The production of miniature animals has been suggested for use in organ transplantation. At present, many of the studies about application of animal organs to human have been focused on pigs because of the number of advantages involved and due to their similarities with human. However, a physiological analysis of the organs to be transplanted has not yet been carried out. Therefore, this study analyzed whether or not there were physiological and morphological differences in the hearts of conventionallyreared pigs and micropigs. In this study, the morphological and physiological functions of the heart were examined using radiographic and echocardiographic equipment. In the lateral radiographic view, the heart of the micropig has a larger cardiac long axis : short axis ratio than does the conventional pig, but the difference in the vertebral heart score was not significant. In addition, there were no morphological differences on the X-ray fluoroscopic view. There were no differences in echocardiographic values, except for several values in the left ventricle traces. Overall, it is expected that the values measured in this study will contribute to understanding of the physiological characteristics of micropigs.
Animals ; Echocardiography/veterinary ; Fluoroscopy/veterinary ; Heart/*physiology/*radiography ; Stroke Volume/physiology ; Swine ; Swine, Miniature

BACKGROUNDImpaired exercise capacity is one of the most common clinical manifestations in patients with chronic heart failure (CHF). The severity of reduced exercise capacity is an indicator of disease prognosis. The aim of the current study was to investigate the association between left heart size and mass with exercise capacity.

METHODSA total of 74 patients were enrolled in the study, with 37 having congestive heart failure (left ventricular ejection fraction (LVEF) < 0.45) and the other 37 with coronary heart disease (by coronary angiography) serving as the control group (LVEF > 0.55). Echocardiography and cardiopulmonary exercise test were performed. The multiply linear regression model was used to evaluate the association between echocardiogrphic indices and exercise capacities.

RESULTSThe study showed that left ventricular end diastolic/systolic diameter (LVEDD/LVESD), left atrial diameter (LAD) and left ventricular mass index (LVMI) were significantly enlarged in patients with chronic heart failure compared with controls (P < 0.01). The VO(2)AT, Peak VO(2), Load AT, and Load Peak in chronic heart failure patients were also significantly reduced compared with controls (P < 0.05), VE/VCO(2) slope was increased in patients with chronic heart failure (P < 0.01). Multivariate linear regression analysis indicated that the patients' exercise capacity was significantly associated with the left heart size and mass, however, the direction and/or strength of the associations sometimes varied in chronic heart failure patients and controls. Load AT correlated negatively with LVEDD in chronic heart failure patients (P = 0.012), while Load AT correlated positively with LVEDD in control patients (P = 0.006). VE/VCO(2) slope correlated positively with LAD (B = 0.477, P < 0.0001) in chronic heart failure patients, while the VE/VCO(2) slope correlated negatively with LAD in control patients (P = 0.009).

CONCLUSIONThe study indicates that the size of LVEDD and LAD are important determinants of exercise capacity in patients with CHF, which may be helpful to identify exercise tolerance for routine monitoring of systolic heart failure.

Aged ; Cardiac Volume ; physiology ; Echocardiography ; Exercise Test ; Exercise Tolerance ; physiology ; Female ; Heart Failure ; physiopathology ; Heart Ventricles ; diagnostic imaging ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Radiography

Pigs are the most likely source animals for cardiac xenotransplantation. However, an appropriate method for estimating the cardiac function of micropigs had not been established. Computed tomography (CT) analysis aimed at estimating cardiac function and assessing the coronary arteries has not been carried out in micropigs. This study determined the feasibility of evaluating cardiac function in a micropig model using multidetector row computed tomography (MDCT) and compared the cardiac function values with those of conventional pigs. The mean age of the conventional pigs and micropigs was approximately 80 days and approximately 360 days, respectively. The mean body weight in the conventional pigs and micropigs was 29.70 +/- 0.73 and 34.10 +/- 0.98 kg, respectively. Cardiac MDCT detected ejection fractions of 52.93 +/- 3.10% and 59.00 +/- 5.56% and cardiac outputs of 1.46 +/- 0.64 l/min and 1.21 +/- 0.24 l/min in conventional pigs and micropigs, respectively. There were no significant differences in cardiac function between conventional pigs and micropigs in the reconstructed CT images. There were also no differences in the coronary angiographic images obtained by MDCT. It is expected that the results of this study will help improve understanding of cardiac function in micropigs. The data presented in this study suggest that MDCT is a feasible method for evaluating cardiac function in micropigs.
Animals ; Coronary Angiography/*methods ; Heart/*physiology/radiography ; *Models, Animal ; Sus scrofa/*physiology ; Swine ; Swine, Miniature/*physiology ; Tomography, X-Ray Computed/*methods

