1
|
Dissabandara T, Lin K, Forwood M, Sun J. Validating real-time three-dimensional echocardiography against cardiac magnetic resonance, for the determination of ventricular mass, volume and ejection fraction: a meta-analysis. Clin Res Cardiol 2024; 113:367-392. [PMID: 37079054 PMCID: PMC10881629 DOI: 10.1007/s00392-023-02204-5] [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: 12/07/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Real-time three-dimensional echocardiography (RT3DE) is currently being developed to overcome the challenges of two-dimensional echocardiography, as it is a much cheaper alternative to the gold standard imaging method, cardiac magnetic resonance (CMR). The aim of this meta-analysis is to validate RT3DE by comparing it to CMR, to ascertain whether it is a practical imaging method for routine clinical use. METHODS A systematic review and meta-analysis method was used to synthesise the evidence and studies published between 2000 and 2021 were searched using a PRISMA approach. Study outcomes included left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), left ventricular mass (LVM), right ventricular end-systolic volume (RVESV), right ventricular end-diastolic volume (RVEDV) and right ventricular ejection fraction (RVEF). Subgroup analysis included study quality (high, moderate), disease outcomes (disease, healthy and disease), age group (50 years old and under, over 50 years), imaging plane (biplane, multiplane) and publication year (2010 and earlier, after 2010) to determine whether they explained the heterogeneity and significant difference results generated on RT3DE compared to CMR. RESULTS The pooled mean differences for were - 5.064 (95% CI - 10.132, 0.004, p > 0.05), 4.654 (95% CI - 4.947, 14.255, p > 0.05), - 0.783 (95% CI - 5.630, 4.065, p > 0.05, - 0.200 (95% CI - 1.215, 0.815, p > 0.05) for LVEF, LVM, RVESV and RVEF, respectively. We found no significant difference between RT3DE and CMR for these variables. Although, there was a significant difference between RT3DE and CMR for LVESV, LVEDV and RVEDV where RT3DE reports a lower value. Subgroup analysis indicated a significant difference between RT3DE and CMR for studies with participants with an average age of over 50 years but no significant difference for those under 50. In addition, a significant difference between RT3DE and CMR was found in studies using only participants with cardiovascular diseases but not in those using a combination of diseased and healthy participants. Furthermore, for the variables LVESV and LVEDV, the multiplane method shows no significant difference between RT3DE and CMR, as opposed to the biplane showing a significant difference. This potentially indicates that increased age, the presence of cardiovascular disease and the biplane analysis method decrease its concordance with CMR. CONCLUSION This meta-analysis indicates promising results for the use of RT3DE, with limited difference to CMR. Although in some cases, RT3DE appears to underestimate volume, ejection fraction and mass when compared to CMR. Further research is required in terms of imaging method and technology to validate RT3DE for routine clinical use.
Collapse
Affiliation(s)
- Thilini Dissabandara
- School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
| | - Kelly Lin
- Schools of Medicine and Dentistry, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
| | - Mark Forwood
- School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Jing Sun
- Schools of Medicine and Dentistry, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
- Institute for Integrated Intelligence and Systems, Griffith University, Brisbane, Australia.
| |
Collapse
|
2
|
Cheang I, Zhu X, Lu X, Shi S, Yue X, Tang Y, Gao Y, Liao S, Yao W, Zhou Y, Zhang H, Zhu Y, Xu Y, Li X. Correlation of ventricle epicardial fat volume and triglyceride-glucose index in patients with chronic heart failure. Int J Cardiovasc Imaging 2024:10.1007/s10554-024-03048-4. [PMID: 38212592 DOI: 10.1007/s10554-024-03048-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
To explore the association of ventricle epicardial fat volume (EFV) calculated by cardiac magnetic resonance (CMR) and the insulin resistance indicator of triglyceride-glucose (TyG) index in patients with chronic HF (CHF), this retrospective cohort study included adult CHF patients with confirmed diagnosis of heart failure from January 2018 to December 2020. All patients underwent 3.0T CMR, and EFV were measured under short-axis cine. Spearman correlation, multivariate linear regression, and restricted cubic spline (RCS) regression were used to analyze their association. There were 516 patients with CHF, of whom 69.8% were male. Median EFV was 57.14mL and mean TyG index was 8.48. Spearman correlation analysis showed that TyG index was significantly correlated with the EFV in CHF patients (r = 0.247, P < 0.001). Further analysis showed that TyG index levels were significantly associated with EFV as both continuous variables (Unstandardized β = 6.556, P < 0.001) and across the increasing quartiles (β = 7.50, 95% CI [1.41, 13.59], P < 0.05). RCS demonstrated there were a positive trend and linear association between EFV and TyG index in CHF patients (P for nonliearity = 0.941). In patients with CHF, the TyG index was positively and linearly associated with the EFV, which supports the metabolic roles of epicardial adipose tissue regarding insulin resistance.
Collapse
Affiliation(s)
- Iokfai Cheang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xu Zhu
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xinyi Lu
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shi Shi
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xin Yue
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yuan Tang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yujie Gao
- Department of Radiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shengen Liao
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Wenming Yao
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yanli Zhou
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Haifeng Zhang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Department of Cardiology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China
| | - Yinsu Zhu
- Department of Radiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yi Xu
- Department of Radiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Xinli Li
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| |
Collapse
|
3
|
Hu M, Shen Y, Song Y, Li S, Yang P, Kan A, Fang Q, Peng Y, Ren H, Zhang Y, Gong L. The use of cardiac magnetic resonance in hypertrophic cardiomyopathy over the past 10 years [2013-2023]: a CiteSpace-based bibliometric analysis. Quant Imaging Med Surg 2024; 14:566-578. [PMID: 38223124 PMCID: PMC10784000 DOI: 10.21037/qims-23-1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 01/16/2024]
Abstract
Background Hypertrophic cardiomyopathy (HCM) is a common genetic cardiac disorder characterized by the hypertrophy of a segment of the myocardium. Cardiac magnetic resonance (CMR) has been widely used in the assessment of HCM. However, no bibliometric assessment has been conducted on the progress of research in this field. This study thus aimed to examine the current state of research into the application of CMR in HCM and the hotspots and trends that have emerged in this field over the past decade. Methods A systematic search was conducted on the Web of Science regarding CMR in the assessment of HCM. The databases were searched from 2013 to June 2023. CiteSpace is an application that can be used to characterize the underlying knowledge of the scientific literature in a given field. We used it to analyze the relationship between publication year and country, institution, journal, author, bibliography, and keywords in the field of CMR for the assessment of HCM. Results A total of 1,427 articles were included in the analysis. In the assessment of HCM, the findings from the past decade have consistently demonstrated a progressive rise in the quantity of articles pertaining to CMR. The country with the largest number of publications was the United States [310], and the institution with the greatest number of publications was the University College London [45]. The analysis of keywords revealed the diagnosis and management of HCM with CMR to be the current research focus and emerging trend within this academic field. Conclusions This study used a novel approach to visually analyze the use of CMR in HCM assessment. The current research trajectory in CMR consists of the diagnosis and management of patients with HCM. Although most studies confirmed the indispensability of CMR in the assessment of HCM, larger-scale cohorts are still needed to more comprehensively evaluate the role of CMR in the differential diagnosis, pre- and post-treatment assessment, and long-term management of patients with HCM.
Collapse
Affiliation(s)
- Mengyao Hu
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Shen
- Department of Neurology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yipei Song
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shuhao Li
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pei Yang
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ao Kan
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qiming Fang
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yun Peng
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haibo Ren
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yajing Zhang
- Department of Neurology, the People’s Hospital of Tiantai County, Taizhou, China
| | - Lianggeng Gong
- Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
4
|
Korosoglou G, Thiele H, Baldus S, Böhm M, Frey N. Lessons learned from SCOT-HEART, DISCHARGE, and PRECISE: a patient-centered perspective with implications for the appropriate use of CCTA. Clin Res Cardiol 2023; 112:1347-1350. [PMID: 37580532 DOI: 10.1007/s00392-023-02277-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Grigorios Korosoglou
- Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany.
- Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany.
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany
| | - Stephan Baldus
- Clinic III for Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Michael Böhm
- Clinic of Cardiology, Angiology and Intensive Care Medicine, University Hospital Homburg, Saarland University, Homburg, Germany
| | - Norbert Frey
- Departments of Cardiology, Angiology and Pneumology, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
5
|
Li Q, Gao X, Zhou Z, Zhang H, Li W, Gao Y, Bo K, Wang H, Wang R, Sun Z, Xu L. Impaired cardiac pump function assessment with normalized cardiac power using cardiac magnetic resonance in patients with hypertrophic cardiomyopathy. Quant Imaging Med Surg 2023; 13:4103-4116. [PMID: 37456301 PMCID: PMC10347308 DOI: 10.21037/qims-22-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/06/2023] [Indexed: 07/18/2023]
Abstract
Background Cardiac power (CP; CP = 0.222 × cardiac output × mean blood pressure) output in patients with heart failure has been studied previously, but its importance in patients with hypertrophic cardiomyopathy (HCM) remains unclear. The present study aimed to explore the role of normalized CP (normalized CP = CP/ventricle mass) in assessing cardiac function in patients with HCM with normal ejection fraction using cardiac magnetic resonance (CMR). Methods This cross-sectional study enrolled 99 patients with HCM who underwent CMR from December 2020 to January 2022 at Beijing Anzhen Hospital, and these patients were classified into heart failure or non-heart failure subgroups. Meanwhile, a control group comprising 65 gender- and age-matched healthy volunteers was also enrolled. The baseline clinical characteristics and cardiac functional parameters were compared between the patients with HCM and the controls, and multivariable linear regression analysis was performed to analyze the relationship between normalized CP and the relevant factors. Results Significantly higher CP (1.19 vs. 1.01 W; P=0.03) but lower normalized CP (0.73 vs. 1.12 W/100 g; P<0.001) were found in patients with HCM as compared with the controls. Multivariable analysis showed that HCM correlated well with normalized CP [β=-0.235; 95% confidence interval (CI): -0.341 to -0.129; P<0.001]. In the HCM group, there were 34 cases with heart failure and 65 with non-heart failure, and the patients with HCM with heart failure showed similar CP (1.14 vs. 1.24 W; P=0.06) but significantly lower normalized CP (0.54 vs. 0.78 W/100 g; P<0.001). The correlation analysis of normalized CP and functional parameters revealed that normalized CP was inversely correlated with left ventricle mass/body surface area (R=-0.509; 95% CI: -0.646 to -0.341; P<0.001) in patients with HCM. Conclusions Normalized CP decreased significantly and was negatively correlated with ventricle mass, indicating impaired cardiac pump function in patients with HCM. Normalized CP might play a critical role in detecting and evaluating impaired cardiac pump function in patients with HCM with preserved ejection fraction.
