1
|
Schwitter J. Quantitative Myocardial Perfusion - and the Power of Numbers. Eur Heart J Cardiovasc Imaging 2024:jeae108. [PMID: 38651339 DOI: 10.1093/ehjci/jeae108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, University Hospital Lausanne, CHUV, Lausanne, Switzerland
- Director Cardiac MR Center and Interventional MR Center of the University Hospital Lausanne, CHUV, Lausanne, Switzerland
- Faculty of Biology & Medicine, Lausanne University, UniL, Lausanne, Switzerland
| |
Collapse
|
2
|
Bergamaschi L, Landi A, Maurizi N, Pizzi C, Leo LA, Arangalage D, Iglesias JF, Eeckhout E, Schwitter J, Valgimigli M, Pavon AG. Acute Response of the Noninfarcted Myocardium and Surrounding Tissue Assessed by T2 Mapping After STEMI. JACC Cardiovasc Imaging 2024:S1936-878X(23)00540-5. [PMID: 38276932 DOI: 10.1016/j.jcmg.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/02/2023] [Accepted: 11/30/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND ST-segment elevation myocardial infarction (STEMI) is associated with a systemic and local inflammatory response with edema. However, their role at the tissue level is poorly characterized. OBJECTIVES This study aims to characterize T2 values of the noninfarcted myocardium (NIM) and surrounding tissue and to investigate prognostic relevance of higher NIM T2 values after STEMI. METHODS A total of 171 consecutive patients with STEMI without prior cardiovascular events who underwent cardiac magnetic resonance after primary percutaneous coronary intervention were analyzed in terms of standard infarct characteristics. Edema of the NIM, liver, spleen, and pectoralis muscle was assessed based on T2 mapping. Follow-up was available for 130 patients. The primary endpoint was major adverse cardiac events (MACE), defined as cardiovascular death, myocardial infarction, unplanned coronary revascularization or rehospitalization for heart failure. The median time from primary percutaneous coronary intervention to cardiac magnetic resonance was 3 days (IQR: 2-5 days). RESULTS Higher (above the median value of 45 ms) T2 values in the NIM area were associated with larger infarct size, microvascular obstruction, and left ventricular dysfunction and did not correlate with C-reactive protein, white blood cells, or T2 values of the pectoralis muscle, liver, and spleen. At a median follow-up of 17 months, patients with higher (>45 ms) NIM T2 values had increased risk of MACE (P < 0.001) compared with subjects with NIM T2 values ≤45 ms, mainly caused by a higher rate of myocardial reinfarction (26.3% vs 1.4%; P < 0.001). At multivariable analysis, higher NIM T2 values independently predicted MACE (HR: 2.824 [95% CI: 1.254-6.361]; P = 0.012). CONCLUSIONS Higher NIM T2 values after STEMI are independently associated with worse cardiovascular outcomes, mainly because of higher risk of myocardial infarction.
Collapse
Affiliation(s)
- Luca Bergamaschi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Antonio Landi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Niccolò Maurizi
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland; Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Carmine Pizzi
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences-DIMEC-Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Laura Anna Leo
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Dimitri Arangalage
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Juan F Iglesias
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; University of Lausanne (Unil), Lausanne, Switzerland
| | - Juerg Schwitter
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland; Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; University of Lausanne (Unil), Lausanne, Switzerland
| | - Marco Valgimigli
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Anna Giulia Pavon
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland.
| |
Collapse
|
3
|
Salihu A, Meier D, Kilani N, Burdet O, Tzimas G, Antiochos P, Masi A, Teres C, Ascione C, Rosset S, Daux A, Domenichini G, Ladouceur M, Yerly P, Schwitter J, Monney P, Rutz T, Bouchardy J, Pruvot E, Muller O, Fournier S. [Cardiology: what's new in 2023]. Rev Med Suisse 2024; 20:19-24. [PMID: 38231094 DOI: 10.53738/revmed.2024.20.856-7.19] [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] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The year 2023 has been extremely rich in new publications in the various subfields of cardiology. Furthermore, the European Society of Cardiology (ESC) has issued revised guidelines focused on the management of acute coronary syndrome (ACS) and endocarditis, as well as an update on the recommendations for the management of heart failure and cardiovascular prevention. The most significant updates according to the Cardiology Department of CHUV are summarized in this review article.
Collapse
Affiliation(s)
- Adil Salihu
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - David Meier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Nadia Kilani
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Odile Burdet
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Georgios Tzimas
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Ambra Masi
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Cheryl Teres
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Ciro Ascione
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Sabina Rosset
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Aurélien Daux
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Magalie Ladouceur
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Patrick Yerly
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| |
Collapse
|
4
|
Pontone G, Guaricci AI, Fusini L, Baggiano A, Guglielmo M, Muscogiuri G, Volpe A, Abete R, Aquaro G, Barison A, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Dobrovie M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Lanzillo C, Lombardi M, Lorenzoni V, Lozano-Torres J, Martini C, Marzo F, Masi A, Memeo R, Moro C, Nese A, Palumbo A, Pavon AG, Pedrotti P, Marra MP, Pica S, Pradella S, Presicci C, Rabbat MG, Raineri C, Rodriguez-Palomares JF, Sbarbati S, Schoepf UJ, Squeri A, Sverzellati N, Symons R, Tat E, Timpani M, Todiere G, Valentini A, Varga-Szemes A, Masci PG, Schwitter J. Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE-ICM International Registry. JACC Cardiovasc Imaging 2023; 16:1387-1400. [PMID: 37227329 DOI: 10.1016/j.jcmg.2023.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 01/03/2023] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation. OBJECTIVES The DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy; NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM. METHODS A total of 861 patients with ICM (mean age 65 ± 11 years, 86% male) with chronic heart failure and TTE-LVEF <50% participated. Major adverse arrhythmic cardiac events (MAACE) were the primary endpoints. RESULTS During a median follow-up of 1,054 days, MAACE occurred in 88 (10.2%). Left ventricular end-diastolic volume index (HR: 1.007 [95% CI: 1.000-1.011]; P = 0.05), CMR-LVEF (HR: 0.972 [95% CI: 0.945-0.999]; P = 0.045) and late gadolinium enhancement (LGE) mass (HR: 1.010 [95% CI: 1.002-1.018]; P = 0.015) were independent predictors of MAACE. A multiparametric CMR weighted predictive derived score identifies subjects at high risk for MAACE compared with TTE-LVEF cutoff of 35% with a NRI of 31.7% (P = 0.007). CONCLUSIONS The DERIVATE-ICM registry is a large multicenter registry showing the additional value of CMR to stratify the risk for MAACE in a large cohort of patients with ICM compared with standard of care.
Collapse
Affiliation(s)
- Gianluca Pontone
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
| | - Andrea Igoren Guaricci
- University Cardiology Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Laura Fusini
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Andrea Baggiano
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | | | | | - Raffaele Abete
- Department of Cardiology, Policlinico di Monza, Monza, Italy
| | - Giovanni Aquaro
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Andrea Barison
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Jan Bogaert
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | | | - Samuela Carigi
- Department of Cardiology, Infermi Hospital, Rimini, Italy
| | - Nazario Carrabba
- Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy
| | - Grazia Casavecchia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Stefano Censi
- Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA), Italy
| | - Gloria Cicala
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Emory University, Atlanta, Georgia, USA
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Medical School, Padova, Italy
| | | | - Mauro Di Roma
- Radiology Department, Policlinico Casilino, Rome, Italy
| | - Monica Dobrovie
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Nicola Gaibazzi
- Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Annalaura Gismondi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Matteo Gravina
- Department of Radiology, University of Foggia, Foggia, Italy
| | | | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Jordi Lozano-Torres
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red-CV, CIBER CV, Spain
| | - Chiara Martini
- Department of Diagnostic, Parma University Hospital, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Ambra Masi
- De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Riccardo Memeo
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Claudio Moro
- Department of Cardiology, ASST Monza, P.O. Desio, Italy
| | - Alberto Nese
- Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy
| | - Alessandro Palumbo
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Anna Giulia Pavon
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Lausanne, Switzerland
| | - Patrizia Pedrotti
- De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Medical School, Padova, Italy
| | - Silvia Pica
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Cristina Presicci
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mark G Rabbat
- Loyola University of Chicago, Chicago, Illinois, USA; Edward Hines Jr VA Hospital, Hines, Illinois, USA
| | - Claudia Raineri
- Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - José F Rodriguez-Palomares
- Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red-CV, CIBER CV, Spain
| | | | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Angelo Squeri
- Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA), Italy
| | - Nicola Sverzellati
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rolf Symons
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Emily Tat
- Loyola University of Chicago, Chicago, Illinois, USA
| | - Mauro Timpani
- U.O.C. Radiologia, "F. Spaziani" Hospital, Frosinone, Italy
| | - Giancarlo Todiere
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Adele Valentini
- Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Pier-Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Juerg Schwitter
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Lausanne, Switzerland; Faculty of Medicine and Biology, University of Lausanne, UniL, Lausanne, Switzerland
| |
Collapse
|
5
|
Pavon AG, Martinez Fernandez R, Arangalage D, Bergamaschi L, Maurizi N, Colombier S, Rotman S, Nowacka A, Bouchardy J, Schwitter J, Kirsch M, Monney P, Rutz T. Prevalence of Pericardial Late Gadolinium Enhancement in Patients After Cardiac Surgery: Clinical and Histological Correlations. Circ Cardiovasc Imaging 2023; 16:e015606. [PMID: 37988447 DOI: 10.1161/circimaging.123.015606] [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: 04/21/2023] [Accepted: 09/07/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Pericardial late gadolinium enhancement (LGE) is usually associated with active pericarditis, but it is not infrequently found in patients after cardiac surgery even a long time after the intervention. The clinical relevance of this finding and its histological correlates are unknown. We sought to determine the prevalence of chronic pericardial LGE in patients after cardiac surgery. METHODS All consecutive patients with previous cardiac surgery, who were referred to cardiovascular magnetic resonance between January 2017 and December 2021 were enrolled in the study. Cardiovascular magnetic resonance examination protocol was adapted to clinical indication but always included standard LGE acquisitions. Two independent observers blinded to clinical data assessed the presence of pericardial enhancement on LGE sequences. Fifteen patients underwent cardiac reintervention and pericardial biopsies were obtained. The primary study end point was to assess the prevalence of pericardial enhancement after cardiac surgery and identify possible determinants. The secondary end point was to correlate pericardial enhancement with clinical symptoms and histopathology. RESULTS Two hundred four patients were included in the study. The median time between surgery and cardiovascular magnetic resonance was 160 months (35-226 months). Pericardial LGE was observed in 90 patients (44%). All patients were asymptomatic, and no specific treatment for pericarditis was started. All patients remained asymptomatic at a 1-year clinical follow-up. Pericardial LGE was significantly correlated with the number of previous surgeries (P=0.03). Pericardial fibrosis was detected in all 15 pericardial biopsy specimens; pericardial LGE was present in 7 patients (47%) who underwent biopsy. Histological signs of low-grade inflammation were detected in 6 patients (40%) with severe, circumferential pericardial LGE but in no patient without pericardial enhancement. CONCLUSIONS Pericardial LGE is a frequent finding even several years after cardiac surgery. Its histological correlate is a chronic subclinical post-pericardiotomy inflammation.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University hospital, Switzerland (A.G.P., D.A., J.S., P.M., T.R.)
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland (A.G.P., L.B.)
| | | | - Dimitri Arangalage
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University hospital, Switzerland (A.G.P., D.A., J.S., P.M., T.R.)
| | - Luca Bergamaschi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland (A.G.P., L.B.)
| | - Niccolò Maurizi
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
| | - Sebastien Colombier
- Department of Cardiac Surgery, Lausanne University Hospital (CHUV), Switzerland (S.C., A.N., M.K.)
- Department of Cardiac Surgery, Hôpital du Valais (HVS), Sion, Switzerland (S.C.)
| | - Samuel Rotman
- Service of Clinical Pathology, Lausanne University Hospital (CHUV) and University of Lausanne, Switzerland (S.R.)
| | - Anna Nowacka
- Department of Cardiac Surgery, Lausanne University Hospital (CHUV), Switzerland (S.C., A.N., M.K.)
| | - Judith Bouchardy
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
| | - Juerg Schwitter
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University hospital, Switzerland (A.G.P., D.A., J.S., P.M., T.R.)
- University of Lausanne (Unil), Switzerland (R.M.F., J.S., P.M., T.R.)
| | - Matthias Kirsch
- Department of Cardiac Surgery, Lausanne University Hospital (CHUV), Switzerland (S.C., A.N., M.K.)
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University hospital, Switzerland (A.G.P., D.A., J.S., P.M., T.R.)
- University of Lausanne (Unil), Switzerland (R.M.F., J.S., P.M., T.R.)
| | - Tobias Rutz
- Department of Cardiology, Lausanne University Hospital (CHUV), Switzerland (A.G.P., D.A., N.M., J.B., J.S., P.M., T.R.)
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University hospital, Switzerland (A.G.P., D.A., J.S., P.M., T.R.)
- University of Lausanne (Unil), Switzerland (R.M.F., J.S., P.M., T.R.)
| |
Collapse
|
6
|
Barison A, Ricci F, Pavon AG, Muscogiuri G, Bisaccia G, Camastra G, De Lazzari M, Lanzillo C, Raguso M, Monti L, Vargiu S, Pedrotti P, Piacenti M, Todiere G, Pontone G, Indolfi C, Dellegrottaglie S, Lombardi M, Schwitter J, Aquaro GD. Cardiovascular Magnetic Resonance in Patients with Cardiac Electronic Devices: Evidence from a Multicenter Study. J Clin Med 2023; 12:6673. [PMID: 37892813 PMCID: PMC10607654 DOI: 10.3390/jcm12206673] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Most recent cardiac implantable electronic devices (CIEDs) can safely undergo a cardiovascular magnetic resonance (CMR) scan under certain conditions, but metal artifacts may degrade image quality. The aim of this study was to assess the overall diagnostic yield of CMR and the extent of metal artifacts in a multicenter, multivendor study on CIED patients referred for CMR. METHODS We analyzed 309 CMR scans from 292 patients (age 57 ± 16 years, 219 male) with an MR-conditional pacemaker (n = 122), defibrillator (n = 149), or loop recorder (n = 38); CMR scans were performed in 10 centers from 2012 to 2020; MR-unsafe implants were excluded. Clinical and device parameters were recorded before and after the CMR scan. A visual analysis of metal artifacts was performed for each sequence on a segmental basis, based on a 5-point artifact score. RESULTS The vast majority of CMR scans (n = 255, 83%) were completely performed, while only 32 (10%) were interrupted soon after the first sequences and 22 (7%) were only partly acquired; CMR quality was non-diagnostic in 34 (11%) scans, poor (<1/3 sequences were diagnostic) in 25 (8%), or acceptable (1/3 to 2/3 sequences were diagnostic) in 40 (13%), while most scans (n = 201, 68%) were of overall good quality. No adverse event or device malfunctioning occurred, and only nonsignificant changes in device parameters were recorded. The most affected sequences were SSFP (median score 0.32 [interquartile range 0.07-0.91]), followed by GRE (0.18 [0.02-0.59]) and LGE (0.14 [0.02-0.55]). ICDs induced more artifacts (median score in SSFP images 0.87 [0.50-1.46]) than PMs (0.11 [0.03-0.28]) or ILRs (0.11 [0.00-0.56]). Moreover, most artifacts were located in the anterior, anteroseptal, anterolateral, and apical segments of the LV and in the outflow tract of the RV. CONCLUSIONS CMR is a versatile imaging technique, with a high safety profile and overall good image quality even in patients with MR-conditional CIEDs. Several strategies are now available to optimize image quality, substantially enhancing overall diagnostic yield.
