Imaging the Propagation of the Electromechanical Wave in Heart Failure Patients with Cardiac Resynchronization Therapy.

BACKGROUND: Current electrocardiographic and echocardiographic measurements in heart failure (HF) do not take into account the complex interplay between electrical activation and local wall motion. The utilization of novel technologies to better characterize cardiac electromechanical behavior may lead to improved response rates with cardiac resynchronization therapy (CRT). Electromechanical wave imaging (EWI) is a noninvasive ultrasound-based technique that uses the transient deformations of the myocardium to track the intrinsic EW that precedes myocardial contraction. In this paper, we investigate the performance and reproducibility of EWI in the assessment of HF patients and CRT. METHODS: EWI acquisitions were obtained in five healthy controls and 16 HF patients with and without CRT pacing. Responders (n = 8) and nonresponders (n = 8) to CRT were identified retrospectively on the basis of left ventricular (LV) reverse remodeling. Electromechanical activation maps were obtained in all patients and used to compute a quantitative parameter describing the mean LV lateral wall activation time (LWAT). RESULTS: Mean LWAT was increased by 52.1 ms in HF patients in native rhythm compared to controls (P < 0.01). For all HF patients, CRT pacing initiated a different electromechanical activation sequence. Responders exhibited a 56.4-ms ± 28.9-ms reduction in LWAT with CRT pacing (P < 0.01), while nonresponders showed no significant change. CONCLUSION: In this initial feasibility study, EWI was capable of characterizing local cardiac electromechanical behavior as it pertains to HF and CRT response. Activation sequences obtained with EWI allow for quantification of LV lateral wall electromechanical activation, thus providing a novel method for CRT assessment.

Polyvinyl Alcohol Phantoms With Heterogeneous Plaques: Estimation of Pulse Wave Velocity at the Stenotic Region Using Pulse Wave Imaging.

OBJECTIVE: Plaque characterization is essential for stroke prevention. In the study reported herein, we describe a heterogeneous phantom manufacturing technique with varying plaque compositions of different stiffness using polyvinyl alcohol (PVA) to emulate stenotic arteries and evaluated the use of pulse wave imaging (PWI) to assess plaque stiffness by comparing derived pulse wave velocities, with the goal of assessing plaque vulnerability and identifying high-risk patients for stroke. METHODS: Five stenotic phantoms (50% stenosis) were fabricated by pouring PVA solutions into 3-D-printed molds. Two of the phantoms had heterogeneous plaque compositions of soft (E0 = 13 kPa) and intermediate (E0 = 40 kPa) materials and of stiff (E0 = 54 kPa) and intermediate materials. Ultrasound sequences were acquired as the arterial phantoms were connected to a pulsating pump, and PWI was performed on the ultrasound acquisition using normalized cross-correlation to track the pulse-induced phantom wall distension propagations. Pulse wave velocities were estimated by fitting a linear regression line between the arrival time of the peak acceleration of the wall distension waveform and the corresponding location. RESULTS: Arterial phantoms with heterogeneous plaque stiffness were successfully fabricated. Pulse wave velocities of 2.06, 2.21, 2.49, 2.67 and 3.31 m/s were found in the phantom experiments using PWI for homogeneous soft plaque, the heterogeneous soft and intermediate plaque, homogeneous intermediate plaque, the heterogeneous stiff and intermediate plaque and homogeneous stiff plaque, respectively. CONCLUSION: A novel arterial phantom building technique was reported with varying heterogenous plaque compositions of different stiffness. The feasibility of using PWI to evaluate plaque stiffness in stenotic arteries was determined and found that PWI can distinguish between plaques of distinct stiffness and composition.

Pulse wave imaging of a stenotic artery model with plaque constituents of different stiffnesses: Experimental demonstration in phantoms and fluid-structure interaction simulation.

