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Doeblin P, Goetze C, Al-Tabatabaee S, Berger A, Steinbeis F, Witzenrath M, Faragli A, Stehning C, Chiribiri A, Scannell CM, Alskaf E, Pieske B, Kelle S. Stress myocardial blood flow reduced after severe COVID-19, not related to symptoms. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0213] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Persistent cardiopulmonary symptoms after COVID-19 are reported in a large number of patients and the underlying pathology is still poorly understood. (1) Histopathologic studies revealed myocardial macrophage infiltrates in deceased patients, likely an unspecific finding of severe illness, and increased prevalence of micro- and macrovascular thrombi. (2) We examined whether microvascular perfusion, measured by quantitative cardiac magnetic resonance under vasodilator stress, was altered post COVID-19.
Methods
Our population consisted of 12 patients from the Pa-COVID-19-Study of the Charité Berlin, which received a cardiac MRI as part of a systematic follow up post discharge, 10 patients that presented at the German Heart Center Berlin with persistent cardiac symptoms post COVID-19 and 12 patients from the Kings College London referred for stress MRI and previous COVID-19.
The scan protocol included standard functional, edema and scar imaging and quantitative stress and rest perfusion to assess both macro- and microvascular coronary artery disease. The pharmacological stress agent was regadenosone in 20 and adenosine in 13 of the patients. To control for the higher heart rate increase under regadenosone compared to adenosine, we calculated the myocardial blood flow per heartbeat (MBF_HRi) under stress.
Results
The median time between first positive PCR for COVID-19 and the CMR exam was 2 months (Range 0 to 12). None of the 33 patients exhibited signs of myocardial edema. One patient with a previous history of myocarditis had focal fibrosis. Three patients with known coronary artery disease showed ischemic Late Enhancement. Five patients had a small pericardial effusion; one of these four patients showed slight focal pericardial edema and LGE, consistent with mild focal pericarditis. Five Patients had a stress-induced focal perfusion deficit.
Mean Stress MBF_HRi was 32.5±6.5 μl/beat/g. Stress MBF_HRi was negatively correlated with COVID-19 severity (rho=−0.361, P=0.039) and age (r=−0.452, P=0.009). The correlation with COVID-19 severity remained significant after controlling for age (rho=−0.390, P=0.027). There was no apparent difference in stress MBF_HRi between patients with and without persistent chest pain (34.5 vs. 31.5 μl/beat/g, P=0.229)
Conclusion
While vasodilator-stress myocardial blood flow after COVID-19 was negatively correlated to COVID-19 severity, it was not correlated to the presence of chest pain. The etiology of persistent cardiac symptoms after COVID-19 remains unclear.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Philips Figure 1. A) Quantitative regadenosone stress myocardial blood flow (MBF) map, medial short axis slice, in a patient with persistent cardiac symptoms after COVID-19. B) Boxplot of stress MBF per heart beat by COVID-19 severity, showing decreasing MBF with increasing COVID-19 severity.
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Affiliation(s)
- P Doeblin
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - C Goetze
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | | | - A Berger
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - F Steinbeis
- Charite - Campus Mitte (CCM), Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany
| | - M Witzenrath
- Charite - Campus Mitte (CCM), Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany
| | - A Faragli
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | | | - A Chiribiri
- King's College London, Division of Imaging Sciences, London, United Kingdom
| | - C M Scannell
- King's College London, Division of Imaging Sciences, London, United Kingdom
| | - E Alskaf
- King's College London, Division of Imaging Sciences, London, United Kingdom
| | - B Pieske
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S Kelle
- Deutsches Herzzentrum Berlin, Berlin, Germany
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Faragli A, Tanacli R, Kolp C, Abawi D, Lapinskas T, Stehning C, Schnackenburg B, Lo Muzio FP, Fassina L, Pieske B, Nagel E, Post H, Kelle S, Alogna A. Cardiovascular magnetic resonance-derived left ventricular mechanics-strain, cardiac power and end-systolic elastance under various inotropic states in swine. J Cardiovasc Magn Reson 2020; 22:79. [PMID: 33256761 PMCID: PMC7708216 DOI: 10.1186/s12968-020-00679-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 10/06/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) strain imaging is an established technique to quantify myocardial deformation. However, to what extent left ventricular (LV) systolic strain, and therefore LV mechanics, reflects classical hemodynamic parameters under various inotropic states is still not completely clear. Therefore, the aim of this study was to investigate the correlation of LV global strain parameters measured via CMR feature tracking (CMR-FT, based on conventional cine balanced steady state free precession (bSSFP) images) with hemodynamic parameters such as cardiac index (CI), cardiac power output (CPO) and end-systolic elastance (Ees) under various inotropic states. METHODS Ten anaesthetized, healthy Landrace swine were acutely instrumented closed-chest and transported to the CMR facility for measurements. After baseline measurements, two steps were performed: (1) dobutamine-stress (Dobutamine) and (2) verapamil-induced cardiovascular depression (Verapamil). During each protocol, CMR images were acquired in the