Collapse
Affiliation(s)
- Andrea Barison
- Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
- Life Science Institute, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
| | - Anna Giulia Pavon
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
| | - Giuseppe Muscogiuri
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Giandomenico Bisaccia
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Manuel De Lazzari
- Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, 35122 Padova, Italy
| | | | - Mario Raguso
- Ospedale Policlinico Casilino, 00169 Roma, Italy
| | - Lorenzo Monti
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Sara Vargiu
- Cardiologia 3, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Patrizia Pedrotti
- Cardiac Magnetic Resonance Laboratory, Cardiologia 4, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | | | | | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Ciro Indolfi
- Division of Cardiology, Magna Graecia University, 88100 Catanzaro, Italy
- Center for Cardiovascular Research, Magna Graecia University, 88100 Catanzaro, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Santo Dellegrottaglie
- Advanced Cardiovascular Imaging Unit, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, 80011 Acerra, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, University Hospital Lausanne—CHUV, 1011 Lausanne, Switzerland
- CMR Center, University Hospital Lausanne—CHUV, 1011 Lausanne, Switzerland
- Faculty of Biology & Medicine, University of Lausanne—UniL, 1015 Lausanne, Switzerland
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | | | | |
Collapse
|
7
|
van Heeswijk RB, Bauer WR, Bönner F, Janjic JM, Mulder WJM, Schreiber LM, Schwitter J, Flögel U. Cardiovascular Molecular Imaging With Fluorine-19 MRI: The Road to the Clinic. Circ Cardiovasc Imaging 2023; 16:e014742. [PMID: 37725674 DOI: 10.1161/circimaging.123.014742] [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] [Indexed: 09/21/2023]
Abstract
Fluorine-19 (19F) magnetic resonance imaging is a unique quantitative molecular imaging modality that makes use of an injectable fluorine-containing tracer that generates the only visible 19F signal in the body. This hot spot imaging technique has recently been used to characterize a wide array of cardiovascular diseases and seen a broad range of technical improvements. Concurrently, its potential to be translated to the clinical setting is being explored. This review provides an overview of this emerging field and demonstrates its diagnostic potential, which shows promise for clinical translation. We will describe 19F magnetic resonance imaging hardware, pulse sequences, and tracers, followed by an overview of cardiovascular applications. Finally, the challenges on the road to clinical translation are discussed.
Collapse
Affiliation(s)
- Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Switzerland (R.B.v.H.)
| | - Wolfgang R Bauer
- Department of Internal Medicine I, Universitätsklinikum Würzburg, Germany (W.R.B.)
| | - Florian Bönner
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of Heinrich Heine University, University Hospital Düsseldorf, Germany (F.B.)
| | - Jelena M Janjic
- Graduate School of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA (J.M.J.)
| | - Willem J M Mulder
- Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology, the Netherlands (W.J.M.M.)
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands (W.J.M.M.)
| | - Laura M Schreiber
- Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center (CHFC), Wuerzburg University Hospitals, Germany (L.M.S.)
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department (J.S.), Lausanne University Hospital (CHUV), Switzerland
- CMR Center (J.S.), Lausanne University Hospital (CHUV), Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Switzerland (J.S.)
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging (U.F.), Heinrich Heine University, Germany
- Cardiovascular Research Institute Düsseldorf (CARID) (U.F.), Heinrich Heine University, Germany
| |
Collapse
|
8
|
Greutmann M, Tobler D, Engel R, Heg D, Mueller C, Frenk A, Gabriel H, Rutz T, Buechel RR, Willhelm M, Trachsel L, Freese M, Ruperti-Repilado FJ, Valsangiacomo Buechel E, Beitzke D, Haaf P, Wustmann K, Schwitz F, Possner M, Schwitter J, Bouchardy J, Schwerzmann M. Effect of phosphodiesterase-5 inhibition on SystEmic Right VEntricular size and function. A multicentre, double-blind, randomized, placebo-controlled trial: SERVE. Eur J Heart Fail 2023; 25:1105-1114. [PMID: 37264734 DOI: 10.1002/ejhf.2924] [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: 01/28/2023] [Revised: 04/11/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023] Open
Abstract
AIMS In adults with congenital heart disease and systemic right ventricles, progressive right ventricular systolic dysfunction is common and is associated with adverse outcomes. Our aim was to assess the impact of the phosphodiesterase-5-inhibitor tadalafil on right ventricular systolic function. METHODS AND RESULTS This was a double-blind, randomized, placebo-controlled, multicentre superiority trial (NCT03049540) involving 100 adults with systemic right ventricles (33 women, mean age: 40.7 ± 10.7 years), comparing tadalafil 20 mg once daily versus placebo (1:1 ratio). The primary endpoint was the change in right ventricular end-systolic volume after 3 years of therapy. Secondary endpoints were changes in right ventricular ejection fraction, exercise capacity and N-terminal pro-B-type natriuretic peptide concentration. Primary endpoint assessment by intention to treat analysis at 3 years of follow-up was possible in 83 patients (42 patients in the tadalafil group and 41 patients in the placebo group). No significant changes over time in right ventricular end-systolic volumes were observed in the tadalafil and the placebo group, and no significant differences between treatment groups (3.4 ml, 95% confidence interval -4.3 to 11.0, p = 0.39). No significant changes over time were observed for the pre-specified secondary endpoints for the entire study population, without differences between the tadalafil and the placebo group. CONCLUSIONS In this trial in adults with systemic right ventricles, right ventricular systolic function, exercise capacity and neuro-hormonal activation remained stable over a 3-year follow-up period. No significant treatment effect of tadalafil was observed. Further research is needed to find effective treatment for improvement of ventricular function in adults with systemic right ventricles.
Collapse
Affiliation(s)
- Matthias Greutmann
- University Heart Center, Department of cardiology, University of Zurich, Zürich, Switzerland
| | - Daniel Tobler
- Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Reto Engel
- Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dik Heg
- CTU Bern, University of Bern, Bern, Switzerland
| | - Christian Mueller
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - André Frenk
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Harald Gabriel
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Tobias Rutz
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Willhelm
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Trachsel
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Michael Freese
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | | | | | - Dietrich Beitzke
- Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Philip Haaf
- Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Kerstin Wustmann
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
| | - Fabienne Schwitz
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Possner
- University Heart Center, Department of cardiology, University of Zurich, Zürich, Switzerland
| | - Juerg Schwitter
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, Lausanne University (UniL), Lausanne, Switzerland
| | - Judith Bouchardy
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Division of Cardiology, Hôpitaux Universitaires de Genève (HUG), Genève, Switzerland
| | - Markus Schwerzmann
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| |
Collapse
|
9
|
Salihu A, Stadelmann R, Solimando E, Schwitter J. Eosinophilic myocarditis during treatment of acute myeloid leukaemia: cardiac magnetic resonance in the very early phase mimicking triple-vessel coronary artery disease: a case report. Eur Heart J Case Rep 2023; 7:ytad185. [PMID: 37123659 PMCID: PMC10141456 DOI: 10.1093/ehjcr/ytad185] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
Background Chemotherapy of acute myeloid leukaemia (AML) can cause a broad spectrum of cardiotoxic effects. Cardiac magnetic resonance (CMR) is key for the diagnosis of eosinophilic myocarditis (EM) defined by the presence of sub-endocardial necrosis and fibrosis. This case report describes the picture of severe triple-vessel ischaemia due to infiltration of eosinophilia without atherosclerotic coronary artery disease (CAD). Case summary A 57-year-old woman was diagnosed with AML requiring chemotherapy. Three days after initiation of chemotherapy, the patient presented with chest pain and new left ventricular (LV) dysfunction and hyper-eosinophilia. A CMR examination initially was compatible with severe triple-vessel ischaemia. Tissue characterization by CMR was not done due to severe dyspnoea promoting the differential diagnosis of triple-vessel CAD or chemotherapy-induced triple-vessel coronary spasm. However, invasive coronary angiography excluded obstructive CAD. Severe LV dysfunction and troponin elevation persisted arguing against coronary vasospasm. Chemotherapy induced a massive increase in blood eosinophils, and EM was considered as most likely diagnosis. Immunosuppressive treatment improved the patient's status and a CMR later on confirmed the diagnosis of EM. Discussion Chemotherapy-induced massive eosinophilia can cause widespread coronary micro-vascular infiltration mimicking severe triple-vessel CAD. Early CMR did not evaluate tissue composition, and EM was not considered which delayed adequate treatment. A complete CMR assessment is key to establish the correct diagnosis.
Collapse
Affiliation(s)
- Adil Salihu
- Corresponding author. Tel: +41 79 556 30 32,
| | - Raphael Stadelmann
- Faculty of Biology and Medicine, Lausanne University, UNIL, Quartier Centre, 1015 Lausanne, Switzerland
- Department of Hematology, CHUV, Rue du bugnon 46, 1011 Lausanne, Switzerland
| | - Emilie Solimando
- Department of internal Medicine, CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, Lausanne University, UNIL, Quartier Centre, 1015 Lausanne, Switzerland
| | | |
Collapse
|
10
|
Ghanbari F, Joyce T, Lorenzoni V, Guaricci AI, Pavon AG, Fusini L, Andreini D, Rabbat MG, Aquaro GD, Abete R, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Lanzillo C, Lombardi M, Lozano-Torres J, Masi A, Moro C, Muscogiuri G, Nese A, Pradella S, Sbarbati S, Schoepf UJ, Valentini A, Crelier G, Masci PG, Pontone G, Kozerke S, Schwitter J. AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry. Radiology 2023; 307:e222239. [PMID: 36943075 DOI: 10.1148/radiol.222239] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background Scar burden with late gadolinium enhancement (LGE) cardiac MRI (CMR) predicts arrhythmic events in patients with postinfarction in single-center studies. However, LGE analysis requires experienced human observers, is time consuming, and introduces variability. Purpose To test whether postinfarct scar with LGE CMR can be quantified fully automatically by machines and to compare the ability of LGE CMR scar analyzed by humans and machines to predict arrhythmic events. Materials and Methods This study is a retrospective analysis of the multicenter, multivendor CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry. Patients with chronic heart failure, echocardiographic left ventricular ejection fraction (LVEF) of less than 50%, and LGE CMR were recruited (from January 2015 through December 2020). In the current study, only patients with ischemic cardiomyopathy were included. Quantification of total, dense, and nondense scars was carried out by two experienced readers or a Ternaus network, trained and tested with LGE images of 515 and 246 patients, respectively. Univariable and multivariable Cox analyses were used to assess patient and cardiac characteristics associated with a major adverse cardiac event (MACE). Area under the receiver operating characteristic curve (AUC) was used to compare model performances. Results In 761 patients (mean age, 65 years ± 11, 671 men), 83 MACEs occurred. With use of the testing group, univariable Cox-analysis found New York Heart Association class, left ventricle volume and/or function parameters (by echocardiography or CMR), guideline criterion (LVEF of ≤35% and New York Heart Association class II or III), and LGE scar analyzed by humans or the machine-learning algorithm as predictors of MACE. Machine-based dense or total scar conferred incremental value over the guideline criterion for the association with MACE (AUC: 0.68 vs 0.63, P = .02 and AUC: 0.67 vs 0.63, P = .01, respectively). Modeling with competing risks yielded for dense and total scar (AUC: 0.67 vs 0.61, P = .01 and AUC: 0.66 vs 0.61, P = .005, respectively). Conclusion In this analysis of the multicenter CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry, fully automatic machine learning-based late gadolinium enhancement analysis reliably quantifies myocardial scar mass and improves the current prediction model that uses guideline-based risk criteria for implantable cardioverter defibrillator implantation. ClinicalTrials.gov registration no.: NCT03352648 Published under a CC BY 4.0 license. Supplemental material is available for this article.
Collapse
Affiliation(s)
- Fahime Ghanbari
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Thomas Joyce
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Valentina Lorenzoni
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Andrea I Guaricci
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Anna-Giulia Pavon
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Laura Fusini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Daniele Andreini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Mark G Rabbat
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giovanni Donato Aquaro
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Raffaele Abete
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Jan Bogaert
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giovanni Camastra
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Samuela Carigi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Nazario Carrabba
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Grazia Casavecchia
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Stefano Censi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gloria Cicala
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Carlo N De Cecco
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Manuel De Lazzari
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gabriella Di Giovine
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Mauro Di Roma
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Marta Focardi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Nicola Gaibazzi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Annalaura Gismondi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Matteo Gravina
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Chiara Lanzillo
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Massimo Lombardi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Jordi Lozano-Torres
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Ambra Masi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Claudio Moro
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giuseppe Muscogiuri
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Alberto Nese
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Silvia Pradella
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Stefano Sbarbati
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - U Joseph Schoepf
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Adele Valentini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gérard Crelier
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Pier Giorgio Masci
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gianluca Pontone
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Sebastian Kozerke
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Juerg Schwitter
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| |
Collapse
|
11
|
Figliozzi S, Georgiopoulos G, Lopes PM, Bauer KB, Moura-Ferreira S, Tondi L, Mushtaq S, Censi S, Pavon AG, Bassi I, Servato ML, Teske AJ, Biondi F, Filomena D, Pica S, Torlasco C, Muraru D, Monney P, Quattrocchi G, Maestrini V, Agati L, Monti L, Pedrotti P, Vandenberk B, Squeri A, Lombardi M, Ferreira AM, Schwitter J, Aquaro GD, Chiribiri A, Rodríguez Palomares JF, Yilmaz A, Andreini D, Florian A, Leiner T, Abecasis J, Badano LP, Bogaert J, Masci PG. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse. Radiology 2023; 306:112-121. [PMID: 36098639 DOI: 10.1148/radiol.220454] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gerber in this issue.
