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Federspiel JM, Reil JC, Xu A, Scholtz S, Batzner A, Maack C, Sequeira V. Retrofitting the Heart: Explaining the Enigmatic Septal Thickening in Hypertrophic Cardiomyopathy. Circ Heart Fail 2024; 17:e011435. [PMID: 38695186 DOI: 10.1161/circheartfailure.123.011435] [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: 12/08/2023] [Accepted: 02/26/2024] [Indexed: 05/23/2024]
Abstract
Hypertrophic cardiomyopathy is the most common genetic cardiac disease and is characterized by left ventricular hypertrophy. Although this hypertrophy often associates with sarcomeric gene mutations, nongenetic factors also contribute to the disease, leading to diastolic dysfunction. Notably, this dysfunction manifests before hypertrophy and is linked to hypercontractility, as well as nonuniform contraction and relaxation (myofibril asynchrony) of the myocardium. Although the distribution of hypertrophy in hypertrophic cardiomyopathy can vary both between and within individuals, in most cases, it is primarily confined to the interventricular septum. The reasons for septal thickening remain largely unknown. In this article, we propose that alterations in muscle fiber geometry, present from birth, dictate the septal shape. When combined with hypercontractility and exacerbated by left ventricular outflow tract obstruction, these factors predispose the septum to an isometric type of contraction during systole, consequently constraining its mobility. This contraction, or more accurately, this focal increase in biomechanical stress, prompts the septum to adapt and undergo remodeling. Drawing a parallel, this is reminiscent of how earthquake-resistant buildings are retrofitted with vibration dampers to absorb the majority of the shock motion and load. Similarly, the heart adapts by synthesizing viscoelastic elements such as microtubules, titin, desmin, collagen, and intercalated disc components. This pronounced remodeling in the cytoskeletal structure leads to noticeable septal hypertrophy. This structural adaptation acts as a protective measure against damage by attenuating myofibril shortening while reducing cavity tension according to Laplace Law. By examining these events, we provide a coherent explanation for the septum's predisposition toward hypertrophy.
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Affiliation(s)
- Jan M Federspiel
- Comprehensive Heart Failure Center, Department of Translational Science University Clinic Würzburg, Germany (J.M.F., A.X., A.B., C.M., V.S.)
- Saarland University, Faculty of Medicine, Institute for Legal Medicine, Homburg (Saar), Germany (J.M.F.)
| | - Jan-Christian Reil
- Klinik für allgemeine und interventionelle Kardiologie, Herz- und Diabetes-Zentrum Nordrhein-Westphalen, Germany (J.-C.R., S.S.)
| | - Anton Xu
- Comprehensive Heart Failure Center, Department of Translational Science University Clinic Würzburg, Germany (J.M.F., A.X., A.B., C.M., V.S.)
| | - Smita Scholtz
- Klinik für allgemeine und interventionelle Kardiologie, Herz- und Diabetes-Zentrum Nordrhein-Westphalen, Germany (J.-C.R., S.S.)
| | - Angelika Batzner
- Comprehensive Heart Failure Center, Department of Translational Science University Clinic Würzburg, Germany (J.M.F., A.X., A.B., C.M., V.S.)
- Department of Internal Medicine I, University Hospital Würzburg, Germany (A.B.)
| | - Christoph Maack
- Comprehensive Heart Failure Center, Department of Translational Science University Clinic Würzburg, Germany (J.M.F., A.X., A.B., C.M., V.S.)
| | - Vasco Sequeira
- Comprehensive Heart Failure Center, Department of Translational Science University Clinic Würzburg, Germany (J.M.F., A.X., A.B., C.M., V.S.)
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Goubergrits L, Vellguth K, Obermeier L, Schlief A, Tautz L, Bruening J, Lamecker H, Szengel A, Nemchyna O, Knosalla C, Kuehne T, Solowjowa N. CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics. Front Cardiovasc Med 2022; 9:901902. [PMID: 35865389 PMCID: PMC9294248 DOI: 10.3389/fcvm.2022.901902] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Cardiac computed tomography (CCT) based computational fluid dynamics (CFD) allows to assess intracardiac flow features, which are hypothesized as an early predictor for heart diseases and may support treatment decisions. However, the understanding of intracardiac flow is challenging due to high variability in heart shapes and contractility. Using statistical shape modeling (SSM) in combination with CFD facilitates an intracardiac flow analysis. The aim of this study is to prove the usability of a new approach to describe various cohorts. Materials and Methods CCT data of 125 patients (mean age: 60.6 ± 10.0 years, 16.8% woman) were used to generate SSMs representing aneurysmatic and non-aneurysmatic left ventricles (LVs). Using SSMs, seven group-averaged LV shapes and contraction fields were generated: four representing patients with and without aneurysms and with mild or severe mitral regurgitation (MR), and three distinguishing aneurysmatic patients with true, intermediate aneurysms, and globally hypokinetic LVs. End-diastolic LV volumes of the groups varied between 258 and 347 ml, whereas ejection fractions varied between 21 and 26%. MR degrees varied from 1.0 to 2.5. Prescribed motion CFD was used to simulate intracardiac flow, which was analyzed regarding large-scale flow features, kinetic energy, washout, and pressure gradients. Results SSMs of aneurysmatic and non-aneurysmatic LVs were generated. Differences in shapes and contractility were found in the first three shape modes. Ninety percent of the cumulative shape variance is described with approximately 30 modes. A comparison of hemodynamics between all groups found shape-, contractility- and MR-dependent differences. Disturbed blood washout in the apex region was found in the aneurysmatic cases. With increasing MR, the diastolic jet becomes less coherent, whereas energy dissipation increases by decreasing kinetic energy. The poorest blood washout was found for the globally hypokinetic group, whereas the weakest blood washout in the apex region was found for the true aneurysm group. Conclusion The proposed CCT-based analysis of hemodynamics combining CFD with SSM seems promising to facilitate the analysis of intracardiac flow, thus increasing the value of CCT for diagnostic and treatment decisions. With further enhancement of the computational approach, the methodology has the potential to be embedded in clinical routine workflows and support clinicians.
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Affiliation(s)
- Leonid Goubergrits
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center Digital Future, Berlin, Germany
| | - Katharina Vellguth
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lukas Obermeier
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Adriano Schlief
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lennart Tautz
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Jan Bruening
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Olena Nemchyna
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Christoph Knosalla
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Titus Kuehne
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Natalia Solowjowa
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- *Correspondence: Natalia Solowjowa
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Ultrafast four-dimensional imaging of cardiac mechanical wave propagation with sparse optoacoustic sensing. Proc Natl Acad Sci U S A 2021; 118:2103979118. [PMID: 34732573 DOI: 10.1073/pnas.2103979118] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 12/25/2022] Open
Abstract
Propagation of electromechanical waves in excitable heart muscles follows complex spatiotemporal patterns holding the key to understanding life-threatening arrhythmias and other cardiac conditions. Accurate volumetric mapping of cardiac wave propagation is currently hampered by fast heart motion, particularly in small model organisms. Here we demonstrate that ultrafast four-dimensional imaging of cardiac mechanical wave propagation in entire beating murine heart can be accomplished by sparse optoacoustic sensing with high contrast, ∼115-µm spatial and submillisecond temporal resolution. We extract accurate dispersion and phase velocity maps of the cardiac waves and reveal vortex-like patterns associated with mechanical phase singularities that occur during arrhythmic events induced via burst ventricular electric stimulation. The newly introduced cardiac mapping approach is a bold step toward deciphering the complex mechanisms underlying cardiac arrhythmias and enabling precise therapeutic interventions.