Collapse
Affiliation(s)
- Qing Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xuelian Gao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhen Zhou
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hongkai Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wenjie Li
- Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Yifeng Gao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Kairui Bo
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hui Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Rui Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Polidori T, De Santis D, Rucci C, Tremamunno G, Piccinni G, Pugliese L, Zerunian M, Guido G, Pucciarelli F, Bracci B, Polici M, Laghi A, Caruso D. Radiomics applications in cardiac imaging: a comprehensive review. Radiol Med 2023:10.1007/s11547-023-01658-x. [PMID: 37326780 DOI: 10.1007/s11547-023-01658-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
Radiomics is a new emerging field that includes extraction of metrics and quantification of so-called radiomic features from medical images. The growing importance of radiomics applied to oncology in improving diagnosis, cancer staging and grading, and improved personalized treatment, has been well established; yet, this new analysis technique has still few applications in cardiovascular imaging. Several studies have shown promising results describing how radiomics principles could improve the diagnostic accuracy of coronary computed tomography angiography (CCTA) and magnetic resonance imaging (MRI) in diagnosis, risk stratification, and follow-up of patients with coronary heart disease (CAD), ischemic heart disease (IHD), hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD), and many other cardiovascular diseases. Such quantitative approach could be useful to overcome the main limitations of CCTA and MRI in the evaluation of cardiovascular diseases, such as readers' subjectiveness and lack of repeatability. Moreover, this new discipline could potentially overcome some technical problems, namely the need of contrast administration or invasive examinations. Despite such advantages, radiomics is still not applied in clinical routine, due to lack of standardized parameters acquisition, inconsistent radiomic methods, lack of external validation, and different knowledge and experience among the readers. The purpose of this manuscript is to provide a recent update on the status of radiomics clinical applications in cardiovascular imaging.
Collapse
Affiliation(s)
- Tiziano Polidori
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Domenico De Santis
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Carlotta Rucci
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giuseppe Tremamunno
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giulia Piccinni
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Luca Pugliese
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Marta Zerunian
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Gisella Guido
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Francesco Pucciarelli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Benedetta Bracci
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Michela Polici
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
| | - Damiano Caruso
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| |
Collapse
|
7
|
Jiang X, Yan Y, Yang Z, Wen M, Long Y, Fu B, Jiang J. Diagnostic accuracy of left atrial function and strain for differentiating between acute and chronic myocardial infarction. BMC Cardiovasc Disord 2023; 23:218. [PMID: 37118657 PMCID: PMC10148459 DOI: 10.1186/s12872-023-03254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/20/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The cardiac magnetic resonance tissue tracking (CMR-TT) technique was used to obtain left atrial strain and strain rate in patients with myocardial infarction (MI) and to evaluate the utility of this technique in the quantitative assessment of myocardial infarction for distinguishing acute from chronic myocardial infarction. METHODS We retrospectively analyzed 36 consecutive patients with acute myocardial infarction (AMI) and 29 patients with chronic myocardial infarction (CMI) who underwent CMR and 30 controls. Left atrial (LA) and ventricular functions were quantified by volumetric, and CMR-TT derived strain analysis from long and short left ventricular view cines. Receiver Operating Characteristics (ROC) analysis was used to determine the diagnostic accuracy of CMR-TT strain parameters for discriminating between acute and chronic myocardial infarction. RESULTS AMI and CMI participants had impaired LA reservoir function, conduit function and LA booster pump dysfunction compared to the controls. LA strain was more sensitive than LV global strain for the assessment of the MI stage. Peak late-negative SR yielded the best areas under the ROC curve (AUC) of 0.879, showing differentiation between acute and chronic myocardial infarction of all the LA strain parameters obtained. The highest significant differences between chronic myocardial infarction and normal myocardium were also found in the LV strain (p < 0.001) and LA functional parameters (p < 0.001), but there was no difference between AMI and normals. CONCLUSIONS CMR-TT-derived LA strain is a potential and robust tool in demonstrating impaired LA mechanics and quantifying LA dynamics, which have high sensitivity and specificity in the differential diagnosis of acute versus chronic myocardial infarction. Their use is thus worth popularizing in clinical application.
Collapse
Affiliation(s)
- Xiaofeng Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Yi Yan
- Department of Pain, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhi Yang
- The Fifth People's Hospital of Chengdu, Chengdu, China
| | - Miao Wen
- The Fifth People's Hospital of Chengdu, Chengdu, China
| | - Yitian Long
- The Fifth People's Hospital of Chengdu, Chengdu, China
| | - Bing Fu
- The Fifth People's Hospital of Chengdu, Chengdu, China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| |
Collapse
|
8
|
Altibi A, Alani A, Zhao Y, Masri A. Baseline and Longitudinal Imaging of Hypertrophic Cardiomyopathy in the Era of Emerging Therapeutics. Curr Cardiol Rep 2023; 25:583-595. [PMID: 37103749 DOI: 10.1007/s11886-023-01883-w] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE OF REVIEW In this review, we will overview the baseline and longitudinal imaging modalities utilized in the care of patients with hypertrophic cardiomyopathy (HCM) with a focus on echocardiography and cardiac magnetic resonance (CMR) imaging, especially in the new era of cardiac myosin inhibitors (CMIs). RECENT FINDINGS Traditional therapies for hypertrophic cardiomyopathy (HCM) have been well established for decades. Attempts to investigate new drug therapy in HCM resulted in neutral clinical trials, until the discovery of cardiac myosin inhibitors (CMIs). The introduction of this new class of small oral molecules which target the hypercontractility resulting from excessive actin-myosin cross-bridging at the sarcomere level is the first therapeutic option which directly addresses the underlying pathophysiology of HCM. While imaging has always played a central role in HCM diagnosis and management, CMIs introduced a new paradigm in the use of imaging to evaluate and monitor patients with HCM. Echocardiography and cardiac magnetic resonance imaging (CMR) are the central modalities in the care of patients with HCM, but their roles and our understanding of their strengths and limitations are evolving as newer therapeutics are being investigated in clinical trials and in daily practice. In this review, we will focus the recent CMI trials and discuss the role of baseline and longitudinal imaging with echocardiography and CMR in the care of patients with HCM in the era of CMIs.
Collapse
Affiliation(s)
- Ahmed Altibi
- Division of Cardiovascular Medicine, Hypertrophic Cardiomyopathy Center, Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Ahmad Alani
- Division of Cardiovascular Medicine, Hypertrophic Cardiomyopathy Center, Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Yuanzi Zhao
- Division of Cardiovascular Medicine, Hypertrophic Cardiomyopathy Center, Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Ahmad Masri
- Division of Cardiovascular Medicine, Hypertrophic Cardiomyopathy Center, Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| |
Collapse
|
9
|
Honjo O. Integrating Novel Physiologic Data into Decision-Making in Congenital Heart Surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2022; 25:19-27. [PMID: 35835512 DOI: 10.1053/j.pcsu.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/20/2022] [Accepted: 02/03/2022] [Indexed: 11/11/2022]
Abstract
Optimal decision-making to determine the type and timing of surgical intervention for various congenital heart disease (CHD) requires adequate understanding and interpretation of anatomic and physiologic data obtained from various imaging modalities. Cardiac magnetic resonance (CMR) has revolutionized the way we evaluate the anatomy and physiology of CHD. In addition to 2- and 3-dimensional anatomic data and volumetry, phase-contrast CMR allows quantitative measurements of cardiac output, pulmonary blood flow, pulmonary-to-systemic flow ratio, the amount of intracardiac shunt, valve regurgitation, and aortopulmonary collateral flows. This review article describes the utilization of CMR-derived flow data in surgical decision-making in three distinct subgroups: (1) patients with borderline left ventricle (LV) with emphasis on the ascending aortic flow and other physiologic parameters, (2) single ventricle patients who undergo bidirectional cavopulmonary shunt with emphasis on the impact of superior vena cava blood flow on postoperative physiology, and (3) patients with pulmonary atresia and major aortopulmonary collateral arteries with emphasis on the impact of total pulmonary blood flow and systemic-to-pulmonary flow ratio on clinical outcomes.
