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The Purkinje system is a heart structure responsible for transmitting electrical impulses through the ventricles in a fast and coordinated way to trigger mechanical contraction. Estimating a patient-specific compatible Purkinje Network from an electro-anatomical map is a challenging task, that could help to improve models for electrophysiology simulations or provide aid in therapy planning, such as radiofrequency ablation. In this study, we present a methodology to inversely estimate a Purkinje network from a patient's electro-anatomical map. First, we carry out a simulation study to assess the accuracy of the method for different synthetic Purkinje network morphologies and myocardial junction densities. Second, we estimate the Purkinje network from a set of 28 electro-anatomical maps from patients, obtaining an optimal conduction velocity in the Purkinje network of 1.95 ± 0.25 m/s, together with the location of their Purkinje-myocardial junctions, and Purkinje network structure. Our results showed an average local activation time error of 6.8±2.2 ms in the endocardium. Finally, using the personalized Purkinje network, we obtained correlations higher than 0.85 between simulated and clinical 12-lead ECGs.

The emergence of more effective methods for treatment of pulmonary arterial hypertension (PAH) has called for more reliable methods of diagnostics, monitoring, and evaluating responses to the treatment. More reports have become available about the relevance of using magnetic resonance imaging (MRI) for examination of patients with PAH. This review provides data on the significance of MRI for noninvasive evaluation of the heart structure and function in patients with PAH, as well as for visualization and evaluation of the remodeling of the pulmonary circulation. According to the data presented in this review, the results obtained with various, modern MRI technologies can be used for monitoring the effect of treatment and for risk stratification in patients with PAH.

Purpose: To investigate the influence of bexarotene (Bex) on cardiac structure and function in streptozotocin (STZ)-induced diabetes mellitus (DM) rats, and the mechanism of action involved. Methods: Four groups of Sprague Dawley rats (n = 40) were used: normal control, DM, DM+ Bex (10 mg/kg/day), and DM+ Bex (20 mg/kg/day) (n = 10). The DM rat model was established by intraperitoneal injection of STZ. Cardiac structure and function of rats were determined and compared. Whole heart and left ventricle were weighed. The protein expressions of Bcl2 and Bax in rat myocardial tissue were determined using Western blotting. Results: Compared to control group, there was significant reduction in the levels of IVSd (inlet ventricular septal defect) and LVPWd (left ventricle posterior wall in diastole) in DM group, but significant increase in these parameters in DM +Bex (20 mg/kg/day) group, relative to DM-treated rats (p < 0.05). Moreover, there were higher expression levels of Bcl2 and Bax in DM group, when compared with normal control, but Bcl2/Bax ratio was significantly lower (p < 0.05). Furthermore, Bcl2 and Bax levels in DM + Bex (20 mg/kg/day) group were significantly lower than those in DM group, while Bcl2/Bax ratio increased significantly (p < 0.05). Conclusion: Bexarotene improves the cardiac structure of DM rats by lowering blood glucose, and by inhibiting ventricular remodeling and cardiomyocyte apoptosis. These findings may be beneficial in the development of new anti-DM drugs.

Cardiovascular disease (CVD) is one of the critical diseases and the most common cause of morbidity and mortality worldwide. Therefore, early detection and prediction of such a disease is extremely essential for a healthy life. Cardiac imaging plays an important role in the diagnosis of cardiovascular disease but its role has been limited to visual assessment of heart structure and its function. However, with the advanced techniques and tools of big data and machine learning, it become easier to clinician to diagnose the CVD. Stenosis with in the Coronary Arteries (CA) are often determined by using the Coronary Cine Angiogram (CCA). It comes under the invasive image modality. CCA is the effective method to detect and predict the stenosis. In this paper a coronary analysis automation method is proposed in disease diagnosis. The proposed method includes pre-processing, segmentation, identifying vessel path and statistical analysis.

With research progress on longevity, we have gradually recognized that cardiac aging causes changes in heart structure and function, including progressive myocardial remodeling, left ventricular hypertrophy, and decreases in systolic and diastolic function. Elucidating the regulatory mechanisms of cardiac aging is a great challenge for biologists and physicians worldwide. In this review, we discuss several key molecular mechanisms of cardiac aging and possible prevention and treatment methods developed in recent years. Insights into the process and mechanism of cardiac aging are necessary to protect against age-related diseases, extend lifespan, and reduce the increasing burden of cardiovascular disease in elderly individuals. We believe that research on cardiac aging is entering a new era of unique significance for the progress of clinical medicine and social welfare.

Background Primates represent a unique object for biomedical research, in particular in the field of physiology and pathology of the cardiovascular system. Echocardiography is the most important non-invasive method for the intravital study of the heart structure and function, intracardiac and systemic haemodynamics. The available data on reference values of echocardiographic parameters in primates are limited. Methods We determined and described 29 structural and functional parameters in echocardiographic examination using B-mode (two-dimensional scanning), M-mode (one-dimensional scanning) and in various Doppler modes together with blood pressure in 17 male cynomolgus macaques with an average age of 5.7 ± 0.6 years. We compared available literature data on reference values of echocardiography in this species. Results and conclusions Echocardiographic values in cynomolgus macaques depend on age, sex composition and the anaesthesia method. There is lack of presentation in the published studies of complete list of parameters that can be obtained by echocardiographic examination.

