L’objectif de cette thèse de doctorat était de développer l’échographie ultrarapide 3D du cœur, plus particulièrement dans le but de caractériser le muscle cardiaque. A cet effet, un échographe ultrarapide assemblé dans notre laboratoire a été utilisé. Dans la première partie de cette thèse, un mode d’imagerie temps-réel a été développé pour faciliter l’imagerie in-vivo en utilisant ce scanner, ainsi que des outils de visualisation 3D et 4D. Par la suite, l’imagerie 3D du tenseur de rétrodiffusion a été développée pour analyser l’orientation des fibres musculaires du cœur de manière non-invasive au cours du cycle cardiaque. Des résultats obtenus sur un volontaire avant et après la contraction cardiaque ont été obtenus. De plus, les effets indésirables du mouvement axial ont été étudiés, et une méthode d’estimation de la vitesse axiale et de correction des aberrations induites a été proposée et appliquée sur l’homme. Cette technique pourrait devenir un outil intéressant de diagnostic et quantification de la désorganisation des fibres musculaires dans le cadre de cardiomyopathies hypertrophiques. De plus, l’échographie ultrarapide 3D a été utilisée pour visualiser la propagation dans les parois du cœur d’ondes de cisaillement générées naturellement au cours du cycle cardiaque, et un algorithme pour déterminer leurs vitesses a été développé. Cette technique a été validée grâce à des simulations numériques puis appliquée sur deux volontaires sains, pendant les phases de contraction et relaxation du myocarde. Etant donné que la vitesse des ondes de cisaillement est directement reliée à la rigidité du cœur, cette méthode pourrait permettre d’estimer la capacité du cœur à de contracter et à se relâcher, qui sont des paramètres important pour son fonctionnement. Enfin, l’activation de la contraction cardiaque de cœurs de rats isolés a été imagée à haute cadence et en 3D dans le but d’analyser la synchronisation de la contraction. Les délais d’activation mécanique ont pu correctement être quantifiés lors du rythme naturel du cœur, de stimulations électriques extérieures ainsi qu’en hypothermie. Ensuite, la faisabilité de la technique en 2D sur des cœurs humains de manière non-invasive a été étudiée et appliquée sur des fœtus et des adultes. Cette technique d’imagerie pourrait aider la caractérisation d’arythmies et améliorer leur traitement. En conclusion, nous avons introduit dans ces travaux de thèse trois nouvelles modalités d’imagerie ultrarapide 3D permettant de quantifier des propriétés structurelles et fonctionnelles du myocarde qui jusqu’ici ne pouvaient pas être imagée en échocardiographie. L’imagerie 3D ultrarapide est une modalité très prometteuse, non ionisante, transportable et qui pourrait améliorer fortement dans le futur le diagnostic et la prise en charge des patients. / The objectives of this PhD thesis were to develop 3D ultrafast ultrasound imaging of the human heart toward the characterization of cardiac tissues. In order to do so, a customized, programmable, ultrafast scanner built in our group was used. In the first part of this thesis, a real-time imaging sequence was developed to facilitate in-vivo imaging using this scanner, as well as dedicated 3D and 4D visualization tools. Then, we developed 3D Backscatter Tensor Imaging (BTI), a technique to visualize the muscular fibres orientation within the heart wall non-invasively during the cardiac cycle. Applications on a healthy volunteer before and after cardiac contraction was shown. Moreover, the undesired effects of axial motion on BTI were studied, and a methodology to estimate motion velocity and reduce the undesired affects was introduced and applied on a healthy volunteer. This technique may become an interesting tool for the diagnosis and quantification of fibres disarrays in hypertrophic cardiomyopathies. Moreover, 3D ultrafast ultrasound was used to image the propagation of naturally generated shear waves in the heart walls, and an algorithm to determine their speed was developed. The technique was validated in silico and the in vivo feasibility was shown on two healthy volunteers, during cardiac contraction and relaxation. As the velocity of shear waves is directly related to the rigidity of the heart, this technique could be a way to assess the ability of the ventricle to contract and relax, which is an important parameter for cardiac function evaluation. Finally, the transient myocardial contraction was imaged in 3D on isolated rat hearts at high framerate in order to analyse the contraction sequence. Mechanical activation delays were successfully quantified during natural rhythm, pacing and hypothermia. Then, the feasibility of the technique in 2D on human hearts non-invasively was investigated. Applications on foetuses and adults hearts were shown. This imaging technique may help the characterization of cardiac arrhythmias and thus improve their treatment. In conclusion, we have introduced in this work three novel 3D ultrafast imaging modalities for the quantification of structural and functional myocardial properties. 3D ultrafast imaging may become an important non-ionizing, transportable diagnostic tool that may improve the patient care at the bed side.