Collapse
Affiliation(s)
- Osami Honjo
- Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
10
|
Qiu D, Cheng Y, Wang X. Dual U-Net residual networks for cardiac magnetic resonance images super-resolution. Comput Methods Programs Biomed 2022; 218:106707. [PMID: 35255374 DOI: 10.1016/j.cmpb.2022.106707] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 10/03/2021] [Revised: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Heart disease is a vital disease that has threatened human health, and is the number one killer of human life. Moreover, with the added influence of recent health factors, its incidence rate keeps showing an upward trend. Today, cardiac magnetic resonance (CMR) imaging can provide a full range of structural and functional information for the heart, and has become an important tool for the diagnosis and treatment of heart disease. Therefore, improving the image resolution of CMR has an important medical value for the diagnosis and condition assessment of heart disease. At present, most single-image super-resolution (SISR) reconstruction methods have some serious problems, such as insufficient feature information mining, difficulty to determine the dependence of each channel of feature map, and reconstruction error when reconstructing high-resolution image. METHODS To solve these problems, we have proposed and implemented a dual U-Net residual network (DURN) for super-resolution of CMR images. Specifically, we first propose a U-Net residual network (URN) model, which is divided into the up-branch and the down-branch. The up-branch is composed of residual blocks and up-blocks to extract and upsample deep features; the down-branch is composed of residual blocks and down-blocks to extract and downsample deep features. Based on the URN model, we employ this a dual U-Net residual network (DURN) model, which combines the extracted deep features of the same position between the first URN and the second URN through residual connection. It can make full use of the features extracted by the first URN to extract deeper features of low-resolution images. RESULTS When the scale factors are 2, 3, and 4, our DURN can obtain 37.86 dB, 33.96 dB, and 31.65 dB on the Set5 dataset, which shows (i) a maximum improvement of 4.17 dB, 3.55 dB, and 3.22dB over the Bicubic algorithm, and (ii) a minimum improvement of 0.34 dB, 0.14 dB, and 0.11 dB over the LapSRN algorithm. CONCLUSION Comprehensive experimental study results on benchmark datasets demonstrate that our proposed DURN can not only achieve better performance for peak signal to noise ratio (PSNR) and structural similarity index (SSIM) values than other state-of-the-art SR image algorithms, but also reconstruct clearer super-resolution CMR images which have richer details, edges, and texture.
Collapse
Affiliation(s)
- Defu Qiu
- Engineering Research Center of Intelligent Control for Underground Space, Ministry of Education, China University of Mining and Technology, Xuzhou 221116, China; School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - Yuhu Cheng
- Engineering Research Center of Intelligent Control for Underground Space, Ministry of Education, China University of Mining and Technology, Xuzhou 221116, China; School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - Xuesong Wang
- Engineering Research Center of Intelligent Control for Underground Space, Ministry of Education, China University of Mining and Technology, Xuzhou 221116, China; School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China.
| |
Collapse
|
11
|
Dolan RS, Stillman AE, Davarpanah AH. Feasibility of Hepatic T1-Mapping and Extracellular Volume Quantification on Routine Cardiac Magnetic Resonance Imaging in Patients with Infiltrative and Systemic Disorders. Acad Radiol 2022; 29 Suppl 4:S100-S109. [PMID: 34702675 DOI: 10.1016/j.acra.2021.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/05/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES Cardiac magnetic resonance imaging (CMR) is commonly obtained to evaluate for myocardial infiltrative disorders and fibrosis. Pre- and post-Gadolinium contrast T1-mapping sequences are employed to estimate interstitial expansion using extracellular volume fraction (ECV). Given the proximity of the liver to the heart, T1 and ECV quantification of the liver is feasible on CMR. The purpose of this study was to evaluate for hepatic measures of fibrosis and interstitial expansion in patients with amyloidosis or systemic disease on CMR. MATERIALS AND METHODS Myocardial and hepatic native T1 values were measured retrospectively using a cardiac short axis modified Look-Locker inversion recovery sequence. Myocardial and hepatic ECV were calculated using pre- and post-contrast T1 and blood pool values according to the following formula: ECV = (Δ(1/T1) myocardium or liver and/or Δ(1/T1) blood)x(1 - hematocrit). Patients were divided into three cohorts by final diagnosis: amyloidosis, systemic disease (e.g. sarcoid, scleroderma), and controls (EF > 50, no ischemia). RESULTS Of the 135 patients who underwent CMR, 22 had cardiac amyloidosis (age 59.9 ± 12.6 yrs, 41% female), 20 had systemic disease (age 50.9 ± 13.4 yrs, 35% female), and 93 were controls (age 49.5 ± 17.3 yrs, 50% female). Myocardial T1 and ECV values were highest for patients with amyloid, second highest for systemic disease, and least for controls (T1: 1169 ± 92 vs 1101 ± 53 vs 1027 ± 73 ms, p < 0.0001; ECV: 0.47 ± 0.11 vs 0.31 ± 0.05 vs 0.27 ± 0.04, p < 0.0001). Hepatic T1 and ECV were similarly higher in patients with amyloid and systemic disease compared to controls (T1: 646 ± 101 vs 660 ± 93 vs 595 ± 58 ms, p < 0.0001; ECV: 0.38 ± 0.08 vs 0.37 ± 0.05 vs 0.31 ± 0.03, p < 0.0001). There was a positive correlation between hepatic T1 and ECV (R2 = 0.282, p < 0.0001). No patients had abnormal liver function tests or clinical liver disease. CONCLUSION Hepatic ECV quantification on CMR in patients with amyloidosis and systemic disorders is feasible. Further longitudinal investigation regarding detection of early or subclinical liver disease is warranted.
Collapse
Affiliation(s)
- Ryan S Dolan
- Department of Radiology (R.S.D., A.E.S., A.H.D.), Emory University, 1364 Clifton Road NE, Atlanta, GA 30322.
| | - Arthur E Stillman
- Department of Radiology (R.S.D., A.E.S., A.H.D.), Emory University, 1364 Clifton Road NE, Atlanta, GA 30322
| | - Amir H Davarpanah
- Department of Radiology (R.S.D., A.E.S., A.H.D.), Emory University, 1364 Clifton Road NE, Atlanta, GA 30322
| |
Collapse
|
12
|
Yao Q, Hu XH, He LL. Evaluation of comprehensive myocardial contractility in children with Kawasaki disease by cardiac magnetic resonance in a large single center. Quant Imaging Med Surg 2022; 12:481-492. [PMID: 34993095 DOI: 10.21037/qims-20-1402] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Children with Kawasaki disease (KD) and coronary artery lesions (CALs) can develop myocardial ischemia, fibrosis, and abnormal contractility. We aimed to assess the association between myocardial mechanical deformation with myocardial fibrosis, ischemia, and CALs. METHODS In total, 76 KD and 20 healthy volunteers received cardiac magnetic resonance (CMR). Peak systolic left ventricular (LV) longitudinal, radial, and circumferential strain and strain rate [LV strain longitudinal (LVSL), LV strain radial (LVSR), LV strain circumferential (LVSC), LV strain rate longitudinal (LVSRL), LV strain rate radial (LVSRR), and LV strain rate circumferential (LVSRC)], along with late gadolinium enhancement (LGE), perfusion deficit, and CALs in related segments were analyzed. The KD group was subdivided by CALs, perfusion, and LGE results, and strain results were compared with controls and in subgroups. RESULTS Cardiac fibrosis and ischemia were not confined to the territory of CALs. In a global analysis, strain and strain rates were lower in the KD group, especially in the subgroup with LGE and perfusion deficit. In segmental analysis, LVSR, LVSC, LVSL, and LVSRR decreased in the giant aneurysm group, and a lower LVSR (20.369%±10.603% vs. 26.071%±12.349%) and LVSC (-13.37%±5.365% vs. -15.847%±5.778%) were observed in thrombosed segments. The strain and strain rate were all lower in segments with LGE and perfusion deficit, and no obvious difference was found between groups with and without stenosis. LVSR had a better ability to identify giant aneurysm, thrombosis, stenosis, perfusion deficit, and LGE. CONCLUSIONS We detected lower strain values in KD patients, which was more pronounced in segments with aneurysm, thrombi, LGE, and perfusion deficit. LVSR is useful to discern patients with higher risk.
Collapse
Affiliation(s)
- Qiong Yao
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Xi-Hong Hu
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Li-Li He
- Department of Ultrasound, Children's Hospital of Fudan University, Shanghai, China
| |
Collapse
|
13
|
Gatti M, Liguori C, Muscogiuri G, Faletti R, Dell'Aversana S, Toia P, De Rubeis G, Di Renzi P, Russo V, Polizzi G, Galea N, Esposito A, Francone M. Challenges and opportunities to delivering cardiac imaging training: a national survey by the Italian college of cardiac radiology. Insights Imaging 2021; 12:136. [PMID: 34570297 PMCID: PMC8475361 DOI: 10.1186/s13244-021-01076-5] [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: 03/22/2021] [Accepted: 08/14/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Delivering consistent levels of training in cardiac imaging to radiologist is of pivotal importance because of the increasing clinical indications to coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR). Our study sought to capture the heterogeneity of cardiac imaging training programs and to explore residents' vision on cardiac imaging both in the present and in the future. METHODS Two web-based surveys were created. The first was administered to all chief residents from the 42 University Hospitals within Italy, aiming to explore the local educational offer in cardiac imaging. The second was administered via social media to all Italian residents, including questions about their overall vision regarding cardiac imaging. RESULTS 42/42 University Hospitals responded to the first survey and 235 residents to the second. There was at least a 64-slice CT scanner and a 1.5 T MR scanner per center. In the majority of sites, the weekly routine consisted of more than 10 CCTA and more than 5 CMR. Approximately, half of the centers used advanced CCTA and CMR techniques. The majority of the interviewed resident (94%) perceived cardiac imaging training to be moderately to very important, while requirement for external educational resources was advocated in 25% of the cases. CONCLUSION Our survey highlighted a significant awareness of radiology residents regarding the importance of cardiac imaging in their training curriculum. All centers met the technical requirements for cardiac imaging, limiting its use to basic applications in around half of cases. Implementation of an educational network might be the key for supporting the growth of this subspecialty field.
