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Wang YRJ, Yang K, Wen Y, Wang P, Hu Y, Lai Y, Wang Y, Zhao K, Tang S, Zhang A, Zhan H, Lu M, Chen X, Yang S, Dong Z, Wang Y, Liu H, Zhao L, Huang L, Li Y, Wu L, Chen Z, Luo Y, Liu D, Zhao P, Lin K, Wu JC, Zhao S. Screening and diagnosis of cardiovascular disease using artificial intelligence-enabled cardiac magnetic resonance imaging. Nat Med 2024:10.1038/s41591-024-02971-2. [PMID: 38740996 DOI: 10.1038/s41591-024-02971-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 04/03/2024] [Indexed: 05/16/2024]
Abstract
Cardiac magnetic resonance imaging (CMR) is the gold standard for cardiac function assessment and plays a crucial role in diagnosing cardiovascular disease (CVD). However, its widespread application has been limited by the heavy resource burden of CMR interpretation. Here, to address this challenge, we developed and validated computerized CMR interpretation for screening and diagnosis of 11 types of CVD in 9,719 patients. We propose a two-stage paradigm consisting of noninvasive cine-based CVD screening followed by cine and late gadolinium enhancement-based diagnosis. The screening and diagnostic models achieved high performance (area under the curve of 0.988 ± 0.3% and 0.991 ± 0.0%, respectively) in both internal and external datasets. Furthermore, the diagnostic model outperformed cardiologists in diagnosing pulmonary arterial hypertension, demonstrating the ability of artificial intelligence-enabled CMR to detect previously unidentified CMR features. This proof-of-concept study holds the potential to substantially advance the efficiency and scalability of CMR interpretation, thereby improving CVD screening and diagnosis.
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Affiliation(s)
| | - Kai Yang
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Wen
- Changhong AI Research (CHAIR), Sichuan Changhong Electronics Holding Group, Mianyang, China
| | - Pengcheng Wang
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| | - Yuepeng Hu
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
| | - Yongfan Lai
- School of Engineering, University of Science and Technology of China, Hefei, China
| | - Yufeng Wang
- Department of Computer Science, Stony Brook University, New York, NY, USA
| | - Kankan Zhao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
| | - Siyi Tang
- School of Medicine, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Angela Zhang
- School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cardiovascular Institute, School of Medicine (Division of Cardiology), Stanford University, Stanford, CA, USA
| | - Huayi Zhan
- Changhong AI Research (CHAIR), Sichuan Changhong Electronics Holding Group, Mianyang, China
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiuyu Chen
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shujuan Yang
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhixiang Dong
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yining Wang
- Peking Union Medical College Hospital, Beijing, China
| | - Hui Liu
- Guangdong Provincial People's Hospital, Guangzhou, China
| | - Lei Zhao
- Beijing Anzhen Hospital, Beijing, China
| | | | - Yunling Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Zixian Chen
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Yi Luo
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Dongbo Liu
- Changhong AI Research (CHAIR), Sichuan Changhong Electronics Holding Group, Mianyang, China
| | - Pengbo Zhao
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA
| | - Keldon Lin
- Mayo Clinic Alix School of Medicine, Phoenix, AZ, USA
| | - Joseph C Wu
- School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cardiovascular Institute, School of Medicine (Division of Cardiology), Stanford University, Stanford, CA, USA
| | - Shihua Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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2
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Ranard LS, Bonow RO, Nishimura R, Mack MJ, Thourani VH, Bavaria J, O'Gara PT, Bax JJ, Blanke P, Delgado V, Leipsic J, Lang RM, Michelena HI, Cavalcante JL, Vahl TP, Leon MB, Rigolin VH. Imaging Methods for Evaluation of Chronic Aortic Regurgitation in Adults: JACC State-of-the-Art Review. J Am Coll Cardiol 2023; 82:1953-1966. [PMID: 37940233 DOI: 10.1016/j.jacc.2023.08.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/21/2023] [Indexed: 11/10/2023]
Abstract
A global multidisciplinary workshop was convened to discuss the multimodality diagnostic evaluation of aortic regurgitation (AR). Specifically, the focus was on assessment tools for AR severity and analyzing evolving data on the optimal timing of aortic valve intervention. The key concepts from this expert panel are summarized as: 1) echocardiography is the primary imaging modality for assessment of AR severity; however, when data is incongruent or incomplete, cardiac magnetic resonance may be helpful; 2) assessment of left ventricular size and function is crucial in determining the timing of intervention; 3) recent evidence suggests current cutpoints for intervention in asymptomatic severe AR patients requires further scrutiny; 4) left ventricular end-systolic volume index has emerged as an additional parameter that has promise in guiding timing of intervention; and 5) the role of additional factors (including global longitudinal strain, regurgitant fraction, and myocardial extracellular volume) is worthy of future investigation.