As the core organ of cardiovascular system, fetal heart plays a very important role. With the development of pregnancy, the early fetal heart rate tends to mature, and the corresponding cardiac function tends to mature and stable. But the fetal heart is very fragile during pregnancy. Various diseases during pregnancy directly lead to fetal heart growth restriction, and even lead to fetal heart function damage. Ultrasound image diagnosis is one of the most important diagnostic methods in medical imaging. It is of great significance to detect the early heart structure of the fetus in gynecology and obstetrics. It can detect the early fetal heart in real time and noninvasively. However, the traditional ultrasonic image detection has many disadvantages in the process of application, such as many noise points, low performance of processing algorithm, which to some extent affects the detection performance of ultrasonic image detection in the detection of fetal heart structure in gynecology and obstetrics. Based on the above problems, this paper proposes an adaptive detection algorithm of superimposed moving image based on ultrasonic image detection, which can accurately extract and analyze fetal heart region when the signal-to-noise ratio of ultrasonic image sequence is low. The average anisotropy algorithm is also proposed innovatively in this paper. In order to predict the structure of fetal heart more accurately, the active heart model combining fetal heart structure and motion information is considered in the actual analysis process. Experiments show that the accuracy error of the algorithm is less than 11 pixels.

Background: Atrial fibrillation is still a most common arrhythmia. The incidence increases according to each remodeling of the heart chamber. Valvular and non valvular heart diseases have differences in hemodynamic adaptations that trigger a certain remodeling. However, until now it is not known whether there is a difference between the left heart structure and valvular and non valvular atrial fibrillation. Method: There were 60 patients with atrial fibrillation hospitalized from August 2018 to December 2018. The samples were then divided into 2 groups, namely the valvular and non valvular groups, each with 30 samples. All samples that met the criteria underwent echocardiography. Then comparative statistics were carried out with p values ​​

IntroductionPost-contrast delayed-enhancement MRI helps to show the extent of myocardial infarction (MI), as well as allowing the morphometric analysis of the heart structure, e.g., left ventricular volume (LVV). Here the author deployed Bayesian implementation of statistical inference to determine the difference between the LVV in MI cases and in normal controls.MethodsSixty-seven MI patients and thirty-three controls from the EMIDEC dataset challenge were used. These were acquired at the University Hospital of Dijon (France). A cardiologist with 10 years of experience in cardiology and MRI and a biophysicist with 20 years of experience of cardiovascular MRI supervised the acquisition and annotated the images. ITK-Snap was used to extract the LVV and Bayesian inference were used to investigate the data.ResultsPatients with MI were younger than the controls (58.3 ± 11.5 vs. 66.5 ± 12.9 years; BF10 = 17.9). With age taken into consideration, the patients showed larger LVV relative to the controls (128.1 ± 46.3 vs. 83.4 ± 24.4 cm3; post-hoc BF10 = 12663.8).SummaryUsing Bayesian approach, we can conclude decisively that there is volumetric difference or remodeling in individuals with MI.

To determine the feasibility of simultaneously conducting history and physical (HP), limb-lead electrocardiogram (ECG), and preparticipation echocardiography by frontline providers (PEFP) at one screening station.This cross-sectional study compares limb-lead versus 12-lead ECG as part of a preparticipation physical examination (PPE) including HP and PEFP conducted in year 1 and year 2 on 2 cohorts (n = 36, n = 53, respectively) of college athletes at one institution. Year 1 screening was conducted at 3 stations, one station per screening component. Time to complete each station was recorded, and total time for screening was the summation of times for each station. Year 2 screening was conducted at one station; timing began when the patient entered the room and ended when all 3 components of screening were complete. An unpaired t test was used to compare the mean time difference between years 1 and 2 screening stations.Year 1 screening time was significantly longer than time to complete cardiac screening using the year 2 protocol (10.51 ± 1.98 vs 3.96 ± 1.43 minutes, respectively; P0.001). Five athletes in year 1 and 3 athletes in year 2 were referred to cardiology for further evaluation; all athletes were ultimately cleared to participate.A comprehensive PPE can be completed in a timely fashion using a single screening station and limb-lead ECG to improve efficiency, while still allowing providers to gather information on history, physical examination, heart rhythm, and heart structure. This strategy may serve as a potential solution in the longstanding debate over best practices for PPEs.

