Central

    Mackenzie, J W; Lemole, G M

    1994-01-01

    Pseudoaneurysm of the left ventricle most often occurs after transmural myocardial infarction but may also follow cardiac operations, trauma, inflammation, or infection. In contrast to patients with true ventricular aneurysm, those with false aneurysm most commonly die of hemorrhage. Review of the reported surgical experience and of our 14 cases confirms that standard chest radiographs with an abnormal cardiac silhouette and rapidly expanding size may alert the physician to this sometimes overlooked diagnosis. Noninvasive tests such as color-flow Doppler echocardiography, 2-dimensional echocardiography, cineangiographic computed tomography, and transesophageal echocardiography allow relatively easy recognition of these apparently rare lesions with increasing frequency. Cardiac catheterization, however, is usually still necessary for a clear picture of the location and anatomy of the aneurysm and the state of the coronary arteries. Finally, a new classification is proposed, consisting of true aneurysm, false aneurysm, pseudo-false aneurysm, and mixed aneurysm. Images PMID:7888805

  17. Chamber propagation

    SciTech Connect

    Langdon, B.

    1991-01-16

    Propagation of a heavy ion beam to the target appears possible under conditions thought to be realizable by several reactor designs. Beam quality at the lens is believed to provide adequate intensity at the target -- but the beam must pass through chamber debris and its self fields along the way. This paper reviews present consensus on propagation modes and presents recent results on the effects of photoionization of the beam ions by thermal x-rays from the heated target. Ballistic propagation through very low densities is a conservative mode. The more-speculative self-pinched mode, at 1 to 10 Torr, offers reactor advantages and is being re-examined by others. 13 refs.

  18. Minimally invasive video-assisted thoracoscopic left ventricular epicardial lead implantation for biventricular pacing in a patient with persistent left superior vena cava

    Microsoft Academic Search

    Yukihiro Matsuno; Yoshio Mori; Yukio Umeda; Matsuhisa Imaizumi; Hiroshi Takiya

    2008-01-01

    Cardiac resynchronization therapy (CRT) by biventricular pacing reduces symptoms and improves left ventricular function in\\u000a many patients with heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony. Implantation of the\\u000a biventricular pacing lead in association with persistent left superior vena cava is technically challenging. We report a successful\\u000a case of minimally invasive video-assisted thoracoscopic left ventricular epicardial lead

  19. Congenital cardiac disease in dogs.

    PubMed

    Aronson, E; McCaw, D

    1984-09-01

    Aortic stenosis is a heritable cardiac anomaly most common in German Shepherds, Boxers and Newfoundlands, and less common in Pugs, English Bulldogs, Boston Terriers, Fox Terriers, Schnauzers and Bassets. Clinical signs are associated with secondary left-sided heart failure and include coughing, moist rales, exercise intolerance, arrhythmias and a weak femoral pulse. It causes an ejection-type crescendo-decrescendo, systolic murmur best heard on the left side near the elbow. The ECG may be normal or may show signs of left ventricular hypertrophy, including an axis of less than 40 degrees, a QRS complex of greater than 60 seconds in duration, R waves greater than 3 mv in amplitude, ST segment slurring or depression, or T waves of an amplitude greater than 25% of that of R waves. A LAT radiograph usually reveals an enlarged cardiac silhouette, loss of the cranial cardiac waist, and normal pulmonary vasculature, while DV projections show an elongated cardiac silhouette, rounding of the left ventricular border, and a normal descending aorta. Nonselective angiocardiography reveals poststenotic dilatation of the aorta. Treatment of severely affected dogs involves surgical correction. PMID:6482869

  20. An integrated platform for image-guided cardiac resynchronization therapy

    NASA Astrophysics Data System (ADS)

    Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.

    2012-05-01

    Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets by computing the registration error of the LV pacing lead electrodes which was found to be 2.2 ± 0.9 mm. Furthermore, the use of Unfold Navigation was demonstrated in real-time for four clinical cases.

  1. Non-invasive assessment of cardiac physiology by tissue Doppler echocardiography A comparison with invasive haemodynamics

    Microsoft Academic Search

    J. Zamorano; D. R. Wallbridge; J. Ge; J. Drozd; J. Nesser; R. Erbel

    Aim The purpose of this study was to determine the relationship of myocardial velocity patterns, as assessed by tissue Doppler echocardiography, to the contraction and relaxation phases of the cardiac cycle, as determined during cardiac catheterization. Methods Recordings of left ventricular\\/aortic and left ventricular\\/pulmonary wedge pressures were obtained sim- ultaneously with apical tissue Doppler echocardiographic images of the left ventricle.

  2. Brain Slice Chamber System

    E-print Network

    Kleinfeld, David

    Brain Slice Chamber System User's Manual BSC-BU Brain Slice Chamber System Base Unit MA1 65-0073 BSC-ZT Brain Slice Chamber System Zbicz Top MA1 65-0074 BSC-HT Brain Slice Chamber System Haas Top MA1 65-0075 BSC-PC Brain Slice Chamber System Prechamber MA1 65-0076 BSC-BUW Brain Slice Chamber Base

  3. REGIONAL CHANGES IN CARDIAC AND STELLATE GANGLION NOREPINEPHRINE TRANSPORTER IN DOCA-SALT HYPERTENSION

    PubMed Central

    Wehrwein, Erica A.; Novotny, Martin; Swain, Greg M.; Parker, Lindsay M.; Esfahanian, Mohammad; Spitsbergen, John M.; Habecker, Beth A.; Kreulen, David L.

    2013-01-01

    Uptake of norepinephrine via the neuronal norepinephrine transporter is reduced in the heart during deoxycorticosterone (DOCA)-salt hypertension. We hypothesized that this was due to reduced norepinephrine transporter mRNA and/or protein expression in the stellate ganglia and heart. After 4-weeks of DOCA-salt treatment there was no change in norepinephrine transporter mRNA in either the right or the left stellate ganglia from hypertensive rats (n=5–7, p>0.05). Norepinephrine transporter immunoreactivity in the left stellate ganglion was significantly increased (n=4, p<0.05) while the right stellate ganglion was unchanged (n=4, p>0.05). Whole heart norepinephrine content was significantly reduced in DOCA rats consistent with reduced uptake function; however, when norepinephrine was assessed by chamber, a significant decrease was noted only in the right atrium and right ventricle (n=6, p<0.05). Cardiac norepinephrine transport binding by chamber revealed that it was only reduced in the left atrium (n=5–7, p>0.05). Therefore, 1) contrary to our hypothesis reduced reuptake in the hypertensive heart is not exclusively due to an overall reduction in norepinephrine transporter mRNA or protein in the stellate ganglion or heart, and 2) norepinephrine transporter regulation occurs regionally in the heart and stellate ganglion in the hypertensive rat heart. PMID:24075956

  4. Left ventricular echocardiographic and histologic changes: Impact of chronic unloading by an implantable ventricular assist device

    Microsoft Academic Search

    Satoshi Nakatani; Patrick M. McCarthy; Kandice Kottke-Marchant; Hiroaki Harasaki; Karen B. James; Robert M. Savage; James D. Thomas

    1996-01-01

    Objectives. We studied the effects of chronic left ventricular unloading by a ventricular assist device and assessed left ventricular morphologic and histologic changes.Background. The implantable left ventricular assist device has been effective as a “bridge” to cardiac transplantation. Although there are reports documenting its circulatory support, little is known about the effects of chronic left ventricular unloading on the heart

  5. 8. EMPTY LOCK CHAMBER FROM DOWNSTREAM (WEST) END, WITH VISITORS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. EMPTY LOCK CHAMBER FROM DOWNSTREAM (WEST) END, WITH VISITORS CENTER (LEFT) AND LOCKMASTER'S HOUSE ON NORTH BANK. VIEW TO NORTHEAST. - Starved Rock Locks & Dam, Illinois Waterway River mile 231, Peru, La Salle County, IL

  6. Comparative analysis of oncofetal fibronectin and tenascin-C expression in right atrial auricular and left ventricular human cardiac tissue from patients with coronary artery disease and aortic valve stenosis

    Microsoft Academic Search

    Anja Baldinger; Bernhard R. Brehm; Petra Richter; Torsten Bossert; Katja Gruen; Khosro Hekmat; Hartwig Kosmehl; Dario Neri; Hans-Reiner Figulla; Alexander Berndt; Marcus Franz

    2011-01-01

    Aortic valve stenosis (AVS) and coronary artery disease (CAD) are accompanied by changes in the cardiac extra cellular matrix\\u000a (cECM) including the re-expression of oncofetal fibronectin (Fn) and tenascin-C (Tn-C) variants. Human antibodies against\\u000a these variants are usable for targeted therapy. Aim of the study was the comparative analysis of cECM remodelling in tissue\\u000a samples from right atrial auricle (RAA)

  7. Cardiac Catheterization

    MedlinePLUS

    ... done during a cardiac catheterization include: closing small holes inside the heart repairing leaky or narrow heart ... bandage. It's normal for the site to be black and blue, red, or slightly swollen for a ...

  8. Cardiac Sarcoidosis

    MedlinePLUS

    ... do at National Jewish Health? We provide comprehensive cardiology evaluation and consultation and non-invasive cardiac testing. ... the whole person, not just the disease. Our cardiology team works with healthcare providers from all areas ...

  9. Underwater welding test chamber

    Microsoft Academic Search

    Berghof

    1975-01-01

    An apparatus is described which is capable of testing a small hand-held welding chamber for use in underwater welding. Specifically, the apparatus includes 2 interconnected chambers, one being elevated above the other. Within the lower chamber, there is a plate on which is positioned a workpiece to be welded. The welding chamber, a tubular welding housing having a side aperture

  10. Nuclear cardiac

    SciTech Connect

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques. (KRM)

  11. Comparison of Left Ventricular Electromechanical Mapping and Left Ventricular Angiography

    PubMed Central

    Sarmento-Leite, Rogerio; Silva, Guilherme V.; Dohman, Hans F.R.; Rocha, Ricardo Mourilhe; Dohman, Hans J.F.; de Mattos, Nelson Durval S.G.; Carvalho, Luis Antonio; Gottschall, Carlos A.M.; Perin, Emerson C.

    2003-01-01

    We performed this prospective cohort study to correlate the findings of left ventricular angiography (LVA) and NOGA™ left ventricular electromechanical mapping (LVEM) in the evaluation of cardiac wall motion and also to establish standards for wall motion assessment by LVEM. Fifty-five patients (35 men; mean age, 60.4 ± 11.8 years) eligible for elective left cardiac catheterization underwent LVA and LVEM. Wall motion scores, LV ejection fractions (LVEF), and LV volumes derived from LVA versus LVEM data were compared and analyzed statistically. Receiver operating characteristic (ROC) curves were used to assess the accuracy of LVEM in distinguishing between normal, hypokinetic, and akinetic/dyskinetic wall motion. Mean LVEM procedure time was 37 ± 11 minutes. The LVEM and LVA findings differed for mean LVEF (55% ± 13% vs 36% ± 9%), mean end-systolic volume (56 ± 13 mL vs 36 ± 10 mL), and mean end-diastolic volume (174 ± 104 mL vs 123 ± 65 mL). Mean wall motion scores (± SD) for normokinetic, hypokinetic, and akinetic/dyskinetic segments were 13.9% ± 5.6%, 8.3% ± 5.2%, and 3.2% ± 3.1%, respectively. Cutpoints for differentiating between wall motion types were 12% and 6%. The ROC curves showed LVEM to have a 93% accuracy in differentiating between normokinetic and akinetic/dyskinetic segments and a 73% accuracy between normokinetic and hypokinetic segments. These data suggest that LVEM can differentiate between normal and abnormal cardiac wall motion, although it is more accurate at differentiating between normokinetic and akinetic/dyskinetic motion than between normokinetic and hypokinetic motion. (Tex Heart Inst J 2003;30:19–26) PMID:12638666

  12. Unbiased stratification of left ventricles.

    PubMed

    Srinivasan, Rajagopalan; Shriram, K S; Suryanarayanan, Srikanth

    2008-01-01

    Image based quantitative stratification of the Left Ventricles (LV) across a population helps in unraveling the structure-function symbiosis of the heart. An unbiased, reference less grouping scheme that automatically determines the number of clusters and a physioanatomically relevant strategy that aligns the intra cluster LV shapes would enable the robust construction of pathology stratified cardiac atlas. This paper achieves this hitherto elusive stratification and alignment by adapting the conventional strategies routinely followed by clinicians. The individual LV shape models (N=127) are independently oriented to an "attitudinally consistent orientation" that captures the physioanatomic variations of the LV morphology. Affinity propagation technique based on the automatically identified inter-LV_landmark distances is used to group the LV shapes. The proposed algorithm is computationally efficient and, if the inter cluster variations are linked to pathology, could provide a clinically relevant cardiac atlas. PMID:18979790

  13. Cardiac arrest in kearns-sayre syndrome.

    PubMed

    van Beynum, Ingrid; Morava, Eva; Taher, Marjan; Rodenburg, Richard J; Karteszi, Judit; Toth, Kalman; Szabados, Eszter

    2012-01-01

    The prognosis of progressive ophthalmoplegia in patients with large-scale mitochondrial DNA deletions is highly variable and almost unpredictable. The risk to develop cardiac involvement and sudden cardiac death is strikingly high, especially in patients with Kearns-Sayre syndrome (KSS). The most typical cardiac complications of the disease are conduction defects, which usually begin with left anterior fascicular block with or without right bundle branch block (RBBB), progressing sometimes rapidly to complete atrioventricular block. Other cardiac manifestations reported are first or second degree of AV block, QT prolongation, torsades de pointes ventricular tachycardia, and rarely dilated cardiomyopathy. Most frequently syncope, sometimes even sudden cardiac death, is the first clinical sign of the cardiac disease in KSS. Due to these life-threatening cardiac conditions, patients should be carefully monitored for cardiac signs and symptoms and pacemaker implantation should be suggested early to avoid sudden cardiac arrest in KSS.Here, we present two cases of KSS with life-threatening syncope due to complete atrioventricular block. To emphasize the importance of an early pacemaker implantation, we review the literature on cardiac complications in KSS in the last 20 years. In almost all of the reviewed cases, ophthalmoplegia or ptosis was present before the cardiac manifestations. In most of the cases, syncope was the first symptom of the cardiac involvement. There was no correlation between the age of the onset of the disease and the onset of cardiac manifestations.With our current report, we increase awareness for life-threatening cardiac complications in patients with KSS. PMID:23430846

  14. Segmentation of the Left Heart Ventricle in Ultrasound Images Using a Region Based Snake

    E-print Network

    Lunds Universitet

    Segmentation of the Left Heart Ventricle in Ultrasound Images Using a Region Based Snake Matilda that uses a region based snake. To avoid any unwanted concavities in the segmentations due to the cardiac valve we use two anchor points in the snake that are located to the left and to the right of the cardiac

  15. Cardiac compartment-specific overexpression of a modified retinoic acid receptor produces dilated cardiomyopathy and congestive heart failure in transgenic mice.

    PubMed Central

    Colbert, M C; Hall, D G; Kimball, T R; Witt, S A; Lorenz, J N; Kirby, M L; Hewett, T E; Klevitsky, R; Robbins, J

    1997-01-01

    Retinoids play a critical role in cardiac morphogenesis. To examine the effects of excessive retinoid signaling on myocardial development, transgenic mice that overexpress a constitutively active retinoic acid receptor (RAR) controlled by either the alpha- or beta-myosin heavy chain (MyHC) promoter were generated. Animals carrying the alpha-MyHC-RAR transgene expressed RARs in embryonic atria and in adult atria and ventricles, but developed no signs of either malformations or disease. In contrast, beta-MyHC-RAR animals, where expression was activated in fetal ventricles, developed a dilated cardiomyopathy that varied in severity with transgene copy number. Characteristic postmortem lesions included biventricular chamber dilation and left atrial thrombosis; the incidence and severity of these lesions increased with increasing copy number. Transcript analyses showed that molecular markers of hypertrophy, alpha-skeletal actin, atrial natriuretic factor and beta-MyHC, were upregulated. Cardiac performance of transgenic hearts was evaluated using the isolated perfused working heart model as well as in vivo, by transthoracic M-mode echocardiography. Both analyses showed moderate to severe impairment of left ventricular function and reduced cardiac contractility. Thus, expression of a constitutively active RAR in developing atria and/ or in postnatal ventricles is relatively benign, while ventricular expression during gestation can lead to significant cardiac dysfunction. PMID:9329959

  16. Late onset seroma post-thymectomy presenting as cardiac tamponade

    PubMed Central

    Poudel, Dilli Ram; Giri, Smith; Pathak, Ranjan; Morsey, Mohamed; Alsafwah, Shadwan

    2015-01-01

    Late onset seroma is a rare post-operative complication occurring after various surgeries including thymectomy. Most cases are asymptomatic; however, seromas occurring in the mediastinal cavity may cause compression symptoms including airway compression or cardiac tamponade. We present a 62-year-old male with a history of thymectomy for myasthenia gravis who presented with cardiac tamponade several years ago. Further evaluation revealed a late onset seroma anteriorly compressing the cardiac chambers resulting in tamponade physiology. PMID:26091658

  17. 7. SEDIMENTATION CHAMBER AT 520', CONSTRUCTED 19371938, VIEWED FROM DOWNSTREAM. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. SEDIMENTATION CHAMBER AT 520', CONSTRUCTED 1937-1938, VIEWED FROM DOWNSTREAM. DEBRIS REMOVED FROM TOP PLANKS FOR CLARITY. ONE OF TWO SPILLWAYS SEEN AT RIGHT. FLUSH VALVE SEEN AT LOWER LEFT AND WRENCH FOR VALVES IS PROPPED AGAINST CHAMBER. - Kalaupapa Water Supply System, Waikolu Valley to Kalaupapa Settlement, Island of Molokai, Kalaupapa, Kalawao County, HI

  18. Improved Bakeout Chambers Within Vacuum Chambers

    NASA Technical Reports Server (NTRS)

    Johnson, Kenneth R.; Taylor, Daniel M.; Lane, Robert W.; Cortez, Maximo G.; Anderson, Mark R.

    1995-01-01

    Improved bakeout chamber incorporates hardware features that, in conjunction with improved bakeout procedure, reduce spurious contamination and increase accuracy of contamination measurements. When operated according to revised bakeout procedure, they yield measurements of contamination on vacuum-bake test articles more accurate than available previously, and potential for post-bake recontamination of vacuum-baked articles reduced. These chambers improved versions of one described in "Bakeout Chamber Within Vacuum Chamber" (NPO-18959). By enclosing test article in enclave and keeping walls of enclave hotter than test article during bakeout, one prevents condensation of contaminants on inner walls of enclave.

  19. 8. SEDIMENTATION CHAMBER, VIEW UPSTREAM (PLANK COVER REMOVED FOR CLARITY). ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. SEDIMENTATION CHAMBER, VIEW UPSTREAM (PLANK COVER REMOVED FOR CLARITY). BOX FLUME DROPS SLIGHTLY INTO CHAMBER ON LEFT SIDE. CHAMBER IS A SERIES OF BAFFLES DESIGNED TO SLOW THE FLOW OF WATER. FLOW IS REDUCED TO ALLOW PARTICULATES TO SETTLE TO THE BOTTOM. TWO SCREENS (NOT SHOWN) FILTER LARGER DEBRIS. - Kalaupapa Water Supply System, Waikolu Valley to Kalaupapa Settlement, Island of Molokai, Kalaupapa, Kalawao County, HI

  20. Impact of heart failure and left ventricular systolic dysfunction on quality of life. A cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population

    Microsoft Academic Search

    F. D. R. Hobbs; J. E. Kenkre; A. K. Roalfe; R. C. Davis; R. Hare; M. K. Davies

    2002-01-01

    Background Heart failure and left ventricular systolic dysfunction (LVSD) are increasingly common disorders, with outcomes worse than many cancers. Evidence-based therapies, such as ACE inhibitors and beta-blockers, improve prognosis and symptoms, and reduce healthcare expenditure. However, despite the high prevalence and malignant prognosis, few studies have reported the impact of heart failure and LVSD on overall quality of life and,

  1. 12. VIEW, LOOKING SOUTH FROM LEFT TO RIGHT, SHOWING DRESSING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. VIEW, LOOKING SOUTH FROM LEFT TO RIGHT, SHOWING DRESSING FROM AND WORK/CHAMBER ROOM - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  2. Old Riverdale Cotton Mill office building on left. The old ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Old Riverdale Cotton Mill office building on left. The old office building has also been used as a starch mixing house. Note entrance to new office building on right - Riverdale Cotton Mill, Office Building, Old, Valley, Chambers County, AL

  3. A Randomized Controlled Trial to Evaluate the Safety and Efficacy of Cardiac Contractility Modulation in Patients With Moderately Reduced Left Ventricular Ejection Fraction and a Narrow QRS Duration: Study Rationale and Design

    PubMed Central

    ABRAHAM, WILLIAM T.; LINDENFELD, JOANN; REDDY, VIVEK Y.; HASENFUSS, GERD; KUCK, KARL-HEINZ; BOSCARDIN, JOHN; GIBBONS, ROBERT; BURKHOFF, DANIEL

    2015-01-01

    Cardiac contractility modulation (CCM) signals are nonexcitatory electrical signals delivered during the cardiac absolute refractory period that enhance the strength of cardiac muscular contraction. The FIX-HF-5 study was a prospective randomized study comparing CCM plus optimal medical therapy (OMT) to OMT alone that included 428 New York Heart Association (NYHA) functional class III or IV heart failure patients with ejection fraction (EF) ?45% according to core laboratory assessment. The study met its primary safety end point, but did not reach its primary efficacy end point: a responders analysis of changes in ventilatory anaerobic threshold (VAT). However, in a prespecified subgroup analysis, significant improvements in primary and secondary end points, including the responder VAT end point, were observed in patients with EFs ranging from 25% to 45%, who constituted about one-half of the study subjects. We therefore designed a new study to prospectively confirm the efficacy of CCM in this population. A hierarchic bayesian statistical analysis plan was developed to take advantage of the data already available from the first study. In addition, based on technical difficulties encountered in reliably quantifying VAT and the relatively large amount of nonquantifiable studies, the primary efficacy end point was changed to peak VO2, with significant measures incorporated to minimize the influence of placebo effect. In this paper, we provide the details and rationale of the FIX-HF-5C study design to study CCM plus OMT compared with OMT alone in subjects with normal QRS duration, NYHA functional class III or IV, and EF 25%–45%. This study is registered on www.clinicaltrials.gov with identifier no. NCT01381172. PMID:25285748

  4. Left-sided biventricular pacemaker implantation in the presence of persistent left superior vena cava.

    PubMed

    Sankhla, Vineet; Vajifdar, Bhavesh; Shah, Mandar; Lokhandwala, Yash

    2010-01-01

    Persistent Left Superior Vena Cava (PLSVC) is the most common thoracic venous anomaly encountered during device implantation. The most common problems related to the unusual anatomic access to the heart are reaching a convenient pacing site and ensuring stable lead placement. This report describes left sided implantation of RA, RV and LV leads in a patient with a PLSVC who was referred for cardiac resynchronizaiton therapy. The literature regarding the interventional approach for device implantation in patients with PLSVC is reviewed. PMID:21280477

  5. What type of different clinical manifestations can cardiac sarcoidosis present?

    PubMed

    ?entürk, Ay?egül; Mara?, Yüksel; Argüder, Emine; Karalezli, Ay?egül; Hasano?lu, H Canan; Ö?üt, Tuba; Ba?tu?, Serdal; Karabekir, Ercan

    2015-06-01

    Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45 %. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement. PMID:25429793

  6. Supravalvular aortic stenosis with sudden cardiac death

    PubMed Central

    Vaideeswar, Pradeep; Regi, Preet

    2015-01-01

    Sudden cardiac death (SCD) most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS) due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  7. Best evidence topic - Cardiac general Does cardiac resynchronisation therapy improve survival and quality of life in patients with end-stage heart failure?

    Microsoft Academic Search

    Andrew J. Turley; Shahzad G. Raja; Kareem Salhiyyah; Kumaresan Nagarajan

    2010-01-01

    Summary A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether bi- ventricular pacing, also referred to as cardiac resynchronisation therapy (CRT), improves survival and quality of life in patients with severe (NYHA IIIyIV) symptomatic heart failure. Cardiac pacing can be achieved by stimulation of the right ventricle, left ventricle (LV

  8. Motion Extraction for Left Ventricular Volume Measurement

    Microsoft Academic Search

    Manfred Tasto

    1974-01-01

    Methods to automatically determine the boundary of left heart chambers from X-ray films (cineangiocardiograms) by computer are discussed. Several authors have considered entering a first approximation to the boundary manually by light-pen, and then letting the computer determine the exact boundary from successive frames automatically. A method to do the first step automatically as well is proposed in this paper,

  9. Cardiac sarcoidosis

    PubMed Central

    Smedema, J.P.; Zondervan, P.E.; van Hagen, P.; ten Cate, F.J.; Bresser, P.; Doubell, A.F.; Pattynama, P.; Hoogsteden, H.C.; Balk, A.H.M.M.

    2002-01-01

    Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology. Symptomatic cardiac involvement occurs in approximately 5% of patients. The prevalence of sarcoidosis in the Netherlands is unknown, but estimated to be approximately 20 per 100,000 population (3200 patients). We report on five patients who presented with different manifestations of cardiac sarcoidosis, and give a brief review on the current management of this condition. Magnetic Resonance Imaging (MRI) can be of great help in diagnosing this condition as well as in the follow-up of the response to therapy. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:25696121

  10. Analysis of cardiac function by MRI and stereology.

    PubMed

    Roberts, N; Cruz-Orive, L M; Bourne, M; Herfkens, R J; Karwoski, R A; Whitehouse, G H

    1997-07-01

    Design-based stereology and phase contrast magnetic resonance imaging (MRI) were combined to monitor changes in the volume of the four chambers of the human heart during the cardiac cycle. The data set consisted of 18 adjacent slices (or 'scanning levels') of 0.5 cm thickness, perpendicular to the long axis of the body, and encompassing the whole heart of a healthy volunteer. At each scanning level, a cardiac gated MR image was obtained at each of 16 equally spaced time frames within the cardiac cycle. Given stationarity with respect to time, absence of image artefacts and appropriate definition of chamber boundaries, for each time frame unbiased estimates of total blood volume in the relevant heart chambers were efficiently obtained using the Cavalieri method and point counting. Combined with a proper MRI acquisition, modern stereological methods constitute an efficient and reliable tool to quantify cardiac function noninvasively. PMID:9263438

  11. Relationship of Exercise Capacity and Left Ventricular Dimensions in Patients with a Normal Ejection Fraction. An Exploratory Study

    PubMed Central

    Nyotowidjojo, Iwan; Chu, Guoxiang; LeWinter, Martin M.

    2015-01-01

    Objectives Extreme endurance exercise is known to be associated with an enlargement of the left ventricular (LV) chamber, whereas inactivity results in inverse changes. It is unknown if these dimensional relationships exist in patients. Methods We analyzed the relationship of exercise capacity and LV dimension in a cohort of sequential patients with a normal ejection fraction undergoing stress echocardiography. In a total of 137 studies the following questions were addressed: (a) is there a difference in LV dimensions of patients with an excellent exercise capacity versus patients with a poor exercise capacity, (b) how is LV dimension and exercise capacity affected by LV wall thickness and (c) how do LV dimensions of patients who are unable to walk on a treadmill compare to the above groups. Results Patients with a poor exercise capacity or who are unable to physically exercise have a 34 percent smaller LV cavity size when compared to patients with an excellent exercise capacity (p<0.001). This reduction in LV chamber size is associated with concentric LV hypertrophy and a reciprocal increase in resting heart rate. In addition, cardiac output reserve is further blunted by chronotropic incompetence and a tachycardia-induced LV volume reduction. In conclusion the relationship of exercise capacity and cardiac dimensions described in extreme athletes also applies to patients. Our exploratory analysis suggests that patients who cannot sufficiently exercise have small LV cavities. PMID:25756359

  12. 3-D Imaging of the Heart Chambers with C-arm CT

    E-print Network

    Fiebig, Peter

    3-D Imaging of the Heart Chambers with C-arm CT 3D-Bildgebung der Herzkammern mit C-Bogen-CT Der to now, high resolution 2-D X-ray images are acquired with a C-arm system in standard views of the cardiac chambers can be performed in 3-D. In the last years, cardiac imaging in 3-D using a C-arm system

  13. Myocardial Fibrosis in Hypertrophic Cardiomyopathy Demonstrated by Integrated Cardiac F-18 FDG PET/MR.

    PubMed

    Kong, Eun-Jung; Lee, Sang-Hee; Cho, Ihn-Ho

    2013-09-01

    Hypertrophic cardiomyopathy (HCM) is a common condition defined as a diffuse or segmental left ventricular (LV) hypertrophy with a nondilated and hyperdynamic chamber as well as cardiac arrhythmias. Cardiac MR (CMR) imaging is a key modality for evaluation of HCM. In addition to the assessment of LV wall thickness, LV function and aortic flow, CMR is capable of estimation of late gadolinium enhancement (LGE) in affected myocardium which has been shown to have a direct correlation with incidence and severity of arrhythmias in HCM. In patients with HCM, LGE on CMR is presumed to represent intramyocardial fibrosis. Meanwhile, F-18 FDG myocardial PET has been sporadically studied in HCM, mostly for evaluation of the metabolic status of a hypertrophic myocardial segment, especially after interventions or to demonstrate partial myocardial fibrosis. We presented here the case of a 25-year-old male patient referred for simultaneous F-18 FDG cardiac PET/MR for the evaluation of septal hypertrophy. The PET/MR revealed myocardial fibrosis in the septum associated with FDG-defect and LGE. PMID:24900107

  14. Proven cardiac changes during death-feigning (tonic immobility) in rabbits (Oryctolagus cuniculus).

    PubMed

    Giannico, Amália Turner; Lima, Leandro; Lange, Rogério Ribas; Froes, Tilde Rodrigues; Montiani-Ferreira, Fabiano

    2014-04-01

    Tonic immobility (TI) is a response to fear or threat by remaining motionless, principally when attacked by predators from which there is no possibility of escape. Thus, here we demonstrate a way of easily reproducing this phenomenon in a laboratory setting and characterize the cardiac electromechanical alterations during TI. We observed a significant decrease in heart rate (HR) and changes of rhythm in electrocardiogram during TI in rabbits. Echocardiogram showed a significant increase in the left ventricle chamber diameter during systole and a consequent decrease in fractional shortening and ejection fraction, in addition to the HR and rhythm changes. There was also a significant decrease in aortic and pulmonary artery blood flow. Diastolic functional changes included a significant decrease of the peak atrial contraction velocity (A peak) and consequent increase in the ratio of peak early diastolic velocity to A peak and increased isovolumetric relaxation time. We were able to prove that TI changes the cardiac function considerably. Although the "fight-or-flight" response is the most common response to fear, which is characterized by the action of sympathetic nervous system with tachycardia and increased physical activity, TI is an alternative anti-predator behavior causing cardiac changes opposite to the "fight-or-flight" phenomenon. PMID:24515628

  15. The interference threshold of unipolar cardiac pacemakers in extremely low frequency magnetic fields.

    PubMed

    Scholten, A; Silny, J

    2001-01-01

    The effective induction loop area of implanted cardiac pacemaker (CPM) systems in magnetic fields was determined. The results were verified in a tank model placed in the centre of a Helmholtz-coil-arrangement. Both a left and a right pectorally implanted unipolar dual chamber CPM system were simulated. On this basis and with the results of benchmark-tests the interference thresholds for a collection of modern CPMs in extremely low frequency (ELF) magnetic fields were estimated. The investigations clearly showed that there are two loops, the CPM-lead-tissue-loop and the body loop, responsible for the magnitude of the disturbance voltage on the input of a cardiac pacemaker. The effective induction loop areas rangedfrom 100 to 221 cm2. For a left pectorally implanted, atrially controlled CPM system the interference thresholds for the magnetic induction lay between 16 and 552 micro T (RMS) for frequencies of the magneticfield between 10 and 250 Hz. Thus, there is a limited possibility for an interference of implanted CPM by ELF magnetic fields in everyday life. PMID:11695658

  16. Two chamber reaction furnace

    DOEpatents

    Blaugher, R.D.