Indiana University-Purdue University Indianapolis (IUPUI) / Friedreich’s Ataxia (FRDA) is a rare and poorly understood autosomal recessive disease caused by a pathological deficiency of the mitochondrial protein frataxin. Patients suffer neurodegeneration, ataxia, diabetes, and heart failure. In an effort to understand the mechanisms of heart failure in FRDA, we investigated the role of the protein modification acetylation, which is highly abundant on mitochondrial proteins and has been implicated in regulating intermediary metabolism. Using mouse models of FRDA, we found that cardiac frataxin deficiency causes progressive hyperacetylation of mitochondrial proteins which is correlated with loss of respiratory chain subunits and an altered mitochondrial redox state. Mitochondrial protein hyperacetylation could be reversed by the mitochondria-localized deacetylase SIRT3 in vitro, suggesting a defect in endogenous SIRT3 activity. Consistently, frataxin-deficient cardiac mitochondria showed significantly decreased rates of fatty acid oxidation and complete oxidation to carbon dioxide. However, the degree of protein hyperacetylation in FRDA could not be fully explained by SIRT3 loss. Our data suggested that intermediary metabolites and perhaps acetyl-CoA, which is required for protein acetylation, are accumulating in frataxin-deficient mitochondria. Upon testing the hypothesis that mitochondrial protein acetylation is non-enzymatic, we found that the minimal chemical conditions of the mitochondrial matrix are sufficient to cause widespread non-enzymatic protein acetylation in vitro. These data suggest that mitochondrial protein hyperacetylation in FRDA cardiomyopathy mediates progressive post-translational suppression of mitochondrial oxidative pathways which is caused by a combination of SIRT3 deficiency and, likely, an accumulation of unoxidized acetyl-CoA capable of initiating non-enzymatic protein acetylation. These findings provide novel insight into the mechanisms underlying a poorly understood and fatal cardiomyopathy and highlight a fundamental biochemical mechanism that had been previously overlooked in biological systems.

No description available.

317 pathologisch-anatomische Befundberichte über die Morphologie des Myokards, der Koronararterien, der Aorta und der Pulmonalarterien von Herzen, die in der Homograftbank des Deutschen Herzzentrums Berlin in den Jahren 1996 bis 1998 für eine potentielle Klappenspende (Aorten- und Pulmonalklappen) seziert worden waren, wurden ausgewertet. 178 dieser Herzen stammten von Herztransplantatempfängern und zeigten naturgemäß schwere pathologische Veränderungen. Sechs Herzen stammten von Leichen. 133 Herzen waren hirntoten Menschen entnommen worden. Ursprünglich hatte bei vielen dieser 133 Spenderherzen die Absicht bestanden, sie für die Transplantation zu verwenden, was aus verschiedenen Gründen nicht möglich war. Ziel der retrospektiven Studie war die Erfassung der morphologischen Situation der Organe, wobei der Schwerpunkt auf der Gruppe der Spenderherzen lag. / This work contains an analysis of 317 records with a detailed description of the morphology of myocardium, coronary arteries, aortas and pulmonary arteries of hearts dissected for the purpose of harvesting the aortic and pulmonary valves as allografts in the Heart Valve Bank of the German Heart Institute, Berlin, from 1996 through 1998. 178 hearts stemmed from patients who recieved heart transplants. Naturally these organs revealed severe pathologic findings. Cadaveric organs (non beating hearts) amounted to six. 133 hearts were taken from brain dead human beings. Many of these 133 donor organs were originally considered to be potentially usable for transplantation, but were discarded for various reasons. The objective of this retrospective study was to ascertain the morphologic state of the hearts with special focus on the 133 donor hearts.