OBJECTIVE: This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). MATERIALS AND METHODS: Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. RESULTS: Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. CONCLUSION: The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.
Adult ; Aged ; Electrocardiography ; Female ; Heart Ventricles/radiography ; Humans ; Hypertension, Pulmonary/complications/*diagnosis ; Lung/radiography ; Male ; Middle Aged ; Multidetector Computed Tomography ; Pulmonary Disease, Chronic Obstructive/complications/*radiography ; Pulmonary Emphysema/complications/*radiography ; Regression Analysis ; Ventricular Function/*physiology

OBJECTIVE: To evaluate the influence of papillary muscles and trabeculae on left ventricular (LV) cardiovascular magnetic resonance (CMR) analysis using three methods of cavity delineation (classic or modified inclusion methods, and the exclusion method) in patients with hypertrophic cardiomyopathy (HCM). MATERIALS AND METHODS: This retrospective study included 20 consecutive HCM patients who underwent 1.5-T CMR imaging with short-axis cine stacks of the entire LV. LV measurements were performed using three different methods of manual cavity delineation of the endocardial and epicardial contours: method A, presumed endocardial boundary as seen on short-axis cine images; method B, including solely the cavity and closely adjacent trabeculae; or method C, excluding papillary muscles and trabeculae. Ascending aorta forward flow was measured as reference for LV-stroke volume (SV). Interobserver reproducibility was assessed using intraclass correlation coefficients. RESULTS: Method A showed larger end-diastole and end-systole volumes (largest percentage differences of 25% and 68%, respectively, p < 0.05), compared with method C. The ejection fraction was 55.7 +/- 6.9% for method A, 68.6 +/- 8.4% for B, and 71.7 +/- 7.0% for C (p < 0.001). Mean mass was also significantly different: 164.6 +/- 47.4 g for A, 176.5 +/- 50.5 g for B, and 199.6 +/- 53.2 g for C (p < 0.001). LV-SV error was largest with method B (p < 0.001). No difference in interobserver agreement was observed (p > 0.05). CONCLUSION: In HCM patients, LV measurements are strikingly different dependent on whether papillary muscles and trabeculae are included or excluded. Therefore, a consistent method of LV cavity delineation may be crucial during longitudinal follow-up to avoid misinterpretation and erroneous clinical decision-making.
Adult ; Aged ; Cardiomyopathy, Hypertrophic/*pathology ; Female ; Heart Ventricles/physiopathology/*radiography ; Humans ; *Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; Papillary Muscles/*physiopathology ; Retrospective Studies ; Stroke Volume/physiology ; Systole/physiology