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Chen V, Barker AJ, Golan R, Scott MB, Huh H, Wei Q, Sojoudi A, Markl M. Effect of age and sex on fully automated deep learning assessment of left ventricular function, volumes, and contours in cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2021; 37:3539-3547. [PMID: 34185211 DOI: 10.1007/s10554-021-02326-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/24/2021] [Indexed: 01/03/2023]
Abstract
Deep learning algorithms for left ventricle (LV) segmentation are prone to bias towards the training dataset. This study assesses sex- and age-dependent performance differences when using deep learning for automatic LV segmentation. Retrospective analysis of 100 healthy subjects undergoing cardiac MRI from 2012 to 2018, with 10 men and women in the following age groups: 18-30, 31-40, 41-50, 51-60, and 61-80 years old. Subjects underwent 1.5 T, 2D CINE SSFP MRI. 35 pathologic cases from local clinical exams and the SCMR 2015 consensus contours dataset were also analyzed. A fully convolutional network (FCN) similar to U-Net trained on the U.K. Biobank was used to automatically segment LV endocardial and epicardial contours. FCN and manual segmentation were compared using Dice metrics and measurements of end-diastolic volume (EDV), end-systolic volume (ESV), mass (LVM), and ejection fraction (LVEF). Paired t-tests and linear regressions were used to analyze measurement differences with respect to sex and age. Dice metrics (median ± IQR) for n = 135 cases were 0.94 ± 0.04/0.87 ± 0.10 (ED endocardium/ES endocardium). Measurement biases (mean ± SD) among the healthy cohort were - 0.3 ± 10.1 mL for EDV, - 6.7 ± 9.6 mL for ESV, 4.6 ± 6.4% for LVEF, and - 2.2 ± 11.0 g for LVM; biases were independent of sex and age. Biases among the 35 pathologic cases were 0.1 ± 19 mL for EDV, - 4.8 ± 19 mL for ESV, 2.0 ± 7.6% for LVEF, and 1.0 ± 20 g for LVM. In conclusion, automatic segmentation by the Biobank-trained FCN was independent of age and sex. Improvements in end-systolic basal slice detection are needed to decrease bias and improve precision in ESV and LVEF.
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Affiliation(s)
- Vincent Chen
- Department of Internal Medicine, Northwestern University, Chicago, IL, USA.,Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
| | - Alex J Barker
- Department of Radiology, University of Colorado, Denver, CO, USA
| | - Rotem Golan
- Circle Cardiovascular Imaging, Inc., Calgary, Canada
| | - Michael B Scott
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
| | - Hyungkyu Huh
- Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, South Korea
| | - Qiao Wei
- Circle Cardiovascular Imaging, Inc., Calgary, Canada
| | | | - Michael Markl
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA.
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Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling in the Community. Curr Cardiol Rep 2021; 23:86. [PMID: 34081212 DOI: 10.1007/s11886-021-01512-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Echocardiography is a noninvasive tool of choice for evaluating cardiac structure and function in numerous cardiac conditions ranging from congenital heart disease, myocardial diseases, coronary artery disease (CAD), valvulopathies, arrhythmias, and pericardial disorders. We review the prognostic significance of echocardiographic indices of cardiac remodeling in the general population. RECENT FINDINGS Recent meta-analyses have confirmed the prognostic significance of echocardiographic measurements (left ventricular mass/hypertrophy, systolic and diastolic dysfunction, left atrial dimensions and function, and strain rate measures) in asymptomatic people in the community for adverse clinical outcomes including CAD, stroke, heart failure, atrial fibrillation, sudden death, and all-cause mortality. The clinical utility of screening echocardiography has been examined comprehensively in hypertensive patients, where it is challenged by measurement variability. Echocardiographic measures predict cardiovascular disease outcomes consistently in multiple community-based epidemiological studies. However, the clinical utility of screening asymptomatic individuals with echocardiography in population-based settings is limited.
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Legler M, Koy L, Kummerfeld N, Fehr M. Diastolic and Systolic Longitudinal Myocardial Velocities of Healthy Racing Pigeons ( Columba livia f. domestica) Measured by Tissue Doppler Imaging. Vet Sci 2021; 8:vetsci8020023. [PMID: 33572501 PMCID: PMC7912189 DOI: 10.3390/vetsci8020023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Tissue Doppler imaging (TDI) is a noninvasive sonographic method of acquiring and quantifying myocardial velocities. This technique is used in human and small animal medicine to diagnose cardiac diseases. Using this technique, we evaluated the longitudinal myocardial peak velocities of the interventricular septum, and the left and right ventricular free walls in the systole and diastole in 40 racing pigeons. The TDI examinations confirmed the movement of the heart base toward the apex in the systole and away from the apex in the diastole. Inhomogeneous distribution of the myocardial velocities with a statistically significant velocity gradient from the basal to the apical myocardial segments was found. The left and right free walls have significantly higher myocardial velocities than the myocardium of the septum. The myocardial velocities during active ventricular filling were significantly higher in the right ventricular free wall than in the left one. The validation of the method resulted in coefficients of variation between 3% and 33% for the systolic and 3% and 75% for the diastolic individual myocardial velocities. Weekly repeated measurements resulted in variation coefficients between 3% and 45% for systolic and diastolic myocardial velocities, respectively.
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Kihlberg J, Gupta V, Haraldsson H, Sigfridsson A, Sarvari SI, Ebbers T, Engvall JE. Clinical validation of three cardiovascular magnetic resonance techniques to measure strain and torsion in patients with suspected coronary artery disease. J Cardiovasc Magn Reson 2020; 22:83. [PMID: 33280612 PMCID: PMC7720468 DOI: 10.1186/s12968-020-00684-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Several cardiovascular magnetic resonance (CMR) techniques can measure myocardial strain and torsion with high accuracy. The purpose of this study was to compare displacement encoding with stimulated echoes (DENSE), tagging and feature tracking (FT) for measuring circumferential and radial myocardial strain and myocardial torsion in order to assess myocardial function and infarct scar burden both at a global and at a segmental level. METHOD 116 patients with a high likelihood of coronary artery disease (European SCORE > 15%) underwent CMR examination including cine images, tagging, DENSE and late gadolinium enhancement (LGE) in the short axis direction. In total, 97 patients had signs of myocardial disease and 19 had no abnormalities in terms of left ventricular (LV) wall mass index, LV ejection fraction, wall motion, LGE or a history of myocardial infarction. Thirty-four patients had myocardial infarct scar with a transmural LGE extent (transmurality) that exceeded 50% of the wall thickness in at least one segment. Global circumferential strain (GCS) and global radial strain (GRS) was analyzed using FT of cine loops, deformation of tag lines or DENSE displacement. RESULTS DENSE and tagging both showed high sensitivity (82% and 71%) at a specificity of 80% for the detection of segments with > 50% LGE transmurality, and receiver operating characteristics (ROC) analysis showed significantly higher area under the curve-values (AUC) for DENSE (0.87) than for tagging (0.83, p < 0.001) and FT (0.66, p = 0.003). GCS correlated with global LGE when determined with DENSE (r = 0.41), tagging (r = 0.37) and FT (r = 0.15). GRS had a low but significant negative correlation with LGE; DENSE r = - 0.10, FT r = - 0.07 and tagging r = - 0.16. Torsion from DENSE and tagging had a weak correlation (- 0.20 and - 0.22 respectively) with global LGE. CONCLUSION Circumferential strain from DENSE detected segments with > 50% scar with a higher AUC than strain determined from tagging and FT at a segmental level. GCS and torsion computed from DENSE and tagging showed similar correlation with global scar size, while when computed from FT, the correlation was lower.
