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Mountjoy ML, Bigard X, Harcourt P, Miller S, Moran J, Nikolic N, Weber A, Foster J, Carr J. International Sports Federation's commitment to protecting clean athletes: an evolution of priority and action. BMJ Open Sport Exerc Med 2024; 10:e001980. [PMID: 38562151 PMCID: PMC10982803 DOI: 10.1136/bmjsem-2024-001980] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Margo Lynn Mountjoy
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
- IGF Golf, ASOIF Medical & Scientific Consultative Group, Lausanne, Switzerland
| | - Xavier Bigard
- Union Cycliste Internationale, Aigle, Switzerland
- Medical and Scientific Consultative Group, ASOIF, Lausanne, Switzerland
| | - Peter Harcourt
- Medical and Scientific Consultative Group, ASOIF, Lausanne, Switzerland
- Australian Football League, Melbourne, Victoria, Australia
| | - Suart Miller
- Medical and Scientific Consultative Group, ASOIF, Lausanne, Switzerland
- International Tennis Federation, London, UK
| | - Jane Moran
- ASOIF Medical & Scientific Consultative Group, Lausanne, Switzerland
- International Skating Union, Lausanne, Switzerland
| | - Neb Nikolic
- ASOIF Medical & Scientific Consultative Group, Lausanne, Switzerland
- Medicine, World Sailing, London, UK
| | - Alexis Weber
- Medical and Scientific Consultative Group, ASOIF, Lausanne, Switzerland
- Medicine & Science, FIFA, Zürich, Switzerland
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Bardien S, Braun A, Van Coller R, Hassan Amod F, Carr J, Moosa S. Genetic screening of South African families with Parkinson's disease. S Afr Med J 2024; 114:e1750. [PMID: 38525571 DOI: 10.7196/samj.2024.v114i2.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Indexed: 03/26/2024] Open
Affiliation(s)
- S Bardien
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; and South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa.
| | - A Braun
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - R Van Coller
- Department of Neurology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa; and Pretoria Institute of Neurology, Die Wilgers, Pretoria, South Africa.
| | - F Hassan Amod
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa; and Department of Neurology, Faculty of Medicine and Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - J Carr
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - S Moosa
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and Medical Genetics, Tygerberg Hospital, Cape Town, South Africa.
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Arai AE, Schulz-Menger J, Shah DJ, Han Y, Bandettini WP, Abraham A, Woodard PK, Selvanayagam JB, Hamilton-Craig C, Tan RS, Carr J, Teo L, Kramer CM, Wintersperger BJ, Harisinghani MG, Flamm SD, Friedrich MG, Klem I, Raman SV, Haverstock D, Liu Z, Brueggenwerth G, Santiuste M, Berman DS, Pennell DJ. Stress Perfusion Cardiac Magnetic Resonance vs SPECT Imaging for Detection of Coronary Artery Disease. J Am Coll Cardiol 2023; 82:1828-1838. [PMID: 37914512 DOI: 10.1016/j.jacc.2023.08.046] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND GadaCAD2 was 1 of 2 international, multicenter, prospective, Phase 3 clinical trials that led to U.S. Food and Drug Administration approval of gadobutrol to assess myocardial perfusion and late gadolinium enhancement (LGE) in adults with known or suspected coronary artery disease (CAD). OBJECTIVES A prespecified secondary objective was to determine if stress perfusion cardiovascular magnetic resonance (CMR) was noninferior to single-photon emission computed tomography (SPECT) for detecting significant CAD and for excluding significant CAD. METHODS Participants with known or suspected CAD underwent a research rest and stress perfusion CMR that was compared with a gated SPECT performed using standard clinical protocols. For CMR, adenosine or regadenoson served as vasodilators. The total dose of gadobutrol was 0.1 mmol/kg body weight. The standard of reference was a 70% stenosis defined by quantitative coronary angiography (QCA). A negative coronary computed tomography angiography could exclude CAD. Analysis was per patient. CMR, SPECT, and QCA were evaluated by independent central core lab readers blinded to clinical information. RESULTS Participants were predominantly male (61.4% male; mean age 58.9 ± 10.2 years) and were recruited from the United States (75.0%), Australia (14.7%), Singapore (5.7%), and Canada (4.6%). The prevalence of significant CAD was 24.5% (n = 72 of 294). Stress perfusion CMR was statistically superior to gated SPECT for specificity (P = 0.002), area under the receiver operating characteristic curve (P < 0.001), accuracy (P = 0.003), positive predictive value (P < 0.001), and negative predictive value (P = 0.041). The sensitivity of CMR for a 70% QCA stenosis was noninferior and nonsuperior to gated SPECT. CONCLUSIONS Vasodilator stress perfusion CMR, as performed with gadobutrol 0.1 mmol/kg body weight, had superior diagnostic accuracy for diagnosis and exclusion of significant CAD vs gated SPECT.
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Affiliation(s)
| | - Jeanette Schulz-Menger
- Helios Klinikum Berlin Buch Klinik für Kardiologie und Nephrologie Abteilung Kardio-MRT, Berlin, Germany
| | - Dipan J Shah
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Yuchi Han
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - W Patricia Bandettini
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Arun Abraham
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Pamela K Woodard
- Washington University School of Medicine, St Louis, Missouri, USA
| | | | | | - Ru-San Tan
- National Heart Centre Singapore, Singapore
| | - James Carr
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lynette Teo
- National University Hospital, Singapore, Singapore
| | | | - Bernd J Wintersperger
- University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada
| | | | | | | | - Igor Klem
- Duke University, Durham, North Carolina, USA
| | - Subha V Raman
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Zheyu Liu
- Bayer Pharmaceuticals LLC, Whippany, New Jersey, USA
| | | | | | | | - Dudley J Pennell
- National Heart and Lung Institute, Imperial College, London, United Kingdom; Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Johnson EMI, Scott MB, Jarvis K, Allen B, Carr J, Chris Malaisrie S, McCarthy P, Mehta C, Fedak PWM, Barker AJ, Markl M. Global Aortic Pulse Wave Velocity is Unchanged in Bicuspid Aortopathy With Normal Valve Function but Elevated in Patients With Aortic Valve Stenosis: Insights From a 4D Flow MRI Study of 597 Subjects. J Magn Reson Imaging 2023; 57:126-136. [PMID: 35633284 PMCID: PMC9701914 DOI: 10.1002/jmri.28266] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/17/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Aortopathy is common with bicuspid aortic valve (BAV), and underlying intrinsic tissue abnormalities are believed causative. Valve-mediated hemodynamics are altered in BAV and may contribute to aortopathy and its progression. The contribution of intrinsic tissue defects versus altered hemodynamics to aortopathy progression is not known. PURPOSE To investigate relative contributions of tissue-innate versus hemodynamics in progression of BAV aortopathy. STUDY TYPE Retrospective. SUBJECTS Four hundred seventy-three patients with aortic dilatation (diameter ≥40 mm; comprised of 281 BAV with varied AS severity, 192 tricuspid aortic valve [TAV] without AS) and 124 healthy controls. Subjects were 19-91 years (141/24% female). FIELD STRENGTH/SEQUENCE 1.5T, 3T; time-resolved gradient-echo 3D phase-contrast (4D flow) MRI. ASSESSMENT A surrogate measure for global aortic wall stiffness, pulse wave velocity (PWV), was quantified from MRI by standardized, automated technique based on through-plane flow cross-correlation maximization. Comparisons were made between BAV patients with aortic dilatation and varying aortic valve stenosis (AS) severity and healthy subjects and aortopathy patients with normal TAV. STATISTICAL TESTS Multivariable regression, analysis of covariance (ANCOVA), Tukey's, student's (t), Mann-Whitney (U) tests, were used with significance levels P < 0.05 or P < 0.01 for post-hoc Bonferroni-corrected t/U tests. Bland-Altman and ICC calculations were performed. RESULTS Multivariable regression showed age with the most significant association for increased PWV in all groups (increase 0.073-0.156 m/sec/year, R2 = 0.30-48). No significant differences in aortic PWV were observed between groups without AS (P = 0.20-0.99), nor were associations between PWV and regurgitation or Sievers type observed (P = 0.60, 0.31 respectively). In contrast, BAV AS patients demonstrated elevated PWV and a significant relationship for AS severity with increased PWV (covariate: age, R2 = 0.48). BAV and TAV patients showed no association between aortic diameter and PWV (P = 0.73). DATA CONCLUSION No significant PWV differences were observed between BAV patients with normal valve function and control groups. However, AS severity and age in BAV patients were directly associated with PWV increases. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
| | - Michael B Scott
- Northwestern University, Radiology,Northwestern University, Bioengineering
| | | | | | | | | | | | | | | | - Alex J Barker
- University of Colorado Anschutz, Radiology, Bioengineering
| | - Michael Markl
- Northwestern University, Radiology,Northwestern University, Bioengineering
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Kilinc O, Chu S, Baraboo J, Weiss EK, Engel J, Maroun A, Giese D, Jin N, Chow K, Bi X, Davids R, Mehta C, Malaisrie SC, Hoel A, Carr J, Markl M, Allen BD. Hemodynamic Evaluation of Type B Aortic Dissection Using Compressed Sensing Accelerated 4D Flow MRI. J Magn Reson Imaging 2022; 57:1752-1763. [PMID: 36148924 PMCID: PMC10033465 DOI: 10.1002/jmri.28432] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/30/2022] [Accepted: 09/03/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND 4D Flow MRI is a quantitative imaging technique to evaluate blood flow patterns; however, it is unclear how compressed sensing (CS) acceleration would impact aortic hemodynamic quantification in type B aortic dissection (TBAD). PURPOSE To investigate CS-accelerated 4D Flow MRI performance compared to GRAPP-accelerated 4D Flow MRI (GRAPPA) to evaluate aortic hemodynamics in TBAD. STUDY TYPE Prospective. POPULATION Twelve TBAD patients, two volunteers. FIELD STRENGTH/SEQUENCE 1.5T, 3D time-resolved cine phase-contrast gradient echo sequence. ASSESSMENT GRAPPA (acceleration factor [R] = 2) and two CS-accelerated (R = 7.7 [CS7.7] and 10.2 [CS10.2]) 4D Flow MRI scans were acquired twice for interscan reproducibility assessment. Voxelwise kinetic energy (KE), peak velocity (PV), forward flow (FF), reverse flow (RF), and stasis were calculated. Plane-based mid-lumen flows were quantified. Imaging times were recorded. TESTS Repeated measures analysis of variance, Pearson correlation coefficients (r), intraclass correlation coefficients (ICC). P < 0.05 indicated statistical significance. RESULTS The KE and FF in true lumen (TL) and PV in false lumen (FL) did not show difference among three acquisition types (P = 0.818, 0.065, 0.284 respectively). The PV and stasis in TL were higher, KE, FF, and RF in FL were lower, and stasis was higher in GRAPPA compared to CS7.7 and CS10.2. The RF was lower in GRAPPA compared to CS10.2. The correlation coefficients were strong in TL (r = [0.781-0.986]), and low to strong in FL (r = [0.347-0.948]). The ICC levels demonstrated moderate to excellent interscan reproducibility (0.732-0.989). The FF and net flow in mid-descending aorta TL were significantly different between CS7.7 and CS10.2. CONCLUSION CS-accelerated 4D Flow MRI has potential for clinical utilization with shorter scan times in TBAD. Our results suggest similar hemodynamic trends between acceleration types, but CS-acceleration impacts KE, FF, RF, and stasis more in FL. EVIDENCE LEVEL 1 Technical Efficacy: Stage 2.
