Imaging of human aortic atherosclerotic plaques by polarization-sensitive optical coherence tomography.

Optical coherence tomography (OCT) is analogous to ultrasound imaging except that it uses infrared light instead of sound. Polarization-sensitive optical coherence tomography (PS-OCT) combines the advantages of OCT and provides additional image contrast of the tested sample. We demonstrate this technique for imaging of back-reflected light, birefringence, and fast-axis orientation simultaneously in different kinds of atherosclerosis plaque. This in vitro study suggests birefringence changes in plaque are due to the prominent deposition of collagen or cholesterol by correlating PS-OCT images with histology. Thus the combination of high resolution structural imaging and birefringence detection make PS-OCT a potentially powerful tool for early assessment of atherosclerosis appearance and prediction of plaque rupture.

Development of a totally implantable pulsatile centrifugal pump as a ventricular assist device.

The Taita No. 1 ventricular assist device (T-VAD) is a totally implantable pulsatile impeller centrifugal pump driven by a magnetically suspended motor. The flow can achieve 2.01 +/- 0.17 L/min against a pressure of 100 mm Hg under 0.266 +/- 0.017 amp and 13.55 +/- 0.41 voltage. The speed was around 3,500 rpm. It consumed less than 6 W of power, resulting in less heat production and mechanical bearing complications. The impeller vane was designed to have both radial and axial curves according to the stream surface and stream lines to reduce thrombosis and hemolysis. Eight calves weighing 80 to 100 kg (mean 87 +/- 12 kg) were used for experiments. With the calves under general anesthesia, left posterolateral thoracotomy was performed to connect the inflow tube with the atrial appendage and to anastomose the outflow tube with the descending aorta. The calves usually awoke and stood up within hours after discontinuation of anesthetics. The mean survival of the calves was 75 +/- 42 days (range 33-148 days). The terminations of experiments were mainly due to infection. During the course of pumping, no significant deterioration of liver or renal function was noted. The evaluation of serum samples from the implanted calves indicated that hemolysis was not associated with use of the T-VAD. The average daily free hemoglobin level was 8.08 +/- 3.05 mg/dl, which was less than the set limit of 20 mg/dl. The red blood cell and platelet count and hemoglobin of implanted animals were within the normal range. In our results, the T-VAD provided competent pulsatile function without severe blood damage or organ dysfunction.

Physiologic analysis of cardiac cycle in an implantable impeller centrifugal left ventricular assist device.

The purpose of this study was to determine the physiologic relationship between the cardiac cycle and the nonpulsatile impeller centrifugal Taita No.1 left ventricular assist device (T-LVAD) in a chronic animal study. The relationship of the cardiac cycle, pump flow, aortic pressure, left ventricle pressure, and pump power were analyzed by 5 phases in 4 stages. The isovolumetric ventricular phase is from mitral valve closure (MVC) to aortic valve opening (AVO) and is called Stage 1. The ejection phase is from AVO to aortic valve closure (AVC) and is called Stage 2. The isovolumetric relaxation phase is from AVC to MVC and is called Stage 3. The passive filling and atrial contraction phase is from MVC to mitral valve opening (MVO) and called Stage 4. Based on evidence from the physiologic volume change of the left ventricle, the change of pump flow of the T-LVAD in a cardiac cycle by variable voltages of pump control was evaluated using animal models. After left posteriolateral thoracotomy via the fifth intercostal space under general anesthesia, the nonpulsatile centrifugal T-LVAD was implanted into 2 healthy calves. The inflow of the T-LVAD was inserted into the left ventricle through the mitral valve via the left atrial appendage. The arterial blood pressure waveform was measured and recorded on the outflow of the T-LVAD. The 4 phases of a cardiac cycle were defined as MVC-AVO (Stage 1), AVO-AVC (Stage 2), AVC-MVO (Stage 3) and MVC-MVO (Stage 4) according to the outflow pressure of the outflow of the T-LVAD and differential pressure between the outflow and inflow of the T-LVAD. We carried out the real-time waveform measurement for electrocardiogram, the outflow pressure, the T-LVAD flow and the speed, as well as open loop and constant voltage (V). In a cardiac cycle, the sensing current of the T-LVAD was inverse to the speed. The flow of the T-LVAD at the 4 stages was measured individually and analyzed with different control voltages from 10 to 18 V. The highest flow ratio of MVC-AVC/AVC-MVC was noted when the T-LVAD worked on 14 V. By using analysis methodology of the flow ratio of a cardiac cycle, the optimal physiologically effective control of the T-LVAD might be achieved.

Heritability estimate of hypertrophic cardiomyopathy in pigs (Sus scrofa domestica).