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Affiliation(s)
- Johan Kihlberg
- Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - Vikas Gupta
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Henrik Haraldsson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Andreas Sigfridsson
- Department of Clinical Physiology & Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Sebastian I Sarvari
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, 0316, Oslo, Norway
| | - Tino Ebbers
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jan E Engvall
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Hedayat M, Patel TR, Kim T, Belohlavek M, Hoffmann KR, Borazjani I. A hybrid echocardiography-CFD framework for ventricular flow simulations. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e03352. [PMID: 32419374 DOI: 10.1002/cnm.3352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Image-based CFD is a powerful tool to study cardiovascular flows while 2D echocardiography (echo) is the most widely used noninvasive imaging modality for the diagnosis of heart disease. Here, echo is combined with CFD, that is, an echo-CFD framework, to study ventricular flows. To achieve this, the previous 3D reconstruction from multiple 2D echo at standard cross sections is extended by: (a) reconstructing aortic and mitral valves from 2D echo and closing the left-ventricle (LV) geometry by approximating a superior wall; (b) incorporating the physiological assumption of the fixed apex as a reference (fixed) point in the 3D reconstruction; and (c) incorporating several smoothing algorithms to remove the nonphysical oscillations (ringing) near the basal section. The method is applied to echo from a baseline LV and one after inducing acute myocardial ischemia (AMI). The 3D reconstruction is validated by comparing it against a reference reconstruction from many echo sections while flow simulations are validated against the Doppler ultrasound velocity measurements. The sensitivity study shows that the choice of the smoothing algorithm does not change the flow pattern inside the LV. However, the presence of the mitral valve can significantly change the flow pattern during the diastole phase. In addition, the abnormal shape of a LV with AMI can drastically change the flow during diastole. Furthermore, the hemodynamic energy loss, as an indicator of the LV pumping performance, for different test cases is calculated, which shows a larger energy loss for a LV with AMI compared to the baseline one.
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Affiliation(s)
- Mohammadali Hedayat
- J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, Texas, USA
| | - Tatsat R Patel
- Department of Mechanical and Aerospace Engineering, State University of New York at Buffalo, Buffalo, New York, USA
| | - Taeouk Kim
- J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, Texas, USA
| | - Marek Belohlavek
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA
| | - Kenneth R Hoffmann
- Department of Neurosurgery, University at Buffalo SUNY, Buffalo, New York, USA
| | - Iman Borazjani
- J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, Texas, USA
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Thermodynamic interference with bile acid demicelleization reduces systemic entry and injury during cholestasis. Sci Rep 2020; 10:8462. [PMID: 32439972 PMCID: PMC7242474 DOI: 10.1038/s41598-020-65451-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 05/04/2020] [Indexed: 02/07/2023] Open
Abstract
Bile acids (BA), with their large hydrophobic steroid nucleus and polar groups are amphipathic molecules. In bile, these exist as micelles above their critical micellar concentration (CMC). In blood at low concentrations, these exist as monomers, initiating cellular signals. This micellar to monomer transition may involve complex thermodynamic interactions between bile salts alone or with phospholipids, i.e. mixed micelles and the aqueous environment. We therefore went on to test if therapeutically relevant changes in temperature could influence micellar behavior of bile salts, and in turn whether this affected the biological responses in cells, and in vivo. Sodium taurocholate (STC) belongs to a major class of bile salts. STC has a CMC in the 5–8 mM range and its infusion into the pancreatic duct is commonly used to study pancreatitis. We thus studied micellar breakdown of STC using isothermal titration calorimetry (ITC), dynamic light scattering and cryogenic transmission electron microscopy. Under conditions relevant to the in vivo environment (pH 7.4, Na 0.15 M), ITC showed STC to have a U shaped reduction in micellar breakdown between 37 °C and 15 °C with a nadir at 25 °C approaching ≈90% inhibition. This temperature dependence paralleled pancreatic acinar injury induced by monomeric STC. Mixed micelles of STC and 1-palmitoyl, 2-oleyl phosphatidylcholine, a phospholipid present in high proportions in bile, behaved similarly, with ≈75% reduction in micellar breakdown at 25 °C compared to 37 °C. In vivo pancreatic cooling to 25 °C reduced the increase in circulating BAs after infusion of 120 mM (5%) STC into the pancreatic duct, and duct ligation. Lower BA levels were associated with improved cardiac function, reduced myocardial damage, shock, lung injury and improved survival independent of pancreatic injury. Thus micellar breakdown of bile salts is essential for their entry into the systemic circulation, and thermodynamic interference with this may reduce their systemic entry and consequent injury during cholestasis, such as from biliary pancreatitis.
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Javed A, Nayak KS. Single-shot EPI for ASL-CMR. Magn Reson Med 2020; 84:738-750. [PMID: 32060949 DOI: 10.1002/mrm.28165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/23/2019] [Accepted: 12/15/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate single-shot echo planar imaging (SS-EPI), as an alternative to snapshot balanced steady state free precession (bSSFP) imaging, for arterial-spin-labeled cardiac MR (ASL-CMR). This study presents a practical implementation SS-EPI tailored to the needs of ASL-CMR at 3T and demonstrates sequential multi-slice ASL with no increase in scan time. METHODS Reduced field of view SS-EPI was performed using a 2DRF pulse. A spin-echo was used with crushers optimized to maximize blood suppression and minimize myocardial signal loss, based on experiments in 4 healthy volunteers. SS-EPI was evaluated against the widely used bSSFP reference method in single-slice ASL-CMR in 4 healthy volunteers, during both systole and diastole. Sequential multi-slice ASL-CMR with SS-EPI was demonstrated during diastole (3 slices: basal, mid, and apical short-axis) and during systole (2 slices: mid and apical short-axis), in 3 volunteers. RESULTS Global myocardial perfusion for diastolic SS-EPI (1.66 ± 0.73 mL/g/min) and systolic SS-EPI (1.50 ± 0.36 mL/g/min) were found to be statistically equivalent (2 one-sided test with a difference of 0.4 mL/g/min) to diastolic bSSFP (duration of 1 cardiac cycle, 1.60 ± 0.80 mL/g/min) with P-values of 0.022 and 0.031, respectively. Global myocardial perfusion for sequential multi-slice experiments was 1.64 ± 0.47, 1.34 ± 0.29, and 1.88 ± 0.58 for basal, mid, and apical SAX slices during diastole and was 1.61 ± 0.35, and 1.66 ± 0.49 for mid and apical slice during systole. These values are comparable to published ASL-CMR and positron emission tomography studies. CONCLUSION SS-EPI is a promising alternative to bSSFP imaging for ASL-CMR and can potentially improve the spatial coverage of ASL-CMR by 3-fold during diastole and 2-fold during systole, without increasing scan time.
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Affiliation(s)
- Ahsan Javed
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California
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Samnøy SF, Cuypers J, Greve G, Larsen TH. 4D left ventricular resultant wall motion and blood flow assessed by phase-shift velocity mapping at high-field 3T MRI. Clin Physiol Funct Imaging 2017; 37:615-621. [DOI: 10.1111/cpf.12345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 12/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Stig F. Samnøy
- Department of Civil Engineering; Bergen University College; Bergen Norway
- Department of Clinical Engineering; Haukeland University Hospital; Bergen Norway
| | - Jochem Cuypers
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Gottfried Greve
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
| | - Terje H. Larsen
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
- Department of Biomedicine; University of Bergen; Bergen Norway
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Chang MC, Wu MT, Weng KP, Su MY, Menza M, Huang HC, Peng HH. Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping. Eur Radiol 2017; 28:104-114. [PMID: 28677054 DOI: 10.1007/s00330-017-4908-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/20/2017] [Accepted: 05/23/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function. METHODS We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VØ) directions in basal, middle, and apical slices. The VØ peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VØ inconsistency were computed for evaluating LV twist function and VØ dyssynchrony. RESULTS As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VØ PTP, higher VØ inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage. CONCLUSIONS MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function. KEY POINTS • Patients with rTOF presented significantly reduced systolic and diastolic Vz in the LV. • rTOF patients demonstrated significantly increased diastolic Vr in the septum. • Abnormal characteristics of the segmental dynamic velocity evolution were shown in rTOF. • rTOF patients presented altered circumferential rotation and velocity inconsistency in early stage.
