Improved myocardial performance in infarcted rat heart by injection of disulfide-cross-linked chitosan hydrogels loaded with basic fibroblast growth factor

Myocardial infarction (MI) has been considered as the leading cause of cardiovascular-related deaths worldwide. Basic fibroblast growth factor (bFGF) is a member of the fibroblast growth factors that promotes angiogenesis...

Fetal cardiac function: myocardial performance index

The Myocardial Performance Index (MPI) or Tei index, presented by Tei in 1995, is the ratio of the sum of the duration of the isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) to the duration of the ejection time (ET). The Modified Myocardial Performance Index (Mod-MPI), proposed in 2005, is considered a reliable and useful tool in the study of fetal heart function in several conditions, such as growth restriction, twin-twin transfusion syndrome, maternal diabetes, preeclampsia, intrahepatic cholestasis of pregnancy, and adverse perinatal outcomes. Nevertheless, clinical translation is currently limited by poorly standardised methodology as variations in the technique, machine settings, calliper placement, and specific training required can result in significantly different MPI values. This review aims to provide a survey of the relevant literature on MPI, present a strict methodology and technical considerations, and propose future research.

149 Myocardial performance in opera singers

Aims Opera singers are subjected to continuous exercise in the cardiopulmonary district, however the impact on cardiac performance has not been studied in depth. In addition to the standard echo parameters, the deformation one offer the possibility to evaluate more clearly the myocardial performance. Objective was to verify the impact of singing in heart’s performance by the evaluation of traditional and particularly deformation parameters as strain, rotation, and twist. Methods and results A population of 17 OS (opera singers, aged 50 ± 5 years) (M/F: 7/9; 5 sopranos; 2 tenors; 2 contraltos; 2 basses) have been submitted to an echocardiographic evaluation (MLX8exp Release F100001) by standard 2D and deformation parameters (Figure 1). The data expressed as mean as SD were compared to an high level athletes (A) group (M 16) regularly trained. T-Student test for paired data was used and P < 0.05 was considered significant. All the 2D standard systo-diastolic parameters were within the normal range and the pulmonary pressure (PP) as well in both. In SO group were: LVDd: 47.31 ± 3.77 mm; LVSd: 30.48 ± 4.42 mm; E/A: 1.07 ± 0.32; RV: 27.63 ± 4.50 mm; in A group: LVDd: 50.81 ± 2.97 mm; LVSd: 31.44 ± 4.26 mm; E/A: 2.68 ± 1.67; RV: 27.63 ± 4.50 mm. As expected Cardiac mass index (CMI) was significantly greater in athletes, while the ejection fraction (EF) resulted to be higher in OS. Despite the deformation parameters were not different among the two groups, with the exclusion of GLS expressing a major value in athletes, on the contrary the rotational parameters resulted, in OS group similar to the athletes and in agreement with an high performance status. Conclusions OS show an high myocardial performance as athletes. The data obtained are suggestive for a positive impact of regular training as an opera singers. Deformation parameters highlight the fitness status in this particular group. Classic music singing seems to have a training effect on the heart. Further studies will be necessary to confirm this hypothesis

Novel Approach to Assess Cardiac Function Using Systolic Performance and Myocardial Performance Indices From Simultaneous Electrocardiography and Phonocardiography Recordings in Dogs With Various Stages of Myxomatous Mitral Valve Disease

Background and Objective: Myxomatous mitral valve disease (MMVD) progression entails changes in the structural and functional properties of the heart affecting cardiac timings and intervals within the cardiac cycle. Conventionally, echocardiography is used to determine the cardiac time intervals (CTIs) including systolic and myocardial performance indices (SPI and MPI) in evaluating cardiac function. Alternatively, these CTIs can also be measured using simultaneous recordings of electrocardiography (ECG) and phonocardiography (PCG), but their values in different MMVD stages remain to be established. This study aimed to establish and prove the use of derived SPI and MPI from a dedicated device as a novel approach to assess cardiac function in different stages of MMVD dogs.Materials and Methods: A prospective study in 52 dogs with different MMVD stages measured the CTIs using a novel device. These were compared and correlated with standard echocardiographic parameters. The predictive value of SPI and three new proposed formulas to estimate MPI (i.e., F1, F2, and F3) in association with asymptomatic from symptomatic MMVD dogs were investigated.Results: Our findings revealed that CTI parameters measured from a novel device including QS1, QS2, S1S2, MPI-F1, and MPI-F2 were altered at different stages of MMVD. The SPI and all proposed MPI formulas were comparable with the systolic time interval and Tei index from echocardiography. In addition, the SPI, MPI-F1, and MPI-F2 were significantly correlated with the Tei index. However, the SPI was not able to differentiate the various stages of MMVD. Conversely, only the MPI-F1 (i.e., (QS1 + S2)/S1S2) demonstrated good predictive accuracy when compared between asymptomatic and symptomatic MMVD dogs similar to the Tei index. Moreover, this formula was able to differentiate stages B1 and C with remarkable predictive accuracy, higher sensitivity, and high specificity when compared with the Tei index.Conclusion: We have successfully described the CTI parameters in different MMVD stages using simultaneous ECG and PCG recordings in dogs. Furthermore, we have proven that the concept of using the newly proposed parameters from a novel device is equivalent to the Tei index. Thus, we established a novel approach to evaluate cardiac function and its supportive use in the diagnosis of MMVD patients.

Cardiac function in fetal and infants born to mothers with gestational diabetes

Background The intraventricular pressure differences (IVPD) IVPD using color M-mode is a specific marker in infants of mothers with gestational diabetes mellitus (GDM). (Circulation R 2019, 378–388). Purpose This study investigated the myocardial performance of fetuses in mothers with GDM under the new GDM definition. Method The study population comprised of 27 mothers with GDM and the fetus. Women with GDM were defined as those with a glucose metabolism abnormality that existed before or began during the current pregnancy and was diagnosed using OGTTs. The 5 mothers with type 1 or type 2 DM were receiving insulin before their pregnancy. Fetal echo measurements were performed about median gestational age 35 weeks. The primary outcomes were comparisons of the fetal myocardial performance of GDM with insulin administration and without administration using echocardiography with IVPD, and IVPG. The secondary outcome has investigated the relationships between echocardiography parameters, IVPD, and IVPG, and maternal factors. For all statistical analyses, P<0.05 was considered significant. Result In the insulin group was higher RV output (Fig. 2A). Maternal max HbA1c was observed to have a positive correlation with fetal RV output, significantly (Fig. 2B). Maternal max fasting blood glucose was observed to have a negative correlation with the Total, Basal and Mid to apical IVPD, significantly, respectively. Serial change of LV Total IVPD from fetal to after birth shown in Slide. In both groups, LV Total IVPD was increasing from fetal and after birth significantly. Conclusion The mechanism associated with the favorable systolic and diastolic performances in IGDMs is suggested to involve metabolic adaptations in the heart. In diabetic mice, these adaptations seem to prevent the heart from failing during conditions of pressure overload, suggesting a restoration of the balance between glucose and fatty acid utilization is beneficial for cardiac function. In fetal LV and RV-IVPD might be interacted the mother's blood sugar control. These indexes can predict the sensitive fetal and infant's cardiac dysfunction for GDM. FUNDunding Acknowledgement Type of funding sources: None.