Collapse
Affiliation(s)
- Stefano Figliozzi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Georgios Georgiopoulos
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pedro M Lopes
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Klemens B Bauer
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Sara Moura-Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lara Tondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Saima Mushtaq
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Stefano Censi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anna Giulia Pavon
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ilaria Bassi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Maria Luz Servato
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Arco J Teske
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Federico Biondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Domenico Filomena
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Silvia Pica
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Camilla Torlasco
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Denisa Muraru
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pierre Monney
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giuseppina Quattrocchi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Viviana Maestrini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luciano Agati
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lorenzo Monti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Patrizia Pedrotti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Bert Vandenberk
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Angelo Squeri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Massimo Lombardi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - António M Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Juerg Schwitter
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giovanni Donato Aquaro
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Amedeo Chiribiri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - José F Rodríguez Palomares
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ali Yilmaz
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Daniele Andreini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anca Florian
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Tim Leiner
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - João Abecasis
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luigi Paolo Badano
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Jan Bogaert
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pier-Giorgio Masci
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| |
Collapse
|
12
|
Schwitter J. Getting Deeper Insight by Hyperpolarization: The Multilevel Assessment of Myocardial Infarction by Adding Hyperpolarized 13C-Carbon-CMR. JACC Cardiovasc Imaging 2022; 15:2065-2068. [PMID: 36481074 DOI: 10.1016/j.jcmg.2022.09.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, University Hospital Lausanne, Lausanne, Switzerland, and the Faculty of Biology and Medicine, University of Lausanne, UniL, Switzerland.
| |
Collapse
|
13
|
Mavrogeni S, Pepe A, Nijveldt R, Ntusi N, Sierra-Galan LM, Bratis K, Wei J, Mukherjee M, Markousis-Mavrogenis G, Gargani L, Sade LE, Ajmone-Marsan N, Seferovic P, Donal E, Nurmohamed M, Cerinic MM, Sfikakis P, Kitas G, Schwitter J, Lima JAC, Dawson D, Dweck M, Haugaa KH, Keenan N, Moon J, Stankovic I, Donal E, Cosyns B. Cardiovascular magnetic resonance in autoimmune rheumatic diseases: a clinical consensus document by the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2022; 23:e308-e322. [PMID: 35808990 DOI: 10.1093/ehjci/jeac134] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/12/2022] Open
Abstract
Autoimmune rheumatic diseases (ARDs) involve multiple organs including the heart and vasculature. Despite novel treatments, patients with ARDs still experience a reduced life expectancy, partly caused by the higher prevalence of cardiovascular disease (CVD). This includes CV inflammation, rhythm disturbances, perfusion abnormalities (ischaemia/infarction), dysregulation of vasoreactivity, myocardial fibrosis, coagulation abnormalities, pulmonary hypertension, valvular disease, and side-effects of immunomodulatory therapy. Currently, the evaluation of CV involvement in patients with ARDs is based on the assessment of cardiac symptoms, coupled with electrocardiography, blood testing, and echocardiography. However, CVD may not become overt until late in the course of the disease, thus potentially limiting the therapeutic window for intervention. More recently, cardiovascular magnetic resonance (CMR) has allowed for the early identification of pathophysiologic structural/functional alterations that take place before the onset of clinically overt CVD. CMR allows for detailed evaluation of biventricular function together with tissue characterization of vessels/myocardium in the same examination, yielding a reliable assessment of disease activity that might not be mirrored by blood biomarkers and other imaging modalities. Therefore, CMR provides diagnostic information that enables timely clinical decision-making and facilitates the tailoring of treatment to individual patients. Here we review the role of CMR in the early and accurate diagnosis of CVD in patients with ARDs compared with other non-invasive imaging modalities. Furthermore, we present a consensus-based decision algorithm for when a CMR study could be considered in patients with ARDs, together with a standardized study protocol. Lastly, we discuss the clinical implications of findings from a CMR examination.
Collapse
Affiliation(s)
- S Mavrogeni
- Onassis Cardiac Surgery Center, Leof. Andrea Siggrou 356, Kallithea 176 74, Greece.,Exercise Physiology and Sport Medicine Clinic, Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 115 27 Athens, Greece
| | - A Pepe
- Institute of Radiology, Department of Medicine, University of Padua, 35122 Padua, Italy
| | - R Nijveldt
- Department of Cardiology, Radboud University Medical Center, 6525 GA, Nijmegen, the Netherlands
| | - N Ntusi
- University of Cape Town & Groote Schuur Hospital, City of Cape Town, 7700 Western Cape, South Africa
| | - L M Sierra-Galan
- Department of Cardiology, American British Cowdray Medical Center, 05330 Mexico City, Mexico
| | - K Bratis
- Department of Cardiology, Manchester Royal Infirmary, Manchester M13 9WL, UK
| | - J Wei
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA 90048, USA.,Preventive and Rehabilitative Cardiac Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA 90048, USA
| | - M Mukherjee
- Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | | | - L Gargani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - L E Sade
- University of Pittsburgh, University of Pittsburgh Medical Center, Heart and Vascular Institute, Pittsburgh, PA 15260, USA.,Department of Cardiology, Baskent University, 06790 Ankara, Turkey
| | - N Ajmone-Marsan
- Department of Cardiology, Leiden University Medical Center, 2311 EZ Leiden, the Netherlands
| | - P Seferovic
- Department of Cardiology, Belgrade University, 11000 Belgrade, Serbia
| | - E Donal
- Université RENNES-1, CHU, 35000 Rennes, France
| | - M Nurmohamed
- Amsterdam Rheumatology Immunology Center, Amsterdam University Medical Centers, 1105 AZ, Amsterdam, the Netherlands
| | - M Matucci Cerinic
- Experimental and Clinical Medicine, Division of Internal Medicine and Rheumatology, Azienda Ospedaliera Universitaria Careggi, University of Florence, 50121 Florence, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS, San Raffaele Hospital, 20132 Milan, Italy
| | - P Sfikakis
- First Department of Propeudeutic and Internal medicine, Laikon Hospital, Athens University Medical School, 115 27 Athens, Greece
| | - G Kitas
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PL, UK
| | - J Schwitter
- Lausanne University Hospital, CHUV, CH-1011 Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, 1015 UniL, Switzerland.,Director CMR Center of the University Hospital Lausanne, CHUV, CH-1011 Lausanne, Switzerland
| | - J A C Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Ogier AC, Bustin A, Cochet H, Schwitter J, van Heeswijk RB. The Road Toward Reproducibility of Parametric Mapping of the Heart: A Technical Review. Front Cardiovasc Med 2022; 9:876475. [PMID: 35600490 PMCID: PMC9120534 DOI: 10.3389/fcvm.2022.876475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
Parametric mapping of the heart has become an essential part of many cardiovascular magnetic resonance imaging exams, and is used for tissue characterization and diagnosis in a broad range of cardiovascular diseases. These pulse sequences are used to quantify the myocardial T1, T2, T2*, and T1ρ relaxation times, which are unique surrogate indices of fibrosis, edema and iron deposition that can be used to monitor a disease over time or to compare patients to one another. Parametric mapping is now well-accepted in the clinical setting, but its wider dissemination is hindered by limited inter-center reproducibility and relatively long acquisition times. Recently, several new parametric mapping techniques have appeared that address both of these problems, but substantial hurdles remain for widespread clinical adoption. This review serves both as a primer for newcomers to the field of parametric mapping and as a technical update for those already well at home in it. It aims to establish what is currently needed to improve the reproducibility of parametric mapping of the heart. To this end, we first give an overview of the metrics by which a mapping technique can be assessed, such as bias and variability, as well as the basic physics behind the relaxation times themselves and what their relevance is in the prospect of myocardial tissue characterization. This is followed by a summary of routine mapping techniques and their variations. The problems in reproducibility and the sources of bias and variability of these techniques are reviewed. Subsequently, novel fast, whole-heart, and multi-parametric techniques and their merits are treated in the light of their reproducibility. This includes state of the art segmentation techniques applied to parametric maps, and how artificial intelligence is being harnessed to solve this long-standing conundrum. We finish up by sketching an outlook on the road toward inter-center reproducibility, and what to expect in the future.
Collapse
Affiliation(s)
- Augustin C. Ogier
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Aurelien Bustin
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Juerg Schwitter
- Cardiac MR Center, Cardiology Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- *Correspondence: Ruud B. van Heeswijk
| |
Collapse
|
15
|
Sharrack N, Chiribiri A, Schwitter J, Plein S. How to do quantitative myocardial perfusion cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging 2022; 23:315-318. [PMID: 34587625 PMCID: PMC8863076 DOI: 10.1093/ehjci/jeab193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/10/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Noor Sharrack
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, University Hospital Lausanne, Rue de Bugnon 46, CH-1011 Lausanne, Switzerland
- Cardiac MR Center, University Hospital Lausanne, Rue de Bugnon 46, CH-1011 Lausanne, Switzerland
- University of Lausanne, UniL, Faculty of Biology and Medicine, Rue du Bugnon 21, Lausanne, Switzerland
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| |
Collapse
|
16
|
Pavon AG, Masci PG, Pucci L, Landi A, Bermano A, Vaxman A, Gotsman C, Rutz T, Monney P, Godihno R, Saraiva Rodrigues D, Muller O, Valgimigli M, Schwitter J. Left atrial adaptation in ischemic heart disease: insights from a cardiovascular magnetic resonance study. Int J Cardiovasc Imaging 2022; 38:10.1007/s10554-022-02536-9. [PMID: 35174427 DOI: 10.1007/s10554-022-02536-9] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
Left atrium (LA) plays a key role in the overall cardiac performance. However, it remains unclear how LA adapts, in terms of function and volumes, to left ventricular dysfunction in the acute and post-acute phases of myocardial infarction. LA volumes and function were evaluated in patients in the acute phase of ST-segment elevation myocardial infarction (acute-STEMI group) and in the post-acute phase after STEMI (post-acute STEMI group). Ten age and sex-matched healthy controls served as control group. In all subjects LA was assessed by a compressed-sensing cine pulse sequence and by a 3D non-model-based reconstruction. LV infarct size and microvascular obstruction were determined on late-gadolinium-enhancement data and LV myocardial oedema and myocardial haemorrhage were measured on T2-mapping data. Indexed LA maximum and minimum volumes did not differ between the acute (n = 50) and post-acute (n = 47) STEMI groups. LA active emptying fraction (LAAEF) was higher in the acute-STEMI as compared with the post-acute STEMI groups (0.63 ± 0.23 vs 0.37 ± 0.24, p < 0.0001). Conversely, LA passive emptying fraction (LAPEF) was lower in the acute-STEMI compared with post-acute-STEMI (0.34 ± 0.15 vs 0.65 ± 0.15, p < 0.0001) patients. In the acute-STEMI group, LAAEF was positively and LAPEF negatively correlated with LV myocardial tissue damage (r = 0.523 p = 0.0001; r = - 0.451 p = 0.0013). Negative and positive correlations were also found between LAAEF and LAPEF and time after STEMI (r = - 0.559 p = 0.0013 and r = 0.589 p = 0.0006, respectively). LA increases its active contractile function in the acute phase of STEMI to support LV filling. The extent (but not the type) of LV damage determines LA adaptions which normalizes over time.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland.
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland.
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland.
| | - Pier Giorgio Masci
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- School of Bioengineer and Medical Sciences, Life Sciences, King's College London, London, UK
| | - Lorenzo Pucci
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Antonio Landi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland
| | - Amit Bermano
- The Blavatnik School of Computer Science, Tel-Aviv University, Tel Aviv, Israel
| | - Amir Vaxman
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Craig Gotsman
- Ying Wu College of Computing, New-Jersey Institute of Technology, Newark, USA
| | - Tobias Rutz
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Pierre Monney
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Rita Godihno
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
| | - David Saraiva Rodrigues
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Olivier Muller
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Marco Valgimigli
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland
| | - Juerg Schwitter
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| |
Collapse
|
17
|
Lu H, Roux O, Fournier S, Aur S, Hullin R, Antiochos P, Pucci L, Monney P, Schwitter J, Le Bloa M, Domenichini G, Pascale P, Pruvot E, Mahendiran T, Bouchardy J, Rutz T, Duchini M, Muller O. [Cardiology]. Rev Med Suisse 2022; 18:144-151. [PMID: 35107886 DOI: 10.53738/revmed.2022.18.767.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Significant advances have been made in 2021 in the areas of interventional cardiology, heart failure, cardiac imaging, electrophysiology and congenital heart disease. In addition to improving the screening, diagnosis and management of many heart diseases, these advances will change our daily practice. Moreover, the European Society of Cardiology has updated its guidelines on heart failure, valve disease, cardiac pacing and cardiovascular disease prevention. As in previous years, members of the Cardiology division of Lausanne University Hospital (CHUV) came together to select and present to you the papers that they considered to be the most important of the past year.
Collapse
Affiliation(s)
- Henri Lu
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Roux
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stefania Aur
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Roger Hullin
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Lorenzo Pucci
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Thabo Mahendiran
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mattia Duchini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| |
Collapse
|
18
|
Pavon AG, Porretta AP, Arangalage D, Domenichini G, Rutz T, Hugelshofer S, Pruvot E, Monney P, Pascale P, Schwitter J. Feasibility of adenosine stress cardiovascular magnetic resonance perfusion imaging in patients with MR-conditional transvenous permanent pacemakers and defibrillators. J Cardiovasc Magn Reson 2022; 24:9. [PMID: 35022037 PMCID: PMC8756706 DOI: 10.1186/s12968-021-00842-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of stress perfusion-cardiovascular magnetic resonance (CMR) imaging remains limited in patients with implantable devices. The primary goal of the study was to assess the safety, image quality, and the diagnostic value of stress perfusion-CMR in patients with MR-conditional transvenous permanent pacemakers (PPM) or implantable cardioverter-defibrillators (ICD). METHODS Consecutive patients with a transvenous PPM or ICD referred for adenosine stress-CMR were enrolled in this single-center longitudinal study. The CMR protocol was performed using a 1.5 T system according to current guidelines while all devices were put in MR-mode. Quality of cine, late-gadolinium-enhancement (LGE), and stress perfusion sequences were assessed. An ischemia burden of ≥ 1.5 segments was considered significant. We assessed the safety, image quality and the occurrence of interference of the magnetic field with the implantable device. In case of ischemia, we also assessed the correlation with the presence of significant coronary lesions on coronary angiography. RESULTS Among 3743 perfusion-CMR examinations, 66 patients had implantable devices (1.7%). Image quality proved diagnostic in 98% of cases. No device damage or malfunction was reported immediately and at 1 year. Fifty patients were continuously paced during CMR. Heart rate and systolic blood pressure remained unchanged during adenosine stress, while diastolic blood pressure decreased (p = 0.007). Six patients (9%) had an ischemia-positive stress CMR and significant coronary stenoses were confirmed by coronary angiography in all cases. CONCLUSION Stress perfusion-CMR is safe, allows reliable ischemia detection, and provides good diagnostic value.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland
| | - Alessandra Pia Porretta
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Dimitri Arangalage
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiology Department, AP-HP, Bichat Hospital and Université de Paris, Paris, France
| | - Giulia Domenichini
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Tobias Rutz
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac Magnetic Resonance Center of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UniL), Lausanne, Switzerland
| | - Sarah Hugelshofer
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac Magnetic Resonance Center of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
| | - Etienne Pruvot
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UniL), Lausanne, Switzerland
| | - Pierre Monney
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac Magnetic Resonance Center of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UniL), Lausanne, Switzerland
| | - Patrizio Pascale
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UniL), Lausanne, Switzerland
| | - Juerg Schwitter
- Cardiovascular Department, Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac Magnetic Resonance Center of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UniL), Lausanne, Switzerland
| |
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Yoshihara HAI, Comment A, Schwitter J. Assessment of Aspartate and Bicarbonate Produced From Hyperpolarized [1- 13C]Pyruvate as Markers of Renal Gluconeogenesis. Front Physiol 2021; 12:792769. [PMID: 34955898 PMCID: PMC8702956 DOI: 10.3389/fphys.2021.792769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
As both a consumer and producer of glucose, the kidney plays a significant role in glucose homeostasis. Measuring renal gluconeogenesis requires invasive techniques, and less invasive methods would allow renal gluconeogenesis to be measured more routinely. Magnetic resonance spectroscopy and imaging of infused substrates bearing hyperpolarized carbon-13 spin labels allows metabolism to be detected within the body with excellent sensitivity. Conversion of hyperpolarized 1-13C pyruvate in the fasted rat liver is associated with gluconeogenic flux through phosphoenolpyruvate carboxykinase (PEPCK) rather than pyruvate dehydrogenase (PDH), and this study tested whether this was also the case in the kidney. The left kidney was scanned in fed and overnight-fasted rats either with or without prior treatment by the PEPCK inhibitor 3-mercaptopicolinic acid (3-MPA) following infusion of hyperpolarized 1-13C pyruvate. The 13C-bicarbonate signal normalized to the total metabolite signal was 3.2-fold lower in fasted rats (p = 0.00073) and was not significantly affected by 3-MPA treatment in either nutritional state. By contrast, the normalized [1-13C]aspartate signal was on average 2.2-fold higher in the fasted state (p = 0.038), and following 3-MPA treatment it was 2.8-fold lower in fed rats and 15-fold lower in fasted rats (p = 0.001). These results confirm that, unlike in the liver, most of the pyruvate-to-bicarbonate conversion in the fasted kidney results from PDH flux. The higher conversion to aspartate in fasted kidney and the marked drop following PEPCK inhibition demonstrate the potential of this metabolite as a marker of renal gluconeogenesis.