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Affiliation(s)
- Ozden Kilinc
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Stanley Chu
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Justin Baraboo
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| | - Elizabeth K Weiss
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| | - Joshua Engel
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Anthony Maroun
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Daniel Giese
- Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ning Jin
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Cleveland, Ohio, USA
| | - Kelvin Chow
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - Xiaoming Bi
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - Rachel Davids
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - Christopher Mehta
- Department of Surgery (Cardiac Surgery), Northwestern University, Chicago, Illinois, USA
| | - S Chris Malaisrie
- Department of Surgery (Cardiac Surgery), Northwestern University, Chicago, Illinois, USA
| | - Andrew Hoel
- Department of Surgery (Vascular Surgery), Northwestern University, Chicago, Illinois, USA
| | - James Carr
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| | - Bradley D Allen
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
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Gradl S, Lee S, Lange M, Wu X, Goldoni S, Lewis T, Kopitz C, Garvie C, Lienau P, Hoyt S, Seidel H, Kaulfuss S, Ellermann M, de Waal L, Tersteegen A, Golfier S, Suelzle D, Hegele-Hartung C, Carr J, Brookfield F, Bruening M, Berthold M, Jourdan T, Schenone M, Gao G, McGaunn J, Wengner A, Aquilanti E, Siegel F, Garrido M, Walter A, Genvresse I, Cherniack A, Schreiber S, Eis K, Eheim A, Meyerson M, Greulich H. Abstract ND04: BAY 2666605: The first PDE3A-SLFN12 complex inducer for cancer therapy. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-nd04] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Velcrin compounds are a class of small molecules that induce complex formation between PDE3A and SLFN12, killing cancer cells that express elevated levels of these two proteins by a mechanism independent of PDE3A enzymatic inhibition. Instead, PDE3A binding stimulates the RNase activity of SLFN12, resulting in cleavage of the specific SLFN12 substrate, tRNA-Leu-TAA. Cleavage of tRNA-Leu-TAA in turn causes ribosomal pausing, inhibition of protein synthesis, and cancer cell death. Unlike traditional targeted therapies that leverage dependencies created in cancer cells by genomic alterations, velcrins instead kill cancer cells by a gain-of-function mechanism dependent on the RNase activity of SLFN12.
In a collaboration between the Broad Institute and Bayer Pharmaceuticals, we developed the first velcrin, BAY 2666605, to enter Phase I clinical trials. BAY 2666605 is active in cell line and patient-derived xenografts of several tumor types, specifically where elevated levels of the two biomarkers, PDE3A and SLFN12, are expressed. Biomarker-positive tumors are especially enriched among melanomas, and we have consistently observed tumor regression in biomarker-positive melanoma tumor models in vivo. BAY 2666605 furthermore shows drug-like properties, excellent brain penetration, increased stimulation of SLFN12 RNase activity, and reduced inhibition of PDE3A enzymatic activity compared with most other velcrins and approved PDE3A inhibitors. BAY 2666605 has recently entered a First-in-Human study (NCT04809805) in patients with advanced solid tumors that co-express PDE3A and SLFN12, including melanoma, ovarian cancer, and sarcoma.
Citation Format: Stefan Gradl, Sooncheol Lee, Martin Lange, Xiaoyun Wu, Silvia Goldoni, Timothy Lewis, Charlotte Kopitz, Colin Garvie, Philip Lienau, Stephanie Hoyt, Henrik Seidel, Stephan Kaulfuss, Manuel Ellermann, Luc de Waal, Adrian Tersteegen, Sven Golfier, Detlev Suelzle, Christa Hegele-Hartung, James Carr, Frederick Brookfield, Michael Bruening, Melanie Berthold, Thibaud Jourdan, Monica Schenone, Galen Gao, Joseph McGaunn, Antje Wengner, Elisa Aquilanti, Franziska Siegel, Marine Garrido, Annette Walter, Isabelle Genvresse, Andrew Cherniack, Stuart Schreiber, Knut Eis, Ashley Eheim, Matthew Meyerson, Heidi Greulich. BAY 2666605: The first PDE3A-SLFN12 complex inducer for cancer therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr ND04.
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Affiliation(s)
| | | | - Martin Lange
- 3Bayer Pharma AG and Nuvisan ICB GmbH, Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sven Golfier
- 3Bayer Pharma AG and Nuvisan ICB GmbH, Berlin, Germany
| | | | | | | | | | | | | | | | | | - Galen Gao
- 2The Broad Institute Inc, Cambridge, MA
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Pandya A, Yu YJ, Ge Y, Nagel E, Kwong RY, Bakar RA, Grizzard JD, Merkler AE, Ntusi N, Petersen SE, Rashedi N, Schwitter J, Selvanayagam JB, White JA, Carr J, Raman SV, Simonetti OP, Bucciarelli-Ducci C, Sierra-Galan LM, Ferrari VA, Bhatia M, Kelle S. Evidence-based cardiovascular magnetic resonance cost-effectiveness calculator for the detection of significant coronary artery disease. J Cardiovasc Magn Reson 2022; 24:1. [PMID: 34986851 PMCID: PMC8734365 DOI: 10.1186/s12968-021-00833-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 07/12/2021] [Accepted: 11/30/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs. METHODS We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR Cost-Effectiveness Calculator) based on a larger CMR cost-effectiveness simulation model that can approximate CMR lifetime discount cost, QALY, and cost effectiveness compared to relevant comparators [such as single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA)] or invasive coronary angiography. RESULTS CMR was cost-effective for evaluation of significant CAD (either health-improving and cost saving or having a cost-per-QALY or cost-per-life-year result lower than the cost-effectiveness threshold) versus its relevant comparator in 10 out of 15 studies, with 3 studies reporting uncertain cost effectiveness, and 2 studies showing CCTA was optimal. Our cost-effectiveness calculator showed that CCTA was not cost-effective in the US compared to CMR when the most recent publications on imaging performance were included in the model. CONCLUSIONS Based on current world-wide evidence in the literature, CMR usually represents a cost-effective option compared to relevant comparators to assess for significant CAD.
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Affiliation(s)
- Ankur Pandya
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, 2nd Floor, Boston, MA, 02115, USA.
| | - Yuan-Jui Yu
- National Taiwan University Hospital, Taipei, Taiwan
| | - Yin Ge
- Cardiovascular Division of the Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK (German Centre for Cardiovascular Research) Centre for Cardiovascular Imaging, Partner Site RheinMain, University Hospital Frankfurt/Main, Frankfurt am Main, Germany
| | - Raymond Y Kwong
- Cardiovascular Division of the Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Rafidah Abu Bakar
- Department of Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
| | - John D Grizzard
- Department of Radiology, Virginia Commonwealth University Medical Center, Main Hospital, Richmond, VA, USA
| | - Alexander E Merkler
- Department of Neurology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, USA
| | - Ntobeko Ntusi
- Department of Medicine, University of Cape Town & Groote Schuur Hospital, Cape Town, South Africa
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Nina Rashedi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, CMR Center University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, UniL, Lausanne, Switzerland
| | - Joseph B Selvanayagam
- Department of Medicine, School of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Heart Health, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - James A White
- Division of Cardiology, Department of Cardiac Sciences, Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Canada
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Orlando P Simonetti
- Departments of Internal Medicine and Radiology, The Ohio State University, Columbus, OH, USA
| | - Chiara Bucciarelli-Ducci
- Royal Brompton and Harefield Hospitals, Guys' and St Thomas NHS Hospitals and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Lilia M Sierra-Galan
- Cardiovascular Division, Department of Cardiology, American British Cowdray Medical Center, Mexico City, Mexico
| | - Victor A Ferrari
- Cardiovascular Division and Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Mona Bhatia
- Department of Imaging, Fortis Escorts Heart Institute, New Delhi, India
| | - Sebastian Kelle
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
- Department of Internal Medicine and Cardiology, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, German Heart Institute Berlin (DHZB), Berlin, Germany
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Kalisz K, Scott M, Avery R, Sarnari R, Barker AJ, Carr J, Markl M, Allen BD. Cardiac Magnetic Resonance Imaging Feature Tracking Demonstrates Altered Biventricular Strain in Obese Subjects in the Absence of Clinically Apparent Cardiovascular Disease. J Thorac Imaging 2022; 37:W1-W2. [PMID: 32520847 PMCID: PMC7718327 DOI: 10.1097/rti.0000000000000539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Kevin Kalisz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael Scott
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Ryan Avery
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Roberto Sarnari
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alex J Barker
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - James Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley D Allen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Walter B, Carr J, Little J, Gambhir R. Quality Improvement Project to Reduce Turnaround Times to Improve Vascular Theatre Efficiency. EJVES Vasc Forum 2022. [DOI: 10.1016/j.ejvsvf.2021.12.052] [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: 10/18/2022] Open
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Gupta AN, Avery R, Soulat G, Allen BD, Collins JD, Choudhury L, Bonow RO, Carr J, Markl M, Elbaz MSM. Direct mitral regurgitation quantification in hypertrophic cardiomyopathy using 4D flow CMR jet tracking: evaluation in comparison to conventional CMR. J Cardiovasc Magn Reson 2021; 23:138. [PMID: 34865629 PMCID: PMC8647422 DOI: 10.1186/s12968-021-00828-y] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/16/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Quantitative evaluation of mitral regurgitation (MR) in hypertrophic cardiomyopathy (HCM) by cardiovascular magnetic resonance (CMR) relies on an indirect volumetric calculation. The aim of this study was to directly assess and quantify MR jets in patients with HCM using 4D flow CMR jet tracking in comparison to standard-of-care CMR indirect volumetric method. METHODS This retrospective study included patients with HCM undergoing 4D flow CMR. By the indirect volumetric method from CMR, MR volume was quantified as left ventricular stroke volume minus forward aortic volume. By 4D flow CMR direct jet tracking, multiplanar reformatted planes were positioned in the peak velocity of the MR jet during systole to calculate through-plane regurgitant flow. MR severity was collected for agreement analysis from a clinical echocardiograms performed within 1 month of CMR. Inter-method and inter-observer agreement were assessed by intraclass correlation coefficient (ICC), Bland-Altman analysis, and Cohen's kappa. RESULTS Thirty-seven patients with HCM were included. Direct jet tracking demonstrated good inter-method agreement of MR volume compared to the indirect volumetric method (ICC = 0.80, p = 0.004) and fair agreement of MR severity (kappa = 0.27, p = 0.03). Direct jet tracking showed higher agreement with echocardiography (kappa = 0.35, p = 0.04) than indirect volumetric method (kappa = 0.16, p = 0.35). Inter-observer reproducibility of indirect volumetric method components revealed the lowest reproducibility in end-systolic volume (ICC = 0.69, p = 0.15). Indirect volumetric method showed good agreement of MR volume (ICC = 0.80, p = 0.003) and fair agreement of MR severity (kappa = 0.38, p < 0.001). Direct jet tracking demonstrated (1) excellent inter-observer reproducibility of MR volume (ICC = 0.97, p < 0.001) and MR severity (kappa = 0.84, p < 0.001) and (2) excellent intra-observer reproducibility of MR volume (ICC = 0.98, p < 0.001) and MR severity (kappa = 0.88, p < 0.001). CONCLUSIONS Quantifying MR and assessing MR severity by indirect volumetric method in HCM patients has limited inter-observer reproducibility. 4D flow CMR jet tracking is a potential alternative technique to directly quantify and assess MR severity with excellent inter- and intra-observer reproducibility and higher agreement with echocardiography in this population.
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Affiliation(s)
- Aakash N Gupta
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
| | - Ryan Avery
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
| | - Gilles Soulat
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
| | - Bradley D Allen
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
| | | | - Lubna Choudhury
- Department of Medicine, Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Robert O Bonow
- Department of Medicine, Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - James Carr
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA
- Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, IL, 60208, USA
| | - Mohammed S M Elbaz
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan, Suite 1600, Chicago, IL, 60611, USA.
