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  • Ovid Technologies (Wolters Kluwer Health)  (20)
  • 1
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    Online Resource
    Association of Left Atrial High-Resolution Late Gadolinium Enhancement on Cardiac Magnetic Resonance With Electrogram Abnormalities Beyond Voltage in Patients With Atrial Fibrillation
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation: Arrhythmia and Electrophysiology Vol. 13, No. 2 ( 2020-02)
    Details
    In: Circulation: Arrhythmia and Electrophysiology, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 2 ( 2020-02)
    Abstract: Conflicting data have been reported on the association of left atrial (LA) late gadolinium enhancement (LGE) with atrial voltage in patients with atrial fibrillation. The association of LGE with electrogram fractionation and delay remains to be examined. We sought to examine the association between LA LGE on cardiac magnetic resonance and electrogram abnormalities in patients with atrial fibrillation. Methods: High-resolution LGE cardiac magnetic resonance was performed before electrogram mapping and ablation in atrial fibrillation patients. Cardiac magnetic resonance features were quantified using LA myocardial signal intensity Z score (SI-Z), a continuous normalized variable, as well as a dichotomous LGE variable based on previously validated methodology. Electrogram mapping was performed pre-ablation during sinus rhythm or LA pacing, and electrogram locations were coregistered with cardiac magnetic resonance images. Analyses were performed using multilevel patient-clustered mixed-effects regression models. Results: In the 40 patients with atrial fibrillation (age, 63.2±9.2 years; 1312.3±767.3 electrogram points per patient), lower bipolar voltage was associated with higher SI-Z in patients who had undergone previous ablation (coefficient, −0.049; P 〈 0.001) but not in ablation-naive patients (coefficient, −0.004; P =0.7). LA electrogram activation delay was associated with SI-Z in patients with previous ablation (SI-Z: coefficient, 0.004; P 〈 0.001 and LGE: coefficient, 0.04; P 〈 0.001) but not in ablation-naive patients. In contrast, increased LA electrogram fractionation was associated with SI-Z (coefficient, 0.012; P =0.03) and LGE (coefficient, 0.035; P 〈 0.001) only in ablation-naive patients. Conclusions: The association of LA LGE with voltage is modified by ablation. Importantly, in ablation-naive patients, atrial LGE is associated with electrogram fractionation even in the absence of voltage abnormalities.
    Type of Medium: Online Resource
    ISSN: 1941-3149 , 1941-3084
    URL: Article
    DOI: 10.1161/CIRCEP.119.007586
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2425487-3
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  • 2
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    Abstract 12655: Lipomatous Metaplasia in Chronic Infarcts is Associated With Prolonged Activation Recovery Interval Within Ventricular Tachycardia Corridors
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: We studied the association of infarct scar versus lipomatous metaplasia (LM) with the activation recovery interval (ARI) in putative ventricular tachycardia (VT) corridors traversing the infarct zone. Methods: The cohort included 32 patients from the prospective Intra-Myocardial Fat Deposition and Ventricular Tachycardia in Ischemic Cardiomyopathy (INFINITY) study. We defined myocardial scar, border zone (BZ) and potential viable corridors through infarct by late gadolinium enhancement (LGE)-cardiac magnetic resonance (CMR), and LM by computed tomography (CT). The images were registered with electroanatomic maps wherein the ARI of each point (1,530 within LM, 4,946 within scar) was calculated using a custom Python code as the time interval from the minimum derivative within the QRS to the maximum derivative within the T wave. ARI dispersion was defined as the standard deviation (SD) of ARI per AHA segment. Multilevel random effects linear regression models, clustered by patient, were used to evaluate the association between ARI (or ARI dispersion) with tissue types. Results: LM exhibited higher myocardial ARI than normal myocardium, BZ, scar [regression coefficient: 35.5 vs. 0, 11.4, and 25.4, P 〈 0.001]. Of 100 corridors computed from LGE-CMR and electrophysiologically confirmed to participate in VT reentry, 97 traversed through or near LM, and displayed prolonged ARI compared to 123 non-critical corridors distant from LM [356 (319, 396) vs. 283 (266, 316) ms, P 〈 0.001, Figure 1]. The association of LM with Log(ARI SD ) was more robust than that of scar (likelihood ratio χ 2 47.5 vs. 23.4, and 5.9% vs. 1.6% increase in Log(ARI SD ) /1 cm 2 increase per AHA segment, respectively). Additionally, LM and scar exhibited interaction (p 〈 0.001) in their association with Log(ARI SD ). Conclusion: LM is closely associated with prolonged local action potential duration of corridors and ARI dispersion, which may facilitate the propensity of VT circuit reentry.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.12655
