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De Lazzari M, Cipriani A, Cecere A, Niero A, De Gaspari M, Giorgi B, De Conti G, Motta R, Rizzo S, Tona F, Cacciavillani L, Tarantini G, Gerosa G, Basso C, Iliceto S, Perazzolo Marra M. Cardiac rupture in acute myocardial infarction: a cardiac magnetic resonance study. Eur Heart J Cardiovasc Imaging 2023; 24:1491-1500. [PMID: 37200615 PMCID: PMC10610764 DOI: 10.1093/ehjci/jead088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 05/20/2023] Open
Abstract
AIMS We assessed the feasibility of cardiac magnetic resonance (CMR) and the role of myocardial strain in the diagnostic work-up of patients with acute myocardial infarction (AMI) and a clinical suspicion of cardiac rupture (CR). METHODS AND RESULTS Consecutive patients with AMI complicated by CR who underwent CMR were enrolled. Traditional and strain CMR findings were evaluated; new parameters indicating the relative wall stress between AMI and adjacent segments, named wall stress index (WSI) and WSI ratio, were analysed. A group of patients admitted for AMI without CR served as control. 19 patients (63% male, median age 73 years) met the inclusion criteria. Microvascular obstruction (MVO, P = 0.001) and pericardial enhancement (P < 0.001) were strongly associated with CR. Patients with clinical CR confirmed by CMR exhibited more frequently an intramyocardial haemorrhage than controls (P = 0.003). Patients with CR had lower 2D and 3D global radial strain (GRS) and global circumferential strain (in 2D mode P < 0.001; in 3D mode P = 0.001), as well as 3D global longitudinal strain (P < 0.001), than controls. The 2D circumferential WSI (P = 0.010), as well as the 2D and 3D circumferential (respectively, P < 0.001 and P = 0.042) and radial WSI ratio (respectively, P < 0.001 and P: 0.007), were higher in CR patients than controls. CONCLUSION CMR is a safe and useful imaging tool to achieve the definite diagnosis of CR and an accurate visualization of tissue abnormalities associated with CR. Strain analysis parameters can give insights into the pathophysiology of CR and may help to identify those patients with sub-acute CR.
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Affiliation(s)
- Manuel De Lazzari
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Alberto Cipriani
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Annagrazia Cecere
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Alice Niero
- Cardiology Unit, Ospedale dell’Angelo, Venice, Italy
| | - Monica De Gaspari
- Cardiovascular Pathology Unit, University Hospital of Padua, Padua, Italy
| | - Benedetta Giorgi
- Radiology Unit, University of Padua—University Hospital of Padua, Padua, Italy
| | - Giorgio De Conti
- Radiology Unit, University of Padua—University Hospital of Padua, Padua, Italy
| | - Raffaella Motta
- Department of Medicine, University of Padua—Azienda Ospedaliera, Padua, Italy
| | - Stefania Rizzo
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
- Cardiovascular Pathology Unit, University Hospital of Padua, Padua, Italy
| | - Francesco Tona
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Luisa Cacciavillani
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
| | - Giuseppe Tarantini
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Gino Gerosa
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
- Cardiac Surgery Unit, University Hospital of Padua, Padua, Italy
| | - Cristina Basso
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
- Cardiovascular Pathology Unit, University Hospital of Padua, Padua, Italy
| | - Sabino Iliceto
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
| | - Martina Perazzolo Marra
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University Hospital of Padua, Via Giustiniani, 2, 35121 Padua, Italy
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy
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Maries L, Moatar AI, Sala-Cirtog M, Sima L, Anghel A, Marian C, Chis AR, Sirbu IO. Clinical Variables Influence the Ability of miR-101, miR-150, and miR-21 to Predict Ventricular Remodeling after ST-Elevation Myocardial Infarction. Biomedicines 2023; 11:2738. [PMID: 37893111 PMCID: PMC10604279 DOI: 10.3390/biomedicines11102738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Left ventricle remodeling (LVR) after acute myocardial infarction (MI) leads to impairment of both systolic and diastolic function, a significant contributor to heart failure (HF). Despite extensive research in the field, predicting post-MI LVR and HF is still a challenge. Several circulant microRNAs have been proposed as LVR predictors; however, their clinical value is controversial. Here, we used real-time quantitative PCR to quantify the plasma levels of hsa-miR-101, hsa-miR-150, and hsa-miR-21 on the first day of hospital admission of MI patients with ST-elevation (STEMI). We analyzed their correlation to the patient's clinical and paraclinical variables and evaluated their ability to discriminate between post-MI LVR and non-LVR. We show that, despite being excellent MI discriminators, none of these microRNAs can distinguish between LVR and non-LVR patients. Furthermore, we found that diabetes mellitus (DM), Hb level, and the number of erythrocytes significantly influence all three plasma microRNA levels. This suggests that plasma microRNAs' diagnostic and prognostic value in STEMI patients should be reevaluated and interpreted in the context of associated pathologies.