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11
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Wang AA, Cai X, Srivastava A, Prasad PV, Sprague SM, Carr J, Wolf M, Ix JH, Block GA, Chonchol M, Raphael KL, Cheung AK, Raj DS, Gassman JJ, Rahsepar AA, Middleton JP, Fried LF, Sarnari R, Isakova T, Mehta R. Abnormalities in Cardiac Structure and Function among Individuals with CKD: The COMBINE Trial. Kidney360 2021; 3:258-268. [PMID: 35373122 PMCID: PMC8967624 DOI: 10.34067/kid.0005022021] [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] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/10/2021] [Indexed: 01/10/2023]
Abstract
Background Individuals with CKD have a high burden of cardiovascular disease (CVD). Abnormalities in cardiac structure and function represent subclinical CVD and can be assessed by cardiac magnetic resonance imaging (cMRI). Methods We investigated differences in cMRI parameters in 140 individuals with CKD stages 3b-4 who participated in the CKD Optimal Management with BInders and NicotinamidE (COMBINE) trial and in 24 age- and sex-matched healthy volunteers. Among COMBINE participants, we examined the associations of eGFR, urine albumin-creatinine ratio (UACR), phosphate, fibroblast growth factor 23 (FGF23), and parathyroid hormone (PTH) with baseline (N=140) and 12-month change (N=112) in cMRI parameters. Results Mean (SD) ages of the COMBINE participants and healthy volunteers were 64.9 (11.9) and 60.4 (7.3) years, respectively. The mean (SD) baseline eGFR values in COMBINE participants were 32.1 (8.0) and 85.9 (16.0) ml/min per 1.73 m2 in healthy volunteers. The median (interquartile range [IQR]) UACR in COMBINE participants was 154 (20.3-540.0) mg/g. Individuals with CKD had lower mitral valve E/A ratio compared with healthy volunteers (for CKD versus non-CKD, β estimate, -0.13; 95% CI, -0.24 to -0.012). Among COMBINE participants, multivariable linear regression analyses showed that higher UACR was significantly associated with lower mitral valve E/A ratio (β estimate per 1 unit increase in natural-log UACR, -0.06; 95% CI, -0.09 to -0.03). This finding was preserved among individuals without baseline CVD. UACR was not associated with 12-month change in any cMRI parameter. eGFR, phosphate, FGF23, and PTH were not associated with any cMRI parameter in cross-sectional or change analyses. Conclusions Individuals with CKD stages 3b-4 have evidence of cMRI abnormalities. Albuminuria was independently associated with diastolic dysfunction, as assessed by mitral valve E/A ratio, in individuals with CKD with and without clinical CVD. Albuminuria was not associated with change in any cMRI parameter.
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Affiliation(s)
- Ann A. Wang
- Graduate Medical Education, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Xuan Cai
- Center for Translational Metabolism and Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anand Srivastava
- Center for Translational Metabolism and Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois,Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pottumarthi V. Prasad
- Department of Radiology, NorthShore University Health System Evanston, Evanston, Illinois
| | - Stuart M. Sprague
- Division of Nephrology and Hypertension, NorthShore University Health System, Evanston, Illinois,University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Myles Wolf
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina,Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Joachim H. Ix
- Division of Nephrology, Department of Medicine, University of San Diego School of Medicine and Veterans Affairs San Diego Healthcare System, San Diego, California
| | | | - Michel Chonchol
- Division of Renal Disease/Hypertension, Department of Internal Medicine, University of Colorado Hospitals, Aurora, Colorado
| | - Kalani L. Raphael
- Division of Nephrology and Hypertension, Department of Medicine, Oregon Health and Science University and Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Alfred K. Cheung
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah
| | - Dominic S. Raj
- Division of Kidney Diseases and Hypertension, George Washington University School of Medicine, Washington, DC
| | | | - Amir Ali Rahsepar
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John P. Middleton
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Linda F. Fried
- Renal Section, Veterans Affairs Pittsburgh Healthcare System and Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Roberto Sarnari
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Tamara Isakova
- Center for Translational Metabolism and Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois,Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rupal Mehta
- Center for Translational Metabolism and Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois,Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois,Division of Nephrology, Department of Medicine, Jesse Brown Veterans Administration Medical Center, Chicago, Illinois
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12
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Hall J, Fried D, Marks L, Gupta G, Jones E, Elmore S, Downs-Canner S, Gallagher K, Carr J, Ogunleye Y, Casey D. Dosimetric and Clinical Factors Associated With Increased Risk of Reconstruction Complications in Patients With Breast Cancer Receiving Post-Mastectomy Radiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.770] [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: 10/20/2022]
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13
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Gambhir R, Carr J, Walter B, Little J. TP5.2.3 Quality improvement project to reduce turn-around times to improve vascular theatre efficiency. Br J Surg 2021. [PMCID: PMC8574479 DOI: 10.1093/bjs/znab362.009] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aim One of the factors influencing theatre efficiency is turn-around time (TAT). The aim of this QIP was to reduce turnaround times by 25% thereby reducing financial implications of theatre idle time. Methods Baseline data was obtained from electronic theatre record system ‘Galaxy’ for the period October 2019 to February 2020. TAT (Time from the last patient going to recovery and the next one coming into the theatre) was measured and a period average was established. This QIP mapped processes and conducted interviews, to identify issues contributing to longer turnaround times. Interventions were then constructed and implemented over 6 weeks. Results One of preventable causes of delay identified from staff interviews and personal observations was inadequate patient preparation by the ward. Preintervention percentage theatre utilisation was 86% and turnaround times was 51.7 minutes. A PDSA cycle was initiated focusing on advanced warning (30 minutes prior to the end of the previous surgery) from theatres to wards and advanced preparation from wards, using a newly designed ward-based checklist. After the first PDSA cycle there has been an improvement in TAT to 42.8 minutes, a decrease of 18.2%. Whilst this did not meet our goal of a 25% reduction, this remains significant. Unfortunately due to COVID -19 the second cycle has been delayed. Conclusions Affordable and sustainable improvements will be needed in post COVID-19 recovery phase to tackle the backlog of surgeries. This project has demonstrated that advanced warning system can decrease turnaround times.
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Affiliation(s)
| | - James Carr
- King's College Hospital NHS Foundation Trust
| | - Ben Walter
- King's College Hospital NHS Foundation Trust
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14
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Carr J, Quick V, Papaconstantinou E. Relationships of Eating and Physical Activity Behaviors with Perceived Stress Among Women College Students. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.095] [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: 11/29/2022]
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15
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Serhal A, Aouad P, Serhal M, Pathrose A, Lombardi P, Carr J, Avery R, Edelman RR. Evaluation of Renal Allograft Vasculature Using Non-contrast 3D Inversion Recovery Balanced Steady-state Free Precession MRA and 2D Quiescent-interval Slice-selective MRA. Explor Res Hypothesis Med 2021; 6:90-98. [PMID: 34589655 PMCID: PMC8478288 DOI: 10.14218/erhm.2021.00011] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Renal transplant patients often require periodic imaging to evaluate the transplant vessel anastomosis for potential vascular complications. The use of non-contrast enhanced magnetic resonance angiography (NCE-MRA) techniques is encouraged in these patients because they are at increased risk of nephrogenic systemic fibrosis (NSF) due to their renal insufficiency. This study aimed to evaluate the performance of two NCE-MRA techniques (three-dimensional [3D] balanced steady-state free precession [bSSFP] with inversion recovery and quiescent-interval slice-selective [QISS]) for the evaluation of renal allograft vasculature in patients with clinical suspicion, or Doppler ultrasound, or both of arterial anastomotic stenosis. METHODS A total of 43 patients were included in this retrospective study. Two radiologists independently scored the images from 3D bSSFP and QISS MRA sequences for image quality and confidence in anastomosis interpretation, and the degree of stenosis at the arterial anastomosis. Correlations with digital subtraction angiography (DSA) were carried out when available. In addition, inter-rater agreement was calculated. RESULTS In total, 43 patients underwent QISS and 3D bSSFP MRA. For QISS, all cases were adequate for evaluation. For 3D SSFP, 86% of cases were adequate for evaluation. There was a good-to-excellent inter-rater agreement for all scores and an excellent correlation between NCE-MRA and DSA results when available (12 patients). CONCLUSIONS QISS and 3D SSFP showed good inter-rater agreement for image quality and stenosis grade, with more cases being of adequate image quality that used QISS. Further study is required; however, NCE-MRA shows potential as a risk-free alternative to CTA and contrast-enhanced MRA (CE-MRA) for the evaluation of arterial anastomoses in renal transplant patients.
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Affiliation(s)
- Ali Serhal
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Correspondence to: Ali Serhal, Radiology, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Chicago, IL 60611, USA. ORCID: http://orcid.org/0000-0002-3855-6915. Tel: +1-312-695-3755, Fax: +1-312-695-5645,
| | - Pascale Aouad
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Muhamad Serhal
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Ashitha Pathrose
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamela Lombardi
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - James Carr
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ryan Avery
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert R. Edelman
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Radiology, Northshore University HealthSystem, Evanston, IL, USA
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16
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Ordovas KG, Baldassarre LA, Bucciarelli-Ducci C, Carr J, Fernandes JL, Ferreira VM, Frank L, Mavrogeni S, Ntusi N, Ostenfeld E, Parwani P, Pepe A, Raman SV, Sakuma H, Schulz-Menger J, Sierra-Galan LM, Valente AM, Srichai MB. Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR). J Cardiovasc Magn Reson 2021; 23:52. [PMID: 33966639 PMCID: PMC8108343 DOI: 10.1186/s12968-021-00746-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/17/2021] [Indexed: 01/09/2023] Open
Abstract
This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR.
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Affiliation(s)
| | | | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol, UK
- Bristol National Institute of Health Research (NIHR) Biomedical , Research Centre, Bristol, UK
- University Hospitals Bristol, Bristol, UK
- University of Bristol, Bristol, UK
| | - James Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Luba Frank
- Medical College of Wisconsin, Wisconsin, USA
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, Athens, Greece
- Kapodistrian University of Athens, Athens, Greece
| | - Ntobeko Ntusi
- University of Cape Town, Cape Town, South Africa
- Groote Schuur Hospital, Cape Town, South Africa
| | - Ellen Ostenfeld
- Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital Lund, Lund University, Lund, Sweden
| | - Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA, USA
| | - Alessia Pepe
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio C.N.R., Pisa, Italy
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University, Indianapolis, USA
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, Mie, Japan
| | - Jeanette Schulz-Menger
- harite Hospital, University of Berlin, Berlin, Germany
- HELIOS-Clinics Berlin-Buch, Berlin, Germany
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17
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Fujikura K, Albini A, Barr RG, Parikh M, Kern J, Hoffman E, Hiura GT, Bluemke DA, Carr J, Lima JAC, Michos ED, Gomes AS, Prince MR. Aortic enlargement in chronic obstructive pulmonary disease (COPD) and emphysema: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD study. Int J Cardiol 2021; 331:214-220. [PMID: 33587941 DOI: 10.1016/j.ijcard.2021.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/12/2020] [Revised: 12/25/2020] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prevalence of abdominal aortic aneurysm is high in chronic obstructive pulmonary disease (COPD) population. Emphysema involves proteolytic destruction of elastic fibers. Therefore, emphysema may also contribute to thoracic aorta dilatation. This study assessed aorta dilation in smokers stratified by presence of COPD, emphysema and airway thickening. METHODS Aorta diameters were measured on 3D magnetic resonance angiography in smokers recruited from the Multi-Ethnic Study of Atherosclerosis (MESA), the Emphysema and Cancer Action Project (EMCAP), and the local community. COPD was defined by standard spirometric criteria; emphysema was measured quantitatively on computed tomography and bronchitis was determined from medical history. RESULTS Participants (n = 315, age 58-79) included 150 with COPD and 165 without COPD, of whom 56% and 19%, respectively, had emphysema. Subjects in the most severe quartile of emphysematous change showed the largest diameter at all four aorta locations compared to those in the least severe quartiles (all p < 0.001). Comparing subjects with and without COPD, aorta diameters were larger in participants with severe COPD in ascending and arch (both p < 0.001), and abdominal aorta (p = 0.001). Chronic bronchitis and bronchial wall thickness did not correlate with aorta diameter. In subjects with emphysema, subjects with coexistence of COPD showed larger aorta than those without COPD in ascending (p = 0.003), arch (p = 0.002), and abdominal aorta (p = 0.04). CONCLUSIONS This study showed larger aorta diameter in subjects with COPD and severe emphysema compared to COPD related to chronic bronchitis or bronchial wall thickening.
