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1.
J Cardiovasc Magn Reson ; 23(1): 86, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34193197

RESUMO

BACKGROUND: Cardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2. The incidence of CMR abnormalities 1-3 months after recovery is over 50% in older adults and has ranged between 1 and 15% in college athletes. Abnormal cardiac biomarkers are common in adults, even during recovery. METHODS: We performed CMR imaging in a prospectively-recruited pediatric cohort recovered from COVID-19 and multisystem inflammatory syndrome in children (MIS-C). We obtained CMR data and serum biomarkers. We compared these results to age-matched control patients, imaged prior to the SARS-CoV-2 pandemic. RESULTS: CMR was performed in 17 children (13.9 years, all ≤ 18 years) and 29 age-matched control patients without SARS-CoV-2 infection. Cases were recruited with symptomatic COVID-19 (11/17, 65%) or MIS-C (6/17, 35%) and studied an average of 2 months after diagnosis. All COVID-19 patients had been symptomatic with fever (73%), vomiting/diarrhea (64%), or breathing difficulty (55%) during infection. Left ventricular and right ventricular ejection fractions were indistinguishable between cases and controls (p = 0.66 and 0.70, respectively). Mean native global T1, global T2 values and segmental T2 maximum values were also not statistically different from control patients (p ≥ 0.06 for each). NT-proBNP and troponin levels were normal in all children. CONCLUSIONS: Children prospectively recruited following SARS-CoV-2 infection had normal CMR and cardiac biomarker evaluations during mid-term recovery. Trial Registration Not applicable.


Assuntos
COVID-19/complicações , Coração/diagnóstico por imagem , Coração/fisiologia , Imageamento por Ressonância Magnética/métodos , Síndrome de Resposta Inflamatória Sistêmica/complicações , Adolescente , Biomarcadores/sangue , COVID-19/sangue , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica/sangue
2.
Wiad Lek ; 74(5): 1158-1163, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090283

RESUMO

OBJECTIVE: The aim: Studying the features of the structure and function of the heart in athletes and identifying the factors that influence the development of these changes. PATIENTS AND METHODS: Materials and methods: The study included 54 athletes, 29 men and 25 women. The ultrasound study was performed according to standard methods with determining the size of the main structures of the heart, indicators normalized to body surface area, height. RESULTS: Results: The heart of dilatation and hypertrophy of the left ventricular myocardium were found in 25.93% of the athletes. When comparing the diameter of the left ventricle of individual athletes with the average values of the norm, their excess was found in 94.44% of athletes. The Odds ratio (OR) of the relationship between left ventricle diameter (LVd) and time of the exercise less than 10 y was 16.13, time of the exercise less than 5 y - 0.17 (p <0.05). OR of increase LVd to age less than 20 years was 3.56 units (p <0.05). The ejection fraction was above the normative mean in 75.93%, as well as the ratio of the periods of filling of the ventricles. CONCLUSION: Conclusions: The most common sign of an athlete's heart development was left ventricular dilatation, which occurred at a rate of 25 percent. Age less than 20 years and the duration of sports activities from 5 to 10 years is associated with a higher frequency of the athlete's heart.


Assuntos
Cardiomegalia Induzida por Exercícios , Esportes , Adulto , Feminino , Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Ultrassonografia , Adulto Jovem
3.
Medicina (Kaunas) ; 57(5)2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-34066119

RESUMO

Muscular disorders are mainly characterized by progressive skeletal muscle weakness. There are several aspects that can be monitored, which are used to differentiate between the types of muscular disorders, ranging from the targeted muscle up to the mutated gene. An aspect that holds critical importance when managing muscular dystrophies is that most of them exhibit cardiac abnormalities. Therefore, cardiac imaging is an essential part of muscular disorder monitoring and management. In the first section of the review, several cardiac abnormalities are introduced; afterward, different muscular dystrophies' pathogenesis is presented. Not all muscular dystrophies necessarily present cardiac involvement; however, the ones that do are linked with the cardiac abnormalities described in the first section. Moreover, studies from the last 3 years on muscular disorders are presented alongside imaging techniques used to determine cardiac abnormalities.


