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Pubblicazioni recenti - cardiac magnetic resonance
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Effect of High-Intensity Interval Training on Visceral and Liver Fat in Cardiac Rehabilitation: A Randomized Controlled Trial.
Obesity (Silver Spring)2020 May;():. doi: 10.1002/oby.22833.
Taylor Jenna L, Holland David J, Mielke Gregore I, Bailey Tom G, Johnson Nathan A, Leveritt Michael D, Gomersall Sjaan R, Rowlands Alex V, Coombes Jeff S, Keating Shelley E,
Abstract
OBJECTIVE:
This study aimed to investigate the effect of exercise intensity on visceral adipose tissue (VAT) and liver fat reduction in patients with coronary artery disease (CAD) over 3 months and the maintenance of improvements over 12 months.
METHODS:
Forty-two participants with CAD were randomized to three sessions/week of either 4?×?4-minute high-intensity interval training (HIIT) or 40 minutes of usual care moderate-intensity continuous training (MICT) for a 4-week supervised cardiac rehabilitation program, followed by three home-based sessions/week for 11 months. Liver fat (as intrahepatic lipid) and VAT were measured via magnetic resonance techniques. Data are mean change (95% CI).
RESULTS:
HIIT and MICT significantly reduced VAT over 3 months (-350 [-548 to -153] cm vs. -456 [-634 to -278] cm ; time?×?group effect: P?=?0.421), with further improvement over 12 months (-545 [-818 to -271] cm vs. -521 [-784 to -258] cm ; time?×?group effect: P?=?0.577) and no differences between groups. Both groups improved liver fat over 3 months, with HIIT tending to show greater reduction than MICT (-2.8% [-4.0% to -1.6%] vs. -1.4% [-2.4% to -0.4%]; time?×?group effect: P?=?0.077). After 12 months, improvements were maintained to a similar degree. Higher exercise intensity predicted liver fat reduction (??=?-0.3 [-0.7 to 0.0]; P?=?0.042).
CONCLUSIONS:
HIIT and MICT reduced VAT over 3 and 12 months. For liver fat, HIIT tended to provide a slightly greater reduction compared with MICT. These findings support HIIT as a beneficial adjunct or alternative to MICT for reducing visceral and liver fat in patients with CAD.
© 2020 The Obesity Society.
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Role of antiangiogenic VEGF-Ab in angiogenesis and systolic function after reperfused myocardial infarction.
Rev Esp Cardiol (Engl Ed)2020 May;():. doi: S1885-5857(20)30161-4.
Ríos-Navarro César, Hueso Luisa, Díaz Ana, Marcos-Garcés Víctor, Bonanad Clara, Ruiz-Sauri Amparo, Vila José M, Sanz María J, Chorro Francisco J, Piqueras Laura, Bodi Vicente,
Abstract
INTRODUCTION AND OBJECTIVES:
Angiogenesis helps to reestablish microcirculation after myocardial infarction (MI). In this study, we aimed to further understand the role of the antiangiogenic isoform vascular endothelial growth factor (VEGF)-Ab after MI and to explore its potential as a coadjuvant therapy to coronary reperfusion.
METHODS:
Two mice MI models were formed: a) permanent coronary ligation (nonreperfused MI); b) transient 45-minute coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. We determined serum and myocardial VEGF-Ab levels. In both experimental MI models, we assessed the functional and structural role of VEGF-Ab blockade. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-Ab levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6 months and with the occurrence of adverse events (death, heart failure, and/or reinfarction).
RESULTS:
In both models, circulating and myocardial VEGF-Ab levels were increased 21 days after MI induction. Serum VEGF-Ab levels inversely correlated with systolic function evaluated by echocardiography. VEGF-Ab blockade increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in nonreperfused, MI experiments. In patients, higher VEGF-Ab levels correlated with depressed ejection fraction and worse outcomes.
CONCLUSIONS:
In experimental and clinical studies, higher serum VEGF-Ab levels are associated with worse systolic function. Their blockade enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in nonreperfused, MI experiments. Therefore, VEGF-Ab neutralization represents a potential coadjuvant therapy to coronary reperfusion.
Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
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Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging on magnetic resonance imaging in patients with cardiac electronic implantable devices.
Arch Cardiovasc Dis2020 May;():. doi: S1875-2136(20)30106-6.
