No abstract

Abstract-Restitution of action potential duration (APD) is thought to be critical in activation instability. Although restitution is used to predict APD during sequential changes in diastolic interval (DI), currently used protocols to determine restitution do not use sequential changes in DI. We explored restitution using a new pacing protocol to change DI sequentially and independently of APD. Transmembrane potentials were recorded from right ventricular endocardial tissue isolated from six dogs. We used three patterns of DIs: oscillatory, to demonstrate differences in APDs depending on previous activation history; random, to minimize effects of previous activation history, each DI preceding an APD had an equal probability of being short or long; and linear, to compare restitution relationship obtained during sequential changes in DI with those obtained using currently used protocols; DIs mimicked those that resulted using currently used protocols, except that they changed in sequence. During oscillatory DIs, restitution showed bimodal trajectory similar to hysteresis. Decrease in APD during decreasing DIs was faster than increase in APD during increasing DIs. When effects of previous activation history were minimized, we observed that for a given DI there were multiple values of APD. Restitution relationship obtained during sequential changes in DI was shallower than those obtained using currently used protocols. Our results show that the new pacing protocol may permit direct evaluation of effects of memory on APD. Sequential and explicit control of DI suggests that use of a unimodal relationship to predict APD when DIs change in sequence may not be appropriate. Key Words: action potential duration Ⅲ electrical restitution Ⅲ arrhythmia Ⅲ fibrillation C ardiac electrical restitution is considered to importantly influence whether an electrical disturbance degenerates into a reentrant activation. 1 Specifically, it is hypothesized that the slope of action potential duration (APD) restitution function, which relates diastolic interval (DI) and following APD, can predict stability of electrical activation. 2-9 The hypothesized mechanism is that a slope equal to or greater than 1 can lead to alternans of APD and block propagation. Activation block, in turn, facilitates reentry, leading to arrhythmia. Conversely, for slopes less than 1, disturbances in APD get smaller, returning to a stable activation. Consistent with this view, in a few animal studies, drugs that decrease the slope of restitution have been shown to have antiarrhythmic properties. 10,11 Therefore, it has been suggested that investigation of restitution relationship may prove helpful during development of treatments for arrhythmia or in evaluation of efficacy of antiarrhythmia drugs. 2 The APD restitution function is widely quantified using one of two pacing schemes. In one scheme, tissue is paced for several tens of beats at constant cycle length (S1) followed by a stimulus (S2) delivered at progressively shorter or longer intervals. The APD resultin...

No abstract

Compared with a routine radiation dose FBP protocol, 50% reduced dose acquisition using IR preserves image quality and diagnostic accuracy at coronary CTA.

Our results indicate that mechanism of repolarization alternans has restitution-dependent and restitution-independent components. However, our results also provide direct evidence that shows that DI-dependent restitution of APD is not a necessary mechanism for the alternans to exist. Ability to pace with explicit control of DI provides a novel approach to dissect mechanisms of alternans into restitution-dependent and restitution-independent effects.

Iodine quantification with DECT may help in differentiating benign periablational reactive tissue from residual tumour in VX2 carcinoma in rabbits after RFA.

No abstract

The aim of the present study was to investigate the performance of low keV mono-energetic reconstructions in spectral coronary computed tomography angiography (CCTA) using spectral detector CT (SDCT) with reduced contrast media and radiation dose. Sixty patients were randomly assigned to Groups A and B (both n = 30) to undergo CCTA on a dual-layer SDCT with tube voltage 120 kVp and 100 kVp (average tube current: 108.5 and 73.8 mAs, respectively), with contrast media volume of 36 mL used in both groups. The mono-energetic 40-80 keV and conventional 120 kVp images in Group A and conventional 100 kVp images in Group B were reconstructed. Quantitative and qualitative image quality (IQ) were evaluated in the aortic root and distal segments of the coronary arteries. The patient characteristics were not significantly different between the two groups (all P !0.47), nor was the effective radiation dose (1.5 ± 0.3 and 1.4 ± 0.3 mSv, P = 0.20). The quantitative IQ in aorta and coronary arteries of mono-energetic 40-60 keV was superior to conventional 120 kVp and 100 kVp images (all P < 0.05). The noise in spectral images was lower compared to conventional images (all P < 0.01). The subjective IQ score of 40-50 keV images was not significantly different from that of 100 kVp images (P > 0.8). The mono-energetic 40-50 keV reconstructions from spectral CCTA using SDCT provide improved IQ compared to conventional techniques while facilitating reduced radiation dose and contrast media.