Vulnerable plaques associated with softer components may rupture, releasing thrombotic emboli to smaller vessels in the brain, thus causing an ischemic stroke. Pulse Wave Imaging (PWI) is an ultrasound-based method that allows for pulse wave visualization while the regional pulse wave velocity (PWV) is mapped along the arterial wall to infer the underlying wall compliance. One potential application of PWI is the non-invasive estimation of plaque's mechanical properties for investigating its vulnerability. In this study, the accuracy of PWV estimation in stenotic vessels was investigated by computational simulation and PWI in validation phantoms to evaluate this modality for assessing future stroke risk. Polyvinyl alcohol (PVA) phantoms with plaque constituents of different stiffnesses were designed and constructed to emulate stenotic arteries in the experiment, and the novel fabrication process was described. Finite-element fluid-structure interaction simulations were performed in a stenotic phantom model that matched the geometry and parameters of the experiment in phantoms. The peak distension acceleration of the phantom wall was tracked to estimate PWV. PWVs of 2.57 ms-1, 3.41 ms-1, and 4.48 ms-1 were respectively obtained in the soft, intermediate, and stiff plaque material in phantoms during the experiment using PWI. PWVs of 2.10 ms-1, 3.33 ms-1, and 4.02 ms-1 were respectively found in the soft, intermediate, and stiff plaque material in the computational simulation. These results demonstrate that PWI can effectively distinguish the mechanical properties of plaque in phantoms as compared to computational simulation.

Adaptive Wall Shear Stress Imaging in Phantoms, Simulations and In Vivo.

WSS measurement is challenging since it requires sensitive flow measurements at a distance close to the wall. The aim of this study is to develop an ultrasound imaging technique which combines vector flow imaging with an unsupervised data clustering approach that automatically detects the region close to the wall with optimally linear flow profile, to provide direct and robust WSS estimation. The proposed technique was evaluated in phantoms, mimicking normal and atherosclerotic vessels, and spatially registered Fluid Structure Interaction (FSI) simulations. A relative error of 6.7% and 19.8% was obtained for peak systolic (WSSPS) and end diastolic (WSSED) WSS in the straight phantom, while in the stenotic phantom, a good similarity was found between measured and simulated WSS distribution, with a correlation coefficient, R, of 0.89 and 0.85 for WSSPS and WSSED, respectively. Moreover, the feasibility of the technique to detect pre-clinical atherosclerosis was tested in an atherosclerotic swine model. Six swines were fed atherogenic diet, while their left carotid artery was ligated in order to disturb flow patterns. Ligated arterial segments that were exposed to low WSSPS and WSS characterized by high frequency oscillations at baseline, developed either moderately or highly stenotic plaques (p < 0.05). Finally, feasibility of the technique was demonstrated in normal and atherosclerotic human subjects. Atherosclerotic carotid arteries with low stenosis had lower WSSPS as compared to control subjects (p < 0.01), while in one subject with high stenosis, elevated WSS was found on an arterial segment, which coincided with plaque rupture site, as determined through histological examination.

Pulse wave and vector flow Imaging for atherosclerotic disease progression in hypercholesterolemic swine.

Non-invasive monitoring of atherosclerosis remains challenging. Pulse Wave Imaging (PWI) is a non-invasive technique to measure the local stiffness at diastolic and end-systolic pressures and quantify the hemodynamics. The objective of this study is twofold, namely (1) to investigate the capability of (adaptive) PWI to assess progressive change in local stiffness and homogeneity of the carotid in a high-cholesterol swine model and (2) to assess the ability of PWI to monitor the change in hemodynamics and a corresponding change in stiffness. Nine (n=9) hypercholesterolemic swine were included in this study and followed for up to 9 months. A ligation in the left carotid was used to cause a hemodynamic disturbance. The carotids with detectable hemodynamic disturbance showed a reduction in wall shear stress immediately after ligation (2.12 ± 0.49 to 0.98 ± 0.47 Pa for 40-90% ligation (Group B) and 1.82 ± 0.25 to 0.49 ± 0.46 Pa for >90% ligation (Group C)). Histology revealed subsequent lesion formation after 8-9 months, and the type of lesion formation was dependent on the type of the induced ligation, with more complex plaques observed in the carotids with a more significant ligation (C: >90%). The compliance progression appears differed for groups B and C, with an increase in compliance to 2.09 ± 2.90×10-10 m2 Pa-1 for group C whereas the compliance of group B remained low at 8 months (0.95 ± 0.94×10-10 m2 Pa-1). In summary, PWI appeared capable of monitoring a change in wall shear stress and separating two distinct progression pathways resulting in distinct compliances.