Gandjbakhch Estelle, Dacher Jean-Nicolas, Taieb Jerome, Chauvin Michel, Anselme Frederic, Bartoli Axel, Boyer Louis, Cassagnes Lucie, Cochet Hubert, Defaye Pascal, Deharo Jean-Claude, Dubourg Benjamin, Fauchier Laurent, Gras Daniel, Klug Didier, Laurent Gabriel, Mansourati Jacques, Marijon Eloi, Maury Philippe, Piot Olivier, Pontana François, Sacher Frederic, Sadoul Nicolas, Jacquier Alexis, Boveda Serge, ,
Abstract
Magnetic resonance imaging (MRI) has become the reference imaging technique for the management of a large number of diseases. The number of MRI examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). The presence of a CEID was considered an absolute contraindication for MRI for many years. The progressive replacement of conventional pacemakers and defibrillators by "magnetic resonance (MR)-conditional" CEIDs and recent data on the safety of MRI in patients with "MR-non-conditional" CEIDs have gradually increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with MR-conditional devices, because these devices are not "MR safe". Specific programming of the device in "MR mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging describes the effect of and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional non-guaranteed" and MR-non-conditional devices.
Copyright © 2020. Published by Elsevier Masson SAS.
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The heart in growth hormone (GH) deficiency and the cardiovascular effects of GH.
Ann Endocrinol (Paris)2020 Mar;():. doi: S0003-4266(20)30040-8.
Chanson Philippe,
Abstract
Besides its effects on longitudinal growth in childhood and its metabolic effects with consequences on body composition and lipid levels, growth hormone (GH) has important roles on maintaining the structure and function of the normal adult heart. GH/insulin like growth factor-I (IGF-I) also interacts with the vascular system and plays a role in the regulation of vascular tone. GH deficiency (GHD) in adulthood is associated with increased fat mass (particularly visceral) and abnormal lipid profile, which may contribute to the excess cardiovascular mortality observed in patients with panhypopituitarism. Treatment with GH improved body composition (by increasing lean mass and decreasing fat mass) and improved lipid profile. It also has beneficial effects on vascular walls. The improvement in cardiovascular morbidity and mortality induced by GH is less clear as data are scarce and obtained on small populations. The importance of alteration in cardiac morphology and function observed in GHD is debated, particularly when cardiac magnetic resonance is used rather than echocardiography. The effects of treatment with GH on heart function and morphology are modest when studied by echocardiography.
Copyright © 2020 Elsevier Masson SAS. All rights reserved.
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Cardiovascular complications in patients with Turner's syndrome.
Curr Pharm Des2020 May;():. doi: 10.2174/1381612826666200531152459.
Kostopoulou Eirini, Bosdou Julia K, Anagnostis Panagiotis, Stevenson John C, Goulis Dimitrios G,
Abstract
Turner's or Turner syndrome (TS) is the most prevalent chromosomal abnormality in female live births. Patients with TS are predisposed to increased risk of cardiovascular disease (CVD), mainly due to the frequently observed congenital structural cardiovascular defects, such as valvular and aortic abnormalities (coarctation, dilatation and dissection). The increased prevalence of cardiometabolic risk factors, such as arterial hypertension, insulin resistance, diabetes mellitus, dyslipidaemia, central obesity and increased carotid intima-media thickness, also contribute to increased morbidity and mortality in TS patients. Menopausal hormone therapy (MHT) is the treatment of choice, combined with growth hormone (GH). Although MHT may, in general, ameliorate CVD risk factors, its effect on CVD mortality in TS has not yet been established. The exact effect of GH on these parameters has not yet been clarified. Specific consideration should be provided in TS cases during pregnancy, due to the higher risk of CVD complications, such as aortic dissection. Optimal cardiovascular monitoring, including physical examination, electrocardiogram, CVD risk factor assessment and transthoracic echocardiography is recommended. Moreover, cardiac magnetic resonance from the age of 12 years is recommended due to the high risk of aortic aneurysm and other anatomical vascular complications.
Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
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Duchenne and Becker muscular dystrophy carriers: Evidence of cardiomyopathy by exercise and cardiac MRI testing.
Int J Cardiol2020 May;():. doi: S0167-5273(20)30477-0.
Mah May Ling, Cripe Linda, Slawinski Michelle K, Al-Zaidy Samiah A, Camino Eric, Lehman Kelly J, Jackson Jamie L, Iammarino Megan, Miller Natalie, Mendell Jerry R, Hor Kan N,
Abstract
BACKGROUND:
Varied detection methods have resulted in conflicting reports on the prevalence of cardiac disease in Duchenne and Becker muscular dystrophy carriers (MDC).