Collapse
Affiliation(s)
- Hikari A. I. Yoshihara
- Laboratory for Functional and Metabolic Imaging, Institute of Physics, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Arnaud Comment
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
- General Electric Healthcare, Chalfont St Giles, United Kingdom
| | - Juerg Schwitter
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac MR Center, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| |
Collapse
|
21
|
Pavon AG, Arangalage D, Pascale P, Hugelshofer S, Rutz T, Porretta AP, Le Bloa M, Muller O, Pruvot E, Schwitter J, Monney P. Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse. J Cardiovasc Magn Reson 2021; 23:102. [PMID: 34517908 PMCID: PMC8438990 DOI: 10.1186/s12968-021-00797-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events. BACKGROUND In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. METHODS In this retrospective study, 30 patients with MVP and MAD (MVP-MAD) underwent cardiovascular magnetic resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECVsyn). The control group included 14 patients with mitral regurgitation (MR) but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24 h-Holter monitoring. RESULTS LGE was observed in 47% of MVP-MAD patients and was absent in all controls. ECVsyn was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p < 0.001 and vs 24 ± 2% NoMR-NoMAD, p < 0.001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p < 0.001 and vs 24 ± 2%, p < 0.001, respectively). MAD length correlated with ECVsyn (rho = 0.61, p < 0.001), but not with LGE extent. Four patients had history of out-of-hospital cardiac arrest; LGE and ECVsyn were equally performant to identify those high-risk patients, area under the receiver operating characteristic (ROC) curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECVsyn was above the cut-off value in all while only 53% had LGE. CONCLUSION Increase in ECVsyn, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and increased risk of out-of-hospital cardiac arrest. ECV should be includedin the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, CH-6900 Lugano, Switzerland
| | - Dimitri Arangalage
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Sarah Hugelshofer
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
| | - Tobias Rutz
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Alessandra Pia Porretta
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Juerg Schwitter
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| |
Collapse
|
22
|
Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, Pontone G. CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry. Europace 2021; 23:1072-1083. [PMID: 33792661 DOI: 10.1093/europace/euaa401] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. METHODS AND RESULTS In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction <50% were included. All-cause mortality and major adverse arrhythmic cardiac events (MAACE) were the primary and secondary endpoints, respectively. During a median follow-up of 959 days, all-cause mortality and MAACE occurred in 72 (7%) and 93 (9%) patients, respectively. Age and >3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. CONCLUSION In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.
Collapse
Affiliation(s)
| | | | - Giuseppe Muscogiuri
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Marco Guglielmo
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Andrea Baggiano
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Laura Fusini
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | | | - Chiara Martini
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Daniele Andreini
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Anna Giulia Pavon
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Switzerland
| | - Giovanni D Aquaro
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Andrea Barison
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Giancarlo Todiere
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | | | - Emily Tat
- Loyola University of Chicago, Chicago, IL, USA
| | - Claudia Raineri
- Department of Cardiology, Città della salute e della Scienza - Ospedale Molinette -Turin, Pavia, Italy
| | - Adele Valentini
- Department of Radiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Carlo N De Cecco
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.,Division of Cardiothoracic Imaging, Emory University, Atlanta, GA, USA
| | - Jan Bogaert
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Monica Dobrovie
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Rolf Symons
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Annalaura Gismondi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Jordi Lozano-Torres
- Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josè F Rodriguez-Palomares
- Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigaciín Biomédica en Red-CV, CIBER CV. Spain
| | | | - Mauro Di Roma
- Cardiology Department, Policlinico Casilino, Rome, Italy
| | - Claudio Moro
- Department of Cardiology, ASST Monza, P.O. Desio, Italy
| | | | | | | | | | - Alberto Nese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Medical School, Padova, Italy
| | - Grazia Casavecchia
- Cardiology Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Matteo Gravina
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Samuela Carigi
- Department of Cardiology, Infermi Hospital, Rimini, Italy
| | - Silvia Pica
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Stefano Censi
- Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
| | - Angelo Squeri
- Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
| | - Alessandro Palumbo
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicola Gaibazzi
- Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy
| | | | | | - Patrizia Pedrotti
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ambra Masi
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nazario Carrabba
- Cardiovascular and Thoracic Department of Careggi Hospital, Florence, Italy
| | | | - Mauro Timpani
- Department of Neuroscience, Imaging and Clinical Sciences, SS Annunziata Hospital, Chieti, Italy
| | - Gloria Cicala
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cristina Presicci
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sara Puglisi
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Mauro Pepi
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Juerg Schwitter
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Switzerland.,Lausanne University, Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Gianluca Pontone
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| |
Collapse
|
23
|
Ghanbari F, Joyce T, Kozerke S, Guaricci AI, Masci PG, Pavon AG, Crelier G, Pantone G, Schwitter J. Performance of a machine-learning algorithm for fully automatic LGE scar quantification in the large multi-national derivate registry. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.023] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): J. Schwitter receives research support by “ Bayer Schweiz AG “. C.N.C. received grant by Siemens. Gianluca Pontone received institutional fees by General Electric, Bracco, Heartflow, Medtronic, and Bayer. U.J.S received grand by Astellas, Bayer, General Electric. This work was supported by Italian Ministry of Health, Rome, Italy (RC 2017 R659/17-CCM698). This work was supported by Gyrotools, Zurich, Switzerland.
Background
Late Gadolinium enhancement (LGE) scar quantification is generally recognized as an accurate and reproducible technique, but it is observer-dependent and time consuming. Machine learning (ML) potentially offers to solve this problem.
Purpose
to develop and validate a ML-algorithm to allow for scar quantification thereby fully avoiding observer variability, and to apply this algorithm to the prospective international multicentre Derivate cohort.
Method
The Derivate Registry collected heart failure patients with LV ejection fraction <50% in 20 European and US centres. In the post-myocardial infarction patients (n = 689) quality of the LGE short-axis breath-hold images was determined (good, acceptable, sufficient, borderline, poor, excluded) and ground truth (GT) was produced (endo-epicardial contours, 2 remote reference regions, artefact elimination) to determine mass of non-infarcted myocardium and of dense (≥5SD above mean-remote) and non-dense scar (>2SD to <5SD above mean-remote). Data were divided into the learning (total n = 573; training: n = 289; testing: n = 284) and validation set (n = 116). A Ternaus-network (loss function = average of dice and binary-cross-entropy) produced 4 outputs (initial prediction, test time augmentation (TTA), threshold-based prediction (TB), and TTA + TB) representing normal myocardium, non-dense, and dense scar (Figure 1).Outputs were evaluated by dice metrics, Bland-Altman, and correlations.
Results
In the validation and test data sets, both not used for training, the dense scar GT was 20.8 ± 9.6% and 21.9 ± 13.3% of LV mass, respectively. The TTA-network yielded the best results with small biases vs GT (-2.2 ± 6.1%, p < 0.02; -1.7 ± 6.0%, p < 0.003, respectively) and 95%CI vs GT in the range of inter-human comparisons, i.e. TTA yielded SD of the differences vs GT in the validation and test data of 6.1 and 6.0 percentage points (%p), respectively (Fig 2), which was comparable to the 7.7%p for the inter-observer comparison (n = 40). For non-dense scar, TTA performance was similar with small biases (-1.9 ± 8.6%, p < 0.0005, -1.4 ± 8.2%, p < 0.0001, in the validation and test sets, respectively, GT 39.2 ± 13.8% and 42.1 ± 14.2%) and acceptable 95%CI with SD of the differences of 8.6 and 8.2%p for TTA vs GT, respectively, and 9.3%p for inter-observer.
Conclusions
In the large Derivate cohort from 20 centres, performance of the presented ML-algorithm to quantify dense and non-dense scar fully automatically is comparable to that of experienced humans with small bias and acceptable 95%-CI. Such a tool could facilitate scar quantification in clinical routine as it eliminates human observer variability and can handle large data sets.
Collapse
Affiliation(s)
- F Ghanbari
- University Hospital Centre Vaudois (CHUV), Cardiovascular Division and Cardiac MR Center, Lausanne, Switzerland
| | - T Joyce
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Biomedical Engineering, Zurich, Switzerland
| | - S Kozerke
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Biomedical Engineering, Zurich, Switzerland
| | - AI Guaricci
- Policlinico of Bari University Hospital, Heart Failure and Transplant Unit, Bari, Italy
| | - PG Masci
- School of Biomedical Engineering & Imaging Sciences, King"s College, London, United Kingdom of Great Britain & Northern Ireland
| | - AG Pavon
- University Hospital Centre Vaudois (CHUV), Cardiovascular Division and Cardiac MR Center, Lausanne, Switzerland
| | - G Crelier
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Biomedical Engineering, Zurich, Switzerland
| | - G Pantone
- Centro Cardiologico Monzino IRCCS, University of Milan, Cardiovascular Imaging , Milan, Italy
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Cardiovascular Division and Cardiac MR Center, Lausanne, Switzerland
| |
Collapse
|
24
|
Moschetti K, Kwong RY, Petersen SE, Lombardi M, Garot J, Atar D, Rademakers FE, Sierra-Galan LM, Mavrogeni S, Li K, Lara Fernandes J, Antiochos P, Bruder O, Marholdt H, Schwitter J. Cost-Minimization analysis for cardiac revascularization in 12 healthcare systems based on the EuroCMR/SPINS registries. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): EuroCMR registry (Life Sciences GE Healthcare, Medtronic Inc., Minneapolis MN, USA; Novartis International AG, Basel, Switzerland; Siemens Healthcare, Erlangen, Germany), SPINS registry (Siemens Healthineers, Erlangen, Germany; Bayer AG, Leverkusen, Germany)
Background
Coronary artery disease (CAD) is a major contributor to the public health burden. Stress perfusion cardiac magnetic resonance (CMR) has an excellent accuracy to detect CAD, but data on its cost effectiveness are scarce.
Purpose
To compare the costs of a CMR-guided strategy vs 2 invasive strategies based on 2 large international CMR registries.
Methods
In the EuroCMR registry (n = 3’647, 59 centers, 18 countries) and the US-based SPINS registry (n = 2’349, 13 centers, 11 states) costs were calculated for 12 healthcare systems (8 Europe, US, 2 Latin America, 1 Asia). They included diagnostic examinations (CMR, X-ray coronarography (CXA) with/without FFR), revascularizations, and complications during a 1-year follow-up. Endpoints in both registries were all-cause and cardiovascular (CV) death, sudden cardiac death (SCD), aborted SCD, non-fatal myocardial infarction (nf-MI), and stroke. 7 sub-group analyses covered low to high-risk cohorts. Patients with ischemia-positive CMR underwent CXA and revascularization (percuteneous and surgical intervention) at the treating physician’s discretion (=CMR + CXA-strategy). In the hypothetical invasive CXA + FFR-strategy, costs were calculated for an initial CXA and an FFR in vessels with ≥50% stenoses assuming the same proportion of revascularizations/complications as in the CMR + CXA-strategy and FFR positive rates as given in the literature. In the CXA-only strategy, costs included CXA and revascularizations of ≥50% stenoses.
Results
Revascularizations were performed in 8.0% and 6.2% (p < 0.01) of SPINS and EuroCMR patients, respectively. Consistent cost savings were observed for the CMR + CXA strategy vs CXA + FFR in all 12 healthcare systems ranging from 42 ± 20% and 52 ± 15% in the low-risk EuroCMR and SPINS patients with atypical chest pain (CV-death and nf-MI 0.4-0.7%/y), respectively, to 31 ± 16% in the high-risk SPINS patients (CV-death and nf-MI 3.2%/y) with known CAD (p < 0.0001 vs 0 in all groups, Fig 1/2). Cost savings were even higher vs CXA-only with 63 ± 11%, 73 ± 6%, and 52 ± 9%, respectively (p < 0.0001 vs 0 in all groups, Fig 2).
Conclusions
In 12 healthcare systems, a CMR + CXA-strategy yielded consistent moderate to high cost savings compared to a hypothetical CXA + FFR-strategy over the entire spectrum of risk. Cost savings were consistently high vs a CXA-only strategy for all risk groups.
Figure 1: SPINS refers to the subgroup of patients with suspected CAD (n = 1’530), EuroCMR (= suspected CAD; n = 3’647). EuroCMR vs SPINS ns. Countries per region are listed in alphabetical order.