OBJECTIVE: Post-contrast T1 values are closely related to the degree of myocardial extracellular space expansion. We determined the relationship between post-contrast T1 values and left ventricular (LV) diastolic function, LV remodeling, and neurohormonal activation in patients with dilated cardiomyopathy (DCM). MATERIALS AND METHODS: Fifty-nine patients with DCM (mean age, 55 +/- 15 years; 41 males and 18 females) who underwent both 1.5T magnetic resonance imaging and echocardiography were enrolled. The post-contrast 10-minute T1 value was generated from inversion time scout images obtained using the Look-Locker inversion recovery sequence and a curve-fitting algorithm. The T1 sample volume was obtained from three interventricular septal points, and the mean T1 value was used for analysis. The N-Terminal pro-B-type natriuretic peptide (NT-proBNP) level was measured in 40 patients. RESULTS: The mean LV ejection fraction was 24 +/- 9% and the post-T1 value was 254.5 +/- 46.4 ms. The post-contrast T1 value was significantly correlated with systolic longitudinal septal velocity (s'), peak late diastolic velocity of the mitral annulus (a'), the diastolic elastance index (Ed, [E/e']/stroke volume), LV mass/volume ratio, LV end-diastolic wall stress, and LV end-systolic wall stress. In a multivariate analysis without NT-proBNP, T1 values were independently correlated with Ed (beta = -0.351, p = 0.016) and the LV mass/volume ratio (beta = 0.495, p = 0.001). When NT-proBNP was used in the analysis, NT-proBNP was independently correlated with the T1 values (beta = -0.339, p = 0.017). CONCLUSION: Post-contrast T1 is closely related to LV remodeling, diastolic function, and neurohormonal activation in patients with DCM.
Adult ; Aged ; Algorithms ; Blood Pressure ; Cardiomyopathy, Dilated/*diagnosis/radiography ; Echocardiography ; Extracellular Space/physiology/*radiography ; Female ; Heart Ventricles/physiopathology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multivariate Analysis ; Natriuretic Peptide, Brain/analysis ; Peptide Fragments/analysis ; *Ventricular Remodeling

Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CDChest PA/CDChest AP ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CDChest PA was inferred from multiplying CDChest AP by this ratio. Incorporating this CD and substituting the most recent TDChest PA, we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CDChest PA/CDChest AP ratio was {0.00099 x (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P < 0.001). The corrected CTR was highly correlated with the conventional one (n = 34, difference: 0.00016 +/- 0.029; r = 0.92, P < 0.001). It was higher in congestive than non-congestive patients (0.53 +/- 0.085; n = 38 vs 0.49 +/- 0.061; n = 46, P = 0.006). Its sensitivity and specificity was 61% and 54%. In summary, reliable CTR can be calculated from chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP.
Aged ; Aged, 80 and over ; Cardiomegaly/*radiography ; Cross-Sectional Studies ; Dyspnea ; Female ; Heart/*radiography ; Humans ; Male ; Middle Aged ; Point-of-Care Systems ; Radiography, Thoracic/*methods ; Thorax/anatomy & histology/physiology ; Tomography, X-Ray Computed/methods

Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
Cardiomyopathies/diagnosis/radiography ; Cardiotonic Agents/therapeutic use ; Chest Pain/complications/diagnosis/radiography ; Coronary Artery Bypass ; Coronary Artery Disease/*diagnosis/drug therapy/radiography ; Dobutamine/therapeutic use ; Echocardiography ; Heart Defects, Congenital/diagnosis/radiography ; Heart Failure/diagnosis/ultrasonography ; Humans ; *Magnetic Resonance Imaging ; Mucocutaneous Lymph Node Syndrome/complications/diagnosis ; Percutaneous Coronary Intervention ; Prognosis ; Risk Assessment ; Ventricular Function, Left/physiology

BACKGROUNDPulmonary artery sling (PAS) is a rare congenital heart anomaly and may cause unexplained respiratory symptoms in infants. Since the non-specific respiratory symptoms of PAS may lead to misdiagnosis, the aim of this study was to clarify the clinical and imaging features of this disease for timely diagnosis and treatment.

METHODSClinical histories, physical examinations and imaging studies were retrospectively evaluated in nine infants with PAS. Chest X-ray, echocardiography and contrast-enhanced computed tomography (CT) with 3-dimensional reconstructions were performed in all patients and three of them received surgical treatment.