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Affiliation(s)
- Meng-Chu Chang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, No.101, Sec. 2, Kuang-Fu Rd., BMES Building, R415, Hsinchu, 300, Taiwan
| | - Ming-Ting Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ken-Pen Weng
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Mao-Yuan Su
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Marius Menza
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hung-Chieh Huang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsu-Hsia Peng
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, No.101, Sec. 2, Kuang-Fu Rd., BMES Building, R415, Hsinchu, 300, Taiwan.
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13
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Nacif MS, Almeida ALC, Young AA, Cowan BR, Armstrong AC, Yang E, Sibley CT, Hundley WG, Liu S, Lima JA, Bluemke DA. Three-Dimensional Volumetric Assessment of Diastolic Function by Cardiac Magnetic Resonance Imaging: The Multi-Ethnic Study of Atherosclerosis (MESA). Arq Bras Cardiol 2017; 108:552-563. [PMID: 28562831 PMCID: PMC5489326 DOI: 10.5935/abc.20170063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 12/19/2016] [Indexed: 11/20/2022] Open
Abstract
Background: Cardiac Magnetic Resonance is in need of a simple and robust method for diastolic function assessment that can be done with routine protocol sequences. Objective: To develop and validate a three-dimensional (3D) model-based volumetric assessment of diastolic function using cardiac magnetic resonance (CMR) imaging and compare the results obtained with the model with those obtained by echocardiography. Methods: The study participants provided written informed consent and were included if having undergone both echocardiography and cine steady-state free precession (SSFP) CMR on the same day. Guide points at the septal and lateral mitral annulus were used to define the early longitudinal relaxation rate (E'), while a time-volume curve from the 3D model was used to assess diastolic filling parameters. We determined the correlation between 3D CMR and echocardiography and the accuracy of CMR in classifying the diastolic function grade. Results: The study included 102 subjects. The E/A ratio by CMR was positively associated with the E/A ratio by echocardiography (r = 0.71, p < 0.0001). The early diastolic relaxation velocity by tissue Doppler and longitudinal relaxation rate for the lateral mitral annulus displacement were positively associated (p = 0.007), as were the ratio between Doppler E/e' and CMR E/E' (p = 0.01). CMR-determined normalized peak E (NE) and deceleration time (DT) were able to predict diastolic dysfunction (areas under the curve [AUCs] = 0.70 and 0.72, respectively). In addition, the lateral E/E' ratio showed good utility in identifying diastolic dysfunction (AUC = 0.80). Overall, echocardiography and CMR interobserver and intraobserver agreements were excellent (intraclass correlation coefficient range 0.72 - 0.97). Conclusion: 3D modeling of standard cine CMR images was able to identify study subjects with reduced diastolic function and showed good reproducibility, suggesting a potential for a routine diastolic function assessment by CMR. Fundamento: A ressonância magnética cardíaca necessita de um método simples e robusto para a avaliação da função diastólica que pode ser feito com sequências protocolares de rotina. Objetivo: Desenvolver e validar a avaliação volumétrica da função diastólica através de um modelo tridimensional (3D) com utilização de imagens de ressonância magnética cardíaca (RMC) e comparar os resultados obtidos com este modelo com os obtidos por ecocardiografia. Métodos: Os participantes do estudo assinaram um termo de consentimento e foram incluídos se tivessem sido submetidos no mesmo dia tanto à ecocardiografia quanto à cine RMC com precessão livre no estado estacionário (steady-state free precession, SSFP). Pontos-guia foram utilizados no anel mitral septal e lateral para definir a velocidade de estiramento no início da diástole (E'), enquanto curvas de volume-tempo do modelo 3D foram utilizadas para avaliar os parâmetros de enchimento diastólico. Foram determinadas a correlação entre a RMC 3D e a ecocardiografia, além da acurácia da RMC em classificar o grau de função diastólica. Resultados: Ao todo, 102 sujeitos foram incluídos no estudo. A razão E/A pela RMC esteve positivamente associada com a razão E/A obtida pela ecocardiografia (r = 0,71, p < 0,0001). Estiveram positivamente associadas a velocidade de relaxamento diastólico inicial ao Doppler tecidual e a velocidade de relaxamento longitudinal de deslocamento do anel mitral lateral (p = 0,007), bem como a razão entre E/e' por Doppler e E/E' pela RMC (p = 0,01). A velocidade normalizada de pico de enchimento (EM) determinada pela RMC e o tempo de desaceleração (TD) foram capazes de predizer a disfunção diastólica (áreas sob a curva [AUCs] = 0,70 e 0,72, respectivamente). Além disso, a razão E/E' lateral mostrou boa utilidade para a identificação da disfunção diastólica (AUC = 0,80). No geral, a ecocardiografia e a RMC apresentaram excelente concordância interobservador e intraobservador (coeficiente de correlação intraclasse 0,72 - 0,97). Conclusão: Uma modelagem 3D de imagens padrões de cine RMC foi capaz de identificar os indivíduos do estudo com função diastólica reduzida e mostrou uma boa reprodutibilidade, sugerindo ter potencial na avaliação rotineira da função diastólica por RMC.
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Affiliation(s)
- Marcelo S Nacif
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA.,Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Radiology Department, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Andre L C Almeida
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alistair A Young
- Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
| | - Brett R Cowan
- Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
| | - Anderson C Armstrong
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eunice Yang
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Christopher T Sibley
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - W Gregory Hundley
- Department of Internal Medicine and Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Songtao Liu
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Joao Ac Lima
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David A Bluemke
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA.,Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
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14
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Gimpel C, Jung BA, Jung S, Brado J, Schwendinger D, Burkhardt B, Pohl M, Odening KE, Geiger J, Arnold R. Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease. Pediatr Radiol 2017; 47:169-177. [PMID: 27966039 DOI: 10.1007/s00247-016-3741-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/26/2016] [Accepted: 10/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. OBJECTIVE To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. MATERIALS AND METHODS Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle. RESULTS Patients and controls (age: 8 years-20 years) were matched for age, height, weight, gender and heart rate. Patients had higher systolic blood pressure. No patient had left ventricular hypertrophy on MRI or diastolic dysfunction on echocardiography. Fifteen patients underwent tissue Doppler echocardiography, with normal z-scores for mitral early diastolic (VE), late diastolic (VA) and peak systolic (VS) velocities. Throughout all left ventricular levels, peak diastolic Vz and Vr (cm/s) were reduced in patients: Vzbase -10.6 ± 1.9 vs. -13.4 ± 2.0 (P < 0.0003), Vzmid -7.8 ± 1.6 vs. -11 ± 1.5 (P < 0.0001), Vzapex -3.8 ± 1.6 vs. -5.3 ± 1.6 (P = 0.01), Vrbase -4.2 ± 0.8 vs. -4.9 ± 0.7 (P = 0.01), Vrmid -4.7 ± 0.7 vs. -5.4 ± 0.7 (P = 0.01), Vrapex -4.7 ± 1.4 vs. -5.6 ± 1.1 (P = 0.05). CONCLUSION Tissue phase mapping is feasible in children and adolescents. Children with chronic kidney disease show significantly reduced peak diastolic long- and short-axis left ventricular wall velocities, reflecting impaired early diastolic filling. Thus, tissue phase mapping detects chronic kidney disease-related functional myocardial changes before overt left ventricular hypertrophy or echocardiographic diastolic dysfunction occurs.