Collapse
Affiliation(s)
- Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Carlo Liguori
- Radiology Unit, ASL Napoli1Centro-Ospedale del Mare, Naples, Italy
| | - Giuseppe Muscogiuri
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, University Milano Bicocca, Milan, Italy
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Serena Dell'Aversana
- Department of Radiology, Ospedale S. Maria Delle Grazie - ASL Napoli 2 Nord, Pozzuoli, Italy
| | - Patrizia Toia
- Department of Biomedicine, Neurosciences and Advanced Diagnostics - BIND, University of Palermo, Palermo, Italy
| | - Gianluca De Rubeis
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.,Department of Diagnostic Imaging, AO San Camillo/Forlanini, Rome, Italy
| | - Paolo Di Renzi
- Radiology Unit, "San Giovanni Calibita" Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Vincenzo Russo
- U.O, Radiologia Cardio-Toracica, Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Gesualdo Polizzi
- Unit of Radiodiagnostics II, University Hospital Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Nicola Galea
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Antonio Esposito
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy. .,IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.
| |
Collapse
|
14
|
Winther S, Andersen IT, Gormsen LC, Steffensen FH, Nielsen LH, Grove EL, Diederichsen ACP, Urbonaviciene G, Lambrechtsen J, Zaremba T, Elpert FP, Husain M, Zelechowski MW, Bøtker HE, Bøttcher M. Prognostic value of myocardial perfusion imaging after first-line coronary computed tomography angiography: A multi-center cohort study. J Cardiovasc Comput Tomogr 2021; 16:34-40. [PMID: 34475016 DOI: 10.1016/j.jcct.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Further diagnostic testing may be required after a coronary computed tomography angiography (CTA) showing suspected coronary stenosis. Whether myocardial perfusion imaging (MPI) provides further prognostic information post-CTA remains debated. We evaluated the prognosis for patients completing CTA stratified for post-CTA diagnostic work-up using real-world data. METHODS We identified all patients in our uptake area with angina symptoms undergoing first-time CTA over a 10-year period. Follow-up time was a median of 3.7 years [1.9-5.8]. The primary endpoint was a composite of myocardial infarction or death. The secondary endpoint was late revascularization. RESULTS During the study period 53,351 patients underwent CTA. Of these, 24% were referred for further down-stream testing, 3,547 (7%) to MPI and 9,135 (17%) to invasive coronary angiography (ICA). The primary and secondary endpoints occurred in 2,026 (3.8%) and 954 (1.8%) patients. Patient-characteristic-adjusted hazard ratios for the primary and secondary endpoint using patients with a normal CTA as reference were 1.37 (1.21-1.55) and 2.50 (1.93-3.23) for patient treated medically, 1.68 (1.39-2.03) and 6.13 (4.58-8.21) for patients referred to MPI and 1.94 (1.69-2.23) and 9.18 (7.16-11.78) for patients referred for ICA, respectively. Adjusted analysis with stratification for disease severity at CTA showed similar hazard ratios for patients treated medically after CTA and patients referred for MPI and treated medically after the MPI. CONCLUSION In patients completing coronary CTA, second-line MPI testing seems to identify patients at low risk of future events. MPI seems to have the potential to act as gatekeeper for ICA after coronary CTA.
Collapse
Affiliation(s)
- Simon Winther
- Department of Cardiology, Hospital Unit West, Herning, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
| | | | | | | | | | - Erik Lerkevang Grove
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Denmark.
| | | | | | - Jess Lambrechtsen
- Department of Cardiology, Odense University Hospital, Svendborg, Denmark.
| | - Tomas Zaremba
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
| | - Frank-Peter Elpert
- Department of Cardiology, Regional Hospital of South Jutland, Aabenraa, Denmark.
| | - Majed Husain
- Department of Cardiology, Regional Hospital of South West Denmark, Esbjerg, Denmark.
| | | | - Hans Erik Bøtker
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Denmark.
| | - Morten Bøttcher
- Department of Cardiology, Hospital Unit West, Herning, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
| | | |
Collapse
|
15
|
Buckert D, Belal A, Seidl A, Rottbauer W, Thiele H, Rasche V, Wöhrle J. Acute phase segmental radial strain correlates with recovery and late gadolinium extent in ST-elevation myocardial infarction (STEMI): analysis of the abciximab intracoronary versus intravenously drug application in STEMI substudy. Quant Imaging Med Surg 2021; 11:3595-3603. [PMID: 34341734 DOI: 10.21037/qims-21-56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/22/2021] [Indexed: 11/06/2022]
Abstract
Background The role of regional strain evaluation in patients with acute reperfused ST-elevation myocardial infarction (STEMI) is not well determined. The objective of this study was the description of regional strain characteristics in the acute and chronic phase of myocardial infarction and its correlation with symptom-to-balloon time and final extent of myocardial scar assessed by cardiac magnetic resonance imaging. Methods The study cohort has been derived from the randomized controlled Abciximab Intracoronary versus Intravenously Drug Application in STEMI (AIDA STEMI) trial enrolled at the University of Ulm. All patients received comprehensive cardiac magnetic resonance imaging examinations in the acute phase and 6 months later. Results There was a significant improvement of all global deformation indices over time (global longitudinal strain: -13.1%±5.1% to -15.5%±5.8%, P=0.001; global circumferential strain: -14.4%±3.7% to -16.8%±3.6%, P<0.0001; global radial strain: 28.1%±8.7% to 31.9%±9.2%, P=0.0002). Mean radial strain of ischemic segments significantly improved (16.6%±10.8% to 23.7%±12.8%, P<0.0001), while mean radial strain of remote segments remained unchanged (40.2%±9.4% to 39.4%±9.4%, P=0.570). There was a significant correlation between acute phase radial strain of ischemic segments and either symptom-to-balloon time (P=0.013), as well as extent of late gadolinium enhancement at follow-up (P<0.0001). Using a cut-off of ≤27%, acute phase radial strain predicted infarction of the corresponding segment with high sensitivity and specificity (74.4% and 69.0% respectively, P<0.001). Conclusions Segmental radial strain in the acute phase of infarction showed a significant correlation to either symptom-to-balloon-time and the extent of late gadolinium enhancement at follow-up, thus potentially serving as early surrogate for left ventricular remodeling and outcome in STEMI.
Collapse
Affiliation(s)
- Dominik Buckert
- Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
| | - Awad Belal
- Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
| | - Adrian Seidl
- Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Volker Rasche
- Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
| | - Jochen Wöhrle
- Department of Cardiology, Medical Campus Lake Constance, Friedrichshafen, Germany
| |
Collapse
|
16
|
Asadian S, Rezaeian N, Hosseini L, Toloueitabar Y, Komasi MMH, Shayan L. How does iron deposition modify the myocardium? A feature-tracking cardiac magnetic resonance study. Int J Cardiovasc Imaging 2021; 37:3269-3277. [PMID: 34105082 DOI: 10.1007/s10554-021-02305-0] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022]
Abstract
Iron-overload cardiomyopathy is the principal cause of mortality in thalassemia. Via feature-tracking cardiac magnetic resonance (FT-CMR), we investigated alterations in cardiac deformation with the progression in myocardial iron overload (MIO). We enrolled 154 patients with thalassemia (50.64% male, mean age = 32.19 ± 9.79 years) referred for MIO assessment and 28 controls (50% male, mean age = 31.07 ± 4.35 years). Functional, strain, and T2* values were assessed in 4 study groups: no MIO (T2* > 20), mild-to-moderate MIO (T2* = 10-20), severe MIO (T2* < 10), and healthy controls. The recorded strain values were compared between the groups. The study groups were statistically significantly different vis-à-vis left ventricular (LV) global longitudinal strain (GLS) (F [3, 178] = 20.30), LV global radial strain (GRS) (F [3, 178] = 11.61), right ventricular (RV) GLS (F [3, 178]) = 5.32), RV global circumferential strain (GCS) (F [3, 178] = 26.02), and RVGRS (F [3, 178] = 16.86) (Ps < 0.005). The post hoc test revealed that LVGLS, RVGCS, and RVGRS were different between patients with thalassemia but without MIO and the control group (Ps < 0.001). A significant difference in LVGLS and LVGRS was detected between the T2* > 20 and 10 ≤ T2* ≤ 20 groups (Ps < 0.05). The multivariate logistic regression analysis depicted LVGRS as the most robust predictor of MIO (T2* ≤ 20) (odds ratio = 0.920, 95% CI 0.886 to 0.955), which predicted MIO with a cutoff point of 31.16% or less (sensitivity = 62% and specificity = 80.77%). Biventricular FT-CMR values are impaired in patients with thalassemia even without MIO. With MIO progression, LV strain values are the first ones to be undermined. Notably, functional CMR indices are jeopardized late, only after severe iron deposition.
Collapse
Affiliation(s)
- Sanaz Asadian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Rezaeian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Leila Hosseini
- North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Yaser Toloueitabar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Shayan
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, Chamran Boulevard, Shiraz, Iran
| |
Collapse
|
17
|
Bays HE, Khera A, Blaha MJ, Budoff MJ, Toth PP. Ten things to know about ten imaging studies: A preventive cardiology perspective ("ASPC top ten imaging"). Am J Prev Cardiol 2021; 6:100176. [PMID: 34327499 PMCID: PMC8315431 DOI: 10.1016/j.ajpc.2021.100176] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Knowing the patient's current cardiovascular disease (CVD) status, as well as the patient's current and future CVD risk, helps the clinician make more informed patient-centered management recommendations towards the goal of preventing future CVD events. Imaging tests that can assist the clinician with the diagnosis and prognosis of CVD include imaging studies of the heart and vascular system, as well as imaging studies of other body organs applicable to CVD risk. The American Society for Preventive Cardiology (ASPC) has published "Ten Things to Know About Ten Cardiovascular Disease Risk Factors." Similarly, this "ASPC Top Ten Imaging" summarizes ten things to know about ten imaging studies related to assessing CVD and CVD risk, listed in tabular form. The ten imaging studies herein include: (1) coronary artery calcium imaging (CAC), (2) coronary computed tomography angiography (CCTA), (3) cardiac ultrasound (echocardiography), (4) nuclear myocardial perfusion imaging (MPI), (5) cardiac magnetic resonance (CMR), (6) cardiac catheterization [with or without intravascular ultrasound (IVUS) or coronary optical coherence tomography (OCT)], (7) dual x-ray absorptiometry (DXA) body composition, (8) hepatic imaging [ultrasound of liver, vibration-controlled transient elastography (VCTE), CT, MRI proton density fat fraction (PDFF), magnetic resonance spectroscopy (MRS)], (9) peripheral artery / endothelial function imaging (e.g., carotid ultrasound, peripheral doppler imaging, ultrasound flow-mediated dilation, other tests of endothelial function and peripheral vascular imaging) and (10) images of other body organs applicable to preventive cardiology (brain, kidney, ovary). Many cardiologists perform cardiovascular-related imaging. Many non-cardiologists perform applicable non-cardiovascular imaging. Cardiologists and non-cardiologists alike may benefit from a working knowledge of imaging studies applicable to the diagnosis and prognosis of CVD and CVD risk - both important in preventive cardiology.