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 3
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    Abstract 10387: Utility of Esophageal Image Segmentation for Guidance of Posterior Wall Lesions During Atrial Fibrillation Ablation
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: Despite luminal esophageal temperature (LET) monitoring, esophageal injury remains a risk which impacts decision making during atrial fibrillation (AF) ablation. We sought to compare procedural characteristics including radiofrequency (RF) power, duration, and LET, among ablation procedures with and without visualization of esophageal segmentations relative to the left atrial dome. Hypothesis: We sought to test the hypothesis that esophageal image registration and visualization during AF ablation would improve operator efficiency and reduce esophageal temperature changes during the procedure. Methods: The retrospective cohort included 63 patients (mean age 65.5 ± 8.8 years, 33% female, 54% paroxysmal AF) that underwent pre-procedural cardiac magnetic resonance (CMR) and LET monitoring. Of all patients, 35 underwent standard AF ablation without esophageal image segmentation, and 28 underwent AF ablation with registration of esophageal image segmentation. Results: Total RF time was shorter with esophageal visualization (28.6 ± 11.8 min versus 39.1 ± 22.5 min, P 〈 0.05). The distribution of ablation power delivery was skewed toward higher power with esophageal visualization (P 〈 0.001), while the mean LET was identical among patient groups and the standard deviation of LET was lower in those with esophageal visualization (35.9 ± 0.5 °C versus 35.9 ± 0.7 °C, P=NS). The within patient standard deviation for LET change during posterior wall ablation was 0.3 ± 0.1 °C and 0.4 ± 0.2 °C for patients with and without esophageal visualization respectively (P=0.017). Conclusions: Esophageal visualization was associated with improved efficiency of AF ablation using higher power and resulting in shorter RF time, while reducing the variation in esophageal temperature.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.10387
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 4
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    Prognostic Value of Hepatic Native T1 and Extracellular Volume Fraction in Patients with Pulmonary Arterial Hypertension
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American Heart Association Vol. 11, No. 22 ( 2022-11-15)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 22 ( 2022-11-15)
    Abstract: Right heart failure may lead to impaired liver perfusion and venous congestion, resulting in different extents of liver fibrosis. However, whether hepatic tissue deterioration determined by native T1 mapping and extracellular volume fraction using cardiac magnetic resonance imaging is associated with poor outcomes in patients with pulmonary arterial hypertension remains unclear. Methods and Results A total of 131 participants with pulmonary arterial hypertension (mean age, 36±13 years) and 64 healthy controls (mean age, 44±18) between October 2013 and December 2019 were prospectively enrolled. Hepatic native T1 and extracellular volume fraction values were measured using modified Look–Locker inversion recovery T1 mapping sequences. The primary end point was all‐cause mortality; the secondary end point was all‐cause mortality and repeat hospitalization attributable to heart failure. Cox regression models and Kaplan–Meier survival analysis were used to identify the association between variables and clinical outcome. During a median follow‐up of 34.5 months (interquartile range: 25.3–50.8), hepatic native T1 (hazard ratio per 30‐ms increase, 1.22 [95% CI, 1.07–1.39]; P =0.003) and extracellular volume fraction (hazard ratio per 3% increase, 1.18 [95% CI, 1.04–1.34]; P =0.010) values were associated with a higher risk of death. In the multivariate Cox model, hepatic native T1 value (hazard ratio per 30‐ms increase, 1.15 [95% CI, 1.04–1.27]; P =0.009) remained as an independent prognostic factor for the secondary end point. Conclusions Hepatic T1 mapping values were predictors of adverse cardiovascular events in participants with pulmonary arterial hypertension and could be novel imaging biomarkers for poor prognosis recognition.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.122.026254
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2653953-6
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  • 5
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    Resveratrol Preserves Myocardial Function and Perfusion in Remote Nonischemic Myocardium in a Swine Model of Metabolic Syndrome
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Journal of the American College of Surgeons Vol. 215, No. 5 ( 2012-11), p. 681-689
    Details
    In: Journal of the American College of Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 215, No. 5 ( 2012-11), p. 681-689
    Type of Medium: Online Resource
    ISSN: 1072-7515
    URL: Article
    DOI: 10.1016/j.jamcollsurg.2012.06.417
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