    1998-05-05

    A vertical two chamber reaction furnace is described. The furnace comprises a lower chamber having an independently operable first heating means for heating the lower chamber and a gas inlet means for admitting a gas to create an ambient atmosphere, and an upper chamber disposed above the lower chamber and having an independently operable second heating means for heating the upper chamber. Disposed between the lower chamber and the upper chamber is a vapor permeable diffusion partition. The upper chamber has a conveyor means for conveying a reactant there through. Of particular importance is the thallinating of long-length thallium-barium-calcium-copper oxide (TBCCO) or barium-calcium-copper oxide (BCCO) precursor tapes or wires conveyed through the upper chamber to thereby effectuate the deposition of vaporized thallium (being so vaporized as the first reactant in the lower chamber at a temperature between about 700 C and 800 C) on TBCCO or BCCO tape or wire (the second reactant) at its simultaneous annealing temperature in the upper chamber of about 800 to 950 C to thereby replace thallium oxide lost from TBCCO tape or wire because of the high annealing temperature or to deposit thallium on BCCO tape or wire. Continuously moving the tape or wire provides a single-step process that effectuates production of long-length TBCCO superconducting product. 2 figs.

  17. Evaluation of Carbon Dioxide Dissipation within a Euthanasia Chamber

    PubMed Central

    Djoufack-Momo, Shelly M; Amparan, Ashlee A; Grunden, Beverly; Boivin, Gregory P

    2014-01-01

    CO2 euthanasia is used widely for small laboratory animals, such as rodents. A common necessity in many animal research facilities is to euthanize mice in sequential batches. We assessed the effects of several variables on the time it took for CO2 to dissipate within a chamber. Using standard euthanasia time, changes in flow rate were compared between a slow 15% fill rate for 7 min, and a slow 15% followed by a rapid 50% filling for a total of 5 min. Additional variables assessed included the effects of opening the lid after the completion of chamber filling, turning the chamber over after completion of filling, and the use and removal of a cage from within the chamber. For all trials, CO2 levels in the chambers peaked between 50% and 80%. After the gas was turned off, the concentration of CO2 dropped to below 10% CO2 within 2 min, except when the lid was left on the chamber, where concentration levels remained above 10% after 20 min. CO2 dissipation was significantly faster when the chamber was turned upside down after filling. Significant interaction effects occurred among the factors of cage presence within the chamber, flow rate, and chamber position. Only leaving the lid on the chamber had any practical implication for delaying CO2 dissipation. We recommend that users allow 2 min for CO2 to clear from the chamber before subsequent euthanasia procedures, unless the chamber is manipulated to increase the dissipation rate. PMID:25199098

  18. Photocopy of drawing. ALTITUDE CHAMBER LIGHTING MODS., O&C BUILDING. NASA, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of drawing. ALTITUDE CHAMBER LIGHTING MODS., O&C BUILDING. NASA, John F. Kennedy Space Center, Florida. Drawing 203-644, U.S. Army Corps of Engineers, May, 1967. LIGHTING LAYOUT, LEFT CHAMBER. Sheet 5 - Cape Canaveral Air Force Station, Launch Complex 39, Altitude Chambers, First Street, between Avenue D and Avenue E, Cape Canaveral, Brevard County, FL

  19. Contour extraction from cardiac MRI studies using snakes

    Microsoft Academic Search

    Surendra Ranganath

    1995-01-01

    The author investigated automatic extraction of left ventricular contours from cardiac magnetic resonance imaging (MRI) studies. The contour extraction algorithms were based on active contour models, or snakes. Based on cardiac MR image characteristics, the author suggested algorithms for extracting contours from these large data sets. The author specifically considered contour propagation methods to make the contours reliable enough despite

  20. Homogeneity of Cardiac Contraction Despite Physiological Asynchrony of Depolarization: A Model Study

    Microsoft Academic Search

    R. C. P. Kerckhoffs; P. H. M. Bovendeerd; J. C. S. Kotte; F. W. Prinzen; K. Smits; T. Arts

    2003-01-01

    The use of mathematical models combining wave propagation and wall mechanics may provide new insights in the interpretation of cardiac deformation toward various forms of cardiac pathology. In the present study we investigated whether combining accepted mechanisms on propagation of the depolarization wave, time variant mechanical properties of cardiac tissue after depolarization, and hemodynamic load of the left ventricle (LV)

  1. Taxol, a Microtubule Stabilizer, Improves Cardiac Contractile Function during Ischemia in vitro

    Microsoft Academic Search

    Junjie Xiao; Hong Zhao; Dandan Liang; Ying Liu; Hong Zhang; Yi Liu; Jun Li; Luying Peng; Zhaonian Zhou; Yi-Han Chen

    2010-01-01

    Ischemic heart disease is one of the leading causes of heart failure, and microtubule disruption has been implicated in the response to ischemia in cardiac myocytes. The present study was designed to explore the effects of taxol, a microtubule stabilizer, on cardiac contractile function during ischemia. Heart rate, left ventricular developed pressure, left ventricular end-diastolic pressure, maximal time derivatives of

  2. Cardiac Circulation

    NSDL National Science Digital Library

    PhD Jack D Thatcher (West Virginia School of Osteopathic Medicine Structural Biology)

    2009-11-20

    This simple FlashTM animation depicts blood flow through the great vessels and chambers of the mature heart. Clicking brings up labels. A second click brings up arrows defining venous flow. A third click brings up arrows tracing the arterial flow.

  3. Mechanisms of decreased left ventricular preload during continuous positive pressure ventilation in ARDS

    Microsoft Academic Search

    J. F. Dhainaut; J. Y. Devaux; J. F. Monsallier; F. Brunet; D. Villemant; M. F. Huyghebaert

    1986-01-01

    Continuous positive pressure ventilation is associated with a reduction in left ventricular preload and cardiac output, but the mechanisms responsible are controversial. The decrease in left ventricular preload may result exclusively from a decreased systemic venous return due to increased pleural pressure, or from an additional effect such as decreased left ventricular compliance. To determine the mechanisms responsible, we studied

  4. [Implantation of a biventricular pacing system via a persistent left-sided superior vena cava].

    PubMed

    Gorr, E; Grove, R; Weitkamp, P; Kranig, W; Thale, J

    2004-10-01

    Cardiac resynchronization therapy by multisite biventricular pacing presents an additive therapeutic option in the treatment of severe heart failure. Biventricular pacemaker implantation is challenging in patients with persistent left superior vena cava. We describe in this case report the implantation of a biventricular pacemaker using a left-sided approach in a patient with persistent left superior vena cava. PMID:15492897

  5. Reproducibility of cine displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance for measuring left ventricular strains, torsion, and synchrony in mice

    PubMed Central

    2013-01-01

    Background Advanced measures of cardiac function are increasingly important to clinical assessment due to their superior diagnostic and predictive capabilities. Cine DENSE cardiovascular magnetic resonance (CMR) is ideal for quantifying advanced measures of cardiac function based on its high spatial resolution and streamlined post-processing. While many studies have utilized cine DENSE in both humans and small-animal models, the inter-test and inter-observer reproducibility for quantification of advanced cardiac function in mice has not been evaluated. This represents a critical knowledge gap for both understanding the capabilities of this technique and for the design of future experiments. We hypothesized that cine DENSE CMR would show excellent inter-test and inter-observer reproducibility for advanced measures of left ventricular (LV) function in mice. Methods Five normal mice (C57BL/6) and four mice with depressed cardiac function (diet-induced obesity) were imaged twice, two days apart, on a 7T ClinScan MR system. Images were acquired with 15–20 frames per cardiac cycle in three short-axis (basal, mid, apical) and two long-axis orientations (4-chamber and 2-chamber). LV strain, twist, torsion, and measures of synchrony were quantified. Images from both days were analyzed by one observer to quantify inter-test reproducibility, while inter-observer reproducibility was assessed by a second observer’s analysis of day-1 images. The coefficient of variation (CoV) was used to quantify reproducibility. Results LV strains and torsion were highly reproducible on both inter-observer and inter-test bases with CoVs???15%, and inter-observer reproducibility was generally better than inter-test reproducibility. However, end-systolic twist angles showed much higher variance, likely due to the sensitivity of slice location within the sharp longitudinal gradient in twist angle. Measures of synchrony including the circumferential (CURE) and radial (RURE) uniformity of strain indices, showed excellent reproducibility with CoVs of 1% and 3%, respectively. Finally, peak measures (e.g., strains) were generally more reproducible than the corresponding rates of change (e.g., strain rate). Conclusions Cine DENSE CMR is a highly reproducible technique for quantification of advanced measures of left ventricular cardiac function in mice including strains, torsion and measures of synchrony. However, myocardial twist angles are not reproducible and future studies should instead report torsion. PMID:23981339

  6. Cardiac troponin levels in heart failure.

    PubMed

    Potluri, Srinivasa; Ventura, Hector O; Mulumudi, Mahesh; Mehra, Mandeep R

    2004-01-01

    Congestive heart failure (CHF) is a major cardiovascular disorder that is increasing in incidence, prevalence, and lethality. The prognostic significance of cardiac troponin levels among symptomatic and asymptomatic CHF has attracted recent interest. We sought to assess the significance of cardiac troponins in heart failure. These cardiac markers are associated with decreased left ventricular ejection fraction and poor prognosis in patients with CHF and are related to the severity of heart failure. The mechanism for the release of these markers seems to be from ventricular remodeling, ongoing myocyte degeneration, the presence of coronary artery disease, and reduced coronary reserve. In addition to B-type (brain) natriuretic peptide (BNP), cardiac troponin levels measured in patients admitted to the hospital could help risk-stratify patients and manage them effectively. BNP and cardiac troponins are easy to measure and can be repeated many times to follow patients, without interobserver variability. Theoretically, BNP is a marker of heart failure status and cardiac troponin is a marker of myocyte injury. The first therapeutic goal could be relief of circulatory congestion and lowering of BNP. The second goal could be attenuation of myocyte injury and lowering of cardiac troponins. Measuring and monitoring the levels of both could be highly effective means to reliably stratify the patients into low-, intermediate-, and high-risk groups for cardiac events and progression of heart failure. Furthermore, large-scale trials are necessary to establish them as noninvasive monitoring markers of heart failure and effectiveness of treatment. PMID:14667259

  7. Cardiac Arrhythmias

    Microsoft Academic Search

    William J. Bonney; Ra-id Abdulla

    \\u000a An initial and crucial step in managing any child with a cardiac arrhythmia is to determine the hemodynamic stability of the\\u000a child. A healthy pink color of skin\\/mucosa, brisk capillary refill, good peripheral pulses, normal blood pressure, and absence\\u000a of respiratory distress are all reassuring signs that the hemodynamic status of the child is normal or near normal. Stable\\u000a hemodynamics

  8. Increase in cardiac myosin heavy-chain (MyHC) alpha protein isoform in hibernating ground squirrels, with echocardiographic visualization of ventricular wall hypertrophy and prolonged contraction.

    PubMed

    Nelson, O Lynne; Rourke, Bryan C

    2013-12-15

    Deep hibernators such as golden-mantled ground squirrels (Callospermophilus lateralis) have multiple challenges to cardiac function during low temperature torpor and subsequent arousals. As heart rates fall from over 300 beats min(-1) to less than 10, chamber dilation and reduced cardiac output could lead to congestive myopathy. We performed echocardiography on a cohort of individuals prior to and after several months of hibernation. The left ventricular chamber exhibited eccentric and concentric hypertrophy during hibernation and thus calculated ventricular mass was ~30% greater. Ventricular ejection fraction was mildly reduced during hibernation but stroke volumes were greater due to the eccentric hypertrophy and dramatically increased diastolic filling volumes. Globally, the systolic phase in hibernation was ~9.5 times longer, and the diastolic phase was 28× longer. Left atrial ejection generally was not observed during hibernation. Atrial ejection returned weakly during early arousal. Strain echocardiography assessed the velocity and total movement distance of contraction and relaxation for regional ventricular segments in active and early arousal states. Myocardial systolic strain during early arousal was significantly greater than the active state, indicating greater total contractile movement. This mirrored the increased ventricular ejection fraction noted with early arousal. However, strain rates were slower during early arousal than during the active period, particularly systolic strain, which was 33% of active, compared with the rate of diastolic strain, which was 67% of active. As heart rate rose during the arousal period, myocardial velocities and strain rates also increased; this was matched closely by cardiac output. Curiously, though heart rates were only 26% of active heart rates during early arousal, the cardiac output was nearly 40% of the active state, suggesting an efficient pumping system. We further analyzed proportions of cardiac myosin heavy-chain (MyHC) isoforms in a separate cohort of squirrels over 5 months, including time points before hibernation, during hibernation and just prior to emergence. Hibernating individuals were maintained in both a 4°C cold room and a 20°C warm room. Measured by SDS-PAGE, relative percentages of cardiac MyHC alpha were increased during hibernation, at both hibernacula temperatures. A potential increase in contractile speed, and power, from more abundant MyHC alpha may aid force generation at low temperature and at low heart rates. Unlike many models of cardiomyopathies where the alpha isoform is replaced by the beta isoform in order to reduce oxygen consumption, ground squirrels demonstrate a potential cardioprotective mechanism to maintain cardiac output during torpor. PMID:24072796

  9. Increase in cardiac myosin heavy-chain (MyHC) alpha protein isoform in hibernating ground squirrels, with echocardiographic visualization of ventricular wall hypertrophy and prolonged contraction

    PubMed Central

    Nelson, O. Lynne; Rourke, Bryan C.

    2013-01-01

    SUMMARY Deep hibernators such as golden-mantled ground squirrels (Callospermophilus lateralis) have multiple challenges to cardiac function during low temperature torpor and subsequent arousals. As heart rates fall from over 300 beats min?1 to less than 10, chamber dilation and reduced cardiac output could lead to congestive myopathy. We performed echocardiography on a cohort of individuals prior to and after several months of hibernation. The left ventricular chamber exhibited eccentric and concentric hypertrophy during hibernation and thus calculated ventricular mass was ~30% greater. Ventricular ejection fraction was mildly reduced during hibernation but stroke volumes were greater due to the eccentric hypertrophy and dramatically increased diastolic filling volumes. Globally, the systolic phase in hibernation was ~9.5 times longer, and the diastolic phase was 28× longer. Left atrial ejection generally was not observed during hibernation. Atrial ejection returned weakly during early arousal. Strain echocardiography assessed the velocity and total movement distance of contraction and relaxation for regional ventricular segments in active and early arousal states. Myocardial systolic strain during early arousal was significantly greater than the active state, indicating greater total contractile movement. This mirrored the increased ventricular ejection fraction noted with early arousal. However, strain rates were slower during early arousal than during the active period, particularly systolic strain, which was 33% of active, compared with the rate of diastolic strain, which was 67% of active. As heart rate rose during the arousal period, myocardial velocities and strain rates also increased; this was matched closely by cardiac output. Curiously, though heart rates were only 26% of active heart rates during early arousal, the cardiac output was nearly 40% of the active state, suggesting an efficient pumping system. We further analyzed proportions of cardiac myosin heavy-chain (MyHC) isoforms in a separate cohort of squirrels over 5 months, including time points before hibernation, during hibernation and just prior to emergence. Hibernating individuals were maintained in both a 4°C cold room and a 20°C warm room. Measured by SDS-PAGE, relative percentages of cardiac MyHC alpha were increased during hibernation, at both hibernacula temperatures. A potential increase in contractile speed, and power, from more abundant MyHC alpha may aid force generation at low temperature and at low heart rates. Unlike many models of cardiomyopathies where the alpha isoform is replaced by the beta isoform in order to reduce oxygen consumption, ground squirrels demonstrate a potential cardioprotective mechanism to maintain cardiac output during torpor. PMID:24072796

  10. Embolization of the Device to the Left Pulmonary Artery after the Interventional Closure of Ruptured Sinus of Valsalva Aneurysm

    PubMed Central

    Choudhry, Lalit Kumar; Rao, Vinay M; Gnanamuthu, Birla Roy; Agrawal, Vishal; Shankar, Ravi; Prasath, Ram

    2015-01-01

    Formation of an aneurysm in the sinus of Valsalva of the aortic root is usually due to an area of congenital weakness in its wall. This aneurysm may progressively dilate and rupture into any of the cardiac chambers or into the pericardial cavity. Though this is conventionally treated by surgery, interventional therapy using various closure devices is becoming more common. Embolization of these closure devices may occur. We report a case of embolization of such a device into the left pulmonary artery which during surgical retrieval, unmasked the hidden ventricular septal defect (VSD). Therefore one has to be cautious while making a diagnosis of rupture of the sinus of Valsalva of right coronary sinus without VSD.

  11. Retrograde crystalloid cardioplegia preserves left ventricular systolic function better than antegrade cardioplegia in patients with occluded coronary arteries

    Microsoft Academic Search

    Jarl Ehrenberg; Mario Intonti; Anders Öwall; Lars-Åke Brodin; Torbjörn Ivert; Dan Lindblom

    2000-01-01

    Objective: To investigate retrograde and antegrade crystalloid cardioplegia in terms of cardiac cooling and postoperative cardiac function. Design: Prospective, randomized, and blinded. Setting: University hospital. Participants: Twenty male patients with triple-vessel disease and proximal occlusion of the circumflex or the left anterior descending coronary artery. Interventions: Left ventricular ejection fraction at rest and during exercise was evaluated by nuclear ventriculography

  12. Long-term trajectory of two unique cardiac biomarkers and subsequent left ventricular structural pathology and risk of incident heart failure in community dwelling older adults at low baseline risk

    PubMed Central

    Glick, Danielle; de Filippi, Christopher R.; Christenson, Robert; Gottdiener, John S.; Seliger, Stephen L.

    2013-01-01

    Background Initial low levels of hs cTnT and NT-proBNP identify older adults at lower risk for CV events. Objective To determine whether the combined trajectories of cardiac biomarkers identify those older adults with initial low levels who have an increased risk for structural heart disease, incident HF, and CV death. Methods Observational study among older adults without prevalent HF in the Cardiovascular Health Study. NT-proBNP and hs cTnT were measured at baseline and after 2-3 years. In those with low baseline levels, significant increase was defined as: cTnT >50%; NT-proBNP >25% increase to >190 pg/mL. LVEF and LV mass were measured by echocardiography at baseline and 5 years. Cox regression was used to estimate the association of change in biomarkers with HF and CV mortality. Results Among 2,008 participants with initially low biomarker concentrations, significant increases occurred in 14.8% for cTnT only, 13.2% for NT-proBNP only and 6.1% for both. After 10 years, cumulative HF incidence was 50.4% vs. 12.2% among those with both vs. neither biomarkers increased. The adjusted relative risk comparing those with increases in both vs. neither biomarkers was 3.56 for incident HF (95% confidence interval [CI]: 2.56-4.97) and 2.98 for CV mortality (95% CI: 2.98-4.26). Among 1340 participants with serial echocardiography, the frequency of new abnormal LVEF was 11.8% vs. 4.0% for those with increases in both vs. neither biomarkers (p=0.007). Conclusions Among older adults without HF with initially low cTnT and NT-proBNP, the long-term trajectory of both biomarkers predicts systolic dysfunction, incident HF, and CV death. PMID:24621939

  13. Left ventricular function in chronic renal failure.

    PubMed Central

    Lewis, B S; Milne, F J; Goldberg, B

    1976-01-01

    Left ventricular function was studied in 14 patients with end-stage chronic renal failure using non-invasive methods (echocardiography and systolic time intervals). Patients were divided into 3 groups. Group 1 consisted of 5 patients who were normotensive at the time of study and group 2 of 7 patients who were hypertensive when studied. Group 3 consisted of 2 patients: one was receiving propranolol and the other, studied 302 days after renal transplantation, was receiving digitalis for recurrent episodes of cardiac failure. All except the patient receiving propranolol had normal left ventricular function in systole with normal measurements of fractional fibre shortening (% delta S, EF) and normal measurements relating to the velocity of ventricular contraction (mean Vcf, mean velocity of posterior wall motion). Stroke volume and cardiac output were normal in some patients but were increased in patients with fluid overload. Early diastolic compliance of the left ventricle seemed to be normal except in the patient with recurrent cardiac failure. The study provided no evidence for the existence of a specific uraemic cardiomyopathy. PMID:1008967

  14. Treatment of Heart Failure by a Methanocarba Derivative of Adenosine Monophosphate: Implication for a Role of Cardiac Purinergic P2X Receptors

    PubMed Central

    Zhou, Si-Yuan; Mamdani, Mohammed; Qanud, Khaled; Shen, Jian-Bing; Pappano, Achilles J.; Kumar, T. Santhosh; Jacobson, Kenneth A.; Hintze, Thomas; Recchia, Fabio A.

    2010-01-01

    Evidence is accumulating to support a potentially important role for purinergic (P2X) receptors in heart failure (HF). We tested the hypothesis that a hydrolysis-resistant nucleotide analog with agonist activity at myocardial P2X receptors (P2XRs) improves the systolic HF phenotype in mouse and dog models. We developed a hydrolysis-resistant adenosine monophosphate derivative, (1?S,2R,3S,4?R,5?S)-4-(6-amino-2-chloro-9H-purin-9-yl)-1-[phosphoryloxymethyl] bicycle[3.1.0]hexane-2,3-diol) (MRS2339), with agonist activity at native cardiac P2XRs. Chronic MRS2339 infusion in postinfarct and calsequestrin (CSQ) mice with HF resulted in higher rates of pressure change (+dP/dt), left ventricle (LV)-developed pressure, and cardiac output in an in vitro working heart model. Heart function in vivo, as determined by echocardiography-derived fractional shortening, was also improved in MRS2339-infused mice. The beneficial effect of MRS2339 was dose-dependent and was identical to that produced by cardiac myocyte-specific overexpression of the P2X4 receptor. The HF improvement was associated with the preservation of LV wall thickness in both systole and diastole in postinfarct and CSQ mice. In dogs with pacing-induced HF, MRS2339 infusion reduced left ventricular end-diastolic pressure, improved arterial oxygenation, and increased +dP/dt. MRS2339 treatment also decreased LV chamber size in mice and dogs with HF. In murine and canine models of systolic HF, in vivo administration of a P2X nucleotide agonist improved contractile function and cardiac performance. These actions were associated with preserved LV wall thickness and decreased LV remodeling. The data are consistent with a role of cardiac P2XRs in mediating the beneficial effect of this agonist. PMID:20200116

  15. Cardiac torsion and electromagnetic fields: the cardiac bioinformation hypothesis.

    PubMed

    Burleson, Katharine O; Schwartz, Gary E

    2005-01-01

    Although in physiology the heart is often referred to as a simple piston pump, there are in fact two additional features that are integral to cardiac physiology and function. First, the heart as it contracts in systole, also rotates and produces torsion due to the structure of the myocardium. Second, the heart produces a significant electromagnetic field with each contraction due to the coordinated depolarization of myocytes producing a current flow. Unlike the electrocardiogram, the magnetic field is not limited to volume conduction and extends outside the body. The therapeutic potential for interaction of this cardioelectromagnetic field both within and outside the body is largely unexplored. It is our hypothesis that the heart functions as a generator of bioinformation that is central to normative functioning of body. The source of this bioinformation is based on: (1) vortex blood flow in the left ventricle; (2) a cardiac electromagnetic field and both; (3) heart sounds; and (4) pulse pressure which produce frequency and amplitude information. Thus, there is a multidimensional role for the heart in physiology and biopsychosocial dynamics. Recognition of these cardiac properties may result in significant implications for new therapies for cardiovascular disease based on increasing cardiac energy efficiency (coherence) and bioinformation from the cardioelectromagnetic field. Research studies to test this hypothesis are suggested. PMID:15823696

  16. Left atrium function assessment by echocardiography - physiological and clinical implications.

    PubMed

    Lupu, Silvia; Mitre, Adriana; Dobreanu, Dan

    2014-06-01

    Left atrium enlargement is a pathophysiological response to volume and pressure overload associated with a wide range of cardiovascular disorders leading to left ventricle systolic and diastolic dysfunction. Physiological factors contribute to significant differences in left atrium size in normal individuals. Moreover, left atrium enlargement was shown to have a significant prognostic value for cardiovascular events such as heart failure, atrial fibrillation or stroke, and increased cardiovascular and all-cause mortality rates. Current imaging techniques such as two- and three dimensional echocardiography, cardiac magnetic resonance imaging and multi-detector computed tomography allow a detailed assessment of the left atrium. The current paper aims to offer an overview of two-dimensional echocardiography parameters which provide data concerning left atrium dimensions and phasic functions and may lead to a better understanding of left atrium physiology and pathology. PMID:24791847

  17. Optimal vortex formation as an index of cardiac health

    E-print Network

    Dabiri, John O.

    in the blood flow during early diastole, as measured by a dimension- less numerical index. This index ventricle mitral flow biofluid dynamics Previous research has indicated that dynamics of the cardiac left­8). The flow of blood from the atrium to the ventricle of the left heart during early diastolic filling, known

  18. [Noninvasive measurement of cardiac output by pulsed Doppler echocardiography. Correlation with thermodilution].

    PubMed

    Dericbourg, C; Tribouilloy, C; Kugener, H; Avinee, P; Rey, J L; Lesbre, J P

    1990-02-01

    Cardiac output was measured simultaneously by pulsed Doppler echocardiography and thermodilution in 22 patients, 18 of whom also underwent atrial pacing at different rates to give a total of 42 different measurements. The aortic diameter was measured firstly at the aortic ring at the level of insertion of the aortic cusps and then at the point of maximum separation of the valve cups in the left parasternal long-axis view. The aortic velocities were recorded in the apical 5-chamber view immediately below the level of the aortic valve. The correlations obtained at the aortic ring (R1) and at the point of maximum separation of the valve cusps (R2) were 0.77 (y = 0.67x + 1.17: standard error = 0.81 l/m) and 0.64 (y = 0.56x + 0.87; standard error = 1.01 l/mn) respectively. The correlations were much better when 7 technically unsatisfactory measurements were excluded (R2 = 0.76: y = 0.59x + 0.74: standard error = 0.79 l/mn) (R1 = 0.87: y = 0.72x + 1.04: standard error = 0.65 l/mn). THe correlations of stroke volume measured at aortic ring level also improved from r = 0.82 (y = 0.75x + 7.29: standard error = 8.9 ml) to r = 0.89 (y = 0.78x + 7.38: standard error = 7.3 ml). The measurement of cardiac output by pulsed Doppler echocardiography in the aortic root seems to be reliable. The correlations of the values of stroke volume and cardiac output with the thermodilution method are good, allowing detection of beat-to-beat variations of cardiac output, in suitable patients in the hands of experienced operators. PMID:2106860

  19. Factors influencing left-ventricular stiffness.

    PubMed

    Yettram, A L; Grewal, B S; Dawson, J R; Gibson, D G

    1992-01-01

    The aim of the study was to investigate the relative contributions of geometrical and material factors to overall left-ventricular cavity stiffness. Left-ventricular cavity shapes were reconstructed using a computer and the variation of myocardial elastic modulus was calculated, by the finite element method, through the passive phase of diastole when rising volume coincided with rising pressure. Geometric data were obtained from biplane cineangiography, with micromanometer pressure measurements, for ten patients with left ventricular disease. Dimensional analysis was applied to the initial and derived data from which the influences of myocardial compliance, wall thickness-to-long dimension ratio, and aspect ratio (long-to-short axes) were determined. The ratio between the volume elasticity and the myocardial modulus of elasticity, the normalized stiffness ratio (NSR), is proposed as a useful index of left ventricular mechanical behaviour in diastole. The volume elasticity of the chamber is dependent not only upon the myocardium elastic modulus and the wall thickness ratio, but also on the shape of the chamber. Changes in the thickness/radius ratio of the ventricle have less effect upon its distention than those in the long dimension/radius ratio. The left ventricle becomes more spherical in shape through diastole and hence becomes stiffer by this geometric mechanism. PMID:1569735

  20. Controlled atmosphere exposure chamber

    Microsoft Academic Search

    R. J. Bryan; W. M. Blackmore

    1969-01-01

    A room-sized chamber was constructed capable of automatically maintaining levels of single or mixed contaminants for prolonged periods. The system can add specific contaminants to the natural smog or filter them out or do both. The chamber can house 20 dogs or subhuman primates adequately. Air flow is laminar from side to side. Several aspects of the design are discussed.

  1. The Mobile Chamber

    NASA Technical Reports Server (NTRS)

    Scharfstein, Gregory; Cox, Russell

    2012-01-01

    A document discusses a simulation chamber that represents a shift from the thermal-vacuum chamber stereotype. This innovation, currently in development, combines the capabilities of space simulation chambers, the user-friendliness of modern-day electronics, and the modularity of plug-and-play computing. The Mobile Chamber is a customized test chamber that can be deployed with great ease, and is capable of bringing payloads at temperatures down to 20 K, in high vacuum, and with the desired metrology instruments integrated to the systems control. Flexure plans to lease Mobile Chambers, making them affordable for smaller budgets and available to a larger customer base. A key feature of this design will be an Apple iPad-like user interface that allows someone with minimal training to control the environment inside the chamber, and to simulate the required extreme environments. The feedback of thermal, pressure, and other measurements is delivered in a 3D CAD model of the chamber's payload and support hardware. This GUI will provide the user with a better understanding of the payload than any existing thermal-vacuum system.

  2. Surgical treatment of cardiac pheochromocytomas

    SciTech Connect

    Orringer, M.B.; Sisson, J.C.; Glazer, G.; Shapiro, B.; Francis, I.; Behrendt, D.M.; Thompson, N.W.; Lloyd, R.V.

    1985-05-01

    The development at our institution of the radiopharmaceutical /sup 131/-I-metaiodobenzylguanidine has permitted for the first time scintigraphic localization of pheochromocytomas. By the use of this scan in combination with contrast-enhanced computed tomography, intrapericardial pheochromocytomas have been demonstrated in eight patients at our hospital during the past 2 years. Four of these patients have been operated upon by us, and each was found to have a pheochromocytoma arising from the heart (left atrium in three and interventricular groove at the aortic root in one). While in one patient it was possible to shell the tumor away from the left atrial wall without cardiopulmonary bypass, in the remaining patients, bypass and cardioplegia were required to resect the pheochromocytomas without inducing life-threatening intraoperative hypertension and cardiac arrhythmias. One patient required coronary artery reconstruction and two, excision of the posterior left atrial wall with pericardial replacement. One of these latter two patients died intraoperatively of uncontrollable hemorrhage. The three remaining patients are well and normotensive after more than 1 year of follow-up. Cardiac pheochromocytomas should not be approached as typical posterior mediastinal tumors, or as they are in the abdomen, with the expectation that they will shell away from contiguous structures. Cardiopulmonary bypass should be available, and resection of involved myocardium may be necessary for complete removal.