Collapse
Affiliation(s)
- Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville KY 40213 USA
| | - Amit Khera
- UT Southwestern Medical Center, Dallas, TX USA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore MD USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance CA USA
| | - Peter P. Toth
- CGH Medical Cener, Sterling, IL 61081 USA
- Cicarrone center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD USA
| |
Collapse
|
18
|
Yang L, Cao S, Liu W, Wang T, Xu H, Gao C, Zhang L, Wang K. Cardiac Magnetic Resonance Feature Tracking: A Novel Method to Assess Left Ventricular Three-Dimensional Strain Mechanics After Chronic Myocardial Infarction. Acad Radiol 2021; 28:619-27. [PMID: 32340915 DOI: 10.1016/j.acra.2020.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/05/2020] [Accepted: 03/07/2020] [Indexed: 01/22/2023]
Abstract
RATIONALE AND OBJECTIVES This study was designed to assess left ventricular deformation after chronic myocardial infarction (CMI) using cardiac magnetic resonance feature tracking (CMR-FT) technology, and analyze its relationship with left ventricular ejection fraction (LVEF) and infarcted transmurality. MATERIALS AND METHODS Ninety-six patients with CMI and 72 controls underwent 3.0 T CMR scanning. Strain parameters were measured by dedicated software, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), segmental peak longitudinal strain (PLS), peak circumferential strain (PCS), and peak radial strain (PRS). All enhanced myocardium segments were divided into subendocardial infarction (SI) and transmural infarction (TI) group. Pearson, intraclass correlation coefficient and receiver operating characteristic analysis were performed to compare the parameters' mean values between SI and TI groups. RESULTS GPLS, GPRS, and GPCS in CMI group were significantly decreased comparing with control group. PRS and PCS in TI group were significantly lower than those in SI group, whereas no statistical difference was observed in PLS. In Pearson correlation analysis, LVEF was strongly correlated with GPLS, GPRS, and GPCS in CMI patients. Additionally, excellent reproducibility of all strain parameters was observed. In receiver operating characteristic analysis, segmental PRS and PCS might differentiate SI from TI with higher diagnostic efficiency (p < 0.05), while PLS was less valuable (p > 0.05). CONCLUSION CMR-FT could noninvasively and quantitatively assess global and regional myocardial strain in CMI patients with excellent reproducibility and strong correlation with LVEF. Additionally, segmental myocardial strain parameters indicate potential clinical value in differentiating myocardial infarction subtype.
Collapse
|
19
|
Sree Raman K, Shah R, Stokes M, Walls A, Woodman RJ, Perry R, Walker JG, Proudman S, De Pasquale CG, Celermajer DS, Selvanayagam JB. Right ventricular myocardial deoxygenation in patients with pulmonary artery hypertension. J Cardiovasc Magn Reson 2021; 23:22. [PMID: 33678188 PMCID: PMC7938464 DOI: 10.1186/s12968-020-00694-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In pulmonary arterial hypertension (PAH), progressive right ventricular (RV) dysfunction is believed to be largely secondary to RV ischaemia. A recent pilot study has demonstrated the feasibility of Oxygen-sensitive (OS) cardiovascular magnetic resonance (CMR) to detect in-vivo RV myocardial oxygenation. The aims of the present study therefore, were to assess the prevalence of RV myocardial ischaemia and relationship with RV myocardial interstitial changes in PAH patients with non-obstructive coronaries, and corelate with functional and haemodynamic parameters. METHODS We prospectively recruited 42 patients with right heart catheter (RHC) proven PAH and 11 healthy age matched controls. The CMR examination involved standard functional imaging, OS-CMR imaging and native T1 mapping. An ΔOS-CMR signal intensity (SI) index (stress/rest signal intensity) was acquired at RV anterior, RV free-wall and RV inferior segments. T1 maps were acquired using Shortened Modified Look-Locker Inversion recovery (ShMOLLI) at the inferior RV segment. RESULTS The inferior RV ΔOS-CMR SI index was significantly lower in PAH patients compared with healthy controls (9.5 (- 7.4-42.8) vs 12.5 (9-24.6)%, p = 0.02). The inferior RV ΔOS-CMR SI had a significant correlation to RV inferior wall thickness (r = - 0.7, p < 0.001) and RHC mean pulmonary artery pressure (mPAP) (r = - 0.4, p = 0.02). Compared to healthy controls, patients with PAH had higher native T1 in the inferior RV wall: 1303 (1107-1612) vs 1232 (1159-1288)ms, p = 0.049. In addition, there was a significant difference in the inferior RV T1 values between the idiopathic PAH and systemic sclerosis associated PAH patients: 1242 (1107-1612) vs 1386 (1219-1552)ms, p = 0.007. CONCLUSION Blunted OS-CMR SI suggests the presence of in-vivo microvascular RV dysfunction in PAH patients. The native T1 in the inferior RV segments is significantly increased in the PAH patients, particularly among the systemic sclerosis associated PAH group.
Collapse
Affiliation(s)
- Karthigesh Sree Raman
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia
- Cardiac Imaging Research, South Australian Health & Medical Research Institute, Adelaide, Australia
- Department of Medicine (Northland Campus), Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ranjit Shah
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia
- Cardiac Imaging Research, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Michael Stokes
- Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia
| | - Angela Walls
- Clinical Research and Imaging Centre, South Australian Health & Medical Research Institute, Auckland, Australia
| | - Richard J Woodman
- Flinders Centre of Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Rebecca Perry
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia
- Cardiac Imaging Research, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Jennifer G Walker
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia
| | - Susanna Proudman
- Rheumatology Unit, Royal Adelaide Hospital and Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Carmine G De Pasquale
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia
| | - David S Celermajer
- Sydney Medical School, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Joseph B Selvanayagam
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, South Australia, 5042, Australia.
- Cardiac Imaging Research, South Australian Health & Medical Research Institute, Adelaide, Australia.
| |
Collapse
|
20
|
Lei D, Xie J, Dai Q, Huang Y, Wei X, Mu D, Bao X, Li J, Xu B. Prognostic relevance and clinical features of papillary muscle infarction with mitral regurgitation in patients with ST segment elevation myocardial infarction. J Thorac Dis 2021; 13:334-342. [PMID: 33569213 PMCID: PMC7867801 DOI: 10.21037/jtd-20-3476] [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] [Indexed: 11/23/2022]
Abstract
Background Papillary muscle infarction (PapMI) combined with mitral regurgitation (MR) is a severe complication of ST-segment elevation myocardial infarction (STEMI). The features detected by cardiac magnetic resonance (CMR) imaging in PapMI have not been characterized. The aim of the present study was to assess the incidence, determinants, and the prognostic significance of PapMI with MR at 1-year follow-up in a study of patients with STEMI after primary percutaneous coronary intervention (pPCI). Methods We enrolled 209 patients with STEMI reperfused by pPCI (<12 hours after symptom onset) at 2 centers. CMR and echocardiography were performed within 1 week after infarction using a standardized protocol. According to the results of CMR and echocardiography, patients were divided into PapMI with MR, PapMI (PapMI without MR), and non-PapMI groups. The primary clinical endpoint of the study was the occurrence of major adverse cardiovascular events (MACE). Results PapMI with MR was found in 27 patients (13%). The existence of PapMI with MR was associated with age (P<0.001), impaired left ventricular ejection fraction (LVEF) (P=0.005), higher SYNTAX score (P=0.002), concentration of troponin I (P<0.001), longer time to reperfusion (P<0.001), more diabetics (P<0.001), and microvascular occlusion (MVO) (P<0.001). Binary logistic regression with stepwise backward selection analysis showed that advanced age, MVO, and impaired LVEF were independent risk factors for PapMI with MR. Patients in the PapMI with MR group had significantly more MACE compared with the PapMI and non-PapMI groups [PapMI with MR, 23 (85.2%) vs. PapMI, 21 (55.3%) vs. non-PapMI, 29 (20.1%)] at 1-year follow-up (P<0.001). However, there were no pronounced differences in mortality rates among the 3 groups (P=0.071). Conclusions The presence of PapMI with MR in patients with STEMI is associated with advanced age, MVO, and impaired LVEF, which can increase the rates of MACE.