Assuntos
Cardiopatias Congênitas , Distrofias Musculares , Coração/diagnóstico por imagem , Humanos , Músculos , Distrofias Musculares/diagnóstico
4.
Medicina (Kaunas) ; 57(5)2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34066957

RESUMO

Athlete's heart (AH) is the result of morphological and functional cardiac modifications due to long-lasting athletic training. Athletes can develop very marked structural myocardial changes, which may simulate or cover unknown cardiomyopathies. The differential diagnosis between AH and cardiomyopathy is necessary to prevent the risk of catastrophic events, such as sudden cardiac death, but it can be a challenging task. The improvement of the imaging modalities and the introduction of the new technologies in cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) can allow overcoming this challenge. Therefore, the radiologist, specialized in cardiac imaging, could have a pivotal role in the differential diagnosis between structural adaptative changes observed in the AH and pathological anomalies of cardiomyopathies. In this review, we summarize the main CMR and CCT techniques to evaluate the cardiac morphology, function, and tissue characterization, and we analyze the imaging features of the AH and the key differences with the main cardiomyopathies.


Assuntos
Cardiomegalia Induzida por Exercícios , Cardiomiopatia Hipertrófica , Atletas , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Morte Súbita Cardíaca , Diagnóstico Diferencial , Coração/diagnóstico por imagem , Humanos , Radiologistas
5.
Medicine (Baltimore) ; 100(23): e26304, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34115039

RESUMO

INTRODUCTION: Air embolism has the potential to be serious and fatal. In this paper, we report 3 cases of air embolism associated with endoscopic medical procedures in which the patients were treated with hyperbaric oxygen immediately after diagnosis by transesophageal echocardiography. In addition, we systematically review the risk factors for air embolism, clinical presentation, treatment, and the importance of early hyperbaric oxygen therapy efficacy after recognition of air embolism. PATIENT CONCERNS: We present 3 patients with varying degrees of air embolism during endoscopic procedures, one of which was fatal, with large amounts of gas visible in the right and left heart chambers and pulmonary artery, 1 showing right heart enlargement with increased pulmonary artery pressure and tricuspid regurgitation, and 1 showing only a small amount of gas images in the heart chambers. DIAGNOSES: Based on ETCO2 and transesophageal echocardiography (TEE), diagnoses of air embolism were made. INTERVENTIONS: The patients received symptomatic supportive therapy including CPR, 100% O2 ventilation, cerebral protection, hyperbaric oxygen therapy and rehabilitation. OUTCOMES: Air embolism can causes respiratory, circulatory and neurological dysfunction. After aggressive treatment, one of the 3 patients died, 1 had permanent visual impairment, and 1 recovered completely without comorbidities. CONCLUSIONS: While it is common for small amounts of air/air bubbles to enter the circulatory system during endoscopic procedures, life-threatening air embolism is rare. Air embolism can lead to serious consequences, including respiratory, circulatory, and neurological impairment. Therefore, early recognition of severe air embolism and prompt hyperbaric oxygen therapy are essential to avoid its serious complications.


Assuntos
Ecocardiografia Transesofagiana/métodos , Embolia Aérea , Endoscopia/efeitos adversos , Oxigenação Hiperbárica/métodos , Administração dos Cuidados ao Paciente/métodos , Adulto , Intervenção Médica Precoce/métodos , Embolia Aérea/diagnóstico , Embolia Aérea/etiologia , Embolia Aérea/fisiopatologia , Embolia Aérea/terapia , Endoscopia/métodos , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/diagnóstico por imagem , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
6.
Int J Mol Sci ; 22(11)2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34070781

RESUMO

Ischemic heart disease is one of the leading causes of deaths worldwide. A major hindrance to resolving this challenge lies in the mammalian hearts inability to regenerate after injury. In contrast, zebrafish retain a regenerative capacity of the heart throughout their lifetimes. Apex resection (AR) is a popular zebrafish model for studying heart regeneration, and entails resecting 10-20% of the heart in the apex region, whereafter the regeneration process is monitored until the heart is fully regenerated within 60 days. Despite this popularity, video tutorials describing this technique in detail are lacking. In this paper we visualize and describe the entire AR procedure including anaesthesia, surgery, and recovery. In addition, we show that the concentration and duration of anaesthesia are important parameters to consider, to balance sufficient levels of sedation and minimizing mortality. Moreover, we provide examples of how zebrafish heart regeneration can be assessed both in 2D (immunohistochemistry of heart sections) and 3D (analyses of whole, tissue cleared hearts using multiphoton imaging). In summary, this paper aims to aid beginners in establishing and conducting the AR model in their laboratory, but also to spur further interest in improving the model and its evaluation.


