Imaging the right heart: the use of integrated multimodality imaging

During recent years, right ventricular (RV) structure and function have been found to be an important determinant of outcome in different cardiovascular and also pulmonary diseases. Currently, echocardiography and cardiac magnetic resonance (CMR) imaging are the two imaging modalities most commonly used to visualize the RV. Most structural abnormalities of the RV can be reliably described by echocardiography but due its complex geometrical shape, echocardiographic assessment of RV function is more challenging. Newer promising echocardiographic techniques are emerging but lack of validation and limited normal reference data influence their routine clinical application. Cardiac magnetic resonance is generally considered the clinical reference technique due to its unlimited imaging planes, superior image resolution, and three-dimensional volumetric rendering. The accuracy and reliability of CMR measurements make it the ideal tool for serial examinations of RV function. Multidetector computed tomography (MDCT) plays an important role in the diagnosis of pulmonary emboli but can also be used for assessing RV ischaemic disease or as an alternative for CMR if contra-indicated. Radionuclide techniques have become more obsolete in the current era. The different imaging modalities should be considered complimentary and each plays a role for different indication

The effect of stretching on transmural shear wave anisotropy in cardiac shear wave elastography

Shear Wave Elastography (SWE) is a potential tool for non-invasively assessing myocardial stiffness to support diagnosis and treatment choice in patients with cardiac disorders. Previous studies demonstrated a 3D anisotropic shear wave propagation in cardiac SWE due to the intrinsic myocardial fiber architecture. The aim of this work is to further investigate the performance of cardiac SWE by studying the effect of uniaxial stretching on anisotropic shear wave propagation and characterization. Results showed a clear increase in group and dominant phase speed during stretching, especially along the direction of the fiber. Additionally, the maximal group and dominant phase speed value spatially shifted while stretching, indicating an alignment of the fibers to the stretching direction. Complementary numerical modeling could further explore these interactions between myocardial fiber architecture and cardiac loading during SWE

Using Machine Learning to Generate a Core Set of Echocardiographic Indices for Pediatric Research: A Sub-study in the PCS2 Cohort

With a multitude of echocardiographic (echo) parameters at a clinician’s disposal and clinical efficiency paramount, determining the most reliable and relevant pediatric echo parameters remains challenging. Using machine learning (ML), clinical relevance, and inter/intra-rater reliability, we aimed to identify a core set of echo parameters from the PCS2 cohort of childhood cancer survivors and healthy controls to guide pediatric research and clinical care. A standard set of 94 echocardiographic parameters were chosen and screened for missing variation, linear combinations, and high correlations. A hierarchical cluster analysis using Ward’s method was performed on the remaining variables to produce a clustering dendrogram. Thereafter, inter- and intra-rater reliability analyses were conducted using intraclass correlation coefficients (ICC) and Bland-Altman (B-A) plots. Using highly reliable (\u3e0.65 ICC) and available (\u3e80% scored) parameters, five pediatric cardiologists ranked each parameter within cluster for clinical relevance. Of the 61 echo parameters selected for the dendrogram, only 54 were scored due to feasibility of sonographer acquisition. ≥73% of all scored parameters had good (0.60-0.74) or excellent (≥0.75) ICC in the inter- and intra-rater analyses. Mean within cluster ranks were assigned per parameter to identify a core set of 10, and minimal set of 5 parameters: ejection fraction (EF), mitral valve E/E’, tissue doppler interventricular septum valve S-velocity, average global longitudinal strain, and LV end diastolic diameter. Using clustering analysis, clinical relevance rankings, and reliability we have identified 10 core and 5 minimal echo indices to guide further pediatric echocardiographic research and clinical care

Electrochemical synthesis of new electroactive polymers from dithienylene-vinylene derivatives

peer reviewedHighly conjugated thiophene derivatives, based on thienylene-vinylene and thieneylene-vinylene-phenylene units, have been synthesized in order to examine: (i) the effect of such regular conjugated monomer structures on the polymerization; (ii) the optical and electrochemical properties of the corresponding conjugated polymers. The all-trans monomers have been prepared by a Wittig reaction and the polymers have then been synthesized electrochemically. The polymers are electrochromic and can be reversibly doped both oxidatively and reductively. Their electrochemical behavior and optical properties have been analysed on the basis of quantum-chemical calculations