METHODS:
We performed a prospective cohort study of 77 genetically-confirmed MDC mothers, 22 non-carrier mothers, and 25 controls. All participants underwent Cardiopulmonary Exercise Testing (CPET) and Cardiac Magnetic Resonance imaging (CMR).
RESULTS:
25% of carriers had ventricular ectopy in recovery of exercise (RecVE) as compared to 1 non-carrier and no controls (p?=?.003). No difference in age or maximal oxygen consumption was noted. 11 carriers had abnormal (<55%) left ventricular ejection fraction by CMR. Evidence of late gadolinium enhancement (LGE) was noted in 48% of MDC, 1 non-carrier patient and no control subjects (p? 289?U/L; 52.8% v 31.6%, p?=?.065).
CONCLUSION:
We describe the prevalence of disease using CPET and CMR in genetically-proven MDC. 49% of carriers had fibrosis, opposed to 5% of non-carriers, highlighting the importance of genetic testing in this population. Despite cardiomyopathy, functional assessment by treadmill was normal, illustrating the discrepancy in cardiac and skeletal muscle impacts. Age, RecVE and serum CK appear to have an important role in predicting cardiomyopathy. Serum CK levels suggest that a systemic higher global disease severity and not tissue heterogeneity may be the etiology for greater cardiac disease and relatively spared skeletal muscle disease in this population. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT02972580?term=mendell&cond=Duchenne+Muscular+Dystrophy&rank=5; ClinicalTrials.gov Identifier: NCT02972580.
Copyright © 2020. Published by Elsevier B.V.
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Left Ventricular Fibrosis in Middle-Age Athletes and Physically Active Adults.
Med Sci Sports Exerc2020 May;():. doi: 10.1249/MSS.0000000000002411.
Banks Laura, Altaha Mustafa A, Yan Andrew T, Dorian Paul, Konieczny Kaja, Deva Djeven P, La Gerche Andre, Akhavein Farhad, Bentley Robert F, Connelly Kim A, Goodman Jack M,
Abstract
INTRODUCTION:
Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and T1 mapping techniques enable the quantification of focal and diffuse myocardial LGE, respectively. Studies have shown evidence of fibrosis in middle-aged athletes, but not relative to physically-active (PA) adults who perform recommended physical activity levels. Therefore, we examined cardiac remodeling and presence of left-ventricular (LV) LGE and T1 values in both recreational middle-aged endurance athletes (EA) and PA adults.
METHODS:
Healthy EA and PA adults (45-65 yrs) completed a standardized 3 Tesla CMR protocol with ventricular volumetry, LV LGE and T1 mapping.
RESULTS:
Seventy-two EA and 20 PA participants (mean age= 53±5 vs. 56±4, p<0.01, VO2peak =50±7 vs. 37±9 ml/kg/min, p<0.0001) were studied, with CMR data available in 89/92 participants. Focal LV LGE was observed in 30% of participants (n=27/89): 33% of EA (n=23/69, 33%) and 20% of PA (n=4/20, 20%). LGE was present at the RV hinge point (n=21/89, 23.5%), or identified as ischemic (n=2/89, 2%) or non-ischemic (n=4/89, 4%). Focal LV LGE was observed similarly in both EA and PA (p=0.25). EA had larger LV chamber sizes and T1 native values (1169±35 vs. 1190±26, p=0.02) compared to PA, with similar LV ejection fraction. Global ECV was similar in both EA and PA (22.6±3.5% vs. 21.5±2.6, p=0.26), with no relationship between global ECV and LV mass (r=-0.16, p=0.19).
CONCLUSION:
Focal LGE at the RV hinge point was detected at the same frequency in both groups, was unrelated to demographic or clinical indices, and was found without evidence of global ECV expansion in EA, suggesting a physiologic remodelling response. The long-term clinical implications of hinge point LGE requires clarification using prospective, long-term follow up studies.
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Hybrid PET/MR imaging for the prediction of left ventricular recovery after percutaneous revascularisation of coronary chronic total occlusions.
Eur J Nucl Med Mol Imaging2020 May;():. doi: 10.1007/s00259-020-04877-w.