Assuntos
Anestesia em Procedimentos Cardíacos/métodos , Recursos Audiovisuais , Procedimentos Cirúrgicos Cardíacos/métodos , Coração/diagnóstico por imagem , Regeneração/fisiologia , Aminobenzoatos , Anestésicos , Animais , Técnicas de Imagem Cardíaca , Proliferação de Células , Humanos , Cinetocardiografia/métodos , Miócitos Cardíacos/citologia , Miócitos Cardíacos/fisiologia , Peixe-Zebra
7.
J Cardiovasc Magn Reson ; 23(1): 68, 2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-34107985

RESUMO

BACKGROUND: Early detection of myocardial involvement can be relevant in coronavirus disease 2019 (COVID-19) patients to timely target symptomatic treatment and decrease the occurrence of the cardiac sequelae of the infection. The aim of the present study was to assess the clinical value of cardiovascular magnetic resonance (CMR) in characterizing myocardial damage in active COVID-19 patients, through the correlation between qualitative and quantitative imaging biomarkers with clinical and laboratory evidence of myocardial injury. METHODS: In this retrospective observational cohort study, we enrolled 27 patients with diagnosis of active COVID-19 and suspected cardiac involvement, referred to our institution for CMR between March 2020 and January 2021. Clinical and laboratory characteristics, including high sensitivity troponin T (hs-cTnT), and CMR imaging data were obtained. Relationships between CMR parameters, clinical and laboratory findings were explored. Comparisons were made with age-, sex- and risk factor-matched control group of 27 individuals, including healthy controls and patients without other signs or history of myocardial disease, who underwent CMR examination between January 2020 and January 2021. RESULTS: The median (IQR) time interval between COVID-19 diagnosis and CMR examination was 20 (13.5-31.5) days. Hs-cTnT values were collected within 24 h prior to CMR and resulted abnormally increased in 18 patients (66.6%). A total of 20 cases (74%) presented tissue signal abnormalities, including increased myocardial native T1 (n = 11), myocardial T2 (n = 14) and extracellular volume fraction (ECV) (n = 10), late gadolinium enhancement (LGE) (n = 12) or pericardial enhancement (n = 2). A CMR diagnosis of myocarditis was established in 9 (33.3%), pericarditis in 2 (7.4%) and myocardial infarction with non-obstructive coronary arteries in 3 (11.11%) patients. T2 mapping values showed a moderate positive linear correlation with Hs-cTnT (r = 0.58; p = 0.002). A high degree positive linear correlation between ECV and Hs-cTnT was also found (r 0.77; p < 0.001). CONCLUSIONS: CMR allows in vivo recognition and characterization of myocardial damage in a cohort of selected COVID-19 individuals by means of a multiparametric scanning protocol including conventional imaging and T1-T2 mapping sequences. Abnormal T2 mapping was the most commonly abnormality observed in our cohort and positively correlated with hs-cTnT values, reflecting the predominant edematous changes characterizing the active phase of disease.


Assuntos
COVID-19/complicações , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Fatores Etários , Estudos de Coortes , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Fatores Sexuais
8.
Clin Imaging ; 76: 247-264, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33991744

RESUMO

As research continues to demonstrate successes in the use of percutaneous trans-vascular techniques in structural heart intervention, both the subspecialty trained and non-subspecialty trained cardiac imager find themselves performing and reporting larger amounts of information regarding cardiovascular findings. It is therefore imperative that the imager gains understanding and appreciation for how these various measurements are obtained, as well as their implication in a patient's care. Cardiac gated computed tomography (CT) has solidified its role and ability at providing high resolution images that can be used to obtain the key measurements used in structural heart intervention planning. This manuscript aims to provide an overview of what measurements are necessary to report when interpreting CT examinations purposed for structural heart intervention. This includes a review on indications and brief discussion on complications related to these procedures.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Tomografia Computadorizada por Raios X , Coração/diagnóstico por imagem , Humanos
9.
Toxicol Appl Pharmacol ; 423: 115575, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34000265