  3. Tissue Doppler Echocardiographic Findings of Left Ventricle in Children with Sickle-Cell Anemia

    PubMed Central

    Ghaderian, Mehdi; Keikhaei, Bijan; Heidari, Morteza; Salehi, Zahra; Azizi Malamiri, Reza

    2012-01-01

    Background: Sickle-cell disease (SCD) is an inherited hemoglobin childhood disorder, frequently complicated by pulmonary hypertension and cardiac involvement. Cardiovascular events and complications are the leading cause of mortality and morbidity in patients with SCD. Tissue Doppler imaging and the myocardial performance index (Tei index), are simple indices for the assessment of the cardiac function. The purpose of this study was to assess the left ventricular function in children with SCD. Methods: Sixty-four patients with SCD (mean age = 11.7 ± 5.5 years) were compared with 50 age-matched healthy controls (mean age = 11.2 ± 5.20 years). Myocardial wall motion velocities at the lateral mitral annulus and the junction between the medial mitral annulus and the interventricular septum were assessed during systole (Sa), early diastole (Ea), and late diastole (Aa) through a four-chamber view using pulsed Doppler echocardiography. The ejection fraction and shortening fraction were estimated. The Tei index was estimated via tissue Doppler echocardiography. Results: The results showed that Ea and Aa velocity in the mitral annulus and interventricular septum had no difference between the patients and controls (p value > 0.05), and nor was there any difference between the two groups as regards the Tei index, Ea/Aa, ejection fraction, and shortening fraction (p value > 0.05). Sam wave velocity, however, had a significant difference between the two groups (p value < 0.038). Conclusion: The Tei index is a sensitive indicator for the cardiac function in chronic diseases and the right ventricular function in some disorders such as SCD. PMID:23304178

  4. Case report - Cardiac general Non-perforating pericardial rupture causing cardiac tamponade

    Microsoft Academic Search

    Hiroshi Onda; Yuichiro Kaminishi; Yoshio Misawa; Katsuo Fuse

    2010-01-01

    A 51-year-old auto truck driver was transferred to our hospital after crashing. He had a severe pain on the left anterior chest wall with high central venous pressure of 30 cm H2O. Surveillance of the chest revealed cardiac tamponade and the right seventh rib fracture with left pleural effusion. Pericardiotomy through median sternotomy led to extrusive bloody pericardial effusion. Non-perforating

  5. Ulnar nerve repair by the silicone chamber technique. Case report.

    PubMed

    Lundborg, G; Dahlin, L B; Danielsen, N

    1991-01-01

    The ulnar nerve of a 21-year old man was repaired at the wrist by a silicone chamber technique 10 days after a traumatic transection. A 3 mm gap was left between the nerve ends inside the chamber. At follow-up three years later, motor and sensory recovery was excellent. At exploration at that time a macroscopically normal nerve was found in the tube. PMID:2052913

  6. Myocardial Infarction and Left Ventricular Hypertrophy Seen on an Infant's Electrocardiogram.

    PubMed

    Glancy, D Luke; King, Terry D; Glancy, Cynthia F; King, Nancy B; Morgan, Joy

    2015-06-15

    The clinical and electrocardiographic features of anomalous left coronary artery from the pulmonary trunk, ALCAPA, a frequently fatal congenital cardiac malformation, are described in an 8 1/2-month-old female. PMID:25918028

  7. Cardiac aquaporins.

    PubMed

    Rutkovskiy, Arkady; Valen, Guro; Vaage, Jarle

    2013-11-01

    Aquaporins are a group of proteins with high-selective permeability for water. A subgroup called aquaglyceroporins is also permeable to glycerol, urea and a few other solutes. Aquaporin function has mainly been studied in the brain, kidney, glands and skeletal muscle, while the information about aquaporins in the heart is still scarce. The current review explores the recent advances in this field, bringing aquaporins into focus in the context of myocardial ischemia, reperfusion, and blood osmolarity disturbances. Since the amount of data on aquaporins in the heart is still limited, examples and comparisons from better-studied areas of aquaporin biology have been used. The human heart expresses aquaporin-1, -3, -4 and -7 at the protein level. The potential roles of aquaporins in the heart are discussed, and some general phenomena that the myocardial aquaporins share with aquaporins in other organs are elaborated. Cardiac aquaporin-1 is mostly distributed in the microvasculature. Its main role is transcellular water flux across the endothelial membranes. Aquaporin-4 is expressed in myocytes, both in cardiac and in skeletal muscle. In addition to water flux, its function is connected to the calcium signaling machinery. It may play a role in ischemia-reperfusion injury. Aquaglyceroporins, especially aquaporin-7, may serve as a novel pathway for nutrient delivery into the heart. They also mediate toxicity of various poisons. Aquaporins cannot influence permeability by gating, therefore, their function is regulated by changes of expression-on the levels of transcription, translation (by microRNAs), post-translational modification, membrane trafficking, ubiquitination and subsequent degradation. Studies using mice genetically deficient for aquaporins have shown rather modest changes in the heart. However, they might still prove to be attractive targets for therapy directed to reduce myocardial edema and injury caused by ischemia and reperfusion. PMID:24158693

  8. Echocardiographic assessment of cardiac disease

    NASA Technical Reports Server (NTRS)

    Popp, R. L.

    1976-01-01

    The physical principles and current applications of echocardiography in assessment of heart diseases are reviewed. Technical considerations and unresolved points relative to the use of echocardiography in various disease states are stressed. The discussion covers normal mitral valve motion, mitral stenosis, aortic regurgitation, atrial masses, mitral valve prolapse, and idiopathic hypertrophic subaortic stenosis. Other topics concern tricuspic valve abnormalities, aortic valve disease, pulmonic valve, pericardial effusion, intraventricular septal motion, and left ventricular function. The application of echocardiography to congenital heart disease diagnosis is discussed along with promising ultrasonic imaging systems. The utility of echocardiography in quantitative evaluation of cardiac disease is demonstrated.

  9. Myocardialization of the Cardiac Outflow Tract

    Microsoft Academic Search

    Antoon F. M. Moorman; Jan M. Ruijter; Wout H. Lamers; Rossi W. Bennington; Roger R. Markwald; Andy Wessels

    1999-01-01

    During development, the single-circuited cardiac tube transforms into a double-circuited four-chambered heart by a complex process of remodeling, differential growth, and septation. In this process the endocardial cushion tissues of the atrioventricular junction and outflow tract (OFT) play a crucial role as they contribute to the mesenchymal components of the developing septa and valves in the developing heart. After fusion,

  10. Automatic Left Ventricular cavity detection using Fuzzy Isodata and connected-components labeling algorithms

    Microsoft Academic Search

    Abd Ei Ouahab Boudraa; Jacques Champier; Jerome Damien; Jean-Eugene Besson; Jean-Claude Bordet; Jean-Jacques Mallet

    1992-01-01

    Extraction of the Left Ventricle (LV) contours is essential in the quantitative analysis of cardiac function. We present a new method that employs Fuzzy Isodata (FI) and conne nents Labeling algorithms to automatically detect the LV contours. The FI algorithm is applied to each cardiac image to generate a given number of fuzzy subsets. Each heart's substructure (aorta. is considered

  11. Accelerated circumferential strain quantification of the left ventricle using CIRCOME: simulation and factor analysis

    Microsoft Academic Search

    Abbas N. Moghaddam; J. Paul Finn

    2008-01-01

    Circumferential strain of the left ventricle reflects myocardial contractility and is considered a key index of cardiac function. It is also an important parameter in the quantitative evaluation of heart failure. Circumferential compression encoding, CIRCOME, is a novel method in cardiac MRI to evaluate this strain non-invasively and quickly. This strain encoding technique avoids the explicit measurement of the displacement

  12. TNF-induced mitochondrial damage: a link between mitochondrial complex I activity and left ventricular dysfunction

    Microsoft Academic Search

    Nithya Mariappan; Carrie M. Elks; Bruno Fink; Joseph Francis

    2009-01-01

    Mitochondrial damage is implicated in the progression of cardiac disease. Considerable evidence suggests that proinflammatory cytokines induce oxidative stress and contribute to cardiac dysfunction. This study was conducted to determine whether a TNF-induced increase in superoxide (O2?) contributes to mitochondrial damage in the left ventricle (LV) by impairing respiratory complex I activity. We employed an electron paramagnetic resonance (EPR) method

  13. Numerical Investigation of Macroscopic Cardiac Mechanics.

    NASA Astrophysics Data System (ADS)

    Buxton, Gavin; Balazs, Anna

    2003-03-01

    In order to gain insight into the complex interactions between electrical excitation of the myocardial tissue, the mechanical contraction of the heart muscles and cardiac fluid dynamics, three computational techniques are successfully coupled. A Gerhardt-Schuster-Tyson Cellular Automata algorithm enables the excitation kinetics of myocardial tissue to be simulated in a computationally efficient manner. The cardiac excitation spreading is then coupled with a dynamic Born Lattice Spring Model which enables the contraction of the heart muscles and their subsequent relaxation to be modelled. The velocities at the inner surfaces of the heart can then be transferred to a Lattice Boltzmann simulation of blood flow within the cardiac chambers. The interactions (and complex feedback mechanisms) between electrical excitation, mechanical deformation, and fluid flow in the heart are explored through these three-dimensional models and the regular functionality of the whole heart is visualised.

  14. Acoustic-Levitation Chamber

    NASA Technical Reports Server (NTRS)

    Barmatz, M. B.; Granett, D.; Lee, M. C.

    1984-01-01

    Uncontaminated environments for highly-pure material processing provided within completely sealed levitation chamber that suspends particles by acoustic excitation. Technique ideally suited for material processing in low gravity environment of space.

  15. Computational modeling and analysis for left ventricle motion using CT/Echo image fusion

    NASA Astrophysics Data System (ADS)

    Kim, Ji-Yeon; Kang, Nahyup; Lee, Hyoung-Euk; Kim, James D. K.

    2014-03-01

    In order to diagnose heart disease such as myocardial infarction, 2D strain through the speckle tracking echocardiography (STE) or the tagged MRI is often used. However out-of-plane strain measurement using STE or tagged MRI is inaccurate. Therefore, strain for whole organ which are analyzed by simulation of 3D cardiac model can be applied in clinical diagnosis. To simulate cardiac contraction in a cycle, cardiac physical properties should be reflected in cardiac model. The myocardial wall in left ventricle is represented as a transversely orthotropic hyperelastic material, with the fiber orientation varying sequentially from the epicardial surface, through about 0° at the midwall, to the endocardial surface. A time-varying elastance model is simulated to contract myocardial fiber, and physiological intraventricular systolic pressure curves are employed for the cardiac dynamics simulation in a cycle. And an exact description of the cardiac motion should be acquired in order that essential boundary conditions for cardiac simulation are obtained effectively. Real time cardiac motion can be acquired by using echocardiography and exact cardiac geometrical 3D model can be reconstructed using 3D CT data. In this research, image fusion technology from CT and echocardiography is employed in order to consider patient-specific left ventricle movement. Finally, longitudinal strain from speckle tracking echocardiography which is known to fit actual left ventricle deformation relatively well is used to verify these results.

  16. Slurry-Mixing Chamber

    NASA Technical Reports Server (NTRS)

    Lewis, E. V.

    1985-01-01

    Paddles and water jets create uniform, continuous flow. Slurry-mixing chamber on hydrojet-jaw mining machine ensures uniform, continuously flowing slurry of coal particles in water. By mixing coal and water at high speed and keeping resulting slurry in constant motion, chamber prevents slurry from becoming dry semisolid that blocks flow. Also prevents coal particles from settling and caking in bends, corners, and other locations where flow changes in direction or speed.

  17. The pressures of surgicel® in cardiac surgery

    PubMed Central

    Arora, Niket Dilip; Varghese, Roy; Pavithran, Sreeja; Kothandam, Sivakumar

    2015-01-01

    Surgicel® is bioabsorbable hemostatic mesh, frequently packed around oozing surgical bed. We report two morbidities due to it. Following transannular patch repair for Fallot's tetralogy, Surgicel® was packed around distal main pulmonary artery. Echocardiography in the intensive care unit (ICU) showed right ventricular dysfunction due to extrinsic obstruction and complete occlusion of left pulmonary artery (LPA) flows. Another patient with arterial switch operation had postoperative fibrillatory cardiac arrest, needing resuscitation with internal cardiac massage. The arrest was triggered by coronary ischemia due to periaortic compression. Both instances were caused by hygroscopic nature of Surgicel®, which absorbed blood, swelled, and compressed the luminal tissues.

  18. Sleeve reaction chamber system

    DOEpatents

    Northrup, M. Allen (Berkeley, CA); Beeman, Barton V. (San Mateo, CA); Benett, William J. (Livermore, CA); Hadley, Dean R. (Manteca, CA); Landre, Phoebe (Livermore, CA); Lehew, Stacy L. (Livermore, CA); Krulevitch, Peter A. (Pleasanton, CA)

    2009-08-25

    A chemical reaction chamber system that combines devices such as doped polysilicon for heating, bulk silicon for convective cooling, and thermoelectric (TE) coolers to augment the heating and cooling rates of the reaction chamber or chambers. In addition the system includes non-silicon-based reaction chambers such as any high thermal conductivity material used in combination with a thermoelectric cooling mechanism (i.e., Peltier device). The heat contained in the thermally conductive part of the system can be used/reused to heat the device, thereby conserving energy and expediting the heating/cooling rates. The system combines a micromachined silicon reaction chamber, for example, with an additional module/device for augmented heating/cooling using the Peltier effect. This additional module is particularly useful in extreme environments (very hot or extremely cold) where augmented heating/cooling would be useful to speed up the thermal cycling rates. The chemical reaction chamber system has various applications for synthesis or processing of organic, inorganic, or biochemical reactions, including the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction.

  19. High interleukin 17 expression is correlated with better cardiac function in human Chagas disease.

    PubMed

    Magalhães, Luisa M D; Villani, Fernanda N A; Nunes, Maria do Carmo P; Gollob, Kenneth J; Rocha, Manoel O C; Dutra, Walderez O

    2013-02-15

    This study was designed to investigate whether the expression of interleukin 17 (IL-17) is associated with the indeterminate or cardiac clinical forms of Chagas disease and whether IL-17 expression can be correlated with patients' cardiac function. Our results demonstrated that cardiac Chagas patients have a lower intensity of expression of IL-17 by total lymphocytes and lower frequency of circulating T helper 17 cells. Correlative analysis showed that high IL-17 expression was associated with better cardiac function, as determined by left ventricular ejection fraction and left ventricular diastolic diameter values. Therefore, IL-17 expression can be a protective factor to prevent myocardial damage in human Chagas disease. PMID:23204182

  20. Cardiac response induced by voluntary self-paced finger movement.

    PubMed

    Florian, G; Stancák, A; Pfurtscheller, G

    1998-05-01

    Cardiac responses induced by slow and brisk voluntary self-paced index finger movements of the dominant and non-dominant hand were investigated in a group of 12 right-handed subjects. Since subjects synchronised movement and respiration, initiating movement preferably during inspiration, a novel method of evaluating the movement-induced cardiac response was used. This method allows one to distinguish the differential effects on the cardiac response due to movement and respiration. The effect of type of movements (slow vs. brisk) and hand (right vs. left) were analysed. Slow movements induced a monophasic cardiac response, consisting of cardiac deceleration preceding and accompanying movement. Brisk movements induced a biphasic cardiac response, consisting of preparatory deceleration followed by slight post-movement cardiac acceleration. Hand-dominance did not influence the movement-induced cardiac response. The results suggest that neocortical structures involved in planning and execution of voluntary movement impinge upon brainstem cardiovascular nuclei. Vagal cardiac outflow is affected and gives rise to movement-induced changes in cardiac chronotropism. PMID:9545662

  1. The 'cardiac-lung mass' artifact: an echocardiographic sign of lung atelectasis and/or pleural effusion

    PubMed Central

    Karabinis, Andreas; Saranteas, Theodosios; Karakitsos, Dimitrios; Lichtenstein, Daniel; Poularas, John; Yang, Clifford; Stefanadis, Christodoulos

    2008-01-01

    Introduction We conducted an ultrasound study to investigate echocardiographic artifacts in mechanically ventilated patients with lung pathology. Methods A total of 205 mechanically ventilated patients who exhibited lung atelectasis and/or pleural effusion were included in this 36-month study. The patients underwent lung echography and transthoracic echocardiography, with a linear 5 to 10 MHz and with a 1.5 to 3.6 MHz wide-angle phased-array transducer, respectively. Patients were examined by two experienced observers who were blinded to each other's interpretation. Results A total of 124 patients (60,48%) were hospitalized because of multiple trauma; 60 patients (29,26%) because of respiratory insufficiency, and 21 (10,24%) because of recent postoperative surgery. The mean duration ( ± standard deviation) of hospitalization was 35 ± 27 days. An intracardiac artifact was documented in 17 out of 205 patients (8.29%) by echocardiography. It was visible only in the apical views, whereas subsequent transesophageal echocardiography revealed no abnormalities. The artifact consisted of a mobile component that exhibited, on M-mode, a pattern of respiratory variation similar to the lung 'sinusoid sign'. Lung echography revealed lung atelectasis and/or pleural effusion adjacent to the heart, and a similar M-mode pattern was observed. The artifact was recorded within the left cardiac chambers in 11 cases and within the right cardiac chambers in six. Conclusions Lung atelectasis and/or pleural effusion may create a mirror image, intracardiac artifact in mechanically ventilated patients. The latter was named the 'cardiac-lung mass' artifact to underline the important diagnostic role of both echocardiography and lung echography in these patients. Trial registration This trial is ISRCTN registered: ISRCTN 49216096. PMID:18826590

  2. Case report Hypoplastic left heart syndrome in situs inversus totalis

    Microsoft Academic Search

    Guido Oppido; Carlo Pace Napoleone; Stefania Martano; Gaetano Gargiulo

    2010-01-01

    A very rare case of a newborn with hypoplastic left heart syndrome and situs inversus totalis is herein reported. Successful surgical treatment of this cardiac malformation was accomplished at our institution and consisted of: modified Norwood stage I procedure, with direct anastomosis of the transected main pulmonary artery to the aortic arch, without any prosthetic material interposition and right ventricle

  3. Hypoplastic left heart syndrome in situs inversus totalis

    Microsoft Academic Search

    Guido Oppido; Carlo Pace Napoleone; Stefania Martano; Gaetano Gargiulo

    2004-01-01

    A very rare case of a newborn with hypoplastic left heart syndrome and situs inversus totalis is herein reported. Successful surgical treatment of this cardiac malformation was accomplished at our institution and consisted of: modified Norwood stage I procedure, with direct anastomosis of the transected main pulmonary artery to the aortic arch, without any prosthetic material interposition and right ventricle

  4. Congenital left atrial appendage aneurysm associated with a systemic embolism.

    PubMed

    Tidake, Abhay; Gangurde, Pranil; Mahajan, Ajay

    2015-03-01

    A 20 year-old woman presented with systemic embolisation. On subsequent investigation, she was diagnosed with a congenital left atrial appendage aneurysm. Few case reports are reported in the literature. This cardiac malformation presents a diagnostic challenge in patients with cardiomegaly. PMID:24854482

  5. Left Ventricular Metastasis from a Primary Pancreatobiliary Tumor

    PubMed Central

    Makaryus, Amgad N; Boxt, Lawrence

    2015-01-01

    Metastatic disease to the heart is not uncommon. We describe a case of a man in his 60s with an unusual metastasis to the heart and detail its intracardiac location by means of cardiac computerized tomography (CCT) and transthoracic echocardiography. To our knowledge, this is the first report of a pancreatobiliary tumor metastasizing exclusively to the left ventricle (LV) of the heart.

  6. Collagen network remodelling and left ventricular function in constrictive pericarditis

    Microsoft Academic Search

    M. Chello; P. Mastroroberto; R. Romano; F. Perticone; A. R. Marchese

    1996-01-01

    OBJECTIVE: To investigate whether patients with constrictive pericarditis have changes in collagen content and architecture that could influence left ventricular function. DESIGN: Cohort study. SETTING: University teaching hospital. PATIENTS: Biopsy specimens of myocardium from 13 patients admitted consecutively for treatment of chronic constrictive pericarditis were compared with normal heart tissue taken at necropsy from 15 patients free of cardiac disease.

  7. Secondary lesions of penetrating cardiac injuries: a frequent complication.

    PubMed Central

    Fallahnejad, M; Kutty, A C; Wallace, H W

    1980-01-01

    Between July 1962 and July 1978, 29 patients )23 male and 6 female) from 17 to 48 years of age were followed from two weeks to 15 years after penetrating cardiac injuries involving right ventricle (12), right atrium (6), left ventricle (8), left atrium (2), and pulmonary conus (1). Thoracotomies were performed on all patients either in the emergency room during resuscitation or in the operating room. Repair of the injuries were carried out. All patients were followed for presence of residual cardiac damage. To our surprise, secondary complications were noted in 15 of the 29 patients as follows: Coronary damage (3), pseudoanuerysm (2), bullet embolus (1), VSD (4), recurrent pericarditis (1), mitral valve injury (2), aorta caval (1), and aorto pulmonary fistula (1). Between July 1962 and July 1974, only symptomatic patients with subjective and objective findings had detailed cardiac evaluations. Eight of 20 patients were found to have secondary cardiac complications. Since July 1974, seven of nine patients underwent a posttraumatic cardiac evaluation. Six of the seven patients were found to have significant cardiac lesions which were unrecognized at the time of initial operation. The incidence of posttraumatic remediable cardiac lesions is probably higher than previously suspected. An aggressive, detailed postoperative evaluation is recommended for all patients with penetrating cardiac injuries. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:7362289

  8. GOVERNOR'S COUNCIL CHAMBER; WEST WALL. Glass plate stereopair number PA1430139 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; WEST WALL. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-W 157.4839. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  9. GOVERNOR'S COUNCIL CHAMBER; EAST WALL. Glass plate stereopair number PA1430139 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; EAST WALL. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-E 157.4846. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  10. Left ventricular lead implantation assisted by magnetic navigation in a patient with a persistent left superior vena cava

    Microsoft Academic Search

    Máximo Rivero-Ayerza; Yves van Belle; Joris Mekel; Luc J. Jordaens

    2007-01-01

    In a woman with a persistent left superior vena cava and a dilated coronary sinus, a right-sided biventricular ICD implantation was performed assisted by remote magnetic navigation. Intra-cardiac echocardiography was helpful in locating the coronary sinus os.

  11. Laparoscopic cholecystectomy for left sided gallbladder in situs inversus totalis.

    PubMed

    Butt, Muhammad Qasim; Chatha, Sohail Saqib; Ghumman, Adeel Qamar; Rasheed, Asif; Farooq, Mahwish; Ahmed, Javed

    2015-04-01

    Situs inversus totalisis a rare condition affecting intra abdominal and intra thoracic organs. Situs inversususually remains asymptomatic. Life expectancy is normal in the absence of rare cardiac abnormalities. Left sided gallbladder can occur even without situs inversus totalis.Cholelithiasis is not more common in patients with situs inversusthan the general population. However, these patients may pose a diagnostic difficulty. An ultrasound scan can confirm the presence of gallstones and the left-sided gallbladder. Here we present the case of a 40-year female with this diagnosis who was diagnosed on abdominal scanning and underwent laparoscopic cholecystectomy for left sided cholelithiasis. PMID:25933453

  12. Transseptal fine needle aspiration of a large left atrial tumour.

    PubMed

    Wong, Chi Wing; Ruygrok, Peter; Sutton, Timothy; Ding, Patricia; van Vliet, Chris; Occleshaw, Christopher; Smith, Warren

    2010-07-01

    The diagnosis of cardiac tumours is often based on images without tissue diagnosis or tissue obtained at surgery. Percutaneous myocardial biopsy via a transvenous approach has been described in literatures but this technique is not feasible with left atrial tumours. We report a patient presenting with heart failure and left atrial tumour. The diagnosis of spindle cell neoplasm was established pre-operatively via successful transseptal fine needle aspiration of cells from a left atrial tumour. We believe this technique worth consideration to aid pre-surgery diagnosis. PMID:19656723

  13. Sudden cardiac death risk stratification.

    PubMed

    Deyell, Marc W; Krahn, Andrew D; Goldberger, Jeffrey J

    2015-06-01

    Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized. PMID:26044247

  14. Cardiac atrophy after bed-rest deconditioning: a nonneural mechanism for orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Levine, B. D.; Zuckerman, J. H.; Pawelczyk, J. A.; Blomqvist, C. G. (Principal Investigator)

    1997-01-01

    BACKGROUND: The cardiovascular adaptation to bed rest leads to orthostatic intolerance, characterized by an excessive fall in stroke volume (SV) in the upright position. We hypothesized that this large fall in SV is due to a change in cardiac mechanics. METHODS AND RESULTS: We measured pulmonary capillary wedge pressure (PCWP), SV, left ventricular end-diastolic volume (LVEDV), and left ventricular mass (by echocardiography) at rest, during lower-body negative pressure, and after saline infusion before and after 2 weeks of bed rest with -6 degrees head-down tilt (n=12 subjects aged 24+/-5 years). Pressure (P)-volume (V) curves were modeled exponentially by P=ae(kV)+b and logarithmically by P=-Sln[(Vm-V)/(Vm-V0)], where V0 indicates volume at P=0, and the constants k and S were used as indices of normalized chamber stiffness. Dynamic stiffness (dP/dV) was calculated at baseline LVEDV. The slope of the line relating SV to PCWP during lower-body negative pressure characterized the steepness of the Starling curve. We also measured plasma volume (with Evans blue dye) and maximal orthostatic tolerance. Bed rest led to a reduction in plasma volume (17%), baseline PCWP (18%), SV (12%), LVEDV (16%), V0 (33%), and orthostatic tolerance (24%) (all P<.05). The slope of the SV/PCWP curve increased from 4.6+/-0.4 to 8.8+/-0.9 mL/mm Hg (P<.01) owing to a parallel leftward shift in the P-V curve. Normalized chamber stiffness was unchanged, but dP/dV was reduced by 50% at baseline LVEDV, and cardiac mass tended to be reduced by 5% (P<.10). CONCLUSIONS: Two weeks of head-down-tilt bed rest leads to a smaller, less distensible left ventricle but a shift to a more compliant portion of the P-V curve. This results in a steeper Starling relationship, which contributes to orthostatic intolerance by causing an excessive reduction in SV during orthostasis.

  15. 78. (Credit JTL) Mixing chambers (19241926) in foreground, looking west ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    78. (Credit JTL) Mixing chambers (1924-1926) in foreground, looking west along south facade of station. Settling basins to left, new filter house (1942) in background. Aerators added in 1930-31 to remove carbon dioxide from water. - McNeil Street Pumping Station, McNeil Street & Cross Bayou, Shreveport, Caddo Parish, LA

  16. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER RIGHT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER RIGHT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-6 157.4845. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  17. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER RIGHT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER RIGHT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-6 157.4838. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  18. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER MIDDLE. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, UPPER MIDDLE. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-4 157.4843. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  19. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER MIDDLE. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, UPPER MIDDLE. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-4 157.4836. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  20. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER MIDDLE. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER MIDDLE. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-3 157.4842. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  1. GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER RIGHT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; NORTH WALL, LOWER RIGHT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-N-5 157.4844. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  2. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER MIDDLE. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER MIDDLE. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-3 157.4835. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  3. GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER RIGHT. Glass plate stereopair ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GOVERNOR'S COUNCIL CHAMBER; SOUTH WALL, LOWER RIGHT. Glass plate stereopair number PA-1430-139 LC-HABS-GS05-GC-S-5 157.4837. Left (printed) - Independence Hall Complex, Independence Hall, 500 Chestnut Street, Philadelphia, Philadelphia County, PA

  4. Filament wound rocket motor chambers

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The design, analysis, fabrication and testing of a Kevlar-49/HBRF-55A filament wound chamber is reported. The chamber was fabricated and successfully tested to 80% of the design burst pressure. Results of the data reduction and analysis from the hydrotest indicate that the chamber design and fabrication techniques used for the chamber were adequate and the chamber should perform adequately in a static test.

  5. Automated soil gas monitoring chamber

    DOEpatents

    Edwards, Nelson T.; Riggs, Jeffery S.

    2003-07-29

    A chamber for trapping soil gases as they evolve from the soil without disturbance to the soil and to the natural microclimate within the chamber has been invented. The chamber opens between measurements and therefore does not alter the metabolic processes that influence soil gas efflux rates. A multiple chamber system provides for repetitive multi-point sampling, undisturbed metabolic soil processes between sampling, and an essentially airtight sampling chamber operating at ambient pressure.

  6. Impact of Acute Changes of Left Ventricular Contractility on the Transvalvular Impedance: Validation Study by Pressure-Volume Loop Analysis in Healthy Pigs

    PubMed Central

    Lionetti, Vincenzo; Romano, Simone Lorenzo; Bianchi, Giacomo; Bernini, Fabio; Dushpanova, Anar; Mascia, Giuseppe; Nesti, Martina; Di Gregorio, Franco; Barbetta, Alberto; Padeletti, Luigi

    2013-01-01

    Background The real-time and continuous assessment of left ventricular (LV) myocardial contractility through an implanted device is a clinically relevant goal. Transvalvular impedance (TVI) is an impedentiometric signal detected in the right cardiac chambers that changes during stroke volume fluctuations in patients. However, the relationship between TVI signals and LV contractility has not been proven. We investigated whether TVI signals predict changes of LV inotropic state during clinically relevant loading and inotropic conditions in swine normal heart. Methods The assessment of RVTVI signals was performed in anesthetized adult healthy anesthetized pigs (n?=?6) instrumented for measurement of aortic and LV pressure, dP/dtmax and LV volumes. Myocardial contractility was assessed with the slope (Ees) of the LV end systolic pressure-volume relationship. Effective arterial elastance (Ea) and stroke work (SW) were determined from the LV pressure-volume loops. Pigs were studied at rest (baseline), after transient mechanical preload reduction and afterload increase, after 10-min of low dose dobutamine infusion (LDDS, 10 ug/kg/min, i.v), and esmolol administration (ESMO, bolus of 500 µg and continuous infusion of 100 µg·kg?1·min?1). Results We detected a significant relationship between ESTVI and dP/dtmax during LDDS and ESMO administration. In addition, the fluctuations of ESTVI were significantly related to changes of the Ees during afterload increase, LDDS and ESMO infusion. Conclusions ESTVI signal detected in right cardiac chamber is significantly affected by acute changes in cardiac mechanical activity and is able to predict acute changes of LV inotropic state in normal heart. PMID:24260431

  7. Cardiac and lung complication probabilities after breast cancer irradiation

    Microsoft Academic Search

    Coen W Hurkmans; Jacques H Borger; Luc J Bos; Astrid van der Horst; Bradley R Pieters; Joos V Lebesque; Ben J Mijnheer

    2000-01-01

    Purpose: To assess for locoregional irradiation of breast cancer patients, the dependence of cardiac (cardiac mortality) and lung (radiation pneumonitis) complications on treatment technique and individual patient anatomy.Materials and methods: Three-dimensional treatment planning was performed for 30 patients with left-sided breast cancer and various breast sizes. Two locoregional techniques (Techniques A and B) and a tangential field technique, including only

  8. Role of Cardiac MR Imaging in Cardiomyopathies.

    PubMed

    Kramer, Christopher M

    2015-06-01

    Cardiac MR imaging has made major inroads in the new millennium in the diagnosis and assessment of prognosis for patients with cardiomyopathies. Imaging of left and right ventricular structure and function and tissue characterization with late gadolinium enhancement (LGE) as well as T1 and T2 mapping enable accurate diagnosis of the underlying etiology. In the setting of coronary artery disease, either transmurality of LGE or contractile reserve in response to dobutamine can assess the likelihood of recovery of function after revascularization. The presence of scar reduces the likelihood of a response to medical therapy and to cardiac resynchronization therapy in heart failure. The presence and extent of LGE relate to overall cardiovascular outcome in cardiomyopathies. A major role for cardiac MR imaging in cardiomyopathies is to identify myocardial scar for diagnostic and prognostic purposes. PMID:26033902

  9. Morphometric study of cardiac muscle: the problem of tissue shrinkage

    Microsoft Academic Search

    A. M. Gerdes; J. Kriseman; S. P. Bishop

    1982-01-01

    Comparison of data from morphometric studies dealing with the heart is complicated by the fact that little information dealing with cell size changes during tissue processing is available. To investigate these changes, isolated cardiac myocytes were adhered to glass cover slips of Sykes Moore chambers and photographed after each step of processing for transmission electron microscopy. Six different experiments with

  10. Activation of coagulation and fibrinolytic pathways in patients with left ventricular assist devices

    Microsoft Academic Search

    Talia Spanier; Mehmet Oz; Howard Levin; Alan Weinberg; Kathy Stamatis; David Stern; Eric Rose; Ann Marie Schmidt

    1996-01-01

    Left ventricular assist devices have provided successful supportive therapy for patients awaiting cardiac transplantation for extended periods of time. Although thromboembolic events have complicated support with these devices, the HeartMate left ventricular assist device developed by Thermo Cardiosystems, Inc., Woburn, Massachusetts, was specifically designed with a textured blood-contacting surface to minimize this risk. Clinical experience with this device has been

  11. Silent Coronary Artery-Left Ventricular Fistula: A Disorder of the Thebesian System?

    Microsoft Academic Search

    Se Do Cha; Edward Singer; Vladir Maranhao; Harry Goldberg

    1978-01-01

    Two cases with abnormal elec trocardiogram were found to have the unusual direct communication between the coronary artery and left ventricular chamber without any manifestations of the other reported coronary arterial fis tula.

