Three dimensional echocardiographic assessment of multiple rhabdomyoma in newborn

Cardiac rhabdomyomas represent the most common primary cardiac tumour in children and are strongly associated with tuberous sclerosis complex. This article reports a newborn for whom three-dimensional echocardiogram, with multiplane mode, real-time imaging, full volume and i-slice view, allowed detailed visualisation of multiple highly echogenic and well-circumscribed cardiac rhabdomyoma. Three-dimensional imaging allowed a better definition of the tumour characteristics and provided a better delineation of the spatial relationship of the mass with a tomographic perspective. Three dimensional imaging may facilitate a possible operative planning and should be included in cardiac mass evaluation and follow-up.peer-reviewe

Synergic PDE3 and PDE4 control intracellular cAMP and cardiac excitation-contraction coupling in a porcine model

International audienc

Sport resumption and quality of life after surgical correction of anomalous origin of a coronary artery from the opposite sinus

ObjectivesWe sought to assess the resumption of sport, exercise performances, and quality of life (QoL) in adults and children after surgical repair of anomalous coronary arteries originating from the opposite sinus (ACAOS).Materials and methodsPatients who underwent surgical repair for ACAOS between 2002 and 2022 were retrospectively identified. Information about sports activity and exercise performance based on metabolic equivalents of task (METs) calculated at the last exercise stress test, were collected. QoL was assessed using age-appropriate questionnaires (Paediatric QoL Inventory, cardiac module version 3.0 for patients <18 years; SF-36 QoL Inventory for adults). Patients' METS and patients’ QoL-scores were compared to reference population using the Wilcoxon test.Results45 patients were enrolled (males 71%, adults 49%, anomalous right coronary 84%). Median age at surgery was 15 years; median follow-up after surgery was 2.3 years [4 months–12 years]. All post-operative exercise stress tests were normal, METs and VO2 max patients' values did not differ from healthy children or adults (Exercise intensity: 12.5 ± 4.7 vs. 13.4 ± 2 METS, p = 0.3; VO2 max: 43.6 ± 16.6 vs. 46.9 ± 7 ml/kg/min, p = 0.37). For adults, QoL—scores were similar between ACAOS patients and controls. For children, there was no significant difference between the study patients' scores and those of the reference population, except for physical appearance proxy-report (p = 0.02).ConclusionIn our study, the practice of sports, exercise stress testing and QoL were not adversely affected after ACAOS repair

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Echocardiographic assessment of the athlete’s heart using myocardial deformation, ventricular volumes, and intracardiac flows

L’athlète entrainé est un modèle physiologique d’adaptation cardiaque extrême où il est parfois difficile de faire la distinction entre le remodelage cardiaque adaptatif induit par l’exercice physique et certaines cardiomyopathies débutantes. L’échocardiographie est l’examen d’imagerie de premier choix pour l’étude du cœur d’athlète au repos et à l’effort. Les développements semi-récents du speckle tracking et de l’imagerie tridimensionnelle (3D) ont montré un intérêt clinique dans la description de la réponse cardiaque à l’exercice. Toutefois certains aspects techniques nécessitent d’être investigués. De plus, les outils de post-traitement actuels ne permettent qu’une évaluation incomplète de l’hémodynamique cardiaque et de l’analyse morphofonctionnelle régionale. Dans un premier temps, à l’aide d’un modèle expérimental mimant l’échocardiographie de stress, nous avons démontré la validité du speckle tracking pour l’étude de la déformation régionale dans une large gamme de fréquences de déformation en comparaison à la technique de référence par sonomicrométrie. Secondairement, nous avons étudié chez des sujets volontaires sans cardiopathie avérée (athlètes et non athlètes) une méthode de quantification non invasive des gradients de pressions intraventriculaires (GPIVs) pour l’évaluation de la fonction systolique et diastolique ventriculaire gauche (VG), qui est basée sur le post-traitement des données de vitesses de flux intra cavitaires acquises en mode TM Doppler couleur. Nous avons montré que cet indice hémodynamique était facilement accessible, et bien corrélé au mécanisme de succion VG. L’analyse des mesures de GPIVs a mis en évidence une variabilité inter-constructeur qui était principalement liée aux différences de résolution de l’image Doppler couleur. Enfin, en utilisant une approche échocardiographique multiparamétrique (speckle tracking, GPIV, et volumes 3D), nous nous sommes intéressés à caractériser la relation physiologique entre le type d’entrainement physique et le remodelage cardiaque gauche et droit au sein d’une équipe de footballeurs canadiens suivie de manière longitudinale. L’analyse régionale des modifications morphologiques et fonctionnelles du ventricule droit (VD) induites par l’exercice chronique a été réalisée à l’aide d’un nouvel algorithme de post- traitement des acquisitions 3D permettant une segmentation tripartite (apex, chambre d’admission, chambre d’éjection) des volumes VD en échocardiographie. En conclusion, les outils de post-traitement échocardiographique étudiés dans ce travail pour l’analyse globale et régionale de la fonction et de la morphologie cardiaques semblent applicables au cœur d’athlète et pourraient avoir un intérêt dans la caractérisation du remodelage cardiaque physiologique à l’exercice.The trained athlete is a physiological model of extreme cardiac adaptation for whom the distinction between adaptive cardiac remodeling induced by chronic exercise and certain early cardiomyopathies can be difficult to assess. Echocardiography is the first-choice imaging modality to evaluate the athlete’s heart at rest and during exercise. Semi-recent developments in speckle tracking and 3D ultrasound imaging have shown clinical interest in the echocardiographic description of the athlete’s heart. However, some technical aspects require further investigation. Moreover, current post-treatment tools provide only a partial analysis of cardiac hemodynamics and regional myocardial function. Using an experimental model mimicking stress echocardiography, we first demonstrated the validity of speckle tracking in comparison to sonomicrometry to measure regional deformation in a large range of deformation rates. Secondly, we studied in volunteers without heart disease (athletes and non- athletes) the reliability of a method to assess non-invasively the left ventricular (LV) systolic and diastolic intraventricular pressure gradients (IVPGs) based on post-processing of intracardiac flow velocity data acquired using color Doppler M-mode. This hemodynamic index was highly feasible and well correlated with LV suction. Analysis of IVPG measurements revealed inter-vendor variability which was mainly related to differences in color Doppler image resolution. Finally, using a multiparametric echocardiographic approach (speckle tracking, IVPGs, and 3D volumes), we studied the physiological relationship between the type of exercise training and the left and right cardiac remodeling among a Canadian football team followed longitudinally. The regional analysis of right ventricular (RV) morphological and functional changes induced by chronic exercise was performed using a new computational method based on 3D echocardiography that volumetrically parcellated the RV into three segments (apex, outlet, and inlet). In conclusion, our workhas shown that the echocardiographic post-processing tools studied for the global and regional analysis of cardiac function and morphology apply to the athlete’s heart and could be useful in the characterization of the exercise-induced cardiac remodeling