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Affiliation(s)
- Liana Maries
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Ioana Moatar
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Maria Sala-Cirtog
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Laurentiu Sima
- Surgical Semiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Andrei Anghel
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
| | - Catalin Marian
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Aimee Rodica Chis
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioan-Ovidiu Sirbu
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.); (A.I.M.); (M.S.-C.); (A.A.); (C.M.); (I.-O.S.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Sun Z, Wang Y, Hu Y, Wu F, Zhang N, Liu Z, Lu J, Li K. Left ventricular dyssynchrony measured by cardiovascular magnetic resonance-feature tracking in anterior ST-elevation myocardial infarction: relationship with microvascular occlusion myocardial damage. Front Cardiovasc Med 2023; 10:1255063. [PMID: 37900576 PMCID: PMC10602888 DOI: 10.3389/fcvm.2023.1255063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives Cardiovascular magnetic resonance-feature tracking (CMR-FT) enables quantification of myocardial deformation and may be used as an objective measure of myocardial involvement in ST-elevation myocardial infarction (STEMI). We sought to investigate the associations between myocardial dyssynchrony parameters and myocardium damage for STEMI. Methods We analyzed 65 patients (45-80 years old) with anterior STEMI after primary percutaneous coronary intervention during 3-7 days [observational (STEMI) group] and 60 healthy volunteers [normal control (NC) group]. Myocardial dyssynchrony parameters were derived, including global and regional strain, radial rebound stretch and displacement, systolic septal time delay, and circumferential stretch. Results CMR characteristics, including morphologic parameters such as left ventricular ejection fraction (LVEF) (45.3% ± 8.2%) and myocardium damage in late gadolinium enhancement (LGE) (19.4% ± 4.7% LV), were assessed in the observation group. The global radial strain (GRS) and global longitudinal strain (GLS) substantially decreased in anterior STEMI compared with the NC group (GRS: 19.4% ± 5.1% vs. 24.8% ± 4.0%, P < 0.05; GLS: -10.1% ± 1.7% vs. -13.7% ± 1.0%, P < 0.05). Among 362 infarcted segments, radial and circumferential peak strains of the infarcted zone were the lowest (14.4% ± 3.2% and -10.7% ± 1.6%, respectively). The radial peak displacement of the infarct zone significantly decreased (2.6 ± 0.4 mm) (P < 0.001) and manifested in the circumferential displacement (3.5° ± 0.7°) in the STEMI group (P < 0.01). As microvascular occlusion (MVO) was additionally present, some strain parameters were significantly impaired in LGE+/MVO+ segments (radial strain [RS]: 12.2% ± 2.1%, circumferential strain [CS]: -9.6% ± 0.7%, longitudinal strain [LS]: -6.8% ± 1.0%) compared to LGE+/MVO- (RS: 14.6% ± 3.2%, CS: -10.8% ± 1.8%, LS: -9.2% ± 1.3%) (P < 0.05). When the extent of transmural myocardial infarction is greater than 75%, the parameter of the systolic septal delay (mean, 148 ms) was significantly reduced compared to fewer degrees of infarction (P < 0.01). Conclusion In anterior STEMI, the infarcted septum swings in a bimodal mode, and myocardial injury reduces the radial strain contractility. A more than 75% transmural degree was the septal strain-contraction reserve cut-off point.
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Affiliation(s)
- Zheng Sun
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yu Wang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Yingying Hu
- Department of Radiology, The Peking University International Hospital, Beijing, China
| | - Fang Wu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Nan Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Zhi Liu
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Kuncheng Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
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Wang J, Kong Y, Xi J, Zhang M, Lu Y, Hu C, Xu K. Recovery and prognostic values of myocardial strain in acute anterior and non-anterior wall myocardial infarction. PLoS One 2023; 18:e0282027. [PMID: 36800349 PMCID: PMC9937471 DOI: 10.1371/journal.pone.0282027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND To assess the recovery and prognostic values of myocardial strain using cardiac magnetic resonance (CMR)- feature tracking (FT) in acute anterior and non-anterior wall myocardial infarction. METHODS 103 reperfused patients after STEMI who underwent CMR at about 4 days (baseline) and 4 months (follow-up) were included, including 48 and 55 patients with anterior wall myocardial infarction (AWMI) and non-anterior wall myocardial infarction(NAWMI). CMR-FT analysis was performed using cine images to measure LV global radial, circumferential, and longitudinal peak strains (GRS, GCS, and GLS, respectively). Infarct size (IS) and microvascular obstruction (MVO) were estimated by late-gadolinium enhancement imaging. The primary clinical endpoint was the occurrence of major adverse cardiac events (MACE) after infarction. RESULTS Patients with AWMI had higher IS, higher MVO, lower ejection fraction, and more significantly impaired CMR-FT strain values than patients with NAWMI (all p<0.05). Global strain significantly improved at 4 months (all p<0.01), especial in NAWMI. GLS was an independent predictor (odds ratio = 2.08, 95% confidence interval = 1.032-4.227, p = 0.04] even after adjustment for IS and MVO. The optimal cutoff of GLS was -7.9%, with sensitivity and specificity were 73.3% and 75.0%, respectively. In receiver operating characteristic analysis, IS remained the strongest predictor (area under the curve [AUC] = 0.83, p<0.01), followed by MVO (AUC = 0.81, p<0.01) and GLS (AUC = 0.78, p<0.01). CONCLUSION CMR-FT-derived global myocardial strains significantly improved over time, especial in NAWMI. GLS measurement independently predicted the occurrence of medium-term MACE.