  12. Absence of Type VI Collagen Paradoxically Improves Cardiac Function, Structure and Remodeling Following Myocardial Infarction

    PubMed Central

    Luther, Daniel J.; Thodeti, Charles K.; Shamhart, Patricia E.; Adapala, Ravi K.; Hodnichak, Cheryl; Weihrauch, Dorothee; Bonaldo, Paolo; Chilian, William M.; Meszaros, J. Gary

    2014-01-01

    Rationale We previously reported that type VI collagen deposition increases in the infarcted myocardium in vivo. To date, a specific role for this non-fibrillar collagen has not been explored in the setting of myocardial infarction (MI). Objective To determine whether deletion of type VI collagen in an in vivo model of post-MI wound healing would alter cardiac function and remodeling in the days to weeks after injury. Methods and Results Wild type (WT) and Col6a1-/- mice were subjected to MI followed by serial echocardiographic and histological assessments. At 8 weeks post-MI, infarct size was significantly reduced, ejection fraction was significantly preserved (43.9 ± 3.3% vs. 29.1 ± 4.3% for WT) and left ventricular (LV) chamber dilation was attenuated in the Col6a1-/- MI group (25.8 ± 7.9% increase vs. 62.6 ± 16.5% for WT). The improvement in cardiac remodeling was evident as early as 10 days post-MI in the Col6a1-/- mice. Myocyte apoptosis within the infarcted zones was initially greater in the Col6a1-/- group 3 days post-MI but by day 14 this was significantly reduced. Collagen deposition was also reduced in the infarcted and remote areas of the Col6a1-/- hearts. The reductions in chronic myocyte apoptosis and fibrosis are critical events leading to improved long-term remodeling and functional outcomes. Conclusions These unexpected results demonstrate for the first time that deletion of type VI collagen in this knockout model plays a critical protective role following MI by limiting infarct size, chronic apoptosis, aberrant remodeling and fibrosis leading to preservation of cardiac function. PMID:22343710

  13. Carotid-cardiac baroreflex response and LBNP tolerance following resistance training

    NASA Technical Reports Server (NTRS)

    Tatro, D. L.; Dudley, G. A.; Convertino, V. A.

    1992-01-01

    The purpose of this study was to examine the effect of lower body resistance training on cardiovascular control mechanisms and blood pressure maintenance during an orthostatic challenge. Lower body negative pressure (LBNP) tolerance, carotid-cardiac baroreflex function (using neck chamber pressure), and calf compliance were measured in eight healthy males before and after 19 wk of knee extension and leg press training. Resistance training sessions consisted of four or five sets of 6-12 repetitions of each exercise, performed two times per week. Training increased strength 25 +/- 3 (SE) percent (P = 0.0003) and 31 +/- 6 percent (P = 0.0004), respectively, for the leg press and knee extension exercises. Average fiber size in biopsy samples of m. vastus lateralis increased 21 +/- 5 percent (P = 0.0014). Resistance training had no significant effect on LBNP tolerance. However, calf compliance decreased in five of the seven subjects measured, with the group average changing from 4.4 +/- 0.6 ml.mm Hg-1 to 3.9 +/- 0.3 ml.mm Hg-1 (P = 0.3826). The stimulus-response relationship of the carotid-cardiac baroreflex response shifted to the left on the carotid pressure axis as indicated by a reduction of 6 mm Hg in baseline systolic blood pressure (P = 0.0471). In addition, maximum slope increased from 5.4 +/- 1.3 ms.mm Hg-1 before training to 6.6 +/- 1.6 ms.mm Hg-1 after training (P = 0.0141). Our results suggest the possibility that high resistance, lower extremity exercise training can cause a chronic increase in sensitivity and resetting of the carotid-cardiac baroreflex.

  14. Huge Left Atrium Accompanied by Normally Functioning Prosthetic Valve

    PubMed Central

    Sabzi, Feridoun

    2015-01-01

    Abstract Giant left atria are defined as those measuring larger than 8 cm and are typically found in patients who have rheumatic mitral valve disease with severe regurgitation. Enlargement of the left atrium may create compression of the surrounding structures such as the esophagus, pulmonary veins, respiratory tract, lung, inferior vena cava, recurrent laryngeal nerve, and thoracic vertebrae and lead to dysphagia, respiratory dysfunction, peripheral edema, hoarse voice, or back pain. However, a huge left atrium is usually associated with rheumatic mitral valve disease but is very rare in a normally functioning prosthetic mitral valve, as was the case in our patient. A 46-year-old woman with a past medical history of mitral valve replacement and chronic atrial fibrillation was admitted to our hospital with a chief complaint of cough and shortness of breath, worsened in the last month. Physical examination showed elevated jugular venous pressure, respiratory distress, cardiac cachexia, heart failure, hepatomegaly, and severe edema in the legs. Chest radiography revealed an inconceivably huge cardiac sell-out. Transthoracic echocardiography demonstrated a huge left atrium, associated with thrombosis, and normal function of the prosthetic mitral valve. Cardiac surgery with left atrial exploration for the extraction of the huge thrombosis and De Vega annuloplasty for tricuspid regurgitation were carried out. The postoperative course was eventful due to right ventricular failure and low cardiac output syndrome; and after two days, the patient expired with multiple organ failure. Thorough literature review showed that our case was the largest left atrium (20 × 22 cm) reported thus far in adults with a normal prosthetic mitral valve function. PMID:26157465

  15. Cardiac arrest management

    Microsoft Academic Search

    Richard V. Aghababian; Gregory Mears; Joseph P. Ornato; Peter J. Kudenchuk

    2001-01-01

    Approximately 1,000 people in the United States suffer cardiac arrest each day, most often as a complication of acute myocardial infarction (AMI) with accompanying ventricular fibrillation or unstable ventricular tachycardia. Increasing the number of patients who survive cardiac arrest and minimizing the clinical sequelae associated with cardiac arrest in those who do survive are the objectives of emergency medical personnel.

  16. Cardiac Metabolic Alterations in Hypertensive Obese Pigs.

    PubMed

    Zhang, Xin; Li, Zi-Lun; Eirin, Alfonso; Ebrahimi, Behzad; Pawar, Aditya S; Zhu, Xiang-Yang; Lerman, Amir; Lerman, Lilach O

    2015-08-01

    Obesity and hypertension are major risk factors for cardiovascular diseases, and their growing coexistence accounts for an increase in adverse cardiac events, but the mechanisms are yet to be determined. We hypothesized that obesity exacerbates mitochondrial dysregulation imposed by hypertension and augments left ventricular dysfunction. Obesity-prone Ossabaw pigs were randomized to lean (standard diet) and obese (high-fat diet), without (Lean-sham and Obese-sham) or with renovascular hypertension (Lean-hypertension and Obese-hypertension), induced after 12 weeks of diet (n=7 each). Cardiac function, myocardial perfusion and oxygenation, and microvascular remodeling were assessed 4 weeks later. Mitochondrial biogenesis signals and structural proteins, respiratory chain complex activities, and mitochondrial self-degradation were examined, as was fibrosis. Obesity alone exerted no apparent effect on mitochondrial dynamics, but aggravated in hypertensive hearts the reduction of mitochondrial proteins, deoxyribonucleic acid content, and respiratory chain complex IV subunits activity, and amplified mitochondrial self-degradation. Synergistic interaction of obesity with hypertension also exacerbated myocardial fibrosis and left ventricular diastolic dysfunction. Mitochondrial content, respiratory chain complex IV subunits activity, and mitophagy were correlated with myocardial fibrosis. These findings suggest that obesity aggravates in renovascular hypertension cardiac mitochondrial aberrations. Mitochondrial function may regulate the progression of cardiac injury and functional deterioration in hypertension concomitant with obesity. PMID:26077566

  17. Solar thermal plasma chamber

    Microsoft Academic Search

    Joseph Bonometti; Donald R. Buchele; Charles H. Castle; Don A. Gregory

    2001-01-01

    A unique solar thermal chamber has been designed and fabricated to produce the maximum concentration of solar energy and highest temperature possible. Its primary purpose was for solar plasma propulsion experiments and related material specimen testing above 3000 Kelvin. The design not only maximized solar concentration, but also, minimized infrared heat loss. This paper provides the underlining theory and operation

  18. Engine combustion chamber structure

    Microsoft Academic Search

    Tanaka

    1988-01-01

    This patent describes a combustion chamber structure comprising an upper wall surface which is shaped like a pent-roof and into which an intake passage opens, a piston having on a head portion thereof a bulged portion conforming to the upper wall surface in shape, a first bowl portion which is formed substantially at the center of the bulged portion and

  19. Liquid Wall Chambers

    SciTech Connect

    Meier, W R

    2011-02-24

    The key feature of liquid wall chambers is the use of a renewable liquid layer to protect chamber structures from target emissions. Two primary options have been proposed and studied: wetted wall chambers and thick liquid wall (TLW) chambers. With wetted wall designs, a thin layer of liquid shields the structural first wall from short ranged target emissions (x-rays, ions and debris) but not neutrons. Various schemes have been proposed to establish and renew the liquid layer between shots including flow-guiding porous fabrics (e.g., Osiris, HIBALL), porous rigid structures (Prometheus) and thin film flows (KOYO). The thin liquid layer can be the tritium breeding material (e.g., flibe, PbLi, or Li) or another liquid metal such as Pb. TLWs use liquid jets injected by stationary or oscillating nozzles to form a neutronically thick layer (typically with an effective thickness of {approx}50 cm) of liquid between the target and first structural wall. In addition to absorbing short ranged emissions, the thick liquid layer degrades the neutron flux and energy reaching the first wall, typically by {approx}10 x x, so that steel walls can survive for the life of the plant ({approx}30-60 yrs). The thick liquid serves as the primary coolant and tritium breeding material (most recent designs use flibe, but the earliest concepts used Li). In essence, the TLW places the fusion blanket inside the first wall instead of behind the first wall.

  20. Bubble Chamber Site

    NSDL National Science Digital Library

    This substantial site features a large number of photos of bubble chamber (BC) tracks, many with a discussion of the physics. There is a description of how the BC works and also useful tutorial on reading BC pictures. The high quality of the images and the explanations of the events that are shown make this site especially valuable.

  1. Left Business Observer

    NSDL National Science Digital Library

    Edited by Wall Street author Doug Henwood, the Left Business Observer site features selected articles from the print journal by the same name (1992-present). The site provides special reports on current political issues, in addition to a discussion forum and US labor statistics with commentary from a "left" perspective.

  2. Determinants of Right Ventricular Muscle Mass in Idiopathic Dilated Cardiomyopathy: Impact of Left Ventricular Muscle Mass and Pulmonary Hypertension

    PubMed Central

    Vormbrock, Julia; Liebeton, Jeanette; Wirdeier, Sophia; Meissner, Axel; Butz, Thomas; Trappe, Hans-Joachim; Plehn, Gunnar

    2014-01-01

    Introduction: Although chronic pulmonary hypertension and right ventricular (RV) function carry important functional and prognostic implications in idiopathic dilated cardiomyopathy (IDC), little information on RV muscle mass (RVMM) and its determinants has been published. Methods: Our study comprised thirty-five consecutive patients with IDC, left ventricular (LV) ejection fraction <40% and NYHA class ?2. Hemodynamic data and parameters on LV and RV geometry were derived from right heart catheterisation and cardiac magnetic resonance imaging. Results: RVMM was normalized to body size using a common linear, body surface area based approach (RVMMI) and by an allometric index (RVMM-AI) incorporating adjustment for age, height and weight. Stepwise multiple regression analysis revealed that pulmonary artery pressure and left ventricular muscle mass were independent predictors of RVMM-AI. The interventricular mass ratio of RV and LV mass (IVRM) was closely related to RVMM (r = 0.79, p < 0.001) and total muscle mass (r = 0.39, p < 0.02). However, there was no significant relationship between LVMM and IVMR (r = 0.17, p = 0.32). Conclusion: Our data suggest that an increase in RV mass in IDC may be explained by two mechanisms: First, as a consequence of the myopathic process itself resulting in a balanced hypertrophy of both ventricles. Second, due to the chamber specific burden of pulmonary artery pressure rise, resulting in unbalanced RV hypertrophy. PMID:24936147

  3. 72. VISITOR'S CENTER, MODEL OF BOILER CHAMBER, AUXILIARY CHAMBER, REACTOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    72. VISITOR'S CENTER, MODEL OF BOILER CHAMBER, AUXILIARY CHAMBER, REACTOR AND CANAL (LOCATION T) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

  4. Cardiac Oxidative Stress Is Elevated at the Onset of Dilated Cardiomyopathy in Streptozotocin-Diabetic Rats

    Microsoft Academic Search

    María J. Crespo; Joaquin Zalacaín; Donald C. Dunbar; Nildris Cruz; Lucy Arocho

    2008-01-01

    The association between nitric oxide synthase (eNOS and iNOS) status, oxidative stress, and cardiac function was evaluated in streptozotocin (STZ)-diabetic rats to understand the etiology of diabetic cardiomyopathy. Cardiac function was determined by echocardiography. eNOS and iNOS status and superoxide production were assessed by immunohistochemistry and chemiluminescence, respectively. In STZ-diabetic rats, stroke volume, cardiac output, and left ventricular ejection fraction

  5. Controlled Cardiac Computed Tomography

    PubMed Central

    Wang, Chenglin; Liu, Ying; Wang, Ge

    2006-01-01

    Cardiac computed tomography (CT) has been a hot topic for years because of the clinical importance of cardiac diseases and the rapid evolution of CT systems. In this paper, we propose a novel strategy for controlled cardiac CT that may effectively reduce image artifacts due to cardiac and respiratory motions. Our approach is radically different from existing ones and is based on controlling the X-ray source rotation velocity and powering status in reference to the cardiac motion. We theoretically show that by such a control-based intervention the data acquisition process can be optimized for cardiac CT in the cases of periodic and quasiperiodic cardiac motions. Specifically, we formulate the corresponding coordination/control schemes for either exact or approximate matches between the ideal and actual source positions, and report representative simulation results that support our analytic findings. PMID:23165017

  6. Human cardiac physiology in the phase plane: the ejection fraction to limit cycle area relation

    Microsoft Academic Search

    S. Eucker; J. B. Lisauskas; J. Singh; S. J. Kovacs

    1999-01-01

    Current physiologic parameters acquired during cardiac catheterization include the systolic, minimum, and end-diastolic left ventricular pressures, the ejection fraction, and the maximum and minimum rates of pressure rise and fall. To extract additional physiologic information from the left ventricular pressure (LVP) contour, we utilized phase plane analysis (dP\\/dt vs P) to study LVP. One cardiac cycle generates a closed loop,

  7. A Case of Isolated Cardiac Hydatid Cyst that Mimics Lymphoproliferative Malignancy.

    PubMed

    Yildiz, Cenk Eray; Sinan, Ümit Ya?ar; Yildiz, Ahmet; Çetin, Gürkan; Küçüko?lu, Serdar

    2015-06-01

    Cardiac cystic echinococcosis is a rare parasitic infestation caused by Echinococcus granulosus larvae and it composes 0.5-2% of all human cystic echinococcosis cases. The left ventricle is the most common affected area followed by right ventricle, interventricular septum, left atrium, right atrium, and interatrial septum. The diagnosis is difficult because of nonspecific clinical and radiographic findings. We present a case of isolated apical cardiac cystic echinococcosis mimicking lymphoproliferative disease. PMID:25470654

  8. Three chamber negative ion source

    DOEpatents

    Leung, Ka-Ngo (Hercules, CA); Ehlers, Kenneth W. (Alamo, CA); Hiskes, John R. (Livermore, CA)

    1985-01-01

    A negative ion vessel is divided into an excitation chamber, a negative ionization chamber and an extraction chamber by two magnetic filters. Input means introduces neutral molecules into a first chamber where a first electron discharge means vibrationally excites the molecules which migrate to a second chamber. In the second chamber a second electron discharge means ionizes the molecules, producing negative ions which are extracted into or by a third chamber. A first magnetic filter prevents high energy electrons from entering the negative ionization chamber from the excitation chamber. A second magnetic filter prevents high energy electrons from entering the extraction chamber from the negative ionizing chamber. An extraction grid at the end of the negative ion vessel attracts negative ions into the third chamber and accelerates them. Another grid, located adjacent to the extraction grid, carries a small positive voltage in order to inhibit positive ions from migrating into the extraction chamber and contour the plasma potential. Additional electrons can be suppressed from the output flux using ExB forces provided by magnetic field means and the extractor grid electric potential.

  9. Optimization of Cardiac Fiber Orientation for Homogeneous Fiber Strain During Ejection

    Microsoft Academic Search

    JM Rijcken; P. H. M. Bovendeerd; A. J. G. Schoofs; D. H. van Campen; T. Arts

    1999-01-01

    The strain of muscle fibers in the heart is likely to be distributed uniformly over the cardiac walls during the ejection period of the cardiac cycle. Mathematical models of left ventricular (LV) wall mechanics have shown that the distribution of fiber strain during ejection is sensitive to the orientation of muscle fibers in the wall. In the present study, we

  10. Determination of cardiac size following space missions of different durations - The second manned Skylab mission

    NASA Technical Reports Server (NTRS)

    Nicogossian, A.; Hoffler, G. W.; Johnson, R. L.; Gowen, R. J.

    1976-01-01

    A simple method to estimate cardiac size from single frontal plane chest roentgenograms has been described. Pre- and postflight chest X-rays from Apollo 17, and Skylab 2 and 3 have been analyzed for changes in the cardiac silhouette size. The data obtained from the computed cardiothoracic areal ratios compared well with the clinical cardiothoracic diametral ratios (r = .86). Though an overall postflight decrease in cardiac size is evident, the mean difference was not statistically significant (n = 8). The individual decreases in the cardiac silhouette size postflight are thought to be due to decrements in intracardiac chamber volumes rather than in myocardial muscle mass.

  11. Effect of prolonged exercise in a hypoxic environment on cardiac function and cardiac troponin T

    PubMed Central

    Shave, R; Dawson, E; Whyte, G; George, K; Gaze, D; Collinson, P

    2004-01-01

    Objective: To investigate if exercise induced cardiac fatigue and or cardiac damage occurs after prolonged exercise in a hypoxic environment. Methods: Eight trained male triathletes volunteered for the study. Each completed two 50 mile cycle trials, randomly assigned from normobaric normoxia and normobaric hypoxia (15% FIO2). Echocardiographic assessment and whole blood collection was completed before, immediately after, and 24 hours after exercise. Left ventricular systolic and diastolic functional variables were calculated, and serum was analysed for cardiac troponin T. Results were analysed using a two way repeated measures analysis of variance, with ? set at 0.05. Results: No significant differences were observed in either systolic or diastolic function across time or between trials. Cardiac troponin T was detected in one subject immediately after exercise in the normobaric hypoxic trial. Conclusions: A 50 mile cycle trial in either normobaric normoxia or normobaric hypoxia does not induce exercise induced cardiac fatigue. Some people, however, may exhibit minimal cardiac damage after exercise in normobaric hypoxia. The clinical significance of this is yet to be elucidated. PMID:14751955

  12. Strings containing left bundle branch conductive tissue in the left ventricle. Observations in man.

    PubMed

    Asmussen, I; Ornvold, K

    1985-11-01

    Several reports have demonstrated the presence of strings within the heart chambers e.g.: on the basis of autopsy materials (Goforth 1926, Knoblich et al. 1962, Hudson 1965, Gould 1968, Roberts 1969, Franck 1970, Olsen & Valentine 1972) or by echocardiography (Nishimura et al. 1981, Choo et al. 1982, Lindvall et al. 1982, Asmussen submitted for publication). Prompted by the echocardiographic observations by Asmussen (Asmussen submitted for publication) we tested the hypothesis that left ventricular strings may contain left bundle branch conductive tissue. During a six months' survey period at the Laboratory of Pediatric Pathology we found two such cases. It is suggested that left bundle branch block and/or hemiblock may be a consequence of this abnormality in the event of stretching or rupture of such strings. PMID:4090986

  13. Demography of penetrating cardiac trauma.

    PubMed Central

    Naughton, M J; Brissie, R M; Bessey, P Q; McEachern, M M; Donald, J M; Laws, H L

    1989-01-01

    All cases of penetrating cardiac trauma in 1985 and 1986 in Jefferson County, Alabama, where patients dying of penetrating trauma received autopsies, were retrospectively reviewed. All hospitals in the county plus the single coroner's office provided the records of the 72 patients comprising this study. Incidents occurred most often in the home or residence (70%) by a known assailant (83%) due to domestic/social disputes (73%). Frequency was greatest in the evening hours (73% between 6:00 PM and 3:00 AM), on weekends in spring and summer. Victims tended to be male (86%), black (72%), married (46%), blue collar workers (62%). There were 41 (57%) gunshot wounds, 3 (4%) shotgun wounds, and 28 (39%) stab wounds with an associated mortality rate of 97%, 100%, and 68%, respectively. Prehospital mortality rate (dead at the scene) was 54.2% (39/72), and death on arrival was 26.4% (19/72), for a combined pretreatment mortality rate of 80.6%. All patients who arrived with no vital signs died. Mortality appeared to be related to mechanism of injury, age, race, sex, vital signs on arrival, number and specific cardiac chambers injured, associated major vascular injury, hematocrit, and mode of transportation. Mortality was not related to caliber of weapon, ethanol level, transport time, time from arrival to operation, or transfusion requirements. There were only ten survivors (1 gunshot wound and 9 stab wounds), all of whom had ventricular injuries and no associated major vascular injuries. The ten survivors represented a 71.4% (10/14) salvage rate for those victims arriving with vital signs. Complications occurred in three patients. Hospitalization averaged 7.3 days in the survivors. Penetrating cardiac trauma remains a serious, socially linked disease with a high rate of mortality. Rapid transport, aggressive resuscitation and cardiorrhaphy remain the best treatment. PMID:2730180

  14. Left ventricular noncompaction in Sotos syndrome.

    PubMed

    Martinez, Hugo R; Belmont, John W; Craigen, William J; Taylor, Michael D; Jefferies, John L

    2011-05-01

    Sotos syndrome is an autosomal dominant condition characterized by pre- and postnatal overgrowth (tall stature and macrocephaly), a typical facial appearance, advanced bone age, and developmental delay. The syndrome is caused by mutations or deletions of the nuclear receptor binding SET domain protein 1 (NSD1) gene, which encodes a histone methyltransferase implicated in the regulation of chromatin. Left ventricular noncompaction (LVNC), also called left ventricular (LV) hypertrabeculation, is a rare disorder classified as a primary genetic cardiomyopathy by the American Heart Association. This condition is characterized by an altered myocardial wall due to arrest of embryonic compaction of the loose interwoven meshwork that makes up the fetal myocardial primordium. The cardiac manifestations of this cardiomyopathy are variable, ranging from an absence of symptoms to a progressive deterioration in cardiac function, with heart failure, arrhythmias, and systemic thromboemboli. We describe two unrelated patients who had LVNC, as based on echocardiographic findings, and Sotos syndrome, as based on physical features and molecular analysis. To our knowledge, the literature contains no previous reports of concomitant LVNC and Sotos syndrome. In the light of these two cases, we suggest that patients with Sotos syndrome be evaluated for LVNC cardiomyopathy when being screened for heart defects. PMID:21484993

  15. Multiwire proportional chamber development

    NASA Technical Reports Server (NTRS)

    Doolittle, R. F.; Pollvogt, U.; Eskovitz, A. J.

    1973-01-01

    The development of large area multiwire proportional chambers, to be used as high resolution spatial detectors in cosmic ray experiments is described. A readout system was developed which uses a directly coupled, lumped element delay-line whose characteristics are independent of the MWPC design. A complete analysis of the delay-line and the readout electronic system shows that a spatial resolution of about 0.1 mm can be reached with the MWPC operating in the strictly proportional region. This was confirmed by measurements with a small MWPC and Fe-55 X-rays. A simplified analysis was carried out to estimate the theoretical limit of spatial resolution due to delta-rays, spread of the discharge along the anode wire, and inclined trajectories. To calculate the gas gain of MWPC's of different geometrical configurations a method was developed which is based on the knowledge of the first Townsend coefficient of the chamber gas.

  16. The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

    PubMed Central

    Badano, Luigi P.

    2014-01-01

    Three-dimensional echocardiography is a novel imaging technique based on acquisition and display of volumetric data sets in the beating heart. This permits a comprehensive evaluation of left ventricular (LV) anatomy and function from a single acquisition and expands the diagnostic possibilities of noninvasive cardiology. It provides the possibility of quantitating geometry and function of LV without preestablished assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible. Further developments and improvements for widespread routine applications include higher spatial and temporal resolution to improve image quality, faster acquisition, processing and reconstruction, and fully automated quantitative analysis. At present, three-dimensional echocardiography complements routine 2DE in clinical practice, overcoming some of its limitations and offering additional valuable information that has led to recommending its use for routine assessment of the LV of patients in whom information about LV size and function is critical for their clinical management. PMID:24959374

  17. Left ventricular endocardial surface detection based on real-time 3D echocardiographic data

    NASA Technical Reports Server (NTRS)

    Corsi, C.; Borsari, M.; Consegnati, F.; Sarti, A.; Lamberti, C.; Travaglini, A.; Shiota, T.; Thomas, J. D.

    2001-01-01

    OBJECTIVE: A new computerized semi-automatic method for left ventricular (LV) chamber segmentation is presented. METHODS: The LV is imaged by real-time three-dimensional echocardiography (RT3DE). The surface detection model, based on level set techniques, is applied to RT3DE data for image analysis. The modified level set partial differential equation we use is solved by applying numerical methods for conservation laws. The initial conditions are manually established on some slices of the entire volume. The solution obtained for each slice is a contour line corresponding with the boundary between LV cavity and LV endocardium. RESULTS: The mathematical model has been applied to sequences of frames of human hearts (volume range: 34-109 ml) imaged by 2D and reconstructed off-line and RT3DE data. Volume estimation obtained by this new semi-automatic method shows an excellent correlation with those obtained by manual tracing (r = 0.992). Dynamic change of LV volume during the cardiac cycle is also obtained. CONCLUSION: The volume estimation method is accurate; edge based segmentation, image completion and volume reconstruction can be accomplished. The visualization technique also allows to navigate into the reconstructed volume and to display any section of the volume.

  18. Engine combustion chamber structure

    SciTech Connect

    Tanaka, H.

    1988-09-13

    This patent describes a combustion chamber structure comprising an upper wall surface which is shaped like a pent-roof and into which an intake passage opens, a piston having on a head portion thereof a bulged portion conforming to the upper wall surface in shape, a first bowl portion which is formed substantially at the center of the bulged portion and which is substantially semispherical in shape, a pair of second bowl portions which respectively extend on opposite sides of the first bowl portion to the corresponding ends of the bulged portion of the piston along the edge of the bulged portion and are in communication with the first bowl portion, a swirl generating means which is adapted to generate a swirl of intake air in the combustion chamber when the engine load is light, and a spark plug disposed to substantially face the center of the first bowl portion from the upper wall surface; the swirl generating means being adapted to generate the swirl of intake air in a tangential direction in the combustion chamber; and the diameter of the first bowl portion being larger than the width of the second bowl portion.

  19. MAIN CHAMBER NEUTRAL PRESSURE IN

    E-print Network

    Pitcher, C. S.