Thesis (PhD (Physiology (Human and animal))-- University of Stellenbosch, 2007. / Definition: Stem cells are unspecialised cells with the capacity for long-term self-renewal and the ability to differentiate into multiple cell-lineages. The potential for the application of stem cells in clinical settings has had a profound effect on the future of regenerative medicine. However, to be of greater therapeutic use, selection of the most appropriate cell type, as well as optimisation of stem cell incorporation into the damaged tissue is required. In adult skeletal muscle, satellite cells are the primary stem cell population which mediate postnatal muscle growth. Following injury or in diseased conditions, these cells are activated and recruited for new muscle formation. In contrast, the potential of resident adult stem cell incorporation into the myocardium has been challenged and the response of cardiac tissue, especially to ischaemic injury, is scar formation. Following muscle damage, various growth factors and cytokines are released in the afflicted area which influences the recruitment and incorporation of stem cells into the injured tissue. Transforming Growth Factor-β (TGF-β) is a member of the TGF-β-superfamily of cytokines and has at least three isoforms, TGF-β1, -β2, and -β3, which play essential roles in the regulation of cell growth and regeneration following activation and stimulation of receptor-signalling pathways. By improving the understanding of how TGF-β affects these processes, it is possible to gain insight into how the intercellular environment can be manipulated to improve stem cell-mediated repair following muscle injury. Therefore, the main aims of this thesis were to determine the effect of the three TGF-β isoforms on proliferation, differentiation, migration and fusion of muscle progenitor cells (skeletal and cardiac) and relate this to possible improved mechanisms for muscle repair. The effect of short- and long-term treatment with all three TGF-β isoforms were investigated on muscle progenitor cell proliferation and differentiation using the C2C12 skeletal muscle satellite and P19 multipotent embryonal carcinoma cell-lineages as in vitro model systems. Cells were treated with 5 ng/mℓ TGF-β isoforms unless where stated otherwise. In C2C12 cells, proliferating cell nuclear antigen (PCNA) expression and localisation were analysed, and together with total nuclear counts, used to assess the effect of TGF-β on myoblast proliferation (Chapter 5). The myogenic regulatory factors MyoD and myogenin, and structural protein myosin heavy chain (MHC) were used as protein markers to assess early and terminal differentiation, respectively. To establish possible mechanisms by which TGF-β isoforms regulate differentiation, further analysis included determination of MyoD localisation and the rate of MyoD degradation in C2C12 cells. To assess the effect of TGF-β isoforms on P19 cell differentiation, protein expression levels of connexin-43 and MHC were analysed, together with the determination of embryoid body numbers in differentiating P19 cells (Chapter 6). Furthermore, assays were developed to analyse the effect of TGF-β isoforms on both C2C12 and P19 cell migration (Chapter 7), as well as fusion of C2C12 cells (Chapter 8). Whereas all three isoforms of TGF-β significantly increased proliferation of C2C12 cells, differentiation results, however, indicated that especially following long-term incubation, TGF-β isoforms delayed both early and terminal differentiation of C2C12 cells into myotubes. Similarly, myocyte migration and fusion were also negatively regulated following TGF-β treatment. In the P19 cell-lineage, results demonstrated that isoform-specific treatment with TGF-β1 could potentially enhance differentiation. Further research is however required in this area, especially since migration was greatly reduced in these cells. Taken together, results demonstrated variable effects following TGF-β treatment depending on the cell type and the duration of TGF-β application. Circulating and/or treatment concentrations of this growth factor could therefore be manipulated depending on the area of injury to improve regenerative processes. Alternatively, when selecting appropriate stem or progenitor cells for therapeutic application, the effect of the immediate environment and subsequent interaction between the two should be taken into consideration for optimal beneficial results.

La segmentation d’images médicales est depuis longtemps un sujet de recherche actif. Cette thèse traite des méthodes de segmentation basées modèles, qui sont un bon compromis entre généricité et capacité d’utilisation d’informations a priori sur l’organe cible. Notre but est de construire un algorithme de segmentation pouvant tirer profit d’une grande variété d’informations extérieures telles que des bases de données annotées (via l’apprentissage statistique), d’autres images du même patient (via la co-segmentation) et des interactions de l’utilisateur. Ce travail est basé sur la déformation de modèle implicite, une méthode variationnelle reposant sur une représentation implicite des formes. Après avoir amélioré sa formulation mathématique, nous montrons son potentiel sur des problèmes cliniques difficiles. Nous introduisons ensuite différentes généralisations, indépendantes mais complémentaires, visant à enrichir le modèle de forme et d’apparence utilisé. La diversité des applications cliniques traitées prouve la généricité et l’efficacité de nos contributions. / Within the wide field of medical imaging research, image segmentation is one of the earliest but still open topics. This thesis focuses on model-based segmentation methods, which achieve a good trade-off between genericity and ability to carry prior information on the target organ. Our goal is to build an efficient segmentation framework that is able to leverage all kinds of external information, i.e. annotated databases via statistical learning, other images from the patient via co-segmentation and user input via live interactions. This work is based on the implicit template deformation framework, a variational method relying on an implicit representation of shapes. After improving the mathematical formulation of this approach, we show its potential on challenging clinical problems. Then, we introduce different generalizations, all independent but complementary, aimed at enriching both the shape and appearance model exploited. The diversity of the clinical applications addressed shows the genericity and the effectiveness of our contributions.