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Affiliation(s)
- Jiali Wang
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ying Kong
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jianning Xi
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Min Zhang
- Department of Cardiac Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yuan Lu
- Department of Cardiac Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chunfeng Hu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Kai Xu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- * E-mail:
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Cardiac Magnetic Resonance Imaging in Appraising Myocardial Strain and Biomechanics: A Current Overview. Diagnostics (Basel) 2023; 13:diagnostics13030553. [PMID: 36766658 PMCID: PMC9914753 DOI: 10.3390/diagnostics13030553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Subclinical alterations in myocardial structure and function occur early during the natural disease course. In contrast, clinically overt signs and symptoms occur during late phases, being associated with worse outcomes. Identification of such subclinical changes is critical for timely diagnosis and accurate management. Hence, implementing cost-effective imaging techniques with accuracy and reproducibility may improve long-term prognosis. A growing body of evidence supports using cardiac magnetic resonance (CMR) to quantify deformation parameters. Tissue-tagging (TT-CMR) and feature-tracking CMR (FT-CMR) can measure longitudinal, circumferential, and radial strains and recent research emphasize their diagnostic and prognostic roles in ischemic heart disease and primary myocardial illnesses. Additionally, these methods can accurately determine LV wringing and functional dynamic geometry parameters, such as LV torsion, twist/untwist, LV sphericity index, and long-axis strain, and several studies have proved their utility in prognostic prediction in various cardiovascular patients. More recently, few yet important studies have suggested the superiority of fast strain-encoded imaging CMR-derived myocardial strain in terms of accuracy and significantly reduced acquisition time, however, more studies need to be carried out to establish its clinical impact. Herein, the current review aims to provide an overview of currently available data regarding the role of CMR in evaluating myocardial strain and biomechanics.
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Calvieri C, Riva A, Sturla F, Dominici L, Conia L, Gaudio C, Miraldi F, Secchi F, Galea N. Left Ventricular Adverse Remodeling in Ischemic Heart Disease: Emerging Cardiac Magnetic Resonance Imaging Biomarkers. J Clin Med 2023; 12:jcm12010334. [PMID: 36615133 PMCID: PMC9820966 DOI: 10.3390/jcm12010334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/10/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Post-ischemic left ventricular (LV) remodeling is a biologically complex process involving myocardial structure, LV shape, and function, beginning early after myocardial infarction (MI) and lasting until 1 year. Adverse remodeling is a post-MI maladaptive process that has been associated with long-term poor clinical outcomes. Cardiac Magnetic Resonance (CMR) is the best tool to define adverse remodeling because of its ability to accurately measure LV end-diastolic and end-systolic volumes and their variation over time and to characterize the underlying myocardial changes. Therefore, CMR is the gold standard method to assess in vivo myocardial infarction extension and to detect the presence of microvascular obstruction and intramyocardial hemorrhage, both associated with adverse remodeling. In recent times, new CMR quantitative biomarkers emerged as predictive of post-ischemic adverse remodeling, such as T1 mapping, myocardial strain, and 4D flow. Additionally, CMR T1 mapping imaging may depict infarcted tissue and assess diffuse myocardial fibrosis by using surrogate markers such as extracellular volume fraction, which may predict functional recovery or risk stratification of remodeling. Finally, there is emerging evidence supporting the utility of intracavitary blood flow kinetic energy and hemodynamic features assessed by the 4D flow CMR technique as early predictors of remodeling.
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Affiliation(s)
- Camilla Calvieri
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00100 Rome, Italy
- Correspondence:
| | - Alessandra Riva
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20129 Milan, Italy
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Francesco Sturla
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20129 Milan, Italy
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Lorenzo Dominici
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00100 Rome, Italy
| | - Luca Conia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00100 Rome, Italy
| | - Carlo Gaudio
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00100 Rome, Italy
| | - Fabio Miraldi
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00100 Rome, Italy
| | - Francesco Secchi
- Unit of Radiology, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20129 Milan, Italy
| | - Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00100 Rome, Italy
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Sharifi H, Mann CK, Noor AZ, Nikou A, Ferguson CR, Liu ZQ, Rockward AL, Moonschi F, Campbell KS, Leung SW, Wenk JF. Reproducibility of Systolic Strain in Mice Using Cardiac Magnetic Resonance Feature Tracking of Black-Blood Cine Images. Cardiovasc Eng Technol 2022; 13:857-863. [PMID: 35396692 PMCID: PMC9547031 DOI: 10.1007/s13239-022-00621-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/28/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE Mouse models are widely utilized to enhance our understanding of cardiac disease. The goal of this study is to investigate the reproducibility of strain parameters that were measured in mice using cardiac magnetic resonance (CMR) feature-tracking (CMR42, Canada). METHODS We retrospectively analyzed black-blood CMR datasets from thirteen C57BL/6 B6.SJL-CD45.1 mice (N = 10 female, N = 3 male) that were imaged previously. The circumferential, longitudinal, and radial (Ecc, Ell, and Err, respectively) parameters of strain were measured in the mid-ventricular region of the left ventricle. Intraobserver and interobserver reproducibility were assessed for both the end-systolic (ES) and peak strain. RESULTS The ES strain had larger intraclass correlation coefficient (ICC) values when compared to peak strain, for both the intraobserver and interobserver reproducibility studies. Specifically, the intraobserver study showed excellent reproducibility for all three ES strain parameters, namely, Ecc (ICC 0.95, 95% CI 0.83-0.98), Ell (ICC 0.90, 95% CI 0.59-0.97), and Err (ICC 0.92, 95% CI 0.73-0.97). This was also the case for the interobserver study, namely, Ecc (ICC 0.92, 95% CI 0.60-0.98), Ell (ICC 0.76, 95% CI 0.33-0.93), and Err (ICC 0.93, 95% CI 0.68-0.98). Additionally, the coefficient of variation values were all < 10%. CONCLUSION The results of this preliminary study showed excellent reproducibility for all ES strain parameters, with good to excellent reproducibility for the peak strain parameters. Moreover, all ES strain parameters had larger ICC values than the peak strain. In general, these results imply that feature-tracking with CMR42 software and black-blood cine images can be reliably used to assess strain patterns in mice.
