Quantification of myocardial blood flow with cardiovascular magnetic resonance throughout the cardiac cycle

BACKGROUND: Myocardial blood flow (MBF) varies throughout the cardiac cycle in response to phasic changes in myocardial tension. The aim of this study was to determine if quantitative myocardial perfusion imaging with cardiovascular magnetic resonance (CMR) can accurately track physiological variations in MBF throughout the cardiac cycle. METHODS: 30 healthy volunteers underwent a single stress/rest perfusion CMR study with data acquisition at 5 different time points in the cardiac cycle (early-systole, mid-systole, end-systole, early-diastole and end-diastole). MBF was estimated on a per-subject basis by Fermi-constrained deconvolution. Interval variations in MBF between successive time points were expressed as percentage change. Maximal cyclic variation (MCV) was calculated as the percentage difference between maximum and minimum MBF values in a cardiac cycle. RESULTS: At stress, there was significant variation in MBF across the cardiac cycle with successive reductions in MBF from end-diastole to early-, mid- and end-systole, and an increase from early- to end-diastole (end-diastole: 4.50 ± 0.91 vs. early-systole: 4.03 ± 0.76 vs. mid-systole: 3.68 ± 0.67 vs. end-systole 3.31 ± 0.70 vs. early-diastole: 4.11 ± 0.83 ml/g/min; all p values <0.0001). In all cases, the maximum and minimum stress MBF values occurred at end-diastole and end-systole respectively (mean MCV = 26 ± 5%). There was a strong negative correlation between MCV and peak heart rate at stress (r = -0.88, p < 0.001). The largest interval variation in stress MBF occurred between end-systole and early-diastole (24 ± 9% increase). At rest, there was no significant cyclic variation in MBF (end-diastole: 1.24 ± 0.19 vs. early-systole: 1.28 ± 0.17 vs.mid-systole: 1.28 ± 0.17 vs. end-systole: 1.27 ± 0.19 vs. early-diastole: 1.29 ± 0.19 ml/g/min; p = 0.71). CONCLUSION: Quantitative perfusion CMR can be used to non-invasively assess cyclic variations in MBF throughout the cardiac cycle. In this study, estimates of stress MBF followed the expected physiological trend, peaking at end-diastole and falling steadily through to end-systole. This technique may be useful in future pathophysiological studies of coronary blood flow and microvascular function

A shot to the heart: a rare case of cardiac embolization

This is a case report of intracardiac foreign bodies that gained access to the heart by migration from a peripheral vein. The case report describes the diagnostic findings on cardiac imaging and summarizes different approaches to management

A comparison of cardiovascular magnetic resonance and single photon emission computed tomography (SPECT) perfusion imaging in left main stem or equivalent coronary artery disease: a CE-MARC substudy

Background: Assessment of left main stem (LMS) stenosis has prognostic and therapeutic implications. Data on assessment of LMS disease by cardiovascular magnetic resonance (CMR) and single photon emission computed tomography (SPECT) are limited. CE-MARC is the largest prospective comparison of CMR and SPECT against quantitative invasive coronary angiography (QCA) for detection of coronary artery disease (CAD), and provided the framework for this evaluation. The aims of this study were to compare diagnostic accuracy of visual and quantitative perfusion CMR to SPECT in patients with LMS stable CAD. Methods: Fifty-four patients from the CE-MARC study were included: 27 (4%) with significant LMS or LMS-equivalent disease on QCA, and 27 age/sex-matched patients with no flow-limiting CAD. All patients underwent multi-parametric CMR, SPECT and QCA. Performance of visual and quantitative perfusion CMR by Fermi-constrained deconvolution to detect LMS disease was compared with SPECT. Results: Of 27 patients in the LMS group, 22 (81%) had abnormal CMR and 16 (59%) had abnormal SPECT. All patients with abnormal CMR had abnormal perfusion by visual analysis. CMR demonstrated significantly higher area under the curve (AUC) for detection of disease (0.95; 0.85–0.99) over SPECT (0.63; 0.49–0.76) (p = 0.0001). Global mean stress myocardial blood flow (MBF) by CMR in LMS patients was significantly lower than controls (1.77 ± 0.72 ml/g/min vs. 3.28 ± 1.20 ml/g/min, p < 0.001). MBF of <2.08 ml/g/min had sensitivity of 78% and specificity of 85% for diagnosis of LMS disease, with an AUC (0.87; 0.75–0.94) not significantly different to visual CMR analysis (p = 0.18), and more accurate than SPECT (p = 0.003). Conclusion: Visual stress perfusion CMR had higher diagnostic accuracy than SPECT to detect LMS disease. Quantitative perfusion CMR had similar performance to visual CMR perfusion analysis