Há mais de 20 anos a Catuama® vem sendo utilizada contra fadiga física e mental, disfunção sexual e astenia muscular. Nos últimos anos, diversos estudos demonstraram efeitos como ação antinociceptiva, antidepressiva, neuroprotetora, vasodilatadora e dilatadora dos corpos cavernosos. Dados do Laboratório de Investigação Médica da Disciplina de Emergências Clínicas da FMUSP (LIM-51) demonstraram que a Catuama® é capaz de reverter e prevenir a fibrilação ventricular (FV) induzida em coração isolado de coelho. Tendo em vista a comprovação de que a Catuama® possui efeito cardíaco significativo, tornou-se necessário investigar mais a fundo outras potenciais propriedades cardioprotetoras. Investigamos então se a Catuama® e a Trichila catigua podem oferecer proteção ao miocárdio submetido a isquemia e reperfusão em coração isolado de ratos quando administrados cronicamente. Ratos Wistar machos e adultos foram submetidos a um tratamento de 14 dias com Catuama®, T. catigua, Água destilada ou Tween 80 por gavagem. Ao término do tratamento, os animais foram anestesiados com pentobarbital e os corações retirados e perfundidos com solução de Krebs-Henseleit (KHB) pela aorta em sistema de Langendorff. Foi mantido fluxo constante de 8mL/minuto, temperatura de 36º C e oxigenação com 95% de oxigênio e 5% de gás carbônico. Os corações foram submetidos a uma isquemia global através de interrupção da perfusão por 30 minutos seguida de 2 horas de reperfusão. Para avaliar o grau de lesão causada pelo protocolo, analisamos os aspectos hemodinâmicos e biomoleculares. Foi possível observar uma melhora significativa em muitos dos parâmetros analisados. Os grupos que receberam os extratos de Catuama® e T. catigua mostraram área de necrose inferior a 16% da área total, enquanto os grupos Tween 80 e Água destilada apresentaram uma necrose superior a 60%. Além disso, a pressão desenvolvida no ventrículo esquerdo também apresentou melhora nos primeiros minutos de reperfusão, alcançando uma recuperação próxima de 70% da pressão préisquemica nos animais tratados com os extratos, enquanto os animais dos grupos Tween 80 e Água destilada apresentaram uma recuperação em torno de 20% da pressão desenvolvida. O mesmo ocorreu com a pressão diastólica dos grupos que receberam os extratos: nos primeiros minutos de reperfusão a pressão diastólica foi reduzida para valores inferiores a 30 mmHg durante a reperfusão, próximos dos pré-isquemicos, enquanto os outros dois grupos mantiveram valores elevados de pressão diastólica durante toda a reperfusão (Água destilada: 69,56+10,05 mmHg; Tween 80: 101,69+19,80 mmHg). Os grupos tratados com os extratos também apresentaram aumento na expressão de proteínas totais e de Catalase. Por outro lado, houve uma diminuição da peroxidação lipídica e de subprodutos do óxido nítrico. A Catuama® e a T. catigua já são amplamente usadas pela população e, devido a sua popularidade e acessibilidade, podem tornar-se aliadas para seres humanos com risco de doença cardíaca isquêmica. / For over 20 years Catuama® has been used against physical and mental fatigue, muscular asthenia and sexual dysfunction. In the last years, several studies have shown effects such as antinociceptive action, antidepressant, neuroprotective, vasodilator and effects in erectile-dysfunction. Data from the Medical Research Laboratory in the Department of Clinical Emergency demonstrated that Catuama® is able to reverse and prevent ventricular fibrillation (VF) induced in isolated rabbit hearts. Given the evidence that Catuama® has significant cardiac effects, it became necessary to proceed a deeper investigation on other potential cardioprotective properties. We investigated if Catuama® and Trichilia catigua may offer protection to the myocardium subjected to ischemia and reperfusion in the isolated rat heart. Adult male Wistar rats were treated during 14 days with Catuama®, T. catigua, Distilled Water or Tween 80 by gavage. At the end of the treatment, the animals were anesthetized with pentobarbital and their hearts removed and perfused with Krebs-Henseleit (KHB) through the aorta in a Langendorff system. Perfusion flow was kept constant at 8mL/minute, temperature 36° C; the preparation was aerated with 95% oxygen and 5% carbon dioxide. The hearts were submitted to global ischemia by stopping perfusion for 30 minutes