Left ventricle accessory antero-septal papillary muscle: an echocardiography and cardiac MRI case-series report.

We studied by means of echocardiography and cardiac MRI (CMR) the occurrence of an accessory papillary muscle that unites mostly the left ventricle (LV) apex with the basal antero-septum in the immediate vicinity of left ventricle outflow tract (LVOT) in patients with and without hypertrophic cardiomyopathy (HOCM). . We included all good quality echocardiography and CMR studies as reviewed by two cardiologists and assessed the occurrence of a contractile papillary muscle situated between the LV apex and antero-septum.

In-Vitro Sorbent-Mediated Removal of Edoxaban from Human Plasma and Albumin Solution.

Background And Objective: Based on previous experience of sorbent-mediated ticagrelor, dabigatran, and radiocontrast agent removal, we set out in this study to test the effect of two sorbents on the removal of edoxaban, a factor Xa antagonist direct oral anticoagulant.

Methods: We circulated 100 mL of edoxaban solution during six first-pass cycles through 40-mL sorbent columns (containing either CytoSorb in three passes or Porapak Q 50-80 mesh in the remaining three passes) during experiments using human plasma and 4% bovine serum albumin solution as drug vehicles. Drug concentration was measured by liquid chromatography-tandem mass spectrometry.

Removal of dabigatran using sorbent hemadsorption.

Background: The Redual PCI trial has demonstrated the safety of dabigatran and ticagrelor or clopidogrel combination in preventing strokes in patients with atrial fibrillation. There was 15.4% risk of hemorrhage in the dabigatran/ticagrelor or clopidrogel arm, lower than that of triple therapy with warfarin, aspirin and ticagrelor or clopidogrel.

Ticagrelor Removal From Human Blood.

The authors devised an efficient method for ticagrelor removal from blood using sorbent hemadsorption. Ticagrelor removal was measured in 2 sets of in vitro experiments. The first set was a first-pass experiment using bovine serum albumin (BSA) solution pre-incubated with ticagrelor, whereas the second set, performed in a recirculating manner, used human blood mixed with ticagrelor.

Magnetic resonance characterization of septal bounce: findings of blood impact physiology.

'Septal bounce' is a pathognomonic sign of constrictive pericarditis (CP). The objectives of the study are to resolve the etiology of the septal bounce, to generate septal bounce-related diagnostic tools, and to prove that its presence is related to the mechanical interaction between the atrioventricular inflow and the inter-ventricular septum. We compared steady state free precession four-chamber images between 11 CP patients and 11 controls via cardiac magnetic resonance.

In vitro catheter and sorbent-based method for clearance of radiocontrast material during cerebral interventions.

Background: Contrast-induced acute kidney injury is a severe condition resulting from the use of radiology contrast in patients with predisposing factors.

Hypothesis: We hypothesized that a novel system including a device containing polymer resin sorbent beads and a custom-made suctioning catheter could efficiently remove contrast from an in vitro novel model of circulatory system (MOCS) mimicking the cerebral circulation.

Methods: A custom-made catheter was built and optimized for cerebral venous approach.

Predictors of left ventricular function deterioration in patients with left bundle branch block and ejection fraction >50%.

Resynchronization therapy has become standard of care in patients with left bundle branch block (LBBB), congestive heart failure (CHF), and low ejection fraction (EF). In order to characterize the left ventricular (LV) function evolution in patients with LBBB and baseline preserved LVEF, records of all patients who visited an academic echocardiography laboratory during a period of 4 years were retrospectively investigated. Patients were included if they had a baseline EF >50%, LBBB on surface electrocardiography, and at least one follow-up echocardiogram no earlier than 3 months after the baseline study.

Intrinsic versus laser-induced fluorescence spectroscopy for coronary atherosclerosis: a generational comparison model for testing diagnostic accuracy.

Laser-induced fluorescence (LIF) and intrinsic fluorescence spectroscopy (IFS) have been used experimentally for diagnosing coronary atherosclerosis. In this study, we demonstrated the diagnostic superiority of IFS at 342-nm excitation (IFS(342)) versus LIF (LIF(342)) and described a protocol for head-to-head comparison of old (LIF) versus new (IFS) generations of similar diagnostic methods, labeled as "generational comparison model". IFS(342) and LIF(342) were modeled with basis spectra of media, fibrous caps, and superficial foam cells and of their correspondent chemicals (elastin, collagen, and lipoproteins).

Experimental first-pass method for testing and comparing sorbent polymers used in the clearance of iodine contrast materials.

Background: Sorbents have been shown to adsorb iodinated radiocontrast media.