VO Cluster-Stabilized H2O Adsorption on a TiO2 (110) Surface at Room Temperature.

We probe the adsorption of molecular H2O on a TiO2 (110)-(1 × 1) surface decorated with isolated VO clusters using ultrahigh-vacuum scanning tunneling microscopy (UHV-STM) and temperature-programmed desorption (TPD). Our STM images show that preadsorbed VO clusters on the TiO2 (110)-(1 × 1) surface induce the adsorption of H2O molecules at room temperature (RT). The adsorbed H2O molecules form strings of beads of H2O dimers bound to the 5-fold coordinated Ti atom (5c-Ti) rows and are anchored by VO. This RT adsorption is completely reversible and is unique to the VO-decorated TiO2 surface. TPD spectra reveal two new desorption states for VO stabilized H2O at 395 and 445 K, which is in sharp contrast to the desorption of water due to recombination of hydroxyl groups at 490 K from clean TiO2(110)-(1 × 1) surfaces. Density functional theory (DFT) calculations show that the binding energy of molecular H2O to the VO clusters on the TiO2 (110)-(1 × 1) surface is higher than binding to the bare surface by 0.42 eV, and the resulting H2O-VO-TiO2 (110) complex provides the anchor point for adsorption of the string of beads of H2O dimers.

Feasibility of Bilinear Mechanical Characterization of the Abdominal Aorta in a Hypertensive Mouse Model.

A change in elastin and collagen content is indicative of damage caused by hypertension, which changes the non-linear behavior of the vessel wall. This study was aimed at investigating the feasibility of monitoring the non-linear material behavior in an angiotensin II hypertensive mice model. Aortas from 13 hypertensive mice were imaged with pulse wave imaging (PWI) over 4 wk using a 40-MHz linear array. The pulse wave velocity was estimated using two wave features: (i) the maximum axial acceleration of the foot (PWVdia) and (ii) the maximum axial acceleration of the dicrotic notch (PWVend-sys). The Bramwell-Hill equation was used to derive the compliance at diastolic and end-systolic pressure. This study determined the potential of PWI in a hypertensive mouse model to image and quantify the non-linear material behavior in vivo. End-systolic compliance could differentiate between the sham and angiotensin II groups, whereas diastolic compliance could not, indicating that PWI can detect early collagen-dominated remodeling.

Feasibility of longitudinal monitoring of atherosclerosis with pulse wave imaging in a swine model.

Objective.Atherosclerosis is a vascular disease characterized by compositional and mechanical changes in the arterial walls that lead to a plaque buildup. Depending on its geometry and composition, a plaque can ruptured and cause stroke, ischemia or infarction. Pulse wave imaging (PWI) is an ultrasound-based technique developed to locally quantify the stiffness of arteries. This technique has shown promising results when applied to patients. The objective of this study is to assess the capability of PWI to monitor the disease progression in a swine model that mimics human pathology.Approach.The left common carotid of three hypercholesterolemic Wisconsin miniature swines, fed an atherogenic diet, was ligated. Ligated and contralateral carotids were imaged once a month over 9 months, at a high-frame-rate, with a 5-plane wave compounding sequence and a 5 MHz linear array. Each acquisition was repeated after probe repositioning to evaluate the reproducibility. Wall displacements were estimated from the beamformed RF-data and were arranged as spatiotemporal maps depicting the wave propagation. The pulse wave velocity (PWV) estimated by tracking the 50% upstroke of the wave was converted in compliance using the Bramwell-Hill model. At the termination of the experiment, the carotids were extracted for histology analysis.Main results.PWI was able to monitor the evolution of compliance in both carotids of the animals. Reproducibility was demonstrated as the difference of PWV between cardiac cycles was similar to the difference between acquisitions (9.04% versus 9.91%). The plaque components were similar to the ones usually observed in patients. Each animal presented a unique pattern of compliance progression, which was confirmed by the plaque composition observed histologically.Significance.This study provides important insights on the vascular wall stiffness progression in an atherosclerotic swine model. It therefore paves the way for a thorough longitudinal study that examines the role of stiffness in both the plaque formation and plaque progression.