followed by 2 hours of reperfusion. To assess the extension of the injury caused by the protocol, we analyzed the hemodynamic and molecular aspects. It was possible to observe a significant improvement in many parameters. The groups that received the extracts Catuama® and T. catigua showed necrotic area inferior to 16% of the total area, while the groups Tween 80 and Distilled Water showed higher than 60% necrosis. In addition, left ventricular developed pressure also improved in the first minutes of reperfusion, reaching a recovery of about 70% of pre-ischemic values in animals treated with the extracts, while animals in groups Tween 80 and Distilled Water showed a recovery around 20% of the developed pressure. The same occurred with diastolic pressure of the groups that received the extracts: in the first minutes of reperfusion, the diastolic pressure was reduced to below 30 mmHg during reperfusion, close to the pre-ischemic values, while in the other two groups diastolic pressure remained elevated throughout reperfusion (Distilled Water: 69.56 +10.05 mmHg; Tween 80: 101.69 +19.80mmHg). The groups treated with the extracts also showed increased expression of total protein and catalase. On the other hand, there was a decrease in lipid peroxidation products and nitric oxide. Catuama® and T. catigua are already widely used by the population and, due to their popularity and accessibility can become allies to humans at risk for ischemic heart disease.

A poluição atmosférica de São Paulo (SP) pode provocar alterações cardiovasculares em seres humanos e animais experimentais, com maior vulnerabilidade em crianças e fetos. O mecanismo fisiopatológico que explicaria a relação entre a exposição aos poluentes e doenças cardiovasculares não está totalmente estabelecido, sendo que o estresse oxidativo pode estar ligado ao dano e morte celular. Há evidências de que o dano oxidativo pelo mecanismo da peroxidação lipídica pode estar relacionado às causas de diversas cardiovasculopatias. Estudamos o efeito da exposição ao ar ambiental nos níveis de peroxidação lipídica no coração de camundongos nos períodos pré e pós-natal. Os animais foram mantidos em duas câmaras de exposição, uma recebendo ar ambiente e outra ar filtrado, em quatro diferentes grupos: 1) LL: gestados e crescidos em câmara com ar filtrado, 2) PP: gestados e crescidos em câmara com ar poluído de SP, 3) PL: gestados na câmara poluída e crescidos na limpa, e 4) LP: gestados na câmara limpa e crescidos na poluída. A peroxidação lipídica do miocárdio foi avaliada tanto pelo método TBA como por imunohistoquímica para 15-F2t-isoprostano. As concentrações de malondialdeído (MDA, indicador de peroxidação lipídica) foi maior nos animais PP quando comparados aos LL (p = 0,004) e PL (p = 0,026), e não mostrou diferença significativa em relação ao grupo LP (p = 0,894). Os valores de MDA para animais PL e LP mostraram-se equivalentes (p = 0,168). Chama a atenção que o grupo PL apresentou um valor de MDA maior que o LL (p = 0,026). A fração de volume de miocárdio marcada imunohistoquimicamente para 15- F2t-isoprostano apresentou valores maior em PL (p = 2,884x10-5), LP (p = 6,632x10-6) e PP (p = 5,45x10-8) que em LL. O valor de PP foi maior que os de PL e LP (p = 3,661x10-4 e 1,058x10-3, respectivamente), sendo esses últimos equivalentes entre si (p = 0,624). A análise ultra-estrutural mostrou de maneira consistente a presença de lisossomos secundários contendo estruturas lipídicas membranosas nos grupos LP e PP. A porcentagem média de arteríolas com área entre 200 e 1000 ?m² em relação ao número total de vasos de cada grupo foi maior no grupo PP do que nos grupos LL e PL (p=0,0387 e p=0,0362, respectivamente). Estes resultados sugerem que existem altos níveis de peroxidação lipídica no tecido cardíaco dos animais expostos ao ar ambiental de SP. Chama a atenção o fato de que a exposição intra-uterina ter implicado em níveis maiores de estresse oxidativo na fase adulta, mesmo com a melhoria das condições ambientais. Comparam-se estes achados no miocárdio a outros resultados da literatura. / I t is well known that air pollution exposure in São Paulo can elicit cardiovascular injuries in humans and experimental animals and that children and fetuses appear to be particularly vulnerable. However, the mechanisms involved in this cardiovascular damage