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Affiliation(s)
- Charlotte Gimpel
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center - University of Freiburg, Mathildenstr. 1, 79106,, Freiburg, Germany.
| | - Bernd A Jung
- Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern, Bern, Switzerland
| | - Sabine Jung
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Johannes Brado
- Department of Cardiology and Angiology I, University Heart Center Freiburg, Freiburg, Germany
| | | | - Barbara Burkhardt
- Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Martin Pohl
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center - University of Freiburg, Mathildenstr. 1, 79106,, Freiburg, Germany
| | - Katja E Odening
- Department of Cardiology and Angiology I, University Heart Center Freiburg, Freiburg, Germany
| | - Julia Geiger
- Department of Radiology, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Radiology, Northwestern University, 737 N. Michigan Ave., Chicago, IL, USA
| | - Raoul Arnold
- Department of Pediatric and Congenital Cardiology, University Hospital Heidelberg, Heidelberg, Germany
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15
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Kowallick JT, Morton G, Lamata P, Jogiya R, Kutty S, Lotz J, Hasenfuß G, Nagel E, Chiribiri A, Schuster A. Inter-study reproducibility of left ventricular torsion and torsion rate quantification using MR myocardial feature tracking. J Magn Reson Imaging 2015; 43:128-37. [PMID: 26114731 DOI: 10.1002/jmri.24979] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/02/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To determine the inter-study reproducibility of MR feature tracking (MR-FT) derived left ventricular (LV) torsion and torsion rates for a combined assessment of systolic and diastolic myocardial function. METHODS Steady-state free precession (SSFP) cine LV short-axis stacks were acquired at 9:00 (Exam A), 9:30 (Exam B), and 14:00 (Exam C) in 16 healthy volunteers at 3 Tesla. SSFP images were analyzed offline using MR-FT to assess rotational displacement in apical and basal slices. Global peak torsion, peak systolic and peak diastolic torsion rates were calculated using different definitions ("twist", "normalized twist" and "circumferential-longitudinal (CL) shear angle"). Exam A and B were compared to assess the inter-study reproducibility. Morning and afternoon scans were compared to address possible diurnal variation. RESULTS The different methods showed good inter-study reproducibility for global peak torsion (intraclass correlation coefficient [ICC]: 0.90-0.92; coefficient of variation [CoV]: 19.0-20.3%) and global peak systolic torsion rate (ICC: 0.82-0.84; CoV: 25.9-29.0%). Conversely, global peak diastolic torsion rate showed little inter-study reproducibility (ICC: 0.34-0.47; CoV: 40.8-45.5%). Global peak torsion as determined by the CL shear angle showed the best inter-study reproducibility (ICC: 0.90;CoV: 19.0%). MR-FT results were not measurably affected by diurnal variation between morning and afternoon scans (CL shear angle: 4.8 ± 1.4°, 4.8 ± 1.5°, and 4.1 ± 1.6° for Exam A, B, and C, respectively; P = 0.21). CONCLUSION MR-FT based derivation of myocardial peak torsion and peak systolic torsion rate has high inter-study reproducibility as opposed to peak diastolic torsion rate. The CL shear angle was the most reproducible parameter independently of cardiac anatomy and may develop into a robust tool to quantify cardiac rotational mechanics in longitudinal MR-FT patient studies.
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Affiliation(s)
- Johannes T Kowallick
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom.,Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany
| | - Geraint Morton
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Pablo Lamata
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom.,Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Roy Jogiya
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Shelby Kutty
- Children's Hospital and Medical Center, University of Nebraska College of Medicine, Omaha, Nebraska, USA
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany
| | - Gerd Hasenfuß
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany.,Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
| | - Eike Nagel
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Andreas Schuster
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St Thomas' Hospital, King's College London, London, United Kingdom.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany.,Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
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16
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Kowallick JT, Lamata P, Hussain ST, Kutty S, Steinmetz M, Sohns JM, Fasshauer M, Staab W, Unterberg-Buchwald C, Bigalke B, Lotz J, Hasenfuß G, Schuster A. Quantification of left ventricular torsion and diastolic recoil using cardiovascular magnetic resonance myocardial feature tracking. PLoS One 2014; 9:e109164. [PMID: 25285656 PMCID: PMC4186780 DOI: 10.1371/journal.pone.0109164] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/29/2014] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Cardiovascular magnetic resonance feature tracking (CMR-FT) offers quantification of myocardial deformation from routine cine images. However, data using CMR-FT to quantify left ventricular (LV) torsion and diastolic recoil are not yet available. We therefore sought to evaluate the feasibility and reproducibility of CMR-FT to quantify LV torsion and peak recoil rate using an optimal anatomical approach. METHODS Short-axis cine stacks were acquired at rest and during dobutamine stimulation (10 and 20 µg · kg(-1) · min(-1)) in 10 healthy volunteers. Rotational displacement was analysed for all slices. A complete 3D-LV rotational model was developed using linear interpolation between adjacent slices. Torsion was defined as the difference between apical and basal rotation, divided by slice distance. Depending on the distance between the most apical (defined as 0% LV distance) and basal (defined as 100% LV distance) slices, four different models for the calculation of torsion were examined: Model-1 (25-75%), Model-2 (0-100%), Model-3 (25-100%) and Model-4 (0-75%). Analysis included subendocardial, subepicardial and global torsion and recoil rate (mean of subendocardial and subepicardial values). RESULTS Quantification of torsion and recoil rate was feasible in all subjects. There was no significant difference between the different models at rest. However, only Model-1 (25-75%) discriminated between rest and stress (Global Torsion: 2.7 ± 1.5° cm(-1), 3.6 ± 2.0° cm(-1), 5.1 ± 2.2° cm(-1), p<0.01; Global Recoil Rate: -30.1 ± 11.1° cm(-1) s(-1),-46.9 ± 15.0° cm(-1) s(-1),-68.9 ± 32.3° cm(-1) s(-1), p<0.01; for rest, 10 and 20 µg · kg(-)1 · min(-1) of dobutamine, respectively). Reproducibility was sufficient for all parameters as determined by Bland-Altman analysis, intraclass correlation coefficients and coefficient of variation. CONCLUSIONS CMR-FT based derivation of myocardial torsion and recoil rate is feasible and reproducible at rest and with dobutamine stress. Using an optimal anatomical approach measuring rotation at 25% and 75% apical and basal LV locations allows effective quantification of torsion and recoil dynamics. Application of these new measures of deformation by CMR-FT should next be explored in disease states.
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Affiliation(s)
- Johannes T. Kowallick
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Pablo Lamata
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Shazia T. Hussain
- Papworth Hospital NHS Trust, Papworth Everard, Cambridgeshire, United Kingdom
| | - Shelby Kutty
- Children's Hospital and Medical Center, University of Nebraska College of Medicine, Omaha, Nebraska, United States of America
| | - Michael Steinmetz
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Jan M. Sohns
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Martin Fasshauer
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Wieland Staab
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Christina Unterberg-Buchwald
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Boris Bigalke
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, United Kingdom
- Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, United Kingdom
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
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17
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Mori S, Yamashita T, Takaya T, Kinugasa M, Takamine S, Shigeru M, Ito T, Fujiwara S, Nishii T, Kono AK, Hirata KI. Association between the rotation and three-dimensional tortuosity of the proximal ascending aorta. Clin Anat 2014; 27:1200-11. [DOI: 10.1002/ca.22452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/17/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Shumpei Mori
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Tomoya Yamashita
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Tomofumi Takaya
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Mitsuo Kinugasa
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Sachiko Takamine
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Mayumi Shigeru
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Tatsuro Ito
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Sei Fujiwara
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
| | - Tatsuya Nishii
- Department of Radiology; Kobe University Graduate School of Medicine; Kobe Japan
| | - Atsushi K. Kono
- Department of Radiology; Kobe University Graduate School of Medicine; Kobe Japan
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine; Department of Internal Medicine, Kobe University Graduate School of Medicine; Kobe Japan
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18
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Walton S, Berger K, Thiyagalingam J, Duffy B, Fang H, Holloway C, Trefethen AE, Chen M. Visualizing Cardiovascular Magnetic Resonance (CMR) imagery: challenges and opportunities. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2014; 115:349-58. [PMID: 25091538 DOI: 10.1016/j.pbiomolbio.2014.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
Abstract
Cardiovascular Magnetic Resonance (CMR) imaging is an essential technique for measuring regional myocardial function. However, it is a time-consuming and cognitively demanding task to interpret, identify and compare various motion characteristics based on watching CMR imagery. In this work, we focus on the problems of visualising imagery resulting from 2D myocardial tagging in CMR. In particular we provide an overview of the current state of the art of relevant visualization techniques, and a discussion on why the problem is difficult from a perceptual perspective. Finally, we introduce a proof-of-concept multilayered visualization user interface for visualizing CMR data using multiple derived attributes encoded into multivariate glyphs. An initial evaluation of the system by clinicians suggested a great potential for this visualisation technology to become a clinical practice in the future.