RESUMO

AIMS: IQOS is a novel tobacco product claimed to be safer than conventional cigarette smoking due to the heat-not-burn system. This study aimed to evaluate the acute effects of IQOS smoking on myocardial systolic and diastolic functions and also compare the acute impacts of IQOS with cigarette smoking. METHODS: In this prospective study, twenty-seven healthy participants who were using IQOS were included. Transthoracic echocardiography was performed three times for each participant; before smoking any tobacco product (group1), after IQOS smoking (group 2), after cigarette smoking (group3). In addition to conventional echocardiographic measurements, left ventricle (LV) and right ventricle (RV) strain analyses were performed by speckle tracking echocardiography. RESULTS: In comparison with non-smoking status, LV global longitudinal strain (GLS) decreased after IQOS and cigarette smoking (-18.9 ± 2.4% in baseline vs. -17.9 ± 2.4% in IQOS vs. -17.9 ± 2.8% in cigarette smoking; p = 0.003, p = 0.001; respectively). LV global circumferential strain (GCS) reduced after IQOS and cigarette smoking (-19.8 ± 4.4% in baseline vs. -18.3 ± 3.9% in IQOS vs. -17.5 ± 3.9% in cigarette smoking; p = 0.005, p < 0.001; respectively). RV GLS was significantly lower in groups smoking IQOS and cigarette (-23.2 ± 4.6% in baseline vs. -21.4 ± 4.1% in IQOS vs. -19.4 ± 4.1% in cigarette smoking; p < 0.001, p = 0.001; respectively). CONCLUSION: IQOS (heat-not-burn) tobacco smoking impairs myocardial systolic and diastolic functions in the acute phase like conventional cigarette smoking. The use of IQOS is rising among young adults in recent years, so further studies should be designed to evaluate the chronic effects of IQOS on myocardial function.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Fumar Cigarros/efeitos adversos , Ecocardiografia/métodos , Frequência Cardíaca/efeitos dos fármacos , Produtos do Tabaco/efeitos adversos , Adulto , Pressão Sanguínea/fisiologia , Feminino , Coração/diagnóstico por imagem , Coração/efeitos dos fármacos , Testes de Função Cardíaca/métodos , Frequência Cardíaca/fisiologia , Temperatura Alta/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
10.
Phys Med ; 83: 278-286, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33992865

RESUMO

PURPOSE: A radiomics features classifier was implemented to evaluate segmentation quality of heart structures. A robust feature set sensitive to incorrect contouring would provide an ideal quantitative index to drive autocontouring optimization. METHODS: Twenty-five cardiac sub-structures were contoured as regions of interest in 36 CTs. Radiomic features were extracted from manually-contoured (MC) and Hierarchical-Clustering automatic-contouring (AC) structures. A robust feature-set was identified from correctly contoured CT datasets. Features variation was analyzed over a MC/AC dataset. A supervised-learning approach was used to train an Artificial-Intelligence (AI) classifier; incorrect contouring cases were generated from the gold-standard MC datasets with translations, expansions and contractions. ROC curves and confusion matrices were used to evaluate the AI-classifier performance. RESULTS: Twenty radiomics features, were found to be robust across structures, showing a good/excellent intra-class correlation coefficient (ICC) index comparing MC/AC. A significant correlation was obtained with quantitative indexes (Dice-Index, Hausdorff-distance). The trained AI-classifier detected correct contours (CC) and not correct contours (NCC) with an accuracy of 82.6% and AUC of 0.91. True positive rate (TPR) was 85.1% and 81.3% for CC and NCC. Detection of NCC at this point of the development still depended strongly on degree of contouring imperfection. CONCLUSIONS: A set of radiomics features, robust on "gold-standard" contour and sensitive to incorrect contouring was identified and implemented in an AI-workflow to quantify segmentation accuracy. This workflow permits an automatic assessment of segmentation quality and may accelerate expansion of an existing autocontouring atlas database as well as improve dosimetric analyses of large treatment plan databases.