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Affiliation(s)
- Lauren S Ranard
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Robert O Bonow
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Rick Nishimura
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Mack
- Division of Cardiothoracic Surgery, Heart Hospital Baylor Plano, Baylor Healthcare System, Plano, Texas, USA
| | - Vinod H Thourani
- Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Joseph Bavaria
- Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Patrick T O'Gara
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Philipp Blanke
- Department of Radiology, St Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria Delgado
- Department of Cardiology, Hospital University Germans Trias i Pujol, Badalona, Spain
| | - Jonathon Leipsic
- Department of Radiology, St Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Roberto M Lang
- Section of Cardiology, Heart and Vascular Center, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Hector I Michelena
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - João L Cavalcante
- Division of Cardiology, Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Torsten P Vahl
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Martin B Leon
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Vera H Rigolin
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA.
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Longère B, Abassebay N, Gkizas C, Hennicaux J, Simeone A, Rodriguez Musso A, Carpentier P, Coisne A, Pang J, Schmidt M, Toupin S, Montaigne D, Pontana F. A new compressed sensing cine cardiac MRI sequence with free-breathing real-time acquisition and fully automated motion-correction: A comprehensive evaluation. Diagn Interv Imaging 2023:S2211-5684(23)00123-7. [PMID: 37328394 DOI: 10.1016/j.diii.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The purpose of this study was to compare a new free-breathing compressed sensing cine (FB-CS) cardiac magnetic resonance imaging (CMR) to the standard reference multi-breath-hold segmented cine (BH-SEG) CMR in an unselected population. MATERIALS AND METHODS From January to April 2021, 52 consecutive adult patients who underwent both conventional BH-SEG CMR and new FB-CS CMR with fully automated respiratory motion correction were retrospectively enrolled. There were 29 men and 23 women with a mean age of 57.7 ± 18.9 (standard deviation [SD]) years (age range: 19.0-90.0 years) and a mean cardiac rate of 74.6 ± 17.9 (SD) bpm. For each patient, short-axis stacks were acquired with similar parameters providing a spatial resolution of 1.8 × 1.8 × 8.0 mm3 and 25 cardiac frames. Acquisition and reconstruction times, image quality (Likert scale from 1 to 4), left and right ventricular volumes and ejection fractions, left ventricular mass, and global circumferential strain were assessed for each sequence. RESULTS FB-CS CMR acquisition time was significantly shorter (123.8 ± 28.4 [SD] s vs. 267.2 ± 39.3 [SD] s for BH-SEG CMR; P < 0.0001) at the penalty of a longer reconstruction time (271.4 ± 68.7 [SD] s vs. 9.9 ± 2.1 [SD] s for BH-SEG CMR; P < 0.0001). In patients without arrhythmia or dyspnea, FB-CS CMR provided subjective image quality that was not different from that of BH-SEG CMR (P = 0.13). FB-CS CMR improved image quality in patients with arrhythmia (n = 18; P = 0.002) or dyspnea (n = 7; P = 0.02), and the edge sharpness was improved at end-systole and end-diastole (P = 0.0001). No differences were observed between the two techniques in ventricular volumes and ejection fractions, left ventricular mass or global circumferential strain in patients in sinus rhythm or with cardiac arrhythmia. CONCLUSION This new FB-CS CMR addresses respiratory motion and arrhythmia-related artifacts without compromising the reliability of ventricular functional assessment.
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Affiliation(s)
- Benjamin Longère
- Univ. Lille, U1011-European Genomic Institute for Diabetes (EGID), 59000 Lille, France; Inserm, U1011, 59000 Lille, France; CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France; Institut Pasteur Lille, 59000 Lille, France.