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  • 6
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    Metabolic effects of pulmonary obstruction on myocardial functioning : a pilot study using multiple time-point 18F-FDG-PET imaging
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Nuclear Medicine Communications Vol. 36, No. 1 ( 2015-01), p. 78-83
    Details
    In: Nuclear Medicine Communications, Ovid Technologies (Wolters Kluwer Health), Vol. 36, No. 1 ( 2015-01), p. 78-83
    Type of Medium: Online Resource
    ISSN: 0143-3636
    URL: Article
    DOI: 10.1097/MNM.0000000000000212
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2028880-3
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  • 7
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    Myocardial Tissue Reverse Remodeling After Guideline-Directed Medical Therapy in Idiopathic Dilated Cardiomyopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation: Heart Failure Vol. 14, No. 1 ( 2021-01)
    Details
    In: Circulation: Heart Failure, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 1 ( 2021-01)
    Abstract: The prognosis of patients with idiopathic dilated cardiomyopathy (DCM) has improved remarkably in recent decades with guideline-directed medical therapy. Left ventricular (LV) reverse remodeling (LVRR) is one of the major therapeutic goals. Whether myocardial fibrosis or inflammation would reverse associated with LVRR remains unknown. Methods: A total of 157 prospectively enrolled patients with DCM underwent baseline and follow-up cardiovascular magnetic resonance examinations with a median interval of 13.7 months (interquartile range, 12.2–18.5 months). LVRR was defined as an absolute increase in LV ejection fraction of 〉 10% to the final value of ≥35% and a relative decrease in LV end-diastolic volume of 〉 10%. Statistical analyses were performed using paired t test and student t test, logistic regression analysis, and linear regression analysis. Results: Forty-eight (31%) patients reached LVRR. At baseline, younger age, worse New York Heart Association class, new-onset heart failure, lower LV ejection fraction, absence of late gadolinium enhancement, lower myocardial T2, and extracellular volume were significant predictors of LVRR. During the follow-up, patients with and without LVRR both showed a significant decrease of myocardial native T1 (LVRR: [baseline] 1303.0±43.6 ms; [follow-up] 1244.7±51.8 ms; without LVRR: [baseline] 1308.5±80.5 ms; [follow-up] 1287.6±74.9 ms, both P 〈 0.001), matrix and cellular volumes while no significant difference was observed in T2 or extracellular volume values after treatment. Conclusions: In patients with idiopathic DCM, the absence of late gadolinium enhancement, lower T2, and extracellular volume values at baseline are significant predictors of LVRR. The myocardial T1, matrix, and cell volume decrease significantly in patients with LVRR after guideline-directed medical therapy. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: ChiCTR1800017058.
    Type of Medium: Online Resource
    ISSN: 1941-3289 , 1941-3297
    URL: Article
    DOI: 10.1161/CIRCHEARTFAILURE.120.007944
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2428100-1
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  • 8
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    Quantification of Left Ventricular Function With Premature Ventricular Complexes Reveals Variable Hemodynamics
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation: Arrhythmia and Electrophysiology Vol. 9, No. 4 ( 2016-04)
    Details
    In: Circulation: Arrhythmia and Electrophysiology, Ovid Technologies (Wolters Kluwer Health), Vol. 9, No. 4 ( 2016-04)
    Abstract: Premature ventricular complexes (PVCs) are prevalent in the general population and are sometimes associated with reduced ventricular function. Current echocardiographic and cardiovascular magnetic resonance imaging techniques do not adequately address the effect of PVCs on left ventricular function. Methods and Results— Fifteen subjects with a history of frequent PVCs undergoing cardiovascular magnetic resonance imaging had real-time slice volume quantification performed using a 2-dimensional (2D) real-time cardiovascular magnetic resonance imaging technique. Synchronization of 2D real-time imaging with patient ECG allowed for different beats to be categorized by the loading beat RR duration and beat RR duration. For each beat type, global volumes were quantified via summation over all slices covering the entire ventricle. Different patterns of ectopy, including isolated PVCs, bigeminy, trigeminy, and interpolated PVCs, were observed. Global functional measurement of the different beat types based on timing demonstrated differences in preload, stroke volume, and ejection fraction. An average of hemodynamic function was quantified for each subject depending on the frequency of each observed beat type. Conclusions— Application of real-time cardiovascular magnetic resonance imaging in patients with PVCs revealed differential contribution of PVCs to hemodynamics.
