High-pitch ECG-synchronized pulmonary CT angiography versus standard CT pulmonary angiography: a prospective randomized study.

Objective: The purpose of this study was to compare high-pitch ECG-synchronized pulmonary CT angiography (CTA) with standard pulmonary CTA with regard to radiation dose and image quality in patients with suspected pulmonary embolism.

Subjects And Methods: This prospective study was approved by the institutional review board, and participants provided informed consent. Patients with suspected pulmonary embolism (60% women; mean age, 57 ± 14 years) were randomized to undergo high-pitch ECG-synchronized pulmonary CTA (n = 26) or standard pulmonary CTA (n = 21).

Angiotensin inhibition enhances drug delivery and potentiates chemotherapy by decompressing tumour blood vessels.

Cancer and stromal cells actively exert physical forces (solid stress) to compress tumour blood vessels, thus reducing vascular perfusion. Tumour interstitial matrix also contributes to solid stress, with hyaluronan implicated as the primary matrix molecule responsible for vessel compression because of its swelling behaviour. Here we show, unexpectedly, that hyaluronan compresses vessels only in collagen-rich tumours, suggesting that collagen and hyaluronan together are critical targets for decompressing tumour vessels.

Echocardiographic predictors of reverse remodeling after cardiac resynchronization therapy and subsequent events.

Background: Studies of echocardiographic predictors of response after cardiac resynchronization therapy (CRT) have largely involved single parameters. We hypothesized that combining parameters would be more robust and sought to develop a multiparametric echocardiographic score for predicting CRT response.

Methods And Results: Global longitudinal strain of left ventricle was added to standard echocardiographic measurements in 334 consecutive patients (224 men; mean, 65±12 years) who underwent baseline echocardiography before CRT and underwent follow-up echocardiograms at 1 year.

Association between septal strain rate and histopathology in symptomatic hypertrophic cardiomyopathy patients undergoing septal myectomy.

Background: Hypertrophic cardiomyopathy (HCM) is histopathologically characterized by myocyte hypertrophy, disarray, interstitial fibrosis, and small intramural coronary arteriole dysplasia, which contribute to disease progression. Longitudinal systolic and early diastolic strain rate (SR) measurements by speckle tracking echocardiography are sensitive markers of regional myocardial function. We sought to determine the association between septal SR and histopathologic findings in symptomatic HCM patients who underwent surgical myectomy.

Improved interobserver variability and accuracy of echocardiographic visual left ventricular ejection fraction assessment through a self-directed learning program using cardiac magnetic resonance images.

Background: Although not recommended in isolation, visual estimation of echocardiographic ejection fraction (EF) is widely applied to confirm quantitative EF. However, interobserver variability for EF estimation has been reported to be as high as 14%. The aim of this study was to determine whether self-directed education could improve the accuracy and interobserver variability of visual estimation of EF and whether a multireader estimate improves measurement precision.

Long-term survival of patients with radiation heart disease undergoing cardiac surgery: a cohort study.

Background: Thoracic radiation results in radiation-associated heart disease (RAHD), often requiring cardiothoracic surgery (CTS). We sought to measure long-term survival in RAHD patients undergoing CTS, to compare them with a matched control population undergoing similar surgical procedures, and to identify potential predictors of long-term survival.

Methods And Results: In this retrospective observational cohort study of patients undergoing CTS, matched on the basis of age, sex, and type/time of CTS, 173 RAHD patients (75% women; age, 63±14 years) and 305 comparison patients (74% women; age, 63±4 years) were included.

Biventricular mechanics in constrictive pericarditis comparison with restrictive cardiomyopathy and impact of pericardiectomy.

Background: The aim of our study was to compare myocardial mechanics of constrictive pericarditis (CP) with restrictive cardiomyopathy (RCM), or healthy controls; to assess the impact of pericardial thickening detected by cardiac magnetic resonance on regional myocardial mechanics in CP; and to quantitate the effect of pericardiectomy on myocardial mechanics in CP.