    MAIN CHAMBER NEUTRAL PRESSURE IN ALCATOR C-MOD AND JET C S Pitcher, S K Erents*, W Fundamenski*, B on Controlled Fusion and Plasma Physics 18 ­ 22 June 1999, Madeira, Portugal MAIN CHAMBER NEUTRAL PRESSURE Science Centre, Abingdon, Oxon OX14 3DB,UK #12;(1) Introduction · main chamber gas can have a number

  20. Anterior chamber angle vascularization in Sturge-Weber syndrome Report of a case

    Microsoft Academic Search

    Juma H. Mwinula; Takuji Sagawa; Akihiko Tawara; Hajime Inomata

    1994-01-01

    The case of a 20-year-old woman with a left-sided facial hemangioma and a homolateral glaucoma is reported, complete with the histology of a trabeculectomy specimen. Her left eye had an episcleral hemangioma and goniodysgenetic features in the anterior chamber angle, while the intraocular pressure was measured to be 45 mmHg. The left optic disc showed a large cupping and the

  1. Left heart catheterization

    MedlinePLUS

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  2. Regression of Pathological Cardiac Hypertrophy: Signaling Pathways and Therapeutic Targets

    PubMed Central

    Hou, Jianglong; Kang, Y. James

    2012-01-01

    Pathological cardiac hypertrophy is a key risk factor for heart failure. It is associated with increased interstitial fibrosis, cell death and cardiac dysfunction. The progression of pathological cardiac hypertrophy has long been considered as irreversible. However, recent clinical observations and experimental studies have produced evidence showing the reversal of pathological cardiac hypertrophy. Left ventricle assist devices used in heart failure patients for bridging to transplantation not only improve peripheral circulation but also often cause reverse remodeling of the geometry and recovery of the function of the heart. Dietary supplementation with physiologically relevant levels of copper can reverse pathological cardiac hypertrophy in mice. Angiogenesis is essential and vascular endothelial growth factor (VEGF) is a constitutive factor for the regression. The action of VEGF is mediated by VEGF receptor-1, whose activation is linked to cyclic GMP-dependent protein kinase-1 (PKG-1) signaling pathways, and inhibition of cyclic GMP degradation leads to regression of pathological cardiac hypertrophy. Most of these pathways are regulated by hypoxia-inducible factor. Potential therapeutic targets for promoting the regression include: promotion of angiogenesis, selective enhancement of VEGF receptor-1 signaling pathways, stimulation of PKG-1 pathways, and sustention of hypoxia-inducible factor transcriptional activity. More exciting insights into the regression of pathological cardiac hypertrophy are emerging. The time of translating the concept of regression of pathological cardiac hypertrophy to clinical practice is coming. PMID:22750195

  3. Cardiac innervation and sudden cardiac death.

    PubMed

    Fukuda, Keiichi; Kanazawa, Hideaki; Aizawa, Yoshiyasu; Ardell, Jeffrey L; Shivkumar, Kalyanam

    2015-06-01

    Afferent and efferent cardiac neurotransmission via the cardiac nerves intricately modulates nearly all physiological functions of the heart (chronotropy, dromotropy, lusitropy, and inotropy). Afferent information from the heart is transmitted to higher levels of the nervous system for processing (intrinsic cardiac nervous system, extracardiac-intrathoracic ganglia, spinal cord, brain stem, and higher centers), which ultimately results in efferent cardiomotor neural impulses (via the sympathetic and parasympathetic nerves). This system forms interacting feedback loops that provide physiological stability for maintaining normal rhythm and life-sustaining circulation. This system also ensures that there is fine-tuned regulation of sympathetic-parasympathetic balance in the heart under normal and stressed states in the short (beat to beat), intermediate (minutes to hours), and long term (days to years). This important neurovisceral/autonomic nervous system also plays a major role in the pathophysiology and progression of heart disease, including heart failure and arrhythmias leading to sudden cardiac death. Transdifferentiation of neurons in heart failure, functional denervation, cardiac and extracardiac neural remodeling has also been identified and characterized during the progression of disease. Recent advances in understanding the cellular and molecular processes governing innervation and the functional control of the myocardium in health and disease provide a rational mechanistic basis for the development of neuraxial therapies for preventing sudden cardiac death and other arrhythmias. Advances in cellular, molecular, and bioengineering realms have underscored the emergence of this area as an important avenue of scientific inquiry and therapeutic intervention. PMID:26044253

  4. Ensemble Force Changes that Result from Human Cardiac Myosin Mutations and a Small-Molecule Effector.

    PubMed

    Aksel, Tural; Choe Yu, Elizabeth; Sutton, Shirley; Ruppel, Kathleen M; Spudich, James A

    2015-05-12

    Cardiomyopathies due to mutations in human ?-cardiac myosin are a significant cause of heart failure, sudden death, and arrhythmia. To understand the underlying molecular basis of changes in the contractile system's force production due to such mutations and search for potential drugs that restore force generation, an in vitro assay is necessary to evaluate cardiac myosin's ensemble force using purified proteins. Here, we characterize the ensemble force of human ?- and ?-cardiac myosin isoforms and those of ?-cardiac myosins carrying left ventricular non-compaction (M531R) and dilated cardiomyopathy (S532P) mutations using a utrophin-based loaded in vitro motility assay and new filament-tracking software. Our results show that human ?- and ?-cardiac myosin, as well as the mutants, show opposite mechanical and enzymatic phenotypes with respect to each other. We also show that omecamtiv mecarbil, a previously discovered cardiac-specific myosin activator, increases ?-cardiac myosin force generation. PMID:25937279

  5. Left atrial appendage: structure, function, and role in thromboembolism

    PubMed Central

    Al-Saady, N; Obel, O; Camm, A

    1999-01-01

    The left atrial appendage (LAA) is derived from the left wall of the primary atrium, which forms during the fourth week of embryonic development. It has developmental, ultrastructural, and physiological characteristics distinct from the left atrium proper. The LAA lies within the confines of the pericardium in close relation to the free wall of the left ventricle and thus its emptying and filling may be significantly affected by left ventricular function. The physiological properties and anatomical relations of the LAA render it ideally suited to function as a decompression chamber during left ventricular systole and during other periods when left atrial pressure is high. These properties include the position of the LAA high in the body of the left atrium; the increased distensibility of the LAA compared with the left atrium proper; the high concentration of atrial natriuretic factor (ANF) granules contained within the LAA; and the neuronal configuration of the LAA. Thrombus has a predilection to form in the LAA in patients with atrial fibrillation, mitral valve disease, and other conditions. The pathogenesis has not been fully elucidated; however, relative stasis which occurs in the appendage owing to its shape and the trabeculations within it is thought to play a major role. Obliteration or amputation of the LAA may help to reduce the risk of thromboembolism, but this may result in undesirable physiological sequelae such as reduced atrial compliance and a reduced capacity for ANF secretion in response to pressure and volume overload.?? PMID:10525506

  6. Multi-anode ionization chamber

    DOEpatents

    Bolotnikov, Aleksey E. (South Setauket, NY); Smith, Graham (Port Jefferson, NY); Mahler, George J. (Rocky Point, NY); Vanier, Peter E. (Setauket, NY)

    2010-12-28

    The present invention includes a high-energy detector having a cathode chamber, a support member, and anode segments. The cathode chamber extends along a longitudinal axis. The support member is fixed within the cathode chamber and extends from the first end of the cathode chamber to the second end of the cathode chamber. The anode segments are supported by the support member and are spaced along the longitudinal surface of the support member. The anode segments are configured to generate at least a first electrical signal in response to electrons impinging thereon.

  7. Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

    PubMed Central

    Esmer, Aytül Çorbac?o?lu; Yüksel, At?l; Çal?, Halime; Özsürmeli, Mehmet; Ömero?lu, Rukiye Eker; Kalelio?lu, ?brahim; Has, Recep

    2014-01-01

    Background: Persistent left superior vena cava (PLSVC) is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4–8% of patients with congenital heart disease. Aims: To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. Study Design: Retrospective comparative study. Methods: The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. Results: Data of 31 cases were reviewed. Fifteen (48.4%) cases were associated with cardiac defects and 17 (54.8%) cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009). All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extra-cardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases. PMID:25207167

  8. Astronaut Story Musgrave in EMU in thermal vacuum chamber

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Astronaut F. Story Musgrave, wearing a training version of the extravehicular activity unit (EMU), particpates in a dry run for tests in thermal vacuum chamber. The test, conducted in Chamber B ofthe Space Environment and Simulation Laboratory at JSC, verified that the tools being designed for the mission will work in the cold vacuum of space. Others pictured, from the left, are Andrea Tullar and Donna Fender, test directors; Leonard S. Nicholson, acting Director of engineering; and Astronauts Thomas D. Akers and Kathryn C. Thornton, STS-61 mission specialists, along with Musgrave.

  9. Hyperplastic cardiac sarcoma recurrence.

    PubMed

    Shariff, Masood A; Abreu, Juan A; Durrani, Farida; Daniele, Eddie; Bowman, Kimberly C; Sadel, Scott; Asgarian, Kourosh T; McGinn, Joseph T; Nabagiez, John P

    2015-01-01

    Primary cardiac sarcomas are rare tumors with a median survival of 6-12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34. This report discusses the malignant nature of cardiac sarcoma and the importance of postoperative multidisciplinary care. PMID:25861508

  10. Review of wire chamber aging

    SciTech Connect

    Va'Vra, J.

    1986-02-01

    This paper makes an overview of the wire chamber aging problems as a function of various chamber design parameters. It emphasizes the chemistry point of view and many examples are drawn from the plasma chemistry field as a guidance for a possible effort in the wire chamber field. The paper emphasizes the necessity of variable tuning, the importance of purity of the wire chamber environment, as well as it provides a practical list of presently known recommendations. In addition, several models of the wire chamber aging are qualitatively discussed. The paper is based on a summary talk given at the Wire Chamber Aging Workshop held at LBL, Berkeley on January 16-17, 1986. Presented also at Wire Chamber Conference, Vienna, February 25-28, 1986. 74 refs., 18 figs., 11 tabs.

  11. Left coronary arterial blood flow: Noninvasive detection by Doppler US

    SciTech Connect

    Gramiak, R.; Holen, J.; Moss, A.J.; Gutierrez, O.H.; Picone, A.L.; Roe, S.A.

    1986-06-01

    Continuous wave (CW) and pulsed Doppler ultrasound studies with spectral analysis were used to detect the left coronary arterial blood flow in patients who were undergoing routine echocardiography. The pulmonary artery is a stable ultrasonic landmark from which detection of the blood flow can be effected. The left coronary artery can be distinguished by its blood flow toward the cardiac apex and by specific, functional flow features. Flow patterns vary among the left main, circumflex, and anterior descending arteries; patterns also vary with respiration cycles. In the present study, coronary arterial blood flow was detected in 58 of 70 patients (83%). Findings were validated by selectively injecting an agitated saline contrast medium into the left coronary artery and, in another study, by comparing human Doppler phasic flow waveforms with electromagnetic flowmeter recordings obtained in dogs.

  12. Ostial left main coronary stenosis in a frequent flyer.

    PubMed

    O'Sullivan, John F; McFadden, Eugene

    2009-05-15

    A 52 year old gentleman presented with chest pain, after a long distance flight from India; he had made long haul flights every 2 weeks over the last 5 years as part of his job. His ECG revealed T wave inversion in leads V1-3. Cardiac biomarkers including troponin were negative; we proceeded to exercise stress testing (EST). This revealed 2 mm ST depression at 2 min of the standard Bruce protocol, associated with chest pain. He was taken immediately to the coronary catheterization laboratory; engagement of the left main caused pressure damping with 6 French, then 5 French diagnostic Judkins left 4 catheters. An ostial left main stenosis was seen; the right and left coronary trees otherwise had no significant stenoses. He had normal LV function. He underwent inpatient CABG 7 days later. PMID:18378023

  13. Cathepsin K knockout alleviates aging-induced cardiac dysfunction

    PubMed Central

    Hua, Yinan; Robinson, Timothy J; Cao, Yongtao; Shi, Guo-Ping; Ren, Jun; Nair, Sreejayan

    2015-01-01

    Aging is a major risk factor for cardiovascular disease. It has previously been shown that protein levels of cathepsin K, a lysosomal cysteine protease, are elevated in the failing heart and that genetic ablation of cathepsin K protects against pressure overload-induced cardiac hypertrophy and contractile dysfunction. Here we test the hypothesis that cathepsin K knockout alleviates age-dependent decline in cardiac function. Cardiac geometry, contractile function, intracellular Ca2+ properties, and cardiomyocyte apoptosis were evaluated using echocardiography, fura-2 technique, immunohistochemistry, Western blot and TUNEL staining, respectively. Aged (24-month-old) mice exhibited significant cardiac remodeling (enlarged chamber size, wall thickness, myocyte cross-sectional area, and fibrosis), decreased cardiac contractility, prolonged relengthening along with compromised intracellular Ca2+ release compared to young (6-month-old) mice, which were attenuated in the cathepsin K knockout mice. Cellular markers of senescence, including cardiac lipofuscin, p21 and p16, were lower in the aged-cathepsin K knockout mice compared to their wild-type counterpart. Mechanistically, cathepsin K knockout mice attenuated an age-induced increase in cardiomyocyte apoptosis and nuclear translocation of mitochondrial apoptosis-inducing factor (AIF). In cultured H9c2 cells, doxorubicin stimulated premature senescence and apoptosis. Silencing of cathepsin K blocked the doxorubicin-induced translocation of AIF from the mitochondria to the nuclei. Collectively, these results suggest that cathepsin K knockout attenuates age-related decline in cardiac function via suppressing caspase-dependent and caspase-independent apoptosis. PMID:25692548

  14. Ventricular septal defect and double-chambered right ventricle in an alpaca.

    PubMed

    Poser, Helen; Dalla Pria, Angela; De Benedictis, Giulia M; Stelletta, Calogero; Berlanda, Michele; Guglielmini, Carlo

    2015-03-01

    A 20-month-old male alpaca was referred for evaluation of a cardiac murmur evident since birth. Echocardiography identified a ventricular septal defect (VSD) and a fibro-muscular band causing a stenosis of the right ventricular outflow tract. Right ventricular catheterization and selective angiography confirmed the diagnosis of VSD and double-chambered right ventricle with bidirectional shunting. PMID:25595611

  15. Regionalized sequence of myocardial cell growth and proliferation characterizes early chamber formation

    Microsoft Academic Search

    A. T. Soufan; Berg van den G; J. M. Ruijter; Boer de P. A. J; Hoff van den M. J. B; A. F. M. Moorman

    2006-01-01

    Increase in cell size and proliferation of myocytes are key processes in cardiac morphogenesis, yet their regionalization during development of the heart has been described only anecdotally. We have made quantitative reconstructions of embryonic chicken hearts ranging in stage from the fusion of the heart-forming fields to early formation of the chambers. These reconstructions reveal that the early heart tube

  16. Regionalized Sequence of Myocardial Cell Growth and Proliferation Characterizes Early Chamber Formation

    Microsoft Academic Search

    Alexandre T. Soufan; Gert van den Berg; Jan M. Ruijter; Piet A. J. de Boer; Maurice J. B. van den Hoff; Antoon F. M. Moorman

    2010-01-01

    Increase in cell size and proliferation of myocytes are key processes in cardiac morphogenesis, yet their regionalization during development of the heart has been described only anecdotally. We have made quantitative reconstructions of embryonic chicken hearts ranging in stage from the fusion of the heart-forming fields to early formation of the chambers. These reconstructions reveal that the early heart tube

  17. Left-ventricular cavity automated-border detection using an autocovariance technique in echocardiography

    Microsoft Academic Search

    Louis S. Morda; Elisa E. Konofagou

    2005-01-01

    Left-ventricular (LV) segmentation is essential in the early detection of heart disease, where left-ventricular wall motion is being tracked in order to detect ischemia. In this paper, a new method for automated segmentation of the left-ventricular chamber is described. An autocorrelation-based technique isolates the LV cavity from the myocardial wall on 2-D slices of 3D short-axis echocardiograms. A morphological closing

  18. Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects

    SciTech Connect

    Peter, C.A.; Bowyer, K.; Jones, R.H.

    1983-03-01

    In patients with ventricular or atrial septal defect, the ventricle which is chronically volume overloaded might not appropriately respond to increased demand for an augmentation in output and thereby might limit total cardiac function. In this study we simultaneously measured right and left ventricular response to exercise in 10 normal individuals, 10 patients with ventricular septal defect (VSD), and 10 patients with atrial septal defect (ASD). The normal subjects increased both right and left ventricular ejection fraction, end-diastolic volume, and stroke volume to achieve a higher cardiac output during exercise. Patients with VSD failed to increase right ventricular ejection fraction, but increased right ventricular end-diastolic volume and stroke volume. Left ventricular end-diastolic volume did not increase in these patients but ejection fraction, stroke volume, and forward left ventricular output achieved during exercise were comparable to the response observed in healthy subjects. In the patients with ASD, no rest-to-exercise change occurred in either right ventricular ejection fraction, end-diastolic volume, or stroke volume. In addition, left ventricular end-diastolic volume failed to increase, and despite an increase in ejection fraction, left ventricular stroke volume remained unchanged from rest to exercise. Therefore, cardiac output was augmented only by the heart rate increase in these patients. Right ventricular function appeared to be the major determinant of total cardiac output during exercise in patients with cardiac septal defects and left-to-right shunt.

  19. Left ventricular rotation and twist: why should we learn?

    PubMed

    Nakatani, Satoshi

    2011-03-01

    The left ventricle twists in systole storing potential energy and untwists (recoils) in diastole releasing the energy. Twist aids left ventricular ejection and untwist aids relaxation and ventricular filling. Therefore, rotation and torsion are important in cardiac mechanics. However, the methodology of their investigations is limited to invasive techniques or magnetic resonance imaging. With the advent of speckle tracking echocardiography, however, rotation and torsion (twist) become familiar to echocardiographers. In this review, I outline the mechanism and influencing factors of rotation and torsion with the anticipation of the routine use of these measurements in clinical practice. PMID:21519484

  20. Stroke of a cardiac myxoma origin

    PubMed Central

    Yuan, Shi-Min; Humuruola, Gulimila

    2015-01-01

    Objective The clinical features of cardiac myxoma stroke have not been sufficiently described. Debates remain concerning the options and timing of treatment and the clinical outcomes are unknown. This article aims to highlight the pertinent aspects of this rare condition. Methods Data source of the present study came from a comprehensive literature collection of cardiac myxoma stroke in PubMed, Google search engine and Highwire Press for the year range 2000-2014. Results Young adults, female predominance, single cerebral vessel (mostly the middle cerebral artery), multiple territory involvements and solitary left atrial myxoma constituted the outstanding characteristics of this patient setting. The most common affected cerebral vessel (the middle cerebral artery) and areas (the basal ganglion, cerebellum and parietal and temporal regions) corresponded well to the common manifestations of this patient setting, such as conscious alteration, ataxia, hemiparesis and hemiplegia, aphasia and dysarthria. Initial computed tomography scan carried a higher false negative rate for the diagnosis of cerebral infarction than magnetic resonance imaging did. A delayed surgical resection of cardiac myxoma was associated with an increased risk of potential consequences in particular otherwise arterial embolism. The mortality rate of this patient population was 15.3%. Conclusion Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct.

  1. Multiple cardiac thrombi and thromboembolism in a heparin-induced thrombocytopenia antibody-positive patient with heart failure.

    PubMed

    Wake, Ryotaro; Muro, Takashi; Hozumi, Takeshi; Matsumoto, Ryo; Kataoka, Toru; Nakamura, Yasuhiro; Takemoto, Yasuhiko; Takagi, Masahiko; Suehiro, Shigefumi; Yoshiyama, Minoru

    2008-11-01

    A 49-year-old Japanese man presented with orthopnea and edema in both legs. He was diagnosed with congestive heart failure with triple-vessel coronary artery disease. Low antithrombin and left ventricular systolic dysfunction were possible causes of his hypercoagulable state. Echocardiography revealed thrombi in the left ventricle and left trium, poor left ventricular contractility, and a normal mitral valve. Electrocardiogram revealed normal sinus rhythm. We found small infarctions of the brain and spleen in the computed tomography. The heparin treatment of cardiac thrombi is useless because the patient had heparin-induced thrombocytopenia antibody. We removed thrombi in the left ventricle and left atrium by thrombectomy and performed coronary artery bypass graft. Warfarin was administered for anticoagulation. He recovered completely and is now doing well. Our experience indicates that poor cardiac function can together cause multiple cardiac thrombi and subsequent thromboembolism without mitral stenosis or atrial fibrillation. PMID:19091284

  2. The myocardial contraction fraction is superior to ejection fraction in predicting survival in patients with AL cardiac amyloidosis.

    PubMed

    Tendler, Amanda; Helmke, Stephen; Teruya, Sergio; Alvarez, Julissa; Maurer, Mathew S

    2015-03-01

    Cardiac amyloidosis is a cause of diastolic heart failure in which ejection fraction (EF) remains "normal" despite progression of disease. The myocardial contraction fraction (MCF) is an index of myocardial function, defined as stroke volume (SV) over myocardial volume (MV). We hypothesized that MCF would be superior to EF, the conventional measure of left ventricular function, in predicting survival among patients with cardiac amyloidosis. Sixty-six subjects (mean age?=?67?±?12 years; 20% women) with cardiac amyloidosis (34 with light-chain amyloid and 32 with transthyretin amyloid) underwent two-dimensional echocardiography to determine left ventricular structure and function. Cox proportional hazard modeling was used to determine the association of MCF and EF with survival. Over a mean follow-up of 1.86?±?1.78 years (range 0.03-7.36 years), 37 subjects (56.1%) died. Mean EF of the study population was 51?±?13%. There was no significant difference in EF between patients who survived the study period and those who died (54?±?11% versus 49?±?14%; p?=?0.1196) while there was a significant difference in MCF (35?±?19% versus 23?±?10%, p?=?0.0065). Using Cox proportional hazards modeling, MCF was associated with death (HR?=?0.953, 95% CI of 0.932-0.984, p?=?0.0031) while EF was not (HR?=?0.991, 95% CI of 0.968-1.014, p?=?0.4320). In a multivariate model, amyloid light-chain (AL) amyloid type was an independent risk predictor of death with a HR of 2.841 (95% CI of 1.214-6.648, p?=?0.0161) along with a MCF?chamber function, is superior to EF in predicting overall survival among patients with AL cardiac amyloidosis. PMID:25510353

  3. Surgical models for cardiac regeneration in neonatal mice.

    PubMed

    Mahmoud, Ahmed I; Porrello, Enzo R; Kimura, Wataru; Olson, Eric N; Sadek, Hesham A

    2014-02-01

    Although amphibian and fish models of heart regeneration have existed for decades, a mammalian equivalent has long remained elusive. Our discovery of a brief postnatal window for heart regeneration in neonatal mice has led to the establishment of surgical models for cardiac regenerative studies in mammals for the first time. This protocol describes a 10-min surgical procedure to induce cardiac injury in 1-d-old neonatal mice. This allows for the analysis of cardiac regeneration after surgical amputation of the left ventricle (LV) (apical resection) and coronary artery occlusion (myocardial infarction (MI)). A comparative analysis of neonatal and adult responses to myocardial injury should enable identification of the key differences between regenerative and nonregenerative responses to cardiac injury. This protocol can also be adapted to the growing repertoire of genetic models available in the mouse, and it provides a valuable tool for unlocking the molecular mechanisms that guide mammalian heart regeneration during early postnatal life. PMID:24434799

  4. Quantitative evaluation of left ventricular systolic function by Doppler echocardiographic techniques.

    PubMed

    Loutfi, H; Nishimura, R A

    1994-05-01

    Doppler echocardiography provides the ability to measure blood flow velocities noinvasively. These blood flow velocities can be used to obtain powerful hemodynamic information about systolic contractility of the left ventricle, which in the past could only be determined from invasive cardiac catheterization or cumbersome pulse recordings. Volumetric flow rates can be measured using the hydraulic principle of flow through a rigid tube, providing a measurement of stroke volume and cardiac output. The rate of the left ventricular pressure rise derived from a mitral regurgitation velocity curve provides a nonejection phase index of systolic contractility. Acceleration time can be obtained from an ascending aortic velocity and is an indicator of maximum myocardial force. Systolic time intervals can now be quickly and accurately obtained from the standard Doppler tracings. These quantitative measurements of the status of the left ventricular are accurate, reproducible, and should be incorporated into the routine noninvasive assessment of patients with cardiac disease. PMID:10150566

  5. Cardiac risk telemonitoring

    Microsoft Academic Search

    H. Hutten; M. Hribernigg; G. Rauchegger

    2001-01-01

    Utilization of advanced information, telecommunication and implant technology for cardiac risk stratification and management is one of the greatest challenges for modern health care provision. Sudden cardiac death is the major contributor to overall cardiovascular mortality with approximately 60% of all coronary heart disease fatalities occurring annually. Although some high-risk patient groups have been identified with reasonable sensitivity and specificity

  6. Garfinkel Cardiac Data

    NSDL National Science Digital Library

    Alan Garfinkel (University of California Los Angeles; Physiological Sci/Med-Cardio)

    2009-01-10

    Cardiac data on multiple variables for a selected population of 220 men and 338 women participating in a drug treatment study of dobutamine for heart attack prevention. Garfinkel, Alan, et. al. "Prognostic Value of Dobutamine Stress Echocardiography in Predicting Cardiac Events in Patients With Known or Suspected Coronary Artery Disease." Journal of the American College of Cardiology 33.3 (1999) 708-16.

  7. Left ventricular wall motion estimation with tagged cine MR images: software development

    Microsoft Academic Search

    F. Sottilini; P. Clarysse; J. P. Roux; D. Revel; I. E. Magnin

    1995-01-01

    Quantitative analysis of left ventricle (LV) wall motion with imaging modalities is of a great interest for cardiac diagnostics as well as for basic physiological studies of cardiac wall shear. Some parameters (thickness, thickening, wall stress) related to the functional behavior of the myocardium, can be approximated from 2D endocardial and epicardial contours from end-systolic and end-diastolic LV cross-sections. However,

  8. Blunted Nocturnal Blood Pressure Decrease and Left-Ventricular Mass in Hypertensive Hemodialysis Patients

    Microsoft Academic Search

    Riccardo M. Fagugli; Giuseppe Quintaliani; Paolo Pasini; Giovanni Ciao; Beatrice Cicconi; Franca Pasticci; Umberto Buoncristiani

    2002-01-01

    Left-ventricular hypertrophy (LVH) represents a frequent complication in hemodialysis (HD) patients. Hypertension is a well-known risk factor of cardiac morbidity which is present in 2 of 3 patients: among them about 60% have a blunted nocturnal decrease of blood pressure (BP). Although some large studies on essential hypertensives have documented that non-dipper patients have a higher number of cardiac events

  9. Left ventricular volumes and mass in marathon runners and their association with cardiovascular risk factors

    Microsoft Academic Search

    Kai Nassenstein; Frank Breuckmann; Nils Lehmann; Axel Schmermund; Peter Hunold; Martina Broecker-Preuss; Torleif A. Sandner; Martin Halle; Klaus Mann; Karl-Heinz Jöckel; Gerd Heusch; Thomas Budde; Raimund Erbel; Jörg Barkhausen; Stefan Möhlenkamp

    2009-01-01

    Background To assess left ventricular volumes and mass by cardiac magnetic resonance imaging in relation to conventional cardiovascular\\u000a risk factors and coronary atherosclerotic plaque burden in master marathon runners aged ?50 years. Methods Cardiac MRI was performed in 105 clinically healthy male marathon runners (mean age 57.3 ± 5.7 years, range 50–71 years)\\u000a on a 1.5 T MR system (Avanto, Siemens, Germany). Cine steady state

  10. Reduced Right Ventricular Function Predicts Long-Term Cardiac Re-Hospitalization after Cardiac Surgery

    PubMed Central

    Goldsmith, Yulia; Chan, Jacqueline; Iskandir, Marina; Gulkarov, Iosif; Tortolani, Anthony; Brener, Sorin J.; Sacchi, Terrence J.; Heitner, John F.

    2015-01-01

    Background The significance of right ventricular ejection fraction (RVEF), independent of left ventricular ejection fraction (LVEF), following isolated coronary artery bypass grafting (CABG) and valve procedures remains unknown. The aim of this study is to examine the significance of abnormal RVEF by cardiac magnetic resonance (CMR), independent of LVEF in predicting outcomes of patients undergoing isolated CABG and valve surgery. Methods From 2007 to 2009, 109 consecutive patients (mean age, 66 years; 38% female) were referred for pre-operative CMR. Abnormal RVEF and LVEF were considered <35% and <45%, respectively. Elective primary procedures include CABG (56%) and valve (44%). Thirty-day outcomes were perioperative complications, length of stay, cardiac re-hospitalizations and early mortaility; long-term (> 30 days) outcomes included, cardiac re-hospitalization, worsening congestive heart failure and mortality. Mean clinical follow up was 14 months. Findings Forty-eight patients had reduced RVEF (mean 25%) and 61 patients had normal RVEF (mean 50%) (p<0.001). Fifty-four patients had reduced LVEF (mean 30%) and 55 patients had normal LVEF (mean 59%) (p<0.001). Patients with reduced RVEF had a higher incidence of long-term cardiac re-hospitalization vs. patients with normal RVEF (31% vs.13%, p<0.05). Abnormal RVEF was a predictor for long-term cardiac re-hospitalization (HR 3.01 [CI 1.5-7.9], p<0.03). Reduced LVEF did not influence long-term cardiac re-hospitalization. Conclusion Abnormal RVEF is a stronger predictor for long-term cardiac re-hospitalization than abnormal LVEF in patients undergoing isolated CABG and valve procedures. PMID:26197273

  11. Growth, obesity, and cardiac structures in early childhood: the Generation R Study.

    PubMed

    de Jonge, Layla L; van Osch-Gevers, Lennie; Willemsen, Sten P; Steegers, Eric A P; Hofman, Albert; Helbing, Willem A; Jaddoe, Vincent W V

    2011-05-01

    Cardiac structural adaptations in response to physical growth and obesity in older children have been identified and might have long-term consequences. We examined the associations of growth and obesity with cardiac structures during the first 2 years of life. In a population-based prospective cohort study among 974 children, left atrial diameter, left ventricular diastolic diameter, left ventricular mass, aortic root diameter, and fractional shortening were repeatedly measured by ultrasound at the ages of 1.5, 6, and 24 months. Height, weight, and subcutaneous fat mass were measured at the same visits, and blood pressure was measured at the age of 24 months. Height, weight, body mass index, and body surface area were positively associated with all of the cardiac structures during the first 2 years of life. At the age of 24 months, as compared with normal weight children, obese children had a greater left ventricular mass (1.04 SD score [95% CI: 0.20 to 1.89]) and a higher fractional shortening (0.91 SD score [95% CI: 0.02 to 1.80]). Nonsignificant tendencies were found for left atrial diameter, left ventricular diastolic diameter, and aortic root diameter. Our results suggest that normal variation in growth affects cardiac structures in early life. Overweight and obese children show cardiac adaptations already at the age of 2 years. Further studies are needed to assess whether these structural adaptations influence the risk of cardiovascular disease in later life. PMID:21444837

  12. Gross anatomy of the cardiac blood vessels in the North American beaver (Castor canadensis).

    PubMed

    Bisaillon, A

    1981-01-01

    The cardiac arteries and veins are described in the North American beaver (Castor canadensis) following the injection of the vessels of 15 hearts with either latex, vinyl plastic or barium sulfate. The left coronary artery gives off the typical circumflex and paraconal interventricular branches which supply the left atrium and ventricle and part of the right ventricle and interventricular septum. The right coronary artery vascularizes the right atrium and ventricule and by means of its subsinuosal interventricular branch, part of the left ventricle and interventricular septum. The paraconal interventricular branch of the left coronary artery lies within the myocardium and is not visible on the surface of the heart. There are no intercoronary anastomoses between the right and left vessels. The major cardiac veins open into the terminal end of the left cranial vena cava. Unlike the arteries, there are venous anastomoses interconnecting the great cardiac vein and the middle cardiac vein. It is concluded that the cardiac blood vessels in Castor canadensis are typically mammalian and resemble those of both land and aquatic mammals. PMID:7305001

  13. No Baby Left behind

    ERIC Educational Resources Information Center

    Blanton, Dorothy

    2007-01-01

    "No Baby Left Behind" was created to have an impact on the school readiness of children in the community today and in the future. Each year, there are an increasing number of students who have learning difficulties. Many of these problems are preventable. Accidents, poor nutrition (of the mother and/or child), drug use, alcohol use, and lack of…

  14. The Children Left Behind

    ERIC Educational Resources Information Center

    Gillard, Sarah A.; Gillard, Sharlett

    2012-01-01

    This article explores some of the deficits in our educational system in regard to non-hearing students. It has become agonizingly clear that non-hearing students are being left out of the gallant sweep to enrich our children's educations. The big five areas of literacy, at best, present unique challenges for non-hearing students and, in some…

  15. Cardiac involvement in chronic progressive external ophthalmoplegia.

    PubMed

    Galetta, Fabio; Franzoni, Ferdinando; Mancuso, Michelangelo; Orsucci, Daniele; Tocchini, Leonardo; Papi, Riccardo; Speziale, Giuseppe; Gaudio, Carlo; Siciliano, Gabriele; Santoro, Gino

    2014-10-15

    Myocardial involvement has not been extensively investigated in mitochondrial myopathies. The aim of the study was to assess the myocardial morpho-functional changes in patients with chronic progressive external ophthalmoplegia (PEO). Twenty patients with PEO and 20 controls underwent standard echocardiography with tissue Doppler imaging (TDI) and integrated backscatter (IBS) analyses. These techniques are capable of providing non-invasively the early, subtle structural and functional changes of the myocardium. TDI myocardial systolic (Sm) and early (Em) and late (Am) diastolic velocities of left ventricular walls were determined. The systo-diastolic variation of IBS was also determined. Patients with PEO exhibited lower Sm, lower Em, and higher Am, and a reduced Em/Am ratio than controls (p<0.001 for all) at interventricular septum and lateral wall levels. In PEO patients, septal and posterior wall cyclic variations of IBS were significantly lower than those in controls (p<0.001). Patients with PEO showed myocardial wall remodeling characterized by increased fibrosis and early left ventricular systo-diastolic function abnormalities. Although cardiac involvement in PEO is generally considered to be limited to the cardiac conduction system, left ventricular dysfunction may be present and should receive more attention in the management of these patients. PMID:25139213

  16. Alteration of Left Ventricular Filling Evaluated by Doppler Echocardiography as a Potential Marker of Acute Rejection in Orthotopic Heart Transplant

    Microsoft Academic Search

    Adriano Maria Pellicelli; Joaquin Barba Cosial; Edoardo Ferranti; Arturo Gomez; Maria Clotilde Borgia

    1996-01-01

    To evaluate the changes in left ventricular (LV) filling associated with acute cardiac rejection, serial Doppler echocardiographic (ED) examinations were performed on the same day as endomyocardial biopsy (EMB) in 40 patients who underwent orthotopic transplantation. The diameters and wall thickness of the left ventricle were measured. The indexes of LV filling in the following parameters were measured by pulsed

  17. Reversible left ventricular dysfunction associated with raised troponin I after subarachnoid haemorrhage does not preclude successful heart transplantation

    Microsoft Academic Search

    E Deibert; V Aiyagari; M N Diringer

    2000-01-01

    Transient abnormalities in ECGs, echocardiograms, and cardiac enzymes have been described in the acute setting of subarachnoid haemorrhage. In addition, left ventricular dysfunction has been reported at the time of brain death. A patient with an acute subarachnoid haemorrhage who presented with raised troponin I (TnI) concentrations and diffuse left ventricular dysfunction is described. After declaration of brain death 32

  18. Abstract--A new left ventricle segmentation method in two-dimensional echocardiography images is proposed. Image

    E-print Network

    Carvalho, João Luiz

    commonly used in the assessment of cardiac diseases. Semi-automatic left ventricle segmentation using, and morphological operators to extract the contour [4]. Choy et al. proposed using an elevation filter, combined present a semi-automatic algorithm that extracts the left ventricle internal cavity border using classic

  19. Modified ultrafiltration improves global left ventricular systolic function after open-heart surgery in infants and children

    Microsoft Academic Search

    Rajiv R. Chaturvedi; Darryl F. Shore; Paul A. White; Michael H. Scallan; W. W. Gothard; Andrew N. Redington; Christopher Lincoln

    2010-01-01

    Abstract Objectives: Modified ultrafiltration increases blood pressure and cardiac index following open-heart surgery in children, but it is unclear if this is secondary to an improvement,in global left ventricular function. A previous report has suggested that left ventricular systolic function as assessed in a single chord is improved by ultrafiltration (Davies MJ, Nguyen K, Gaynor JW, Elliott MJ. Modified ultrafiltration

  20. Modified ultrafiltration improves global left ventricular systolic function after open-heart surgery in infants and children

    Microsoft Academic Search

    Rajiv R. Chaturvedi; Darryl F. Shore; Paul A. White; Michael H. Scallan; John W. W. Gothard; Andrew N. Redington; Christopher Lincoln

    1999-01-01

    Objectives: Modified ultrafiltration increases blood pressure and cardiac index following open-heart surgery in children, but it is unclear if this is secondary to an improvement in global left ventricular function. A previous report has suggested that left ventricular systolic function as assessed in a single chord is improved by ultrafiltration (Davies MJ, Nguyen K, Gaynor JW, Elliott MJ. Modified ultrafiltration

  1. Neutron Detection via Bubble Chambers

    SciTech Connect

    Jordan, David V.; Ely, James H.; Peurrung, Anthony J.; Bond, Leonard J.; Collar, J. I.; Flake, Matthew; Knopf, Michael A.; Pitts, W. K.; Shaver, Mark W.; Sonnenschein, Andrew; Smart, John E.; Todd, Lindsay C.