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Affiliation(s)
- Hossein Sharifi
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Charles K Mann
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Ahmed Z Noor
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA
| | - Amir Nikou
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Connor R Ferguson
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Zhan-Qiu Liu
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Alexus L Rockward
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA
| | - Faruk Moonschi
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Kenneth S Campbell
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Steve W Leung
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA
| | - Jonathan F Wenk
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY, 40506-0503, USA.
- Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY, USA.
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Wang X, Li B, Hu Y, Xiao S, Guo M, Xu T, Wu H, Huan C, Yin J, Zhu H, Pan D. Novel grading system for ischemia‒reperfusion injury manifestations in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Sci Rep 2022; 12:19349. [PMID: 36369283 PMCID: PMC9652336 DOI: 10.1038/s41598-022-24019-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
To establish a simple myocardial ischemia‒reperfusion injury (MIRI) manifestation grading system based on clinical manifestations and coronary angiography during primary percutaneous coronary intervention (PPCI). All STEMI patients treated with PPCI from June 2018 to November 2019 were included. According to the MIRI manifestation grade, patients were divided into four grades (I-IV). Laboratory and clinical indicators of the patients and the occurrence of major adverse cardiac events (MACEs) within one year of follow-up were analyzed. A total of 300 patients were included. The higher the MIRI manifestation grade, the lower was the high-density lipoprotein cholesterol (HDL-C); the higher were the C-reactive protein (CRP), lipoprotein(a) [LP(a)], and peak levels of high-sensitivity troponin T (hs-cTnT), creatine kinase (CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP); and the higher were the proportions of right coronary artery (RCA) and multivessel lesions (P < 0.05). The left ventricular end-diastolic dimension (LVEDD) and E/e' values of patients with higher grades were significantly increased, while the LVEF, left ventricular short-axis functional shortening (LVFS) and E/A values were significantly decreased (P < 0.05). The one-year cumulative incidence of major adverse cardiac events (MACEs) in patients with grade I-IV disease was 7.7% vs. 26.9% vs. 48.4% vs. 93.3%, respectively, P < 0.05. The higher the MIRI manifestation grade, the more obvious is the impact on diastolic and systolic function and the higher is the cumulative incidence of MACEs within one year, especially in patients with multivessel disease, low HDL-C, high CRP, high LP(a) levels, and the RCA as the infarction-related artery.
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Affiliation(s)
- Xiaotong Wang
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Binbin Li
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006 Jiangsu China
| | - Yue Hu
- grid.413389.40000 0004 1758 1622Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004 Jiangsu China
| | - Shengjue Xiao
- grid.263826.b0000 0004 1761 0489Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009 Jiangsu China
| | - Minjia Guo
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Tao Xu
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Huimin Wu
- grid.413389.40000 0004 1758 1622Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004 Jiangsu China
| | - Chunyan Huan
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Jie Yin
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Hong Zhu
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Defeng Pan
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
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9
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Wang L, Liu T, Wang C, Xuan H, Xu X, Yin J, Li X, Chen J, Li D, Xu T. Development and validation of a predictive model for adverse left ventricular remodeling in NSTEMI patients after primary percutaneous coronary intervention. BMC Cardiovasc Disord 2022; 22:386. [PMID: 36030211 PMCID: PMC9420298 DOI: 10.1186/s12872-022-02831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction To develop and validate clinical evaluators that predict adverse left ventricular remodeling (ALVR) in non-ST-elevation myocardial infarction (NSTEMI) patients after primary percutaneous coronary intervention (PCI). Methods The retrospective study analyzed the clinical data of 507 NSTEMI patients who were treated with primary PCI from the Affiliated Hospital of Xuzhou Medical University and the Second Affiliated Hospital of Xuzhou Medical University, between January 1, 2019 and September 31, 2021. The training cohort consisted of patients admitted before June 2020 (n = 287), and the remaining patients (n = 220) were assigned to an external validation cohort. The endpoint event was the occurrence of ALVR, which was described as an increase ≥ 20% in left ventricular end-diastolic volume (LVEDV) at 3–4 months follow-up CMR compared with baseline measurements. The occurrence probability of ALVR stemmed from the final model, which embodied independent predictors recommended by logistic regression analysis. The area under the receiver operating characteristic curve (AUC), Calibration plot, Hosmer–Lemeshow method, and decision curve analysis (DCA) were applied to quantify the performance. Results Independent predictors for ALVR included age (odds ratio (OR): 1.040; 95% confidence interval (CI): 1.009–1.073), the level of neutrophil to lymphocyte ratio (OR: 4.492; 95% CI: 1.906–10.582), the cardiac microvascular obstruction (OR: 3.416; 95% CI: 1.170–9.970), peak global longitudinal strain (OR: 1.131; 95% CI: 1.026–1.246), infarct size (OR: 1.082; 95% CI: 1.042–1.125) and left ventricular ejection fraction (OR: 0.925; 95% CI: 0.872–0.980), which were screened by regression analysis then merged into the nomogram model. Both internal validation (AUC: 0.805) and external validation (AUC: 0.867) revealed that the prediction model was capable of good discrimination. Calibration plot and Hosmer–Lemeshow method showed high consistency between the probabilities predicted by the nomogram (P = 0.514) and the validation set (P = 0.762) and the probabilities of actual occurrence. DCA corroborated the clinical utility of the nomogram. Conclusions In this study, the proposed nomogram model enabled individualized prediction of ALVR in NSTEMI patients after reperfusion and conduced to guide clinical therapeutic schedules.