Methods And Results: Myocardial mechanics were evaluated by 2-dimensional speckle tracking in 52 consecutive patients with CP who underwent cardiac magnetic resonance examination before pericardiectomy, 35 patients with RCM, and 26 control subjects. CP patients had selectively depressed left ventricular (LV) anterolateral wall strain (LWS) and right ventricular (RV) free wall longitudinal systolic strain (FWS) but preserved LV septal wall systolic strain (SWS).

Prognostic significance of exercise-induced right ventricular dysfunction in asymptomatic degenerative mitral regurgitation.

Background: The role of exercise-induced pulmonary hypertension in decision making regarding surgical timing for asymptomatic chronic mitral regurgitation is controversial. We reasoned that the exercise-induced pulmonary hypertension response could not be interpreted without knowledge of right ventricular (RV) function. The aim of this study was to assess the role of RV measures at rest and during exercise as predictors of prognosis in asymptomatic mitral regurgitation.

Normal ranges of left ventricular strain: a meta-analysis.

Background: The definition of normal values of left ventricular global longitudinal strain (GLS), global circumferential strain, and global radial strain is of critical importance to the clinical application of this modality. The investigators performed a meta-analysis of normal ranges and sought to identify factors that contribute to reported variations.

Methods: MEDLINE, Embase, and the Cochrane Library database were searched through August 2011 using the key terms "strain," "speckle tracking," "left ventricle," and "echocardiography" and related phrases.

Prospective ECG-triggered, axial 4-D imaging of the aortic root, valvular, and left ventricular structures: a lower radiation dose option for preprocedural TAVR imaging.

Background: Transcatheter valve interventions rely on imaging for patient selection, preprocedural planning, and intraprocedural guidance.

Objective: We explored the use of prospective electrocardiogram (ECG)-triggered 4-dimensional (4-D) CT imaging in patients evaluated for transcatheter aortic valve replacement (TAVR).

Methods: A total of 47 consecutive patients underwent 128-slice dual-source CT with wide-window dose-modulated prospective ECG-triggered, axial acquisition of the aortic root, reconstructed during diastolic and systolic cardiac phases.

Reproducibility of echocardiographic techniques for sequential assessment of left ventricular ejection fraction and volumes: application to patients undergoing cancer chemotherapy.

Objectives: The aim of this study was to identify the best echocardiographic method for sequential quantification of left ventricular (LV) ejection fraction (EF) and volumes in patients undergoing cancer chemotherapy.

Background: Decisions regarding cancer therapy are based on temporal changes of EF. However the method for EF measurement with the lowest temporal variability is unknown.

Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with end-systolic volume and viability.

Background: The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by end-systolic volume index (ESVi).

Methods And Results: Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.

Therapeutic effects of selective atrioventricular node vagal stimulation in atrial fibrillation and heart failure.

Introduction: Atrial fibrillation (AF) and heart failure (HF) frequently coexist. We have previously demonstrated that selective atrioventricular node (AVN) vagal stimulation (AVN-VS) can be used to control ventricular rate during AF. Due to withdrawal of vagal activity in HF, the therapeutic effects of AVN-VS may be compromised in the combined condition of AF and HF.

Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis.

Background: The diagnosis of cardiac amyloidosis (CA) is challenging owing to vague symptomatology and non-specific echocardiographic findings.

Objective: To describe regional patterns in longitudinal strain (LS) using two-dimensional speckle-tracking echocardiography in CA and to test the hypothesis that regional differences would help differentiate CA from other causes of increased left ventricular (LV) wall thickness.

Methods And Results: 55 consecutive patients with CA were compared with 30 control patients with LV hypertrophy (n=15 with hypertrophic cardiomyopathy, n=15 with aortic stenosis).

Suppression of inherent ferromagnetism in Pr-doped CeO₂ nanocrystals.