Collapse
Affiliation(s)
- Dazhou Lei
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jun Xie
- Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing Dai
- Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yinhao Huang
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Xuan Wei
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Dan Mu
- Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xue Bao
- Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jianhui Li
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
21
|
Longère B, Chavent MH, Coisne A, Gkizas C, Pagniez J, Simeone A, Silvestri V, Schmidt M, Forman C, Montaigne D, Pontana F. Single breath-hold compressed sensing real-time cine imaging to assess left ventricular motion in myocardial infarction. Diagn Interv Imaging 2020; 102:297-303. [PMID: 33308957 DOI: 10.1016/j.diii.2020.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the reliability of a real-time compressed sensing (CS) cine sequence for the detection of left ventricular wall motion disorders after myocardial infarction in comparison with the reference steady-state free precession cine sequence. MATERIALS AND METHODS One hundred consecutive adult patients referred for either initial work-up or follow-up by cardiac magnetic resonance (CMR) in the context of myocardial infarction were prospectively included. There were 77 men and 23 women with a mean age of 63.12±11.3 (SD) years (range: 29-89 years). Each patient underwent the reference segmented multi-breath-hold steady-state free precession cine sequence including one short-axis stack and both vertical and horizontal long-axis slices (SSFPref) and the CS real-time single-breath-hold evaluated sequence (CSrt) providing the same slices. Wall motion disorders were independently and blindly assessed with both sequences by two radiologists, using the American Heart Association left ventricle segmentation. Paired Wilcoxon signed-rank test was used to search for differences in wall motion disorders conspicuity between both sequences and receiver operating characteristic curve (ROC) analysis was performed to assess the diagnosis performance of CSrt sequence using SSFPref as the reference method. RESULTS Each patient had at least one cardiac segment with wall motion abnormality on SSFPref and CSrt images. The 1700 segments analyzed with SSFPref were classified as normokinetic (360/1700; 21.2%), hypokinetic (783/1700; 46.1%), akinetic (526/1700; 30.9%) or dyskinetic (31/1700; 1.8%). Sensitivity and specificity of the CS sequence were 99.6% (95% CI: 99.1-99.9%) and 99.7% (95% CI: 98.5-100%), respectively. Area under ROC of CSrt diagnosis performance was 0.997 (95% CI: 0.993-0.999). CONCLUSION CS real-time cine imaging significantly reduces acquisition time without compromising the conspicuity of left ventricular -wall motion disorders in the context of myocardial infarction.
Collapse
Affiliation(s)
- Benjamin Longère
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France; INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France
| | - Marc-Henry Chavent
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Augustin Coisne
- INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France; Department of Clinical Physiology and Echocardiography, CHU de Lille, Lille, France
| | - Christos Gkizas
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Julien Pagniez
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Arianna Simeone
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Valentina Silvestri
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | | | | | - David Montaigne
- INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France; Department of Clinical Physiology and Echocardiography, CHU de Lille, Lille, France
| | - François Pontana
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France; INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France.
| |
Collapse
|
22
|
Centonze M, Steidler S, Casagranda G, Alfonsi U, Spagnolli F, Rozzanigo U, Palumbo D, Faletti R, De Cobelli F. Cardiac-CT and cardiac-MR cost-effectiveness: a literature review. Radiol Med 2020; 125:1200-7. [PMID: 32970273 DOI: 10.1007/s11547-020-01290-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/08/2020] [Indexed: 01/18/2023]
Abstract
Cardiovascular diseases are still among the first causes of death worldwide with a huge impact on healthcare systems. Within these conditions, the correct diagnosis of coronary artery disease with the most appropriate imaging-based evaluations is of utmost importance. The sustainability of the healthcare systems, considering the high economic burden of modern cardiac imaging equipments, makes cost-effective analysis an important tool, currently used for weighing different costs and health outcomes, when policy makers have to allocate funds and to prioritize interventions, getting the most out of their financial resources. This review aims at evaluating cost-effective analysis in the more recent literature, focused on the role of Calcium Score, coronary computed tomography angiography and cardiac magnetic resonance.
Collapse
|
23
|
Pradella S, Grazzini G, De Amicis C, Letteriello M, Acquafresca M, Miele V. Cardiac magnetic resonance in hypertrophic and dilated cardiomyopathies. Radiol Med 2020; 125:1056-1071. [PMID: 32946001 DOI: 10.1007/s11547-020-01276-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023]
Abstract
Cardiomyopathies are a heterogeneous entity. The progress in the field of genetics has allowed over the years to determine its origin more and more often. The classification of these pathologies has changed over the years; it has been updated with new knowledge. Imaging allows to define the phenotypic characteristics of the different forms of cardiomyopathy. Cardiac magnetic resonance (CMR) allows a morphological evaluation of the associated (and sometimes pathognomonic) cardiac findings of any form of cardiomyopathy. The tissue characterization sequences also make magnetic resonance imaging unique in its ability to detect changes in myocardial tissue. This review aims to define the features that can be highlighted by CMR in hypertrophic and dilated forms and the possible differential diagnoses. In hypertrophic forms, CMR provides: precise evaluation of wall thickness in all segments, ventricular function and size and evaluation of possible presence of areas of fibrosis as well as changes in myocardial tissue (measurement of T1 mapping and extracellular volume values). In dilated forms, cardiac resonance is the gold standard in the assessment of ventricular volumes. CMR highlights also the potential alterations of the myocardial tissue.
Collapse
Affiliation(s)
- Silvia Pradella
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - Giulia Grazzini
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Cristian De Amicis
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Mayla Letteriello
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Manlio Acquafresca
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| |
Collapse
|
24
|
Liu H, Fu H, Guo YK, Yang ZG, Xu HY, Shuai X, Xu R, Li ZL, Xia CC, He Y, Zhou XY. The prognostic value of right ventricular deformation derived from cardiac magnetic resonance tissue tracking for all-cause mortality in light-chain amyloidosis patients. Cardiovasc Diagn Ther 2020; 10:161-172. [PMID: 32420096 DOI: 10.21037/cdt.2020.01.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Early detection of right ventricular (RV) dysfunction is vital for determining the prognosis of light-chain amyloidosis (AL) patients. While few studies focused on RV deformation due to the limitation of research methods. The aim of this study was to determine the prognostic significance of RV myocardial strain in AL patients assessed by cardiac magnetic resonance (CMR) tissue tracking. Methods Sixty-four AL patients (28 females and 36 males, mean age 58±12.8 years old; range 25-81 years old) were enrolled from 1 October 2014 through 31 March 2017 and compared with 20 age- and sex-matched controls. Fifty-one AL patients met the criteria for cardiac amyloidosis (CA). Deformation parameters of both RV and left ventricle (LV) were measured by the CMR tissue tracking technique including myocardial global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS). The follow-up time was 20 months or until the occurrence of death. Results Thirty-two (50%) had preserved RV ejection fraction (RVEF ≥45%). AL patients had significantly lower RV-GRPS (20.3±2.12 vs. 31.31±7.61), GCPS (-2.12±0.88 vs. -13.71±2.53), and GLPS (-5.33±0.64 vs. -14.239±2.99) than controls even RVEF remain preserved (all P<0.001). Compared with controls and patients without CA, RV-GRPS (12.26±1.26 vs. 29.72±3.54, P<0.001) and RV-GLPS (-3.78±2.25 vs. -5.66±2.08, P<0.05) were significantly lower in patients with CA. Cox multivariate analyses demonstrated that RV-GRPS [hazard ratio (HR) =0.93, 95% CI: 0.88-0.98, P=0.007] and Mayo stage were (HR =3.11, 95% CI: 1.30-7.41, P=0.01) predictors of mortality in AL patients. Conclusions CMR tissue tracking is a feasible and highly reproducible technique for the analysis of RV deformation and could aid in the early diagnosis of RV involvement in AL patients. RV-GRPS of RV strain and Mayo stage provides prognostic information about mortality in AL patients.
Collapse
Affiliation(s)
- Hui Liu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Hang Fu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Zhi-Gang Yang
- Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao Shuai
- Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rong Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Zhen-Lin Li
- Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chun-Chao Xia
- Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao-Yue Zhou
- MR Collaboration, Siemens Healthcare Ltd., Shanghai 201318, China
| |
Collapse
|
25
|
Ananthapadmanabhan S, Deng E, Femia G, Tang S, Koh ES, Schuster A, Puranik R, Gupta P, Nguyen T, Dimitri H, Otton J. Intra- and inter-observer reproducibility of multilayer cardiac magnetic resonance feature tracking derived longitudinal and circumferential strain. Cardiovasc Diagn Ther 2020; 10:173-182. [PMID: 32420097 DOI: 10.21037/cdt.2020.01.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Multilayer strain measurement with cardiac magnetic resonance feature tracking (CMR-FT) allows independent assessment of endocardial and epicardial strain. This novel method of layer-specific quantification of myocardial deformation parameters provides greater insight into contractility compared to whole-layer strain analysis. The clinical utility of this technique is promising. The aim of this study is to investigate the intra- and inter- observer reproducibility of CMR-FT derived multilayer global longitudinal strain (GLS) and global circumferential strain (GCS) parameters in the setting of normal cardiac function, cardiac pathology, and differing MRI field strengths. Methods We studied 4 groups of 20 subjects, comprising of patients with dilated cardiomyopathy, ischemic heart disease, and patients without cardiac pathology at both 1.5 and 3 T. Quantitative measures of whole-layer and multi-layer longitudinal and circumferential strain were calculated using CMR-FT software. Results Intraclass correlation coefficients (ICC) for intraobserver reproducibility of endocardial, epicardial, and whole-layer measurements of GLS were 0.979, 0.980, and 0.978 respectively, and those for GCS were 0.986, 0.977, and 0.985. ICCs for inter-observer reproducibility of endocardial, epicardial, and whole-layer measurements of GLS were 0.976, 0.970, and 0.976, and those for GCS were 0.982, 0.969, and 0.981. Bland Altman analysis showed minimal bias and acceptable limits of agreement (LOA) within each patient subgroup and the overall cohort. Circumferential and longitudinal strain parameters were equally reproducible in the overall cohort. Conclusions CMR-FT derived multilayer measurements of longitudinal and circumferential strain demonstrate high intra- and inter- observer reproducibility, with suitability for use in clinical practice.