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Affiliation(s)
- Lili Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Tao Liu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Chaofan Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Haochen Xuan
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Xianzhi Xu
- School of Stomatology, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Jie Yin
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Xiaoqun Li
- Department of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Junhong Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Dongye Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Tongda Xu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
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10
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El-Saadi W, Engvall JE, Alfredsson J, Karlsson JE, Martins M, Sederholm S, Faisal Zaman S, Ebbers T, Kihlberg J. A head-to-head comparison of myocardial strain by fast-strain encoding and feature tracking imaging in acute myocardial infarction. Front Cardiovasc Med 2022; 9:949440. [PMID: 35966533 PMCID: PMC9366255 DOI: 10.3389/fcvm.2022.949440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Myocardial infarction (MI) is a major cause of heart failure. Left ventricular adverse remodeling is common post-MI. Several studies have demonstrated a correlation between reduced myocardial strain and the development of adverse remodeling. Cardiac magnetic resonance (CMR) with fast-strain encoding (fast-SENC) or feature tracking (FT) enables rapid assessment of myocardial deformation. The aim of this study was to establish a head-to-head comparison of fast-SENC and FT in post-ST-elevated myocardial infarction (STEMI) patients, with clinical 2D speckle tracking echocardiography (2DEcho) as a reference. Methods Thirty patients treated with primary percutaneous coronary intervention for STEMI were investigated. All participants underwent CMR examination with late gadolinium enhancement, cine-loop steady-state free precession, and fast-SENC imaging using a 1.5T scanner as well as a 2DEcho. Global longitudinal strain (GLS), segmental longitudinal strain (SLS), global circumferential strain (GCS), and segmental circumferential strain (SCS) were assessed along with the MI scar extent. Results The GCS measurements from fast-SENC and FT were nearly identical: the mean difference was 0.01 (2.5)% (95% CI - 0.92 to 0.95). For GLS, fast-SENC values were higher than FT, with a mean difference of 1.8 (1.4)% (95% CI 1.31-2.35). Tests of significance for GLS did not show any differences between the MR methods and 2DEcho. Average strain in the infarct-related artery (IRA) segments compared to the remote myocardium was significantly lower for the left anterior descending artery and right coronary artery culprits but not for the left circumflex artery culprits. Fast-SENC displayed a higher area under the curve for detecting infarcted segments than FT for both SCS and SLS. Conclusion GLS and GCS did not significantly differ between fast-SENC and FT. Both showed acceptable agreement with 2DEcho for longitudinal strain. Segments perfused by the IRA showed significantly reduced strain values compared to the remote myocardium. Fast-SENC presented a higher sensitivity and specificity for detecting infarcted segments than FT.
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Affiliation(s)
- Walid El-Saadi
- Department of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,*Correspondence: Walid El-Saadi
| | - Jan Edvin Engvall
- Department of Clinical Physiology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden
| | - Joakim Alfredsson
- Department of Cardiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jan-Erik Karlsson
- Department of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Martins
- Department of Radiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sofia Sederholm
- Department of Cardiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Shaikh Faisal Zaman
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden
| | - Johan Kihlberg
- Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden,Department of Radiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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11
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Del Toro R, Galeano-Otero I, Bevilacqua E, Guerrero-Márquez F, Falcon D, Guisado-Rasco A, Díaz-de la Llera L, Barón-Esquivias G, Smani T, Ordóñez-Fernández A. Predicted Value of MicroRNAs, Vascular Endothelial Growth Factor, and Intermediate Monocytes in the Left Adverse Ventricular Remodeling in Revascularized ST-Segment Elevation Myocardial Infarction Patients. Front Cardiovasc Med 2022; 9:777717. [PMID: 35402537 PMCID: PMC8987717 DOI: 10.3389/fcvm.2022.777717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPrimary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) improves the survival of patients; nevertheless, some patients develop left ventricular adverse remodeling (LVAR) a few months after the intervention. The main objective of this study was to characterize the role of pro-inflammatory cell populations, related cytokines, and microRNAs (miRNAs) released after PPCI as reliable prognostic biomarkers for LVAR in patients with STEMI.MethodsWe evaluated the level of pro-inflammatory subsets, before and after revascularization, 1 and 6 months after PPCI, using flow cytometry. We also performed a miRNA microarray in isolated peripheral blood mononuclear cells (PBMCs) and examined the levels of 27 cytokines in patients’ serum of patients by multiplex ELISA.ResultsWe observed that the levels of classical and intermediate monocytes increased 6 h after PPCI in patients who developed LVAR later. Multivariate regression analysis and ROC curves indicated that intermediate monocytes, after PPCI, were the best monocyte subset that correlated with LVAR. Within the 27 evaluated cytokines evaluated, we found that the increase in the level of vascular endothelial growth factor (VEGF) correlated with LVAR. Furthermore, the microarray analysis of PBMCs determined that up to 1,209 miRNAs were differentially expressed 6 h after PPCI in LVAR patients, compared with those who did not develop LVAR. Using RT-qPCR we confirmed a significant increase in miR-16, miR-21-5p, and miR-29a-3p, suggested to modulate the expression of different cytokines, 6 h post-PPCI in LVAR patients. Interestingly, we determined that the combined analysis of the levels of the intermediate monocyte subpopulation, VEGF, and miRNAs gave a better association with LVAR appearance. Similarly, combined ROC analysis provided high accurate specificity and sensibility to identify STEMI patients who will develop LVAR.ConclusionOur data suggest that the combined analysis of intermediate monocytes, VEGF, and miRNAs predicts LVAR in STEMI patients.
