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Bilberries, Vaccinium myrtillus, have a high content of phenolic compounds including anthocyanins, which could provide cardiometabolic health benefits following acute myocardial infarction (AMI). We hypothesized that standard medical therapy supplemented with freeze-dried bilberry after AMI would have a more beneficial effect on cardiovascular risk markers and exercise capacity than medical therapy alone. Patients were allocated in a 1:1 ratio within 24 hours of percutaneous coronary intervention in an 8-week trial either to V myrtillus powder (40 g/d, equivalent to 480 g fresh bilberries) and standard medical therapy or to a control group receiving standard medical therapy alone. High-sensitivity C-reactive protein and exercise capacity measured with the 6-minute walk test were the primary biochemical and clinical end points, respectively. Fifty subjects completed the study. No statistically significant difference in high-sensitivity C-reactive protein was detected between groups. The mean 6-minute walk test distance increased significantly more in the bilberry group compared to the control group: mean difference 38 m at follow-up (95% confidence interval 14-62, P = .003). Ex vivo oxidized low-density lipoprotein was significantly lowered in the bilberry group compared to control, geometric mean ratio 0.80 (95% confidence interval 0.66-0.96, P = .017), whereas total cholesterol and low-density lipoprotein cholesterol did not differ significantly between groups. Anthocyanin-derived metabolites in blood increased significantly in the bilberry group during the intervention and were different after 8 weeks between the bilberry group and control. Findings in the present study suggest that bilberries may have clinically relevant beneficial effects following AMI; a larger, double-blind clinical trial is warranted to confirm this., Funding Agency:Örebro University Hospital Research Foundation

Background: There is today no established approach to estimate right ventricular ejection fraction (RVEF) using 2D transthoracic echocardiography (TTE). The aim of this study was to evaluate a new method for RVEF calculations using 2D TTE and compare the results with cardiac magnetic resonance (CMR) imaging and tricuspid annular plane systolic excursion (TAPSE). Methods: A total of 37 subjects, 25 retrospectively included patients and twelve healthy volunteers, were included to give a wide range of RVEF. The right ventricle (RV) was modeled as a part of an ellipsoid enabling calculation of the RV volume by combining three distance measurements. RVEF calculated according to the model, RVEFTTE, were compared with reference CMR-derived RVEF, RVEFCMR. Further, TAPSE was measured in the TTE images and the correlations were calculated between RVEFTTE, TAPSE and RVEFCMR. Results: The mean values were RVEFCMR = 43 +/- 12% (range 20-66%) and RVEFTTE = 50 +/- 9% (range 34-65%). There was a high correlation (r = 0.80, p < 0.001) between RVEFTTE and RVEFCMR. Bland-Altman analysis showed a mean difference between RVEFCMR and RVEFTTE of 6 percentage points (ppt) with limits of agreement from -11 to 23 ppt. The mean value for TAPSE was 19 +/- 5 mm and the correlation between TAPSE and RVEFCMR was moderate (r = 0.54, p < 0.001). The correlation between RVEFTTE and RVEFCMR was significantly higher (p < 0.05) than the correlation between TAPSE and RVEFCMR. Conclusions: The ellipsoid model shows promise for RVEF calculations using 2D TTE for a wide range of RVEF, providing RVEF estimates that were significantly better correlated to RVEF obtained from CMR compared to TAPSE., Funding Agency:Research Committee of Region Orebro County OLL-573211

Background: The position of the right ventricle (RV), often partly behind the sternum, implies difficulties to image the RV free wall using transthoracic echocardiography (TTE) and consequently limits the possibilities of stroke volume calculations. The aim of this study was to evaluate whether the volume of the right ventricle (RV) can be determined by combining TTE distance measurements that do not need the RV free wall to be fully visualized. Methods: The RV volume was approximated by an ellipsoid composed of three distances. Distance measurements, modeled RV stroke volumes (RVSV), and RV ejection fraction (RVEF) were compared to reference values obtained from cardiac magnetic resonance (CMR) imaging for 12 healthy volunteers. Results: Inter-modality comparisons showed that distance measurements were significantly underestimated in TTE compared to CMR. The modeled RV volumes using TTE distance measurements were underestimated compared to reference CMR volumes. There was, however, for TTE an agreement between modeled RVSV and left ventricular stroke volumes determined by biplane Simpson's rule. Similar agreement was shown between modeled RVSV based on CMR distance measurements and the CMR reference. Regarding RVEF, further studies including patients with a wider range of RVEF are needed to evaluate the method. Conclusion: In conclusion, the ellipsoid model of the RV provides good estimates of RVSVs, but volumes based on distance measurements from different modalities cannot be used interchangeably., Funding Agency:Örebro County Council

Purpose: It has previously been shown that stroke volumes measured by transthoracic echocardiography (TTE) are underestimated, compared to cardiac magnetic resonance (CMR) imaging. The purpose of this study was to evaluate differences in distance and area measurements of the right atrium (RA) and the right ventricle (RV) by TTE and CMR. Methods: TTE examinations and CMR examinations were subsequently performed in 12 healthy volunteers. Three distances (RAL - right atrial length, RVIT3 - right ventricular inflow tract, RVLAX - right ventricular long axis) and one area (RVA - right ventricular area) were measured in TTE and CMR. Stroke volumes were also calculated using conventional methods available on each modality. Both intramodality and intermodality comparisons were performed based on measurements from three observers. One of the observers performed measurements in both TTE and CMR. Results: Intermodality comparisons showed that all distance and area measurements were significantly smaller using TTE (Table 1). Two of the measurements, RVIT3 and RVA, differed at about 50%. Calculated stroke volumes showed, consistent with previous results, that the TTE stroke volumes are substantially underestimated compared to CMR volumes. Intramodality variations of distance and area measurements were considerably smaller (Table 1). Conclusions: Our results show that RV distances and areas measured by TTE are smaller compared to CMR, probably due to differences in defining the endocardial borders. These differences subsequently result in smaller stroke volumes when using TTE. Caution should be taken when comparing distances, areas and volumes measured by TTE and CMR.