Pulse Wave Imaging Coupled With Vector Flow Mapping: A Phantom, Simulation, and In Vivo Study.

Pulse wave imaging (PWI) is an ultrasound imaging modality that estimates the wall stiffness of an imaged arterial segment by tracking the pulse wave propagation. The aim of the present study is to integrate PWI with vector flow imaging, enabling simultaneous and co-localized mapping of vessel wall mechanical properties and 2-D flow patterns. Two vector flow imaging techniques were implemented using the PWI acquisition sequence: 1) multiangle vector Doppler and 2) a cross-correlation-based vector flow imaging (CC VFI) method. The two vector flow imaging techniques were evaluated in vitro using a vessel phantom with an embedded plaque, along with spatially registered fluid structure interaction (FSI) simulations with the same geometry and inlet flow as the phantom setup. The flow magnitude and vector direction obtained through simulations and phantom experiments were compared in a prestenotic and stenotic segment of the phantom and at five different time frames. In most comparisons, CC VFI provided significantly lower bias or precision than the vector Doppler method ( ) indicating better performance. In addition, the proposed technique was applied to the carotid arteries of nonatherosclerotic subjects of different ages to investigate the relationship between PWI-derived compliance of the arterial wall and flow velocity in vivo. Spearman's rank-order test revealed positive correlation between compliance and peak flow velocity magnitude ( rs = 0.90 and ), while significantly lower compliance ( ) and lower peak flow velocity magnitude ( ) were determined in older (54-73 y.o.) compared with young (24-32 y.o.) subjects. Finally, initial feasibility was shown in an atherosclerotic common carotid artery in vivo. The proposed imaging modality successfully provided information on blood flow patterns and arterial wall stiffness and is expected to provide additional insight in studying carotid artery biomechanics, as well as aid in carotid artery disease diagnosis and monitoring.

Pulse Wave Imaging in Carotid Artery Stenosis Human Patients in Vivo.

Carotid stenosis involves narrowing of the lumen in the carotid artery potentially leading to a stroke, which is the third leading cause of death in the United States. Several recent investigations have found that plaque structure and composition may represent a more direct biomarker of plaque rupture risk compared with the degree of stenosis. In this study, pulse wave imaging was applied in 111 (n = 11, N = 13 plaques) patients diagnosed with moderate (>50%) to severe (>80%) carotid artery stenosis to investigate the feasibility of characterizing plaque properties based on the pulse wave-induced arterial wall dynamics captured by pulse wave imaging. Five (n = 5 patients, N = 20 measurements) healthy volunteers were also imaged as a control group. Both conventional and high-frame-rate plane wave radiofrequency imaging sequences were used to generate piecewise maps of the pulse wave velocity (PWV) at a single depth along stenotic carotid segments, as well as intra-plaque PWV mapping at multiple depths. Intra-plaque cumulative displacement and strain maps were also calculated for each plaque region. The Bramwell-Hill equation was used to estimate the compliance of the plaque regions based on the PWV and diameter. Qualitatively, wave convergence, elevated PWV and decreased cumulative displacement around and/or within regions of atherosclerotic plaque were observed and may serve as biomarkers for plaque characterization. Intra-plaque mapping revealed the potential to capture wave reflections between calcified inclusions and differentiate stable (i.e., calcified) from vulnerable (i.e., lipid) plaque components based on the intra-plaque PWV and cumulative strain. Quantitatively, one-way analysis of variance indicated that the pulse wave-induced cumulative strain was significantly lower (p < 0.01) in the moderately and severely calcified plaques compared with the normal controls. As expected, compliance was also significantly lower in the severely calcified plaques regions compared with the normal controls (p < 0.01). The results from this pilot study indicated the potential of pulse wave imaging coupled with strain imaging to differentiate plaques of varying stiffness, location and composition. Such findings may serve as valuable information to compensate for the limitations of currently used methods for the assessment of stroke risk.