Assuntos
Processamento de Imagem Assistida por Computador , Planejamento da Radioterapia Assistida por Computador , Coração/diagnóstico por imagem , Radiometria , Tomografia Computadorizada por Raios X
11.
Nat Med ; 27(5): 882-891, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33990806

RESUMO

Congenital heart disease (CHD) is the most common birth defect. Fetal screening ultrasound provides five views of the heart that together can detect 90% of complex CHD, but in practice, sensitivity is as low as 30%. Here, using 107,823 images from 1,326 retrospective echocardiograms and screening ultrasounds from 18- to 24-week fetuses, we trained an ensemble of neural networks to identify recommended cardiac views and distinguish between normal hearts and complex CHD. We also used segmentation models to calculate standard fetal cardiothoracic measurements. In an internal test set of 4,108 fetal surveys (0.9% CHD, >4.4 million images), the model achieved an area under the curve (AUC) of 0.99, 95% sensitivity (95% confidence interval (CI), 84-99%), 96% specificity (95% CI, 95-97%) and 100% negative predictive value in distinguishing normal from abnormal hearts. Model sensitivity was comparable to that of clinicians and remained robust on outside-hospital and lower-quality images. The model's decisions were based on clinically relevant features. Cardiac measurements correlated with reported measures for normal and abnormal hearts. Applied to guideline-recommended imaging, ensemble learning models could significantly improve detection of fetal CHD, a critical and global diagnostic challenge.


Assuntos
Ecocardiografia Tridimensional/métodos , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/patologia , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Biometria , Feminino , Feto/anormalidades , Feto/diagnóstico por imagem , Coração/diagnóstico por imagem , Humanos , Programas de Rastreamento/métodos , Miocárdio/patologia , Redes Neurais de Computação , Gravidez , Segundo Trimestre da Gravidez , Sensibilidade e Especificidade , Tórax/diagnóstico por imagem , Adulto Jovem
12.
Geriatr Gerontol Int ; 21(7): 577-583, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34008321

RESUMO

AIM: Heart failure is increasing in Japan, in particular that with preserved ejection fraction (HFpEF) prevalent in older-aged patients. The purpose of this study was to investigate the pathophysiology during the early stage of left ventricular (LV) diastolic dysfunction by the quantitative proteome analysis of human myocardium. METHODS: Among 331 post-mortem autopsy patients, we selected 23 patients (aged 79 ± 9.6 years) with echocardiographic data and without major comorbidities, except hypertension. Cryopreserved autopsy tissue of the LV myocardium was subjected to proteome analysis. LV diastolic function was evaluated by echocardiographic data. Thirteen patients were classified into the impaired diastolic function (IDF) group, and 10 the normal cardiac function group. We performed comparative proteome analysis between the IDF and normal groups by isobaric tags for relative and absolute quantitation (iTRAQ) using nano-liquid chromatography-tandem mass spectrometry. RESULTS: The iTRAQ-based proteome analysis revealed 57 differentially expressed proteins in the IDF group. Molecular network analysis of differentially expressed proteins indicated that endoplasmic reticulum (ER) stress was a potentially important event. Furthermore, the expressions of proteins associated with the ER stress response, such as glucose-regulated protein 78 kDa, inositol-requiring kinase 1α and spliced X-box binding protein 1, were significantly decreased in the IDF group. CONCLUSIONS: This study suggested that reduced ER stress responses were involved during the early stage of LV diastolic dysfunction. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; 21: 577-583.