    2005-10-06

    The results of a Pacific Northwest National Laboratory (PNNL) exploratory research project investigating the feasibility of fast neutron detection using a suitably prepared and operated, pressure-cycled bubble chamber are described. The research was conducted along two parallel paths. Experiments with a slow pressure-release Halon chamber at the Enrico Fermi Institute at the University of Chicago showed clear bubble nucleation sensitivity to an AmBe neutron source and insensitivity to the 662 keV gammas from a 137Cs source. Bubble formation was documented via high-speed (1000 frames/sec) photography, and the acoustic signature of bubble formation was detected using a piezo-electric transducer element mounted on the base of the chamber. The chamber’s neutron sensitivity as a function of working fluid temperature was mapped out. The second research path consisted of the design, fabrication, and testing of a fast pressure-release Freon-134a chamber at PNNL. The project concluded with successful demonstrations of the PNNL chamber’s AmBe neutron source sensitivity and 137Cs gamma insensitivity. The source response tests of the PNNL chamber were documented with high-speed photography.

  2. Left Ventricular Response to Severe Exertion in Untethered Dogs

    PubMed Central

    Vatner, Stephen F.; Franklin, Dean; Higgins, Charles B.; Patrick, Thomas; Braunwald, Eugene

    1972-01-01

    The left ventricular response to severe exercise was studied by telemetering direct measurements of left ventricular diameter (D) and pressure (P) and aortic blood flow from healthy dogs running at speeds up to 30 mph in the field. Severe exercise increased cardiac output from 101 to 478 ml/kg per min, heart rate from 95 to 297 beats/min, stroke volume from 31 to 44 ml, left ventricular isolength (iso) systolic pressure from 120 to 186 mm Hg, left ventricular end diastolic pressure from 6 to 18 mm Hg, and left ventricular end diastolic diameter from 58.9 to 60.1 mm, while end systolic diameter decreased from 53.0 to 52.2 mm. Two indices of myocardial contractility, (dP/dt)/P increased from 37 to 92 sec?1, while dD/dt, the velocity of myocardial fiber shortening at isolength, rose from 54 to 119 mm/sec. All of these changes were statistically significant. When, in resting dogs, heart rate was first raised to exercise levels by electrical stimulation, severe exercise subsequently increased left ventricular end diastolic diameter more profoundly, from 55.7 to 59.7 mm, while end systolic diameter remained constant and the increases in left ventricular pressure, (dP/dt)/P and velocityiso were roughly comparable to those occurring during exercise in spontaneous rhythm. After propranolol, 1.0 mg/kg, severe exercise resulted in significantly smaller increases in cardiac output (from 82 to 240 ml/kg), in heart rate (from 87 to 186 beats/min), in left ventricular pressureiso (from 122 to 150 mm Hg), in (dP/dt)/P (from 32 to 44 sec?1), in velocityiso (from 47 to 59 mm/sec), and in slightly greater increases in end diastolic diameter, from 59.8 to 62.0 mm and pressure from 8 to 22 mm Hg, while end systolic diameter did not change significantly. Thus, the left ventricle responds to severe exercise with near maximal increases in heart rate and contractility, while significant increases in end diastolic diameter (Frank-Starling mechanism) and stroke volume occur as well. When heart rate was held constant severe exercise produced similar increases in contractility but end systolic size failed to diminish and the increases in end diastolic size were greater. Beta adrenergic receptor blockade interfered with the chronotropic and particularly the inotropic response to severe exercise and while the participation of the Frank-Starling mechanism was somewhat greater, the latter was not sufficient to increase cardiac output normally. Images PMID:4640948

  3. Diogene pictorial drift chamber

    NASA Astrophysics Data System (ADS)

    Gosset, J.

    1984-02-01

    A pictorial drift chamber, called DIOGENE, has been installed at Saturne in order to study central collisions of high energy heavy ions. It has been adapted from the JADE internal detector, with two major differences to be taken into account. First, the center-of-mass of these collisions is not identical to the laboratory reference frame. Second, the energy loss and the momentum ranges of the particles to be detected are different from the ones in JADE. It was also tried to keep the cost as small as possible, hence the choice of minimum size and minimum number of sensitive wires. Moreover the wire planes are shifted from the beam axis: this trick helps very much to quickly reject the bad tracks caused by the ambiguity of measuring drift distances (positive or negative) through times (always positive).

  4. Chambers's Book of Days

    NSDL National Science Digital Library

    Subtitled A Miscellany of Popular Antiquities in connection with the Calendar, Chambers's Book of Days is essentially a collection of "On this Day" trivia, short pieces, and other interesting tidbits, including history, literature, biography, and "oddities of human life and character." Digitized by the University of Wisconsin-Madison Libraries, this electronic reprint may be browsed in page order or via a calendar navigator. The site offers a fun look into pop-history/ tabloid news of the late nineteenth century. For instance, I discovered that on the day of my birth in 1626 "a cod-fish was brought to Cambridge market, which upon being opened, was found to contain a book in its maw or stomach." An auspicious date to be born indeed.

  5. Diogene pictorial drift chamber

    SciTech Connect

    Gosset, J.

    1984-01-01

    A pictorial drift chamber, called DIOGENE, has been installed at Saturne in order to study central collisions of high energy heavy ions. It has been adapted from the JADE internal detector, with two major differences to be taken into account. First, the center-of-mass of these collisions is not identical to the laboratory reference frame. Second, the energy loss and the momentum ranges of the particles to be detected are different from the ones in JADE. It was also tried to keep the cost as small as possible, hence the choice of minimum size and minimum number of sensitive wires. Moreover the wire planes are shifted from the beam axis: this trick helps very much to quickly reject the bad tracks caused by the ambiguity of measuring drift distances (positive or negative) through times (always positive).

  6. Iran Chamber Society

    NSDL National Science Digital Library

    In 2001, the Iran Chamber Society was created in order to provide a non-partisan, non-commercial, comprehensive source of information on Iran. The website's "About Us" section states that their aim is to "create a global awareness about Iranian society and eradicate the misunderstandings and misconceptions about Iranian society, and to play an educational role as well." Visitors will find the website divided up into "Art and Culture", "History", "Society" and "Iran's Guide". The "Exhibitions and Conferences" link on the right side of the homepage leads visitors to a number of exhibitions, including the fascinating "Artistic Murals of Tehran's Metro Stations", which offers a dozen pictures of the beautifully handcrafted murals made of pottery, metal, cement and other materials. The "History" section offers pictures and documents, including some disturbing graphic photos from the Iran-Iraq War in 1980-1988 that appear at the end of the Historic Periods and Events section.

  7. Unusual Diaphragmatic Hernias Mimicking Cardiac Masses

    PubMed Central

    Kim, Si Hun; Kim, Myoung Gun; Kim, Su Ji; Moon, Jeonggeun; Kang, Woong Chol; Shin, Mi-Seung

    2015-01-01

    Hiatal hernia and Morgagni hernia are sorts of diaphragmatic hernias that are rarely detected on transthoracic echocardiography. Although echocardiographic findings have an important role for differential diagnosis of cardiac masses, we often might overlook diaphragmatic hernia. We report three cases of diaphragmatic hernias having specific features. The first case is huge hiatal hernia that encroaches left atrium with internal swirling flow on transthoracic echocardiography. The second case is a hiatal hernia that encroaches on both atria, incidentally detected on preoperative echocardiography. The third case is Morgagni hernia which encroaches on the right atrium only. So, we need to consider possibility of diaphragmatic hernia when we find a cardiac mass with specific echocardiographic features. PMID:26140154

  8. New concepts in cardiac imaging 1985

    SciTech Connect

    Pohost, G.M.; Higgins, C.B.; Morganroth, J.; Ritchie, J.L.; Schelbert, H.R.

    1985-01-01

    This book presents 5 specialists work on reviewing and editing the area of applications for cardiac imaging: Contents: Ultrasound Methods; 1. Echocardiography in Valvular Heart Disease, 2. Echocardiography in Ischemic Heart Disease, 3. Current Status of Doppler Ultrasound for Assessing Regurgitant Valvular Lesions, Radionuclide Methods; 4. Cardiovascular Nuclear Medicine, 5. Single Photon Emission Computed Tomography (SPECT): Validation and Application for Myocardial Perfusion Imaging, 6. Assessment of Regional Myocardial Perfusion with Positron Emission Tomography, 7. Assessment of Regional Myocardial Substrate Metabolism with Positron Emission Tomography, X-Ray Imaging Techniques; 8. The Evaluation of Left Ventricular Function in Ischemic Heart Disease by Digital Subtraction Angigraphy, 9. Digital Angiography in the Assessment of Coronary Artery Disease, 10. Cardiac Computed Tomography: Its Potential Use in Evaluation of Ischemic Heart Disease, Magnetic Methods; 11. NMR Evaluation of the Cardiovascular System, 12. Magnetic Resonance Imaging of the Heart.

  9. HATCH CONNECTING TEMPERED AIR CHAMBER AND HOT AIR CHAMBER OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    HATCH CONNECTING TEMPERED AIR CHAMBER AND HOT AIR CHAMBER OF PLENUM WITH ATTACHED DRAFT REGULATOR. - Hot Springs National Park, Bathhouse Row, Superior Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  10. Isolated left ventricular noncompaction in a case of sotos syndrome: a casual or causal link?

    PubMed

    Saccucci, Patrizia; Papetti, Federica; Martinoli, Roberta; Dofcaci, Alessandro; Tuderti, Ursula; Marcantonio, Andrea; Di Renzi, Paolo; Fahim, Asgharnejad; Ferrante, Federica; Banci, Maria

    2011-01-01

    A 16-year-old boy affected by Sotos syndrome was referred to our clinic for cardiac evaluation in order to play noncompetitive sport. Physical examination was negative for major cardiac abnormalities and rest electrocardiogram detected only minor repolarization anomalies. Transthoracic echocardiography showed left ventricular wall thickening and apical trabeculations with deep intertrabecular recesses, fulfilling criteria for isolated left ventricular noncompaction (ILVNC). Some sporadic forms of ILVNC are reported to be caused by a mutation on CSX gene, mapping on chromosome 5q35. To our knowledge, this is the first report of a patient affected simultaneously by Sotos syndrome and ILVNC. PMID:21747990

  11. [Penetrating injury of the left ventricle caused by a nail gun; report of a case].

    PubMed

    Suda, Hisao; Nakayama, Takuya; Sunada, Masatoshi; Miyata, Yosuke; Yamada, Toshiyuki

    2014-05-01

    Penetrating cardiac injuries are life-threatening emergencies. We present a case of a 24-year-old construction worker who accidentally shot himself with a nail gun. Chest X-ray showed a 6 cm-long nail overlapping the cardiac shadow. A computed tomography (CT) scan revealed the nail penetrating the left ventricle and a large amount of pericardial effusion. Median sternotomy was performed and cardiopulmomary bypass was established. Then, the nail was removed and the left ventricular wound was repaired by 4-0 Prolene mattress sutures buttressed with felt-strips. He had an uncomplicated postoperative course and was discharged 7 days postoperatively. PMID:24917290

  12. Modeling inherited cardiac disorders.

    PubMed

    Sallam, Karim; Kodo, Kazuki; Wu, Joseph C

    2014-01-01

    Advances in the understanding and treatment of cardiac disorders have been thwarted by the inability to study beating human cardiac cells in vitro. Induced pluripotent stem cells (iPSCs) bypass this hurdle by enabling the creation of patient-specific iPSC-derived cardiomyocytes (iPSC-CMs). These cells provide a unique platform to study cardiac diseases in vitro, especially hereditary cardiac conditions. To date, iPSC-CMs have been used to successfully model arrhythmic disorders, showing excellent recapitulation of cardiac channel function and electrophysiologic features of long QT syndrome types 1, 2, 3, and 8, and catecholaminergic polymorphic ventricular tachycardia (CPVT). Similarly, iPSC-CM models of dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) have shown robust correlation of predicted morphologic, contractile, and electrical phenotypes. In addition, iPSC-CMs have shown some features of the respective phenotypes for arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), LEOPARD syndrome, Pompe's disease, and Friedriech's ataxia. In this review, we examine the progress of utilizing iPSC-CMs as a model for cardiac conditions and analyze the potential for the platform in furthering the biology and treatment of cardiac disorders.?? PMID:24632794

  13. [Cardiac manifestations of mitochondrial diseases].

    PubMed

    Ritzenthaler, Thomas; Luis, David; Hullin, Thomas; Fayssoil, Abdallah

    2015-05-01

    Mitochondrial diseases are multi-system disorders in relation with mitochondrial DNA and/or nuclear DNA abnormalities. Clinical pictures are heterogeneous, involving endocrine, cardiac, neurologic or sensory systems. Cardiac involvements are morphological and electrical disturbances. Prognosis is worsened in case of cardiac impairment. Treatments are related to the type of cardiac dysfunction including medication or pacemaker implantation. PMID:25890847

  14. Mechanisms of decreased left ventricular preload during continuous positive pressure ventilation in ARDS

    SciTech Connect

    Dhainaut, J.F.; Devaux, J.Y.; Monsallier, J.F.; Brunet, F.; Villemant, D.; Huyghebaert, M.F.

    1986-07-01

    Continuous positive pressure ventilation is associated with a reduction in left ventricular preload and cardiac output, but the mechanisms responsible are controversial. The decrease in left ventricular preload may result exclusively from a decreased systemic venous return due to increased pleural pressure, or from an additional effect such as decreased left ventricular compliance. To determine the mechanisms responsible, we studied the changes in cardiac output induced by continuous positive pressure ventilation in eight patients with the adult respiratory distress syndrome. We measured cardiac output by thermodilution, and biventricular ejection fraction by equilibrium gated blood pool scintigraphy. Biventricular end-diastolic volumes were then calculated by dividing stroke volume by ejection fraction. As positive end-expiratory pressure increased from 0 to 20 cm H/sub 2/O, stroke volume and biventricular end-diastolic volumes fell about 25 percent, and biventricular ejection fraction remained unchanged. At 20 cm H/sub 2/O positive end-expiratory pressure, volume expansion for normalizing cardiac output restored biventricular end-diastolic volumes without markedly changing biventricular end-diastolic transmural pressures. The primary cause of the reduction in left ventricular preload with continuous positive pressure ventilation appears to be a fall in venous return and hence in right ventricular stroke volume, without evidence of change in left ventricular diastolic compliance.

  15. Molecular Basis of Cardiac Myxomas

    PubMed Central

    Singhal, Pooja; Luk, Adriana; Rao, Vivek; Butany, Jagdish

    2014-01-01

    Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis. PMID:24447924

  16. Small rocket flowfield diagnostic chambers

    NASA Astrophysics Data System (ADS)

    Morren, Sybil; Reed, Brian

    1993-11-01

    Instrumented and optically-accessible rocket chambers are being developed to be used for diagnostics of small rocket (less than 440 N thrust level) flowfields. These chambers are being tested to gather local fluid dynamic and thermodynamic flowfield data over a range of test conditions. This flowfield database is being used to better understand mixing and heat transfer phenomena in small rockets, influence the numerical modeling of small rocket flowfields, and characterize small rocket components. The diagnostic chamber designs include: a chamber design for gathering wall temperature profiles to be used as boundary conditions in a finite element heat flux model; a chamber design for gathering inner wall temperature and static pressure profiles; and optically-accessible chamber designs, to be used with a suite of laser-based diagnostics for gathering local species concentration, temperature, density, and velocity profiles. These chambers were run with gaseous hydrogen/gaseous oxygen (GH2/GO2) propellants, while subsequent versions will be run on liquid oxygen/hydrocarbon (LOX/HC) propellants. The purpose, design, and initial test results of these small rocket flowfield diagnostic chambers are summarized.

  17. Perspectives on anechoic chamber qualification

    Microsoft Academic Search

    Kenneth A. Cunefare; Van B. Biesel

    2002-01-01

    The qualification of a new anechoic chamber requires demonstration that the chamber produces a free-field environment within some tolerance bounds and over some acceptable volume. At the most basic level, qualification requires measurement of sound levels at increasing distances from a test source, and then comparing the levels to a theoretical free-field decay. While simple in concept, the actual performance

  18. Characterization of regional left ventricular function in nonhuman primates using magnetic resonance imaging biomarkers: a test-retest repeatability and inter-subject variability study.

    PubMed

    Sampath, Smita; Klimas, Michael; Feng, Dai; Baumgartner, Richard; Manigbas, Elaine; Liang, Ai-Leng; Evelhoch, Jeffrey L; Chin, Chih-Liang

    2015-01-01

    Pre-clinical animal models are important to study the fundamental biological and functional mechanisms involved in the longitudinal evolution of heart failure (HF). Particularly, large animal models, like nonhuman primates (NHPs), that possess greater physiological, biochemical, and phylogenetic similarity to humans are gaining interest. To assess the translatability of these models into human diseases, imaging biomarkers play a significant role in non-invasive phenotyping, prediction of downstream remodeling, and evaluation of novel experimental therapeutics. This paper sheds insight into NHP cardiac function through the quantification of magnetic resonance (MR) imaging biomarkers that comprehensively characterize the spatiotemporal dynamics of left ventricular (LV) systolic pumping and LV diastolic relaxation. MR tagging and phase contrast (PC) imaging were used to quantify NHP cardiac strain and flow. Temporal inter-relationships between rotational mechanics, myocardial strain and LV chamber flow are presented, and functional biomarkers are evaluated through test-retest repeatability and inter subject variability analyses. The temporal trends observed in strain and flow was similar to published data in humans. Our results indicate a dominant dimension based pumping during early systole, followed by a torsion dominant pumping action during late systole. Early diastole is characterized by close to 65% of untwist, the remainder of which likely contributes to efficient filling during atrial kick. Our data reveal that moderate to good intra-subject repeatability was observed for peak strain, strain-rates, E/circumferential strain-rate (CSR) ratio, E/longitudinal strain-rate (LSR) ratio, and deceleration time. The inter-subject variability was high for strain dyssynchrony, diastolic strain-rates, peak torsion and peak untwist rate. We have successfully characterized cardiac function in NHPs using MR imaging. Peak strain, average systolic strain-rate, diastolic E/CSR and E/LSR ratios, and deceleration time were identified as robust biomarkers that could potentially be applied to future pre-clinical drug studies. PMID:26010607

  19. Characterization of Regional Left Ventricular Function in Nonhuman Primates Using Magnetic Resonance Imaging Biomarkers: A Test-Retest Repeatability and Inter-Subject Variability Study

    PubMed Central

    Sampath, Smita; Klimas, Michael; Feng, Dai; Baumgartner, Richard; Manigbas, Elaine; Liang, Ai-Leng; Evelhoch, Jeffrey L.; Chin, Chih-Liang

    2015-01-01

    Pre-clinical animal models are important to study the fundamental biological and functional mechanisms involved in the longitudinal evolution of heart failure (HF). Particularly, large animal models, like nonhuman primates (NHPs), that possess greater physiological, biochemical, and phylogenetic similarity to humans are gaining interest. To assess the translatability of these models into human diseases, imaging biomarkers play a significant role in non-invasive phenotyping, prediction of downstream remodeling, and evaluation of novel experimental therapeutics. This paper sheds insight into NHP cardiac function through the quantification of magnetic resonance (MR) imaging biomarkers that comprehensively characterize the spatiotemporal dynamics of left ventricular (LV) systolic pumping and LV diastolic relaxation. MR tagging and phase contrast (PC) imaging were used to quantify NHP cardiac strain and flow. Temporal inter-relationships between rotational mechanics, myocardial strain and LV chamber flow are presented, and functional biomarkers are evaluated through test-retest repeatability and inter subject variability analyses. The temporal trends observed in strain and flow was similar to published data in humans. Our results indicate a dominant dimension based pumping during early systole, followed by a torsion dominant pumping action during late systole. Early diastole is characterized by close to 65% of untwist, the remainder of which likely contributes to efficient filling during atrial kick. Our data reveal that moderate to good intra-subject repeatability was observed for peak strain, strain-rates, E/circumferential strain-rate (CSR) ratio, E/longitudinal strain-rate (LSR) ratio, and deceleration time. The inter-subject variability was high for strain dyssynchrony, diastolic strain-rates, peak torsion and peak untwist rate. We have successfully characterized cardiac function in NHPs using MR imaging. Peak strain, average systolic strain-rate, diastolic E/CSR and E/LSR ratios, and deceleration time were identified as robust biomarkers that could potentially be applied to future pre-clinical drug studies. PMID:26010607

  20. Ion chamber based neutron detectors

    DOEpatents

    Derzon, Mark S; Galambos, Paul C; Renzi, Ronald F

    2014-12-16

    A neutron detector with monolithically integrated readout circuitry, including: a bonded semiconductor die; an ion chamber formed in the bonded semiconductor die; a first electrode and a second electrode formed in the ion chamber; a neutron absorbing material filling the ion chamber; and the readout circuitry which is electrically coupled to the first and second electrodes. The bonded semiconductor die includes an etched semiconductor substrate bonded to an active semiconductor substrate. The readout circuitry is formed in a portion of the active semiconductor substrate. The ion chamber has a substantially planar first surface on which the first electrode is formed and a substantially planar second surface, parallel to the first surface, on which the second electrode is formed. The distance between the first electrode and the second electrode may be equal to or less than the 50% attenuation length for neutrons in the neutron absorbing material filling the ion chamber.

  1. Anterior chamber depth during hemodialysis

    PubMed Central

    Gracitelli, Carolina Pelegrini Barbosa; Stefanini, Francisco Rosa; Penha, Fernando; Góes, Miguel Ângelo; Draibe, Sérgio Antonio; Canziani, Maria Eugênia; Junior, Augusto Paranhos

    2013-01-01

    Background Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD) because of anterior chamber depth changes during this therapy. Purpose To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results There was no difference in the axial length between the three measurements (P = 0.241). We observed a significantly decreased anterior chamber depth (P = 0.002) during HD sessions. Conclusion Our results support the idea that there is a change in anterior chamber depth in HD sessions. PMID:23976841

  2. Proton beam monitor chamber calibration.

    PubMed

    Gomà, C; Lorentini, S; Meer, D; Safai, S

    2014-09-01

    The first goal of this paper is to clarify the reference conditions for the reference dosimetry of clinical proton beams. A clear distinction is made between proton beam delivery systems which should be calibrated with a spread-out Bragg peak field and those that should be calibrated with a (pseudo-)monoenergetic proton beam. For the latter, this paper also compares two independent dosimetry techniques to calibrate the beam monitor chambers: absolute dosimetry (of the number of protons exiting the nozzle) with a Faraday cup and reference dosimetry (i.e. determination of the absorbed dose to water under IAEA TRS-398 reference conditions) with an ionization chamber. To compare the two techniques, Monte Carlo simulations were performed to convert dose-to-water to proton fluence. A good agreement was found between the Faraday cup technique and the reference dosimetry with a plane-parallel ionization chamber. The differences-of the order of 3%-were found to be within the uncertainty of the comparison. For cylindrical ionization chambers, however, the agreement was only possible when positioning the effective point of measurement of the chamber at the reference measurement depth-i.e. not complying with IAEA TRS-398 recommendations. In conclusion, for cylindrical ionization chambers, IAEA TRS-398 reference conditions for monoenergetic proton beams led to a systematic error in the determination of the absorbed dose to water, especially relevant for low-energy proton beams. To overcome this problem, the effective point of measurement of cylindrical ionization chambers should be taken into account when positioning the reference point of the chamber. Within the current IAEA TRS-398 recommendations, it seems advisable to use plane-parallel ionization chambers-rather than cylindrical chambers-for the reference dosimetry of pseudo-monoenergetic proton beams. PMID:25109620

  3. Proton beam monitor chamber calibration

    NASA Astrophysics Data System (ADS)

    Gomà, C.; Lorentini, S.; Meer, D.; Safai, S.

    2014-09-01

    The first goal of this paper is to clarify the reference conditions for the reference dosimetry of clinical proton beams. A clear distinction is made between proton beam delivery systems which should be calibrated with a spread-out Bragg peak field and those that should be calibrated with a (pseudo-)monoenergetic proton beam. For the latter, this paper also compares two independent dosimetry techniques to calibrate the beam monitor chambers: absolute dosimetry (of the number of protons exiting the nozzle) with a Faraday cup and reference dosimetry (i.e. determination of the absorbed dose to water under IAEA TRS-398 reference conditions) with an ionization chamber. To compare the two techniques, Monte Carlo simulations were performed to convert dose-to-water to proton fluence. A good agreement was found between the Faraday cup technique and the reference dosimetry with a plane-parallel ionization chamber. The differences—of the order of 3%—were found to be within the uncertainty of the comparison. For cylindrical ionization chambers, however, the agreement was only possible when positioning the effective point of measurement of the chamber at the reference measurement depth—i.e. not complying with IAEA TRS-398 recommendations. In conclusion, for cylindrical ionization chambers, IAEA TRS-398 reference conditions for monoenergetic proton beams led to a systematic error in the determination of the absorbed dose to water, especially relevant for low-energy proton beams. To overcome this problem, the effective point of measurement of cylindrical ionization chambers should be taken into account when positioning the reference point of the chamber. Within the current IAEA TRS-398 recommendations, it seems advisable to use plane-parallel ionization chambers—rather than cylindrical chambers—for the reference dosimetry of pseudo-monoenergetic proton beams.