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Affiliation(s)
- Kana Fujikura
- Advanced Cardiovascular Imaging Laboratory, National Heart, Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, ML, USA
| | | | - R Graham Barr
- Department of Medicine, Columbia University, New York, USA
| | - Megha Parikh
- Department of Medicine, Columbia University, New York, USA
| | - Julia Kern
- Department of Medicine, Columbia University, New York, USA
| | - Eric Hoffman
- Department of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, USA
| | - Grant T Hiura
- Department of Medicine, Columbia University, New York, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin, Madison, USA
| | - James Carr
- Department of Radiology, Northwestern University, Chicago, USA
| | - João A C Lima
- Division of Cardiology, Johns Hopkins University, Baltimore, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, USA
| | - Antoinette S Gomes
- Department of Radiology, University of California-Los Angeles, School of Medicine, Los Angeles, USA
| | - Martin R Prince
- Department of Radiology, Weill Cornell Medicine, NY, New York, USA.
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18
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Grosse-Wortmann L, Francois CJ, Sierra-Galan LM, Markl M, Sanz J, Carr J, Bucciarelli-Ducci C, Powell AJ. Highlights of the 2020 23rd Society for Cardiovascular Magnetic Resonance Scientific Sessions. J Cardiovasc Magn Reson 2020; 22:75. [PMID: 33121511 PMCID: PMC7596987 DOI: 10.1186/s12968-020-00672-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Lars Grosse-Wortmann
- Division of Cardiology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA.
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
- Doernbecher Children's Hospital, CDRC, 707 SW Gaines Street, Portland, OR, 97239, USA.
| | | | | | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Javier Sanz
- Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chiara Bucciarelli-Ducci
- Clinical Research and Imaging Centre, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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19
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Mahdi FM, Shier AP, Fragkopoulos IS, Carr J, Gajjar P, Muller FL. On the Breakage of High Aspect Ratio Crystals in Filter Beds under Continuous Percolation. Pharm Res 2020; 37:231. [PMID: 33123816 PMCID: PMC7596000 DOI: 10.1007/s11095-020-02958-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
Purpose This work details experimental observations on the effect of liquid flow percolating through packed beds of crystals to elucidate how the filtration pressure severely alters the size distribution and crystal shape. Pressure filtration is widely used in the pharmaceutical industry, and frequently results in undesired size distribution changes that hinder further processing. Methods The percolation methodology presented fixes fluid flow through a bed of crystals, resulting in a pressure over the bed. X-ray computed tomography (XCT) provided detailed observations of the bed structure. Detailed 2D particle size data was obtained using automated microscopy and was analysed using an in-house developed tool. Results Crystal breakage is observed when the applied pressure exceeds a critical pressure: 0.5–1 bar for ibuprofen, 1–2 bar for β-L glutamic acid (LGA) and 2–2.5 bar for para amino benzoic acid (PABA). X-ray computed tomography showed significant changes in bed density under the applied pressure. Size analysis and microscope observations showed two modes of breakage: (i) snapping of long crystals and (ii) shattering of crystals. Conclusion LGA and PABA have a similar breakage strength (50 MPa), ibuprofen is significantly weaker (9 MPa). Available breakage strength data may be correlated to the volumetric Gibbs free energy. Data from 12 and 35 mm bed diameters compares well to literature data in a 80 mm filter; the smaller, easy to operate percolation unit is a versatile tool to assess crystal breakage in filtration operations. Electronic supplementary material The online version of this article (10.1007/s11095-020-02958-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- F M Mahdi
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - A P Shier
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - I S Fragkopoulos
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - J Carr
- Henry Moseley X-ray Imaging Facility, Henry Royce Institute for Advanced Materials, Department of Materials, The University of Manchester, Manchester, M13 9PL, UK
| | - P Gajjar
- Henry Moseley X-ray Imaging Facility, Henry Royce Institute for Advanced Materials, Department of Materials, The University of Manchester, Manchester, M13 9PL, UK
| | - F L Muller
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK.
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Pathrose A, Ma L, Berhane H, Scott MB, Chow K, Forman C, Jin N, Serhal A, Avery R, Carr J, Markl M. Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease. Magn Reson Med 2020; 85:2174-2187. [PMID: 33107141 DOI: 10.1002/mrm.28561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 04/30/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically assess the feasibility and performance of a highly accelerated compressed sensing (CS) 4D flow MRI framework at three different acceleration factors (R) for the quantification of aortic flow dynamics and wall shear stress (WSS) in patients with aortic disease. METHODS Twenty patients with aortic disease (58 ± 15 y old; 19 M) underwent four 4D flow scans: one conventional (GRAPPA, R = 2) and three CS 4D flows with R = 5.7, 7.7, and 10.2. All scans were acquired with otherwise equivalent imaging parameters on a 1.5T scanner. Peak-systolic velocity (Vmax ), peak flow (Qmax ), and net flow (Qnet ) were quantified at the ascending aorta (AAo), arch, and descending aorta (DAo). WSS was calculated at six regions within the AAo and arch. RESULTS Mean scan times for the conventional and CS 4D flows with R = 5.7, 7.7, and 10.2 were 9:58 ± 2:58 min, 3:40 ± 1:19 min, 2:50 ± 0:56 min, and 2:05 ± 0:42 min, respectively. Vmax , Qmax , and Qnet were significantly underestimated by all CS protocols (underestimation ≤ -7%, -9%, and -10% by CS, R = 5.7, 7.7, and 10.2, respectively). WSS measurements showed the highest underestimation by all CS protocols (underestimation ≤ -9%, -12%, and -14% by CS, R = 5.7, 7.7, and 10.2). CONCLUSIONS Highly accelerated aortic CS 4D flow at R = 5.7, 7.7, and 10.2 showed moderate agreement with the conventional 4D flow, despite systematically underestimating various hemodynamic parameters. The shortened scan time may enable the clinical translation of CS 4D flow, although potential hemodynamic underestimation should be considered when interpreting the results.
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Affiliation(s)
- Ashitha Pathrose
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Liliana Ma
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Haben Berhane
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Michael B Scott
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Kelvin Chow
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | | | - Ning Jin
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - Ali Serhal
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ryan Avery
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
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21
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Harrison G, Carr J, Chen T, Ikeda D, Lee V, Nealon K, Van Wie J, Viana T. Flavorful Fiber: Investigating Pasta Alternatives as a Method to Increase Fiber Intake in the Diets of Preschool-age Children. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.09.007] [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]
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22
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Aouad P, Jarvis KB, Botelho MF, Serhal A, Blaisdell J, Collins L, Giri S, Kim D, Markl M, Ricciardi MJ, Davidson CJ, Collins J, Carr J. Aortic annular dimensions by non-contrast MRI using k-t accelerated 3D cine b-SSFP in pre-procedural assessment for transcatheter aortic valve implantation: a technical feasibility study. Int J Cardiovasc Imaging 2020; 37:651-661. [PMID: 32968888 DOI: 10.1007/s10554-020-02038-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 09/18/2020] [Indexed: 11/24/2022]
Abstract
To evaluate k-t accelerated 3D cine b-SSFP (balanced steady state free precession) as magnetic resonance imaging (MRI) technique for aortic annular area measurement in transcatheter aortic valve replacement (TAVR) planning compared to computed tomography angiography (CTA) and other non-contrast MRI sequences with reduced imaging time and without contrast administration. 6 volunteers and 7 TAVR candidates were prospectively enrolled. The volunteers underwent an MRI while TAVR candidates underwent an MRI and CTA. The following non-contrast MRI sequences were obtained at the level of the aortic root: 2D cine b-SSFP [GRAPPA (GeneRalized Autocalibrating Partially Parallel Acquisitions), R = 2], 3D cine b-SSFP [GRAPPA R = 2], navigator triggered 3D b-SSFP MRA [GRAPPA, R = 2] and k-t accelerated 3D cine b-SSFP [PEAK GRAPPA, R = 5]. Qualitative analysis and aortic annular area measurements in systole and diastole were obtained. k-t accelerated 3D cine b-SSFP provided image quality that is acceptable for confident diagnosis with very good interrater agreement. There was no statistically significant difference in aortic annular measurements between k-t accelerated 3D cine b-SSFP and CTA or other MRI sequences (p > 0.05). Bland-Altman analysis showed no systemic difference of annular area measurements between k-t accelerated 3D cine b-SSFP and each of the other techniques. There was excellent inter-rater agreement on aortic annular area measurements during systolic (ICC = 0.976, p < 0.001) and diastolic (ICC = 0.971, p < 0.001) phases using k-t accelerated 3D cine b-SSFP. K-t accelerated 3D cine b-SSFP is a promising alternative for the assessment of annular sizing in pre-TAVR evaluation while offering a reasonable combination of imaging parameters during one breath-hold.
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Affiliation(s)
- Pascale Aouad
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA.
| | - Kelly Brooke Jarvis
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Marcos Ferreira Botelho
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Ali Serhal
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Julie Blaisdell
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Louise Collins
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | | | - Daniel Kim
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Michael Markl
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - Mark J Ricciardi
- Department of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Charles J Davidson
- Department of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jeremy Collins
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
| | - James Carr
- Department of Radiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair (Arkes) suite 800, Chicago, IL, 60611, USA
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23
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Kelle S, Bucciarelli-Ducci C, Judd RM, Kwong RY, Simonetti O, Plein S, Raimondi F, Weinsaft JW, Wong TC, Carr J. Society for Cardiovascular Magnetic Resonance (SCMR) recommended CMR protocols for scanning patients with active or convalescent phase COVID-19 infection. J Cardiovasc Magn Reson 2020; 22:61. [PMID: 32878639 PMCID: PMC7467754 DOI: 10.1186/s12968-020-00656-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/21/2020] [Indexed: 12/30/2022] Open
Abstract
The aim of this document is to provide specific recommendations on the use of cardiovascular magnetic resonance (CMR) protocols in the era of the COVID-19 pandemic. In patients without COVID-19, standard CMR protocols should be used based on clinical indication as usual. Protocols used in patients who have known / suspected active COVID-19 or post COVID-19 should be performed based on the specific clinical question with an emphasis on cardiac function and myocardial tissue characterization. Short and dedicated protocols are recommended.
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Affiliation(s)
- Sebastian Kelle
- DZHK (German Centre for Cardiovascular Research), Berlin, Germany
- German Heart Institute Berlin and Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Robert M. Judd
- Department of Cardiology, Duke University, Durham, North Carolina USA
| | - Raymond Y. Kwong
- Cardiac Magnetic Resonance Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Orlando Simonetti
- Departments of Internal Medicine and Radiology, The Ohio State University, Columbus, OH USA
| | - Sven Plein
- Leeds Institute for Genetics Health and Therapeutics & Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - Francesca Raimondi
- Centre de référence “Malformations Cardiaques Congénitales Complexes – M3C” Service de Cardiologie Pédiatrique Hôpital Necker-Enfants Malades, Université Sorbonne Paris Cité, Paris, France
| | | | - Timothy C. Wong
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
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24
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Affiliation(s)
- S. Erickson
- Innovation and Commercial Development Tate&Lyle, Hoffman Estates IL USA
| | - J. Carr
- Innovation and Commercial Development Tate&Lyle, Hoffman Estates IL USA
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Erickson BJ, Carr J, Chalmers PN, Vellios E, Altchek DW. Ulnar Collateral Ligament Tear Location May Affect Return-to-Sports Rate but Not Performance Upon Return to Sports After Ulnar Collateral Ligament Reconstruction Surgery in Professional Baseball Players. Am J Sports Med 2020; 48:2608-2612. [PMID: 32809845 DOI: 10.1177/0363546520947090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 01/31/2023]
Abstract
BACKGROUND The number of ulnar collateral ligament (UCL) tears in professional baseball players is increasing. UCL reconstruction (UCLR) is the treatment of choice in players with failed nonoperative treatment who wish to return to sports (RTS). It is unknown if UCL tear location influences the ability of players to RTS or affects their performance upon RTS. PURPOSE/HYPOTHESIS The purpose was to compare the RTS rate and performance upon RTS in professional baseball players who underwent UCLR based on UCL tear location (proximal vs distal). It was hypothesized that no difference in RTS rate or performance upon RTS will exist between players with proximal or distal UCL tears. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All professional baseball players who underwent primary UCLR by a single surgeon between 2016 and 2018 were eligible for inclusion. Players with purely midsubstance tears or revision UCLR were excluded. Tear location was determined based on preoperative magnetic resonance imaging (MRI) and intraoperative findings. RTS rate and performance were compared between players with proximal versus distal UCL tears. RESULTS Overall, 25 pitchers (15 proximal and 10 distal tears) and 5 position players (2 proximal and 3 distal) underwent primary UCLR between 2016 and 2018. Of the 25 pitchers, 84% were able to RTS. Of the 5 position players, 80% were able to RTS. Among the total cohort of pitchers and position players, 12 out of 17 (71%) players with proximal tears were able to RTS, while of the 13 distal tears, 13 out of 13 (100%) players were able to RTS (P = .05). With regard to performance data, pitchers with distal tears had higher utilization postoperatively and, as such, allowed statistically more hits (P = .03), runs (P = .015), and walks (P = .021) postoperatively. However, the WHIP ([walks + hits]/innings pitched) was not different between players with proximal or distal tears, indicating that efficacy in games was not significantly different between groups. CONCLUSION Professional baseball players who sustain a distal UCL tear and undergo UCLR may be more likely to RTS than those who sustain a proximal UCL tear and undergo UCLR. Players with distal UCL tears who underwent UCLR saw higher utilization postoperatively than those with proximal UCL tears. Further work is needed in this area to confirm this result.