Assuntos
Estresse do Retículo Endoplasmático , Insuficiência Cardíaca , Coração/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda/fisiologia , Idoso , Ecocardiografia , Feminino , Humanos , Japão , Masculino , Miocárdio , Proteoma , Volume Sistólico
13.
Med Image Anal ; 71: 102078, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33957557

RESUMO

Unsupervised domain adaptation (UDA) generally learns a mapping to align the distribution of the source domain and target domain. The learned mapping can boost the performance of the model on the target data, of which the labels are unavailable for model training. Previous UDA methods mainly focus on domain-invariant features (DIFs) without considering the domain-specific features (DSFs), which could be used as complementary information to constrain the model. In this work, we propose a new UDA framework for cross-modality image segmentation. The framework first disentangles each domain into the DIFs and DSFs. To enhance the representation of DIFs, self-attention modules are used in the encoder which allows attention-driven, long-range dependency modeling for image generation tasks. Furthermore, a zero loss is minimized to enforce the information of target (source) DSFs, contained in the source (target) images, to be as close to zero as possible. These features are then iteratively decoded and encoded twice to maintain the consistency of the anatomical structure. To improve the quality of the generated images and segmentation results, several discriminators are introduced for adversarial learning. Finally, with the source data and their DIFs, we train a segmentation network, which can be applicable to target images. We validated the proposed framework for cross-modality cardiac segmentation using two public datasets, and the results showed our method delivered promising performance and compared favorably to state-of-the-art approaches in terms of segmentation accuracies. The source code of this work will be released via https://zmiclab.github.io/projects.html, once this manuscript is accepted for publication.


Assuntos
Coração , Coração/diagnóstico por imagem , Humanos
14.
J Vis Exp ; (170)2021 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-33938885

RESUMO

The development of heart failure is the most powerful predictor of long-term mortality in patients surviving acute myocardial infarction (MI). There is an unmet clinical need for prevention and therapy of post-myocardial infarction heart failure (post-MI HF). Clinically relevant pig models of post-MI HF are prerequisites for final proof-of-concept studies before entering into clinical trials in drug and medical device development. Here we aimed to characterize a closed-chest porcine model of post-MI HF in adult Göttingen minipigs with long-term follow-up including serial cardiac magnetic resonance imaging (CMRI) and to compare it with the commonly used Landrace pig model. MI was induced by intraluminal balloon occlusion of the left anterior descending coronary artery for 120 min in Göttingen minipigs and for 90 min in Landrace pigs, followed by reperfusion. CMRI was performed to assess cardiac morphology and function at baseline in both breeds and at 3 and 6 months in Göttingen minipigs and at 2 months in Landrace pigs, respectively. Scar sizes were comparable in the two breeds, but MI resulted in a significant decrease of left ventricular ejection fraction (LVEF) only in Göttingen minipigs, while Landrace pigs did not show a reduction of LVEF. Right ventricular (RV) ejection fraction increased in both breeds despite the negligible RV scar sizes. In contrast to the significant increase of left ventricular end-diastolic (LVED) mass in Landrace pigs at 2 months, Göttingen minipigs showed a slight increase in LVED mass only at 6 months. In summary, this is the first characterization of post-MI HF in Göttingen minipigs in comparison to Landrace pigs, showing that the Göttingen minipig model reflects post-MI HF parameters comparable to the human pathology. We conclude that the Göttingen minipig model is superior to the Landrace pig model to study the development of post-MI HF.


Assuntos
Modelos Animais de Doenças , Insuficiência Cardíaca/etiologia , Infarto do Miocárdio/complicações , Animais , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/fisiopatologia , Feminino , Coração/diagnóstico por imagem , Coração/fisiopatologia , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/fisiopatologia , Imageamento por Ressonância Magnética , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/fisiopatologia , Reperfusão Miocárdica , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Suínos , Porco Miniatura , Função Ventricular Esquerda
15.
Comput Methods Programs Biomed ; 206: 106142, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34004500