Collapse
Affiliation(s)
| | - Echo Deng
- Faculty of Medicine, University of New South Wales, Bossley Park, Sydney, NSW, Australia
| | - Giuseppe Femia
- Cardiology Department, Liverpool Hospital, Liverpool, Sydney, Australia
| | - Simon Tang
- Cardiology Department, Liverpool Hospital, Liverpool, Sydney, Australia
| | - Eng-Siew Koh
- Department of Radiation Oncology, Liverpool Hospital, Liverpool, Sydney, Australia
| | - Andreas Schuster
- Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia.,University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Raj Puranik
- Cardiology Department, Royal Prince Alfred Hospital, Newtown, Sydney, Australia
| | - Pankaj Gupta
- Cardiology Department, Royal Prince Alfred Hospital, Newtown, Sydney, Australia
| | - Tuan Nguyen
- Faculty of Medicine, University of New South Wales, Bossley Park, Sydney, NSW, Australia.,Cardiology Department, Liverpool Hospital, Liverpool, Sydney, Australia
| | - Hany Dimitri
- Faculty of Medicine, University of New South Wales, Bossley Park, Sydney, NSW, Australia.,Cardiology Department, Liverpool Hospital, Liverpool, Sydney, Australia
| | - James Otton
- Faculty of Medicine, University of New South Wales, Bossley Park, Sydney, NSW, Australia.,Cardiology Department, Liverpool Hospital, Liverpool, Sydney, Australia
| |
Collapse
|
26
|
Gitsioudis G, Nunninger M, Missiou A, Wolf P, Katus HA, Korosoglou G. Multimodality cardiac computed tomography angiography and magnetic resonance with clinical-grade scanners provide robust assessment of cardiac morphology and function in rabbits. J Thorac Dis 2019; 11:4762-4771. [PMID: 31903266 DOI: 10.21037/jtd.2019.10.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Non-invasive computer tomography (CT)- and magnetic resonance (MR)-based cardiac imaging still remains challenging in rodents. To investigate the robustness of non-invasive multimodality cardiac imaging in rabbits using clinical-grade CT and MR scanners. Methods A total of 16 rabbits (2.7-4.0 kg) serially underwent cardiac-gated imaging using a clinical-grade 256-row CT and a 1.5 Tesla MR-scanner at baseline and at 4-month follow-up (16±1 weeks). Image analysis included image quality (5-grade scale), left ventricular (LV) volumes, LV stroke volume, LV diameters, LV wall thickness and ejection fraction (LVEF). Results Cardiac MR (CMR) and CT angiography (CTA) provide images with an overall good image quality (excellent or good quality: CMR 82% vs. CTA 78%, P=0.68). Linear regression analysis demonstrated a good correlation of all diameters (diam.) and volumes (vol.) as assessed by CTA and CMR (diam.: r=0.9, 95% CI: 0.8-0.9; vol.: r=0.8, 95% CI: 0.6-0.9; P<0.0001 for both). CTA-based volumetric analysis revealed slightly higher LVEF values as compared to CMR (CTA: 64%±1%, CMR: 59%±1%, P=0.002). Analysis of inter-/intra-observer agreement demonstrated excellent agreements for diameters (CMR: 98.5%/98.7%; CTA: 98.2%/97.4%) and volumes (CMR: 99.9%/98.8%; CTA 98.7%/98.7%). Finally, serial CMR- and CTA-based assessment of cardiac diameters and volumes delivered excellent intersession agreements of baseline versus follow-up data (diam.: CMR: r=0.89; CTA: r=0.92; vol.: CMR: r=0.87; CTA: r=0.96, P<0.0001 for all). Conclusions Multimodality non-invasive assessment of cardiac function and aortic hemodynamics is feasible and robust in rabbits using clinical-grade and MR and CT scanners. These imaging modalities could improve serial cardiac assessment for disease monitoring in preclinical settings.
Collapse
Affiliation(s)
- Gitsios Gitsioudis
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany.,Department of Internal Medicine, Cardiology, Hospital of Bietigheim-Vaihingen, Academic Hospital of the University of Heidelberg, Bietigheim, Germany
| | - Maximilian Nunninger
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | - Anna Missiou
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany.,Department of Cardiology, Clinic of Ludwigsburg, Academic Hospital of the University of Heidelberg, Ludwigsburg, Germany
| | - Peter Wolf
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | - Hugo A Katus
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | - Grigorios Korosoglou
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany.,Department of Cardiology, University of Heidelberg, Heidelberg, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| |
Collapse
|
27
|
Liu T, Wang C, Li S, Zhao Y, Li P. Age- and gender-related normal references of right ventricular strain values by tissue tracking cardiac magnetic resonance: results from a Chinese population. Quant Imaging Med Surg 2019; 9:1441-1450. [PMID: 31559173 DOI: 10.21037/qims.2019.08.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Myocardial deformation is a sensitive marker for sub-clinical myocardial dysfunction and carries independent prognostic significance across a broad range of cardiovascular diseases. Reproducible and repeatable assessment of right ventricular (RV) function is vital for monitoring congenital and acquired heart diseases. The purpose of this study was to determine the normal references of RV strain and strain rate values using tissue tracking cardiac magnetic resonance imaging (MRI). Methods A cohort of 120 normal human subjects from each decade of life between 20 and 70 without cardiac diseases were enrolled in this study. Retrospectively, electrocardiogram (ECG) gating cardiac MRI imaging was performed at 3.0T with balanced steady-state free precession (bSSFP) imaging. RV global and segmental myocardial strains were analyzed by tissue tracking by two experienced observers. Results The global peak longitudinal strain (GLS) and global peak radial strain (GRS) was -24.3±4.7 and 23.0±8.5 respectively. For the peak circumferential strains (GCS), the values for global, basal, mid-cavity, and apical segments were -13.3±4.1, -13.1±4.0, -12.5±4.7, and -15.9±5.8, respectively. There were significant gender differences in peak GRS (P=0.009) and at the base (P=0.017) and the mid-cavity (P=0.011) with greater deformation in females than in males. There were also significant age differences in GRS (P<0.001), GCS for basal (P<0.001), and mid-cavity segments (P=0.037). On Bland-Altman analysis, peak GLS and GRS had the best intra-observer agreement (mean bias, -0.13±0.51; 95% CI, -1.13-0.87) and inter-observer (mean bias, 0.054±0.31; 95% CI, -0.55-0.66) agreement, respectively. Conclusions Normal values of RV deformation for healthy individuals using tissue tracking cardiac magnetic resonance (CMR-TT) provided good RV peak strain reproducibility. There was a significant correlation between RV strain or strain rate parameters with either age or sex.
Collapse
Affiliation(s)
- Ting Liu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Congcong Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Shu Li
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Yu Zhao
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Peiling Li
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| |
Collapse
|
28
|
Webb J, Fovargue L, Tøndel K, Porter B, Sieniewicz B, Gould J, Rinaldi CA, Ismail T, Chiribiri A, Carr-White G. The Emerging Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Patients with HFpEF. Curr Heart Fail Rep 2018; 15:1-9. [PMID: 29404975 PMCID: PMC5811579 DOI: 10.1007/s11897-018-0372-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW To give an update on the emerging role of cardiac magnetic resonance imaging in the evaluation of patients with heart failure with preserved ejection fraction (HFpEF). This is important as the diagnosis of HFpEF remains challenging and cardiac imaging is pivotal in establishing the function of the heart and whether there is evidence of structural heart disease or diastolic dysfunction. Echocardiography is widely available, although the gold standard in quantifying heart function is cardiac magnetic resonance (CMR) imaging. RECENT FINDINGS This review includes the recently updated 2016 European Society of Cardiology guidelines on diagnosing HFpEF that define the central role of imaging in identifying patients with HFpEF. Moreover, it includes the pathophysiology in HFpEF, how CMR works, and details current CMR techniques used to assess structural heart disease and diastolic function. Furthermore, it highlights promising research techniques that over the next few years may become more used in identifying these patients. CMR has an emerging role in establishing the diagnosis of HFpEF by measuring the left ventricular ejection fraction (LVEF) and evidence of structural heart disease and diastolic dysfunction.
Collapse
Affiliation(s)
- Jessica Webb
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK.
| | - Lauren Fovargue
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Kristin Tøndel
- Division for Methods, Data Collection and Methods, Statistics Norway, Oslo, Norway
- Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - Bradley Porter
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Benjamin Sieniewicz
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Justin Gould
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Christopher Aldo Rinaldi
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Tevfik Ismail
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| | - Gerald Carr-White
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK
| |
Collapse
|
29
|
Abstract
OPINION STATEMENT Right ventricular (RV) structure and function is clinically important in a wide range of conditions. While conventional echocardiography (echo) methods are widely used, its limitations in RV assessment due its complex geometry are well recognized. New applications of traditional echo methods as well as emerging echo techniques including 3-dimensional (3D) echo and speckle tracking strain have the potential to overcome limitations of conventional echo, though widespread clinical use remains to be seen. Volumetric methods using cardiac magnetic resonance (CMR) and computed tomography (CT) provide accurate assessment of RV function without geometric assumptions. In addition, tissue characterization imaging for myocardial scar and fat using CMR and CT provides important information regarding the RV beyond structure and function alone and has clinical applications for diagnosis and prognosis in a broad range of pathologies. Limitations also exist for these two advanced modalities including availability and patient suitability for CMR and need for contrast and radiation exposure for CT. The complementary role of each modality for the RV as well as emerging evidence for the use of each imaging method in diagnosis and management of RV pathologies is outlined in this study.
Collapse
|
30
|
van Dijk R, Kuijpers D, Kaandorp TAM, van Dijkman PRM, Vliegenthart R, van der Harst P, Oudkerk M. Effects of caffeine intake prior to stress cardiac magnetic resonance perfusion imaging on regadenoson- versus adenosine-induced hyperemia as measured by T1 mapping. Int J Cardiovasc Imaging 2017; 33:1753-9. [PMID: 28547666 DOI: 10.1007/s10554-017-1157-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/03/2017] [Indexed: 11/17/2022]
Abstract
The antagonistic effects of caffeine on adenosine receptors are a possible cause of false-negative stress perfusion imaging. The purpose of this study was to determine the effects of coffee intake <4 h prior to stress perfusion cardiac magnetic resonance imaging (CMR) in regadenoson- versus adenosine-induced hyperemia as measured with T1-mapping. 98 consecutive patients with suspected coronary artery disease referred for either adenosine or regadenoson perfusion CMR were included in this analysis. Twenty-four patients reported coffee consumption <4 h before CMR (15 patients with adenosine, and 9 patients with regadenoson); 74 patients reported no coffee intake (50 patients with adenosine, and 24 patients with regadenoson). T1 mapping was performed using a modified look-locker inversion recovery sequence. T1 reactivity was determined by subtracting T1rest from T1stress. T1rest, T1stress, and T1 reactivity in patients referred for regadenoson perfusion CMR were not significantly different when comparing patients with <4 h coffee intake and patients who reported no coffee intake (976 ± 4 ms, 1019 ± 48 ms, and 4.4 ± 3.2% vs 971 ± 33 ms, 1023 ± 43 ms, and 5.4 ± 2.4%) (p = 0.70, 0.79, and 0.40), and similar to values in patients without coffee intake undergoing adenosine CMR. In patients with <4 h coffee intake, T1stress, and T1 reactivity were significantly lower for adenosine (898 ± 51 ms, and −7.8 ± 5.0%) compared to regadenoson perfusion CMR (p < 0.001). Coffee intake <4 h prior to regadenoson perfusion CMR has no effect on stress-induced hyperemia as measured with T1 mapping.