This study evaluated the effects of the herbal medicine red orange (Citrus sinensis (L.) Osbeck) and swimming for 84 days on the animal, heart, and abdominal fat weight and the histomorphometric aspects of heart and total cholesterol of Wistar rats. The rats were divided into seven experimental groups of 12 animals each, consisting of a normocaloric diet (Dn), hypercaloric diet (Dh), normocaloric diet and herbal medicine (DnH), hypercaloric diet and herbal medicine (DhH), normocaloric diet and swimming (DnS), hypercaloric diet and swimming (DhS), and hypercaloric diet, swimming, and herbal medicine (DhSH). The data were analyzed statistically by the Tukey test and considered significant when p

The left atrial appendage (LAA) is a heart structure with known prothrombogenic and pro-arrhythmogenic properties.The aim of this study was to evaluate the specific anatomy of the LAA and to create a simple classification system based on the shape of its body.This study investigated 200 randomly selected autopsied human hearts (25.0% females, 46.6±19.1 years old). Three (3) types of LAAs were distinguished: the cauliflower type (no bend, limited overall length, compact structure [36.5%]); the chicken wing type (substantial bend in the dominant lobe [37.5%]), and the arrowhead type (no bend, one dominant lobe of substantial length [26.0%]). Additional accessory lobes were present in 55.5% of all LAAs. Significant variations between category types were noted in LAA length (chicken wing: 35.7±9.8 mm, arrowhead: 30.8±10.1 mm, cauliflower: 22.3±9.6 mm [p0.001]) and in the thickness of pectinate muscles located within the LAA apex (arrowhead: 1.2±0.7 mm; cauliflower: 1.1±0.6 mm; chicken wing: 0.9±0.6 mm [p0.001]). Left atrial appendage volume and orifice size were not affected by the type of LAA shape. The age of the donor was positively correlated with LAA volume (r=0.29, p=0.005), body length (r=0.26, p=0.012), and area of the orifice (r=0.36, p0.001). Donors with an oval LAA orifice were significantly older than those with round orifices (50.2±16.6 vs 43.7±20.4 years [p=0.014]) and had significantly heavier hearts (458.2±104.8 vs 409.6±114.1g [p=0.002]).This study delivered a new simple classification system of the LAA based on its body shape. An increase in age and heart weight was associated with LAA enlargement and a more oval-shaped orifice. Results of current study may help to estimate the different thrombogenic properties associated with each LAA type and be an assistance during planning and performing interventions on LAA.

Cardiac magnetic resonance imaging is a commonly used method to assess the function and structure of the cardiovascular system. Separating the heart structure from Cardiac MRI is an important step in calculating the cardiac function index. The automatic segmentation algorithm can significantly reduce the workload of the doctor. Most of the current automatic segmentation algorithm has a large calculation amount and size, has high requirements on the hardware. Based on the U-Net model, this paper proposes a lightweight full convolution model with separable convolution and residual connection. Experiments show that the model reduces the number of parameters while ensuring learning ability and balances speed and accuracy.

Aim. The study was aimed on the importance evaluation of the false chords (FC) diagnostics in the left ventricle (LV) of the heart at early age to predict connective tissue dysplasia (CTD) development. Material and methods. The study performed at cardiorheumatological department of MAI “CCCH №11” of Yekaterinburg city. Case histories of 200 patients analyzed, of those had undergone treatment in the department last 6 months. Group consisted of children aged 1 month to 17 year old, mean age 9,7±4,6 y. o. Phenotype of CTD was evaluated according to theGent score criteria (2010) and the Score by Kadurina T. I. et al. Heart structure and functioning were assessed with bi-dimensional transthoracic echocardiography. Statistics was done with SPSS Statistics 17.0 and Microsoft Office Excel 2013. Results. All children had phenotype markers of CTD syndrome. Significance assessment of CTD by Kadurina score was 8,1±3,8 (2-33) points, that is grade 1 severity of CTD. In 17% (n=34) of children there was moderate CTD grade, and in 10% (n=20) there were dysplastic changes in ≥3 organ systems. Most of patients (95,5%) had FC (2,0±0,5 U) localized in various areas of the LV. Chords always correlated with phenotypic CTD markers in other physiological systems. And the number of concomitant markers significantly increased with the children’s age. Conclusion. In most cases CTD syndrome is associated with the changes in the heart, and FC inLV can be regarded as easy approachable and most early and reliable phenotypical marker of this systemic disorder.