RESUMO

BACKGROUND AND OBJECTIVE: Automatic cardiac segmentation plays an utmost role in the diagnosis and quantification of cardiovascular diseases. METHODS: This paper proposes a new cardiac segmentation method in short-axis Magnetic Resonance Imaging (MRI) images, called attention U-Net architecture with input image pyramid and deep supervised output layers (AID), which can fully-automatically learn to pay attention to target structures of various sizes and shapes. During each training process, the model continues to learn how to emphasize the desired features and suppress irrelevant areas in the original images, effectively improving the accuracy of cardiac segmentation. At the same time, we introduce the Focal Tversky Loss (FTL), which can effectively solve the problem of high imbalance in the amount of data between the target class and the background class during cardiac image segmentation. In order to obtain a better representation of intermediate features, we add a multi-scale input pyramid to the attention network. RESULTS: The proposed cardiac segmentation technique is tested on the public Left Ventricle Segmentation Challenge (LVSC) dataset, which is shown to achieve 0.75, 0.87 and 0.92 for Jaccard Index, Sensitivity and Specificity, respectively. Experimental results demonstrate that the proposed method is able to improve the segmentation accuracy compared with the standard U-Net, and achieves comparable performance to the most advanced fully-automated methods. CONCLUSIONS: Given its effectiveness and advantages, the proposed method can facilitate cardiac segmentation in short-axis MRI images in clinical practice.


Assuntos
Imagem Cinética por Ressonância Magnética , Redes Neurais de Computação , Coração/diagnóstico por imagem , Ventrículos do Coração , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética
16.
Pan Afr Med J ; 38: 45, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854674

RESUMO

Introduction: our aim was to investigate the value of conventional echocardiography, pulsed Doppler and speckle tracking imaging (STI) analysis in the assessment of the left ventricular (LV) myocardial function in hemodialysis (HD) patients with preserved LV ejection fraction and to evaluate the effect of a single HD session on the LV systolic and diastolic functions. Methods: the study population consisted of 30 chronic HD patients. Echocardiography and Doppler studies were performed before and after HD. The LV global longitudinal, circumferential and radial strains were measured with two and three-dimensional STI. Results: after HD, LV dimensions, left atrium (LA) area, systolic pulmonary arterial pressure and inferior vena cava diameter decreased significantly. The peak mitral E velocity, the E/A ratio of the mitral inflow and the lateral E/E´ ratio decreased also significantly. The LV and LA volumes index and LV mass index (LVMi) decreased remarkably after HD. The 3D- LV and LA ejection fractions were unchanged after HD. Although, 3D-estimated LVEF seemed to be preserved in the HD patients, the 2D and 3D- strain rates were decreased in all directions. The global strain values improved in all directions after a single HD session. Inverse correlations were found between the LVMi, serum BNP and LV global longitudinal strain. Conclusion: in HD patients with preserved LV ejection fraction, the STI analysis may add important information concerning the subclinical LV dysfunction.


Assuntos
Ecocardiografia/métodos , Diálise Renal , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda/fisiologia , Adulto , Ecocardiografia Doppler , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/terapia , Volume Sistólico
17.
Nutrients ; 13(4)2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33924572

RESUMO

Subclinical effects of coffee consumption (CC) with regard to metabolic, cardiac, and neurological complications were evaluated using a whole-body magnetic resonance imaging (MRI) protocol. A blended approach was used to estimate habitual CC in a population-based study cohort without a history of cardiovascular disease. Associations of CC with MRI markers of gray matter volume, white matter hyperintensities, cerebral microhemorrhages, total and visceral adipose tissue (VAT), hepatic proton density fat fraction, early/late diastolic filling rate, end-diastolic/-systolic and stroke volume, ejection fraction, peak ejection rate, and myocardial mass were evaluated by linear regression. In our analysis with 132 women and 168 men, CC was positively associated with MR-based cardiac function parameters including late diastolic filling rate, stroke volume (p < 0.01 each), and ejection fraction (p < 0.05) when adjusting for age, sex, smoking, hypertension, diabetes, Low-density lipoprotein (LDL), triglycerides, cholesterol, and alcohol consumption. CC was inversely associated with VAT independent of demographic variables and cardiovascular risk factors (p < 0.05), but this association did not remain significant after additional adjustment for alcohol consumption. CC was not significantly associated with potential neurodegeneration. We found a significant positive and independent association between CC and MRI-based systolic and diastolic cardiac function. CC was also inversely associated with VAT but not independent of alcohol consumption.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Doenças Cardiovasculares/epidemiologia , Ingestão de Líquidos/fisiologia , Doenças Neurodegenerativas/epidemiologia , Adiposidade/fisiologia , Idoso , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Café , Feminino , Seguimentos , Alemanha/epidemiologia , Coração/diagnóstico por imagem , Coração/fisiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/fisiologia , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/fisiopatologia , Doenças Neurodegenerativas/prevenção & controle , Fatores de Proteção , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Imagem Corporal Total/métodos
18.
Comput Methods Programs Biomed ; 205: 106085, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33878531