short axisand apical 2Ch, 3Ch and 4Ch views. MEDIS software was utilized to analyze global longitudinal (GLS), global circumferential (GCS), and global radial strain (GRS). RESULTS Dobutamine significantly increased heart rate, CI, CPO and Ees, while Verapamil decreased them. Absolute values of GLS, GCS and GRS accordingly increased during Dobutamine infusion, while GLS and GCS decreased during Verapamil. Linear regression analysis showed a moderate correlation between GLS, GCS and LV hemodynamic parameters, while GRS correlated poorly. Indexing global strain parameters for indirect measures of afterload, such as mean aortic pressure or wall stress, significantly improved these correlations, with GLS indexed for wall stress reflecting LV contractility as the clinically widespread LV ejection fraction. CONCLUSION GLS and GCS correlate accordingly with LV hemodynamics under various inotropic states in swine. Indexing strain parameters for indirect measures of afterload substantially improves this correlation, with GLS being as good as LV ejection fraction in reflecting LV contractility. CMR-FT-strain imaging may be a quick and promising tool to characterize LV hemodynamics in patients with varying degrees of LV dysfunction.
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Affiliation(s)
- A Faragli
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Tanacli
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Kolp
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D Abawi
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Lapinskas
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Street 2, 50161, Kaunas, Lithuania
| | - C Stehning
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - B Schnackenburg
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - F P Lo Muzio
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Via S. Francesco 22, 37129, Verona, Italy
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - L Fassina
- Department of Electrical, Computer and Biomedical Engineering (DIII), Centre for Health Technologies (CHT), University of Pavia, Via Ferrata 5, 27100, Pavia, Italy
| | - B Pieske
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - H Post
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Cardiology, Contilia Heart and Vessel Centre, St. Marien-Hospital Mülheim, 45468, Mülheim, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Alogna
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.
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Wetscherek M, Rutschke W, Frank C, Stehning C, Lurz P, Grothoff M, Thiele H, Gutberlet M, Lücke C. High inter- and intra-observer agreement in mapping sequences compared to classical Lake Louise Criteria assessment of myocarditis by inexperienced observers. Clin Radiol 2020; 75:796.e17-796.e26. [DOI: 10.1016/j.crad.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/08/2020] [Indexed: 11/24/2022]
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4
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Faragli A, Tanacli R, Kolp C, Lapinskas T, Stehning C, Schnackenburg B, Lo Muzio FP, Perna S, Pieske B, Nagel E, Post H, Kelle S, Alogna A. Cardiovascular magnetic resonance feature tracking in pigs: a reproducibility and sample size calculation study. Int J Cardiovasc Imaging 2020; 36:703-712. [PMID: 31950298 PMCID: PMC7125242 DOI: 10.1007/s10554-020-01767-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/02/2020] [Indexed: 12/18/2022]
Abstract
Cardiovascular magnetic resonance feature tracking (CMR-FT) is a novel technique for non-invasive assessment of myocardial motion and deformation. Although CMR-FT is standardized in humans, literature on comparative analysis from animal models is scarce. In this study, we measured the reproducibility of global strain under various inotropic states and the sample size needed to test its relative changes in pigs. Ten anesthetized healthy Landrace pigs were investigated. After baseline (BL), two further steps were performed: (I) dobutamine-induced hyper-contractility (Dob) and (II) verapamil-induced hypocontractility (Ver). Global longitudinal (GLS), circumferential (GCS) and radial strain (GRS) were assessed. This study shows a good to excellent inter- and intra-observer reproducibility of CMR-FT in pigs under various inotropic states. The highest inter-observer reproducibility was observed for GLS at both BL (ICC 0.88) and Ver (ICC 0.79). According to the sample size calculation for GLS, a small number of animals could be used for future trials.
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Affiliation(s)
- A Faragli
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
| | - R Tanacli
- Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Kolp
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - T Lapinskas
- Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Street 2, 50161, Kaunas, Lithuania
| | - C Stehning
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - B Schnackenburg
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - F P Lo Muzio
- Department of Surgery, Dentistry, Paedriatics and Gynaecology, University of Verona, Via S. Francesco 22, 37129, Verona, Italy.,Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - S Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Zallaq, Bahrain
| | - B Pieske
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.,Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - H Post
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.,Department of Cardiology, Contilia Heart and Vessel Centre, St. Marien-Hospital Mülheim, Kaiserstraße 50, 45468, Mülheim, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
| | - A Alogna
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany. .,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.