| | - Neelem Abassebay
- CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France
| | - Christos Gkizas
- CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France
| | - Justin Hennicaux
- CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France
| | - Arianna Simeone
- CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France
| | | | - Paul Carpentier
- CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France
| | - Augustin Coisne
- Univ. Lille, U1011-European Genomic Institute for Diabetes (EGID), 59000 Lille, France; Inserm, U1011, 59000 Lille, France; CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France; Institut Pasteur Lille, 59000 Lille, France
| | - Jianing Pang
- MR R&D, Siemens Medical Solutions USA Inc., Chicago, IL 60611, USA
| | - Michaela Schmidt
- MR Product Innovation and Definition, Healthcare Sector, Siemens GmbH, 91052 Erlangen, Germany
| | - Solenn Toupin
- Scientific Partnerships, Siemens Healthcare France, 93200 Saint-Denis, France
| | - David Montaigne
- Univ. Lille, U1011-European Genomic Institute for Diabetes (EGID), 59000 Lille, France; Inserm, U1011, 59000 Lille, France; CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France; Institut Pasteur Lille, 59000 Lille, France
| | - François Pontana
- Univ. Lille, U1011-European Genomic Institute for Diabetes (EGID), 59000 Lille, France; Inserm, U1011, 59000 Lille, France; CHU Lille, Department of Cardiovascular Radiology, 59000 Lille, France; Institut Pasteur Lille, 59000 Lille, France
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Alattar Y, Soulat G, Gencer U, Messas E, Bollache E, Kachenoura N, Mousseaux E. Left ventricular diastolic early and late filling quantified from 4D flow magnetic resonance imaging. Diagn Interv Imaging 2022; 103:345-352. [DOI: 10.1016/j.diii.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/17/2022] [Accepted: 02/09/2022] [Indexed: 01/02/2023]
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Pirocca U, Hadouiri N, Bartoli A, Morcet-Delattre T, Pontana F, Cochet H, Tacher V, Cadour F, Mandry D, Jacquier A. How attractive is cardiac imaging to French radiology residents? Diagn Interv Imaging 2022; 103:185-188. [PMID: 34998710 DOI: 10.1016/j.diii.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Ugo Pirocca
- Department of Radiology, Centre Hospitalier Universitaire de Besançon, 25030 Besançon, France
| | - Nawale Hadouiri
- Department of Physical Medicine and Rehabilitation, Center Hospitalier Universitaire de Dijon, 21000 Dijon, France; InterSyndicale Nationale des Internes, 75005 Paris, France.
| | - Axel Bartoli
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
| | | | - François Pontana
- Department of Cardiovascular Radiology, Institut Pasteur de Lille, CHU de Lille, Université de Lille, U1011 - EGID, INSERM, 59000 Lille, France
| | - Hubert Cochet
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
| | - Vania Tacher
- Unité Inserm U955, Équipe 18, Université Paris Est, 94010 Créteil, France; Department of Radiology, Hôpital Henri-Mondor, AP-HP, 94010 Créteil, France
| | - Farah Cadour
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
| | - Damien Mandry
- Department of Radiology, CHRU-Nancy, Université de Lorraine, 54035 Nancy, France
| | - Alexis Jacquier
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
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6
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Dubourg B, Dacher JN, Durand E, Caudron J, Bauer F, Bubenheim M, Eltchaninoff H, Serfaty JM. Single-source dual energy CT to assess myocardial extracellular volume fraction in aortic stenosis before transcatheter aortic valve implantation (TAVI). Diagn Interv Imaging 2021; 102:561-570. [PMID: 33903056 DOI: 10.1016/j.diii.2021.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To assess myocardial extracellular volume fraction (ECV) measurement provided by a single-source dual-energy computed tomography (SSDE-CT) acquisition added at the end of a routine CT examination before transcatether aortic valve implantation (TAVI) compared to cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty-one patients (10 men, 11 women; mean age, 86±4.9 years [SD]; age range: 71-92 years) with severe aortic stenosis underwent standard pre-TAVI CT with additional cardiac SSDE-CT acquisition 7minutes after intravenous administration of iodinated contrast material and myocardial MRI including pre- and post-contrast T1-maps. Myocardial ECV and standard deviation (σECV) were calculated in the 16-segments model. ECV provided by SSDE-CT was compared to ECV provided by MRI, which served as the reference. Analyses were performed on a per-segment basis and on a per-patient involving the mean value of the 16-segments. RESULTS ECV was slightly overestimated by SSDE-CT (29.9±4.6 [SD] %; range: 20.9%-48.3%) compared to MRI (29.1±3.9 [SD] %; range: 22.0%-50.7%) (P<0.0001) with a bias and limits of agreement of +2.3% (95%CI: -16.1%-+20.6%) and +2.5% (95%CI: -2.1%-+7.1%) for per-segment and per-patient-analyses, respectively. Good (r=0.81 for per-segment-analysis) to excellent (r=0.97 for per-patient-analysis) linear relationships (both P<0.0001) were obtained. The σECV was significantly higher at SSDE-CT (P<0.0001). Additional radiation dose from CT was 1.89±0.38 (SD) mSv (range: 1.48-2.47 mSv). CONCLUSION A single additional SSDE-CT acquisition added at the end of a standard pre-TAVI CT protocol can provide ECV measurement with good to excellent linear relationship with MRI.