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Affiliation(s)
| | - James Carr
- Hospital for Special Surgery, West Palm Beach, Florida, USA
| | - Peter N Chalmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Evan Vellios
- Hospital for Special Surgery, New York, New York, USA
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26
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Lee V, Carr J, Policastro P. Portion Prejudice: Assessing College Students' Ability to Visually Identify One Standard Portion. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.160] [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]
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27
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Arai AE, Schulz-Menger J, Berman D, Mahrholdt H, Han Y, Bandettini WP, Gutberlet M, Abraham A, Woodard PK, Selvanayagam JB, McCann GP, Hamilton-Craig C, Schoepf UJ, San Tan R, Kramer CM, Friedrich MG, Haverstock D, Liu Z, Brueggenwerth G, Bacher-Stier C, Santiuste M, Pennell DJ, Pennell D, Schulz-Menger J, Mahrholdt H, Gutberlet M, Kramer U, von der Recke G, Nassenstein K, Tillmanns C, Taupitz M, Pache G, Mohrs O, Lotz J, Ko SM, Choo KS, Sung YM, Kang JW, Muzzarelli S, Valeti U, McCann G, Binukrishnam S, Croisille P, Jacquier A, Cowan B, Arai A, Berman D, Shah D, Bandettini WP, Han Y, Woodard P, Avery R, Schoepf J, Carr J, Kramer C, Flamm S, Harsinghani M, Lerakis S, Kim R, Raman S, Marcotte F, Islam A, Friedrich M, Abraham A, Selvanayagam J, Hamilton-Craig C, Chong WK, San Lynette Teo L, San Tan R. Gadobutrol-Enhanced Cardiac Magnetic Resonance Imaging for Detection of Coronary Artery Disease. J Am Coll Cardiol 2020; 76:1536-1547. [DOI: 10.1016/j.jacc.2020.07.060] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 11/26/2022]
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28
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Shaw L, Kwong RY, Nagel E, Salerno M, Jaffer F, Blankstein R, Dilsizian V, Flachskampf F, Grayburn P, Leipsic J, Marwick T, Nieman K, Raman S, Sengupta P, Zoghbi W, Pellikka PA, Swaminathan M, Dorbala S, Thompson R, Al-Mallah M, Calnon D, Polk D, Soman P, Beanlands R, Garrett KN, Henry TD, Rao SV, Duffy PL, Cox D, Grines C, Mahmud E, Bucciarelli-Ducci C, Plein S, Greenwood JP, Berry C, Carr J, Arai AE, Murthy VL, Ruddy TD, Chandrashekhar Y. Cardiac Imaging in the Post-ISCHEMIA Trial Era. JACC Cardiovasc Imaging 2020; 13:1815-1833. [DOI: 10.1016/j.jcmg.2020.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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29
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Wood DA, Mahmud E, Thourani VH, Sathananthan J, Virani A, Poppas A, Harrington RA, Dearani JA, Swaminathan M, Russo AM, Blankstein R, Dorbala S, Carr J, Virani S, Gin K, Packard A, Dilsizian V, Légaré JF, Leipsic J, Webb JG, Krahn AD. Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership. Ann Thorac Surg 2020; 110:733-740. [PMID: 32380058 PMCID: PMC7198197 DOI: 10.1016/j.athoracsur.2020.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022]
Affiliation(s)
- David A. Wood
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Address correspondence to Dr Wood, Centre for Cardiovascular Innovation, St. Paul’s and Vancouver General Hospitals, University of British Columbia, 2775 Laurel St, 9th Flr, Vancouver, British Columbia V5Z 1M9, Canada
| | - Ehtisham Mahmud
- University of California, San Diego Sulpizio Cardiovascular Center, La Jolla, California
| | - Vinod H. Thourani
- Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - Janarthanan Sathananthan
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alice Virani
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Athena Poppas
- Brown University School of Medicine, Providence, Rhode Island
| | | | - Joseph A. Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Madhav Swaminathan
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Andrea M. Russo
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ron Blankstein
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharmila Dorbala
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Carr
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sean Virani
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kenneth Gin
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Packard
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Children’s Hospital Boston/Harvard Medical School, Boston, Massachusetts
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jean-François Légaré
- New Brunswick Heart Centre, Dalhousie University, Saint John, New Brunswick, Canada
| | - Jonathon Leipsic
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - John G. Webb
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew D. Krahn
- Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital, Vancouver, British Columbia, Canada,Centre for Heart Valve Innovation, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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30
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Chaikriangkrai K, Abbasi MA, Sarnari R, Dolan R, Lee D, Anderson AS, Ghafourian K, Khan SS, Vorovich EE, Rich JD, Wilcox JE, Blaisdell JA, Yancy CW, Carr J, Markl M. Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients. JACC Cardiovasc Imaging 2020; 13:1521-1530. [PMID: 32199848 PMCID: PMC8809107 DOI: 10.1016/j.jcmg.2020.01.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of this study was to examine prognostic value of T1- and T2-mapping techniques in heart transplant patients. BACKGROUND Myocardial characterization using T2 mapping (evaluation of edema/inflammation) and pre- and post-gadolinium contrast T1 mapping (calculation of extracellular volume fraction [ECV] for assessment of interstitial expansion/fibrosis) are emerging modalities that have been investigated in various cardiomyopathies. METHODS A total of 99 heart transplant patients underwent the magnetic resonance imaging (MRI) scans including T1- (n = 90) and T2-mapping (n = 79) techniques. Relevant clinical characteristics, MRI parameters including late gadolinium enhancement (LGE), and invasive hemodynamics were collected. Median clinical follow-up duration after the baseline scan was 2.4 to 3.5 years. Clinical outcomes include cardiac events (cardiac death, myocardial infarction, coronary revascularization, and heart failure hospitalization), noncardiac death and noncardiac hospitalization. RESULTS Overall, the global native T1, postcontrast T1, ECV, and T2 were 1,030 ± 56 ms, 458 ± 84 ms, 27 ± 4% and 50 ± 4 ms, respectively. Top-tercile-range ECV (ECV >29%) independently predicted adverse clinical outcomes compared with bottom-tercile-range ECV (ECV <25%) (hazard ratio [HR]: 2.87; 95% confidence interval [CI]: 1.07 to 7.68; p = 0.04) in a multivariable model with left ventricular end-systolic volume and LGE. Higher T2 (T2 ≥50.2 ms) independently predicted adverse clinical outcomes (HR: 3.01; 95% CI: 1.39 to 6.54; p = 0.005) after adjustment for left ventricular ejection fraction, left ventricular end-systolic volume, and LGE. Additionally, higher T2 (T2 ≥50.2 ms) also independently predicted cardiac events (HR: 4.92; CI: 1.60 to 15.14; p = 0.005) in a multivariable model with left ventricular ejection fraction. CONCLUSIONS MRI-derived myocardial ECV and T2 mapping in heart transplant patients were independently associated with cardiac and noncardiac outcomes. Our findings highlight the need for larger prospective studies.
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Affiliation(s)
- Kongkiat Chaikriangkrai
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Muhannad Aboud Abbasi
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Roberto Sarnari
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ryan Dolan
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Daniel Lee
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Allen S Anderson
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Kambiz Ghafourian
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Sadiya S Khan
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Esther E Vorovich
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Jonathan D Rich
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Jane E Wilcox
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Julie A Blaisdell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Clyde W Yancy
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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31
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Wood DA, Mahmud E, Thourani VH, Sathananthan J, Virani A, Poppas A, Harrington RA, Dearani JA, Swaminathan M, Russo AM, Blankstein R, Dorbala S, Carr J, Virani S, Gin K, Packard A, Dilsizian V, Légaré JF, Leipsic J, Webb JG, Krahn AD. Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership. J Am Coll Cardiol 2020; 75:3177-3183. [PMID: 32380033 PMCID: PMC7198172 DOI: 10.1016/j.jacc.2020.04.063] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 11/14/2022]
Affiliation(s)
- David A Wood
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Ehtisham Mahmud
- University of California, San Diego Sulpizio Cardiovascular Center, La Jolla, California
| | - Vinod H Thourani
- Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - Janarthanan Sathananthan
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alice Virani
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Athena Poppas
- Brown University School of Medicine, Providence, Rhode Island
| | | | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Madhav Swaminathan
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ron Blankstein
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharmila Dorbala
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Carr
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sean Virani
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kenneth Gin
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Packard
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Children's Hospital Boston/Harvard Medical School, Boston, Massachusetts
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jean-François Légaré
- New Brunswick Heart Centre, Dalhousie University, Saint John, New Brunswick, Canada
| | - Jonathon Leipsic
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - John G Webb
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew D Krahn
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Wood DA, Mahmud E, Thourani VH, Sathananthan J, Virani A, Poppas A, Harrington RA, Dearani JA, Swaminathan M, Russo AM, Blankstein R, Dorbala S, Carr J, Virani S, Gin K, Packard A, Dilsizian V, Légaré JF, Leipsic J, Webb JG, Krahn AD. Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership. Can J Cardiol 2020; 36:971-976. [PMID: 32380228 PMCID: PMC7198201 DOI: 10.1016/j.cjca.2020.04.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 01/28/2023] Open
Affiliation(s)
- David A Wood
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Ehtisham Mahmud
- University of California, San Diego Sulpizio Cardiovascular Center, La Jolla, California
| | - Vinod H Thourani
- Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - Janarthanan Sathananthan
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alice Virani
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Athena Poppas
- Brown University School of Medicine, Providence, Rhode Island
| | | | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Madhav Swaminathan
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ron Blankstein
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharmila Dorbala
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Carr
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sean Virani
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kenneth Gin
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Packard
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Children's Hospital Boston/Harvard Medical School, Boston, Massachusetts
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jean-François Légaré
- New Brunswick Heart Centre, Dalhousie University, Saint John, New Brunswick, Canada
| | - Jonathon Leipsic
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - John G Webb
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew D Krahn
- Centre for Cardiovascular Innovation, St Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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33
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Srivastava A, Cai X, Lee J, Li W, Larive B, Kendrick C, Gassman JJ, Middleton JP, Carr J, Raphael KL, Cheung AK, Raj DS, Chonchol MB, Fried LF, Block GA, Sprague SM, Wolf M, Ix JH, Prasad PV, Isakova T. Kidney Functional Magnetic Resonance Imaging and Change in eGFR in Individuals with CKD. Clin J Am Soc Nephrol 2020; 15:776-783. [PMID: 32345747 PMCID: PMC7274274 DOI: 10.2215/cjn.13201019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 10/30/2019] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Kidney functional magnetic resonance imaging (MRI) requires further investigation to enhance the noninvasive identification of patients at high risk of CKD progression. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this exploratory study, we obtained baseline diffusion-weighted and blood oxygen level-dependent MRI in 122 participants of the CKD Optimal Management with Binders and Nicotinamide trial, which was a multicenter, randomized, double-blinded, 12-month, four-group parallel trial of nicotinamide and lanthanum carbonate versus placebo conducted in individuals with eGFR 20-45 ml/min per 1.73 m2. Lower values of apparent diffusion coefficient (ADC) on diffusion-weighted MRI may indicate increased fibrosis, and higher values of relaxation rate (R2*) on blood oxygen level-dependent MRI may represent decreased oxygenation. Because there was no effect of active treatment on eGFR over 12 months, we tested whether baseline kidney functional MRI biomarkers were associated with eGFR decline in all 122 participants. In a subset of 87 participants with 12-month follow-up MRI data, we evaluated whether kidney functional MRI biomarkers change over time. RESULTS Mean baseline eGFR was 32±9 ml/min per 1.73 m2, and mean annual eGFR slope was -2.3 (95% confidence interval [95% CI], -3.4 to -1.1) ml/min per 1.73 m2 per year. After adjustment for baseline covariates, baseline ADC was associated with change in eGFR over time (difference in annual eGFR slope per 1 SD increase in ADC: 1.3 [95% CI, 0.1 to 2.5] ml/min per 1.73 m2 per year, ADC×time interaction P=0.04). This association was no longer significant after further adjustment for albuminuria (difference in annual eGFR slope per 1 SD increase in ADC: 1.0 (95% CI, -0.1 to 2.2) ml/min per 1.73 m2 per year, ADC×time interaction P=0.08). There was no significant association between baseline R2* and change in eGFR over time. In 87 participants with follow-up functional MRI, ADC and R2* values remained stable over 12 months (intraclass correlation: 0.71 and 0.68, respectively). CONCLUSIONS Baseline cortical ADC was associated with change in eGFR over time, but this association was not independent of albuminuria. Kidney functional MRI biomarkers remained stable over 1 year. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER CKD Optimal Management with Binders and Nicotinamide (COMBINE), NCT02258074.