BackgroundEmpagliflozin (empa), a selective sodium–glucose cotransporter (SGLT)2 inhibitor, reduced cardiovascular mortality and hospitalization for heart failure in patients with type 2 diabetes at high cardiovascular risk independent of glycemic control. The cardiovascular protective effect of empa was evaluated in an experimental model of metabolic syndrome, the obese ZSF1 rat, and its’ lean control.MethodsLean and obese ZSF1 rats were either non-treated or treated with empa (30 mg/kg/day) for 6 weeks. Vascular reactivity was assessed using mesenteric artery rings, systolic blood pressure by tail-cuff sphygmomanometry, heart function and structural changes by echocardiography, and protein expression levels by Western blot analysis.ResultsEmpa treatment reduced blood glucose levels from 275 to 196 mg/dl in obese ZSF1 rats whereas normoglycemia (134 mg/dl) was present in control lean ZSF1 rats and was unaffected by empa. Obese ZSF1 rats showed increased systolic blood pressure, and blunted endothelium-dependent relaxations associated with the appearance of endothelium-dependent contractile responses (EDCFs) compared to control lean rats. These effects were prevented by the empa treatment. Obese ZSF1 rats showed increased weight of the heart and of the left ventricle volume without the presence of diastolic or systolic dysfunction, which were improved by the empa treatment. An increased expression level of senescence markers (p53, p21, p16), tissue factor, VCAM-1, SGLT1 and SGLT2 and a down-regulation of eNOS were observed in the aortic inner curvature compared to the outer one in the control lean rats, which were prevented by the empa treatment. In the obese ZSF1 rats, no such effects were observed. The empa treatment reduced the increased body weight and weight of lungs, spleen, liver and perirenal fat, hyperglycemia and the increased levels of total cholesterol and triglycerides in obese ZSF1 rats, and increased blood ketone levels and urinary glucose excretion in control lean and obese ZSF1 rats.ConclusionEmpa reduced glucose levels by 28% and improved both endothelial function and cardiac remodeling in the obese ZSF1 rat. Empa also reduced the increased expression level of senescence, and atherothrombotic markers at arterial sites at risk in the control lean, but not obese, ZSF1 rat.

Congenital heart disease (CHD) is the most common type of birth defects, which occurs 1 in every 110 births in the United States. CHD usually comes with severe variations in heart structure and great artery connections that can be classified into many types. Thus highly specialized domain knowledge and time-consuming human process is needed to analyze the associated medical images. On the other hand, due to the complexity of CHD and the lack of dataset, little has been explored on the automatic diagnosis (classification) of CHDs. In this paper, we present ImageCHD, the first medical image dataset for CHD classification. ImageCHD contains 110 3D Computed Tomography (CT) images covering most types of CHD, which is of decent size compared with existing medical imaging datasets. Classification of CHDs requires the identification of large structural changes without any local tissue changes, with limited data. It is an example of a larger class of problems that are quite difficult for current machine-learning based vision methods to solve. To demonstrate this, we further present a baseline framework for automatic classification of CHD, based on a state-of-the-art CHD segmentation method. Experimental results show that the baseline framework can only achieve a classification accuracy of 82.0% under selective prediction scheme with 88.4% coverage, leaving big room for further improvement. We hope that ImageCHD can stimulate further research and lead to innovative and generic solutions that would have an impact in multiple domains. Our dataset is released to the public [1].

Accurate age- and sex-related normal reference values of ventricular structure and function are important to determine the level of dysfunction in patients. The aim of this study therefore was to document normal age range sex-related measurements of LV structural and functional measurements to serve such purpose.We evaluated left ventricular structure and function in 293 healthy subjects between 20 and 90 years with equally distributed gender. Doppler echocardiography was used including measure of both systolic and diastolic functions.Due to systolic LV function, only long axis function correlated with age (r = 0·55, P0·01) and the correlation was stronger in females. Concerning diastolic function, there was a strong age correlation in all parameters used (r = 0·40-0·74, P0·001). Due to LV structural changes over age, females showed a larger reduction in end-diastolic volumes, but no or trivial difference in wall thickness after the age of 60 years.Age is associated with significant normal changes in left ventricular structure and function, which should be considered when deciding on normality. These changes are related to systemic arterial changes as well as body stature, thus reflecting overall body ageing process. Furthermore, normal cardiac ageing in females might partly explain the higher prevalence of heart failure with preserved ejection in females.

Primary cardiac angiosarcomas are frequently found at a large size with infiltration into the adjacent heart structure owing to their asymptomatic characteristics until an advanced stage. Therefore, extensive resection is often required to achieve a good prognosis. We herein report a case of entire circumferential resection of the right atrium surrounded by angiosarcoma and excellent three-dimensional reconstruction of the right atrium.

Background: Hypertensive condition can lead to abnormalities in heart structure and electrical activity. The electrocardiogram (ECG) is a recording of the electrical activity of the heart and widely used to diagnose and detect heart problem. Objective: We conducted a comparative ECG analysis between two hypertension models (L-NAME and SHR) and their controls (Wistar and Wistar-Kyoto) at six and 15 th week of age. Methods: Blood pressure was measured at the end of the 15 th week, and electrocardiography was performed [...]

Background Chronic inflammation is linked to age-associated declines in heart structure and function that contribute to increased risks for cardiovascular mortality and frailty, a state of high vul...