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Affiliation(s)
- Simon Walton
- Oxford e-Research Centre, Oxford University, 7 Keble Road, Oxford OX1 3QG, UK.
| | - Kai Berger
- INRIA Bretagne-Atlantique, Campus universitaire de Beaulieu, 35042 Rennes Cedex, France
| | | | - Brian Duffy
- Oxford e-Research Centre, Oxford University, 7 Keble Road, Oxford OX1 3QG, UK
| | - Hui Fang
- Oxford e-Research Centre, Oxford University, 7 Keble Road, Oxford OX1 3QG, UK
| | - Cameron Holloway
- St Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia
| | - Anne E Trefethen
- Oxford e-Research Centre, Oxford University, 7 Keble Road, Oxford OX1 3QG, UK
| | - Min Chen
- Oxford e-Research Centre, Oxford University, 7 Keble Road, Oxford OX1 3QG, UK.
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19
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Codreanu I, Robson MD, Rider OJ, Pegg TJ, Dasanu CA, Jung BA, Rotaru N, Clarke K, Holloway CJ. Details of left ventricular radial wall motion supporting the ventricular theory of the third heart sound obtained by cardiac MR. Br J Radiol 2014; 87:20130780. [PMID: 24641347 DOI: 10.1259/bjr.20130780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Obtaining new details of radial motion of left ventricular (LV) segments using velocity-encoding cardiac MRI. METHODS Cardiac MR examinations were performed on 14 healthy volunteers aged between 19 and 26 years. Cine images for navigator-gated phase contrast velocity mapping were acquired using a black blood segmented κ-space spoiled gradient echo sequence with a temporal resolution of 13.8 ms. Peak systolic and diastolic radial velocities as well as radial velocity curves were obtained for 16 ventricular segments. RESULTS Significant differences among peak radial velocities of basal and mid-ventricular segments have been recorded. Particular patterns of segmental radial velocity curves were also noted. An additional wave of outward radial movement during the phase of rapid ventricular filling, corresponding to the expected timing of the third heart sound, appeared of particular interest. CONCLUSION The technique has allowed visualization of new details of LV radial wall motion. In particular, higher peak systolic radial velocities of anterior and inferior segments are suggestive of a relatively higher dynamics of anteroposterior vs lateral radial motion in systole. Specific patterns of radial motion of other LV segments may provide additional insights into LV mechanics. ADVANCES IN KNOWLEDGE The outward radial movement of LV segments impacted by the blood flow during rapid ventricular filling provides a potential substrate for the third heart sound. A biphasic radial expansion of the basal anteroseptal segment in early diastole is likely to be related to the simultaneous longitudinal LV displacement by the stretched great vessels following repolarization and their close apposition to this segment.
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Affiliation(s)
- I Codreanu
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
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20
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Codreanu I, Robson MD, Rider OJ, Pegg TJ, Dasanu CA, Jung BA, Clarke K, Holloway CJ. Effects of ventricular insertion sites on rotational motion of left ventricular segments studied by cardiac MR. Br J Radiol 2014; 86:20130326. [PMID: 24133098 DOI: 10.1259/bjr.20130326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Obtaining new details for rotational motion of left ventricular (LV) segments using velocity encoding cardiac MR and correlating the regional motion patterns to LV insertion sites. METHODS Cardiac MR examinations were performed on 14 healthy volunteers aged between 19 and 26 years. Peak rotational velocities and circumferential velocity curves were obtained for 16 ventricular segments. RESULTS Reduced peak clockwise velocities of anteroseptal segments (i.e. Segments 2 and 8) and peak counterclockwise velocities of inferoseptal segments (i.e. Segments 3 and 9) were the most prominent findings. The observations can be attributed to the LV insertion sites into the right ventricle, limiting the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments as viewed from the apex. Relatively lower clockwise velocities of Segment 5 and counterclockwise velocities of Segment 6 were also noted, suggesting a cardiac fixation point between these two segments, which is in close proximity to the lateral LV wall. CONCLUSION Apart from showing different rotational patterns of LV base, mid ventricle and apex, the study showed significant differences in the rotational velocities of individual LV segments. Correlating regional wall motion with known orientation of myocardial aggregates has also provided new insights into the mechanisms of LV rotational motions during a cardiac cycle. ADVANCES IN KNOWLEDGE LV insertion into the right ventricle limits the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments adjacent to the ventricular insertion sites. The pattern should be differentiated from wall motion abnormalities in cardiac pathology.
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Affiliation(s)
- I Codreanu
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
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21
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Codreanu I, Pegg TJ, Selvanayagam JB, Robson MD, Rider OJ, Dasanu CA, Jung BA, Taggart DP, Golding SJ, Clarke K, Holloway CJ. Normal values of regional and global myocardial wall motion in young and elderly individuals using navigator gated tissue phase mapping. AGE (DORDRECHT, NETHERLANDS) 2014; 36:231-241. [PMID: 23604860 PMCID: PMC3889897 DOI: 10.1007/s11357-013-9535-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 04/05/2013] [Indexed: 06/02/2023]
Abstract
The purpose of this study was to evaluate normal values for regional and global myocardial wall motion parameters in young and elderly individuals, as detected by navigator gated high temporal resolution tissue phase mapping. Radial, longitudinal and circumferential ventricular wall motion, as well as ventricular torsion and longitudinal strain rates, were assessed in two age groups of volunteers, 23 ± 3 (n = 14) and 66 ± 7 years old (n = 9), respectively. All subjects were healthy, non-smokers without known cardiac disease. An increased global left ventricular (LV) torsion rate (peak systolic torsion rate 20.6 ± 2.0 versus 14.5 ± 1.0°/s/cm, peak diastolic torsion rate -25.2 ± 1.8 versus -14.1 ± 1.3°/s/cm) and a decrease in longitudinal LV motion (peak systolic values at mid-ventricle 5.9 ± 0.5 versus 8.5 ± 0.8 cm/s, peak diastolic values -10.7 ± 0.7 versus -15.2 ± 0.9 cm/s) in the older age group were the most prominent findings. Lower peak diastolic radial velocities with a longer time-to-peak values, most pronounced at the apex, are consistent with reduced diastolic function with ageing. Lower peak clockwise and counter-clockwise velocities at all LV levels revealed limitations in resting LV rotational motions in the older group. Significant changes in the undulating pattern of the rotational motions of the left ventricle were also observed. The results demonstrate distinct changes in regional and global myocardial wall motion in elderly individuals. Increased LV torsion rate and reduced LV longitudinal motion were particularly prominent in the older group. These parameters may have a role in the assessment of global LV contractility and help differentiate age-related changes from cardiac disease.