Ce(1-x)Pr(x)O(2-δ) (0 ≤ x ≤ 0.4) nanocrystals were synthesized by self-propagating method and thoroughly characterized using X-ray diffraction, Raman and X-ray photoelectron spectroscopy and magnetic measurements. Undoped CeO₂ nanocrystals exhibited intrinsic ferromagnetism at room temperature.

Infected total knee arthroplasty treatment outcome analysis.

Background/aim: Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA.

Methods: This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade.

How similar are the mice to men? Between-species comparison of left ventricular mechanics using strain imaging.

Background: While mammalian heart size maintains constant proportion to whole body size, scaling of left ventricular (LV) function parameters shows a more complex scaling pattern. We used 2-D speckle tracking strain imaging to determine whether LV myocardial strains and strain rates scale to heart size.

Methods: We studied 18 mice, 15 rats, 6 rabbits, 12 dogs and 20 human volunteers by 2-D echocardiography.

Independent association of left atrial function with exercise capacity in patients with preserved ejection fraction.

Objective: Left atrial (LA) function is an important contributor to cardiac function in a variety of disease states and especially with exercise. The purpose of this study was to assess the role of LA function in the left ventricular (LV) filling pressure (E/e') response to exercise and exercise tolerance in patients with preserved LV ejection fraction (LVEF).

Methods: LA contractile function (LA strain peak negative), conduit function (LA strain peak positive), and reservoir function (LA strain total) were measured from speckle tracking in 486 patients with preserved LVEF and negative exercise echocardiography for ischaemia.

Alternating layer addition approach to CdSe/CdS core/shell quantum dots with near-unity quantum yield and high on-time fractions.

We report single-particle photoluminescence (PL) intermittency (blinking) with high on-time fractions in colloidal CdSe quantum dots (QD) with conformal CdS shells of 1.4 nm thickness, equivalent to approximately 4 CdS monolayers. All QDs observed displayed on-time fractions > 60% with the majority > 80%.

Accuracy and interobserver concordance of echocardiographic assessment of right ventricular size and systolic function: a quality control exercise.

Background: Accurate assessment of right ventricular (RV) size (RVS) and RV systolic function (RVSF) is vital in the management of various conditions, but their assessment is challenging using echocardiography. The aim of this study was to determine the accuracy and interobserver concordance of qualitative and quantitative RV echocardiography.

Methods: Fifteen readers evaluated RV function in 12 patients (360 readings) who underwent echocardiography and cardiac magnetic resonance for RV assessment.

Normalization of tumour blood vessels improves the delivery of nanomedicines in a size-dependent manner.

The blood vessels of cancerous tumours are leaky and poorly organized. This can increase the interstitial fluid pressure inside tumours and reduce blood supply to them, which impairs drug delivery. Anti-angiogenic therapies--which 'normalize' the abnormal blood vessels in tumours by making them less leaky--have been shown to improve the delivery and effectiveness of chemotherapeutics with low molecular weights, but it remains unclear whether normalizing tumour vessels can improve the delivery of nanomedicines.

Image quality, contrast enhancement, and radiation dose of ECG-triggered high-pitch CT versus non-ECG-triggered standard-pitch CT of the thoracoabdominal aorta.

Objective: We sought to compare image quality, contrast enhancement, and radiation dose in patients undergoing ECG-triggered high-pitch helical CT or non-ECG-synchronized helical CT of the thoracoabdominal aorta.

Materials And Methods: We retrospectively assessed data from 101 consecutive patients (81 men, 20 women; mean age, 71 ± 11 [SD] years) undergoing clinically indicated CT angiography (CTA) of the thoracoabdominal aorta on a dual-source scanner using either the ECG-triggered high-pitch helical mode (group 1, n = 52) or non-ECG-synchronized standard-pitch helical mode (group 2, n = 49) during the arterial phase. Two independent readers assessed image quality, noise, and contrast enhancement throughout the thoracoabdominal aorta.