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Bohnen S, Radunski UK, Lund GK, Ojeda F, Looft Y, Senel M, Radziwolek L, Avanesov M, Tahir E, Stehning C, Schnackenburg B, Adam G, Blankenberg S, Muellerleile K. Tissue characterization by T1 and T2 mapping cardiovascular magnetic resonance imaging to monitor myocardial inflammation in healing myocarditis. Eur Heart J Cardiovasc Imaging 2018; 18:744-751. [PMID: 28329275 DOI: 10.1093/ehjci/jex007] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [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: 07/26/2016] [Accepted: 01/16/2017] [Indexed: 12/18/2022] Open
Abstract
Aims Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. Methods and Results Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. Conclusion Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR.
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Affiliation(s)
- S Bohnen
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - U K Radunski
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - G K Lund
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - F Ojeda
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - Y Looft
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Senel
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - L Radziwolek
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Avanesov
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - E Tahir
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - C Stehning
- Philips GmbH Market DACH, Roentgenstr. 22, 22335 Hamburg
| | | | - G Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - S Blankenberg
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - K Muellerleile
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
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6
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Tahir E, Sinn M, Avanesov M, Bohnen S, Müllerleile K, Radunksi U, Stehning C, Säring D, Starekova J, Schnackenburg B, Adam G, Lund G. Quantitatives T1- und T2-Mapping CMR zur Differenzierung von akutem und chronischem Myokardinfarkt. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E Tahir
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - M Sinn
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - M Avanesov
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - S Bohnen
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - K Müllerleile
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - U Radunksi
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | | | - D Säring
- FH Wedel, Medizinische und Industrielle Bildverarbeitung, Wedel
| | - J Starekova
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | | | - G Adam
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - G Lund
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
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Glide-Hurst C, Zheng W, Stehning C, Weiss S, Renisch S. SU-G-JeP2-10: On the Need for a Dynamic Model for Patient-Specific Distortion Corrections for MR-Only Pelvis Treatment Planning. Med Phys 2016. [DOI: 10.1118/1.4957030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Angela S, Camaioni C, Bohnen S, Khanji MY, Hilbert S, Goetschalckx K, Calvieri C, Reinstadler SJ, Maestrini V, James S, Bastiaenen R, Reid AB, Amadu A, Pontone G, Alberto C, Manuel DL, Federico M, Francesca P, Bendetta G, Giorgio DC, Giuseppe T, Luisa C, Emanuele B, Domenico C, Sabino I, Martina PM, Morlon L, Vergé MP, Jais P, Roudaut R, Laurent F, Lafitte S, Cochet H, Réant P, Radunski UK, Lund GK, Senel M, Avanesov M, Tahir E, Stehning C, Adam G, Blankenberg S, Muellerleile K, Balawon A, Boubertakh R, Petersen SE, Spampinato R, Oebel S, Hindricks G, Bollmann A, Jahnke C, Paetsch I, Bogaert J, Desmet W, Toth A, Merkely B, Janssens S, Claus P, Preda MB, Perfetti A, Valaperta R, Secchi F, Fedele F, Martelli F, Lombardi M, Eitel C, Fuernau G, de Waha S, Desch S, Mende M, Metzler B, Schuler G, Thiele H, Eitel I, Mun HC, Kotwinski P, Rosmini S, Sanders J, Lloyd G, Dudley JP, Kellman P, Hugh EM, Manisty C, James CM, Waterhouse D, Murphy T, Kenny C, O'Hanlon R, Cox AT, Wijeyeratne Y, Colbeck N, Pakroo N, Ahmed H, Bunce N, Anderson L, Prasad S, Sharma S, Behr ER, Miller C, Jovanovic A, Woolfson P, Abidin N, Schmitt M, Rodrigues J, Dastidar AG, Baritussio A, Lawton C, Venuti G, Meloni G, Conti M, Bucciarelli-Ducci C, Andreini D, SoLbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Rota C, Guaricci AI, Pepi M. ORAL AB QUICK FIRE I1496Myocardial substrates underlyng early ventricular arrhythmias in st-elevation acute myocardial infarction: the role of cardiac magnetic resonance1416Cardiac magnetic resonance predicts atrial fibrillation occurrence in patients with hypertrophic cardiomyopathy1469T1 and T2 mapping cardiovascular magnetic resonance to monitor inflammatory activity in patients with myocarditis1480Impact of electronic coaching on cardiovascular risk reduction in a high-risk