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Affiliation(s)
- Anand Srivastava
- Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Xuan Cai
- Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jungwha Lee
- Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Wei Li
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois
| | - Brett Larive
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Cynthia Kendrick
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Jennifer J Gassman
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - John P Middleton
- Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, North Carolina
| | - James Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kalani L Raphael
- Division of Nephrology and Hypertension, University of Utah Health, Salt Lake City, Utah.,Salt Lake City Veterans Affairs Healthcare System, Salt Lake City, Utah
| | - Alfred K Cheung
- Division of Nephrology and Hypertension, University of Utah Health, Salt Lake City, Utah.,Salt Lake City Veterans Affairs Healthcare System, Salt Lake City, Utah
| | - Dominic S Raj
- Division of Renal Diseases and Hypertension, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Michel B Chonchol
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Linda F Fried
- Division of Nephrology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.,Renal Section, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | | | - Stuart M Sprague
- Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois
| | - Myles Wolf
- Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, North Carolina
| | - Joachim H Ix
- Department of Medicine, Renal Section, University of San Diego, Veterans Affairs San Diego Healthcare System, San Diego, California
| | | | - Tamara Isakova
- Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Han Y, Chen T, Bryant J, Bucciarelli-Ducci C, Dyke C, Elliott MD, Ferrari VA, Friedrich MG, Lawton C, Manning WJ, Ordovas K, Plein S, Powell AJ, Raman SV, Carr J. Society for Cardiovascular Magnetic Resonance (SCMR) guidance for the practice of cardiovascular magnetic resonance during the COVID-19 pandemic. J Cardiovasc Magn Reson 2020; 22:26. [PMID: 32340614 PMCID: PMC7184243 DOI: 10.1186/s12968-020-00628-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [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: 04/08/2020] [Accepted: 04/17/2020] [Indexed: 01/19/2023] Open
Abstract
The aim of this document is to provide general guidance and specific recommendations on the practice of cardiovascular magnetic resonance (CMR) in the era of the COVID-19 pandemic. There are two major considerations. First, continued urgent and semi-urgent care for the patients who have no known active COVID-19 should be provided in a safe manner for both patients and staff. Second, when necessary, CMR on patients with confirmed or suspected active COVID-19 should focus on the specific clinical question with an emphasis on myocardial function and tissue characterization while optimizing patient and staff safety.
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Affiliation(s)
- Yuchi Han
- Departments of Medicine (Cardiovascular Division) and Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Tiffany Chen
- Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Jennifer Bryant
- National Heart Research Institute Singaore, National Heart Center Singapore, 5 Hospital Drive, Singapore, Singapore
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | | | | | - Victor A. Ferrari
- Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Matthias G. Friedrich
- Departments of Medicine and Diagnostic Radiology, McGill University, Montreal, Canada
| | - Chris Lawton
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Warren J. Manning
- Departments of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Karen Ordovas
- Departments of Radiology and Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Sven Plein
- Leeds Institute for Genetics Health and Therapeutics & Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - Andrew J. Powell
- Department of Cardiology, Boston Children’s Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, MA USA
| | - Subha V. Raman
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
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35
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Gajjar P, Styliari ID, Nguyen TTH, Carr J, Chen X, Elliott JA, Hammond RB, Burnett TL, Roberts K, Withers PJ, Murnane D. 3D characterisation of dry powder inhaler formulations: Developing X-ray micro computed tomography approaches. Eur J Pharm Biopharm 2020; 151:32-44. [PMID: 32268190 DOI: 10.1016/j.ejpb.2020.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Carrier-based dry powder inhaler (DPI) formulations need to be accurately characterised for their particle size distributions, surface roughnesses, fines contents and flow properties. Understanding the micro-structure of the powder formulation is crucial, yet current characterisation methods give incomplete information. Commonly used techniques like laser diffraction (LD) and optical microscopy (OM) are limited due to the assumption of sphericity and can give variable results depending on particle orientation and dispersion. The aim of this work was to develop new three dimensional (3D) powder analytical techniques using X-ray computed tomography (XCT) that could be employed for non-destructive metrology of inhaled formulations. α-lactose monohydrate powders with different characteristics have been analysed, and their size and shape (sphericity/aspect ratio) distributions compared with results from LD and OM. The three techniques were shown to produce comparable size distributions, while the different shape distributions from XCT and OM highlight the difference between 2D and 3D imaging. The effect of micro-structure on flowability was also analysed through 3D measurements of void volume and tap density. This study has demonstrated for the first time that XCT provides an invaluable, non-destructive and analytical approach to obtain number- and volume-based particle size distributions of DPI formulations in 3D space, and for unique 3D characterisation of powder micro-structure.
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Affiliation(s)
- P Gajjar
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester M13 9PL, UK.
| | - I D Styliari
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
| | - T T H Nguyen
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - J Carr
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester M13 9PL, UK
| | - X Chen
- Department of Materials Science & Metallurgy, 27 Charles Babbage Road, Cambridge CB3 0FS, UK
| | - J A Elliott
- Department of Materials Science & Metallurgy, 27 Charles Babbage Road, Cambridge CB3 0FS, UK
| | - R B Hammond
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - T L Burnett
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester M13 9PL, UK
| | - K Roberts
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - P J Withers
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester M13 9PL, UK; Henry Royce Institute for Advanced Materials, Oxford Road, Manchester M13 9PL, UK
| | - D Murnane
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK.
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Belkina AC, Azer M, Lee JJ, Elgaali HH, Pihl R, Cleveland M, Carr J, Kim S, Habib C, Hasturk H, Snyder-Cappione JE, Nikolajczyk BS. Single-Cell Analysis of the Periodontal Immune Niche in Type 2 Diabetes. J Dent Res 2020; 99:855-862. [PMID: 32186942 DOI: 10.1177/0022034520912188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Periodontitis (PD) is a common source of uncontrolled inflammation in obesity-associated type 2 diabetes (T2D). PD apparently fuels the inflammation of T2D and associates with poor glycemic control and increased T2D morbidity. New therapeutics are critically needed to counter the sources of periodontal infection and inflammation that are accelerated in people with T2D. The precise mechanisms underlying the relationship between PD and T2D remain poorly understood. Every major immune cell subset has been implicated in the unresolved inflammation of PD, regardless of host metabolic health. However, analyses of inflammatory cells in PD with human periodontal tissue have generally focused on mRNA quantification and immunohistochemical analyses, both of which provide limited information on immune cell function. We used a combination of flow cytometry for cell surface markers and enzyme-linked immunospot methods to assess the subset distribution and function of immune cells isolated from gingiva of people who had PD and were systemically healthy, had PD and T2D (PD/T2D), or, for flow cytometry, were systemically and orally healthy. T-cell subsets dominated the cellular immune compartment in gingiva from all groups, and B cells were relatively rare. Although immune cell frequencies were similar among groups, a higher proportion of CD11b+ or CD4+ cells secreted IFNγ/IL-10 or IL-8, respectively, in cells from PD/T2D samples as compared with PD-alone samples. Our data indicate that fundamental differences in gingival immune cell function between PD and T2D-potentiated PD may account for the increased risk and severity of PD in subjects with T2D. Such differences may suggest unexpected therapeutic targets for alleviating periodontal inflammation in people with T2D.
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Affiliation(s)
- A C Belkina
- Department of Pathology and Laboratory Medicine, School of Medicine, Boston University, Boston, MA, USA.,Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA
| | - M Azer
- Department of Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - J J Lee
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - H H Elgaali
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - R Pihl
- Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA
| | - M Cleveland
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - J Carr
- Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
| | - S Kim
- Department of Medicine, School of Medicine, Boston University, Boston, MA, USA
| | - C Habib
- Department of Medicine, School of Medicine, Boston University, Boston, MA, USA
| | - H Hasturk
- The Forsyth Institute, Cambridge, MA, USA
| | - J E Snyder-Cappione
- Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA.,Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
| | - B S Nikolajczyk
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA.,Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
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37
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Berhane H, Scott M, Elbaz M, Jarvis K, McCarthy P, Carr J, Malaisrie C, Avery R, Barker AJ, Robinson JD, Rigsby CK, Markl M. Fully automated 3D aortic segmentation of 4D flow MRI for hemodynamic analysis using deep learning. Magn Reson Med 2020; 84:2204-2218. [PMID: 32167203 DOI: 10.1002/mrm.28257] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [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: 09/30/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To generate fully automated and fast 4D-flow MRI-based 3D segmentations of the aorta using deep learning for reproducible quantification of aortic flow, peak velocity, and dimensions. METHODS A total of 1018 subjects with aortic 4D-flow MRI (528 with bicuspid aortic valve, 376 with tricuspid aortic valve and aortic dilation, 114 healthy controls) comprised the data set. A convolutional neural network was trained to generate 3D aortic segmentations from 4D-flow data. Manual segmentations served as the ground truth (N = 499 training, N = 101 validation, N = 418 testing). Dice scores, Hausdorff distance, and average symmetrical surface distance were calculated to assess performance. Aortic flow, peak velocity, and lumen dimensions were quantified at the ascending, arch, and descending aorta and compared using Bland-Altman analysis. Interobserver variability of manual analysis was assessed on a subset of 40. RESULTS Convolutional neural network segmentation required 0.438 ± 0.355 seconds versus 630 ± 254 seconds for manual analysis and demonstrated excellent performance with a median Dice score of 0.951 (0.930-0.966), Hausdorff distance of 2.80 (2.13-4.35), and average symmetrical surface distance of 0.176 (0.119-0.290). Excellent agreement was found for flow, peak velocity, and dimensions with low bias and limits of agreement less than 10% difference versus manual analysis. For aortic volume, limits of agreement were moderate within 16.3%. Interobserver variability (median Dice score: 0.950; Hausdorff distance: 2.45; and average symmetrical surface distance: 0.145) and convolutional neural network-based analysis (median Dice score: 0.953-0.959; Hausdorff distance: 2.24-2.91; and average symmetrical surface distance: 0.145-1.98 to observers) demonstrated similar reproducibility. CONCLUSIONS Deep learning enabled fast and automated 3D aortic segmentation from 4D-flow MRI, demonstrating its potential for efficient clinical workflows. Future studies should investigate its utility for other vasculature and multivendor applications.