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Affiliation(s)
- Ion Codreanu
- Department of Physiology, Anatomy and Genetics, University of Oxford, Sherrington Building, Parks Road, Oxford, OX1 3PT, UK,
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22
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Weiss K, Summermatter S, Stoeck CT, Kozerke S. Compensation of signal loss due to cardiac motion in point-resolved spectroscopy of the heart. Magn Reson Med 2013; 72:1201-7. [DOI: 10.1002/mrm.25028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/06/2013] [Accepted: 10/12/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Kilian Weiss
- Institute for Biomedical Engineering; University and ETH Zurich; Switzerland
- Cardiology Division; Department of Medicine; Johns Hopkins University School of Medicine; Baltimore Maryland USA
| | | | - Christian T. Stoeck
- Institute for Biomedical Engineering; University and ETH Zurich; Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering; University and ETH Zurich; Switzerland
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23
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Simpson R, Keegan J, Firmin D. Efficient and reproducible high resolution spiral myocardial phase velocity mapping of the entire cardiac cycle. J Cardiovasc Magn Reson 2013; 15:34. [PMID: 23587250 PMCID: PMC3651364 DOI: 10.1186/1532-429x-15-34] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/29/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Three-directional phase velocity mapping (PVM) is capable of measuring longitudinal, radial and circumferential regional myocardial velocities. Current techniques use Cartesian k-space coverage and navigator-gated high spatial and high temporal resolution acquisitions are long. In addition, prospective ECG-gating means that analysis of the full cardiac cycle is not possible. The aim of this study is to develop a high temporal and high spatial resolution PVM technique using efficient spiral k-space coverage and retrospective ECG-gating. Detailed analysis of regional motion over the entire cardiac cycle, including atrial systole for the first time using MR, is presented in 10 healthy volunteers together with a comprehensive assessment of reproducibility. METHODS A navigator-gated high temporal (21 ms) and spatial (1.4 × 1.4 mm) resolution spiral PVM sequence was developed, acquiring three-directional velocities in 53 heartbeats (100% respiratory-gating efficiency). Basal, mid and apical short-axis slices were acquired in 10 healthy volunteers on two occasions. Regional and transmural early systolic, early diastolic and atrial systolic peak longitudinal, radial and circumferential velocities were measured, together with the times to those peaks (TTPs). Reproducibilities were determined as mean ± SD of the signed differences between measurements made from acquisitions performed on the two days. RESULTS All slices were acquired in all volunteers on both occasions with good image quality. The high temporal resolution allowed consistent detection of fine features of motion, while the high spatial resolution allowed the detection of statistically significant regional and transmural differences in motion. Colour plots showing the regional variations in velocity over the entire cardiac cycle enable rapid interpretation of the regional motion within any given slice. The reproducibility of peak velocities was high with the reproducibility of early systolic, early diastolic and atrial systolic peak radial velocities in the mid slice (for example) being -0.01 ± 0.36, 0.20 ± 0.56 and 0.14 ± 0.42 cm/s respectively. Reproducibility of the corresponding TTP values, when normalised to a fixed systolic and diastolic length, was also high (-13.8 ± 27.4, 1.3 ± 21.3 and 3.0 ± 10.9 ms for early systolic, early diastolic and atrial systolic respectively). CONCLUSIONS Retrospectively gated spiral PVM is an efficient and reproducible method of acquiring 3-directional, high resolution velocity data throughout the entire cardiac cycle, including atrial systole.
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Affiliation(s)
- Robin Simpson
- NIHR Royal Brompton Cardiovascular Biomedical Research Unit, London, UK
- Imperial College, London, UK
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
| | - Jennifer Keegan
- NIHR Royal Brompton Cardiovascular Biomedical Research Unit, London, UK
- Imperial College, London, UK
| | - David Firmin
- NIHR Royal Brompton Cardiovascular Biomedical Research Unit, London, UK
- Imperial College, London, UK
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24
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Pennell DJ, Carpenter JP, Firmin DN, Kilner PJ, Mohiaddin RH, Prasad SK. Review of Journal of Cardiovascular Magnetic Resonance 2011. J Cardiovasc Magn Reson 2012; 14:78. [PMID: 23158097 PMCID: PMC3519784 DOI: 10.1186/1532-429x-14-78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 12/15/2022] Open
Abstract
There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, we remain very pleased with the progress of the journal's impact over the last 5 years. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors feel it is useful to summarize the papers for the readership into broad areas of interest or theme, which we feel would be useful, so that areas of interest from the previous year can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
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Affiliation(s)
- Dudley J Pennell
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - John Paul Carpenter
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - David N Firmin
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Philip J Kilner
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Raad H Mohiaddin
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Sanjay K Prasad
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
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25
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26
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Young AA, Cowan BR. Evaluation of left ventricular torsion by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:49. [PMID: 22827856 PMCID: PMC3461493 DOI: 10.1186/1532-429x-14-49] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 07/24/2012] [Indexed: 12/15/2022] Open
Abstract
Recently there has been considerable interest in LV torsion and its relationship with symptomatic and pre-symptomatic disease processes. Torsion gives useful additional information about myocardial tissue performance in both systolic and diastolic function. CMR assessment of LV torsion is simply and efficiently performed. However, there is currently a wide variation in the reporting of torsional motion and the procedures used for its calculation. For example, torsion has been presented as twist (degrees), twist per length (degrees/mm), shear angle (degrees), and shear strain (dimensionless). This paper reviews current clinical applications and shows how torsion can give insights into LV mechanics and the influence of LV geometry and myocyte fiber architecture on cardiac function. Finally, it provides recommendations for CMR measurement protocols, attempts to stimulate standardization of torsion calculation, and suggests areas of useful future research.
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Affiliation(s)
- Alistair A Young
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
| | - Brett R Cowan
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
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27
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Simpson RM, Keegan J, Firmin DN. MR assessment of regional myocardial mechanics. J Magn Reson Imaging 2012; 37:576-99. [PMID: 22826177 DOI: 10.1002/jmri.23756] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 06/15/2012] [Indexed: 12/30/2022] Open
Abstract
Regional myocardial function can be measured by several MR techniques including tissue tagging, phase velocity mapping, and more recently, displacement encoding with stimulated echoes (DENSE) and strain encoding (SENC). Each of these techniques was developed separately and has undergone significant change since its original implementation. As a result, in the current literature, the common features and the differences between the techniques and what they measure are often unclear and confusing. This review article delivers an extensively referenced introductory text which clarifies the current methodology from the starting point of the Bloch equations. By doing this in a consistent way for each method, the similarities and differences between them are highlighted. In addition, their capabilities and limitations are discussed, together with their relative advantages and disadvantages. While the focus is on sequence design and development, the principal parameters measured by each technique are also summarized, together with brief results, with the reader being directed to the extensive literature on data processing and clinical applications for more detail.
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Affiliation(s)
- Robin M Simpson
- Cardiovascular Magnetic Resonance Unit, Royal Brompton and Harefield NHS Hospital Trust, London, United Kingdom.
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28
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Espe EKS, Aronsen JM, Skrbic B, Skulberg VM, Schneider JE, Sejersted OM, Zhang L, Sjaastad I. Improved MR phase-contrast velocimetry using a novel nine-point balanced motion-encoding scheme with increased robustness to eddy current effects. Magn Reson Med 2012; 69:48-61. [PMID: 22392844 DOI: 10.1002/mrm.24226] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 01/17/2012] [Accepted: 02/04/2012] [Indexed: 01/23/2023]
Abstract
Phase-contrast MRI (PC-MRI) velocimetry is a noninvasive, high-resolution motion assessment tool. However, high motion sensitivity requires strong motion-encoding magnetic gradients, making phase-contrast-MRI prone to baseline shift artifacts due to the generation of eddy currents. In this study, we propose a novel nine-point balanced velocity-encoding strategy, designed to be more accurate in the presence of strong and rapidly changing gradients. The proposed method was validated using a rotating phantom, and its robustness and precision were explored and compared with established approaches through computer simulations and in vivo experiments. Computer simulations yielded a 39-57% improvement in velocity-noise ratio (corresponding to a 27-33% reduction in measurement error), depending on which method was used for comparison. Moreover, in vivo experiments confirmed this by demonstrating a 26-53% reduction in accumulated velocity error over the R-R interval. The nine-point balanced phase-contrast-MRI-encoding strategy is likely useful for settings where high spatial and temporal resolution and/or high motion sensitivity is required, such as in high-resolution rodent myocardial tissue phase mapping.