  4. Cardiac catheterization in children with pulmonary hypertensive vascular disease.

    PubMed

    Bobhate, Prashant; Guo, Long; Jain, Shreepal; Haugen, Richard; Coe, James Y; Cave, Dominic; Rutledge, Jennifer; Adatia, Ian

    2015-04-01

    The risks associated with cardiac catheterization in children with pulmonary hypertension (PH) are increased compared with adults. We reviewed retrospectively all clinical data in children with PH [mean pulmonary artery pressure (mean PAp) ?25 mmHg and pulmonary vascular resistance index (PVRI) ?3 Wood units m(2)] undergoing cardiac catheterization between 2009 and 2014. Our strategy included a team approach, minimal catheter manipulation and sildenafil administration prior to extubation. Adverse events occurring within 48 h were noted. Seventy-five patients (36 males), median age 4 years (0.3-17) and median weight 14.6 kg (2.6-77 kg), underwent 97 cardiac catheterizations. Diagnoses included idiopathic or heritable pulmonary arterial hypertension (PAH) (29 %), PAH associated with congenital heart disease (52 %), left heart disease (5 %) and lung disease (14 %). Mean PAp was 43 ± 19 mmHg; mean PVRI was 9.7 ± 6 Wood units m(2). There were no deaths or serious arrhythmias. No patient required cardiac massage. Three patients who suffered adverse events had suprasystemic PAp (3/3), heritable PAH (2/3), decreased right ventricular function (3/3), and pulmonary artery capacitance index <1 ml/mmHg/m(2) (3/3) and were treatment naïve (3/3). No patient undergoing follow-up cardiac catheterization suffered a complication. In 45 % of cases, the data acquired from the follow-up cardiac catheterization resulted in an alteration of therapy. Three percent of children with PH undergoing cardiac catheterization suffered adverse events. However, there were no intra or post procedural deaths and no one required cardiac massage or cardioversion. Follow-up cardiac catheterization in patients receiving pulmonary hypertensive targeted therapy is safe and provides useful information. PMID:25577228

  5. Combustion chamber for internal combustion engine

    Microsoft Academic Search

    Isida

    1988-01-01

    This patent describes a combustion chamber for an internal combustion engine, comprising: a main combustion chamber hollowed out of the top of a piston; a subsidiary combustion chamber hollowed out of the piston top, the subsidiary combustion chamber communicating with and disposed in side by side relationship to the main combustion chamber; a fuel injection nozzle located generally between the

  6. Starting a High School Chamber Music Group.

    ERIC Educational Resources Information Center

    Rutkowski, Joseph

    2000-01-01

    Presents ideas on how to begin a chamber music ensemble. Discusses how to find time to accomplish chamber music playing in and around the school day. Presents short descriptions of chamber music that can be used with ensembles. Includes chamber music resources and additional chamber works. (CMK)

  7. INITIAL RESULTS OF CARDIAC IMAGING AT 7 T

    PubMed Central

    Snyder, CJ; DelaBarre, L; Metzger, GJ; van de Moortele, P-F; Akgun, C; Ugurbil, K; Vaughan, JT

    2010-01-01

    This work reports preliminary results from the first human cardiac imaging at 7 T. Images were acquired using an 8-channel transmission line (TEM) array together with local B1 shimming. The TEM array consisted of anterior and posterior plates closely positioned to the subjects' thorax. The currents in the independent elements of these arrays were phased to promote constructive interference of the complex, short wavelength RF field over the entire heart. Anatomic and functional images were acquired within a single breath hold to reduce respiratory motion artifacts while a vector cardiogram (VCG) was employed to mitigate cardiac motion artifacts and gating. SAR exposure was modeled, monitored and was limited to FDA guidelines for the human torso in subject studies. Preliminary results including short-axis and four-chamber VCG-retrogated FLASH cines, as well as, short-axis TSE images demonstrate the feasibility of safe and accurate human cardiac imaging at 7 T. PMID:19097233

  8. Cardiac muscle cells

    NSDL National Science Digital Library

    Nathanael Reveal (None; )

    2007-07-02

    Cardiac muscles are found only in the heart. They work together to bring deoxygenated blood in and push oxygenated blood out into the body. Essentially, they keep your heart pumping and your body alive.

  9. What Is Cardiac Rehabilitation?

    MedlinePLUS

    ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ... rate, blood pressure and EKG monitored. A cardiac rehabilitation (rehab) program takes place in a hospital or ...

  10. Cardiac Rehabilitation After Acute Myocardial Infarction Resuscitated From Cardiac Arrest

    PubMed Central

    Kim, Chul; Choi, Hee Eun; Kang, Seong Hoon

    2014-01-01

    Objective To examine the safety and effectiveness of cardiac rehabilitation on patients resuscitated from cardiac arrest due to acute myocardial infarction. Methods The study included 23 subjects, including 8 with history of cardiac arrest and 15 without history of cardiac arrest. Both groups underwent initial graded exercise test (GXT) and subsequent cardiac rehabilitation for 6 weeks. After 6 weeks, both groups received follow-up GXT. Results Statistically significant (p<0.05) increase of VO2peak and maximal MVO2 but significant (p<0.05) decrease of submaximal MVO2 and resting heart rate were observed in both groups after 6 weeks of cardiac rehabilitation. An increasing trend of maximal heart rates was observed in both groups. However, the increase was not statistically significant (p>0.05). There was no statistically significant change of resting heart rate, maximal heart rate, maximal MVO2, or submaximal MVO2 in both groups after cardiac rehabilitation. Fatal cardiac complications, such as abnormal ECG, cardiac arrest, death or myocardial infarction, were not observed. All subjects finished the cardiac rehabilitation program. Conclusion Improvement was observed in the exercise capacity of patients after aerobic exercise throughout the cardiac rehabilitation program. Therefore, cardiac rehabilitation can be safely administered for high-risk patients with history of cardiac arrest. Similar improvement in exercise capacity can be expected in patients without cardiac arrest experience. PMID:25566479

  11. Conserved left-right asymmetry of nodal expression and alterations in murine situs inversus

    Microsoft Academic Search

    Linda A. Lowe; Dorothy M. Supp; Karuna Sampath; Takahiko Yokoyama; Christopher V. E. Wright; S. Steven Potter; Paul Overbeek; Michael R. Kuehn

    1996-01-01

    VERTEBRATES have characteristic and conserved left-right (L-R) visceral asymmetries, for example the left-sided heart. In humans, alterations of L-R development can have serious clinical implications, including cardiac defects1. Although little is known about how the embryonic L-R axis is established, a recent study in the chick embryo revealed L-R asymmetric expression of several previously cloned genes, including Cnr-1 (for chicken

  12. The relationship of physical training and time components of the left ventricle 

    E-print Network

    Bradley, Patrick Walton

    1976-01-01

    cZ, =d~ ad of Department Member mber May 1976 ABSTRACT The Relationship Between Physical Training and Left Ventricular T1me Components. (May 1976) Patrick Malton Bradley B. S. , Texas AIIM University Chairman of Advisory Committee: Dr..., and post-exercise values. The selected cardiac-cycle time components included. pre-ejection period (PEP); electromechanical lag (EML); isovolumetric contraction period (ICP); left ventricular ejection time (LVET); mechanical systole (MS); total systole...

  13. Regression of left ventricular hypertrophy by lisinopril after renal transplantation: Role of ACE gene polymorphism

    Microsoft Academic Search

    Domingo Hernández; Juan Lacalzada; Eduardo Salido; José Linares; Antonio Barragán; Víctor Lorenzo; Luz Higueras; Basilio Martín; Aurelio Rodríguez; Ignacio Laynez; José M González-Posada; Armando Torres

    2000-01-01

    Regression of left ventricular hypertrophy by lisinopril after renal transplantation: Role of ACE gene polymorphism.BackgroundCardiac complications are the main cause of death in renal transplantation (RT), and left ventricular hypertrophy (LVH) may play an important role in these patients. The unfavorable genotype of the angiotensin-converting enzyme (ACE) gene has been associated with cardiovascular disease, including LVH. ACE inhibitors (ACEIs) reduce

  14. Automatic contour propagation in cine cardiac magnetic resonance images.

    PubMed

    Hautvast, Gilion; Lobregt, Steven; Breeuwer, Marcel; Gerritsen, Frans

    2006-11-01

    We have developed a method for automatic contour propagation in cine cardiac magnetic resonance images. The method consists of a new active contour model that tries to maintain a constant contour environment by matching gray values in profiles perpendicular to the contour. Consequently, the contours should maintain a constant position with respect to neighboring anatomical structures, such that the resulting contours reflect the preferences of the user. This is particularly important in cine cardiac magnetic resonance images because local image features do not describe the desired contours near the papillary muscle. The accuracy of the propagation result is influenced by several parameters. Because the optimal setting of these parameters is application dependent, we describe how to use full factorial experiments to optimize the parameter setting. We have applied our method to cine cardiac magnetic resonance image sequences from the long axis two-chamber view, the long axis four-chamber view, and the short axis view. We performed our optimization procedure for each contour in each view. Next, we performed an extensive clinical validation of our method on 69 short axis data sets and 38 long axis data sets. In the optimal parameter setting, our propagation method proved to be fast, robust, and accurate. The resulting cardiac contours are positioned within the interobserver ranges of manual segmentation. Consequently, the resulting contours can be used to accurately determine physiological parameters such as stroke volume and ejection fraction. PMID:17117776

  15. Genetics of sudden cardiac death in the young.

    PubMed

    Saenen, J B; Van Craenenbroeck, E M; Proost, D; Marchau, F; Van Laer, L; Vrints, C J; Loeys, B L

    2015-08-01

    Sudden cardiac death (SCD) has an enormous impact on those who are left behind, evoking strong feelings of anxiety and incomprehension because such a dramatic event was not anticipated. Moreover, over the last decade a prominent genetic contribution to the pathogenesis of SCD has been unveiled. As many inherited cardiac diseases show an autosomal dominant pattern of inheritance, the risk of carrying the same inherited predisposition is a real concern for the relatives. In this article, we discuss the major causes of primary electrical disorders, cardiomyopathies and thoracic aortic dissection and address issues in genotype-phenotype correlation, personalized management and cardiogenetic counselling. PMID:25307320

  16. Value of Cardiac CT in Patients With Heart Failure

    PubMed Central

    Mangalat, Deepa; Kalogeropoulos, Andreas; Georgiopoulou, Vasiliki; Stillman, Arthur; Butler, Javed

    2010-01-01

    Multidetector CT (MDCT) with 64-slice capability continues to gain momentum for cardiovascular imaging. Beyond images of coronary arteries, it also provides reliable information on left ventricular structure and function, cardiac venous anatomy, the pulmonary venous system, and right ventricular function—all aspects important in the management of heart failure patients. Potential unique applications in heart failure include cardiac dyssynchrony evaluation, assessing cardiomyopathies, and post-transplant annual follow-up. This review details the multiple applications and limitations of MDCT in the heart failure population, including comparison with other commonly used imaging modalities such as echocardiography and MRI. PMID:20369033

  17. Multiple Antioxidants Improve Cardiac Complications and Inhibit Cardiac Cell Death in Streptozotocin-Induced Diabetic Rats

    PubMed Central

    Kumar, Santosh; Prasad, Sahdeo; Sitasawad, Sandhya L.

    2013-01-01

    Diabetic cardiomyopathy, a disorder of the heart muscle in diabetic patients, is one of the major causes of heart failure. Since diabetic cardiomyopathy is now known to have a high prevalence in the asymptomatic diabetic patient, prevention at the earliest stage of development by existing molecules would be appropriate in order to prevent the progression of heart failure. In this study, we investigated the protective role of multiple antioxidants (MA), on cardiac dysfunction and cardiac cell apoptosis in streptozotocin (STZ)-induced diabetic rat. Diabetic cardiomyopathy in STZ-treated animals was characterized by declined systolic, diastolic myocardial performance, oxidative stress and apoptosis in cardiac cells. Diabetic rats on supplementation with MA showed decreased oxidative stress evaluated by the content of reduced levels of lipid per-oxidation and decreased activity of catalase with down-regulation of heme-oxygenase-1 mRNA. Supplementation with MA also resulted in a normalized lipid profile and decreased levels of pro-inflammatory transcription factor NF-kappaB as well as cytokines such as TNF-?, IFN-?, TGF-?, and IL-10. MA was found to decrease the expression of ROS-generating enzymes like xanthine oxidase, monoamine oxidase-A along with 5-Lipoxygenase mRNA and/or protein expression. Further, left ventricular function, measured by a microtip pressure transducer, was re-established as evidenced by increase in ±dp/dtmax, heart rate, decreased blood pressure, systolic and diastolic pressure as well as decrease in the TUNEL positive cardiac cells with increased Bcl-2/Bax ratio. In addition, MA supplementation decreased cell death and activation of NF-kappaB in cardiac H9c2 cells. Based on our results, we conclude that MA supplementation significantly attenuated cardiac dysfunction in diabetic rats; hence MA supplementation may have important clinical implications in terms of prevention and management of diabetic cardiomyopathy. PMID:23843977

  18. Multiple antioxidants improve cardiac complications and inhibit cardiac cell death in streptozotocin-induced diabetic rats.

    PubMed

    Kumar, Santosh; Prasad, Sahdeo; Sitasawad, Sandhya L

    2013-01-01

    Diabetic cardiomyopathy, a disorder of the heart muscle in diabetic patients, is one of the major causes of heart failure. Since diabetic cardiomyopathy is now known to have a high prevalence in the asymptomatic diabetic patient, prevention at the earliest stage of development by existing molecules would be appropriate in order to prevent the progression of heart failure. In this study, we investigated the protective role of multiple antioxidants (MA), on cardiac dysfunction and cardiac cell apoptosis in streptozotocin (STZ)-induced diabetic rat. Diabetic cardiomyopathy in STZ-treated animals was characterized by declined systolic, diastolic myocardial performance, oxidative stress and apoptosis in cardiac cells. Diabetic rats on supplementation with MA showed decreased oxidative stress evaluated by the content of reduced levels of lipid per-oxidation and decreased activity of catalase with down-regulation of heme-oxygenase-1 mRNA. Supplementation with MA also resulted in a normalized lipid profile and decreased levels of pro-inflammatory transcription factor NF-kappaB as well as cytokines such as TNF-?, IFN-?, TGF-?, and IL-10. MA was found to decrease the expression of ROS-generating enzymes like xanthine oxidase, monoamine oxidase-A along with 5-Lipoxygenase mRNA and/or protein expression. Further, left ventricular function, measured by a microtip pressure transducer, was re-established as evidenced by increase in ±dp/dtmax, heart rate, decreased blood pressure, systolic and diastolic pressure as well as decrease in the TUNEL positive cardiac cells with increased Bcl-2/Bax ratio. In addition, MA supplementation decreased cell death and activation of NF-kappaB in cardiac H9c2 cells. Based on our results, we conclude that MA supplementation significantly attenuated cardiac dysfunction in diabetic rats; hence MA supplementation may have important clinical implications in terms of prevention and management of diabetic cardiomyopathy. PMID:23843977

  19. The role of cardiac sympathetic innervation and skin thermoreceptors on cardiac responses during heat stress.

    PubMed

    Shibasaki, Manabu; Umemoto, Yasunori; Kinoshita, Tokio; Kouda, Ken; Ito, Tomoyuki; Nakamura, Takeshi; Crandall, Craig G; Tajima, Fumihiro

    2015-06-01

    The mechanism(s) for the changes in cardiac function during heat stress remain unknown. This study tested two unique hypotheses. First, sympathetic innervation to the heart is required for increases in cardiac systolic function during heat stress. This was accomplished by comparing responses during heat stress between paraplegics versus tetraplegics, with tetraplegics having reduced/absent cardiac sympathetic innervation. Second, stimulation of skin thermoreceptors contributes to cardiovascular adjustments that occur during heat stress in humans. This was accomplished by comparing responses during leg only heating between paraplegic versus able-bodied individuals. Nine healthy able-bodied, nine paraplegics, and eight tetraplegics participated in this study. Lower body (i.e., nonsensed area for para/tetraplegics) was heated until esophageal temperature had increased by ?1.0°C. Echocardiographic indexes of diastolic and systolic function were performed before and at the end of heat stress. The heat stress increased cardiac output in all groups, but the magnitude of this increase was attenuated in the tetraplegics relative to the able-bodied (1.3 ± 0.4 vs. 2.3 ± 1.0 l/min; P < 0.05). Diastolic function was maintained in all groups. Indexes of left atrial and ventricular systolic function were enhanced in the able-bodied, but did not change in tetraplegics, while these changes in paraplegics were attenuated relative to the able-bodied. These data suggest that the cardiac sympathetic innervation is required to achieve normal increases in cardiac systolic function during heat stress but not required to maintain diastolic function during this exposure. Second, elevated systolic function during heat stress primarily occurs as a result of increases in internal temperature, although stimulation of skin thermoreceptors may contribute. PMID:25795714

  20. Characterization of ?-adrenergic receptors in the heart chambers of adult turkeys.

    PubMed

    Hoffmann, Sandra; Müller, Torsten; Abraham, Getu

    2015-06-01

    The presence, distribution and characteristics of chamber-specific ?-adrenergic receptors in adult turkey hearts were investigated by radioligand binding studies using (-)-[(125)I]-iodocyanopindolol (ICYP). The ?1-selective (CGP 20712A) and ?2-selective (ICI 118.551) antagonists as well as the nonselective ?-agonists isoproterenol, epinephrine and norepinephrine were used in displacement studies. In all cardiac chambers, ICI 118.551 and CGP 20712A displacement curves were monophasic and steep, with the affinity of CGP 20712A higher than that of ICI 118.551, indicating the exclusive presence of the ?1-adrenergic receptor subtype. The agonist rank order of potency was isoproterenol?>?norepinephrine???epinephrine, typical for the ?1-receptor subtype. In all chambers, the density of ?-adrenergic receptors was ~40?fmol/mg protein and the KD was ~30?pM. The study revealed similar ?-adrenergic receptor density mainly of the ?1-subtype in all cardiac chambers, indicating that this receptor subtype could contribute equally to regulate cardiac physiological function and pathophysiology. PMID:25862393

  1. floor Broida; Left from Elevator

    E-print Network

    Ahlers, Guenter

    New Roundabout Rm 3410 3rd floor Broida; Left from Elevator BROIDA PHYSICS Directions to Institute in Broida; Left from elevator, Rm 3410 -Kate Materials (MRL) 2048 Harold Frank Hall FEL Lab Phys. Sci. South

  2. Multiple piston expansion chamber engine

    SciTech Connect

    Jackson, F.W.

    1986-04-08

    This patent describes a multiple piston expansion chamber in an internal combustion engine wherein combustion, expansion and exhaust functions are performed in a cylinder. This cylinder consists of an auxiliary piston reciprocating in the cylinder, a sleeve valve reciprocating within the auxiliary piston, a working piston reciprocating within the sleeve valve. Leading the auxiliary piston is an auxiliary chamber above the auxiliary piston and a combustion chamber above the working piston. The sleeve valve controls communication of the auxiliary chamber with the combustion chamber to prevent communication of combusted products from the chamber above the working piston to the chamber above the auxiliary piston from when the working piston is at about TDC until a subsequent expansion stroke of the working piston is underway to a point about midway to BDC. When the auxiliary piston is at about TDC at this same instant when the working piston is at the point and the communication then is commenced. In order to permit communication only during the expansion stroke from continuing past the point and a following exhaust stroke of the working piston so as to utilize energy of expansion from the auxiliary piston as it expands until the working piston has passed through BDC and returns to about TDC during the exhaust stroke of the working piston. The controlling means comprises a circular sealing surface on an upward viewing surface of the sleeve valve adjacent to the working piston to prevent communication of the respective chambers. Also provided in the chambers is a dwell of the sleeve valve at its TDC between when the respective pistons each reach their TDC.

  3. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    PubMed Central

    Chen, Olivia; Qian, Li

    2015-01-01

    Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

  4. Ultraviolet laser calibration of drift chambers

    E-print Network

    Elliott, Grant (Grant Andrew)

    2006-01-01

    We demonstrate the use of a focused ultraviolet laser as a track calibration source in drift chambers, and specifically in a small time projection chamber (TPC). Drift chambers such as TPCs reconstruct the trajectories of ...

  5. Left atrial ultrastructure in mitral valvular disease.

    PubMed Central

    Thiedemann, K. U.; Ferrans, V. J.

    1977-01-01

    Light microscopic and ultrastructural observations were made on left atrial tissues obtained from 14 patients at the time of operation for correction of mitral valvular disease. Cardiac muscle cells varied in size but most frequently were hypertrophied. In fibrotic areas, present in all left atria, the muscle cells tended to be isolated from adjacent cells and exhibited degenerative changes of varying severity. These changes consisted or proliferation of Z-band material and cytoskeletal filaments, myofibrillar loss, proliferation of elements of free and extended junctional sarcoplasmic reticulum, variations in size and number of mitochondria, occurrence of abnormal mitochondria, dissociation of intercellular junctions, formation of spherical microparticles, and accumulation of lysosomal degradation products. Hypertrophy was considered to lead to cellular degeneration, with decrease or loss of contractile function. Atrial fibrillation was associated with severe cellular degeneration. The severity of degeneration was greater in patients with mitral regurgitation, with or without associated mitral stenosis, than in patients with pure mitral stenosis. Images Figure 17 Figure 18 Figure 19 Figure 1 Figure 2 Figure 3 Figure 20 Figure 21 Figure 4 Figure 5 Figure 6 Figure 7 Figure 22 Figure 23 Figure 24 Figure 8 Figure 9 Figure 10 Figure 25 Figure 26 Figure 27 Figure 28 Figure 11 Figure 12 Figures 29-30 Figure 13 Figure 14 Figures 15-16 PMID:145805

  6. Persistent left superior vena cava draining to the left atrium: A case report and review of the literature

    PubMed Central

    Duymus, Mahmut; Yesilkaya, Yakup; Orman, Gunes; Bozkurt, Alper; Yilmaz, Omer

    2012-01-01

    Summary Background: Persistent left superior vena cava is a rare but important congenital vascular anomaly. However, PLSVC with absent RSVC (isolated PLSVC) is a very rare venous malformation We report on a rare case of persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC). Case Report: This venous malformation was identified incidentally in a 69-year-old woman during chest multi-detector computed tomography (MDCT). On chest MDCT, the SVC was noted on the left side. A bridging vein drained the right jugular and right subclavian veins and joined the left brachiocephalic vein in order to form the PLSVC, which descended on the left side of the mediastinum and drained into the left atrium (LA). The patient had no additional cardiac anomaly. Conclusions: Isolated PLSVC is usually asymptomatic but it can pose difficulties for establishing central venous access, pacemaker implantation and cardiothoracic surgery. This condition is also associated with an increased incidence of congenital heart disease, arrhythmias and conduction disturbances. A wide spectrum of clinicians should be aware of this anomaly, its variations and possible complications. PMID:23269940

  7. Partial anomalous left pulmonary artery: report of two cases and review of literature.

    PubMed

    Sen, Supratim; Winlaw, David S; Sholler, Gary F

    2015-06-01

    We describe two cases of anomalous origin of the left lower-lobe pulmonary artery from the right pulmonary artery. The primary diagnosis was mitral atresia, hypoplastic left ventricle, aortic arch hypoplasia in the first child, and tetralogy of Fallot in the second. In both cases, the pulmonary trunk gave rise to a left pulmonary artery in the normal position. In addition, a second branch of the left pulmonary artery arose from the right pulmonary artery, and passed posterior and inferior to the left main or upper-lobe bronchus to supply the left lower lobe. In this review, we compare our findings with previously reported examples of this extremely rare cardiac malformation, and discuss possible embryological explanations for the lesion. PMID:25160653

  8. Cardiac-specific disruption of the c-raf-1 gene induces cardiac dysfunction and apoptosis.

    PubMed

    Yamaguchi, Osamu; Watanabe, Tetsuya; Nishida, Kazuhiko; Kashiwase, Kazunori; Higuchi, Yoshiharu; Takeda, Toshihiro; Hikoso, Shungo; Hirotani, Shinichi; Asahi, Michio; Taniike, Masayuki; Nakai, Atsuko; Tsujimoto, Ikuko; Matsumura, Yasushi; Miyazaki, Jun-ichi; Chien, Kenneth R; Matsuzawa, Atsushi; Sadamitsu, Chiharu; Ichijo, Hidenori; Baccarini, Manuela; Hori, Masatsugu; Otsu, Kinya

    2004-10-01

    The Raf/MEK/extracellular signal-regulated kinase (ERK) signaling pathway regulates diverse cellular processes such as proliferation, differentiation, and apoptosis and is implicated as an important contributor to the pathogenesis of cardiac hypertrophy and heart failure. To examine the in vivo role of Raf-1 in the heart, we generated cardiac muscle-specific Raf-1-knockout (Raf CKO) mice with Cre-loxP-mediated recombination. The mice demonstrated left ventricular systolic dysfunction and heart dilatation without cardiac hypertrophy or lethality. The Raf CKO mice showed a significant increase in the number of apoptotic cardiomyocytes. The expression level and activation of MEK1/2 or ERK showed no difference, but the kinase activity of apoptosis signal-regulating kinase 1 (ASK1), JNK, or p38 increased significantly compared with that in controls. The ablation of ASK1 rescued heart dysfunction and dilatation as well as cardiac fibrosis. These results indicate that Raf-1 promotes cardiomyocyte survival through a MEK/ERK-independent mechanism. PMID:15467832

  9. Cardiac-specific disruption of the c-raf-1 gene induces cardiac dysfunction and apoptosis

    PubMed Central

    Yamaguchi, Osamu; Watanabe, Tetsuya; Nishida, Kazuhiko; Kashiwase, Kazunori; Higuchi, Yoshiharu; Takeda, Toshihiro; Hikoso, Shungo; Hirotani, Shinichi; Asahi, Michio; Taniike, Masayuki; Nakai, Atsuko; Tsujimoto, Ikuko; Matsumura, Yasushi; Miyazaki, Jun-ichi; Chien, Kenneth R.; Matsuzawa, Atsushi; Sadamitsu, Chiharu; Ichijo, Hidenori; Baccarini, Manuela; Hori, Masatsugu; Otsu, Kinya

    2004-01-01

    The Raf/MEK/extracellular signal–regulated kinase (ERK) signaling pathway regulates diverse cellular processes such as proliferation, differentiation, and apoptosis and is implicated as an important contributor to the pathogenesis of cardiac hypertrophy and heart failure. To examine the in vivo role of Raf-1 in the heart, we generated cardiac muscle–specific Raf-1–knockout (Raf CKO) mice with Cre-loxP–mediated recombination. The mice demonstrated left ventricular systolic dysfunction and heart dilatation without cardiac hypertrophy or lethality. The Raf CKO mice showed a significant increase in the number of apoptotic cardiomyocytes. The expression level and activation of MEK1/2 or ERK showed no difference, but the kinase activity of apoptosis signal–regulating kinase 1 (ASK1), JNK, or p38 increased significantly compared with that in controls. The ablation of ASK1 rescued heart dysfunction and dilatation as well as cardiac fibrosis. These results indicate that Raf-1 promotes cardiomyocyte survival through a MEK/ERK–independent mechanism. PMID:15467832

  10. Technique for evaluating left ventricular performance with apical two-dimensional echocardiography: Progress report

    PubMed Central

    Edelman, Sidney K.; Pechacek, Leonard W.; Rowe, Dennis W.; Garcia, Efrain; Hall, Robert J.

    1981-01-01

    A technique of modelling the left ventricle for the purpose of volume determination has been devised. Two-dimensional echocardiographic data from the apical four chamber and two chamber views are used to pattern the ventricle as a stack of elliptical discs. The method has been validated for an array of regular geometric shapes commonly associated with ventricular architecture. The relative advantages of this model are discussed. PMID:15216224

  11. 21 CFR 866.2120 - Anaerobic chamber.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2120 Anaerobic chamber. (a) Identification. An anaerobic chamber is a...

  12. 21 CFR 866.2120 - Anaerobic chamber.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2120 Anaerobic chamber. (a) Identification. An anaerobic chamber is a...

  13. 21 CFR 866.2120 - Anaerobic chamber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2120 Anaerobic chamber. (a) Identification. An anaerobic chamber is a...

  14. 21 CFR 866.2120 - Anaerobic chamber.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2120 Anaerobic chamber. (a) Identification. An anaerobic chamber is a...

  15. 21 CFR 866.2120 - Anaerobic chamber.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2120 Anaerobic chamber. (a) Identification. An anaerobic chamber is a...

  16. Extra Terrestrial Environmental Chamber Design

    NASA Technical Reports Server (NTRS)

    Hughes, David W.

    2008-01-01

    A vacuum chamber designed to simulate the dusty environment on the Moon or Mars has been built for Goddard Space Flight Center. The path from concept to delivery is reviewed, with lessons learned and pitfalls highlighted along the way.

  17. Light diffusing fiber optic chamber

    DOEpatents

    Maitland, Duncan J. (Lafayette, CA)

    2002-01-01

    A light diffusion system for transmitting light to a target area. The light is transmitted in a direction from a proximal end to a distal end by an optical fiber. A diffusing chamber is operatively connected to the optical fiber for transmitting the light from the proximal end to the distal end and transmitting said light to said target area. A plug is operatively connected to the diffusing chamber for increasing the light that is transmitted to the target area.

  18. Multiple piston expansion chamber engine

    SciTech Connect

    Jackson, F.W.

    1986-02-18

    This patent describes an internal combustion engine. This engine consists of a cylinder with an auxiliary piston reciprocating in the cylinder; a working piston reciprocating within the auxiliary piston; an auxiliary chamber above the auxiliary piston; a combustion chamber above the working piston and providing a dwell for the auxiliary piston at TDC starting from when the working piston is between 40 degrees before to about TDC and on passing TDC entering an expansion stroke. The auxiliary piston remains at TDC until the working piston expansion stroke is underway and at a point where the working piston is between 20 and 160 degrees past TDC during the expansion stroke at which point the auxiliary piston leaves TDC and moves toward BDC. A controller communicating with the combustion chamber and the auxiliary chamber to prevent communication of combusted products from the combustion chamber above the working piston to the chamber above the auxiliary piston while the auxiliary piston is at TDC. The piston at TDC permits communication only during the working piston expansion stroke continuing past the point between 20 and 160 degrees past TDC, and a following exhaust stroke of the working piston so as to utilize energy of expansion from the auxiliary piston as it expands until the working piston has passed through BDC and returns to about TDC during the exhaust stroke of the working piston.

  19. Multiple piston expansion chamber engine

    SciTech Connect

    Jackson, F.W.

    1987-12-29

    An internal combustion engine is described wherein combustion, expansion and exhaust functions are performed in a cylinder comprised of an auxiliary piston reciprocating in the cylinder, a sleeve valve reciprocating within the auxiliary piston, a working piston reciprocating within the sleeve valve and leading the auxiliary piston, an auxiliary chamber above the auxiliary piston and a combustion chamber above the working piston. The sleeve valve controlling communication of the auxiliary chamber with the combustion chamber to prevent communication of combusted products from the chamber above the working piston to the chamber above the auxiliary piston from when the working piston is at about TDC until a subsequent expansion stroke of the working piston is underway and at a point between 30 and 160 degrees past TDC and with the auxiliary piston being at about TDC at this same instant when the working piston is at the point and the communication then is commenced. To permit communication only during the expansion stroke continuing past the point and a following exhaust stroke of the working piston so as to utilize energy of expansion from the auxiliary piston as it expands until the working piston has passed through BDC and returns to about TDC during the exhaust stroke of the working piston.

