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The aim of this study was to validate carotid artery strain assessment in-vivo using ultrasound speckle tracking. The left carotid artery of five sheep was exposed and sonomicrometry crystals were sutured onto the artery wall to obtain reference strain. Ultrasound imaging was performed at baseline and stress, followed by strain estimation using an in-house speckle tracking algorithm tuned for vascular applications. The correlation between estimated and reference strain was r = 0.95 (p < 0.001) and r = 0.87 (p < 0.01) for longitudinal and circumferential strain, respectively. Moreover, acceptable limits of agreement were found in Bland-Altman analysis (longitudinally: -0.15 to 0.42%, circumferentially: -0.54 to 0.50%), which demonstrates the feasibility of estimating carotid artery strain using ultrasound speckle tracking. However, further studies are needed to test the algorithm on human in-vivo data and to investigate its potential to detect subclinical cardiovascular disease and characterize atherosclerotic plaques., QC 20150210

OBJECTIVE: To assess midterm (3 years) clinical outcomes of transcatheter aortic valve implantation (TAVI) in Belgium using the Edwards SAPIEN valve or the Medtronic CoreValve transcatheter heart valve (THV). BACKGROUND: Medium and long term follow-up data of both THVs are still relatively scarce, although of great clinical relevance for a relatively new but rapidly expanding treatment modality. Therefore, reporting mid- and long term clinical outcome data, coming from large "real world" national registries, remains contributive. METHODS: Between December 2007 and March 2012, 861 "real world" patients who were not candidates for surgical aortic valve replacement as decided by the local heart teams, underwent TAVI at 23 sites. Eleven sites exclusively used SAPIEN THV (n = 460), while 12 exclusively used CoreValve THV (n = 401). Differences in clinical outcomes by valve system were assessed, according to access route and baseline EuroSCORE risk profile (<10%: low, 10-20%: intermediate and >20%: high risk).RESULTS: Overall cumulative survival at 3 years was 51% for SAPIEN vs. 60% for CoreValve (P = 0.021). In transfemorally treated patients, SAPIEN and CoreValve had similar survival at 3 years for each of the baseline EuroSCORE cohorts (low risk: 72% vs. 76%, P = 0.45; intermediate risk: 62% vs. 59%, P = 0.94; high risk: 48% vs. 53%, P = 0.65). CONCLUSION: Cumulative midterm 3 year survival after transfemoral TAVI in "real world" patients refused for surgery with similar baseline EuroSCORE risk profile is not different between SAPIEN or CoreValve.

QC 20150909

Assessment of strain in the longitudinal direction of the arterial wall has been suggested to improve the evaluation of arterial stiffness and atherosclerosis. Recently, we showed the feasibility of ultrasound speckle tracking to assess carotid longitudinal strain in-silico and in-vitro. However, validation in the more challenging in-vivo setting is still lacking. The aim of this study was to validate longitudinal strain assessment in the common carotid artery (CCA) in an animal setup. The left CCAs of five sheep were exposed during Isoflurane anesthesia and sonomicrometry crystals were sutured onto the artery wall to obtain reference longitudinal strain. Ultrasound long-axis images were recorded at baseline and hypertension (Phenylephrine) and an in-house speckle tracking algorithm was applied to estimate longitudinal strain. The estimated strain curves varied cyclically throughout the cardiac cycles, showing a lengthening of the arterial segment in systole. A significant correlation between peak systolic estimated and reference strain was found (r=0.95, p < 0.001). The results indicate the feasibility of arterial longitudinal strain assessment in-vivo using ultrasound speckle tracking., QC 20140103

Assessment of strain in the longitudinal direction of the arterial wall has been suggested to improve the evaluation of arterial stiffness and atherosclerosis. Recently, we showed the feasibility of ultrasound speckle tracking to assess carotid longitudinal strain in-silico and in-vitro. However, validation in the more challenging in-vivo setting is still lacking. The aim of this study was to validate longitudinal strain assessment in the common carotid artery (CCA) in an animal setup. The left CCAs of five sheep were exposed during Isoflurane anesthesia and sonomicrometry crystals were sutured onto the artery wall to obtain reference longitudinal strain. Ultrasound long-axis images were recorded at baseline and hypertension (Phenylephrine) and an in-house speckle tracking algorithm was applied to estimate longitudinal strain. The estimated strain curves varied cyclically throughout the cardiac cycles, showing a lengthening of the arterial segment in systole. A significant correlation between peak systolic estimated and reference strain was found (r=0.95, p < 0.001). The results indicate the feasibility of arterial longitudinal strain assessment in-vivo using ultrasound speckle tracking., QC 20140103