Figure 2: Top: CMR + CXA vs CXA + FFR: ANOVA: overall p = 0.0017, * vs EuroCMR typ angina: p < 0.005 (Scheffe post-hoc testing). Bottom: CMR + CXA vs CXA-only: ANOVA overall p < 0.0001, * vs SPINS with CAD and vs EuroCMR typ A: p < 0.0001; † vs SPINS with CAD: p < 0.03; ‡ vs EuroCMR typ A: p < 0.0001; § vs SPINS with CAD: p < 0.002; ║ vs EuroCMR typ: p < 0.002 (Scheffe post-hoc tesing)
Collapse
Affiliation(s)
- K Moschetti
- Centre for Primary Care and Public Health (Unisante), Health Technology Assessment Unit, Lausanne, Switzerland
| | - RY Kwong
- Brigham And Women"S Hospital, Harvard Medical School, Boston, United States of America
| | - SE Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Center, Queen Mary University, London, United Kingdom of Great Britain & Northern Ireland
| | - M Lombardi
- I.R.C.C.S. Policlinics of San Donato, Milano, Italy
| | - J Garot
- Institut Cardiovasculaire Paris Sud, Hopital prive Jacques Cartier, Ramsay Santé, Paris, France
| | - D Atar
- Oslo University Hospital Ulleval, Institute of clinical sciences, University of Oslo, Oslo, Norway
| | | | - LM Sierra-Galan
- American British Cowdray Medical Center, Mexico City, Mexico
| | - S Mavrogeni
- Onassis Cardiac Surgery Center, Kapoditrian University of Athens, Athens, Greece
| | - K Li
- Xuan Wu Hospital Affiliated to Capital Medical University, Beijing, China
| | - J Lara Fernandes
- Campinas Medical Center, Jose Michel Kalaf Research Institute, Campinas, Brazil
| | - P Antiochos
- Brigham And Women"S Hospital, Harvard Medical School, Boston, United States of America
| | - O Bruder
- Ruhr University Bochum and Elisabeth Hospital, Cardiology and Angiology, Essen, Germany
| | - H Marholdt
- Robert Bosch Hospital, Stuttgart, Germany
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), University of Lausanne, UniL, Lausanne, Switzerland
| |
Collapse
|
25
|
Pavon A, Arangalage D, Hugelshofer S, Rutz T, Porretta AP, Le Bloa M, Muller O, Pruvot E, Schwitter J, Monney P. Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events
Methods
Thirty patients with MVP and MAD (MVP-MAD) underwent Cardiac Magnetic Resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECV). The control group included 14 patients with mitral regurgitation but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24h-Holter monitoring.
Results
LGE was observed in 47% of MVP-MAD patients and absent in controls. ECV was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p < 0.0001 and vs 24 ± 2% NoMR-NoMAD, p < 0.0001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p < 0.0001 and vs 24 ± 2%, p < 0.0001, respectively), Fig.1. MAD length was correlated with ECV (rho = 0.61, p = 0.0003), but not with LGE extent. Four patients had history of OHCA; LGE and ECV were equally performant to identify those high-risk patients (area under the ROC curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECV was above the cut-off value in all while only 53% had LGE.
Conclusion
Increase in ECV, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and OHCA. ECV should be part of the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification.
Collapse
Affiliation(s)
- A Pavon
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - D Arangalage
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - AP Porretta
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - M Le Bloa
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - E Pruvot
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| |
Collapse
|
26
|
Pavon A, Porretta AP, Arangalage D, Rutz T, Hugelshofer S, Domenichini G, Pruvot E, Muller O, Monney P, Pascale P, Schwitter J. Feasibility and prognostic value of adenosine stress perfusion cardiovascular magnetic resonance in patient with implantable device. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
stress CMR has a limited use in patients with implantable device, in order to the possible artefacts due to the metallic component and to the risk of adenosine interaction with cardiac pacing. The aim of the study was to assess the global feasibility and to assess the prognostic value of stress perfusion CMR in patients with implantable device.
Materials and Methods
we conducted a retrospective single-center longitudinal analysis of consecutive patients with an implantable device referred for stress CMR, performed using a 1.5 Tesla unit (Siemens Healthcare,MAGNETOM Aera, Erlangen-Germany). Protocol was adapted according to current guidelines. Cardiac follow-up [6 months to 7 years] was obtained by medical records of direct contact with patient’s cardiologist referral.
Results
44 patients were enrolled. 34 patients needed a continuous pacing during adenosine stress, that was settled in DOO in 14 (32%) and in VOO in 20 (45%). Device integrity was not compromised by CMR and not competitive atrial or ventricular stimulation was observed during examination. Image quality was good in 95% cases. 26% cases had a perfusion deficit corresponding to a previous scar, while 12% of patients had a positive stress test. All of them needed continuous pacing during stress test and underwent to a coronary angiography who confirmed the coronary stenosis. In patients without inducible ischemia 2 patients experienced a Non-ST-elevation Myocardial Infarction after 6 and 2 years while no other cardiac symptoms or cardiac hospitalisation was remarkable during follow up.
Conclusion
adenosine stress CMR in patient who are pacemaker dependent during scanner is feasible, with an overall good image quality, proving an excellent diagnostic and prognostic value in a long term follow up even. Adenosine administration is safe and no the magnetic field interference with the correct functioning of the device have been shown in short or long term follow-up.
Collapse
Affiliation(s)
- A Pavon
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - AP Porretta
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - D Arangalage
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - G Domenichini
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - E Pruvot
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Pascale
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| |
Collapse
|
27
|
Pavon A, Chautems C, Odin Y, Arangalage D, Rutz T, Hugelshofer S, Monney P, Schwitter J. Overcoming claustrophobia in cardiovascular magnetic resonance with medical hypnosis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
the role of Cardiovascular Magnetic Resonance has gained the more and more importance in the field of cardiovascular disease. Claustrophobia remains a frequent cause of failure to complete a CMR. It is estimated that 2 million scans worldwide cannot be performed annually either due to premature termination or refusal of the patient to be scanned due to claustrophobia. In this setting, medical hypnosis may prove useful to overcome this main limitation.
Methods
we propose an observational study of consecutive patients referred to CMR and known for severe claustrophobia. Patients were proposed to undergo CMR examination with the help of medical hypnosis according to Milton H. Erickson’s method or with administration of mild sedation (lorazepam 2.5 mg).
Results
20 severe claustrophobic patients were considered in the study. 1 patient was excluded due to psychiatric condition, 1 patient undergo to general anesthesia, 5 patients refused the examination. Among the 13 patients, 10 underwent medical hypnosis while 3 patients accepted to undergo to CMR examination with the administration of lorazepam 2.5 mg. All patients treated with medical hypnosis were able to complete the examination with a great tolerance and no sign of stress or anxiety were reported. CMR protocol was performed according to clinical request and was not different form non-claustrophobic patients. None of the patients treated with lorazepam 2.5mg was able to complete the exam.
Conclusion
we prove medical hypnosis to be safe and effective in controlling patients’ anxiety, allowing optimal diagnostic imaging quality without the need to adapt the examination. Further studies in larger populations are needed to confirm our results.
Collapse
Affiliation(s)
- A Pavon
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - C Chautems
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - Y Odin
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - D Arangalage
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| |
Collapse
|
28
|
Figliozzi S, Georgiopoulos G, Aquaro GD, Bauer K, Monti L, Filomena D, Pica S, Censi S, Lopez P, Quattrocchi G, Servato ML, Schwitter J, Andreini D, Bogaert J, Masci PG. Late gadolinium enhancement predicts adverse clinical outcome in patients with mitral valve prolapse/mitral annulus disjunction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Mitral vAlve prolapse and disjunction by cardiac maGnetIC resonance (MA-GIC) registry
Backgroung
Mitral valve prolapse (MVP) is 2-3% prevalent in the general population with good prognosis. However, some patients develop complex ventricular arrhythmias (CVAs), sudden cardiac death (SCD), or severe mitral regurgitation (MR). Previous studies suggested that bi-leaflet involvement, mitral annulus disjunction (MAD), and myocardial fibrosis (MF) are associated with adverse outcome. Notwithstanding, these findings were limited to autopsic series or single-centre studies involving highly selected patients. Moreover, MF has been scantly investigated as predictor of clinical outcome.
Purpose
To investigate the prognostic significance of MF in an international multicentre study of MVP patients studied by cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE).
Methods
From October 2007 to June 2020 patients undergoing LGE-CMR were screened in 14 European centres. Inclusion criteria were: i) age > 18 years; ii) full clinical history and cardiac rhythm monitoring at baseline; iii) MVP (leaflet displacement ≥ 2 mm beyond the annulus). Exclusion criteria were: i) ischemic heart disease; ii) primary cardiomyopathy; iii) inflammatory heart disease; iv) congenital heart diseases; v) moderate-to-severe valvular heart disease. CVAs at the study outset was defined as one of the following: i) ventricular ectopic beats >10000/24h; ii) ≥ 1 episode of non-sustained ventricular tachycardia (VT); iii) sustained VT; iv) aborted SCD. Primary end-point was a composite of SCD, unexplained syncope, and mitral valve repair/replacement. Secondary end-point was a composite of SCD and unexplained syncope.
Results
Four-hundred-fifty-eight MVP patients were eventually included (46 ± 16 years old, 51% males) of whom 68% had MAD. LGE was detected in 103 (22%) of subjects with mid-wall pattern (46%) in left ventricular (LV) lateral wall (66%) as the most prevalent feature. At baseline, 37% of LGE-positive patients vs. 18% of LGE-negative individuals had CVAs (P < 0.001). SVT and/or aborted SCD were more prevalent in LGE-positive than in LGE-negative patients (9% vs 2%, P < 0.001). By multivariable Cox-regression analysis, LGE presence or extent were strong independent predictors of the primary (HR = 4.02, P = 0.003 and HR = 4.76 per 10% increase, P = 0.032, respectively) and secondary (HR = 5.39, P = 0.008 and HR = 8.78 per 10% increase, P = 0.012, respectively) endpoints after correction for major confounders including LV volumes, left atrial size and MAD presence.
Conlusion
Myocardial fibrosis by LGE is the strongest independent predictor of clinical outcome in MVP. In contrast, MAD per se does not harbinger worse prognosis.
Collapse
Affiliation(s)
- S Figliozzi
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences; San Luca Hospital, Milan, Italy
| | - G Georgiopoulos
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - GD Aquaro
- Fondazione Toscana Gabriele Monasterio, Magnetic Resonance Unit, Pisa, Italy
| | - K Bauer
- University Hospital Muenster, Department of Cardiology, Muenster, Germany
| | - L Monti
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - D Filomena
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Rome, Italy
| | - S Pica
- IRCCS Policlinico San Donato, Multimodality Cardiac Imaging Section, San Donato Milanese, Italy
| | - S Censi
- Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy
| | - P Lopez
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Cardiology Department, Lisboa, Portugal
| | - G Quattrocchi
- Niguarda Hospital, CardioThoraxVascular Department "De Gasperis", Milan, Italy
| | - ML Servato
- Universit Autònoma de Barcelona (UAB), Vall Hebron Hospital Institut de Recerca (VIHR) y CIBER-CV, Cardiovascular Imaging Unit, Cardiology Department at Vall Hebron Hospital, Barcelona, Spain
| | - J Schwitter
- Lausanne University Hospital, Cardiac MRI Centre, Lausanne, Switzerland
| | - D Andreini
- Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy
| | - J Bogaert
- Gasthuisberg University Hospital, Imaging & Pathology Department, Leuven, Belgium
| | - PG Masci
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
29
|
Meier D, Fournier S, Masci PG, Eeckhout E, Antiochos P, Tzimas G, Stoyanov N, Muenkaew M, Monney P, Schwitter J, Muller O, Harbaoui B. Impact of manual thrombectomy on microvascular obstruction in STEMI patients. Catheter Cardiovasc Interv 2021; 97:1141-1148. [PMID: 32277793 DOI: 10.1002/ccd.28907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/27/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the effect of manual thrombectomy (MT) on microvascular obstruction (MVO) using cardiac magnetic resonance (CMR) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS Three hundred and eighty-three patients admitted for STEMI and undergoing CMR fulfilled the inclusion criteria and were categorized into two groups (did or did not undergo MT). The two primary endpoints were the occurrence and extent of MVO, analyzed as a categorical variable and as a semicontinuous variable. Among the 383 patients, 49.1% exhibited MVO. Both the incidence of MVO and the median number of segments presenting with MVO were significantly higher in the MT group than in the no-MT group, (59.5 vs. 38.9%, p < .001) and (1.5 [0;4] vs. 0 [0;2], p < .001). Analysis stratified on coronary thrombus grade showed similar results, only in patients with a high thrombus burden (60.7 vs. 43.5%, p = .004, and 2 [0;4] vs. 0 [0;3], p = .001. When adjusting for baseline differences, MT remained a determinant of MVO occurrence and extent (odds ratio, OR 1.802 [95% confidence interval, CI 1.080-3.009], p = .024) and β = .137, p = .024) in patients with a high thrombus grade. CONCLUSION In STEMI patients, MT was associated with the occurrence and extent of MVO, on CMR, especially in patients with a high thrombus burden.
Collapse
Affiliation(s)
- David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.,Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Pier G Masci
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Georgios Tzimas
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nikolay Stoyanov
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Muenpetch Muenkaew
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Juerg Schwitter
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Brahim Harbaoui
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.,Department of Cardiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
30
|
Roy CW, Heerfordt J, Piccini D, Rossi G, Pavon AG, Schwitter J, Stuber M. Motion compensated whole-heart coronary cardiovascular magnetic resonance angiography using focused navigation (fNAV). J Cardiovasc Magn Reson 2021; 23:33. [PMID: 33775246 PMCID: PMC8006382 DOI: 10.1186/s12968-021-00717-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/26/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Radial self-navigated (RSN) whole-heart coronary cardiovascular magnetic resonance angiography (CCMRA) is a free-breathing technique that estimates and corrects for respiratory motion. However, RSN has been limited to a 1D rigid correction which is often insufficient for patients with complex respiratory patterns. The goal of this work is therefore to improve the robustness and quality of 3D radial CCMRA by incorporating both 3D motion information and nonrigid intra-acquisition correction of the data into a framework called focused navigation (fNAV). METHODS We applied fNAV to 500 data sets from a numerical simulation, 22 healthy subjects, and 549 cardiac patients. In each of these cohorts we compared fNAV to RSN and respiratory resolved extradimensional golden-angle radial sparse parallel (XD-GRASP) reconstructions of the same data. Reconstruction times for each method were recorded. Motion estimate accuracy was measured as the correlation between fNAV and ground truth for simulations, and fNAV and image registration for in vivo data. Percent vessel sharpness was measured in all simulated data sets and healthy subjects, and a subset of patients. Finally, subjective image quality analysis was performed by a blinded expert reviewer who chose the best image for each in vivo data set and scored on a Likert scale 0-4 in a subset of patients by two reviewers in consensus. RESULTS The reconstruction time for fNAV images was significantly higher than RSN (6.1 ± 2.1 min vs 1.4 ± 0.3, min, p < 0.025) but significantly lower than XD-GRASP (25.6 ± 7.1, min, p < 0.025). Overall, there is high correlation between the fNAV and reference displacement estimates across all data sets (0.73 ± 0.29). For simulated data, healthy subjects, and patients, fNAV lead to significantly sharper coronary arteries than all other reconstruction methods (p < 0.01). Finally, in a blinded evaluation by an expert reviewer fNAV was chosen as the best image in 444 out of 571 data sets (78%; p < 0.001) and consensus grades of fNAV images (2.6 ± 0.6) were significantly higher (p < 0.05) than uncorrected (1.7 ± 0.7), RSN (1.9 ± 0.6), and XD-GRASP (1.8 ± 0.8). CONCLUSION fNAV is a promising technique for improving the quality of RSN free-breathing 3D whole-heart CCMRA. This novel approach to respiratory self-navigation can derive 3D nonrigid motion estimations from an acquired 1D signal yielding statistically significant improvement in image sharpness relative to 1D translational correction as well as XD-GRASP reconstructions. Further study of the diagnostic impact of this technique is therefore warranted to evaluate its full clinical utility.