RESUMO

BACKGROUND AND OBJECTIVE: Non-rigid image registration is a well-established method for estimating cardiac motion on 3D echocardiographic images. However, such images have relatively poor spatio-temporal resolution making registration challenging. Some of the main challenges are extracting features relevant to the registration problem and defining a suitable geometrical transformation to be applied. The latter can be tackled using a fuzzy inference system considering its potential in transformation modeling. From this point of view, feature-based image registration can be considered an identification problem in which the transformation parameters are computed through an optimization process. This study, thus, aims to estimate cardiac motion on 3D echocardiographic images based on feature-based non-rigid image registration through sets of modified fuzzy rules. METHODS: The 3D volume features were extracted with the popular scale-invariant feature transform (SIFT) descriptors in 3D space. Sets of fuzzy rules were generated according to the extracted features to register every two consecutive frames. Finally, some supplementary rules modified the registration rule for estimating cardiac motion. RESULTS: Applying the fuzzy feature-based inference system on the STRAUS synthetic database showed the proposed method to be competitive with other well-established registration algorithms in terms of tracking error and accuracy of strain estimates. The proposed algorithm yielded a tracking error of 1 mm and a relative circumferential strain error of 0.82±4.69%. In addition, the potential of the proposed algorithm for clinical applications was confirmed by evaluating its performance on an in-vivo database called CETUS. CONCLUSION: This paper proposes a novel registration method based on fuzzy logic which was shown to enable tracking complex cardiac deformations in 3D echocardiographic images with high accuracy.


Assuntos
Algoritmos , Imageamento Tridimensional , Ecocardiografia , Lógica Fuzzy , Coração/diagnóstico por imagem , Movimento (Física)
19.
Rheumatol Int ; 41(6): 1037-1044, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33864498

RESUMO

Multisystem Inflammatory Syndrome in Children (MIS-C) recently reported in a minority of children affected by SARS-CoV-2, mimics Kawasaki disease (KD), a medium vessel vasculitis of unknown cause. In contrast to acute COVID-19 infection, which is usually mild in children, 68% of patients with MIS-C will need intensive care unit. Myocarditis and coronary artery ectasia/aneurysm are included between the main cardiovascular complications in MIS-C. Therefore, close clinical assessment is need it both at diagnosis and during follow-up. Echocardiography is the cornerstone modality for myocardial function and coronary artery evaluation in the acute phase. Cardiovascular magnetic resonance (CMR) detects diffuse myocardial inflammation including oedema/fibrosis, myocardial perfusion and coronary arteries anatomy during the convalescence and in adolescents, where echocardiography may provide inadequate images. Brain involvement in MIS-C is less frequent compared to cardiovascular disease. However, it is not unusual and should be monitored by clinical evaluation and brain magnetic resonance (MRI), as we still do not know its effect in brain development. Brain MRI in MIS-C shows T2-hyperintense lesions associated with restricted diffusion and bilateral thalamic lesions. To conclude, MIS-C is a multisystem disease affecting many vital organs, such as heart and brain. Clinical awareness, application of innovative, high technology imaging modalities and advanced treatment protocols including supportive and anti-inflammatory medication will help physicians to prevent the dreadful complications of MIS-C.


Assuntos
Encéfalo/diagnóstico por imagem , COVID-19/diagnóstico , Coração/diagnóstico por imagem , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Adolescente , COVID-19/fisiopatologia , Criança , Pré-Escolar , Angiografia Coronária , Ecocardiografia , Eletrocardiografia , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Neuroimagem , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia
20.
Vet J ; 271: 105653, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33840484

RESUMO

Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia.


Assuntos
Ecocardiografia/veterinária , Coração/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Sístole/fisiologia , Função Ventricular Direita/fisiologia , Anestesia/veterinária , Animais , Cães , Feminino , Masculino
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