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Affiliation(s)
- Benjamin Dubourg
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France.
| | - Jean-Nicolas Dacher
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France
| | - Eric Durand
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Jérôme Caudron
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France
| | - Fabrice Bauer
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Michael Bubenheim
- Department of Biostatistics, University Hospital of Rouen, 76031 Rouen, France
| | - Hélène Eltchaninoff
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Jean-Michel Serfaty
- Department of Radiology, Institut du Thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, 44000 Nantes, France
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Le Ven F, Dacher JN, Pontana F, Barone-Rochette G, Macron L, Garot J, Genée O, Mandry D, Christiaens LP, Gilard M, Boyer L, Furber A, Jacquier A. Position paper on stress cardiac magnetic resonance imaging in chronic coronary syndrome: Endorsed by the Société française de radiologie (SFR), the Société française d'imagerie cardiovasculaire (SFICV) and the Société française de cardiologie (SFC). Arch Cardiovasc Dis 2021; 114:325-335. [PMID: 33888446 DOI: 10.1016/j.acvd.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 12/20/2022]
Abstract
This paper is intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging in chronic coronary syndrome, published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, the procedure (with patient preparation), stress-inducing drugs, the acquisition protocol, interpretation and risk stratification by stress magnetic resonance imaging.
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Affiliation(s)
- Florent Le Ven
- Department of Cardiology, Brest University Hospital, EA3878GETBO, Université de Bretagne Occidentale, 29609 Brest, France.
| | - Jean-Nicolas Dacher
- Normandy University, UNIROUEN, INSERM U1096, Department of Medical Imaging, Cardiac Imaging Unit, Rouen University Hospital, 76000 Rouen, France
| | - François Pontana
- Université de Lille, U1011-EGID, 59045 Lille, France; INSERM U1011, 59019 Lille, France; Institut Pasteur de Lille, 59000 Lille, France; Department of Cardiovascular Radiology, CHU de Lille, 59000 Lille, France
| | - Gilles Barone-Rochette
- Department of Cardiology, CHU Grenoble Alpes, 38700 La Tronche, France; Radiopharmaceutiques Biocliniques, INSERM U1039, Grenoble Alpes University, 38700 La Tronche, France; French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 75018 Paris, France
| | - Laurent Macron
- Department of Imaging, Centre Cardiologique du Nord de Saint-Denis, 93200 Saint-Denis, France
| | - Jerome Garot
- Cardiac MRI-Institut Cardiovasculaire Paris Sud, Jacques-Cartier Private Hospital-Ramsay Health, 91300 Massy, France
| | - Olivier Genée
- Pôle Santé Oréliance, Centre Cardiologique d'Orléans, 45770 Saran, France
| | - Damien Mandry
- Lorraine University, IADI, INSERM U1254, 54000 Nancy, France; Department of Radiology, Brabois, CHRU Nancy, 54000 Nancy, France
| | | | - Martine Gilard
- Department of Cardiology, Brest University Hospital, EA 4324 ORPHY, Université de Bretagne Occidentale, 29609 Brest, France
| | - Louis Boyer
- Pôle Imagerie Diagnostique et Radiologie Interventionnelle, CHU Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Alain Furber
- Institut MITOVASC, UMR INSERM U1083, CNRS 6015, Équipe Physiopathologie Cardiovasculaire, Service de Cardiologie, CHU d'Angers, Université d'Angers, 49000 Angers, France
| | - Alexis Jacquier
- Aix-Marseille Université, Department of Radiology and Cardiovascular Imaging, Hôpital Timone, AP-HM, CNRS, Centre de Résonance Magnétique Biologique et Médicale (CRMBM), 13385 Marseille, France
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8
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Le Ven F, Pontana F, Barone-Rochette G, Macron L, Garot J, Genée O, Mandry D, Christiaens L, Furber A, Dacher JN, Jacquier A. Position paper on stress cardiac MRI in chronic coronary syndrome: Endorsed by the Société Française de Radiologie (SFR) the Société Française d'Imagerie CardioVasculaire (SFICV) and the Société Française de Cardiologie (SFC). Diagn Interv Imaging 2021; 102:337-345. [PMID: 33712412 DOI: 10.1016/j.diii.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/30/2021] [Accepted: 02/05/2021] [Indexed: 01/20/2023]
Abstract
This position paper was intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging (MRI) in chronic coronary syndrome published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, procedure with patient preparation, stress inducing drugs, acquisition protocol, interpretation and risk stratification by stress MRI.