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Affiliation(s)
- Raquel Del Toro
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Seville, Spain
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
- *Correspondence: Raquel Del Toro,
| | - Isabel Galeano-Otero
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Seville, Spain
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
| | - Elisa Bevilacqua
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
| | | | - Debora Falcon
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Seville, Spain
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
| | | | | | - Gonzalo Barón-Esquivias
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Tarik Smani
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Seville, Spain
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
- Tarik Smani,
| | - Antonio Ordóñez-Fernández
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Seville, Spain
- Antonio Ordóñez-Fernández,
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12
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Calvieri C, Galea N, Cilia F, Pambianchi G, Mancuso G, Filomena D, Cimino S, Carbone I, Francone M, Agati L, Catalano C. Protective Value of Aspirin Loading Dose on Left Ventricular Remodeling After ST-Elevation Myocardial Infarction. Front Cardiovasc Med 2022; 9:786509. [PMID: 35369291 PMCID: PMC8965885 DOI: 10.3389/fcvm.2022.786509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
AimsLeft ventricular (LV) remodeling after ST-elevation myocardial infarction (STEMI) is a complex process, defined as changes of LV volumes over time. CMR feature tracking analysis (CMR-FT) offers an accurate quantitative assessment of LV wall deformation and myocardial contractile function. This study aimed to evaluate the role of myocardial strain parameters in predicting LV remodeling and to investigate the effect of Aspirin (ASA) dose before primary coronary angioplasty (pPCI) on myocardial injury and early LV remodeling.Methods and ResultsSeventy-eight patients undergoing CMR, within 9 days from symptom onset and after 6 months, were enrolled in this cohort retrospective study. We divided the study population into three groups based on a revised Bullock's classification and we evaluated the role of baseline CMR features in predicting early LV remodeling. Regarding CMR strain analysis, worse global circumferential and longitudinal strain (GCS and GLS) values were associated with adverse LV remodeling. Patients were also divided based on pre-pPCI ASA dosage. Significant differences were detected in patients receiving ASA 500 mg dose before pPCI, which showed lower infarct size extent and better strain values compared to those treated with ASA 250 mg. The stepwise multivariate logistic regression analysis, adjusted for covariates, indicated that a 500 mg ASA dose remained an inverse independent predictor of early adverse LV remodeling.ConclusionGCS and GLS have high specificity to detect early LV adverse remodeling. We first reported a protective effect of ASA loading dose of 500 mg before pPCI on LV myocardial damage and in reducing early LV adverse remodeling.