Collapse
Affiliation(s)
- Christopher W Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland.
| | - John Heerfordt
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Davide Piccini
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Giulia Rossi
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
| | - Anna Giulia Pavon
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Juerg Schwitter
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Director CMR-Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| |
Collapse
|
31
|
Burdet O, Pavon AG, Bouchardy J, Blanche C, Monney P, Hugelshofer S, Schwitter J, Rutz T. Evolution of biventricular T1 values in patients with right-sided congenital heart disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Conflicting reports exist on the prevalence and clinical impact of interstitial fibrosis in right ventricular (RV) congenital heart disease (CHD). This study evaluates the longitudinal evolution of native myocardial T1 relaxation time (T1) in RV CHD.
Methods
On a 1.5T scanner, an ECG-triggered modified Look-Locker inversion recovery sequence (scheme 3(3)3(3)5) was acquired on a short-axis basal slice covering the RV and left ventricle (LV) on two consecutive CMR exams. Global and segmental (LV = 6, RV = 4) RV and LV T1 values were calculated (Figure).
Results
Mean time between CMR exams for 36 included patients (age 34 ± 2y) was 22 ± 2 months. All LV segments and 81/88% of RV segments of first and second CMR could be analyzed, respectively. T1 increased mildly but not significantly (table). There was no relationship of T1 to pulmonary regurgitation fraction, pulmonary stenosis or RV enddiastolic volume (p > 0.05). Global RV T1 of the second CMR was related to RV ejection fraction (RVEF): r = 0.353, 3.0 ± 1.4, p = 0.038. T1 of the infero-septal LV segment of first and second CMR, global LV T1 of second CMR and increase of T1 of global LV, anterior, antero-lateral and –septal LV segments, were related to age at CMR: r = 0.333 - 0.463, p < 0.05, respectively.
Conclusions
Native T1 values increased mildly in patients with stable RV CHD, which was not statistically significant probably due to the short to median follow-up. Global RV T1 appears to be related to RVEF which could be sign of increasing interstitial fibrosis whereas the relationship of LV T1 to age might be a physiological finding.
First CMR native T1 (ms) Second CMR native T1 (ms) p LV Global 1007 ± 37 1014 ± 39 0.413 LV Anterior 994 ± 53 999 ± 54 0.710 LV Antero-lateral 965 ± 63 981 ± 58 0.186 LV Infero-lateral 1000 ± 52 1004 ± 63 0.695 LV Inferior 1035 42 1037 ± 50 0.744 LV Infero-septal 1028 ± 35 1036 ± 43 0.282 LV Antero-septal 1016 ± 38 1024 ± 48 0.347 RV Global 1091 ± 90 1096 ± 85 0.410 RV Inferior 1112 ± 104 1115 ± 118 0.696 RV Infero-lateral 1061 ± 130 1077 ± 115 0.425 RV Antero-lateral 1046 ± 127 1080 ± 109 0.088 RV Anterior 1088 ± 156 1108 ± 154 0.410 Abstract Figure. Determination of biventricular T1 values
Collapse
Affiliation(s)
- O Burdet
- University Hospital of Lausanne, Lausanne, Switzerland
| | - AG Pavon
- University Hospital of Lausanne, Lausanne, Switzerland
| | - J Bouchardy
- University Hospital of Lausanne, Lausanne, Switzerland
| | - C Blanche
- Geneva University Hospitals, Cardiology Division, Geneva, Switzerland
| | - P Monney
- University Hospital of Lausanne, Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital of Lausanne, Lausanne, Switzerland
| | - J Schwitter
- University Hospital of Lausanne, Lausanne, Switzerland
| | - T Rutz
- University Hospital of Lausanne, Lausanne, Switzerland
| |
Collapse
|
32
|
Arangalage D, Pavon AG, Hugelshofer S, Rutz T, Muller O, Schwitter J, Monney P. Myocardial interstitial fibrosis assessed by extracellular volume quantification is a determinant of symptoms in aortic valve regurgitation with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
According to current guidelines indication for surgery is straightforward with a class I recommendation in case of severe symptomatic aortic regurgitation (AR) and/or left ventricular ejection fraction (LVEF) decrease ≤50%. However, the management of patients with asymptomatic severe AR with preserved LVEF remains debated, with a cruel lack of prognostic factors to identify patients who may benefit from early intervention. An explanation to the absence of such factors is that the determinants of symptoms, a strong prognostic parameter, have been poorly identified. Beyond LV dilation and systolic dysfunction, which are both recognized prognostic factors in chronic AR, we hypothesized that interstitial myocardial fibrosis, as an early indicator of LV remodeling, may also influence the occurrence of symptoms. Cardiovascular magnetic resonance (CMR)-based myocardial extracellular volume (ECV) quantification by T1 mapping has emerged as a valuable tool to quantify diffuse myocardial fibrosis.
Objective
To study the relationship between myocardial interstitial fibrosis quantified by T1 mapping and the symptomatic status of patients with chronic aortic valve regurgitation.
Methods
We retrospectively included 38 consecutive patients with chronic, isolated, mild to severe AR who underwent a CMR at our institution. Exclusion criteria were the presence of any other heart condition that may induce myocardial fibrosis, ≥ mild associated valve disease, AR secondary to endocarditis, genetic, inflammatory or congenital disease except bicuspid aortic valve. T1 mapping of the basal segments was performed before and after contrast administration measuring native and post-contrast T1 relaxation time and ECV.
Results
Mean age was 56 ± 20 years, 30 patients (79%) were males, and symptoms were reported in 11 patients (29%). Mean LVEF was 57 ± 9% and ≥50% in 30 patients (79%). Aortic valve regurgitation fraction (RF) was 25 ± 13%, ECV 0.27 ± 0.04%, indexed LV end-diastolic volume (LVEDVi) 98 ± 32 ml/m2, end-systolic volume (LVESVi) 46 ± 19 ml/m2, and LV mass 79 ± 21 g/m2. LVESVi (r = 0.41,p = 0.01), LVEF (r=-0.59,p = 0.0001), and ECV (r = 0.42,p = 0.008) were correlated with symptoms, whereas age (r = 0.16,p = 0.33), gender (r=-0.24,p = 0.15), LVEDVi (r = 0.28,p = 0.09), LV mass index (r = 0.08,p = 0.62), and RF (r = 0.31,p = 0.06) were not. In the subgroup of patients with preserved LVEF (≥50%), after adjustment for LVESVi and RF, only ECV remained independently associated with symptoms (p = 0.046). Interestingly, when including the patients with a reduced LVEF < 50% in the multivariable analysis only LVESVi was an independent determinant of symptoms (p = 0.04) and ECV was not (p = 0.07)
Conclusion
myocardial fibrosis quantified by ECV calculation is a determinant of symptoms in AR with preserved LVEF. Further studies are warranted to determine the prognostic value of ECV that may justify earlier intervention.
Abstract Figure. ECV in AR with preserved LVEF
Collapse
Affiliation(s)
- D Arangalage
- University Hospital Centre Vaudois (CHUV), Department of Cardiology, Lausanne, Switzerland
| | - AG Pavon
- University Hospital Centre Vaudois (CHUV), Center for Cardiac Magnetic Resonance, Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital Centre Vaudois (CHUV), Department of Cardiology, Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Department of Cardiology, Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Department of Cardiology, Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Center for Cardiac Magnetic Resonance, Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Department of Cardiology, Lausanne, Switzerland
| |
Collapse
|
33
|
Nussbaumer C, Bouchardy J, Blanche C, Piccini D, Pavon AG, Hugelshofer S, Monney P, Stuber M, Schwitter J, Rutz T. 2D cine vs. 3D free-breathing self-navigated whole heart for aortic root measurements in congenital heart disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cardiac magnetic resonance is considered the method of choice for determination of aortic root diameters in congenital heart disease. Usually, a cross-sectional 2D cine stack is acquired perpendicular to the vessel’s axis. However, this method requires a considerable patient collaboration and precise planning of image planes. This study compares a recently introduced free-breathing high-resolution 3D self-navigating whole heart sequence (3D self nav) to the 2D cine technique for determination of aortic root diameters.
Methods
Two observers measured on 2D cine and 3D self nav cross-sectional planes of the aortic root (figure A and B), acquired on a 1.5T scanner, cusp-commissure (CuCo) and cusp-cusp (CuCu) enddiastolic diameters (figure B and C). Asymmetry of the aortic root was evaluated by the ratio of the minimal to maximum CuCu diameter. CuCu diameters were compared to transthoracic echocardiographic (TTE) aortic root diameters.
Results
65 exams in 58 patients (mean age 32 ± 15y) were included. 2D cine and 3D self nav spatial resolution was 1.4x4.5-6mm and 1.1³mm, respectively. 3D self nav and CuCu yielded larger diameters than 2D cine and CuCo, respectively (table). Intra- and interobserver variabilities were excellent for both techniques ( bias -0.5 to 1.0 mm). Intra-observer variability of the experienced observer was better for 3D self nav (F-test p < 0.05). Aortic root asymmetry was more pronounced in patients with bicuspid aortic valve (BAV: 0.73 (0.69; 0.78) vs. 0.93 (0.9; 0.96), p < 0.001), which was associated with a larger difference of maximum CuCu to TTE diameters: 5.5 ± 3.3 vs. 3.3 ± 3.8 mm, p = 0.03.
Conclusion
Both, the 3D self nav and 2D cine techniques allow reliable determination of aortic root diameters. However, the 3D self nav technique and measurement of the CuCu diameters should be privileged to avoid underestimation of the maximum diameter, particularly in patients with asymmetric aortic roots and/or BAV
2D cine vs. 3D self nav CuCo min CuCo mid CuCo max CuCu min CuCu mid CuCu max Mean diameter 2D cine (mm) 33.5 34.8 36.2 33.4 37.6 38.5 Mean diameter 3D self nav (mm) 34.5 35.9 37.2 34.3 38.5 39.7 Mean difference (mm) -1.0 -1.1 -1.0 -0.8 -1.3 -1.2 95% Limits of agreement (mm) -5.1 to 3.2 -5.3 to 3.1 -5.5 to 3.5 -5.5 to 3.8 -4.7 to 2.0 -4.7 to 2.3 Standard deviation (mm) 3.2 2.1 2.3 2.4 1.7 1.8 Variance (mm2) 4.5 4.5 5.2 5.6 2.9 3.2 Pearson’s correlation (r) 0.952 0.954 0.945 0.944 0.972 0.951 P value (t-test) 0.003 0.001 0.006 0.005 <0.001 <0.001 Abstract Figure.
Collapse
Affiliation(s)
- C Nussbaumer
- University Hospital of Lausanne, Lausanne, Switzerland
| | - J Bouchardy
- University Hospital of Lausanne, Lausanne, Switzerland
| | - C Blanche
- Geneva University Hospitals, Cardiology Division, Geneva, Switzerland
| | - D Piccini
- University Hospital of Lausanne, Lausanne, Switzerland
| | - AG Pavon
- University Hospital of Lausanne, Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital of Lausanne, Lausanne, Switzerland
| | - P Monney
- University Hospital of Lausanne, Lausanne, Switzerland
| | - M Stuber
- University Hospital of Lausanne, Lausanne, Switzerland
| | - J Schwitter
- University Hospital of Lausanne, Lausanne, Switzerland
| | - T Rutz
- University Hospital of Lausanne, Lausanne, Switzerland
| |
Collapse
|
34
|
Pascale P, Pavon AG, Bogaert J, Bennett J, Monney P, Muller O, Schwitter J, Masci PG. Acute chest pain with ST-segment elevation in lead V1-V3: when you hear hoofbeats, also look for zebras. Clin Res Cardiol 2021; 110:1516-1522. [PMID: 33547960 DOI: 10.1007/s00392-021-01803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/06/2021] [Indexed: 11/24/2022]
Abstract
ST-segment elevation (STE) in the anterior precordial leads is the hallmark of anterior myocardial infarction. In rare cases, this ECG pattern may be due to isolated infarction of the right ventricle since leads V1-V3 directly overlie the right ventricular free wall. Herein, we aimed to provide clues to recognize and understand this diagnostic pitfall through a series of 4 patients presenting with STE in the anterior leads.
Collapse
Affiliation(s)
- Patrizio Pascale
- Cardiology Division, Heart and Vessels Department, Lausanne University Hospital, BH 10-982, Rue de Bugnon 46, 1011, Lausanne, Switzerland.
| | - Anna Giulia Pavon
- Centre of Cardiac Magnetic Resonance, University Hospital Lausanne, Lausanne, Switzerland
| | - Jan Bogaert
- Gasthuisberg University Hospitals, Leuven, Belgium
| | | | - Pierre Monney
- Cardiology Division, Heart and Vessels Department, Lausanne University Hospital, BH 10-982, Rue de Bugnon 46, 1011, Lausanne, Switzerland.,Centre of Cardiac Magnetic Resonance, University Hospital Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Cardiology Division, Heart and Vessels Department, Lausanne University Hospital, BH 10-982, Rue de Bugnon 46, 1011, Lausanne, Switzerland
| | - Juerg Schwitter
- Cardiology Division, Heart and Vessels Department, Lausanne University Hospital, BH 10-982, Rue de Bugnon 46, 1011, Lausanne, Switzerland.,Centre of Cardiac Magnetic Resonance, University Hospital Lausanne, Lausanne, Switzerland
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| |
Collapse
|
35
|
Kilani N, Haddad C, Lu H, Ghanbari F, Domenichini G, Pavon AG, Tzimas G, Fournier S, Hullin R, Pascale P, Eeckhout E, Schwitter J, Pruvot E, Bouchardy J, Monney P, Muller O, Rutz T. [Cardiology]. Rev Med Suisse 2021; 17:172-180. [PMID: 33507655] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In 2020, new guidelines have been published by the European Society of Cardiology including those on non-ST-segment elevation acute coronary syndromes, atrial fibrillation and adult congenital heart disease. Regarding interventional cardiology, POPular TAVI opens the possibility of anti-platelet monotherapy after transcutaneous aortic valve replacement. EMPEROR-Reduced confirms the importance of SGLT2 inhibitors in the treatment of heart failure with reduced ejection fraction. Within the field of imaging, stress MRI has now become the first-line technique for the screening of coronary artery disease, demonstrating an excellent cost-benefit ratio. Finally, renin-angiotensin-aldosterone inhibitors do not appear to increase the risk of an infection by COVID-19.