Accurate whole-heart segmentation from multi-modality medical images (MRI, CT) plays an important role in many clinical applications, such as precision surgical planning and improvement of diagnosis and treatment. This paper presents a deeply-supervised 3D U-Net for fully automatic whole-heart segmentation by jointly using the multi-modal MRI and CT images. First, a 3D U-Net is employed to coarsely detect the whole heart and segment its region of interest, which can alleviate the impact of surrounding tissues. Then, we artificially enlarge the training set by extracting different regions of interest so as to train a deep network. We perform voxel-wise whole-heart segmentation with the end-to-end trained deeply-supervised 3D U-Net. Considering that different modality information of the whole heart has a certain complementary effect, we extract multi-modality features by fusing MRI and CT images to define the overall heart structure, and achieve final results. We evaluate our method on cardiac images from the multi-modality whole heart segmentation (MM-WHS) 2017 challenge.

Feature tracking in cine cardiac magnetic resonance (CMR) is a quantitative technique to assess heart structure and function. We investigated 4-dimensional (4D) dynamics and morphology of the mitral annulus (MA) using a novel tracking system based on radially rotational long-axis cine CMR series. A total of 30 normal controls and patients with mitral regurgitation were enrolled. The spatiotemporal changes of the MA were characterized by an in-house developed program. Dynamic and morphological parameters extracted from all 18 radial slices were used as references and were compared with those from subsequently generated sub-datasets with different degrees of sparsity. An excellent agreement was found among all datasets including routine 2-, 3- and 4-chamber views for MA dynamics such as peak systolic velocity (Sm) and mitral annular plane systolic excursion (MAPSE). MA morphology for size and shape was addressed adequately by as few as 6 radial slices, but poorly by only three routine views. Patients with regurgitation showed significantly reduced mitral dynamics and mild annular deformation, which was consistent between three routine views and 18 reference slices. In conclusion, feature tracking cine CMR provided a comprehensive and distinctive profile for 4D MA dynamics and morphology, which may help in studying different cardiac diseases.

Introduction. Atrial fibrillation (AF) occurs in 8.0-22.0% of patients with acute myocardial infarction (MI). It is associated with a significant increase in both hospital mortality and mortality over a 5-year observation period. AF can be the result of a number of pathological processes – hemodynamic disorders, ischemia or AF (especially in patients with early AF), right ventricular infarction, pericarditis, excessive release of catecholamines, chronic lung diseases, acute hypoxia, use of sympathomimetics, hypokalemia, etc. Aim. To find out the incidence of AF, its association with structural changes in the heart, heart failure, and other factors in patients in the remote period after MI. Materials and methods. To assess the AF prevalence and its association with the changes in heart structure and heart failure 169 patients with previous MI (135 men, 34 women; mean age 57,3 ± 11,4 years) were included into the study. Mean time after the first MI was 4,96 ± 4,64 years. AF was found in 33 patients (19,5 %): in 23 patients (13,6 %) AF was considered as permanent, in 10 (5,9 %) as paroxysmal. Results. As result of a multiple logistic regression analysis, only the age and the volume of a right atrium were found as the independent predictors of AF. Every 10 years of life of the patients the probability of the permanent AF risk increases more then two-fold (110,0 %), and increase of the volume of right atrium for every 50,0 ml – three-fold (200,0 %). Prevalence of permanent AF increases with the growth of heart failure functional class whereas paroxysmal AF does not depend on heart failure severity. It was found that AF occurs in 19.5% of the patients in the remote period after MI, paroxysmal form – in 5.9%, permanent – in 13.6%. The frequency of continuous permanent AF in patients after MI increases with an increase of the severity of heart failure. At the same time, the functional class of heart failure was not an independent predictor of AF. Patients with permanent AF were older, had larger atrium, more severe heart failure, and greater degree of regurgitation through the mitral and tricuspid valves. Patients with paroxysmal form of arrhythmia occupied an intermediate position among the patients with a permanent form and without arrhythmia for most of the indices. Independent predictors of AF were only the age and volume of the right atrium. Conclusions. When assessing the risk of AF special attention should be paid to the parameters like the size of the right atrium and the degree of regurgitation through the tricuspid valve.

У статті наведені результати вивчення впливу підвищеної тиреоїдної функції на тлі інсулінорезистентності на показники структури і функції серця. Встановлено, що при підвищенні функції щитоподібної залози основною нозологічною формою ураження міокарда у пацієнтів без супутньої серцево-судинної патології є розвиток метаболічної ендокринної кардіоміопатії. Особливістю ураження серця при синдромі тиреотоксикозу є відсутність кардіосклеротичних, міокардитичних та ішемічних процесів. Особливостями клінічних, інструментальних і лабораторних змін у пацієнтів з підвищеною функцією щитоподібної залози є суб’єктивна маніфестація, тенденція до розвитку систолічної артеріальної гіпертензії, виражена гіполіпідемія, тенденція до гіперглікемії. Проявами електричної дисфункції міокарда при гіпертиреозі є збільшення частоти серцевих скорочень, виражена тенденція до підвищення аритмогенезу (здебільшого шлуночкового типу), порушення процесів реполяризації шлуночків і переважання електричної негомогенності міокарда як передсердь, так і шлуночків. Морфофункціональні зміни серця при синдромі тиреотоксикозу проявляються збільшенням розмірів його порожнин, маси міокарда лівого шлуночка, пришвидшеним розслабленням останнього. Ураження серця при тиреотоксикозі характеризується збільшенням тривалості і дисперсії інтервалу QTc, що свідчить про порушення процесів реполяризації міокарда, і збільшенням його електричної негомогенності, що може бути предиктором ризику розвитку шлуночкових порушень ритму. Зміни серцевої діяльності при тиреотоксикозі у пацієнтів чоловічої статі характеризуються більшою вираженістю електрофізіологічних і морфофункціональних змін міокарда порівняно з пацієнтами жіночої статі.