RESULTSNine cases included six males and three females with a mean age of (4.3 ± 2.8) months ranging from 2 to 11 months old. All patients had respiratory symptoms including recurrent cough, stridor and wheezing. The onset of symptoms was within 3 months in all cases and three children had symptoms only a few days after birth. The chest X-ray showed pneumonia in all cases. Contrast-enhanced CT showed the tracheal compression at different lengths in every case. The echocardiograph findings of PAS were anomalous origins of the left pulmonary artery from the posterior aspect of the right pulmonary artery. Of the 9 cases, 8 cases were diagnosed correctly by echocardiography. Of the complicated abnormalities, there were one with secundum atrial septal defect, one with patent foramen ovale and three with persistent left superior vena cava. None of them were complicated with significant blood dynamic changes.

CONCLUSIONSInfants with recurrent respiratory symptoms such as chronic cough, stridor and wheezing, should be examined for the possible presence of congenital pulmonary artery sling. As a noninvasive technique, echocardiography is very helpful and should be the first-choice modality for the diagnosis of pulmonary artery sling. Contrast-enhanced CT, clearly demonstrating the anatomy of pulmonary artery sling and the position and extent of trachea compression, is necessary for the final diagnosis and pre-operation evaluation.

Echocardiography ; Female ; Heart Defects, Congenital ; diagnosis ; diagnostic imaging ; physiopathology ; Hemodynamics ; physiology ; Humans ; Infant ; Male ; Pulmonary Artery ; abnormalities ; diagnostic imaging ; physiopathology ; Radiography

BACKGROUNDPatients with congenital scoliosis often also have intraspinal abnormalities and other organ defects, and few studies of the effects of congenital scoliosis on cardiac function and structure have been published.

METHODSA total of 215 adolescent patients with congenital scoliosis (average age, 13.58 years) underwent preoperative echocardiography and were then assigned to subgroups according to apex vertebral rotation, side of convexity, curvature severity in the coronal and sagittal planes, type of deformity, and sex. Differences between the subgroups were compared by independent-samples t test or a one-factor analysis of variance.

RESULTSWe observed statistically significant differences between patients with right-sided scoliosis curvature and those with left-sided scoliosis curvature, respectively, in left ventricular inner diameter at end-diastole ((39.39 +/- 4.66) mm vs (41.74 +/- 4.90) mm), left ventricular inner diameter at end-systole ((24.80 +/- 3.45) mm vs (25.92 +/- 3.07) mm), interventricular septum thickness at end-diastole ((5.66 +/- 0.98) mm vs (5.98 +/- 1.03) mm), and posterior wall of left ventricle at end-diastole ((5.61 +/- 0.98) mm vs (6.06 +/- 1.20) mm). When the patients were evaluated by coronal plane Cobb angle, significant differences were found between those with Cobb angle of 40 degrees - 80 degrees and of > 80 degrees in left ventricular inner diameter at end-diastole ((40.97 +/- 5.06) mm vs (38.98 +/- 4.45) mm) and left ventricular inner diameter at end-systole ((25.53 +/- 3.39) mm vs (24.36 +/- 3.14) mm), respectively. When the patients were evaluated by sagittal plane Cobb angle (< 20 degrees, group 1; 20 degrees - 40 degrees, group 2; > 40 degrees, group 3), significant differences were found in right ventricular diameter between those with Cobb angle of < 20 degrees and of 20 degrees - 40 degrees ((18.27 +/- 3.66) mm vs (16.54 +/- 3.57) mm) and in diameter of aortic root between those with Cobb angle of 20 degrees - 40 degrees and of > 40 degrees ((23.83 +/- 3.39) mm vs (24.90 +/- 3.30) mm), respectively. No significant differences were found in ejection fraction and fractional shortening between patients according to apex vertebral rotation, side of convexity, coronal plane and sagittal plane Cobb angles, type of deformity, or sex.

CONCLUSIONSCongenital scoliosis influences cardiac structure, but not function.

Adolescent ; Child ; Congenital Abnormalities ; physiopathology ; Echocardiography ; methods ; Female ; Heart ; anatomy & histology ; diagnostic imaging ; physiology ; Humans ; Male ; Radiography ; Retrospective Studies ; Scoliosis ; physiopathology ; Young Adult