Quantitative three-dimensional cardiovascular magnetic resonance myocardial perfusion imaging in systole and diastole

BACKGROUND: Two-dimensional (2D) perfusion cardiovascular magnetic resonance (CMR) remains limited by a lack of complete myocardial coverage. Three-dimensional (3D) perfusion CMR addresses this limitation and has recently been shown to be clinically feasible. However, the feasibility and potential clinical utility of quantitative 3D perfusion measurements, as already shown with 2D-perfusion CMR and positron emission tomography, has yet to be evaluated. The influence of systolic or diastolic acquisition on myocardial blood flow (MBF) estimates, diagnostic accuracy and image quality is also unknown for 3D-perfusion CMR. The purpose of this study was to establish the feasibility of quantitative 3D-perfusion CMR for the detection of coronary artery disease (CAD) and to compare systolic and diastolic estimates of MBF. METHODS: Thirty-five patients underwent 3D-perfusion CMR with data acquired at both end-systole and mid-diastole. MBF and myocardial perfusion reserve (MPR) were estimated on a per patient and per territory basis by Fermi-constrained deconvolution. Significant CAD was defined as stenosis ≥70% on quantitative coronary angiography. RESULTS: Twenty patients had significant CAD (involving 38 out of 105 territories). Stress MBF and MPR had a high diagnostic accuracy for the detection of CAD in both systole (area under curve [AUC]: 0.95 and 0.92, respectively) and diastole (AUC: 0.95 and 0.94). There were no significant differences in the AUCs between systole and diastole (p values >0.05). At stress, diastolic MBF estimates were significantly greater than systolic estimates (no CAD: 3.21 ± 0.50 vs. 2.75 ± 0.42 ml/g/min, p 0.05). Image quality was higher in systole than diastole (median score 3 vs. 2, p = 0.002). CONCLUSIONS: Quantitative 3D-perfusion CMR is feasible. Estimates of MBF are significantly different for systole and diastole at stress but diagnostic accuracy to detect CAD is high for both cardiac phases. Better image quality suggests that systolic data acquisition may be preferable

Time Evolution of the Wettability of Supported Graphene under Ambient Air Exposure.

The wettability of graphene is both fundamental and crucial for interfacing in most applications, but a detailed understanding of its time evolution remains elusive. Here we systematically investigate the wettability of metal-supported, chemical vapor deposited graphene films as a function of ambient air exposure time using water and various other test liquids with widely different surface tensions. The wettability of graphene is not constant, but varies with substrate interactions and air exposure time. The substrate interactions affect the initial graphene wettability, where, for instance, water contact angles of ∼85 and ∼61° were measured for Ni and Cu supported graphene, respectively, after just minutes of air exposure. Analysis of the surface free energy components indicates that the substrate interactions strongly influence the Lewis acid-base component of supported graphene, which is considerably weaker for Ni supported graphene than for Cu supported graphene, suggesting that the classical van der Waals interaction theory alone is insufficient to describe the wettability of graphene. For prolonged air exposure, the effect of physisorption of airborne contaminants becomes increasingly dominant, resulting in an increase of water contact angle that follows a universal linear-logarithmic relationship with exposure time, until saturating at a maximum value of 92-98°. The adsorbed contaminants render all supported graphene samples increasingly nonpolar, although their total surface free energy decreases only by 10-16% to about 37-41 mJ/m2. Our finding shows that failure to account for the air exposure time may lead to widely different wettability values and contradicting arguments about the wetting transparency of graphene.We acknowledge funding from EPSRC (Grant No. EP/K016636/1, GRAPHTED) and ERC (Grant No. 279342, InsituNANO). P.R. Kidambi acknowledges the Lindemann Trust Fellowship. R.S. Weatherup acknowledges a Research Fellowship from St. John’s College, Cambridge and a EU Marie Skłodowska-Curie Individual Fellowship under grant ARTIST (no. 656870) from the European Union’s Horizon 2020 research and innovation programme.This is the final version of the article. It first appeared from the American Chemical Society via https://doi.org/10.1021/acs.jpcc.5b1049