are not well understood. It has been suggested that the oxidative stress generated by air pollution exposure can trigger tissue injury. There is evidence supporting the idea that injury caused by lipid peroxidation may be related to the causes of several cardiovascular diseases. The aim of this study was to investigate the effects of prenatal and postnatal exposure to urban air pollution on the myocardium lipid peroxidation levels of adult mice. Myocardium lipid peroxidation was determined by the TBA method and by the detection of 15-F2t-isoprostan by immunohistochemical technique. The animals were placed in two chambers: one received air that passed through an air filter (clean) and the second received ambient air (polluted), according to four different exposure procedures: 1) Clean (CC): prenatal and postnatal in the clean chamber (control group), 2) Polluted (PP): prenatal and posnatal in the polluted chamber, 3) Polluted-clean (PC): prenatal in the polluted and posnatal in the clean chamber and 4) Clean-polluted (CP): prenatal in the clean and posnatal in the polluted chamber. The concentration of of malondialdehyde (MDA, a indicator of lipid peroxidation) was higher in group PP compared to CC (p = 0.004) and to PC (p = 0.026), and was not different of group CP (p = 0.894). The values of MDA for groups PC and CP turned to be equal (p = 0.168). Interestingly, group PC had a higher value of MDA than group CC (p = 0.026). The volume fraction of myocardium with detection of 15-F2tisoprostane is higher in PC (p = 2.884x10-5), CP (p = 6.632x10-6) and PP (p = 5.45x10-8) than in CC. The value of PP in higher than those of PC and CP (p = 3.661x10-4 and 1.058x10-3, respectively), while the latter two were equal to each other (p = 0.624). ). The mean ratio of arterioles wiht lumen area between 200 and 1000?m² to the total number of vessels in each group was higher in PP than in CC and PC (p=0.0387 and p=0.0362, respectively). These results, which suggest that exposure to air pollution is associated to higher levels of lipid peroxidation in the myocardium, are compared to other results previously published about respiratory and reproductive alterations related to pollution. Interestingly, the increased levels of lipid peroxidation in the PC group gives evidence that the prenatal exposure to urban air pollution can be linked to cardiovascular effects in adult life.

L’imagerie par résonance magnétique (IRM) est un outil de choix pour la caractérisation tissulaire in vivo. Il est démontré que la mesure d’un temps caractéristique en IRM, appelé « T1 », est corrélée à la composition du tissu. Justesse et reproductibilité sont requises dans la mesure du T1 pour : i) discriminer les valeurs de T1 des tissus sains et fibrosés dont la gamme de valeurs est assez restreinte, ii) permettre la mesure avant et après injection d’agent de contraste et iii) comparer les valeurs de T1 entre sites et constructeurs. A ce jour, aucune des techniques publiées n’est en mesure de fournir une mesure de T1 « idéale ». L’objectif principal de cette thèse est d’optimiser et de valider une technique de mesure du T1 sur le myocarde, qui se propose d’allier ces deux qualités. Pour atteindre cet objectif, nous avons travaillé la séquence appelée « SMART1Map » basée sur le principe d’échantillonnage d’une courbe de saturation-récupération. Des essais sur objets tests et sur volontaires à 1,5T et 3T ont d’abord été réalisés. Bien que les valeurs moyennes de T1 mesurées chez 7 sujets étaient justes et correspondaient à la littérature (1150 ± 84 ms à 1,5T), les résultats ont montré une faible reproductibilité imputable en partie à un manque de robustesse de la séquence vis-à-vis des inhomogénéités de champ magnétique particulièrement importantes à 3T. L’optimisation (simulation, implémentation et tests) de l’impulsion radiofréquence de saturation constitutive de la séquence a été mise en œuvre à 3T, sur objets fantômes, puis sur volontaires sains. Ces travaux ouvrent la voie à la mise en place de mesure de biomarqueur IRM de la fibrose / Cardiac Magnetic Resonance Imaging (MRI) has experienced growing interest due to its great potential in myocardial tissue characterization. Myocardium T1 values can be considered a useful imaging biomarker. Although many different T1 mapping techniques already exist, accurate and precise