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Affiliation(s)
- Haben Berhane
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Michael Scott
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois.,Department of Radiology, Northwestern University, Chicago, Illinois
| | - Mohammed Elbaz
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois.,Department of Radiology, Northwestern University, Chicago, Illinois
| | - Kelly Jarvis
- Department of Radiology, Northwestern University, Chicago, Illinois
| | - Patrick McCarthy
- Divison of Cardiac Surgery, Northwestern University, Chicago, Illinois
| | - James Carr
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois
| | - Chris Malaisrie
- Department of Radiology, Northwestern University, Chicago, Illinois
| | - Ryan Avery
- Department of Radiology, Northwestern University, Chicago, Illinois
| | - Alex J Barker
- Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Joshua D Robinson
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Cynthia K Rigsby
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Michael Markl
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois.,Department of Radiology, Northwestern University, Chicago, Illinois
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Scott MB, Huh H, van Ooij P, Chen V, Herrera B, Elbaz M, McCarthy P, Malaisrie SC, Carr J, Fedak PWM, Markl M, Barker AJ. Impact of age, sex, and global function on normal aortic hemodynamics. Magn Reson Med 2020; 84:2088-2102. [PMID: 32162416 DOI: 10.1002/mrm.28250] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/23/2019] [Revised: 01/10/2020] [Accepted: 02/14/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE To examine the effects of age, sex, and left ventricular global function on velocity, helicity, and 3D wall shear stress (3D-WSS) in the aorta of N = 100 healthy controls. METHODS Fifty female and 50 male volunteers with no history of cardiovascular disease, with 10 volunteers per age group (18-30, 31-40, 41-50, 51-60, and 61-80 years) underwent aortic 4D-flow MRI. Quantification of systolic aortic peak velocity, helicity, and 3D-WSS distribution and the calculation of age group-averaged peak systolic velocity and 3D-WSS maps ("atlases") were computed. Age-related and sex-related changes in peak velocity, helicity, and 3D-WSS were computed and correlated with standard metrics of left ventricular function derived from short-axis cine MRI. RESULTS No significant differences were found in peak systolic velocity or 3D-WSS based on sex except for the 18- to 30-year-old group (males 8% higher velocity volume and 3D-WSS surface area). Between successively older groups, systolic velocity decreased (13%, <1%, 7%, and 55% of the aorta volume) and 3D-WSS decreased (21%, 2%, 30%, and 62% of the aorta surface area). Mean velocity, mean 3D-3D-WSS, and median helicity increased with cardiac output (r = 0.27-0.43, all P < .01), and mean velocity and 3D-WSS decreased with increasing diameter (r > 0.35, P < .001). Arch and descending aorta systolic mean velocity, mean 3D-WSS, and median helicity increased with normalized left ventricular volumes: end diastolic volume (r = 0.31-0.37, P < .01), end systolic volume (r = 0.27-0.35, P < .01), and stroke volume (r = 0.28-0.35, P < .01). CONCLUSION Healthy aortic hemodynamics are dependent on subject age, and correlate with vessel diameter and cardiac function.
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Affiliation(s)
- Michael B Scott
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Hyungkyu Huh
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands
| | - Vincent Chen
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brenda Herrera
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mohammed Elbaz
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Chris Malaisrie
- Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul W M Fedak
- Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Alex J Barker
- Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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39
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Affiliation(s)
- Martin J. Power
- Department of Sociology, University of Limerick, Limerick, Ireland
| | - Paul Widdop
- Manchester Metropolitan University, Manchester, UK
| | - Dan Parnell
- Management School, University of Liverpool, Liverpool, UK
| | - James Carr
- Department of Sociology, University of Limerick, Limerick, Ireland
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40
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Gajjar P, Styliari ID, Nguyen TTH, Carr J, Chen X, Elliott JA, Hammond RB, Burnett TL, Roberts K, Withers PJ, Murnane D. WITHDRAWN: 3D characterisation of dry powder inhaler formulations: Developing X-ray micro computed tomography approaches. Int J Pharm 2020:118988. [PMID: 31935476 DOI: 10.1016/j.ijpharm.2019.118988] [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] [Received: 09/26/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Affiliation(s)
- P Gajjar
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK.
| | - I D Styliari
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, AL10 9AB, UK
| | - T T H Nguyen
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - J Carr
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - X Chen
- Department of Materials Science & Metallurgy, 27 Charles Babbage Road, Cambridge, CB3 0FS, UK
| | - J A Elliott
- Department of Materials Science & Metallurgy, 27 Charles Babbage Road, Cambridge, CB3 0FS, UK
| | - R B Hammond
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - T L Burnett
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - K Roberts
- Centre for the Digital Design of Drug Products, School of Chemical and Process Engineering, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - P J Withers
- Henry Moseley X-ray Imaging Facility, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK; Henry Royce Institute for Advanced Materials, Oxford Road, Manchester, M13 9PL, UK
| | - D Murnane
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, AL10 9AB, UK.
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Grubor-Bauk B, Wijesundara DK, Masavuli M, Abbink P, Peterson RL, Prow NA, Larocca RA, Mekonnen ZA, Shrestha A, Eyre NS, Beard MR, Gummow J, Carr J, Robertson SA, Hayball JD, Barouch DH, Gowans EJ. NS1 DNA vaccination protects against Zika infection through T cell-mediated immunity in immunocompetent mice. Sci Adv 2019; 5:eaax2388. [PMID: 31844662 PMCID: PMC6905874 DOI: 10.1126/sciadv.aax2388] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/08/2019] [Indexed: 05/08/2023]
Abstract
The causal association of Zika virus (ZIKV) with microcephaly, congenital malformations in infants, and Guillain-Barré syndrome in adults highlights the need for effective vaccines. Thus far, efforts to develop ZIKV vaccines have focused on the viral envelope. ZIKV NS1 as a vaccine immunogen has not been fully explored, although it can circumvent the risk of antibody-dependent enhancement of ZIKV infection, associated with envelope antibodies. Here, we describe a novel DNA vaccine encoding a secreted ZIKV NS1, that confers rapid protection from systemic ZIKV infection in immunocompetent mice. We identify novel NS1 T cell epitopes in vivo and show that functional NS1-specific T cell responses are critical for protection against ZIKV infection. We demonstrate that vaccine-induced anti-NS1 antibodies fail to confer protection in the absence of a functional T cell response. This highlights the importance of using NS1 as a target for T cell-based ZIKV vaccines.
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Affiliation(s)
- B. Grubor-Bauk
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
- Corresponding author.
| | - D. K. Wijesundara
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - M. Masavuli
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - P. Abbink
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - R. L. Peterson
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - N. A. Prow
- Experimental Therapeutics Laboratory, Cancer Research Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia
- Australian Infectious Diseases Research Centre, Brisbane, QLD 4072, Australia
| | - R. A. Larocca
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Z. A. Mekonnen
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - A. Shrestha
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - N. S. Eyre
- Research Centre for Infectious Diseases, School of Biological Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - M. R. Beard
- Research Centre for Infectious Diseases, School of Biological Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. Gummow
- Gene Silencing and Expression Core Facility, Adelaide Health and Medical Sciences, Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. Carr
- Microbiology and Infectious Diseases, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - S. A. Robertson
- Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. D. Hayball
- Experimental Therapeutics Laboratory, Cancer Research Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia
- Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - D. H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - E. J. Gowans
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
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Kim SB, Bredlaw M, Rousselle H, Farrow F, Carr J, Korolevych VY, Stuart M. Organically bound tritium (OBT) activity concentrations in surface soil at the Chalk River Laboratories, Canada. J Environ Radioact 2019; 208-209:105999. [PMID: 31271849 DOI: 10.1016/j.jenvrad.2019.105999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/11/2019] [Accepted: 06/23/2019] [Indexed: 06/09/2023]
Abstract
Canadian Nuclear Laboratories (CNL)'s Chalk River Laboratories (CRL) site is home to a large nuclear research complex in Canada. CRL's air tritium releases amount to about 1015 Bq/year. The objective of the study was to characterize the spatial footprint of the 60 years of tritium atmospheric releases in surface soil by measurement of organically bound tritium (OBT). Soil OBT activity concentrations were of particular interest because soil represents a long-term tritium reservoir that can act as a historical record of tritium releases into the environment. Soil samples to a 5 cm depth were collected within the CRL site from 2012 to 2014. Each sample was analyzed for tritiated water (HTO) and OBT activity concentrations. The highest HTO and OBT measurements obtained during this study were 154.0 ± 7.8 Bq/L and 180.9 ± 37.3 Bq/L, respectively. A developed OBT map indicated that retained tritium in soil was not related to the distance of sources-term but it was related to the prevailing wind direction.
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Affiliation(s)
- S B Kim
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada.
| | - M Bredlaw
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - H Rousselle
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - F Farrow
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - J Carr
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - V Y Korolevych
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - M Stuart
- Environmental Sciences Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
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Affiliation(s)
- James Carr
- Department of Sociology, University of Limerick, Limerick, Ireland
| | - Martin J. Power
- Department of Sociology, University of Limerick, Limerick, Ireland
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Elbaz MSM, Scott MB, Barker AJ, McCarthy P, Malaisrie C, Collins JD, Bonow RO, Carr J, Markl M. Four-dimensional Virtual Catheter: Noninvasive Assessment of Intra-aortic Hemodynamics in Bicuspid Aortic Valve Disease. Radiology 2019; 293:541-550. [PMID: 31592729 DOI: 10.1148/radiol.2019190411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Four-dimensional (4D) flow MRI enables the evaluation of blood flow alterations in patients with congenital bicuspid aortic valve (BAV). However, current analysis methods are cumbersome and lack the use of the volumetric data from 4D MRI. Purpose To investigate the feasibility and reproducibility of a technique that uses a catheter-like mathematical model (virtual catheter) to assess volumetric intra-aortic hemodynamics from 4D flow MRI in patients with BAV. Materials and Methods In this retrospective study, data were collected from adult patients with BAV and healthy participants who underwent aortic 4D flow MRI from November 2011 through August 2014. Reproducibility was tested in healthy study participants who underwent test-retest examinations within 2 weeks. Patients were grouped on the basis of the severity of aortic valve regurgitation (AVR) and aortic valve stenosis (AVS). A 4D virtual catheter mathematical model for probing intra-aortic hemodynamic flow was constructed as a tube with an automatically derived radius along the entire thoracic aorta centerline. Volumetric intra-aortic hemodynamics were computed from 4D flow MRI only within the virtual catheter, and the following volume-normalized systolic peaks were derived: kinetic energy (KE), viscous energy loss rate (VELR), and vorticity. Hemodynamic data were presented as medians with interquartile ranges and compared by using Mann-Whitney U test and Kruskal-Wallis test. Results The study included 91 participants (57 patients [mean age, 46 years ± 12], 18 women; 34 healthy participants [mean age: 44 years ± 14], 12 women; 15 healthy participants underwent test-retest examinations). Patients showed higher VELR values compared with healthy participants (median, 31 W/m3 [interquartile range, 21-72] vs 23 W/m3 [interquartile range, 17-30], respectively; P < .001) and vorticity (69 sec-1 [interquartile range, 59-87] vs 60 sec-1 [interquartile range, 50-67], respectively; P < .001). Four-dimensional virtual catheter showed differences among different AVS and AVR grades with the highest VELR (120 W/m3; interquartile range, 99-166; P < .001) and vorticity (108 sec-1; interquartile range, 84-151; P < .001) found in severe AVS. High test-retest reproducibility was found for all virtual catheter-derived metrics (intraclass correlation, 0.80 ± 0.07; coefficient of variation, 9% ± 3). Conclusion The proposed four-dimensional (4D) virtual catheter technique enabled reproducible automated evaluation of volumetric intra-aortic hemodynamics alterations from 4D flow MRI in patients with bicuspid aortic valve. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Mitsouras and Hope in this issue.
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Affiliation(s)
- Mohammed S M Elbaz
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Michael B Scott
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Alex J Barker
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Patrick McCarthy
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Chris Malaisrie
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Jeremy D Collins
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Robert O Bonow
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - James Carr
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
| | - Michael Markl
- From the Departments of Radiology (M.S.M.E., M.B.S., J.C., M.M.), Cardiac Surgery (P.M., C.M.), and Cardiology (R.O.B.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.J.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.C.); and Department of Biomedical Engineering, Northwestern University, Evanston, Ill (M.M.)