Development of an ion mobility quadrupole time of flight mass spectrometer.

We describe here a new ion mobility capable mass spectrometer which comprises a drift cell for mobility separation and a quadrapole time of flight mass spectrometer for mass analysis--the MoQTOF. A commercial QToF instrument (Micromass UK Ltd., Manchester, UK) has been modified by the inclusion of an additional chamber containing a drift cell and ancillary ion optics. The drift cell is 5.1 cm long made from a copper block and is mounted from a top hat flange in a chamber situated post source optics and prior to the quadapole analyzer. Details of this instrument are provided along with information about how it can be used to acquire mobilities of ions along with their mass to charge ratios. The MoQTOF is used to examine conformations of a series of antimicrobial peptides based on a beta-defensin template. In vivo, these cationic cystine-rich amphiphilic peptides are conformationally restrained by three or more disulfide bridges, although recent findings by several groups have cast doubt on the importance of canonical disulfide pairing to antimicrobial activities. By synthesizing a panel of variants to Defb14 (the murine orthologue of HBD3), we exploit ion mobility to distinguish conformational differences which arise due to disulfide formation and to the hydrophobicity of the peptide sequence. Our gas-phase results are interpreted in terms of the antimicrobial and chemotacic properties of beta-defensins, and this mass spectrometry based approach to discern structure may have a role in future design of novel antibiotics.

Pinning mononuclear Au on the surface of titania.

We have deposited Au atoms on the surface of titania without sintering or surface damage. Mass-selected Au+ atoms were deposited from the gas phase at room temperature with kinetic energies from <3 to 190+/-3.5 eV. Scanning tunneling microscopy reveals island formation following deposition at <3 eV, while mainly atomic features are observed for energies between approximately 35 and approximately 190 eV. A mixture of islands and atomic features is observed at a landing energy of 20+/-3.5 eV, suggesting a critical energy above which pinning occurs. Cluster size is also probed as a function of coverage in the deposition of Au+ with 100 eV of energy, revealing that sintering begins at a coverage of only 0.06 ML. These observations suggest a mechanism in which high-energy collision leads to the annealing of any impact-created surface damage and the pinning of Au atoms to the surface. We provide a new method of preparing isolated Au atoms on an oxide surface, which can serve as a platform for catalytic studies.

Probing the structure of gas-phase metallic clusters via ligation energetics: sequential addition of C2H4 to Agm+ (m=3-7).

A new method that utilizes ligation to probe geometries of clusters in the gas-phase has been developed. This technique bases structural assignments on thermodynamic quantities obtained for sequential ligand additions to a bare cluster. The information is obtained from temperature-dependent equilibrium data. This method is also sensitive to changes in bare cluster conformations that occur as a result of ligand addition, and the results can be fine-tuned by choosing ligands that appropriately adjust cluster-ligand binding energies.

Intact size-selected Au(n) clusters on a TiO2(110)-(1 x 1) surface at room temperature.

Experiments in which mass-selected gold clusters were deposited on a surface have found that the catalytic properties depend strongly on cluster size. However, these experiments have not established definitively that the clusters maintain their size after deposition. We report here work in which we deposit low kinetic energy, mass-selected Aun+ (n = 1-8) clusters on a rutile TiO2(1 x 1) surface and use ultrahigh vacuum scanning tunneling microscopy (UHV-STM) to determine their size and shape.

Pinning mass-selected Agn clusters on the TiO2(110)-1x1 surface via deposition at high kinetic energy.

We present the first scanning tunneling microscopy (STM) study of the deposition of mass-selected silver clusters (Ag(n),n=1, 2, 3) on a rutile TiO(2)(110)-1x1 surface at room temperature under hard-landing conditions. Under hard-landing conditions, only small features are observed on the surface in all cases without sintering or surface damage. This suggests that the high impact energy of the clusters mainly dissipates as thermal energy in the substrate, resulting in the recovery of any initial impact-induced surface damage and the formation of bound clusters on the surface near the impact point. STM images indicate that Ag(1) binds on the bridging oxygen rows twice as often as on the Ti rows. Density-functional Theory (DFT) calculations are consistent with Ag(1) binding at either bridging oxygen vacancies or with two adjacent bridging oxygen atoms in the same bridging oxygen row. STM images of Ag(2) and Ag(3) depositions indicate almost exclusive binding centered on the Ti-atom rows. DFT calculations suggest that the Ag(2) and Ag(3) clusters are bound between two bridging oxygen rows, which is consistent with the STM observations.