Purpose Automated donor to recipient anastomosis has the potential to reduce procedural & ischemic times . A major impediment to automated anastomosis is creating the hemostatic end to end anastomosis without luminal compromise. We present our design of a conformational felt sandwich anastomotic device. Methods An adjustable anastomotic platform with a calibrated railing system (diameter: 10-100mm) was designed and tested in-vitro with a biomimetic heart phantom. Felt-incorporated two circular platforms, anvil and staple cartridge respectively, can be circumferentially tightened and released. Staples are deployed in an interlocking triangular pattern for hemostasis . Results A one cm cuff is created for both donor and recipient heart structure to be anastomosed. A modular anvil with incorporated conformational felt was then clasped around the structure to be anastomosed and the wall was everted on to the anvil and engaged in the spikes (Figure). The positional pins were then engaged, with a clockwise movement accurate apposition was achieved. The handle was depressed to discharge a specially arranged staple to achieve a hemostatic seal. The automated anastomosis obtains a hemostatic seal with a conformational felt on the outside of the vessel wall (Figure). The system also works well with bovine pericardium . Conclusion An automated donor to recipient anastomosis can improve the operational ease and reduce procedural/ischemic times while obtaining reproducible results.

The aim of this study was to determine the impact of multi-slice computed tomography (MSCT) evaluation of coronary artery stenosis on left heart structure and systolic function. Coronary artery CT angiography was performed in 200 patients diagnosed with coronary heart disease, and then according to the AHA coronary artery 17-segment fractionation method, the Gensini score (GS) was determined for every narrow segment, and one-stop assessment of the correlation between left heart structure and function was performed. After the grouping of GS quartiles from low to high, there were differences between different patients with regard to LVDD, LADD, LVEDV, LVESV, MM, LVEF, and FS, while no difference in SV and CO. GS showed linear negative correlation with LVEF and FS, and linear positive correlation with LVDD, LADD, LVEDV, LVESV, and MM, while no correlation with SV and CO. That is, GS of coronary artery stenosis was negatively correlated with left ventricular systolic function and positively correlated with myocardial mass. The narrower the coronary artery, the worse the cardiac function and the higher the myocardial hypertrophy. Coronary artery stenosis was one of the important causes of the decrease in left ventricular systolic function and cardiac remodeling.

The concept of food has expanded beyond its traditional role of survival and hunger satisfaction, to include a role in the prevention and treatment of disease. Polyphenols are classes of compounds that are synthesized by plants to serve a wide variety of functions including growth pollination and defense. These compounds have recently received increased attention in medical research. In this group, one of the most studied has been resveratrol (3,5,4,-trihydroxystilbene), a polyphenol, which is found predominantly in grapes and berries. Over the past two decades, researchers have studied the ability of resveratrol to prevent or reverse the development of abnormalities in heart structure and function in animal models of heart disease and heart failure. The results from animal studies have been promising, and very recently, this knowledge has been translated into examining the efficacy of resveratrol in humans with heart disease/failure. In this review we will discuss the current status of resveratrol research on cardioprotection.

Objective: Despite a well-documented association between stress and depression with cardiac morbidity and mortality, there is no satisfactory explanation for the mechanisms linking affective and cardiac disorders. This study investigated cardiac electrophysiological properties in an animal model of depression. Methods: Depression-relevant physiological and behavioral parameters were measured in adult male wild-type rats during and after a period of intermittent social defeat stress (n = 12) or empty cage exposure (control, n = 11). Nine days after the last defeat/empty cage exposure, high-definition epicardial mapping was performed under anesthesia. Results: Stressed animals versus controls displayed a larger reduction in the circadian amplitude of heart rate (-32% [3%] versus 13 [2%]; p = .001) and body temperature (-33% [4%] versus -5% [2%]; p = .001) rhythms, had smaller body weight gain (+11% [1%] versus +17% [1%]; p

Frugal products and services generally, though not exclusively, aim at satisfying the unsaturated demand of a large and growing middle class in emerging economies such as India. Although research has been conducted in regard to the strategic importance of frugal innovations, so far, there is a lack of in-depth research on the actual development process of such innovations. Some examples show that inventive analogies are used to develop frugal innovations. For instance, the development of a frugal artificial heart in India was based on the heart structure of cockroaches, which led to a reduction of costs by 20 times.