    Type of Medium: Online Resource
    ISSN: 1941-3149 , 1941-3084
    URL: Article
    DOI: 10.1161/CIRCEP.115.003520
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2425487-3
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  • 9
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    Right Ventricular Global Longitudinal Strain as a Predictor of Acute and Early Right Heart Failure Post Left Ventricular Assist Device Implantation
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  ASAIO Journal Vol. 68, No. 3 ( 2022-03), p. 333-339
    Details
    In: ASAIO Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 68, No. 3 ( 2022-03), p. 333-339
    Abstract: Early right heart failure (RHF) occurs in up to 40% of patients following left ventricular assist device (LVAD) implantation and is associated with increased morbidity and mortality. The most recent report from the Mechanical Circulatory Support-Academic Research Consortium (MCS-ARC) working group subdivides early RHF into early acute RHF and early postimplant RHF. We sought to determine the effectiveness of right ventricular (RV) longitudinal strain (LS) in predicting RHF according to the new MCS-ARC definition. We retrospectively analyzed clinical and echocardiographic data of patients who underwent LVAD implantation between 2015 and 2018. RVLS in the 4-chamber (4ch), RV outflow tract, and subcostal views were measured on pre-LVAD echocardiograms. Fifty-five patients were included in this study. Six patients (11%) suffered early acute RHF, requiring concomitant RVAD implantation intraoperatively. Twenty-two patients (40%) had postimplant RHF. RVLS was significantly reduced in patients who developed early acute and postimplant RHF. At a cutoff of −9.7%, 4ch RVLS had a sensitivity of 88.9% and a specificity of 77.8% for predicting RHF and area under the receiver operating characteristic curve of 0.86 (95% confidence interval 0.76–0.97). Echocardiographic RV strain outperformed more invasive hemodynamic measures and clinical parameters in predicting RHF.
    Type of Medium: Online Resource
    ISSN: 1058-2916
    URL: Article
    DOI: 10.1097/MAT.0000000000001467
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2083312-X
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  • 10
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    Abstract 11288: Conduction Velocity is Slower in Corridors Traversing Lipomatous Metaplasia Than in Corridors Traversing Scar in Chronic Infarcts
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: We sought to examine the association of infarct scar versus lipomatous metaplasia (LM) with impulse conduction velocity (CV) in putative ventricular tachycardia (VT) corridors that traverse the infarct zone in patients with prior myocardial infarction (MI). Methods: The cohort included 31 patients from the prospective In tra-Myocardial F at Deposition and Ventricular Tachycardia in Ischemic Card i omyopa t h y (INFINITY) study. CV was calculated as the mean CV between that point and five adjacent points along the activation wavefront using an automated Python script in myocardial scar, border zone (BZ), and potential viable corridors defined by late gadolinium enhancement (LGE)-cardiac magnetic resonance (CMR), and LM identified by computed tomography (CT). Both image sets were registered with electroanatomic maps (EAM). Results: Regions with LM exhibited lower myocardial CV than scar (median 12.0 vs. 13.5 cm/s, P 〈 0.001). Of 96 corridors computed from LGE-CMR and electrophysiologically confirmed to participate in VT reentry, 95 traversed through or near LM identified on CT. These critical corridors displayed slower CV {median 8.8 [interquartile range (IQR) 6.0, 15.4] vs. 39.0 (IQR 27.8, 56.5) cm/s, P 〈 0.001, Figure 1}, and demonstrated low-peripheral-high-center (mountain-shaped, 25%), or mean low level (45.7%) CV patterns, when compared to 122 non-critical corridors distant from LM that displayed high-peripheral-low-center (valley-shaped, 20.5%) or mean high level (59%) CV patterns. Conclusion: Myocardial LM is a crucial contributor to VT propensity. Corridors traversing through or near LM exhibit significantly slower CV, which likely facilitate the presence and stability of the VT circuit reentry.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.11288
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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