Agreement in Left Ventricular Function Measured by Echocardiography and Cardiac Magnetic Resonance in Patients With Chronic Coronary Total Occlusion

Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P < 0.001) and a moderately strong agreement (Kappa = 0.62, P < 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF <50%. CTO patients without echocardiographic wall motion abnormality (WMA) had stronger intermodality correlations (r = 0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF <50% or abnormal ventricular motion. CMR should be considered in these conditions.

Shear Stress and Hemolysis Analysis of Blood Pump under Constant and Pulsation Speed Based on a Multiscale Coupling Model

Current researches show that the constant speed mode adopted by the existing commercial blood pump may cause damage to the body. The way to solve this problem is to produce pulsating flow by changing the speed of the blood pump’s impeller. But at present, the flow field of the blood pump is not clear, when it changes speed, and the coupling between blood pump and body has not been considered in the simulation of the flow field. A multiscale coupling model combining hemodynamics (0D) and Computational Fluid Dynamics (3D) was established in this paper to solve the problem, and a speed change curve consistent with the ventricular motion was selected. The hemodynamics, shear stress, and hemolysis changes of 6000 rpm at different amplitude (2000, 3000, and 4000 rpm) were simulated, analyzed, and compared with the constant speed (7000 rpm). The results show that the pressure difference obtained by simulation is consistent with the experimental results, and the flow generated by the natural heart still flows through the blood pump, thus changing the working point of the blood pump. When the blood pump works at the changing speed, it could produce more pulsation, and the shear stress and hemolysis in the blood pump increase with the rising of speed and flow. But according to the hemolysis score of a single cardiac cycle, the hemolysis value of the changing speed model at an amplitude of 4000 rpm is only 11.71% higher than that of constant speed at 7000 rpm.

Agreement in left ventricular function measured by echocardiography and cardiac magnetic resonance in patients with chronic total occlusion

Background: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function in CTO patients: including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF).Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within one week of each other. The correlation and agreement of LVEF, LVESV and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis and Bland-Altman method. Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r=0.71, 0.90 and 0.80, respectively, all P<0.001) and a moderately strong agreement (Kappa=0.62, P<0.001) between the two modalities in measurement of LV function. The agreement in patients with EF≧50% was better than in those with an EF <50%. CTO patients without echocardiographic WMA had stronger intermodality correlations (r=0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF<50% or abnormal ventricular motion. CMR should be considered in these conditions.Trial registration: Retrospectively registered