primary prevention population – A cardiovascular magnetic resonance sub-study1598Anatomical and functional evaluation of postinterventional pulmonary vein stenosis by magnetic resonance imaging1364Reduced infarct-adjacent wall thickening and impaired restperfusion in the area at risk of successfully reperfused acute myocardial infarction1580Correlation between circulating microRNA 29 and diffuse myocardial fibrosis, assessed by T1 mapping, in patients affected by non ischemic dilative cardiomyopathy1435Association of Smoking with Myocardial Injury and Clinical Outcome in Patients Undergoing Mechanical Reperfusion for ST-Elevation Myocardial Infarction1640Assessing the risk of late cardiotoxicity in low risk breast cancer survivors receiving contemporary anthracycline treatment: a 6 year 100 patient study1511Risk stratification in sarcoidosis: Incidence of cardiac sarcoidosis in individuals diagnosed with extra-cardiac disease by cardiovascular magnetic resonance1334Patterns of late gadolinium enhancement in Brugada syndrome1591Detailed Left Atrial Assessment in Anderson Fabry Disease1634Role of cardiac magnetic resonance in the diagnosis of ARVC/D mimics1321Comparison of transtlioracic ecliocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patients: Table 1. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Imran M, Wang L, McCrohon J, Yu C, Huang J, Holloway C, James O, Stehning C, Moffat K, Ross J, Kotlyar E, Hayward C, Keogh A, Macdonald P, Jabbour A. Role of Novel Cardiovascular Magnetic Resonance Based Tissue Characterization in the Detection of Cardiac Transplant Rejection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tahir E, Sinn M, Avanesov M, Wien J, Säring D, Stehning C, Radunski U, Müllerleille K, Adam G, Lund G. Reproduzierbarkeit der Größenbestimmung von Läsionen nach akutem Myokardinfarkt mittels nativen und kontrastmittelgestützten Kardio-MRT. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Avanesov M, Weinrich J, Münch J, Well L, Säring D, Stehning C, Müllerleile K, Patten M, Tahir E, Adam G, Lund G. Abschätzung des kalkulierten 5-Jahres-Risikos für plötzlichen Heztod durch quantitative LGE- und ECV-Bestimmung bei Patienten mit hypertropher Kardiomyopathie(HCM). ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Baeßler B, Schaarschmidt F, Schnackenburg B, Stehning C, Dick A, Maintz D, Bunck A. Ein neuer multiparametrischer Ansatz in der MRT-basierten Diagnostik der Myokarditis: Kombination von T2-Mapping mit Feature Tracking basierter Strain-Analyse. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Avanesov M, Säring D, Radunski U, Müllerleile K, Stehning C, Adam G, Lund G. Quantifizierung der Myokardfibrose bei Patienten mit hypertropher Kardiomyopathie mit LGE, prä-/post-KM T1- und ECV-Mapping bezogen auf normal erscheinendes Myokard und Normalwerte gesunder Probanden. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sinn M, Tahir E, Radunski U, Säring D, Müllerleile K, Stehning C, Adam G, Lund G. Serielle Beurteilung der Infarktgröße durch LGE und ECV-Mapping innerhalb von 6 Monaten nach akutem Herzinfarkt. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tahir E, Sinn M, Radunski U, Säring D, Stehning C, Müllerleile K, Adam G, Lund G. Quantitatives Monitoring der Ödemresorption nach akutem Myokardinfarkt mittels seriellem nativem T1- und T2-Mapping. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Luetkens JA, Dörner J, Thomas D, Dabir D, Gieseke J, Sprinkart AM, Fimmers R, Stehning C, Homsi R, Schwab JO, Schild HH, Nähle CP. Diagnostische Wertigkeit der multiparametrischen kardialen Magnetresonanztomografie inklusive T1 Mapping für die Diagnosestellung einer akuten Myokarditis bei 3 Tesla. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schadewaldt N, Helle M, Schulz H, Bystrov D, Vik T, Stehning C, Traughber M, Renisch S. Artifact Correction on MR-Derived Bulk-Density Maps. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Helle M, Schadewaldt N, Traughber M, Schulz H, Bystrov D, Vik T, Stehning C, Renisch S. TU-G-134-03: MR-Only-Based Generation of Electron Density Maps and Digitally Reconstructed Radiographs of the Pelvis. Med Phys 2013. [DOI: 10.1118/1.4815481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lund G, Müllerleile K, Bannas P, Barz D, Cürlis J, Radunski U, Sydow K, Stehning C, Schnackenburg B, Adam G. Serielles T2-mapping zur quantitativen Beurteilung der myokardialen Ödemresorption nach akutem Myokardinfarkt. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hey S, de Smet M, Stehning C, Grüll H, Keupp J, Moonen C, Ries M. Simultaneous T1 measurements and proton resonance frequency shift based thermometry using variable flip angles. Magn Reson Med 2011; 67:457-63. [DOI: 10.1002/mrm.22987] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 03/30/2011] [Accepted: 04/08/2011] [Indexed: 11/11/2022]