  20. T-lymphocytes mediate left ventricular fibrillar collagen cross-linking and diastolic dysfunction in mice.

    PubMed

    Yu, Qianli; Vazquez, Randy; Zabadi, Sherma; Watson, Ronald R; Larson, Douglas F

    2010-07-01

    Aberrant concentrations of cardiac extracellular matrix (ECM) fibrillar collagen cross-linking have been proposed to be an underlying cause of cardiac diastolic dysfunction however the role of the adaptive immune system in this process has yet to be investigated. Fibrillar collagen cross-linking is a product of the enzymatic activities of lysyl oxidase (LOX and LOXL-3) released by the cardiac fibroblast and possibly cardiac myocytes. Our hypothesis is that stimulation of the TH1 lymphocytes activates lysyl oxidase mediated ECM cross-linking and thereby alters left ventricular function. Three-month old C57BL/J female mice were treated with selective TH1 lymphocyte inducers - T-cell receptor V? peptides (TCR). After 6 weeks, candidate gene expression, tissue enzymatic activity, ECM composition, and left ventricular mechanics were quantified. Lymphocyte gene expression and cytokine assay revealed TH1 immune polarization with TCR administration which was associated with a 2.6-fold and 3.1-fold increase of LOX and LOXL3 gene expression, respectively, and a 55% increase in cardiac LOX enzymatic activity. The ECM cross-linked fibrillar collagen increased by 95% when compared with the control. Concurrently, there was a 33% increased ventricular stiffness, decreased cardiac output, and normal ejection fraction. These data implicate the TH1 lymphocyte in the pathogenesis of diastolic dysfunction which has potential clinical application in the pathogenesis of diastolic heart failure. PMID:20600894

  1. Variability in frame by frame analysis of left ventricular wall motion from contrast angiograms

    Microsoft Academic Search

    Hiroaki Hosokawa; Florence H. Sheehan; Takahiko Suzuki; Edward L. Bolson

    1997-01-01

    Background. Measurement of the timing of left ventricular (LV) wall motion, of asynchrony, and of diastolic function from contrast angiograms requires delineation of the endocardial border frame by frame through the cardiac cycle. This study was performed to determine the magnitude of intraobserver and interobserver variability in manual border tracing, and to measure the impact of this variability on the

  2. Regional and Temporal Nonuniformity of Shape and Wall Movement in the Normal Left Ventricle

    Microsoft Academic Search

    G. Barletta; M. Baroni; R. Del Bene; A. Toso; F. Fantini

    1998-01-01

    Asymmetry of left ventricular (LV) shape and asynchrony of regional LV movement have been described in the normal human heart, but never correlated to each other. In 16 normal subjects, right anterior oblique ventriculography was used to obtain volumes, regional wall motion (centerline method) and curvature (windowed Fourier series approximation of contours) over the entire cardiac cycle. The apex had

  3. Obstruction of the Aorta and Left Pulmonary Artery After Gianturco Coil Occlusion of Patent Ductus Arteriosus

    SciTech Connect

    Kuo, H.-Cg [Chang Gung Children's Hospital, Department of Pediatrics (China); Ko, Sheung-Fat [Chang Gung Children's Hospital, Department of Radiology (China); Wu, Yu-Tsun; Huang, Chien-Fu; Chien, Shao-Ju; Tiao, Mao-Meng; Liang, Chi-Di [Chang Gung Children's Hospital, Department of Pediatrics (China)], E-mail: cdliang@adm.cgmh.org.tw

    2005-01-15

    We report an unusual case of simultaneous obstruction of the left pulmonary artery and descending thoracic aorta after Gianturco coil occlusion in a 15-month-old boy. The diagnosis was made by echocardiography and cardiac angiography. At surgery, thrombi coating on the protruded parts of the Gianturco coil in the pulmonary artery and aorta were found.

  4. Prevalent left ventricular hypertrophy in the predialysis population: Identifying opportunities for intervention

    Microsoft Academic Search

    Adeera Levin; Joel Singer; Christopher R. Thompson; Heather Ross; Mary Lewis

    1996-01-01

    Left ventricular hypertrophy (LVH) is present in over 70% of patients commencing dialysis. It is an independent risk factor for cardiac death, which is the cause of death in approximately 45% of patients on dialysis. The prevalence of LVH in patients earlier in the course of renal insufficiency is unknown. As part of a prospective longitudinal study evaluating the progression

  5. Telmisartan, a unique ARB, improves left ventricular remodeling of infarcted heart by activating PPAR gamma

    Microsoft Academic Search

    Yasuhiro Maejima; Hiroyuki Okada; Go Haraguchi; Yasuyuki Onai; Hisanori Kosuge; Jun-ichi Suzuki; Mitsuaki Isobe

    2011-01-01

    Unfavorable left ventricular (LV) remodeling after myocardial infarction (MI) leads to cardiac dysfunction. We examined whether Telmisartan, an angiotensin (Ang) II type I receptor blocker (ARB), could improve the recovery of LV function in a rat model of MI. The effect of Telmisartan as a peroxisome proliferator-activated receptor-? (PPAR-?) agonist was also investigated. After 28 days of MI, a significant

  6. [Left atrial myxoma in a patient with heart failure after myocardial infarction - a case report].

    PubMed

    Detko-Barczy?ska, Joanna; Dabrowski, Rafa?; Kraska, Alicja; Szwed, Hanna

    2008-06-01

    A case of a 54-year-old male patient with left atrial myxoma, coronary heart disease, heart failure and multiple cardiovascular risk factors is described. The patient did not present typical symptoms of myxoma. Diagnosis and treatment of cardiac myxoma as well as the importance of echocardiographic examination in every patient with decompensated chronic heart failure are discussed. PMID:18626835

  7. Analysis of left ventricular wall movement during isovolumic relaxation and its relation to coronary artery disease

    Microsoft Academic Search

    D G Gibson; T A Prewitt; D J Brown

    1976-01-01

    Left ventricular angiograms of 60 patients with ischaemic heart disease and 10 normal subjects were digitized frame by frame in order to study abnormalities of wall movement during the period of isovolumic relaxation. Plots were made of regional wall movement around the cavity throughout the cardiac cycle. In normal subjects 1-5 to 3-0 mm of symmetrical outward wall movement occurred

  8. Assessment of an incidental finding of left bundle-branch block.

    PubMed

    Mair, Luke; Warriner, David; Payne, Gillian

    2015-04-01

    Incidental left bundle-branch block occurs in up to 1.5% of healthy adults without symptoms or signs of cardiovascular disease. It may be found during investigation for non-cardiac disease, during preoperative assessment, private health screening or inpatient monitoring. This article outlines how to assess these patients. PMID:25853348

  9. Impact of ambulatory blood pressure on left ventricular diastolic dysfunction in uncomplicated arterial systemic hypertension

    Microsoft Academic Search

    Maurizio Galderisi; Antonio Petrocelli; Alfonso Alfieri; Mario Garofalo; Oreste de Divitiis

    1996-01-01

    To determine the relations of 24-hour blood pressure (BP) and its different phases with left ventricular (LV) diastolic filling, 125 subjects (mean age 46 years) not taking cardiac drugs were studied by Doppler echocardiography and ambulatory BP recording. Subjects (excluding those with coronary artery or valvular heart disease, heart failure, or diabetes) were classified into 2 groups according to the

  10. Influence of Nighttime Blood Pressure on Left Atrial Size in Uncomplicated Arterial Systemic Hypertension

    Microsoft Academic Search

    Maurizio Galderisi; Antonio Petrocelli; Ayman Fakher; Annibale Izzo; Alfonso Alfieri; Oreste de Divitiis

    1997-01-01

    The aim of the study was to determine the relations of 24-h blood pressure (BP) and its different phases with left atrial size. A total of 130 subjects (mean age 46 years) not taking cardiac drugs were studied by M-mode and Doppler echocardiography and ambulatory BP recording. Subjects (excluding those with coronary artery or valvular heart disease, heart failure, or

  11. Analyzing the deformation of the left ventricle of the heart with a parametric deformable model

    E-print Network

    Cohen, Laurent

    a complete cardiac cycle (contraction and dilation). These images are perfectly adapted to studying creation in 1989, our group has pioneered work in the use of deformable models to extract the left to a model of the surface. Using deformable models and templates, the extraction of a shape is obtained

  12. Correlation Between Severity of Pulmonary Arterial Hypertension and 123I-Metaiodobenzylguanidine Left Ventricular Imaging

    Microsoft Academic Search

    Fumio Sakamaki; Toru Satoh; Noritoshi Nagaya; Shingo Kyotani; Hideo Oya; Norifumi Nakanishi; Sachio Kuribayashi; Yoshio Ishida

    It remains unclear whether cardiac sympathetic nervous function is disturbed in patients with pulmonary arterial hypertension (PH) and how sympathetic dysfunction is related to PH. Methods: In this study, 123l-metaiodobenzylguanidine (MIBG) imaging of the heart, which reveals the sympathetic innervation of the left ventricle, was performed in 7 healthy volunteers without cardio- pulmonary disease (control subjects); 55 patients with PH,

  13. Perioperative Avulsion of a Left Internal Mammary Artery Graft in a Patient with Syphilis

    PubMed Central

    Kaleda, Vasily I.; Belash, Sergei A.; Barsuk, Alexei V.; Barbuhatti, Kirill O.

    2014-01-01

    Avulsion of a graft after coronary artery bypass grafting surgery is a rare but very serious complication which leads to massive bleeding and possible life-threatening cardiac tamponade. In this paper we report a very rare case of a left internal mammary artery graft avulsion on the day of surgery in a patient with syphilis. PMID:25374955

  14. Real-Time Strain Rate Imaging of the Left Ventricle by Ultrasound

    Microsoft Academic Search

    Andreas Heimdal; Asbjørn Støylen; Hans Torp; Terje Skjærpe

    1998-01-01

    The regional function of the left ventricle can be visualized in real-time using the new strain rate imaging method. Deformation or strain of a tissue segment occurs over time during the cardiac cycle. The rate of this deformation, the strain rate, is equivalent to the velocity gradient, and can be estimated using the tissue Doppler technique. We present the strain

  15. Placement of a temporary pacemaker electrode through a persistent left superior vena cava

    Microsoft Academic Search

    T. A. Cron; P. T. Buser; S. Osswald

    1998-01-01

    Perioperative temporary pacing was needed in a patient with congenital skeletal malformations and a cardiac conduction disturbance\\u000a with incomplete trifascicular block. We report the successful placement of the pacemaker electrode through a persistent left\\u000a superior vena cava (SVC).

  16. Assessment of left ventricular volume and mass by cine magnetic resonance imaging in patients with anterior myocardial infarction intra-observer and inter-observer variability on contour detection

    Microsoft Academic Search

    Niels A. A. Matheijssen; Leo H. B. Baur; Johan H. C. Reiber; Edo A. van der Velde; Paul R. M. van Dijkman; Rob J. van der Geest; Albert de Roos; Ernst E. van der Wall

    1996-01-01

    Remodeling of the left ventricle after myocardial infarction can be documented by calculation of left ventricular volume and mass, using endocardial and epicardial tracings of multilevel multiphase short-axis cine magnetic resonance (MR) imaging series. We assessed left ventricular volume and mass from 8 slices and during 12 phases of the cardiac cycle in seven patients with an anterior wall myocardial

  17. 601 octogenarians undergoing cardiac surgery: outcome and comparison with younger age groups

    Microsoft Academic Search

    Joseph M Craver; John D Puskas; William W Weintraub; Yannan Shen; Robert A Guyton; John Parker Gott; Ellis L Jones

    1999-01-01

    Background. Cardiac valve replacement and coronary artery bypass graft surgery (CABG) are being applied with increasing frequency in patients 80 years of age and older.Methods. Six hundred one consecutive patients older than 80 years, undergoing cardiac surgery between 1976 and 1994 (CABG with saphenous vein graft, 329 [54.7%]; CABG with left internal mammary artery, 101 [16.8%]; CABG + valve, 80

  18. MSCT labelling for pre-operative planning in cardiac resynchronization therapy

    PubMed Central

    Rioual, Kristell; Unanua, Edurne; Laguitton, Soizic; Garreau, Mireille; Boulmier, Dominique; Haigron, Pascal; Leclercq, Christophe; Coatrieux, Jean-Louis

    2005-01-01

    The objective of this paper is twofold: (i) to show how Multislice Computed Tomography (MSCT) data sets bring the information required for Cardiac Resynchronisation Therapy (CRT) planning; (ii) to demonstrate the feasibility of 3-D navigation into the veins where Left Ventricular leads have to be placed. The former has been achieved by exploring and labelling the cardiac structures of concern, the latter has been performed by using the concept of virtual navigation with high resolution surface detection and estimation algorithms. PMID:16005608

  19. Noninvasive transesophageal cardiac thermal ablation using a 2-D focused, ultrasound phased array: a simulation study

    Microsoft Academic Search

    Xiangtao Yin; Laurence M. Epstein; Kullervo Hynynen

    2006-01-01

    This simulation study proposes a noninvasive, transesophageal cardiac-thermal ablation using a planar ultrasound phased array (1 MHz, 60 × 10 mm2, 0.525 mm interelement spacing, 114 × 20 elements). Thirty-nine foci in cardiac muscle were defined at 20, 40, and 60-mm distances and at various angles from the transducer surface to simulate the accessible posterior left atrial wall through the

  20. Transient cardiac apoptosis isoproterenol-induced: Participation of angiotensin-I converting enzyme

    Microsoft Academic Search

    Anita S. Gálvez; Jenny L. Fiedler; María Paz Ocaranza; Jorge E. Jalil; Sergio Lavandero; Guillermo Díaz-Araya

    2005-01-01

    Administration of isoproterenol results in apoptosis and cardiac hypertrophy. We have investigated the effect of short-term stimulation by isoproterenol on the activity of plasma, lung, and left ventricular (LV) angiotensin-I converting enzyme (ACE) activity and its association with the development of cardiac apoptosis. Isoproterenol produced an early increase only in bax and bcl-XS pro-apoptotic proteins (day 1) without changes in

  1. Modifications of cardiac function in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt (TIPS)

    Microsoft Academic Search

    Manuela Merli; Valentina Valeriano; Stefania Funaro; Adolfo Francesco Attili; Andrea Masini; Cesare Efrati; Stefano De Castro; Oliviero Riggio

    2002-01-01

    OBJECTIVE:The implantation of a transjugular intrahepatic portosystemic shunt (TIPS) has been shown to exacerbate the hyperdynamic circulation and might induce a significant cardiac overload. We investigated cardiac function before and 1, 3, 6, and 12 months after the TIPS procedure in cirrhotic patients.METHODS:Eleven patients with nonalcoholic cirrhosis were evaluated. Cardiovascular parameters were assessed by two-dimensional Doppler echocardiography.RESULTS:After TIPS, the left

  2. Temporal relation of cardiac hypertrophy, oxidative stress, and fatty acid metabolism in spontaneously hypertensive rat

    Microsoft Academic Search

    Sreeja Purushothaman; R. Renuka Nair; V. S. Harikrishnan; A. C. Fernandez

    2011-01-01

    Left ventricular hypertrophy is an adaptive response to hypertension, and an independent clinical risk factor for cardiac\\u000a failure, sudden death, and myocardial infarction. As regression of cardiac hypertrophy is associated with a lower likelihood\\u000a of cardiovascular events, it is recognized as a target of antihypertensive therapy. This necessitates identification of factors\\u000a associated with the initiation and progression of hypertrophy. Oxidative

  3. Lentivirus-mediated overexpression of angiotensin-(1–7) attenuated ischaemia-induced cardiac pathophysiology

    PubMed Central

    Qi, YanFei; Shenoy, Vinayak; Wong, Fong; Li, Hongwei; Afzal, Aqeela; Mocco, J.; Sumners, Colin; Raizada, Mohan K.; Katovich, Michael J.

    2013-01-01

    Myocardial infarction (MI) results in cell death, development of interstitial fibrosis, ventricular wall thinning and ultimately, heart failure. Angiotensin-(1–7) [Ang-(1–7)] has been shown to provide cardioprotective effects. We hypothesize that lentivirus-mediated overexpression of Ang-(1–7) would protect the myocardium from ischaemic injury. A single bolus of 3.5 ×108 transducing units of lenti-Ang-(1–7) was injected into the left ventricle of 5-day-old male Sprague–Dawley rats. At 6 weeks of age, MI was induced by ligation of the left anterior descending coronary artery. Four weeks after the MI, echocardiography and haemodynamic parameters were measured to assess cardiac function. Postmyocardial infarction, rats showed significant decreases in fractional shortening and dP/dt (rate of rise of left ventricular pressure), increases in left ventricular end-diastolic pressure, and ventricular hypertrophy. Also, considerable upregulation of cardiac angiotensin-converting enzyme (ACE) mRNA was observed in these rats. Lentivirus-mediated cardiac overexpression of Ang-(1–7) not only prevented all these MI-induced impairments but also resulted in decreased myocardial wall thinning and an increased cardiac gene expression of ACE2 and bradykinin B2 receptor (BKR2). Furthermore, in vitro experiments using rat neonatal cardiac myocytes demonstrated protective effects of Ang-(1–7) against hypoxia-induced cell death. This beneficial effect was associated with decreased expression of inflammatory cytokines (tumour necrosis factor-? and interleukin-6) and increased gene expression of ACE2, BKR2 and interleukin-10. Our findings indicate that overexpression of Ang-(1–7) improves cardiac function and attenuates left ventricular remodelling post-MI. The protective effects of Ang-(1–7) appear to be mediated, at least in part, through modulation of the cardiac renin–angiotensin system and cytokine production. PMID:21685447

  4. Drug Treatment of Cardiac Failure

    PubMed Central

    Achong, M. R.; Kumana, C. R.

    1982-01-01

    Treatment of cardiac failure should first be aimed at reversing or ameliorating the underlying pathological processes. This review highlights the common problems and pitfalls in the use of digoxin, diuretics and vasodilators in patients with cardiac failure. PMID:21289849

  5. Drug treatment of cardiac failure.

    PubMed

    Achong, M R; Kumana, C R

    1982-01-01

    Treatment of cardiac failure should first be aimed at reversing or ameliorating the underlying pathological processes. This review highlights the common problems and pitfalls in the use of digoxin, diuretics and vasodilators in patients with cardiac failure. PMID:21289849

  6. Pulmonary edema secondary to a cardiac schwannoma in a dog.

    PubMed

    Thomason, Justin D; Rapoport, Gregg; Fallaw, Tiffany; Calvert, Clay A; Sakamoto, Kaori

    2015-06-01

    A 4-year-old castrated labrador retriever presented for cardiac evaluation to determine the etiology of cardiogenic pulmonary edema diagnosed 1 month prior. A large pedunculated mass involving the ventral aspect of the mural mitral valve leaflet and the endocardial surface of the left ventricular free wall, resulting in severe mitral regurgitation, was identified on echocardiogram. Histopathology and immunohistochemistry of this mass and other endocardial masses identified at necropsy for S-100 protein were consistent with a diagnosis of schwannoma. To the authors' knowledge, this is the first case of a benign intracardiac schwannoma described in the left heart of a dog. PMID:26048635

  7. Primary cardiac tumors.

    PubMed Central

    Silverman, N A

    1980-01-01

    Cardiac tumors are a rare, but potentially curably form of heart disease. A high index of clinical suspicion is necessary for diagnosis as these tumors have protean manifestations that mimic a variety of other cardiac and noncardiac diseases. Presently, M-mode and two-dimensional echocardiography are utilized as safe, reliable, and noninvasive imaging modalities. Seventy-five per cent of these tumors are benign, with myxoma accounting for 50% and rhabodomyoma comprising 20% of lesions. Various histologic types of sarcoma are the predominant malignant cardiac neoplasms. With strict attention to avoiding perioperative tumor embolization, surgical resection of these lesions can be accomplished with minimal morbidity and mortality. Sixteen consecutive primary tumors of the heart have been surgically treated at Duke University Medical Center since 1966 with no perioperative deaths and no late recurrences. Images Figs. 2A and B. Fig. 3. Fig. 4. Figs. 5A and B Fig. 6. PMID:7362282

  8. Cardiac hydatidosis presenting as an acute coronary syndrome

    PubMed Central

    Sogunuru, Guruprasad; DS, Murty; Chinta, Viswanatha Reddy; Vuddanda, Kishan; Moka, Nagabhishek

    2010-01-01

    A 56-year-old man presented as an acute coronary syndrome. A transthoracic echocardiography (TTE) performed to assess left ventricular (LV) function revealed multiple hydatid cysts in the right ventricular cavity compressing the interventricular septum. CT scan for chest and abdomen revealed similar cysts in right-lung apex and left lobe of liver. A polyvisceral involvement in the setting of multiple cardiac cysts suggested cardiac hydatidosis as the most probable diagnosis. CT coronary angiography was normal. A preoperative oral albendazole therapy was initiated. Later the patient underwent elective surgery, ‘Evaculation of RV Hydatid Cysts and Obliteration of Cavity with Bovine Pericardium’. His postoperative recovery was good. Regular exercise, chest physiotherapy, a life-long anticoagulation therapy and antibiotic prophylaxis for invasive procedures were recommended. Patient was scheduled for regular follow-up, to check for any recurrences or late complications. PMID:22752832

  9. Cardiac hydatidosis presenting as an acute coronary syndrome.

    PubMed

    Sogunuru, Guruprasad; Murty, D S; Chinta, Viswanatha Reddy; Vuddanda, Kishan; Moka, Nagabhishek

    2010-01-01

    A 56-year-old man presented as an acute coronary syndrome. A transthoracic echocardiography (TTE) performed to assess left ventricular (LV) function revealed multiple hydatid cysts in the right ventricular cavity compressing the interventricular septum. CT scan for chest and abdomen revealed similar cysts in right-lung apex and left lobe of liver. A polyvisceral involvement in the setting of multiple cardiac cysts suggested cardiac hydatidosis as the most probable diagnosis. CT coronary angiography was normal. A preoperative oral albendazole therapy was initiated. Later the patient underwent elective surgery, 'Evaculation of RV Hydatid Cysts and Obliteration of Cavity with Bovine Pericardium'. His postoperative recovery was good. Regular exercise, chest physiotherapy, a life-long anticoagulation therapy and antibiotic prophylaxis for invasive procedures were recommended. Patient was scheduled for regular follow-up, to check for any recurrences or late complications. PMID:22752832

  10. Intradialytic Hypotension and Cardiac Remodeling: A Vicious Cycle

    PubMed Central

    Huang, Jenq-Wen; Yen, Chung-Jen

    2015-01-01

    Hemodynamic instability during hemodialysis is a common but often underestimated issue in the nephrologist practice. Intradialytic hypotension, namely, a decrease of systolic or mean blood pressure to a certain level, prohibits the safe and smooth achievement of ultrafiltration and solute removal goal in chronic dialysis patients. Studies have elucidated the potential mechanisms involved in the development of Intradialytic hypotension, including excessive ultrafiltration and loss of compensatory mechanisms for blood pressure maintenance. Cardiac remodeling could also be one important piece of the puzzle. In this review, we intend to discuss the role of cardiac remodeling, including left ventricular hypertrophy, in the development of Intradialytic hypotension. In addition, we will also provide evidence that a bidirectional relationship might exist between Intradialytic hypotension and left ventricular hypertrophy in chronic dialysis patients. A more complete understanding of the complex interactions in between could assist the readers in formulating potential solutions for the reduction of both phenomena. PMID:25654122

  11. Influence of Vascular Function and Pulsatile Hemodynamics on Cardiac Function.

    PubMed

    Bell, Vanessa; Mitchell, Gary F

    2015-09-01

    Interactions between cardiac and vascular structure and function normally are optimized to ensure delivery of cardiac output with modest pulsatile hemodynamic overhead. Aortic stiffening with age or disease impairs optimal ventricular-vascular coupling, increases pulsatile load, and contributes to left ventricular (LV) hypertrophy, reduced systolic function, and impaired diastolic relaxation. Aortic pulse pressure and timing of peak systolic pressure are well-known measures of hemodynamic ventricular-vascular interaction. Recent work has elucidated the importance of direct, mechanical coupling between the aorta and the heart. LV systolic contraction results in displacement of aortic and mitral annuli, thereby producing longitudinal stretch in the ascending aorta and left atrium, respectively. Force associated with longitudinal stretch increases systolic load on the LV. However, the resulting energy stored in the elastic elements of the proximal aorta during systole facilitates early diastolic LV recoil and rapid filling. This review discusses current views on hemodynamics and mechanics of ventricular-vascular coupling. PMID:26164466

  12. Anomalous Left Coronary From the Pulmonary Artery Presenting as Ventricular Fibrillation After Persistent Ductus Arteriosus Ligation.

    PubMed

    Fudulu, Daniel P; Tulloh, Robert M R; Wolf, Andrew R; Parry, Andrew J; Stoica, Serban C

    2015-07-01

    An anomalous left coronary artery from the pulmonary artery (ALCAPA) is rarely associated with persistent ductus arteriosus (PDA). A large PDA can maintain perfusion in the left coronary artery, delaying presentation. Assessing the origin of the coronary arteries before PDA ligation is difficult, often being performed in very small or even preterm babies. We present the case of a 5-month-old infant with echocardiographic features of mitral regurgitation and subendocardial ischemia who experienced ischemia and cardiac arrest after PDA ligation. Transesophageal echocardiography demonstrated ALCAPA, and left coronary translocation was performed. The infant was discharged after 10 days. PMID:26140805

  13. Implantation of HeartMate II Left Ventricular Assist Device in a Single-Lung Patient.

    PubMed

    Copeland, Hannah; Stoletniy, Liset; Sakr, Antoine; Razzouk, Anees

    2015-06-01

    The use of mechanical assist devices has been established as an effective therapy for patients with end-stage heart failure. Implantable left ventricular assist devices are becoming more common in the clinical practice of cardiac surgery. This report illustrates the use of a HeartMate II (Thoratec Pleasanton, CA) left ventricular assist device in a patient with a single lung and dilated cardiomyopathy. To our knowledge, this is the first report of a left ventricular assist device placement in a patient with a prior pneumonectomy. PMID:26046884

  14. Nature Optimizes the Swirling Flow in the Human Left Ventricle

    NASA Astrophysics Data System (ADS)

    Pedrizzetti, Gianni; Domenichini, Federico

    2005-09-01

    The asymmetry of the blood flow in the human left ventricle is commonly assumed to facilitate the following ejection of blood in the primary circulation. The intraventricular flow is here studied by the numerical solution of the governing equations written in a prolate spheroid geometry with moving walls. The physiological parameters are taken from pediatric clinical data; then, the entering jet is artificially displaced to modify the asymmetry of the flow. The analysis of flow patterns confirms that the physiological case looks to best comply with the transition from the filling to the ejection phase. The flow energy dissipation is found to be minimized about the physiological conditions. An unnatural asymmetry, as given by cardiac diseases or valvular replacement, could reduce the efficiency of the heart pump by over 10%, thus augmenting the work required by the cardiac muscle.

  15. Dystrophin genotype-cardiac phenotype correlations in Duchenne and Becker muscular dystrophies using cardiac magnetic resonance imaging.

    PubMed

    Tandon, Animesh; Jefferies, John L; Villa, Chet R; Hor, Kan N; Wong, Brenda L; Ware, Stephanie M; Gao, Zhiqian; Towbin, Jeffrey A; Mazur, Wojciech; Fleck, Robert J; Sticka, Joshua J; Benson, D Woodrow; Taylor, Michael D

    2015-04-01

    Duchenne and Becker muscular dystrophies are caused by mutations in dystrophin. Cardiac manifestations vary broadly, making prognosis difficult. Current dystrophin genotype-cardiac phenotype correlations are limited. For skeletal muscle, the reading-frame rule suggests in-frame mutations tend to yield milder phenotypes. We performed dystrophin genotype-cardiac phenotype correlations using a protein-effect model and cardiac magnetic resonance imaging. A translational model was applied to patient-specific deletion, indel, and nonsense mutations to predict exons and protein domains present within truncated dystrophin protein. Patients were dichotomized into predicted present and predicted absent groups for exons and protein domains of interest. Development of myocardial fibrosis (represented by late gadolinium enhancement [LGE]) and depressed left ventricular ejection fraction (LVEF) were compared. Patients (n = 274) with predicted present cysteine-rich domain (CRD), C-terminal domain (CTD), and both the N-terminal actin-binding and cysteine-rich domains (ABD1 + CRD) had a decreased risk of LGE and trended toward greater freedom from LGE. Patients with predicted present CTD (exactly the same as those with in-frame mutations) and ABD1 + CRD trended toward decreased risk of and greater freedom from depressed LVEF. In conclusion, genotypes previously implicated in altering the dystrophinopathic cardiac phenotype were not significantly related to LGE and depressed LVEF. Patients with predicted present CRD, CTD/in-frame mutations, and ABD1 + CRD trended toward milder cardiac phenotypes, suggesting that the reading-frame rule may be applicable to the cardiac phenotype. Genotype-phenotype correlations may help predict the cardiac phenotype for dystrophinopathic patients and guide future therapies. PMID:25702278

  16. Cardiac Bioelectricity and Arrhythmias

    NSDL National Science Digital Library

    Flavio Fenton (Cornell University; )

    2006-09-22

    Deep inside a human heart, its pacemaker sends out bursts of electrical signals that keep the heart pumping rhythmically, supplying life-giving oxygen to the body. When these electrical waves become disorganized, the heart starts beating irregularly or arrhythmically. Flavio Fenton and Elizabeth Cherry of Cornell University made this interactive program to provide education on arrhythmias. It presents detailed information on cardiac anatomy, normal cardiac electrophysiology, and different kinds of arrhythmias using a combination of words, pictures, and interactive, computer simulations and animations.

  17. Left ventricular function in patients with chronic obstructive pulmonary disease

    PubMed Central

    Williams, John F.; Childress, Richard H.; Boyd, Daniel L.; Higgs, Lawrence M.; Behnke, Roy H.

    1968-01-01

    Left ventricular function was assessed in six patients with essentially normal cardiopulmonary function, in five patients with primary myocardial disease, and in 16 patients with chronic obstructive pulmonary disease by determining the response of the ventricle to an increased resistance to ejection. Studies were performed at the time of cardiac catheterization and increased resistance to left ventricular ejection was produced by the intravenous infusion of methoxamine. In the control patients, methoxamine produced an increase in stroke volume index (SVI), in stroke work index (SWI), and stroke power index (SPI), whereas left ventricular end-diastolic pressure (LVEDP) increased only moderately. In contrast SVI, SWI, and SPI fell, whereas LVEDP increased inordinately in the patients with myocardiopathy. The patients with chronic obstructive pulmonary disease responded to the infusion with an increase in SVI, SWI, SPI, and LVEDP comparable to the control patients. Furthermore, in this latter group of patients, a quantitatively similar response was observed in those with essentially normal resting hemodynamics, in those with resting pulmonary hypertension, and in those whose disease had progressed to the stage of right ventricular failure. This study provides no evidence that chronic obstructive pulmonary disease results in chronic impairment of left ventricular function, but on the contrary, has demonstrated that the left ventricle responds normally to an increased pressure load in these patients. PMID:5645859

  18. Transvenous defibrillator implantation in a patient with persistent left superior vena cava.

    PubMed

    Vijayvergiya, Rajesh; Shrivastava, Smit; Kumar, Alok; Otaal, Parminder S

    2013-04-26

    Persistent left superior vena cava (LSVC) can be incidentally detected during pacemaker implantation through left pectoral side. There is technical difficulty of optimal site pacing and lead stability for right ventricle lead in such situation. We hereby report a case of successful single-chamber implantable cardioverter defibrillator (ICD) implantation in a 50 years-old male with LSVC. The practical issues related with right ventricle lead implantation and pacing/defibrillation parameters for ICD device are discussed. PMID:23675558

  19. Transvenous defibrillator implantation in a patient with persistent left superior vena cava

    PubMed Central

    Vijayvergiya, Rajesh; Shrivastava, Smit; Kumar, Alok; Otaal, Parminder S

    2013-01-01

    Persistent left superior vena cava (LSVC) can be incidentally detected during pacemaker implantation through left pectoral side. There is technical difficulty of optimal site pacing and lead stability for right ventricle lead in such situation. We hereby report a case of successful single-chamber implantable cardioverter defibrillator (ICD) implantation in a 50 years-old male with LSVC. The practical issues related with right ventricle lead implantation and pacing/defibrillation parameters for ICD device are discussed. PMID:23675558

  20. Cardiac Response and Personality Organization

    ERIC Educational Resources Information Center

    Blatt, Sidney J.; Feirstein, Alan

    1977-01-01

    This study examines the level and variability of cardiac response during complex problem-solving and interposed rest periods and their differing relationships to estimates of personality integration on the Rorschach. Findings suggest cardiac variability may be a more differentiated measure than level of cardiac response. (Author)