Hodnocení myokardiální energetiky pomocí strain echokardiografie

2nd Department of Medicine - Clinical Department of Cardiology and AngiologyII. interní klinika - klinika kardiologie a angiologie 1.LF a VFN v PrazeFirst Faculty of Medicine1. lékařská fakult

Progress Report No. 20

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1983 to 30 June 1984

Left ventricular mechanics in advanced heart failure patients

The general introduction of the thesis outlines the role of cardiac mechanics assessment in the evaluation and risk stratification of HF patients. Part I This part of the thesis summarizes current imaging techniques to assess various aspects of LV mechanics in HF patients (Chapter 2), differentiating between ischemic and non-ischemic HF (Chapter 3) and investigating its role in the selection of HF patients who are candidates to CRT (Chapters 4-6). Furthermore, the role of imaging techniques to optimize the results of CRT is summarized in Chapter 7. Part II The final part focuses on long-term prognosis of advanced HF patients. Novel echocardiographic techniques provide several parameters that have incremental prognostic value over well-recognized echocardiographic and clinical parameters (Chapters 8-11). CONCLUSIONS The study of cardiac mechanics is crucial in advanced HF patients. Particularly, using imagine techniques as speckle-tracking echocardiography, important information on the effects of CRT in heart failure patients may be derived. Moreover, studying LV mechanics may be helpful for understanding the differences in pathophysiological mechanisms of different HF aetiologies. Finally, the role of non-invasive imaging techniques for the study of LV mechanics may be paramount for the definition of long-term prognosis in advanced HF patients.UBL - phd migration 201

Progress Report No. 19

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1982 to 30 June 1983

EVALUATION OF LEFT VENTRICULAR AND ATRIAL-APPENDAGE FUNCTION IN NORMAL AND ISCHEMIC MOUSE MODELS BY CARDIAC IMAGING TECHNIQUES: A PHARMACOLOGICAL VALIDATION

Despite progress in diagnosis and treatment lead to a significant reduction of the rate of death attributable to cardiovascular disease (CVD), many efforts must to be done to modify the pathological process and enhance protection. Thus the development of new technologies for diagnosis and novel therapeutic agents is fundamental for clinicians and researcher. In the last decade, murine model had become a useful tool to study CVDs mechanism and to test new pharmacological treatments. Noninvasive imaging technique, specific for laboratory animals, provide the opportunity to image longitudinally the same animal, investigating the follow-up of pathologies and assessing the effect of pharmacological treatments. Aims of this work are to set up an animal model of myocardial infarction (MI) and cardiac imaging (cardiac magnetic resonance imaging and echocardiography) of left ventricle (LV), left atrium (LA) and appendage (LAA) in healthy mice, and then evaluate the global and regional functional-structural changes and remodeling occurring on LV, LA and LAA after MI, with or without pharmacological treatment. The in vivo imaging data were supported by morphological, histological and gene expression analysis. Results from this study described the regional area changes occurring on LV after MI with a progressive loss of contractility also in remote non-infarcted tissue; the presence of only three pulmonary veins entering LA and the presence of the large LAA which, working together with LA, plays an important role in LV filling. After MI not only LV but also LA and LAA remodel in order to maintain, with their enlargement, LV stroke volume. The pharmacological treatment with valsartan, a selective inhibitor of AT1 receptor of Ang II, influenced LV remodeling by reducing LV enlargement, infarct size, ECM gene expression (in particular collagen VIII, fibulin-2 involved in fibrosis and hypertrophy), preserving LV SV without affecting LAA and LA increase in dimension

Clinical applications of non-invasive imaging techniques in suspected coronary artery disease and in acute myocardial infarction

Non-invasive cardiac imaging modalities play a crucial role in the diagnostic process and clinical management of patients without known coronary artery disease and patients with acute myocardial infarction. The first part of the thesis discusses the use of non-invasive imaging modalities (including coronary artery calcium scoring, multi-slice computed tomography coronary angiography, conventional two-dimensional echocardiography and speckle-tracking echocardiography) for the diagnosis and risk stratification of patients with suspected coronary artery disease. The second part of the thesis discusses the diagnostic and prognostic value of novel echocardiographic techniques (including contrast echocardiography, myocardial deformation imaging, and three-dimensional echocardiography) in patients admitted with acute myocardial infarction.UBL - phd migration 201