High-Frame-Rate Echocardiography Using Coherent Compounding With Doppler-Based Motion-Compensation

International audience—High-frame-rate ultrasonography based on coherent compounding of unfocused beams can potentially transform the assessment of cardiac function. As it requires successive waves to be combined coherently, this approach is sensitive to high-velocity tissue motion. We investigated coherent compounding of tilted diverging waves, emitted from a 2.5 MHz clinical phased array transducer. To cope with high myocardial velocities, a triangle transmit sequence of diverging waves is proposed, combined with tissue Doppler imaging to perform motion compensation (MoCo). The compound sequence with integrated MoCo was adjusted from simulations and was tested in vitro and in vivo. Realistic myocardial velocities were analyzed in an in vitro spinning disk with anechoic cysts. While a 8 dB decrease (no motion versus high motion) was observed without MoCo, the contrast-to-noise ratio of the cysts was preserved with the MoCo approach. With this method, we could provide high-quality in vivo B-mode cardiac images with tissue Doppler at 250 frames per second. Although the septum and the anterior mitral leaflet were poorly apparent without MoCo, they became well perceptible and well contrasted with MoCo. The septal and lateral mitral annulus velocities determined by tissue Doppler were concordant with those measured by pulsed-wave Doppler with a clinical scanner. To conclude, high-contrast echo-Manuscrip

Left atrial strain quantified after myocardial infarction is associated with early left ventricular remodeling

Background Left ventricular remodeling (LVR) is common and associated with adverse outcome after ST-elevation myocardial infarction (STEMI). We aimed to investigate the association between left atrial (LA) mechanical function using speckle tracking imaging and early LVR at follow-up in STEMI patients. Methods Baseline 3D thoracic echocardiograms were performed within 48 h following admission and at a median follow-up of 7 months after STEMI. A > 20% increase in the left ventricular (LV) end-diastolic volume compared to baseline at follow-up was defined as LVR. LA global longitudinal strain was evaluated for the reservoir, conduit, and contraction (LASct) phases. Results A total of 121 patients without clinical heart failure (HF) were prospectively included, between June 2015 and October 2018 (age 58.3 +/- 12.5 years, male 98 (81%)). Baseline and follow-up LV ejection fraction (LVEF) were 46.8% [41.0, 52.9] and 52.1% [45.8, 57.0] respectively (p < .001). Compared to other patients, those with LVR had significantly lower values of LASct at baseline (-7.4% [-10.1, -6.5] vs. -9.9% [-12.8, -8.1], p < .01), both on univariate and baseline LV volumes-adjusted analyses. Baseline LA strain for reservoir and conduit phases were not associated with significant LVR at follow-up. Intra- and interobserver analysis showed good reproducibility of LA strain. Conclusions Baseline LASct may help identifying patients without HF after STEMI who are at higher risk of further early LVR and subsequent HF and who may benefit from more intensive management

Age impacts left atrial functional remodeling in athletes

International audienceAim Age-associated changes in cardiac filling and function are well known in the general population. Yet, the effect of aging on left atrial (LA) function, and its interaction with left ventricular (LV) adaptation, remain less described when combined with high-intensity chronic training. We aimed to analyze the effects of aging on LA and LV functions in trained athletes. Methods and results Ninety-five healthy highly-trained athletes referred for resting echocardiography were included. Two groups of athletes were retrospectively defined based on age: young athletes aged <35 years (n = 54), and master athletes aged ≥35 years (n = 41). All subjects were questioned about their sports practice. Echocardiographic analysis of LV systolic and diastolic functions (2D-echo, 3D-echo, and Doppler), as well as LA 2D dimensions and phasic deformations assessed by speckle tracking, were analyzed. Master athletes (mean age = 46.3 ± 8.3 years, mean duration of sustained training = 13.7 ± 8.9 years) exhibited significantly stiffer LV and LA with reduced LV early diastolic functional parameters (ratio E/A, peak e’, and ratio e’/a’), LA reservoir and conduit strain, whereas LA volume, LA contractile strain and LV peak a’ were higher, compared to young athletes. Multivariate regression analysis confirmed that age was predictive of peak e’, LA reservoir strain and LA conduit strain, independently of training variables. LA phasic strains were strongly associated with LV diastolic function. Conclusions Regardless of chronic sports practice, master athletes exhibited age-related changes in LA function closely coupled to LV diastolic properties, which led to LV filling shifts to late diastole