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Affiliation(s)
- Florent Le Ven
- Department of Cardiology, University Hospital, 29000 Brest, France. EA3878-GETBO-West Brittany study Group on Thrombosis-University of West Brittany, 29000 Brest, France
| | - François Pontana
- Université de Lille, U1011 - EGID, Lille, France; Inserm, U1011, Institut Pasteur de Lille, Department of Cardiovascular Radiology, CHU de Lille, 59000 Lille, France
| | - Gilles Barone-Rochette
- Department of Cardiology, University Hospital, INSERM, U1039, Radiopharmaceutiques Biocliniques, Grenoble Alpes University, French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 38000 Grenoble, France
| | - Laurent Macron
- Department of Imaging, Centre Cardiologique du Nord de Saint-Denis, 93200 Paris, France
| | - Jérome Garot
- Cardiac MRI - ICPS, Jacques Cartier Private Hospital - Ramsay Health, 91300 Massy, France
| | - Olivier Genée
- Cardioréliance, Centre Cardiologique d'Orléans, Pôle Santé Oréliance, 45770 Saran, France
| | - Damien Mandry
- Lorraine Université de Lorraine, IADI, INSERM U1254, Department of Radiology, Brabois, CHRU Nancy, 54000 Nancy, France
| | - Luc Christiaens
- Department of Cardiology, Centre Hospitalier Universitaire de Poitiers, 86000 Poitiers, France
| | - Alain Furber
- Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Équipe Physiopathologie Cardiovasculaire, Service de Cardiologie, CHU d'Angers, Université Angers, 49000 Angers, France
| | - Jean Nicolas Dacher
- Normandy University, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Medical Imaging (Cardiac Imaging Unit), 76000 Rouen, France
| | - Alexis Jacquier
- Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Department of Radiology and Cardiovascular Imaging, Hôpital Timone, CNRS, CRMBM (Centre de Résonance Magnétique Biologique et Médicale) CEMEREM (Centre d'Exploration Métaboliques par Résonance Magnétique), 13385 Marseille, France.
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Barbieri A, Benfari G, Giubertoni E, Manicardi M, Bursi F, Rossi A, Maritan L, Venturi G, Boriani G. Degree of left ventricular dilatation at end-diastole: Correlation and prognostic utility of quantitative volumes by 2D-echocardiography versus linear dimensions in patients with asymptomatic aortic regurgitation. Echocardiography 2020; 37:1336-1344. [PMID: 32757465 DOI: 10.1111/echo.14815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/19/2020] [Accepted: 07/19/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Guideline recommendations for aortic valve replacement (AVR) in asymptomatic patients with chronic aortic regurgitation (AR) have historically focused on linear dimensions without normalization for the body surface area (BSA). Values for grading the severity of end-diastolic volume dilatation by 2D echocardiography remain to be established. METHODS AND RESULTS We retrospectively analyzed 543 consecutive asymptomatic patients with pure chronic moderate/severe AR (mean age 66 ± 17 years, 37.7% males). Applying the ASE/EACVI guidelines, BSA-indexed LV end-diastolic volume (LVEDVi) and indexed LV end-diastolic diameter (LVEDDi) were assessed. Then, we identified 192 patients with at least mild LV end-diastolic dilatation by volumetric or linear measurements. The outcome endpoint was the combination of cardiac death, hospitalization for acute heart failure or AVR during a median follow-up of 4.5 ± 3.6 years. Multivariable Cox regression analyses including age, LV ejection fraction (EF) and AR severity showed an independent prognostic value of the LVEDDi and LVEDVi (P < .001 and P < .01, respectively). Congruent severe LVEDDi and LVEDVi dilatation was associated with a higher event rate compared to discordant severe LV end-diastolic dilatation or nonsevere LV dilatation (P = .001) even after landmark analysis (P = .02). In patients with EF > 50%, only the LVEDVi showed and independent prognostic value (P < .001). CONCLUSIONS In a cohort of asymptomatic patients with AR, the presence of severe LV volume and diameter dilatation on the basis of the cutoff values proposed by current recommendations and normalized for BSA may be instrumental in the identification of patients at increased risk of clinical progression regardless of EF.
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Affiliation(s)
- Andrea Barbieri
- Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Benfari
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Elisa Giubertoni
- Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Manicardi
- Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Bursi
- Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy.,Division of Cardiology, Heart and Lung Department, San Paolo Hospital, ASST Santi Paolo and Carlo, University of Milan, Milan, Italy
| | - Andrea Rossi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Maritan
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriele Venturi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Giuseppe Boriani
- Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
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