Vitadello Teresa, Kunze Karl P, Nekolla Stephan G, Langwieser Nicolas, Bradaric Christian, Weis Florian, Cassese Salvatore, Fusaro Massimiliano, Hapfelmeier Alexander, Lewalter Thorsten, Schwaiger Markus, Kastrati Adnan, Laugwitz Karl-Ludwig, Rischpler Christoph, Ibrahim Tareq,
Abstract
PURPOSE:
To evaluate myocardial viability assessment with hybrid 2-deoxy-2-[F]fluoro-D-glucose positron emission tomography/magnetic resonance imaging ([F]FDG-PET/MR) in predicting left ventricular (LV) wall motion recovery after percutaneous revascularisation of coronary chronic total occlusion (CTO).
METHODS AND RESULTS:
Forty-nine patients with CTO and corresponding wall motion abnormality (WMA) underwent [F]FDG-PET/MR imaging for viability assessment prior to percutaneous revascularisation. After 3-6 months, 23 patients underwent follow-up MR to evaluate wall motion recovery. In total, 124 segments were assigned to the CTO territories, while 80 segments displayed impaired wall motion. Of these, 68% (54) were concordantly viable in PET and MR; conversely, only 2 segments (2%) were assessed non-viable by both modalities. However, 30% showed a discordant viability pattern, either PET non-viable/MR viable (3 segments, 4%) or PET viable/MR non-viable (21 segments, 26%), and the latter revealed a significant wall motion improvement at follow-up (p?=?0.033). Combined imaging by [F]FDG-PET/MR showed a fair accuracy in predicting myocardial recovery after CTO revascularisation (PET/MR area under ROC curve (AUC)?=?0.72, p?=?0.002), which was superior to LGE-MR (AUC?=?0.66) and [F]FDG-PET (AUC?=?0.58) alone.
CONCLUSION:
Hybrid PET/MR imaging prior to CTO revascularisation predicts more accurately the recovery of dysfunctional myocardium than PET or MR alone. Its complementary information may identify regions of viable myocardium with increased potential for functional recovery.
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Sex differences in patients with repaired tetralogy of Fallot support a tailored approach for males and females: a cardiac magnetic resonance study.
Int J Cardiovasc Imaging2020 May;():. doi: 10.1007/s10554-020-01900-x.
Hagdorn Quint A J, Beurskens Niek E G, Gorter Thomas M, Eshuis Graziëlla, Hillege Hans L, Lui George K, Ceresnak Scott R, Chan Frandics P, van Melle Joost P, Berger Rolf M F, Willems Tineke P,
Abstract
Purpose Substantial differences between sexes exist with respect to cardiovascular diseases, including congenital heart disease. Nevertheless, clinical decisions in the long-term follow-up of patients with repaired tetralogy of Fallot (rTOF) are currently based on unisex thresholds for cardiac magnetic resonance (CMR) measurements. This study aimed to assess whether sex differences exist in cardiac adaptation to hemodynamic loading conditions in patients with rTOF. Methods and Results This cross-sectional, two-center, combined pediatric and adult cohort included 320 rTOF patients (163 males, 51%) who underwent routine CMR. Despite similar age (median and interquartile range [m?+?IQR] 23.4 [15.2-34.4] years), surgical history, and hemodynamic loading, males with rTOF demonstrated higher biventricular CMR-derived volumes and masses, indexed for body surface area, compared to females (e.g. m?+?IQR right ventricular (RV) end-diastolic volume: males 123 [100-151] mL/m, females 114 [94-131] mL/m, P?=?0.007). Sex-specific Z-scores of biventricular volumes and masses were similar for males and females. RV volumes and masses correlated with hemodynamic loading, but these relations did not differ between sexes. Biventricular ejection fraction (EF) appeared to be lower in male patients, compared to female patients (e.g. m?+?IQR RVEF: males 48 [43-54]%, females 52 [46-57]%, P
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Accuracy of cardiac magnetic resonance generated 3D models of the aortic annulus compared to cardiovascular computed tomography generated 3D models.
Int J Cardiovasc Imaging2020 May;():. doi: 10.1007/s10554-020-01902-9.
