Myocardial Deformation by Speckle Tracking in Severe Dilated Cardiomyopathy

Background: The high and increasing prevalence of Dilated Cardiomyopathy (DCM) represents a serious public health issue. Novel technologies have been used aiming to improve diagnosis and the therapeutic approach. In this context, speckle tracking echocardiography (STE) uses natural myocardial markers to analyze the systolic deformation of the left ventricle (LV). Objective: Measure the longitudinal transmural global strain (GS) of the LV through STE in patients with severe DCM, comparing the results with normal individuals and with echocardiographic parameters established for the analysis of LV systolic function, in order to validate the method in this population. Methods: Seventy-one patients with severe DCM (53 +/- 12 years, 72% men) and 20 controls (30 +/- 8 years, 45% men) were studied. The following variables were studied: LV volumes and ejection fraction calculated by two and three-dimensional echocardiography, Doppler parameters, Tissue Doppler Imaging systolic and diastolic LV velocities and GS obtained by STE. Results: Compared with controls, LV volumes were higher in the DCM group; however, LVEF and peak E-wave velocity were lower in the latter. The myocardial performance index was higher in the patient group. Tissue Doppler myocardial velocities (S', e', a') were significantly lower and E/e' ratio was higher in the DCM group. GS was decreased in the DCM group (-5.5% +/- 2.3%) when compared with controls (-14.0% +/- 1.8%). Conclusion: In this study, GS was significantly lower in patients with severe DCM, bringing new perspectives for therapeutic approaches in this specific population. (Arq Bras Cardiol 2012;99(3):834-842)

Influence of normal and radial contributions of local current density on local electrochemical impedance spectroscopy

A new tri-electrode probe is presented and applied to local electrochemical impedance spectroscopy (LEIS) measurements. As opposed to two-probe systems, the three-probe one allows measurement not only of normal, but also of radial contributions of local current densities to the local impedance values. The results concerning the cases of the blocking electrode and the electrode with faradaic reaction are discussed from the theoretical point of view for a disk electrode. Numerical simulations and experimental results are compared for the case of the ferri/ferrocyanide electrode reaction at the Pt working electrode disk. At the centre of the disk, the impedance taking into account both normal and radial contributions was in good agreement with the local impedance measured in terms of only the normal contribution. At the periphery of the electrode, the impedance taking into account both normal and radial contributions differed significantly from the local impedance measured in terms of only the normal contribution. The radial impedance results at the periphery of the electrode are in good agreement with the usual explanation that the associated larger current density is attributed to the geometry of the electrode, which exhibits a greater accessibility at the electrode edge. (C) 2011 Elsevier Ltd. All rights reserved.