Landing of size-selected Agn+ clusters on single crystal TiO2 (110)-(1x1) surfaces at room temperature.

Mass-selected Ag(n) (+) (n=1,2,3) clusters with impact energy less than 2 eV per atom were deposited from the gas phase onto rutile titania (110)-(1x1) single crystal surfaces at room temperature and imaged using ultra-high vacuum scanning tunneling microscopy. Upon reaching the surface, Ag monomers sintered to form three-dimensional islands of approximately 50 atoms in size, with an average measured height of 7.5 A and diameter of 42 A. This suggests that the monomers are highly mobile on the titania surface at room temperature. Dimers also sintered to form large clusters upon deposition, approximately 30 atoms in size, with an average height of 6.2 A and diameter of 33 A. Clusters formed from monomer deposition appeared approximately three times more frequently at step edges than clusters formed from dimer deposition, indicating that the surface mobility of deposited monomers is higher than that of deposited dimers. In sharp contrast to the deposition of monomers and dimers, the deposition of trimers resulted in a high density of very small clusters on the order of a few atoms in size, indicative of intact trimers on the surface, implying that deposited trimers have very limited mobility on the surface at room temperature.

On the dissolution processes of Na2I+ and Na3I2+ with the association of water molecules: mechanistic and energetic details.

The sequential association energies for one through six water molecules clustering to Na(2)I(+), as well as one and two water molecules clustering to Na(3)I(2)(+), are measured. The association energies show a pairwise behavior, indicating a symmetric association of water molecules to the linear Na(2)I(+) and Na(3)I(2)(+) ions. This pairwise behavior is well reproduced by Density Functional Theory (DFT) calculations. DFT calculations also suggest that a significant separation of charge for the Na-I ion pair occurs when four or more water molecules cluster to a single sodium center. Two different solvent-separated ion pairs have been identified with the DFT calculations. Experiments also show that the dissolution processes, loss of a neutral NaI unit, occurs when six or more water molecules have been added to Na(2)I(+) cluster. However, one or two water molecules are able to detach an NaI unit from the Na(3)I(2)(+) cluster. The difference in solubility of the Na(2)I(+) and Na(3)I(2)(+) ions is due to the difference in the energies required to lose an NaI unit from these two species. The experiment also confirms that the loss of a neutral NaI unit, instead of an Na(+) ion, occurs during the dissolution processes of Na(3)I(2)(+). The microsolvation schemes proposed to explain our experimental observations are supported by DFT and phase space theory (PST) calculations.

Conformation and luminescence of isolated molecular semiconductor molecules.

In this article, we describe, for the first time, direct comparisons of the detailed structures of two small molecule organic semiconductors, oligo(phenylenvinylene) (OPV) molecules with chains of five and six phenyl rings (5R-OC(8)H(17) and 6R-OC(8)H(17)), respectively, and their luminescence properties on a single molecule level. Our data originate from a combination of two powerful diagnostic tools in physical chemistry: ion mobility and single molecule fluorescence spectroscopy. These techniques enable us to precisely determine the shapes of isolated molecules in the gas phase and to correlate these structures to the emission from single molecules supported on bare glass substrates. The principal structural uncertainty in OPVs is the (possible) presence and location of cis-vinylene linkages (cis-defects) in the oligomer. The results show that the structures observed in the gas phase are strongly correlated to the categories of molecules observed in the single molecule polarization anisotropy measurements with nearly identical distributions for the two OPV molecules studied. Each category is also characterized by the luminescence efficiency of the molecules in each class, providing a direct correlation between the luminescence efficiency and the shape of the molecule. This combination of techniques provides a level of information far beyond that obtained via any other analytical technique.