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The sensing of left ventricular (LV) activity is fundamental in the diagnosis and monitoring of cardiovascular health in high-risk patients after cardiac surgery to achieve better short- and long-term outcome. Conventional approaches rely on noninvasive measurements even if, in the latest years, invasive microelectromechanical systems (MEMS) sensors have emerged as a valuable approach for precise and continuous monitoring of cardiac activity. The main challenges in designing cardiac MEMS sensors are represented by miniaturization, biocompatibility, and long-term stability. Here, we present a MEMS piezoresistive cardiac sensor capable of continuous monitoring of LV activity over time following epicardial implantation with a pericardial patch graft in adult minipigs. In acute and chronic scenarios, the sensor was able to compute heart rate with a root mean square error lower than 2 BPM. Early after up to 1 month of implantation, the device was able to record the heart activity during the most important phases of the cardiac cycle (systole and diastole peaks). The sensor signal waveform, in addition, closely reflected the typical waveforms of pressure signal obtained via intraventricular catheters, offering a safer alternative to heart catheterization. Furthermore, histological analysis of the LV implantation site following sensor retrieval revealed no evidence of myocardial fibrosis. Our results suggest that the epicardial LV implantation of an MEMS sensor is a suitable and reliable approach for direct continuous monitoring of cardiac activity. This work envisions the use of this sensor as a cardiac sensing device in closed-loop applications for patients undergoing heart surgery. [ABSTRACT FROM AUTHOR]

Aims Pulmonary blood volume (PBV) is a novel clinical application of cardiovascular magnetic resonance (CMR) imaging for the quantitative grading of haemodynamic congestion. In this study, we aimed to assess the prognostic value of PBV in a cohort of outpatients with chronic heart failure (HF). Methods and results One hundred and twelve consecutive patients (91 men, 67 ± 12 years) and 53 age- and sex-matched healthy controls underwent echocardiography and contrast-enhanced CMR. PBV was calculated as the product of stroke volume and the number of cardiac cycles for an intravenous bolus of gadolinium contrast to pass through the pulmonary circulation determined by first-pass perfusion imaging. Compared with healthy controls, HF outpatients showed significantly higher PBV index (PBVI, 308 ± 92 vs. 373 ± 175, mL/m2, P  = 0.012) and pulmonary transit time (6.8 ± 1.8 vs. 9.5 ± 4 s, P  ≤0.001). During a median follow-up of 26 ± 17 months, 27 patients (24%) reached the composite end point of cardiovascular death, HF hospitalization, or sustained ventricular arrhythmias/appropriate implantable cardioverter-defibrillator intervention. Using a cut-off point of PBVI >492 mL/m2, corresponding to two standard deviations above the mean of healthy controls, event-free survival was significantly lower in patients with higher PBVI (P <  0.001). At multivariable-adjusted Cox regression analysis, PBVI was an independent predictor of the composite cardiovascular end point (per 10% increase hazard ratio 1.31, 95% confidence interval: 1.02–1.69, P =  0.03). Conclusions PBVI is a novel application of perfusion CMR potentially useful to quantitatively determine haemodynamic congestion as a surrogate marker of left ventricular diastolic dysfunction. PBVI might prove to be helpful in stratifying the prognosis of asymptomatic or mildly symptomatic patients with left ventricular dysfunction. [ABSTRACT FROM AUTHOR]

Hyperpolarized C magnetic resonance spectroscopy in pig models enables metabolic activity mapping, providing a powerful tool for the study of the heart physiology, but requires the development of dedicated radiofrequency coils, capable of providing large field of view with high signal-to-noise ratio (SNR) data. This work describes the simulations and the tests of a transmit-only (TX) volume coil/receive-only (RX) surface coil both designed for hyperpolarized studies of pig heart with a clinical 3T scanner. The coil characterization is performed by developing an SNR model for coil performance in terms of coil resistance, sample-induced resistance and magnetic field pattern. In particular, coil resistances were calculated from Ohm's law, while magnetic field patterns and sample-induced resistances were calculated using a numerical finite-difference time-domain algorithm. Experimental phantom chemical shift image, showed good agreement with the theoretical SNR-vs-depth profiles and highlighted the advantage of the novel configuration over the single transmit-receive coils throughout the volume of interest for cardiac imaging in pig. Finally, the TX-birdcage/RX-circular configuration was tested by acquiring metabolic maps with hyperpolarized [1-13C] pyruvate injected i.v. in a pig. The results of the phantom and pig experiments show the ability of the coil configuration to image well the metabolites distribution. [ABSTRACT FROM AUTHOR]

Cardiac metabolism assessment with hyperpolarized C magnetic resonance spectroscopy in pig models requires the design of dedicated coils capable of providing large field of view with high signal-to-noise ratio (SNR) data. This work presents a comparison between a commercial C quadrature birdcage coil and a homebuilt C circular coil both designed for hyperpolarized studies of pig heart with a clinical 3T scanner. In particular, the simulation of the two coils is described by developing an SNR model for coil performance prediction and comparison. While coil resistances were calculated from Ohm's law, the magnetic field patterns and sample-induced resistances were calculated using a numerical finite-difference time-domain algorithm. After the numerical simulation of both coils, the results are presented as SNR-versus-depth profiles using experimental SNR extracted from the [1-C]acetate phantom chemical shift image and with a comparison of metabolic maps acquired by hyperpolarized [1-C]pyruvate injected in a pig. The accuracy of the developed SNR models was demonstrated by good agreement between the theoretical and experimental coil SNR-versus-depth profiles. [ABSTRACT FROM AUTHOR]