Effects of polymethylmethacrylate-transfer residues on the growth of organic semiconductor molecules on chemical vapor deposited graphene

Scalably grown and transferred graphene is a highly promising material for organic electronic applications, but controlled interfacing of graphene thereby remains a key challenge. Here, we study the growth characteristics of the important organic semiconductor molecule para-hexaphenyl (6P) on chemical vapor deposited graphene that has been transferred with polymethylmethacrylate (PMMA) onto oxidized Si wafer supports. A particular focus is on the influence of PMMA residual contamination, which we systematically reduce by H2 annealing prior to 6P deposition. We find that 6P grows in a flat-lying needle-type morphology, surprisingly independent of the level of PMMA residue and of graphene defects. Wrinkles in the graphene typically act as preferential nucleation centers. Residual PMMA does however limit the length of the resulting 6P needles by restricting molecular diffusion/attachment. We discuss the implications for organic device fabrication, with particular regard to contamination and defect tolerance.B.C.B acknowledges a College Research Fellowship from Hughes Hall, Cambridge. P.R.K. acknowledges the Lindemann Trust Fellowship. A.M. and G.R. acknowledge support by the Serbian MPNTR through Projects OI 171005 and III 45018. R.S.W. acknowledges a research fellowship from St. John’s College, Cambridge. S.H. acknowledges funding from EPSRC (GRAPHTED, Grant No. EP/K016636/1). We want to thank Dr. Sarah M. Skoff (Vienna University of Technology, Austria) for fruitful discussions.This is the author accepted manuscript. The final published version is available via AIP at http://scitation.aip.org/content/aip/journal/apl/106/10/10.1063/1.4913948

Mechanisms of titania nanoparticle mediated growth of turbostratic carbon nanotubes and nanofibers

Turbostratic carbon nanotubes (CNTs) and nanofibers (CNFs) are synthesized by chemical vapor deposition using titania nanoparticle catalysts, and a quantitative lift-off model is developed to explain CNT and CNF growth. Micron-scale long turbostratic CNTs and CNFs were observed when acetylene is utilized as a carbon feedstock, and an alumina substrate was incorporated to improve the homogeneity of catalyst distribution. Turbostratic CNTs/CNFs are always found attached to nanoparticle corners, in the absence of the graphitic cage that is typically observed with metal nanoparticle-mediated growth. The observed morphology in turbostratic CNTs/CNFs supports a model in which several layers of graphene lift off from high-curvature corners of the titania nanoparticle catalysts. This model explains a key feature, which differentiates the growth of turbostratic CNTs/CNFs via non-metallic nanoparticles from growth using standard metal nanoparticle catalysts. The observed CNT/CNF growth and the accompanying model can impact the assessment of other metal-oxide nanoparticle catalysts, with the findings here contributing to a metal-free synthesis of turbostratic CNTs/CNFs

Hybrid graphene nematic liquid crystal light scattering device.

A hybrid graphene nematic liquid crystal (LC) light scattering device is presented. This device exploits the inherent poly-crystallinity of chemical vapour deposited (CVD) graphene films to induce directional anchoring and formation of LC multi-domains. This thereby enables efficient light scattering without the need for crossed polarisers or separate alignment layers/additives. The hybrid LC device exhibits switching thresholds at very low electric fields (< 1 V μm(-1)) and repeatable, hysteresis free characteristics. This exploitation of LC alignment effects on CVD graphene films enables a new generation of highly efficient nematic LC scattering displays as well as many other possible applications.Funding from the EPSRC (Grant No. EP/K016636/1, GRAPHTED) is acknowledged. P.R.K. acknowledges funding from Cambridge Commonwealth Trust (CCT) and the Lindemann Trust Fellowship. A.A.K would like to thank the Higher Education of Pakistan (HEC) and the CCT for financial support. A.C.V. acknowledges funding from the Cambridge Conacyt Scholarship and the Roberto Rocca Fellowship. A.K. would like to thank the Luys Educational Foundation and Hovnanian Foundation for scholarships.This is the author accepted manuscript. The final version is available from the Royal Society of Chemistry via http://dx.doi.org/10.1039/c5nr04094