myocardial T1 quantification remains a desired yet challenging goal. Cardiac T1 mapping necessitates high precision to: i) discriminate values within the relatively short range of T1 values in healthy and diseased tissues, ii) allow both pre and post contrast agent injection T1 assessment, which is mandatory to compute the ECV and iii) allow comparison across platforms and hospitals. It should also provide a T1 value independent of heart rate. Among published methods, not any of them offer an “ideal” T1 quantification method. The main aim of this work is to optimize and to validate a precise and accurate quantitative T1 mapping technique. In order to achieve this goal, the sequence called « SMART1Map » based on the saturation recovery curve sampling was used. The first step consisted in performing T1 measurements on phantoms and healthy volunteers at 1,5T and 3T. Although this study allowed to assess accurate myocardium T1 values close to literature ones (1150 ± 84 ms), the sequence showed a poor precision likely due to a lack of robustness to magnetic field inhomogeneties and frequency offsets. Optimization (including simulation, implementation and tests) of the saturation RF pulse used in the sequence was carried out in phantoms then on healthy subjects at 3T. From this development, fibrosis detection through T1 measurements in clinical studies can now be started at 1.5T and 3T

Bakgrund: Ekokardiografi har en betydande roll i diagnostisering av vänster kammare. Genom undersökning av segmentell och global longitudinell strain samt strain rate kan regional och global kinetik bedömas. Vid kontraktion och relaxation deformeras myokardiet varvid segmentell strain mäter deformationen av respektive segment uttryckt i procent medan strain rate mäter hastigheten av deformationen. Genom summering av medelvärdet från alla segment erhålls global longitudinell strain. Syfte: Syftet med studien var att jämföra ultraljudbaserade segmentell och global strain samt strain rate i vänster kammare. Jämförelse har gjorts mellan mätningar utförd av erfaren biomedicinsk analytiker samt mindre erfarna biomedicinska analytikerstudenter. Metod: Kvantitativ studie där 10 testpersoner undersökts ekokardiografiskt. Bildtagningen och mätresultaten insamlades med Siemens Acuson SC2000. Sammanställning av insamlade mätvärden gjordes på Microsoft Excel och Microsoft Word i diagram och tabeller. För jämförelse av strain segmentellt och globalt samt strain rate har analysmetoden Related-Samples Wilcoxon Signed Rank Test använts. Resultat: Resultatet visade enbart en statistisk signifikant skillnad (p <0,05) vid segmentell strain i basala segmenten i apikala projektioner mellan erfaren biomedicinsk analytiker och student 1. Konklusion: Datamaterialet är inte tillräckligt för att kunna generalisera resultatet till en större population. Det behövs fortsatta studier inom området för att dra en mer säkerställd slutsats. / Background: Echocardiography has a major role for assessment of the left ventricle. By using segmental and global longitudinal strain and strain rate both regional and global kinetics can be assessed. Segmental strain measures deformation of the myocardium as strain rate measures the velocity of the deformation. By summing the average from all segments, global longitudinal strain is obtained. Purpose:  To compare heart ultrasound-based segmental and global strain and strain rate in the left ventricle. Comparisons have been made between experienced biomedical laboratory scientist and less experienced biomedical laboratory scientist’s students. Method: Quantitative study were 10 test subjects have been examined echocardiographically. Imaging and measurements were collected with Siemens Acuson SC2000. Compilation of collected measurements were made on Microsoft Excel and Microsoft Word in charts and tables. For comparison of segmental and global strain and strain rate the analysis method Related-Samples Wilcoxon Signed Rank Test were used. Result: The result shows only one statistically significant difference (p <0.05) of segmental strain in the basal segments of apical projections between experienced biomedical laboratory scientist and student 1.  Conclusion: The data material is not enough to generalize the result to a larger population. Further studies are needed to draw a more secure conclusion.