Collapse
|
31
|
Carità P, Verdecchia M, Ferro G, Buccheri D, Corrado E, Novo S, Pontone G. Multimodality imaging in cardiac echinococcosis for diagnosis and follow-up of an untreatable cyst. Int J Cardiol 2016; 221:468-70. [PMID: 27414724 DOI: 10.1016/j.ijcard.2016.06.317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Patrizia Carità
- University Hospital "Paolo Giaccone", Department of Cardiology, Palermo, Italy
| | | | - Giovanni Ferro
- University Hospital "Paolo Giaccone", Department of Cardiology, Palermo, Italy
| | - Dario Buccheri
- University Hospital "Paolo Giaccone", Department of Cardiology, Palermo, Italy; Interventional Cardiology, "Paolo Giaccone" Hospital, Palermo, Italy.
| | - Egle Corrado
- University Hospital "Paolo Giaccone", Department of Cardiology, Palermo, Italy
| | - Salvatore Novo
- University Hospital "Paolo Giaccone", Department of Cardiology, Palermo, Italy
| | | |
Collapse
|
32
|
Zhao H, Lee APW, Li Z, Qiao Z, Fan Y, An D, Xu J, Pu J, Shen X, Ge H, He B. Impact of Intramyocardial Hemorrhage and Microvascular Obstruction on Cardiac Mechanics in Reperfusion Injury: A Speckle-Tracking Echocardiographic Study. J Am Soc Echocardiogr 2016; 29:973-982. [PMID: 27523265 DOI: 10.1016/j.echo.2016.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 10/14/2015] [Indexed: 10/21/2022]
Abstract
BACKGROUND Intramyocardial hemorrhage (IMH) and microvascular obstruction (MVO) are two major mechanisms of reperfusion injury of the left ventricle after acute ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess the impact of IMH and MVO on left ventricular (LV) cardiac mechanics using two-dimensional speckle-tracking echocardiography during the acute phase of STEMI and on LV functional recovery. METHODS Eighty-one patients with STEMI who received primary reperfusion therapy were prospectively studied. Infarct segments were classified by cardiac magnetic resonance according to infarct transmurality and the presence or absence of IMH and/or MVO. Segmental systolic longitudinal strain, circumferential strain (CS), and radial strain were measured by two-dimensional speckle-tracking echocardiography. Adverse LV remodeling and major adverse cardiovascular events were assessed at 1 year. RESULTS MVO without IMH was much less frequent in nontransmural infarct segments than in transmural infarct segments (6.0% vs 19.1%, P = .000), while IMH was present only in transmural infarct segments. In nontransmural infarct segments, MVO was not associated with any significant changes in strain (P > .5). In transmural infarct segments, there were no differences in all types of strain between segments without reperfusion injury and those with MVO alone (P > .20). IMH was evident in the midmyocardial layer within the infarct zone in 196 segments (46.1%). The presence of IMH in addition to MVO decreased CS significantly (P = .004), but not longitudinal and radial strain (P > .5). A receiver operating characteristic curve analysis with cross-validation by k-folding showed that the sensitivity and specificity of CS using a cutoff of >-11.66% to diagnose IMH were 78.00% and 79.45%, respectively (area under the curve = 0.86; P = .0001). At 1 year, patients with major adverse cardiovascular events and LV remodeling had significantly lower baseline measurements of all types of global strain (P < .05). CONCLUSIONS In the acute phase of STEMI, reperfusion MVO and IMH injury have differential effects on cardiac mechanics. IMH preferentially affects CS, presumably related to its location in the midmyocardial layer.
Collapse
Affiliation(s)
- Hang Zhao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Alex Pui-Wai Lee
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Zheng Li
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqing Qiao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiting Fan
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dongaolei An
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuedong Shen
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Heng Ge
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
33
|
Wan M, Huang W, Zhang JM, Zhao X, Allen JC, Tan RS, Wan X, Zhong L. Correcting motion in multiplanar cardiac magnetic resonance images. Biomed Eng Online 2016; 15:93. [PMID: 27503101 PMCID: PMC4977636 DOI: 10.1186/s12938-016-0216-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 07/27/2016] [Indexed: 11/29/2022] Open
Abstract
Background Misalignment in cardiac magnetic resonance (CMR) images can adversely affect three-dimensional left ventricle modelling and downstream quantitative analysis. Currently, there are two types of approaches for dealing with realignment and motion distortion problems, one image based and the other geometry based. Image-based approaches are limited by the inherent non-homogeneity and anisotropy of CMR images. Geometry-based approaches rely on idealized models and over-simplified assumptions. This study was motivated by the need for a robust and effective approach for correcting motion related distortions due to misalignment in CMR images. Methods A cine cardiac magnetic resonance image sequence was acquired using our routine clinical imaging protocol. The left ventricular endocardium was delineated manually with software assistance on all long and short-axis images. Long and short-axis contours were projected onto a patient-based coordinate system and then realigned using iterative registration. The realigned contour points were used to reconstruct the shape of the left ventricle for quantitative validation. Results The method was tested on five myocardial infarction patients whose images showed substantial misalignment. Realignment time was about 16 seconds per case, using a 2.5 GHz CPU desktop with obvious elimination of the distortion in the reconstructed model. Using the long-axis contour as a reference in evaluating the reconstructed models, it was apparent that the models with realigned contours had better accuracy than the non-realigned ones. Conclusion This study presents a novel, geometry-based method for correcting motion distortions in CMR images. The method incorporates (1) manual delineation, (2) registration based on a generalized, iterative closest point algorithm, and (3) reconstruction of the shape of the left ventricle for quantitative validation. The effectiveness of our approach is corroborated both visually and by quantitative assessment. We envision the use of our method in current clinical practice as a means of improving accuracy in the evaluation of cardiac function.
Collapse
Affiliation(s)
- Min Wan
- Nanchang University, No. 999, Xuefu Dadao, Nanchang, People's Republic of China
| | - Wei Huang
- Nanchang University, No. 999, Xuefu Dadao, Nanchang, People's Republic of China
| | - Jun-Mei Zhang
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.,Duke-NUS Medical School Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Xiaodan Zhao
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore
| | - John Carson Allen
- Duke-NUS Medical School Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Ru San Tan
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.,Duke-NUS Medical School Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Xiaofeng Wan
- Nanchang University, No. 999, Xuefu Dadao, Nanchang, People's Republic of China
| | - Liang Zhong
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. .,Duke-NUS Medical School Singapore, 8 College Road, Singapore, 169857, Singapore.
| |
Collapse
|
34
|
Cimino S, Canali E, Petronilli V, Cicogna F, De Luca L, Francone M, Sardella G, Iacoboni C, Agati L. Global and regional longitudinal strain assessed by two-dimensional speckle tracking echocardiography identifies early myocardial dysfunction and transmural extent of myocardial scar in patients with acute ST elevation myocardial infarction and relatively preserved LV function. Eur Heart J Cardiovasc Imaging 2012; 14:805-11. [PMID: 23258316 DOI: 10.1093/ehjci/jes295] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIMS Global and regional longitudinal strain (GLS-RLS) assessed by two-dimensional speckle tracking echocardiography (2D-STE) are considered reliable indexes of left-ventricular (LV) function and myocardial viability in chronic ischaemic patients when compared with delayed-enhanced cardiac magnetic resonance (DE-CMR). In the present study, we tested whether GLS and RLS could also identify early myocardial dysfunction and transmural extent of myocardial scar in patients with acute ST elevation myocardial infarction (STEMI) and relatively preserved LV function. METHODS AND RESULTS Twenty STEMI patients with LVEF ≥40%, treated with PPCI within 6 h from symptoms onset, underwent DE-CMR and 2D-echocardiography for 2D-STE analysis 6 ± 2 days after STEMI. Wall motion score index (WMSI) and LV ejection fraction (LVEF) were calculated by both methods. Infarct size and transmural extent of necrosis were assessed by CMR. GLS and RLS were obtained by 2D-STE. Mean GLS of the study population was -14 ± 3.3, showing a significant correlation with both LVEF and WMSI, by CMR (r = -0.86, P = 0.001, and r = 0.80, P = 0.001, respectively) and time-to-PCI (r = 0.66, P = 0.038). A weaker correlation was found between GLS and LVEF and WMSI assessed by 2D-echo (r = -0.65, P = 0.001, and r = 0.53, P = 0.013, respectively). RLS was significantly lower in DE-segments when compared with normal myocardium (P < 0.0001). A cut-off value of RLS of -12.3% by receiver-operating characteristic (ROC) curves identified DE-segments (sensitivity 82%, specificity 78%), whereas a cut-off value of -11.5% identified transmural extent of DE (sensitivity 75%, specificity 78%). CONCLUSION Our findings indicate that RLS and GLS evaluation provides an accurate assessment of global myocardial function and of the presence of segments with transmural extent of necrosis, with several potential clinical implications.
Collapse
Affiliation(s)
- S Cimino
- Department of Cardiology, Sapienza University of Rome, Roma, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|