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Stehning C, Börnert P, Nehrke K, Eggers H, Stuber M. Free-breathing whole-heart coronary MRA with 3D radial SSFP and self-navigated image reconstruction. Magn Reson Med 2005; 54:476-80. [PMID: 16032682 DOI: 10.1002/mrm.20557] [Citation(s) in RCA: 187] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Respiratory motion is a major source of artifacts in cardiac magnetic resonance imaging (MRI). Free-breathing techniques with pencil-beam navigators efficiently suppress respiratory motion and minimize the need for patient cooperation. However, the correlation between the measured navigator position and the actual position of the heart may be adversely affected by hysteretic effects, navigator position, and temporal delays between the navigators and the image acquisition. In addition, irregular breathing patterns during navigator-gated scanning may result in low scan efficiency and prolonged scan time. The purpose of this study was to develop and implement a self-navigated, free-breathing, whole-heart 3D coronary MRI technique that would overcome these shortcomings and improve the ease-of-use of coronary MRI. A signal synchronous with respiration was extracted directly from the echoes acquired for imaging, and the motion information was used for retrospective, rigid-body, through-plane motion correction. The images obtained from the self-navigated reconstruction were compared with the results from conventional, prospective, pencil-beam navigator tracking. Image quality was improved in phantom studies using self-navigation, while equivalent results were obtained with both techniques in preliminary in vivo studies.
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Affiliation(s)
- C Stehning
- Institute of Biomedical Engineering, Karlsruhe, Germany
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Stehning C, Börnert P, Nehrke K, Dössel O. Free breathing 3D balanced FFE coronary magnetic resonance angiography with prolonged cardiac acquisition windows and intra-RR motion correction. Magn Reson Med 2005; 53:719-23. [PMID: 15723401 DOI: 10.1002/mrm.20397] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A shortcoming of today's coronary magnetic resonance angiography (MRA) is its low total scan efficiency (<5%), as only small well-defined fractions of the respiratory (50%) and cardiac (10%) cycle are used for data acquisition. These precautions are necessary to prevent blurring and artifacts related to respiratory and cardiac motion. Hence, scan times range from 4 to 9 min, which may not be tolerated by patients. To overcome this drawback, an ECG-triggered, navigator-gated free breathing radial 3D balanced FFE sequence with intra-RR motion correction is investigated in this study. Scan efficiency is increased by using a long cardiac acquisition window during the RR interval. This allows the acquisition of a number of independent k-space segments during each cardiac cycle. The intersegment motion is corrected using a self-guided epicardial fat tracking procedure in a postprocessing step. Finally, combining the motion-corrected segments forms a high-resolution image. Experiments on healthy volunteers are presented to show the basic feasibility of this approach.
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Affiliation(s)
- C Stehning
- Institute of Biomedical Engineering, Kaiserstrasse 12, D-76128 Karlsruhe, Germany.
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Stehning C, Börnert P, Nehrke K, Eggers H, Dössel O. Fast isotropic volumetric coronary MR angiography using free-breathing 3D radial balanced FFE acquisition. Magn Reson Med 2004; 52:197-203. [PMID: 15236387 DOI: 10.1002/mrm.20128] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A shortcoming of current coronary MRA methods with thin-slab 3D acquisitions is the time-consuming examination necessitated by extensive scout scanning and precise slice planning. To improve ease of use and cover larger parts of the anatomy, it appears desirable to image the entire heart with high spatial resolution instead. For this purpose, an isotropic 3D-radial acquisition was employed in this study. This method allows undersampling of k-space in all three spatial dimensions, and its insensitivity to motion enables extended acquisitions per cardiac cycle. We present initial phantom and in vivo results obtained in volunteers that demonstrate large volume coverage with high isotropic spatial resolution. We were able to visualize all major parts of the coronary arteries retrospectively from the volume data set without compromising the image quality. The scan time ranged from 10 to 14 min during free breathing at a heart rate of 60 bpm, which is comparable to that of a thin-slab protocol comprising multiple scans for each coronary artery.
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Affiliation(s)
- C Stehning
- Institute of Biomedical Engineering (IBT), Karlsruhe, Germany.
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