Menopausal hormone therapy does not seem to have any adverse effect on the structure and function of the heart, and may have a positive effect, according to new research published in PLOS One .1 The effect of menopausal hormone therapy, previously known as hormone replacement therapy (HRT), on cardiovascular health in post-menopausal women remains controversial and unclear. Extensive observational data had suggested menopausal hormone therapy was cardioprotective, leading to it being routinely prescribed for primary and secondary prevention of coronary heart disease. However, subsequent data from the Women’s Health Initiative and elsewhere have cast …

Undernutrition during development increases the risk for adult cardiovascular disease. To determine if PUN alters heart structure function, and maximal exercise capacity in adulthood, newborn control mouse pups were fostered to dams fed a control (CON; 20% protein) or a protein-restricted diet (PUN; 8% protein; n=7-10 litters/treatment). At 21 d (PN21) pups were fed the CON diet ad lib. At PN70 a maximal treadmill test was performed to determine VO2peak; maximal vertical work was calculated for the final 30 sec. At PN80 cardiac function was evaluated by echocardiography. VO2peak was the same in CON and PUN mice and higher in males than females (249 + 9 and 169 + 6 ml/hr, respectively, P

Structure and function in any organ are inseparable categories, both in health and disease. Whether we are ready to accept, or not, many questions in cardiovascular medicine are still pending, due to our insufficient insight in the basic science. Even so, any new concept encounters difficulties, mainly arising from our inert attitude, which may result either in unjustified acceptance or denial. The ventricular myocardial band concept, developed over the last 50 years, has revealed unavoidable coherence and mutual coupling of form and function in the ventricular myocardium. After more than five centuries long debate on macroscopic structure of the ventricular myocardium, this concept has provided a promising ground for its final understanding. Recent validations of the ventricular myocardial band, reviewed here, as well as future research directions that are pointed out, should initiate much wider scientific interest, which would, in turn, lead to reconciliation of some exceeded concepts about developmental, electrical, mechanical and energetical events in human heart. The benefit of this, of course, would be the most evident in the clinical arena.

In recent years small non-coding RNAs such as miRNAs have been identified as important molecular players in the process of pathological cardiac remodeling (1). Cardiac remodeling is one of the major alterations in the heart structure that causes a hemodynamic imbalance leading to change in the dimension, mass, shape and function of the heart.

Use of the zebrafish model system for studying development, regeneration, and disease is expanding toward use of adult hearts for cell dissociation and purification of RNA, DNA, and proteins. All of these applications demand the rapid recovery of significant numbers of zebrafish hearts to avoid gene regulatory, metabolic, and other changes that begin after death. Adult zebrafish hearts are also required for studying heart structure for a variety of mutants and for studying heart regeneration. However, the traditional zebrafish heart dissection is slow and difficult and requires specialized tools, making large-scale dissection of adult zebrafish hearts tedious. Traditional methods also harbor the risk of damaging the heart during the dissection. Here, we describe a method for dissection of adult zebrafish hearts that is fast, reproducible, and preserves heart architecture. Furthermore, this method does not require specialized tools, is painless for the zebrafish, can be performed on fresh or fixed specimens, and can be performed on zebrafish as young as one month old. The approach described expands the use of adult zebrafish for cardiovascular research.

OBJECTIVE: To evaluate the influence of the siesta in ambulatory blood pressure (BP) monitoring and in cardiac structure parameters. METHODS: 1940 ambulatory arterial blood pressure monitoring tests were analyzed (Spacelabs 90207, 15/15 minutes from 7:00 to 22:00 hours and 20/20 minutes from 22:01 to 6.59hours) and 21% of the records indicated that the person had taken a siesta (263 woman, 52±14 years). The average duration of the siesta was 118±58 minutes. RESULTS: (average ± standard deviation) The average of systolic/diastolic pressures during wakefulness, including the napping period, was less than the average for the period not including the siesta (138±16/85±11 vs 139±16/86±11 mmHg, p5%. CONCLUSION: The siesta influenced the heart structure parameters and from a statistical point of view the average of systolic and diastolic pressures and the respective pressure loads of the wakeful period.

Background: In adults central blood pressure has stronger associations with cardiovascular outcomes than peripheral blood pressure, with some evidence that this difference is greater in mid- than older-aged adults. The relationship of central blood pressure to cardiovascular structure and function in adolescence is unclear. Aim: To compare associations of central and peripheral pulse pressure (PP) with cardiac structure and left ventricular function in a general population of adolescents. Methods: 1,421 (17y; 45% males) participants in the Avon Longitudinal Study of Parents and Children had measurements of peripheral and central blood pressure using Omron705 IT and Sphygmocor devices and echocardiography using a HDI 5000 ultrasound system. Results: Central to peripheral amplification was 21 mmHg (95% CI: 20, 21). Central and peripheral PP were positively associated with left ventricular mass index (LVMI), mitral E/A ratio, left atrial size and inversely associated with s′ even when adjusting for age, sex, DEXA determined fat mass and physical activity (Table 1); with consistently greater associations noted for cPP. Neither central nor peripheral PP were associated with relative wall thickness, midwall fractional shortening, ejection fraction e’ or E/e′. Conclusions: Central PP is more strongly associated with measures of cardiac structure and function than peripheral PP in adolescence. Previous studies are likely to have underestimated the effect of PP on cardiac structure and function in children and adolescents based on peripheral measurements. P3.14 Withdrawn by author