Assessment of strain in the longitudinal direction of the arterial wall has been suggested to improve the evaluation of arterial stiffness and atherosclerosis. Recently, we showed the feasibility of ultrasound speckle tracking to assess carotid longitudinal strain in-silico and in-vitro. However, validation in the more challenging in-vivo setting is still lacking. The aim of this study was to validate longitudinal strain assessment in the common carotid artery (CCA) in an animal setup. The left CCAs of five sheep were exposed during Isoflurane anesthesia and sonomicrometry crystals were sutured onto the artery wall to obtain reference longitudinal strain. Ultrasound long-axis images were recorded at baseline and hypertension (Phenylephrine) and an in-house speckle tracking algorithm was applied to estimate longitudinal strain. The estimated strain curves varied cyclically throughout the cardiac cycles, showing a lengthening of the arterial segment in systole. A significant correlation between peak systolic estimated and reference strain was found (r=0.95, p < 0.001). The results indicate the feasibility of arterial longitudinal strain assessment in-vivo using ultrasound speckle tracking., QC 20140103

Assessment of strain in the longitudinal direction of the arterial wall has been suggested to improve the evaluation of arterial stiffness and atherosclerosis. Recently, we showed the feasibility of ultrasound speckle tracking to assess carotid longitudinal strain in-silico and in-vitro. However, validation in the more challenging in-vivo setting is still lacking. The aim of this study was to validate longitudinal strain assessment in the common carotid artery (CCA) in an animal setup. The left CCAs of five sheep were exposed during Isoflurane anesthesia and sonomicrometry crystals were sutured onto the artery wall to obtain reference longitudinal strain. Ultrasound long-axis images were recorded at baseline and hypertension (Phenylephrine) and an in-house speckle tracking algorithm was applied to estimate longitudinal strain. The estimated strain curves varied cyclically throughout the cardiac cycles, showing a lengthening of the arterial segment in systole. A significant correlation between peak systolic estimated and reference strain was found (r=0.95, p < 0.001). The results indicate the feasibility of arterial longitudinal strain assessment in-vivo using ultrasound speckle tracking., QC 20140103

Assessment of strain in the longitudinal direction of the arterial wall has been suggested to improve the evaluation of arterial stiffness and atherosclerosis. Recently, we showed the feasibility of ultrasound speckle tracking to assess carotid longitudinal strain in-silico and in-vitro. However, validation in the more challenging in-vivo setting is still lacking. The aim of this study was to validate longitudinal strain assessment in the common carotid artery (CCA) in an animal setup. The left CCAs of five sheep were exposed during Isoflurane anesthesia and sonomicrometry crystals were sutured onto the artery wall to obtain reference longitudinal strain. Ultrasound long-axis images were recorded at baseline and hypertension (Phenylephrine) and an in-house speckle tracking algorithm was applied to estimate longitudinal strain. The estimated strain curves varied cyclically throughout the cardiac cycles, showing a lengthening of the arterial segment in systole. A significant correlation between peak systolic estimated and reference strain was found (r=0.95, p < 0.001). The results indicate the feasibility of arterial longitudinal strain assessment in-vivo using ultrasound speckle tracking., QC 20140103

AIMS: Type II diabetes, often associated with abdominal obesity, frequently leads to heart failure. Clinical and epidemiological evidence suggests that supplemental dyslipidaemia and hypertension, as clustered in the metabolic syndrome, aggravate the cardiovascular outcome. The differential impact of type II diabetes and the metabolic syndrome on left ventricular function, however, remains incompletely defined. METHODS AND RESULTS: We studied left ventricular function in vivo using pressure-volume analysis in obese diabetic mice with leptin deficiency (ob/ob) and obese diabetic dyslipidemic mice with combined leptin and low-density lipoprotein-receptor deficiency (DKO). ob/ob and DKO mice developed a diabetic cardiomyopathy, characterized by impaired contractility and relaxation, from the age of 24 weeks onwards. This was-at least partially-explained by increased apoptosis and disturbed Ca(2+) reuptake in the sarcoplasmic reticulum (SR) in both mouse models. DKO, but not ob/ob, developed increased end-diastolic ventricular stiffness, paralleled by increased left ventricular myocardial fibrosis. Cardiac output was preserved in ob/ob mice by favourable loading conditions, whereas it decreased in DKO mice. CONCLUSIONS: Type II diabetes in mice leads to impaired contractility and relaxation due to disturbed Ca(2+) reuptake in the SR, but only when dyslipidaemia and hypertension are superimposed does vascular-ventricular stiffening increase and left ventricular myocardial fibrosis develop.