The purpose of this study was to evaluate the heritability of hypertrophic cardiomyopathy (HCM) in pigs and the relation between HCM and heart measurements, pathologic features, and growth to provide references for HCM line development. A total of 353 on-farm tested gilts (females) and boars (males) from 74 sire families were randomly selected from a single breeding farm where HCM was prevalent. Hearts were collected after animals were slaughtered. Heart length, width, and weight, heart-to-body weight ratio, and thickness of the cranial, middle, and caudal portions of the ventricular septum, left and right ventricles, and apex were measured. Cardiac hypertrophy and myocyte disorganization, myocardial and endocardial fibrosis, and intramural coronary arterial occlusion were used as criteria for HCM. Growth traits were evaluated from average daily body weight gain, ultrasonically determined backfat thickness, loin-eye area, and performance selection index. Heritability of the disease was estimated by treating it as a threshold trait. The prevalence of HCM in three studied breeds was 5.26 in Duroc, 22.98 in Landrace, and 5.56% in Yorkshire pigs. The value in Landrace pigs was significantly (P < 0.001) higher than that in the other pigs. There was no significant difference between sexes. In general the heart of pigs with HCM was heavier, wider, longer, and thicker than that of clinically normal pigs. Backfat was the only growth trait with a difference (P < 0.05) among pig breeds. The HCM pigs were leaner than normal pigs. Leaner pigs may have a higher risk of HCM. Heritability of HCM was > 0.30 for all three breeds, but the standard errors of these estimates were high because of limited sample size, in particular for the Yorkshire and Duroc breeds. The preliminary results of this study indicate that HCM in pigs is moderately heritable; thus development of a high-HCM incidence line by selection is possible.

Hypertrophic cardiomyopathy in pigs: quantitative pathologic features in 55 cases.

naturally occurring hypertrophic cardiomyopathy (HCM) was diagnosed in 55 purebred pigs 6 to 12 months of age. Ten (18%) of the pigs died suddenly during auction or shipment or were found dead by their keepers. The other 45 pigs failed to meet the criteria for brediing stock. Forty-six purebred and 64 hybrid pigs were studied for control. Heart weights were significantly heavier (p < 0.001) in the pigs with HCM (473.5 ± 31.8 g; heart weight [HW]/body weight [BW] ratio 4.6 ± 0.7) than in the purebred (334.4 ± 29.7 g; HW/BW 3.4 ± 0.3) and hybrid (344.3 ± 28.9 g; HW/BW 3.4 ± 0.1) pigs without HCM. The ventricular septum (VS) in the 55 pigs with HCM was significantly thicker (26.0 ± 3.1 mm; p < 0.001) than in the purebred (19.6 ± 2.6 mm) and hybrid (14.1 ± 0.5 mm) pigs without HCM. The left ventricular free wall (LV) was significantly thicker (p < 0.001) in the pigs with HCM (20.0 ± 2.7 mm) than in the purebred (18.1 ± 2.1 mm) and hybrid (15.6 ± 0.3 mm) pigs without HCM. Asymmetric septal hypertrophy was evident because the ratio of VS to LV was significantly greater (p < 0.001) in the pigs with HCM (1.3 ± 0.2) than in the purebred (1.0 ± 0.2) and hybrid (0.9 ± 0.01) pigs without HCM. The anterior portion of the VS appeared to bulge into and impinge upon the left ventricular outflow tract, in which a fibrotic endocardial plaque was often seen. Histologic features included marked muscle cell disorganization in the VS, LV, right ventricular free wall. Abnormal intramural coronary arteries and myocardial fibrosis were seen in most pigs with HCM. Silver impregnation stains showed that there were marked increases in perimysial coils, pericellular weaves, and cell-to-cell struts. Matrix disorientation was evident in the hearts with HCM. Quantitation revealed that the collagen protein in the hearts with HCM (23.8 ± 2.8 µg/mg protein) was significantly higher (p < 0.001) than in the hearts of purebred (15.7 ± 1.8 µg/mg protein) and hybrid (13.9 ± 4.2 µg/m pprotein) pigs without HCM. Total muscle protein in the hearts of the purebred pigs with (51.6 ± 3.3 mg) and without (51.9 ± 3.0 mg) HCM was not different; however, in hearts with HCM (51.6 ± 3.3 mg) it was significantly higher (p < 0.001) than in those of hybrid pigs (47.6 ± 4.4 mg) without HCM. There was 47% to 52% more stainable collagen in the heart with HCM (44.7 ± 5.2 µg collagen/mg protein) than in the purebred (30.3 ± 4.0 µg collagen/mg protein) and hybrid (28.3 ± 8.1 µg collagen/mg protein) hearts without HCM. Gross and histologic features and connective tissue abnormalities in the pigs with HCM were strikingly similar to those in humans, cats, and dogs with HCM. Thus we conclude that spontaneous porcine HCM presents a new and important model for the cardiovascular investigator.