Background: Co-administration of ibuprofen (IBU) and isosorbide dinitrate (ISDN) provides synergistic beneficial effects on dystrophic skeletal muscle. Whether this treatment has also cardioprotective effects in this disease was still unknown. Aims: To evaluate the effects of co-administration of IBU and ISDN (a) on left ventricular (LV) structure and function, and (b) on cardiac inflammatory response and fibrosis in mdx mice. Methods: Three groups of mice were studied: mdx mice treated with IBU (50 mg kg−1) + ISDN (30 mg kg−1) administered daily in the diet, mdx mice that received standard diet without drugs and wild type aged-matched mice. Animals were analysed after 10–11 months of treatment. Structural and functional parameters were evaluated by echocardiography while histological analyses were performed to evaluate inflammatory response, collagen deposition, cardiomyocyte number and area. Results: Treatment for 10–11 months with IBU + ISDN preserved LV wall thickness and LV mass. Drug treatment also preserved the total number of cardiomyocytes in the LV and attenuated the increase in cardiomyocyte size, when compared to untreated mdx mice. Moreover, a trend towards a decreased number of inflammatory cells, a reduced LV myocardial interstitial fibrosis and an enhanced global LV function response to stress was observed in treated mdx mice. Conclusions: Treatment for 10–11 months with IBU + ISDN is effective in preventing the alterations in LV morphology of mdx mice while not reaching statistical significance on LV function and cardiac inflammation.

of the thesis entitled “Investigation of Left Ventricular Heart Structure and Functions Using Magnetic Resonance Diffusion Tensor Imaging”

To investigate the distribution and clinical impact of glycogen accumulation on heart structure and function in individuals with GSD III.We examined cardiac tissue and the clinical records of three individuals with GSD IIIa who died or underwent cardiac transplantation. Of the two patients that died, one was from infection and the other was from sudden cardiac death. The third patient required cardiac transplantation for end-stage heart failure with severe hypertrophic cardiomyopathy.Macro- and microscopic examination revealed cardiac fibrosis (n = 1), moderate to severe vacuolation of cardiac myocytes (n = 3), mild to severe glycogen accumulation in the atrioventricular (AV) node (n = 3), and glycogen accumulation in smooth muscle cells of intramyocardial arteries associated with smooth muscle hyperplasia and profoundly thickened vascular walls (n = 1).Our findings document diffuse though variable involvement of cardiac structures in GSD III patients. Furthermore, our results also show a potential for serious arrhythmia and symptomatic heart failure in some GSD III patients, and this should be considered when managing this patient population.

Conventional risk factors of coronary artery disease fail to explain the increased frequency of cardiovascular morbidity in patients with systemic lupus erythematosus (SLE). The study was conducted to determine possible association between the heart structure and function abnormalities with established prognostic value assessed by non-invasive imaging techniques and markers of autoimmune and inflammatory phenomena typical for SLE. Echocardiography and single photon emission computerized tomography (SPECT; Tc-99m-MIBI) at rest were performed in 60 SLE patients in a stable clinical condition of their disease. Laboratory evaluation included serum levels of C-reactive protein (CRP), complement C3c and C4 components and antiphospholipid antibodies (aPL). The latter included serum anticardiolipin (aCL) and anti-β2-glycoprotein I (antiβ2GPI) antibodies, both of IgG and IgM class, and lupus anticoagulant (LA) in plasma. Echocardiography revealed pathologic thickening of valvular leaflets and/or pericardium in more than 60% of patients. Right ventricular systolic pressure (RVSP) was elevated (>30 mmHg) in 16.7%. Myocardial perfusion defects were present in 36.7% of patients, despite normal ECG recordings and a lack of clinical symptoms of myocardial ischaemia. There was a significant association between thickening of valvular leaflets and/or pericardium and high CRP and low C3c and C4 concentrations. On the other hand, increased RVSP and the presence of myocardial perfusion defects were associated with the presence of anticardiolipin and antiβ2GPI antibodies of the IgG class. Increased anticardiolipin IgG levels predicted perfusion defects in SPECT study with 100% sensitivity and 68% specificity, whereas elevated antiβ2GPI IgG levels predicted RVSP elevation (>30 mmHg) with 100% sensitivity and 78% specificity. In stable SLE patients pericardial and valve abnormalities may be associated with markers of an ongoing inflammation. Also, pulmonary systolic pressure elevation and myocardial perfusion defects are combined with elevated levels of anticardiolipin and antiβ2GPI antibodies of the IgG class. These results indicate that even clinically silent pulmonary hypertension and myocardial perfusion defects in SLE patients could be causally related to the presence of antiphospholipid antibodies.