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Affiliation(s)
- Emil K S Espe
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
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29
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Lutz A, Bornstedt A, Manzke R, Etyngier P, Nienhaus GU, Rottbauer W, Rasche V. Acceleration of tissue phase mapping with sensitivity encoding at 3T. J Cardiovasc Magn Reson 2011; 13:59. [PMID: 21992267 PMCID: PMC3217863 DOI: 10.1186/1532-429x-13-59] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 10/12/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the impact of sensitivity encoding on the quantitative assessment of cardiac motion in black blood cine tissue phase mapping (TPM) sequences. Up to now whole volume coverage of the heart is still limited by the long acquisition times. Therefore, a significant increase in imaging speed without deterioration of quantitative motion information is indispensable. METHODS 20 volunteers were enrolled in this study. Each volunteer underwent myocardial short-axis TPM scans with different SENSE acceleration factors. The influence of SENSE acceleration on the measured motion curves was investigated. RESULTS It is demonstrated that all TPM sequences with SENSE acceleration have only minimum influence on the motion curves. Even with a SENSE factor of four, the decrease in the amplitude of the motion curve was less than 3%. No significant difference was observed for the global correlation coefficient and deviation between the motion curves obtained by the reproducibility and the SENSE accelerated measurements. CONCLUSIONS It is feasible to accelerate myocardial TPM measurements with SENSE factors up to 4 without losing substantial information of the motion pattern.
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Affiliation(s)
- Anja Lutz
- Department of Internal Medicine II, University Hospital of Ulm, Ulm Germany
| | - Axel Bornstedt
- Department of Internal Medicine II, University Hospital of Ulm, Ulm Germany
| | - Robert Manzke
- Philips Research North America, Briarcliff Manor, USA
| | | | | | - Wolfgang Rottbauer
- Department of Internal Medicine II, University Hospital of Ulm, Ulm Germany
| | - Volker Rasche
- Department of Internal Medicine II, University Hospital of Ulm, Ulm Germany
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30
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Pennell DJ, Firmin DN, Kilner PJ, Manning WJ, Mohiaddin RH, Prasad SK. Review of journal of cardiovascular magnetic resonance 2010. J Cardiovasc Magn Reson 2011; 13:48. [PMID: 21914185 PMCID: PMC3182946 DOI: 10.1186/1532-429x-13-48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/13/2011] [Indexed: 12/15/2022] Open
Abstract
There were 75 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2010, which is a 34% increase in the number of articles since 2009. The quality of the submissions continues to increase, and the editors were delighted with the recent announcement of the JCMR Impact Factor of 4.33 which showed a 90% increase since last year. Our acceptance rate is approximately 30%, but has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. Last year for the first time, the Editors summarized the papers for the readership into broad areas of interest or theme, which we felt would be useful to practitioners of cardiovascular magnetic resonance (CMR) so that you could review areas of interest from the previous year in a single article in relation to each other and other recent JCMR articles 1. This experiment proved very popular with a very high rate of downloading, and therefore we intend to continue this review annually. The papers are presented in themes and comparison is drawn with previously published JCMR papers to identify the continuity of thought and publication in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
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Affiliation(s)
- Dudley J Pennell
- CMR Unit Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - David N Firmin
- CMR Unit Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Philip J Kilner
- CMR Unit Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA
| | - Raad H Mohiaddin
- CMR Unit Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Sanjay K Prasad
- CMR Unit Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
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31
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Codreanu I, Robson MD, Rider OJ, Pegg TJ, Jung BA, Dasanu CA, Clarke K, Holloway CJ. Chasing the reflected wave back into the heart: a new hypothesis while the jury is still out. Vasc Health Risk Manag 2011; 7:365-73. [PMID: 21731888 PMCID: PMC3119594 DOI: 10.2147/vhrm.s20845] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Indexed: 11/23/2022] Open
Abstract
Background: Arterial stiffness directly influences cardiac function and is independently associated with cardiovascular risk. However, the influence of the aortic reflected pulse pressure wave on left ventricular function has not been well characterized. The aim of this study was to obtain detailed information on regional ventricular wall motion patterns corresponding to the propagation of the reflected aortic wave on ventricular segments. Methods: Left ventricular wall motion was investigated in a group of healthy volunteers (n = 14, age 23 ± 3 years), using cardiac magnetic resonance navigator-gated tissue phase mapping. The left ventricle was divided into 16 segments and regional wall motion was studied in high temporal detail. Results: Corresponding to the expected timing of the reflected aortic wave reaching the left ventricle, a characteristic “notch” of regional myocardial motion was seen in all radial, circumferential, and longitudinal velocity graphs. This notch was particularly prominent in septal segments adjacent to the left ventricular outflow tract on radial velocity graphs and in anterior and posterior left ventricular segments on circumferential velocity graphs. Similarly, longitudinal velocity graphs demonstrated a brief deceleration in the upward recoil motion of the entire ventricle at the beginning of diastole. Conclusion: These results provide new insights into the possible influence of the reflected aortic waves on ventricular segments. Although the association with the reflected wave appears to us to be unambiguous, it represents a novel research concept, and further studies enabling the actual recording of the pulse wave are required.
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Affiliation(s)
- Ion Codreanu
- Department of Physiology, Anatomy, and Genetics, University of Oxford, UK.
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32
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Markl M, Kilner PJ, Ebbers T. Comprehensive 4D velocity mapping of the heart and great vessels by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2011; 13:7. [PMID: 21235751 PMCID: PMC3025879 DOI: 10.1186/1532-429x-13-7] [Citation(s) in RCA: 285] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Accepted: 01/14/2011] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Phase contrast cardiovascular magnetic resonance (CMR) is able to measure all three directional components of the velocities of blood flow relative to the three spatial dimensions and the time course of the heart cycle. In this article, methods used for the acquisition, visualization, and quantification of such datasets are reviewed and illustrated. METHODS Currently, the acquisition of 3D cine (4D) phase contrast velocity data, synchronized relative to both cardiac and respiratory movements takes about ten minutes or more, even when using parallel imaging and optimized pulse sequence design. The large resulting datasets need appropriate post processing for the visualization of multidirectional flow, for example as vector fields, pathlines or streamlines, or for retrospective volumetric quantification. APPLICATIONS Multidirectional velocity acquisitions have provided 3D visualization of large scale flow features of the healthy heart and great vessels, and have shown altered patterns of flow in abnormal chambers and vessels. Clinically relevant examples include retrograde streams in atheromatous descending aortas as potential thrombo-embolic pathways in patients with cryptogenic stroke and marked variations of flow visualized in common aortic pathologies. Compared to standard clinical tools, 4D velocity mapping offers the potential for retrospective quantification of flow and other hemodynamic parameters. CONCLUSIONS Multidirectional, 3D cine velocity acquisitions are contributing to the understanding of normal and pathologically altered blood flow features. Although more rapid and user-friendly strategies for acquisition and analysis may be needed before 4D velocity acquisitions come to be adopted in routine clinical CMR, their capacity to measure multidirectional flows throughout a study volume has contributed novel insights into cardiovascular fluid dynamics in health and disease.
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Affiliation(s)
- Michael Markl
- Department of Radiology, Medical Physics, University Hospital Freiburg, Germany
| | - Philip J Kilner
- CMR Unit, Royal Brompton Hospital and Imperial College, London, UK
| | - Tino Ebbers
- Center for Medical Image Science and Visualization, Linköping University, Sweden
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