Collapse
Affiliation(s)
- Nadia Kilani
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | | | - Henri Lu
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Fahime Ghanbari
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | | | | | - Georgios Tzimas
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | | | - Roger Hullin
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Eric Eeckhout
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, CHUV, Université de Lausanne, 1011 Lausanne
| |
Collapse
|
36
|
Georgiopoulos G, Mitropoulou P, Masci PG, Schwitter J. A concealed carcinoid cardiac metastasis uncovered by comprehensive cardiovascular magnetic resonance-based tissue characterization: a case report. Eur Heart J Case Rep 2021; 4:1-5. [PMID: 33442650 PMCID: PMC7793190 DOI: 10.1093/ehjcr/ytaa354] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/11/2020] [Accepted: 09/08/2020] [Indexed: 02/03/2023]
Abstract
Background Cardiac metastases of carcinoid tumours are extremely rare, and their diagnosis poses a significant challenge. A variety of techniques has been reported in the literature for this purpose, ranging from echocardiogram to the Indium-111 Octreotide, positron emission tomography using specific tracers, and biopsy. Occasionally, the diagnosis is only made post-mortem. Recently, CMR (cardiovascular magnetic resonance) has been added to the diagnostic toolkit. This case report describes the CMR sequences that can be used to characterize cardiac metastases of carcinoid tumours. Case summary A 55-year-old woman with an antecedent history of resected carcinoid tumour of the ileocecal junction underwent whole-body In-111 Octreoscan single-photon emission computed tomography in the context of her follow-up. This raised the suspicion of pericardial involvement, which prompted a CMR study. Comprehensive CMR findings were consistent with isolated carcinoid tumour metastasis embedded within the anterior papillary muscle. We describe the CMR sequences that were used to characterize the metastasis. Discussion The rarity of cardiac metastasis of carcinoid tumour makes its diagnosis challenging and warrants a high level of clinical suspicion. Cardiovascular magnetic resonance imaging proves to be an indispensable tool in the tissue characterization of such tumours.
Collapse
Affiliation(s)
- Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, Westminster Bridge Road, London SE1 7EH, UK.,Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Leoforos Vasilissis Sofias 80, Athens 11528, Greece
| | - Panagiota Mitropoulou
- Department of Cardiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Juerg Schwitter
- Centre of Cardiac Magnetic Resonance, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland
| |
Collapse
|
37
|
Zemrak F, Raisi-Estabragh Z, Khanji MY, Mohiddin SA, Bruder O, Wagner A, Lombardi M, Schwitter J, van Rossum AC, Pilz G, Nothnagel D, Steen H, Nagel E, Prasad SK, Deluigi CC, Dill T, Frank H, Schneider S, Mahrholdt H, Petersen SE. Left Ventricular Hypertrabeculation Is Not Associated With Cardiovascular Morbity or Mortality: Insights From the Eurocmr Registry. Front Cardiovasc Med 2020; 7:158. [PMID: 33195445 PMCID: PMC7536335 DOI: 10.3389/fcvm.2020.00158] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/28/2020] [Indexed: 11/27/2022] Open
Abstract
Aim: Left ventricular non-compaction (LVNC) is perceived as a rare high-risk cardiomyopathy characterized by excess left ventricular (LV) trabeculation. However, there is increasing evidence contesting the clinical significance of LV hyper-trabeculation and the existence of LVNC as a distinct cardiomyopathy. The aim of this study is to assess the association of LV trabeculation extent with cardiovascular morbidity and all-cause mortality in patients undergoing clinical cardiac magnetic resonance (CMR) scans across 57 European centers from the EuroCMR registry. Methods and Results: We studied 822 randomly selected cases from the EuroCMR registry. Image acquisition was according to international guidelines. We manually segmented images for LV chamber quantification and measurement of LV trabeculation (as per Petersen criteria). We report the association between LV trabeculation extent and important cardiovascular morbidities (stroke, atrial fibrillation, heart failure) and all-cause mortality prospectively recorded over 404 ± 82 days of follow-up. Maximal non-compaction to compaction ratio (NC/C) was mean (standard deviation) 1.81 ± 0.67, from these, 17% were above the threshold for hyper-trabeculation (NC/C > 2.3). LV trabeculation extent was not associated with increased risk of the defined outcomes (morbidities, mortality, LV CMR indices) in the whole cohort, or in sub-analyses of individuals without ischaemic heart disease, or those with NC/C > 2.3. Conclusion: Among 882 patients undergoing clinical CMR, excess LV trabeculation was not associated with a range of important cardiovascular morbidities or all-cause mortality over ~12 months of prospective follow-up. These findings suggest that LV hyper-trabeculation alone is not an indicator for worse cardiovascular prognosis.
Collapse
Affiliation(s)
- Filip Zemrak
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Mohammed Y Khanji
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Saidi A Mohiddin
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Oliver Bruder
- Department of Cardiology and Angiology, Elisabeth-Krankenhaus Essen, Ruhr University Bochum, Bochum, Germany
| | - Anja Wagner
- Department of Cardiology, St. Vincent's Medical Centre, Bridgeport, CT, United States
| | - Massimo Lombardi
- I.R.C.C.S. Multimodality Cardiac Imaging, Policlinico San Donato, Milan, Italy
| | - Juerg Schwitter
- Cardiac MR Centre, University Hospital (CHUV), Switzerland and Lausanne University, Lausanne, Switzerland
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam University Centres, Amsterdam, Netherlands
| | - Günter Pilz
- Department of Cardiology, Clinic Agatharied, University of Munich, Munich, Germany
| | - Detlev Nothnagel
- Department of Cardiology, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | | | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging DZHK (German Centre for Cardiovascular Research) Centre for Cardiovascular Imaging, Partner Site RheinMain, University Hospital, Goethe University, Frankfurt, Germany
| | - Sanjay K Prasad
- CMR Unit, Royal Brompton Hospital, London, United Kingdom.,National Heart and Lung Institute, London, United Kingdom
| | - Christina C Deluigi
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Thorsten Dill
- Department of Internal Medicine, Krankenhaus Benrath, Düsseldorf, Germany
| | - Herbert Frank
- Department of Internal Medicine, University Hospital Tulln, Tulln, Austria
| | | | - Heiko Mahrholdt
- Department of Cardiology, Robert Bosch Medical Centre, Stuttgart, Germany
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| |
Collapse
|
38
|
Pavon AG, Georgiopoulos G, Vincenti G, Muller O, Monney P, Berchier G, Cirillo C, Eeckhout E, Schwitter J, Masci PG. Head-to-head comparison of multiple cardiovascular magnetic resonance techniques for the detection and quantification of intramyocardial haemorrhage in patients with ST-elevation myocardial infarction. Eur Radiol 2020; 31:1245-1256. [PMID: 32929640 PMCID: PMC7880961 DOI: 10.1007/s00330-020-07254-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/27/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022]
Abstract
Objectives T2*-weighted (T2*w) is deemed as a reference standard for post-infarction intramyocardial haemorrhage (IMH). However, high proportion of T2* images is affected by off-resonance artefacts hampering image interpretation. Diagnostic accuracy and precision of alternative techniques for IMH diagnosis and quantification have been seldomly investigated. Methods and results Between April 2016 and May 2017, 50 ST-segment elevation myocardial infarction patients (66% male, 57 ± 17 years) and 15 healthy controls (60% male, 58 ± 13) were consecutively enrolled. Subjects underwent head-to-head comparison of single mid-infarct slice acquired on black-blood T2-weighted short-TI-inversion recovery (T2w-STIR), bright-blood T2prep-steady-state-free precession (T2prep-SSFP), and T2/T1 maps for IMH diagnosis and quantification against T2*w. All images were graded for quality (grade 1: very poor; grade 4: excellent) and diagnostic confidence (Likert scale, 1: very unsure and 5: highly confident). Reduced relaxation time/hypointense region (hypocore) embedded in infarct-related oedema on T2 map, T1 map, and T2w-STIR had the best overall diagnostic accuracy (per-subject: 91%, 86%, and 86%, respectively; per segment: 95%, 93%, and 93%, respectively). By mixed-effects analysis, image quality, and diagnostic confidence were higher for T2 map and T1 maps than T2*w (p < 0.05 for both scores). For IMH quantification, hypocore on T2 map and T1 map strongly correlated (Spearman’s r > 0.7, p < 0.001 for both) with IMH extent on T2*w and presented an overall excellent agreement on Bland-Altman analysis. By linear mixed model analysis, absolute hypocore size did not differ among T1-, T2 map, and T2*w. T2/T1 maps had the best intra- and inter-observer reproducibility among CMR techniques. Conclusion Hypocore on T2/T1 map is the best alternative technique to T2*w for diagnosing and quantifying IMH in post-STEMI patients. Key Point • Mapping techniques are the best alternatives for diagnosing post-infarction intramyocardial haemorrhage. • Mapping techniques are valuable tools for imaging intramyocardial haemorrhage. Electronic supplementary material The online version of this article (10.1007/s00330-020-07254-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Centre of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
- Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Gabriella Vincenti
- Centre of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Muller
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre Monney
- Centre of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
- Faculty Biology and Medicine, Lausanne University, Lausanne, Switzerland
| | - Gregoire Berchier
- Radiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Chiara Cirillo
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Eric Eeckhout
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Juerg Schwitter
- Centre of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
- Faculty Biology and Medicine, Lausanne University, Lausanne, Switzerland
| | - Pier Giorgio Masci
- Centre of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Heart & Vessels Department, Lausanne University Hospital, Lausanne, Switzerland
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| |
Collapse
|
39
|
van Assen M, Kuijpers DJ, Schwitter J. MRI perfusion in patients with stable chest-pain. Br J Radiol 2020; 93:20190881. [PMID: 31834813 PMCID: PMC7465855 DOI: 10.1259/bjr.20190881] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022] Open
Abstract
Perfusion-cardiovascular MR (CMR) imaging has been shown to reliably identify patients with suspected or known coronary artery disease (CAD), who are at risk for future cardiac events and thus, allows for guiding therapy including revascularizations. Accordingly, it is an ideal test to exclude prognostically relevant coronary artery disease. Several guidelines, such as the ESC guidelines, currently recommend CMR as non-invasive testing in patients with stable chest pain. CMR has as an advantage over the more conventional pathways as it lacks radiation and it potentially reduces costs.
Collapse
Affiliation(s)
- Marly van Assen
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Dirk Jan Kuijpers
- Department of Radiology, HMC-Bronovo, Haaglanden Medisch Centrum, Den Haag, the Netherlands
| | | |
Collapse
|
40
|
Jumeau R, Ozsahin M, Schwitter J, Elicin O, Reichlin T, Roten L, Andratschke N, Mayinger M, Saguner AM, Steffel J, Blanck O, Vozenin MC, Moeckli R, Zeverino M, Vallet V, Herrera-Siklody C, Pascale P, Bourhis J, Pruvot E. Stereotactic Radiotherapy for the Management of Refractory Ventricular Tachycardia: Promise and Future Directions. Front Cardiovasc Med 2020; 7:108. [PMID: 32671101 PMCID: PMC7329991 DOI: 10.3389/fcvm.2020.00108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/22/2020] [Indexed: 01/22/2023] Open
Abstract
Ventricular tachycardia (VT) caused by myocardial scaring bears a significant risk of mortality and morbidity. Antiarrhythmic drug therapy (AAD) and catheter ablation remain the cornerstone of VT management, but both treatments have limited efficacy and potential adverse effects. Stereotactic body radiotherapy (SBRT) is routinely used in oncology to treat non-invasively solid tumors with high precision and efficacy. Recently, this technology has been evaluated for the treatment of VT. This review presents the basic underlying principles, proof of concept, and main results of trials and case series that used SBRT for the treatment of VT refractory to AAD and catheter ablation.
Collapse
Affiliation(s)
- Raphael Jumeau
- Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Multidisciplinary Cancer Care Service, Radiation Oncology Unit, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - Mahmut Ozsahin
- Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Juerg Schwitter
- Heart and Vessel Department, Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, Zürich, Switzerland
| | - Michael Mayinger
- Department of Radiation Oncology, University Hospital Zurich, Zürich, Switzerland
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, Zürich, Switzerland
| | - Jan Steffel
- Department of Cardiology, University Heart Center Zurich, Zürich, Switzerland
| | - Oliver Blanck
- Department of Radiation Oncology and Department of Internal Medicine III, Cardiology, Section for Electrophysiology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Marie-Catherine Vozenin
- Radio-Oncology Research Laboratory, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raphael Moeckli
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michele Zeverino
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Véronique Vallet
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Claudia Herrera-Siklody
- Heart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrizio Pascale
- Heart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean Bourhis
- Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Etienne Pruvot
- Heart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
41
|
Niclauss L, Masci PG, Pavon AG, Rodrigues D, Schwitter J. Blood flow assessment by transit time flow measurement and its prognostic impact in coronary bypass surgery. J Cardiovasc Surg 2020; 61:356-368. [DOI: 10.23736/s0021-9509.20.11150-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
42
|
Pavon AG, Meier D, Samim D, Rotzinger DC, Fournier S, Marquis P, Monney P, Muller O, Schwitter J. First Documentation of Persistent SARS-Cov-2 Infection Presenting With Late Acute Severe Myocarditis. Can J Cardiol 2020; 36:1326.e5-1326.e7. [PMID: 32522523 PMCID: PMC7834643 DOI: 10.1016/j.cjca.2020.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/23/2023] Open
Abstract
A 64-year-old man presented with severe myocarditis 6 weeks after an initial almost asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) infection. He was found to have a persistent positive swab. Mechanisms explaining myocardial injury in patients with COVID-19 remains unclear, but this case suggests that severe acute myocarditis can develop in the late phase of COVID-19 infection, even after a symptom-free interval.
Collapse
Affiliation(s)
- Anna Giulia Pavon
- Centre of Cardiac Magnetic Resonance, Lausanne University Hospital, Lausanne, Switzerland; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Daryoush Samim
- Service of Internal Medicine, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - David C Rotzinger
- Radiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Patrick Marquis
- Intensive Care Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre Monney
- Centre of Cardiac Magnetic Resonance, Lausanne University Hospital, Lausanne, Switzerland; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Juerg Schwitter
- Centre of Cardiac Magnetic Resonance, Lausanne University Hospital, Lausanne, Switzerland; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
43
|
Piccini D, Demesmaeker R, Heerfordt J, Yerly J, Di Sopra L, Masci PG, Schwitter J, Van De Ville D, Richiardi J, Kober T, Stuber M. Deep Learning to Automate Reference-Free Image Quality Assessment of Whole-Heart MR Images. Radiol Artif Intell 2020; 2:e190123. [PMID: 33937825 DOI: 10.1148/ryai.2020190123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 03/03/2020] [Accepted: 03/11/2020] [Indexed: 11/11/2022]
Abstract
Purpose To develop and characterize an algorithm that mimics human expert visual assessment to quantitatively determine the quality of three-dimensional (3D) whole-heart MR images. Materials and Methods In this study, 3D whole-heart cardiac MRI scans from 424 participants (average age, 57 years ± 18 [standard deviation]; 66.5% men) were used to generate an image quality assessment algorithm. A deep convolutional neural network for image quality assessment (IQ-DCNN) was designed, trained, optimized, and cross-validated on a clinical database of 324 (training set) scans. On a separate test set (100 scans), two hypotheses were tested: (a) that the algorithm can assess image quality in concordance with human expert assessment as assessed by human-machine correlation and intra- and interobserver agreement and (b) that the IQ-DCNN algorithm may be used to monitor a compressed sensing reconstruction process where image quality progressively improves. Weighted κ values, agreement and disagreement counts, and Krippendorff α reliability coefficients were reported. Results Regression performance of the IQ-DCNN was within the range of human intra- and interobserver agreement and in very good agreement with the human expert (R 2 = 0.78, κ = 0.67). The image quality assessment during compressed sensing reconstruction correlated with the cost function at each iteration and was successfully applied to rank the results in very good agreement with the human expert. Conclusion The proposed IQ-DCNN was trained to mimic expert visual image quality assessment of 3D whole-heart MR images. The results from the IQ-DCNN were in good agreement with human expert reading, and the network was capable of automatically comparing different reconstructed volumes.Supplemental material is available for this article.© RSNA, 2020.
