Trabeculated myocardium in healthy adults : a first step in understanding the diagnosis of non-compaction cardiomyopathy by magnetic resonance

La cardiomyopathie non-compacté (NCC) est une maladie rare avec des critères diagnostiques basés sur la détection de l’augmentation du myocarde trabeculé par échocardiographie. L’imagerie par résonance magnétique (IRM) est devenue la méthode de référence pour étudier la fonction et la morphologie du cœur compte tenu de sa meilleure résolution spatiale et temporale. Toutefois, les critères diagnostiques de NCC que nous utilisons en ce moment en IRM ont été tirés d’études en échocardiographie. Ceci pourrait impliquer une augmentation de l’incidence de nouveaux cas de NCC, de même que la positivité chez les adultes en santé. Le présent travail a voulu étudier la “normalité” par IRM en termes de présence et de distribution de myocarde trabeculé chez les adultes en santé et déterminer la présence des associations entre le myocarde trabeculé et les paramètres de fonction cardiaque.Non-compaction cardiomyopathy (NCC) is a rare entity that is currently diagnosed for the most part by echocardiography in cases of an increased layer of trabeculated myocardium. Recently, magnetic resonance imaging (MRI) became the gold standard imaging technique in the study of cardiac function and morphology due to its high spatial and temporal resolution. However, diagnostic NCC criteria developped for echocardiography have been directly applied to MRI in the abscence of a standard definition of trabeculated myocardium. This direct application of echocardiography criteria to MRI may have led to an increased incidence of new NCC cases. The aim of this present work is to clarify clinical practice by determining normality by MRI in terms of presence and distribution of trabeculated myocardium in healthy adults and determine if any association exist between the presence and extension of trabeculated myocardium and cardiac function

The role of echocardiography in the diagnosis and management of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, affecting one in 500 individuals in the general population. In 60% of cases, HCM presents an autosomal dominant trait due to mutations in genes encoding cardiac sarcomeric proteins, and the remaining aetiologies include a variety of clinical entities such as glycogen and lysosomal storage disorders, mitochondrial diseases or cardiac amyloidosis, among others(1). In all cases, a systematised echocardiographic approach is essential to establish the diagnosis of HCM and to decide on specific therapeutic strategies. Moreover, echocardiography plays a key role in the evaluation and guidance of the different options to tackle obstructive HCM (HOCM). Indeed, recent improvements in survival and quality of life in HCM might be attributed to several factors, including the development of reliable imaging techniques. On top of this, echocardiography provides valuable information for the management of HCM regarding other aspects beyond left ventricular tract obstruction (LVOTO). This includes sudden cardiac death (SCD) prediction, thromboembolic risk stratification and family screening. In this article, we review and focus on the current role of echocardiography in the diagnosis and management of HCM.pre-print384 K

Exploration of the Human Purkinje Network in Virtual Populations

This thesis investigates the Purkinje network (PN) and its dependency on the heart shape (HS) through cardiac simulation on virtual populations (VPs). The heart is a complex organ and essential to the wellbeing of humans; its dysfunction is responsible for more than 27% of all deaths in the UK. The PN delivers the activation impulse to the ventricles of the heart and ensures their synchronous activation. Thus, the morphology of the PN is important, but it varies between species and in vivo imaging is not feasible. However, computer simulation could provide an alternative experimental tool. In simulation of the cardiac electrophysiology, the PN is often replaced by stimulus points on the HS that are fitted to physiological measurements (heart activation times, ECG). Thus, not allowing the study of the PN morphology, nor studies of arrhythmia involving re-entry into the PN. In this thesis, three studies involving explicit models of PNs have been conducted. First, an efficient algorithm for solving electrophysiology models for the PN is introduced. These allow performing simulations of physiological activations. To minimise the time for simulations, parallelisation with CPU and GPU architectures are investigated, which is of interest for VP studies. In the second study, false tendons (FTs) are studied, which provide an additional connection from the left bundle branch (LBB) and are potentially beneficial in case of LBB block. Therefore, the reduction in activation times by FT is studied as a function of the HS. In the third study, an automatically generated VP is used to explore uncertainty in the PN morphology. The conjecture is that the PN structure adapts to the HS. The coverage of the septum and the minimum distance of the PN to the base are varied. The features of the resulting ECG are used to find the PN that gives maximally synchronised contraction

Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: an expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association.

Taking into account the complexity and limitations of clinical assessment in hypertrophic cardiomyopathy (HCM), imaging techniques play an essential role in the evaluation of patients with this disease. Thus, in HCM patients, imaging provides solutions for most clinical needs, from diagnosis to prognosis and risk stratification, from anatomical and functional assessment to ischaemia detection, from metabolic evaluation to monitoring of treatment modalities, from staging and clinical profiles to follow-up, and from family screening and preclinical diagnosis to differential diagnosis. Accordingly, a multimodality imaging (MMI) approach (including echocardiography, cardiac magnetic resonance, cardiac computed tomography, and cardiac nuclear imaging) is encouraged in the assessment of these patients. The choice of which technique to use should be based on a broad perspective and expert knowledge of what each technique has to offer, including its specific advantages and disadvantages. Experts in different imaging techniques should collaborate and the different methods should be seen as complementary, not as competitors. Each test must be selected in an integrated and rational way in order to provide clear answers to specific clinical questions and problems, trying to avoid redundant and duplicated information, taking into account its availability, benefits, risks, and cost

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Advancements and Breakthroughs in Ultrasound Imaging

Ultrasonic imaging is a powerful diagnostic tool available to medical practitioners, engineers and researchers today. Due to the relative safety, and the non-invasive nature, ultrasonic imaging has become one of the most rapidly advancing technologies. These rapid advances are directly related to the parallel advancements in electronics, computing, and transducer technology together with sophisticated signal processing techniques. This book focuses on state of the art developments in ultrasonic imaging applications and underlying technologies presented by leading practitioners and researchers from many parts of the world