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Affiliation(s)
- Camilla Calvieri
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Rome, Italy
| | - Nicola Galea
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
- *Correspondence: Nicola Galea
| | - Francesco Cilia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giacomo Pambianchi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Mancuso
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Filomena
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Rome, Italy
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Rome, Italy
| | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Luciano Agati
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
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13
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Leung SW, Charnigo RJ, Ratajczak T, Abo-Aly M, Shokri E, Abdel-Latif A, Wenk JF. End-Systolic Circumferential Strain Derived From Cardiac Magnetic Resonance Feature-Tracking as a Predictor of Functional Recovery in Patients With ST-Segment Elevation Myocardial Infarction. J Magn Reson Imaging 2021; 54:2000-2003. [PMID: 34110672 PMCID: PMC8978756 DOI: 10.1002/jmri.27772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Steve W. Leung
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY
| | - Richard J. Charnigo
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY
| | - Teresa Ratajczak
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY
| | - Mohamed Abo-Aly
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY
- Cardiovascular Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Elica Shokri
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY
| | - Ahmed Abdel-Latif
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY
| | - Jonathan F. Wenk
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, Lexington, KY
- Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY
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14
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Leung SW, Ratajczak TM, Abo-Aly M, Shokri E, Abdel-Latif A, Wenk JF. Regional end-systolic circumferential strain demonstrates compensatory segmental contractile function in patients with ST-segment elevation myocardial infarction. J Biomech 2021; 129:110794. [PMID: 34634593 DOI: 10.1016/j.jbiomech.2021.110794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/06/2021] [Accepted: 09/30/2021] [Indexed: 11/18/2022]
Abstract
Myocardial strain has shown tremendous promise as a potential diagnostic tool for characterizing ventricular function. With regards to myocardial infarction, global circumferential strain (CS) can be used to assess overall function, while regional CS can identify local alterations in contractility. Currently, there is a lack of data related to regional strain in patients with ST-segment elevation myocardial infarction (STEMI). Thus, the goal of this study was to quantify regional strain patterns in STEMI and normal control patients, measuring both peak CS and end-systolic (ES) CS in the mid-ventricular region. This was done by conducting cardiac magnetic resonance (CMR) imaging acutely after STEMI patients underwent primary percutaneous coronary intervention. The CMR datasets were then analyzed using feature-tracking of the cine images. The patients were broken into three groups: (1) control patients (N = 18), (2) STEMI patients with ejection fraction (EF) ≥ 50% (N = 20), and (3) STEMI patients with EF < 50% (N = 20). The key result of the analysis was that ES CS detected a significant increase in the magnitude of strain in the non-infarcted tissue of STEMI patients with EF ≥ 50% when compared to STEMI patients with EF < 50%, whereas peak CS did not detect any differences. This implies that the tissue in this region is contracting more strongly compared to non-infarcted tissue in STEMI patients with EF < 50%. Thus, regional ES CS could potentially be utilized as a diagnostic tool for assessing STEMI patients, by detecting regional changes in contractility after PCI, which could assist in treatment planning.
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Affiliation(s)
- Steve W Leung
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States
| | - Theresa M Ratajczak
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States
| | - Mohamed Abo-Aly
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States; Cardiovascular Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Elica Shokri
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States
| | - Ahmed Abdel-Latif
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States
| | - Jonathan F Wenk
- Department of Mechanical Engineering, College of Engineering, University of Kentucky, Lexington, KY, United States; Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY, United States.
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15
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Pezel T, Besseyre des Horts T, Schaaf M, Croisille P, Bière L, Garcia-Dorado D, Jossan C, Roubille F, Cung TT, Prunier F, Meyer E, Amaz C, Derumeaux G, de Poli F, Hovasse T, Gilard M, Bergerot C, Thibault H, Ovize M, Mewton N. Predictive value of early cardiac magnetic resonance imaging functional and geometric indexes for adverse left ventricular remodelling in patients with anterior ST-segment elevation myocardial infarction: A report from the CIRCUS study. Arch Cardiovasc Dis 2020; 113:710-720. [PMID: 33160891 DOI: 10.1016/j.acvd.2020.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/17/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Postinfarction adverse left ventricular (LV) remodelling is strongly associated with heart failure events. Conicity index, sphericity index and LV global functional index (LVGFI) are new LV remodelling indexes assessed by cardiac magnetic resonance (CMR). AIM To assess the predictive value of the new indexes for 1-year adverse LV remodelling in patients with anterior ST-segment elevated myocardial infarction (STEMI). METHODS CMR studies were performed in 129 patients with anterior STEMI (58±12 years; 78% men) from the randomized CIRCUS trial (CMR substudy) treated with primary percutaneous coronary intervention and followed for the occurrence of major adverse cardiovascular events (MACE) (death or hospitalization for heart failure). Conicity index, sphericity index, LVGFI, infarct size and microvascular obstruction (MVO) were assessed by CMR performed 5±4 days after coronary reperfusion. Adverse LV remodelling was defined as an increase in LV end-diastolic volume of ≥15% by transthoracic echocardiography at 1 year. RESULTS Adverse LV remodelling occurred in 27% of patients at 1 year. Infarct size and MVO were significantly predictive of adverse LV remodelling: odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05 (P<0.001) and OR 1.12, 95% CI 1.05-1.22 (P<0.001), respectively. Among the newly tested indexes, only LVGFI was significantly predictive of adverse LV remodelling (OR 1.10, 95% CI 1.03-1.16; P=0.001). In multivariable analysis, infarct size remained an independent predictor of adverse LV remodelling at 1 year (OR 1.05, 95% CI 1.02-1.08; P<0.001). LVGFI and infarct size were associated with occurrence of MACE: OR 1.21, 95% CI 1.08-1.37 (P<0.001) and OR 1.02, 95% CI 1.00-1.04 (P=0.018), respectively. Conicity and sphericity indexes were not associated with MACE. CONCLUSIONS LVGFI was associated with adverse LV remodelling and MACE 1 year after anterior STEMI.