Collapse
Affiliation(s)
- Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Robin Demesmaeker
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - John Heerfordt
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Jérôme Yerly
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Lorenzo Di Sopra
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Pier Giorgio Masci
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Juerg Schwitter
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Dimitri Van De Ville
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Jonas Richiardi
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Matthias Stuber
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| |
Collapse
|
44
|
Yoshihara HAI, Bastiaansen JAM, Karlsson M, Lerche MH, Comment A, Schwitter J. Detection of myocardial medium-chain fatty acid oxidation and tricarboxylic acid cycle activity with hyperpolarized [1- 13 C]octanoate. NMR Biomed 2020; 33:e4243. [PMID: 31904900 DOI: 10.1002/nbm.4243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 05/05/2023]
Abstract
Under normal conditions, the heart mainly relies on fatty acid oxidation to meet its energy needs. Changes in myocardial fuel preference are noted in the diseased and failing heart. The magnetic resonance signal enhancement provided by spin hyperpolarization allows the metabolism of substrates labeled with carbon-13 to be followed in real time in vivo. Although the low water solubility of long-chain fatty acids abrogates their hyperpolarization by dissolution dynamic nuclear polarization, medium-chain fatty acids have sufficient solubility to be efficiently polarized and dissolved. In this study, we investigated the applicability of hyperpolarized [1-13 C]octanoate to measure myocardial medium-chain fatty acid metabolism in vivo. Scanning rats infused with a bolus of hyperpolarized [1-13 C]octanoate, the primary metabolite observed in the heart was identified as [1-13 C]acetylcarnitine. Additionally, [5-13 C]glutamate and [5-13 C]citrate could be respectively resolved in seven and five of 31 experiments, demonstrating the incorporation of oxidation products of octanoate into the tricarboxylic acid cycle. A variable drop in blood pressure was observed immediately following the bolus injection, and this drop correlated with a decrease in normalized acetylcarnitine signal (acetylcarnitine/octanoate). Increasing the delay before infusion moderated the decrease in blood pressure, which was attributed to the presence of residual gas bubbles in the octanoate solution. No significant difference in normalized acetylcarnitine signal was apparent between fed and 12-hour fasted rats. Compared with a solution in buffer, the longitudinal relaxation of [1-13 C]octanoate was accelerated ~3-fold in blood and by the addition of serum albumin. These results demonstrate the potential of hyperpolarized [1-13 C]octanoate to probe myocardial medium-chain fatty acid metabolism as well as some of the limitations that may accompany its use.
Collapse
Affiliation(s)
- Hikari A I Yoshihara
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Institute of Physics, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Jessica A M Bastiaansen
- Institute of Physics, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Magnus Karlsson
- Albeda Research ApS, Copenhagen, Denmark
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Mathilde H Lerche
- Albeda Research ApS, Copenhagen, Denmark
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Arnaud Comment
- Institute of Physics, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- General Electric Healthcare, Chalfont St Giles, UK
| | - Juerg Schwitter
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac MR Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
45
|
Meier D, Fournier S, Barras N, Regamey J, Rosset S, Pavon AG, Kamani CH, Deliniere A, Domenichini G, Graf D, Hullin R, Pascale P, Girod G, Eeckhout É, Schwitter J, Prior JO, Pruvot É, Bouchardy J, Monney P, Muller O, Rutz T. [Cardiology]. Rev Med Suisse 2020; 16:16-22. [PMID: 31961076] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In 2019, the guidelines on the new entity « chronic coronary syndrome » have been published. They influence importantly the work-up and treatment of patients with stable coronary artery disease. We will also report on publications showing the benefit of percutaneous aortic valve implantation (TAVI) in patients with aortic stenosis and low risk surgical risk. With regard to infectious endocarditis, we elucidate the importance of the vegetation's size for predicting mortality and the prognostic value of the positron emission tomography in predicting septic embolism. We highlight the spectacular results of the DAPA-HF study in patients with heart failure and review publications showing the important role of the detection of myocardial fibrosis and scar by cardiac MRI for risk stratification of sudden cardiac death.
Collapse
Affiliation(s)
- David Meier
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Stéphane Fournier
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Nicolas Barras
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Julien Regamey
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Sabina Rosset
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Anna-Giulia Pavon
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Christel H Kamani
- Service de médecine nucléaire et d'imagerie moléculaire, Département de radiologie médicale, CHUV et Université de Lausanne, 1011 Lausanne
| | - Antoine Deliniere
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Denis Graf
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Roger Hullin
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Grégoire Girod
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Éric Eeckhout
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
- Centre de résonance magnétique cardiaque, CHUV, 1011 Lausanne
| | - John O Prior
- Service de médecine nucléaire et d'imagerie moléculaire, Département de radiologie médicale, CHUV et Université de Lausanne, 1011 Lausanne
| | - Étienne Pruvot
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Département cœur et vaisseaux, CHUV et Université de Lausanne, 1011 Lausanne
| |
Collapse
|
46
|
Pavon A, Hugelshofer S, Rutz T, Pascale P, Pruvot E, Muller O, Schwitter J, Monney P. 1047 Increased interstitial fibrosis in patients with mitral valve prolapse and mitro-annular dysjunction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
in patients with myxomatous mitral valve prolapse (MVP), mitral annular disjunction (MAD) has been associated with the presence of late gadolinium enhancement (LGE) at papillary muscle level and the risk of sudden cardiac death. However, patients with MAD but no detectable LGE still may have arrhythmia. We investigated the relation between MAD and the presence of interstitial fibrosis in the basal inferior left ventricular myocardium.
Methods
28 patient with MVP and associated MAD underwent Cardiovascular Magnetic Resonance imaging (CMR) at 1.5 T scanner (Aera, Siemens Medical Solutions, Erlangen, Germany). Exclusion criteria were ischemic heart disease, infiltrative cardiomyopathy and contraindication to CMR. 12 patients with mitral valve regurgitation but no MAD and 10 patients without mitral disease served as the control group. MAD severity was measured from LA wall-posterior MV leaflet junction to the top of the LV infero-basal wall during end systole. Insterstitial fibrosis was assessed by calculating the extracellular volume (ECV) from T1 mapping of the left ventricular basal slice acquired before and after Gadolinium injection.
Results
Mean age was 47,5+\-23,3 years and 60% were male. ECV was higher in patients with MVP compared with controls (basal septum: 0.27 ± 0.04 vs 0.23 ± 0.03 p = 0.006; basal inferoposterior wall 0.28 ± 0.03 vs 0.23 ± 0.02 p = 0.003) and there was a significant correlation between MAD severity and ECV of the basal inferior wall (spearman rho 0.68, p < 0.0001) (Figure 1). Among MVP patients, ECV of the basal inferoposterior wall was higher in patients positive for LGE in the papillary muscles (ECV 0.31 ± 0.03 vs 0.27 ± 0.03 p 0,004).
Conclusion
In MVP patients, MAD severity was associated with a higher amount of interstitial fibrosis even in the absence of detectable macroscopic fibrosis in the papillary muscle region.
Abstract 1047 Figure 1
Collapse
Affiliation(s)
- A Pavon
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - S Hugelshofer
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Pascale
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - E Pruvot
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| |
Collapse
|
47
|
Jumeau R, Vincenti MG, Pruvot E, Schwitter J, Vallet V, Zeverino M, Moeckli R, Bouchaab H, Bourhis J, Ozsahin M. Curative management of a cardiac metastasis from lung cancer revealed by an electrical storm. Clin Transl Radiat Oncol 2019; 21:62-65. [PMID: 31993511 PMCID: PMC6976909 DOI: 10.1016/j.ctro.2019.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/19/2019] [Accepted: 10/26/2019] [Indexed: 02/07/2023] Open
Abstract
Although cardiac metastases (CM) are more common than primary cardiac malignant tumors, they remain a rare localization of metastatic cancer. Until recently, CM were surgically treated as a palliative approach because of a lack of ablative solutions even for oligometastatic patients. Technological advances in radiation therapy (RT) in thoracic oncology have led to high precision delivery that enlarged the indications for stereotactic body radiotherapy (SBRT). To date, there are limited reports of cardiac SBRT for CM. Herein, we report a cardiac SBRT performed in curative intent for a lung cancer patient metastatic to the heart.
Collapse
Affiliation(s)
- Raphael Jumeau
- Radiation Oncology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Maria Gabriella Vincenti
- Cardiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Etienne Pruvot
- Cardiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Juerg Schwitter
- Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Veronique Vallet
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michele Zeverino
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raphael Moeckli
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hasna Bouchaab
- Oncology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean Bourhis
- Radiation Oncology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mahmut Ozsahin
- Radiation Oncology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
48
|
Abstract
Abstract
Background
Standard of care (SOC) suggests implanted cardioverter defibrillator (ICD) therapy based on the left ventricular ejection fraction (LVEF) cut-off value as detected by transthoracic echocardiography (TTE-LVEF)
Purpose
The aim of this study was to evaluate the additional prognostic value of a cardiac magnetic resonance (CMR) based score over SOC in a large cohort of non-ischemic cardiomyopathy (NICM) patients evaluated for primary ICD therapy
Methods
DERIVATE is an international, multicenter, prospective, observational registry including consecutive patients with chronic heart failure (HF) who undergo clinical evaluation. We included 1000 patients (derivation cohort) and 509 patients (validation cohort) with chronic heart failure (HF) with LVEF<50% affected by NICM enrolled in the period between January 2007 and October 2017. All-cause mortality and arrhythmic major adverse cardiac events (MACE) were the primary and the secondary endpoint, respectively.
Results
During a median follow-up of 959 days, all-cause mortality and combined MACE occurred in 72 (7%) and 93 (9%) patients respectively. Regarding to primary endpoint, age and number of myocardial segments with late gadolinium enhancement (LGE) midwall>3 were the only independent predictors of mortality (HR: 1.037, 95% CI: 1.018–1.057, p<0.001 and HR: 1.78, 95% CI: 1.062–3.005, p=0.029, respectively). Regarding to the secondary endpoint, gender, left ventricle end-diastolic volume indexed as detected by CMR (CMR-LVEDVi)>120.5 ml/m2, and number of myocardial segments with LGE midwall>2 were independent predictors of MACE (HR: 2.13, 95% CI: 1.231–3.690, p=0.007; HR: 3.16, 95% CI: 1.750–5.709, p<0.001 and HR: 1.69, 95% CI: 1.084–2.644, p<0.02 respectively). Accordingly, a weighted CMR score, including these three variables with a maximum of 7 points was calculated and when added to the model based on SOC provided a net reclassification improvement (NRI) of 63.7% (p<0.001). Finally, when the CMR-score was applied to validation cohort showed a NRI of 31.3% (p: 0.022) with a good prognostic stratification (p: 0.001) as compared to the SOC.
Conclusions
CMR provides additional prognostic stratification as compared to the SOC, which may have direct impact on the indication of ICD implantation. Further, prospective randomized trial should be addressed to test the cost-effectiveness of a CMR strategy as compared to SOC in patients undergoing ICD implantation.
Acknowledgement/Funding
funded by the Italian Ministry of Health, Rome, Italy (RC 2017 R659/17-CCM698
Collapse
Affiliation(s)
- A I Guaricci
- Institute of Cardiovascular Disease, Bari, Italy
| | - P G Masci
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - V Lorenzoni
- Sant'Anna School of Advanced Studies, Pisa, Italy
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| |
Collapse
|
49
|
Meier D, Fournier S, Eeckhout E, Masci PG, Schwitter J, Muller O, Harbaoui B. P3631Impact of manual thrombectomy on microvascular obstruction among STEMI patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Manual thrombectomy (MT) in ST segment elevation myocardial infarction (STEMI) is not associated with improved outcome and may even be harmful. Microvascular obstruction (MVO) assessed with cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after STEMI.
Purpose
We aimed to investigate the impact of MT on MVO occurrence and extent.
Method
Between December 2010 and June 2017, 401 consecutive STEMI patients admitted for primary PCI, and still hospitalized in our tertiary care hospital at day 3 or later, (i.e. not transferred to another hospital) underwent a CMR during the index hospitalization (routine care at our institution during this period). Among them, 383 patients fulfilled the inclusion criteria and were classified into 2 categories (with or without MT) while 18 patients were excluded because of incomplete CMR data. The 2 co-primary endpoints were the occurrence and the extent of MVO, with these latter being analyzed either as a categorical variable (MVO vs. No-MVO) or as a semi-continuous variable (numbers of segments with MVO), respectively.
Results
In total, 188 (49.1%) patients experienced MVO. Both the incidence of MVO and the median number of segments with MVO were significantly higher in the MT group as compared to the no-MT group (59.5% vs 38.9%, respectively p<0.001, Figure 1A) and (0 [0; 2] vs 1.5 [0; 4]; respectively, p<0.001). When stratifying the analysis on coronary thrombus grade (Figures 1B and 1C), similar results were found only in patients with high thrombus burden (43.5% vs 60.7%, respectively, p=0.004). When adjusting for baseline differences between the 2 groups, MT remained a determinant of MVO (OR 1.90 (CI 95% 1.08 to 3.34); p=0.026) in patients with high thrombus grade.
Figure 1
Conclusion
In STEMI patients undergoing primary PCI, MT is associated with the occurrence and the extent of MVO assessed by CMR, especially in patients with a high thrombus grade. This suggests thrombus fragmentation with distal embolization as a potential mechanistic explanation.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- D Meier
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - S Fournier
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - E Eeckhout
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - P G Masci
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Cardiology, Lausanne, Switzerland
| | - B Harbaoui
- Civils Hospices of Lyon, Cardiology, Lyon, France
| |
Collapse
|
50
|
Guaricci AI, Masci PG, Lorenzoni V, Schwitter J, Pontone G. 286Cardiac magnetic resonance for primary prevention implantable cardioverter debrillator therapy international registry: results of the derivate study. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez114.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - P G Masci
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - V Lorenzoni
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| |
Collapse
|