Objective: In this study we describe a simple method to compare various sorbents in terms of capacity to adsorb radiocontrast media.

Methods: Iodixanol solution was injected into columns filled with three types of sorbent at filtration velocities of increasing magnitude.

Comparative gene expression analysis between coronary arteries and internal mammary arteries identifies a role for the TES gene in endothelial cell functions relevant to coronary artery disease.

Coronary artery disease (CAD) is the leading cause of death worldwide. It has been established that internal mammary arteries (IMA) are resistant to the development of atherosclerosis, whereas left anterior descending (LAD) coronary arteries are athero-prone. The contrasting properties of these two arteries provide an innovative strategy to identify the genes that play important roles in the development of atherosclerosis.

Detection of coronary atherosclerotic plaques with superficial proteoglycans and foam cells using real-time intrinsic fluorescence spectroscopy.

Objectives: The protein components of low-density lipoprotein (LDL), oxidized LDL and proteoglycans such as versican contain tryptophan, an amino acid with characteristic fluorescence features at 308 nm excitation wavelength. We hypothesize that intrinsic fluorescence spectroscopy at 308 nm excitation wavelength IFS308, a method suitable for clinical use, can identify coronary artery lesions with superficial foam cells (SFCs) and/or proteoglycans.

Methods: We subjected 119 human coronary artery specimens to in vitro fluorescence and reflectance spectroscopy.

Myocardial degradation and left bundle branch block predict conversion to low ejection fraction in heart failure with preserved systolic function.

The authors prospectively investigated whether left bundle branch block (LBBB) and myocardial degradation as indicated by elevated troponin T (tnT) predict the phenomenon of systolic conversion to low ejection fraction (EF 40%). Thirty consecutive patients with HFPSF were included and followed over a 4-year interval. A follow-up EF assessment was performed in 25 patients.

Intrinsic fluorescence and diffuse reflectance spectroscopy identify superficial foam cells in coronary plaques prone to erosion.

Objective: Foam cells perform critical functions in atherosclerosis. We hypothesize that coronary segments with superficial foam cells (SFCs) situated in a region of interest with a depth of 200 mum can be identified using intrinsic fluorescence spectroscopy (IFS) and diffuse reflectance spectroscopy (DRS). This is a key step in our ongoing program to develop a spectroscopic technique for real-time in vivo diagnosis of vulnerable atherosclerotic plaque.

Detection of morphological markers of vulnerable atherosclerotic plaque using multimodal spectroscopy.

Vulnerable plaques, which are responsible for most acute ischemic events, are presently invisible to x-ray angiography. Their primary morphological features include a thin or ulcerated fibrous cap, a large necrotic core, superficial foam cells, and intraplaque hemorrhage. We present evidence that multimodal spectroscopy (MMS), a novel method that combines diffuse reflectance spectroscopy (DRS), intrinsic fluorescence spectroscopy (IFS), and Raman spectroscopy (RS), can detect these markers of plaque vulnerability.

Etiology of troponin I elevation in patients with congestive heart failure and low clinical suspicion of myocardial infarction.

Background: Increased troponin I (TnI) has been detected in congestive heart failure (CHF) patients. We demonstrate that occurrence of LVH, and systolic and diastolic blood pressure values (SBP and DBP, respectively) correlate with increasing levels of serum TnI in a selected CHF population.

Methods: Our team reviewed the medical records of 40 consecutive patients admitted with CHF symptoms, low clinical suspicion of myocardial infarction (MI), and serum TnI measured upon admission.

Identification of new genes differentially expressed in coronary artery disease by expression profiling.

Genetic factors increase the risk to coronary artery disease (CAD). To date, a limited number of genes that potentially contribute to development of CAD have been identified. In this study, we have performed large-scale gene expression analysis of approximately 12,000 human genes in nine severely atherosclerotic and six nonatherosclerotic human coronary arteries using oligonucleotide microarrays.

Proteomic approach to coronary atherosclerosis shows ferritin light chain as a significant marker: evidence consistent with iron hypothesis in atherosclerosis.

Coronary artery disease (CAD) is the leading cause of mortality and morbidity in developed nations. We hypothesized that CAD is associated with distinct patterns of protein expression in the coronary arteries, and we have begun to employ proteomics to identify differentially expressed proteins in diseased coronary arteries. Two-dimensional (2-D) gel electrophoresis of proteins and subsequent mass spectrometric analysis identified the ferritin light chain as differentially expressed between 10 coronary arteries from patients with CAD and 7 coronary arteries from normal individuals.