Felix F. Ungacta, Victor G. Dávila-Román, Michael J. Moulton, Brian P

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Left ventricular assist system as a bridge to myocardial recovery

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Date of download: 1/9/2018 Copyright © ASME. All rights reserved.

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Presentation transcript:

MRI-Radiofrequency Tissue Tagging in Patients With Aortic Insufficiency Before and After Operation Felix F. Ungacta, Victor G. Dávila-Román, Michael J. Moulton, Brian P. Cupps, Pavlos Moustakidis, Douglas S. Fishman, Ricardo Actis, Barna A. Szabo, Debiao Li, Nicholas T. Kouchoukos, Michael K. Pasque The Annals of Thoracic Surgery Volume 65, Issue 4, Pages 943-950 (April 1998) DOI: 10.1016/S0003-4975(98)00065-4

Fig. 1 Short-axis magnetic resonance imaging (A) at end-diastole and (B) at end-systole of the heart of a normal subject. Computer-generated splines are overlayed onto the myocardial tag lines. The intersection of the splines (red circles) identifies myocardial “material points,” which are used to calculate myocardial point displacement. The left ventricular borders are identified manually with two additional closed splines to represent the endocardium and the epicardium. Circumferential strain map of the left ventricle during systole demonstrating the strain patterns and magnitudes in (C) a heart with preoperative aortic insufficiency (pre-op AI) and (D) a heart with postoperative aortic insufficiency (post-op AI) in the same patient. Circumferential strain patterns demonstrate lower strains at the epicardium (red) with increasing strain towards the endocardium (yellow). The Annals of Thoracic Surgery 1998 65, 943-950DOI: (10.1016/S0003-4975(98)00065-4)

Fig. 2 Circumferential and radial strains are demonstrated as (A) overall circumferential shortening, (B) overall radial thickening, (C) regional circumferential shortening, and (D) regional radial thickening. Analysis of overall myocardial strains revealed no significant differences between any of the four groups in overall circumferential shortening or overall radial thickening. On regional analysis, posterior wall circumferential strains were significantly decreased in the postoperative AI group (29% ± 13% preoperative versus 24% ± 12% postoperative; ∗p = 0.02 by paired Student’s t test). (AI-pre = preoperative AI group; AI-post = postoperative AI group; NL = normal group.) The Annals of Thoracic Surgery 1998 65, 943-950DOI: (10.1016/S0003-4975(98)00065-4)

Fig. 3 Magnetic resonance imaging–determined fractional area change (FAC) from left ventricular short-axis images. There was no significant difference between the four groups. (AI-post = postoperative AI group; AI-pre = preoperative AI group; NL = normal group.) The Annals of Thoracic Surgery 1998 65, 943-950DOI: (10.1016/S0003-4975(98)00065-4)

Fig. 4 (A) Left ventricular end-systolic diameter (LV-ESD) demonstrating significantly greater end-systolic diameters in the preoperative aortic insufficiency group (AI-pre) (n = 8) when compared with the normal (NL) group (n = 10) (†p < 0.05) and significantly greater end-systolic diameters in the AI-pre (n = 6) group when compared with the postoperative AI group (AI-post) (n = 6) (∗p < 0.05). (B) Left ventricular end-diastolic diameter (LV-EDD) demonstrating significantly greater end-diastolic diameters in the AI-pre group (n = 8) when compared with the NL group (n = 10) (∗p < 0.05) and significantly greater end-diastolic diameters in the AI-pre group (n = 6) when compared with the AI-post group (n = 6) (†p < 0.05). The Annals of Thoracic Surgery 1998 65, 943-950DOI: (10.1016/S0003-4975(98)00065-4)

Fig. 5 Left ventricular myocardial mass indexed for body surface area (LV-Mass/BSA). The preoperative AI group (AI-pre) (n = 8) had significantly greater LV-Mass/BSA when compared with the normal (NL) group (n = 10) (∗p < 0.01). The postoperative AI group (AI-post) tended toward decreased LV-Mass/BSA compared with the AI-pre group (n = 6); however, this did not reach statistical significance (†p = 0.10). The Annals of Thoracic Surgery 1998 65, 943-950DOI: (10.1016/S0003-4975(98)00065-4)