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Affiliation(s)
- Théo Pezel
- Inserm, UMRS 942, Department of Cardiology, Lariboisière Hospital, Paris University, AP-HP, 75010 Paris, France; Division of Cardiology, Johns-Hopkins University, 21287-0409 Baltimore, MD, USA
| | - Timothée Besseyre des Horts
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Mathieu Schaaf
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Pierre Croisille
- Radiology Department, University Hospital of Saint-Étienne, 42270 Saint-Priest-en-Jarez, France
| | - Loïc Bière
- Cardiology Division, University Hospital of Angers, 49100 Angers, France
| | - David Garcia-Dorado
- CIBERCV, Hospital Universitari Vall d'Hebron & Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Claire Jossan
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - François Roubille
- UMR5203, UMR661, Cardiology Division, University Hospital of Montpellier, University of Montpellier 1 and 2, 34295 Montpellier, France
| | - Thien-Tri Cung
- UMR5203, UMR661, Cardiology Division, University Hospital of Montpellier, University of Montpellier 1 and 2, 34295 Montpellier, France
| | - Fabrice Prunier
- Cardiology Division, University Hospital of Angers, 49100 Angers, France
| | - Elbaz Meyer
- Rangeuil Hospital, University Hospital of Toulouse, Paul-Sabatier University, 31400 Toulouse, France
| | - Camille Amaz
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Geneviève Derumeaux
- DHU-ATVB, Henri-Mondor Hospital, Paris-Est Créteil University, AP-HP, 94010 Créteil, France
| | - Fabien de Poli
- Cardiology Division, Haguenau Hospital, 67500 Haguenau, France
| | - Thomas Hovasse
- Cardiology Division, Jacques-Cartier Institute, 91300 Massy, France
| | - Martine Gilard
- Department of Cardiology, Brest University Hospital, 29200 Brest, France
| | - Cyrille Bergerot
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Hélène Thibault
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Michel Ovize
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France
| | - Nathan Mewton
- Inserm 1407, Clinical Investigation Centre and Heart Failure Department, Cardiovascular Hospital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard Lyon 1, 69677 Bron, France.
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Legallois D, Hodzic A, Alexandre J, Dolladille C, Saloux E, Manrique A, Roule V, Labombarda F, Milliez P, Beygui F. Definition of left ventricular remodelling following ST-elevation myocardial infarction: a systematic review of cardiac magnetic resonance studies in the past decade. Heart Fail Rev 2020; 27:37-48. [DOI: 10.1007/s10741-020-09975-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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17
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Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2020; 36:769-787. [PMID: 32281010 DOI: 10.1007/s10554-020-01845-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Galeano-Otero I, Del Toro R, Guisado A, Díaz I, Mayoral-González I, Guerrero-Márquez F, Gutiérrez-Carretero E, Casquero-Domínguez S, Díaz-de la Llera L, Barón-Esquivias G, Jiménez-Navarro M, Smani T, Ordóñez-Fernández A. Circulating miR-320a as a Predictive Biomarker for Left Ventricular Remodelling in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention. J Clin Med 2020; 9:E1051. [PMID: 32276307 PMCID: PMC7230612 DOI: 10.3390/jcm9041051] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
Restoration of epicardial coronary blood flow, achieved by early reperfusion with primary percutaneous coronary intervention (PPCI), is the guideline recommended to treat patients with ST-segment-elevation myocardial infarction (STEMI). However, despite successful blood restoration, increasing numbers of patients develop left ventricular adverse remodelling (LVAR) and heart failure. Therefore, reliable prognostic biomarkers for LVAR in STEMI are urgently needed. Our aim was to investigate the role of circulating microRNAs (miRNAs) and their association with LVAR in STEMI patients following the PPCI procedure. We analysed the expression of circulating miRNAs in blood samples of 56 patients collected at admission and after revascularization (at 3, 6, 12 and 24 h). The associations between miRNAs and left ventricular end diastolic volumes at 6 months were estimated to detect LVAR. miRNAs were also analysed in samples isolated from peripheral blood mononuclear cells (PBMCs) and human myocardium of failing hearts. Kinetic analysis of miRNAs showed a fast time-dependent increase in miR-133a, miR-133b, miR-193b, miR-499, and miR-320a in STEMI patients compared to controls. Moreover, the expression of miR-29a, miR-29b, miR-324, miR-208, miR-423, miR-522, and miR-545 was differentially expressed even before PPCI in STEMI. Furthermore, the increase in circulating miR-320a and the decrease in its expression in PBMCs were significantly associated with LVAR and correlated with the expression of miR-320a in human failing myocardium from ischaemic origin. In conclusion, we determined the time course expression of new circulating miRNAs in patients with STEMI treated with PPCI and we showed that miR-320a was positively associated with LVAR.
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Affiliation(s)
- Isabel Galeano-Otero
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, 41009 Sevilla, Spain (R.D.T.)
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
| | - Raquel Del Toro
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, 41009 Sevilla, Spain (R.D.T.)
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
| | - Agustín Guisado
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Ignacio Díaz
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
| | - Isabel Mayoral-González
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
| | - Francisco Guerrero-Márquez
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Encarnación Gutiérrez-Carretero
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Sara Casquero-Domínguez
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Luis Díaz-de la Llera
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Gonzalo Barón-Esquivias
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
| | - Manuel Jiménez-Navarro
- Hospital Universitario Virgen de la Victoria, Málaga 29010, CIBERCV, 28029 Madrid, Spain;
| | - Tarik Smani
- Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, 41009 Sevilla, Spain (R.D.T.)
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
| | - Antonio Ordóñez-Fernández
- Grupo de Fisiopatología Cardiovascular, Instituto de Biomedicina de Sevilla-IBiS, Universidad de Sevilla/HUVR/Junta de Andalucía/CSIC, Sevilla 41013, CIBERCV, 28029 Madrid, Spain; (I.D.); (I.M.-G.); (E.G.-C.); (G.B.-E.)
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.G.); (F.G.-M.); (S.C.-D.)
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