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McGann C, Love B, Carr J, O'Connor M, Dolan E. 51 Evaluation of a Clinical Pharmacy Service on an Inpatient Ward in an Acute Hospital. Age Ageing 2019. [DOI: 10.1093/ageing/afz103.28] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Intensive clinical pharmacy input from admission to discharge has been shown to improve patient outcomes. The clinical pharmacy service in our institution has historically been under-resourced. The aim of this study is to develop a ward-based clinical pharmacy service and to evaluate its impact using a number of clinical, safety and financial metrics.
Methods
A clinical pharmacist was assigned to provide pharmaceutical care to patients on a Medicine for the Older Person ward. Over an eight week period, the pharmacist prospectively recorded her interventions/activities. To assess impact on patient care, interventions were graded according to the Eadon criteria. The potential cost avoidance associated with interventions was estimated. Medication incident reporting was analysed to assess the impact on patient safety.
Results
87% of patients had at least one pharmacist intervention, across a spectrum of activities including medication reconciliation and clinical review. 90% of interventions requiring follow-up with the medical team were accepted and resulted in a change to patient’s care. Eadon grading of interventions deemed 99% to be significant, with 81% improving the standard of patient care. Two different methods were used to estimate potential cost avoidance: one estimated annual savings of €154,103 - €344,926; the other estimated these at €174,373. Given current pharmacist salary costs, this equates to a cost-benefit ratio of 2.8:1 to 6.3:1. (This does not include the 27% reduction in drug spend observed during the study period. However, more longitudinal data are required to confirm and characterise this phenomenon.) A five-fold increase in medication incident reporting from the ward was observed, suggestive of an enhanced culture of patient safety.
Conclusion
This study assessed and quantified a wide spectrum of pharmacist contributions to medication management and safety. Costing of these contributions estimates the cost-benefit ratio of the clinical pharmacy service, providing compelling support for the extension of this service throughout the hospital.
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Affiliation(s)
| | | | - James Carr
- Connolly Hospital, Blanchardstown, Ireland
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Rahman O, Markl M, Balte P, Berhane H, Blanken C, Suwa K, Dashnaw S, Wieben O, Bluemke DA, Prince MR, Lima J, Michos E, Ambale-Venkatesh B, Hoffman EA, Gomes AS, Watson K, Sun Y, Carr J, Barr RG. Reproducibility and Changes in Vena Caval Blood Flow by Using 4D Flow MRI in Pulmonary Emphysema and Chronic Obstructive Pulmonary Disease (COPD): The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Substudy. Radiology 2019; 292:585-594. [PMID: 31335282 PMCID: PMC6736177 DOI: 10.1148/radiol.2019182143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Received: 09/18/2018] [Revised: 05/19/2019] [Accepted: 06/03/2019] [Indexed: 11/11/2022]
Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is associated with hemodynamic changes in the pulmonary vasculature. However, cardiac effects are not fully understood and vary by phenotype of chronic lower respiratory disease.PurposeTo use four-dimensional (4D) flow MRI for comprehensive assessment of the right-sided cardiovascular system, assess its interrater and intraobserver reproducibility, and examine associations with venous return to the right heart in individuals with chronic COPD and emphysema.Materials and MethodsThe Multi-Ethnic Study of Atherosclerosis COPD substudy prospectively recruited participants who smoked and who had COPD and nested control participants from population-based samples. Electrocardiography and respiratory gated 4D flow 1.5-T MRI was performed at three sites with full volumetric coverage of the thoracic vessels in 2014-2017 with postbronchodilator spirometry and inspiratory chest CT to quantify percent emphysema. Net flow, peak velocity, retrograde flow, and retrograde fraction were measured on 14 analysis planes. Interrater reproducibility was assessed by two independent observers, and the principle of conservation of mass was employed to evaluate the internal consistency of flow measures. Partial correlation coefficients were adjusted for age, sex, race/ethnicity, height, weight, and smoking status.ResultsAmong 70 participants (29 participants with COPD [mean age, 73.5 years ± 8.1 {standard deviation}; 20 men] and 41 control participants [mean age, 71.0 years ± 6.1; 22 men]), the interrater reproducibility of the 4D flow MRI measures was good to excellent (intraclass correlation coefficient range, 0.73-0.98), as was the internal consistency. There were no statistically significant differences in venous flow parameters according to COPD severity (P > .05). Greater percent emphysema at CT was associated with greater regurgitant flow in the superior and inferior caval veins and tricuspid valve (adjusted r = 0.28-0.55; all P < .01), particularly in the superior vena cava.ConclusionFour-dimensional flow MRI had good-to-excellent observer variability and flow consistency. Percent emphysema at CT was associated with statistically significant differences in retrograde flow, greatest in the superior vena cava.© RSNA, 2019Online supplemental material is available for this article.See also the editorial by Choe in this issue.
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Affiliation(s)
| | | | - Pallavi Balte
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Haben Berhane
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Carmen Blanken
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Kenichiro Suwa
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Stephen Dashnaw
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Oliver Wieben
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - David A. Bluemke
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Martin R. Prince
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Joao Lima
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Erin Michos
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Bharath Ambale-Venkatesh
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Eric A. Hoffman
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Antoinette S. Gomes
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Karol Watson
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Yanping Sun
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - James Carr
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - R. Graham Barr
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
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Xue R, Chung B, Tamaddon M, Carr J, Liu C, Cartmell SH. Osteochondral tissue coculture: An in vitro and in silico approach. Biotechnol Bioeng 2019; 116:3112-3123. [PMID: 31334830 PMCID: PMC6790609 DOI: 10.1002/bit.27127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/10/2019] [Accepted: 07/17/2019] [Indexed: 01/02/2023]
Abstract
Osteochondral tissue engineering aims to regenerate functional tissue‐mimicking physiological properties of injured cartilage and its subchondral bone. Given the distinct structural and biochemical difference between bone and cartilage, bilayered scaffolds, and bioreactors are commonly employed. We present an osteochondral culture system which cocultured ATDC5 and MC3T3‐E1 cells on an additive manufactured bilayered scaffold in a dual‐chamber perfusion bioreactor. Also, finite element models (FEM) based on the microcomputed tomography image of the manufactured scaffold as well as on the computer‐aided design (CAD) were constructed; the microenvironment inside the two FEM was studied and compared. In vitro results showed that the coculture system supported osteochondral tissue growth in terms of cell viability, proliferation, distribution, and attachment. In silico results showed that the CAD and the actual manufactured scaffold had significant differences in the flow velocity, differentiation media mixing in the bioreactor and fluid‐induced shear stress experienced by the cells. This system was shown to have the desired microenvironment for osteochondral tissue engineering and it can potentially be used as an inexpensive tool for testing newly developed pharmaceutical products for osteochondral defects.
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Affiliation(s)
- Ruikang Xue
- School of Materials, Faculty of Science and Engineering, University of Manchester, Manchester, UK
| | - Benedict Chung
- School of Materials, Faculty of Science and Engineering, University of Manchester, Manchester, UK
| | - Maryam Tamaddon
- Institute of Orthopaedics and Musculo-Skeletal Science, University College London, London, UK
| | - James Carr
- Manchester Imaging Facility, University of Manchester, Manchester, UK
| | - Chaozong Liu
- Institute of Orthopaedics and Musculo-Skeletal Science, University College London, London, UK
| | - Sarah Harriet Cartmell
- School of Materials, Faculty of Science and Engineering, University of Manchester, Manchester, UK
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48
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Aherne E, Chow K, Carr J. Cardiac T 1 mapping: Techniques and applications. J Magn Reson Imaging 2019; 51:1336-1356. [PMID: 31334899 DOI: 10.1002/jmri.26866] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 04/19/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 12/18/2022] Open
Abstract
A key advantage of cardiac magnetic resonance (CMR) imaging over other cardiac imaging modalities is the ability to perform detailed tissue characterization. CMR techniques continue to evolve, with advanced imaging sequences being developed to provide a reproducible, quantitative method of tissue interrogation. The T1 mapping technique, a pixel-by-pixel method of quantifying T1 relaxation time of soft tissues, has been shown to be promising for characterization of diseased myocardium in a wide variety of cardiomyopathies. In this review, we describe the basic principles and common techniques for T1 mapping and its use for native T1 , postcontrast T1 , and extracellular volume mapping. We will review a wide range of clinical applications of the technique that can be used for identification and quantification of myocardial edema, fibrosis, and infiltrative diseases with illustrative clinical examples. In addition, we will explore the current limitations of the technique and describe some areas of ongoing development. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1336-1356.
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Affiliation(s)
- Emily Aherne
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Kelvin Chow
- Department of Radiology, Northwestern University, Chicago, Illinois, USA.,Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - James Carr
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
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49
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Chaikriangkrai K, Abbasi MA, Sarnari R, Lee D, Anderson AS, Ghafourian K, Khan SS, Vorovich EE, Rich JD, Wilcox JE, Blaisdell JA, Yancy CW, Carr J, Markl M. Natural History of Myocardial Late Gadolinium Enhancement Predicts Adverse Clinical Events in Heart Transplant Recipients. JACC Cardiovasc Imaging 2019; 12:2092-2094. [PMID: 31326473 DOI: 10.1016/j.jcmg.2019.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 11/26/2022]
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50
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Rahman O, Scott M, Bollache E, Suwa K, Collins J, Carr J, Fedak P, McCarthy P, Malaisrie C, Barker AJ, Markl M. Interval changes in aortic peak velocity and wall shear stress in patients with bicuspid aortic valve disease. Int J Cardiovasc Imaging 2019; 35:1925-1934. [PMID: 31144256 DOI: 10.1007/s10554-019-01632-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/05/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Abstract
Bicuspid aortic valve (BAV) is associated with abnormal valve-mediated hemodynamics including high velocity jets and elevated wall shear stress (WSS). This study investigated interval changes in flow and WSS in a multi-year follow-up study. This cross-sectional study included n = 44 patients with BAV (age = 44.9 ± 12 years), n = 17 patients with tricuspid aortic valve and thoracic aortic dilatation (TAV with dilation, age = 54.6 ± 16.5 years), and n = 9 healthy controls (age = 49.3 ± 14.7 years) underwent baseline and serial aortic 4D flow MRI (follow-up duration: BAV: 2.6 ± 0.7 years, TAV with dilation: 2.7 ± 0.5 years, controls: 1.1 ± 0.5 years). Data analysis included quantification of aortic dimensions, peak systolic velocities, as well as regional 3D WSS in the ascending aorta. At baseline, BAV patients demonstrated uniformly elevated peak velocity and WSS compared to TAV with dilation and control groups (peak velocity 2.2 m/s vs. 1.6 m/s vs. 1.5 m/s, p < 0.004; WSS: 0.74 Pa vs. 0.45 Pa vs. 0.55 Pa, p < 0.001). For BAV, peak velocity increased from baseline to follow up (2.2 ± 0.8 to 2.3 ± 0.9 m/s, p < 0.001) while WSS decreased (0.74 ± 0.22 to 0.65 ± 0.21 Pa, p < 0.001). Aortic growth was minimal for both BAV (0.05 cm/year) and TAV with dilation (0.03-0.04 cm/year) patients. For BAV patients, increase of ascending aorta peak velocities indicated worsening of valve function at follow-up. Compared to TAV with dilation patients, BAV patients demonstrated a reduction in WSS which may indicate a compensatory mechanism to reduce elevated WSS forces by aortic remodeling.
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Affiliation(s)
- Ozair Rahman
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael Scott
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kenichiro Suwa
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jeremy Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Fedak
- Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada.,Division of Surgery-Cardiac Surgery, Northwestern University, Chicago, IL, USA
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute and Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Chris Malaisrie
- Bluhm Cardiovascular Institute and Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA. .,Department of Radiology, Northwestern University, 737 N. Michigan Avenue Suite 1600, Chicago, IL, 60611, USA.
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