Gatti Marco, Cosentino Aurelio, Cura Stura Erik, Bergamasco Laura, Garabello Domenica, Pennisi Giovanni, Puppo Mattia, Salizzoni Stefano, Veglia Simona, Davini Ottavio, Rinaldi Mauro, Fonio Paolo, Faletti Riccardo,
Abstract
To evaluate the accuracy of 3D models of the aortic-root generated from non-contrast cardiac magnetic resonance (CMR). Data were retrospectively collected from 30 consecutive patients who underwent surgical aortic valve replacement and had available records of both intra-operative assessment and pre-surgery annulus assessment by cardiovascular computed tomography (CCT) and CMR. The 3D models were independently segmented, modelled and printed by two blinded "manufacturers". The measurements on the models were carried out by two cardiac surgeons with Hegar dilator. Data were analyzed with non-parametric tests. There was no significant intra- or inter-observer variability (p???0.13). The agreement between the diameter of the 3D model derived from CMR images and either the anatomical reference of the intraoperative measurement (p?=?0.10, r?=?0.97) or the radiological reference of the 3D model generated from CCT (p?=?0.71, r?=?0.92) was very good. The process of segmentation plus the post-processing was about 17?±?2 min for a model created by CMR, significantly higher than a model created from CCT (7?±?2 min; p?
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Influence of contrast agent and spatial resolution on myocardial strain results using feature tracking MRI.
Eur Radiol2020 May;():. doi: 10.1007/s00330-020-06971-x.
von Knobelsdorff-Brenkenhoff Florian, Schunke Tobias, Reiter Stephanie, Scheck Roland, Höfling Berthold, Pilz Günter,
Abstract
OBJECTIVES:
Feature tracking for assessing myocardial strain from cardiac magnetic resonance (CMR) cine images detects myocardial deformation abnormalities with prognostic implication, e.g., in myocardial infarction and cardiomyopathy. Standards for image acquisition and processing are not yet available. Study aim was analyzing the influence of spatial resolution and contrast agent on myocardial strain results.
METHODS:
Seventy-five patients underwent CMR for analyzing peak systolic circumferential, longitudinal, and radial strain. Group A included n?=?50 with normal left ventricular ejection fraction, no wall motion abnormality, and no fibrosis on late enhancement imaging. Group B included n?=?25 with chronic myocardial infarct. For feature tracking, steady-state free precession cine images were acquired repeatedly. (1) Native standard cine (spatial resolution 1.4?×?1.4?×?8 mm). (2) Native cine with lower spatial resolution (2.0?×?2.0?×?8 mm). (3) Cine equal to variant 1 acquired after administration of gadoteracid.
RESULTS:
Lower spatial resolution was associated with elevated longitudinal strain (-?21.7% vs. -?19.8%; p?
CONCLUSIONS:
Variations in spatial resolution and the administration of contrast agent may influence myocardial strain results in viable and partly in infarcted myocardium. Standardized image acquisition seems important for CMR feature tracking.
KEY POINTS:
? Feature tracking is used for calculating myocardial strain from cardiac magnetic resonance (CMR) cine images. ? This prospective study demonstrated that CMR strain results may be influenced by spatial resolution and by the administration of gadolinium-based contrast agent. ? The results underline the need for standardized image acquisition for CMR strain analysis, with constant imaging parameters and without contrast agent.
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Recent Advances in T1 and T2 Mapping in the Assessment of Fulminant Myocarditis by Cardiac Magnetic Resonance.
Curr Cardiol Rep2020 May;22(7):47. doi: 10.1007/s11886-020-01295-0.
Wheen P, Armstrong R, Daly C A,
Abstract
PURPOSE OF REVIEW:
This review was undertaken to summarise recent data relating to T1 and T2 relaxation times in the assessment of myocarditis using cardiac MRI, and the effect new studies have had on the established diagnostic criteria, leading to recently proposed revised criteria for the cardiac MRI assessment of myocarditis.
RECENT FINDINGS:
In 2018, updates to the 2009 Lake Louise Criteria (LLC) were proposed, based on studies showing improved accuracy of T1 mapping techniques over T1 signal intensity ratio-based imaging, although for the detection of myocardial oedema either T2-weighted images or increased T2 relaxation times can be used. Non-ischaemic distribution of scar on late gadolinium-enhanced (LGE) T1-weighted imaging remains in the newly revised criteria, which, although can have low sensitivity due to fibrosis presenting diffusely or due to CMR being performed early in the disease process before scar formation, remains in the LLC due to its high specificity. Early gadolinium enhancement has been removed from the LLC, as T1 quantification has higher diagnostic accuracy for the detection of myocardial injury. In the CMR assessment of myocarditis, T1 and T2 quantifications are now recommended over T1- and T2-weighted imaging. Late gadolinium enhancement in a non-ischaemic pattern remains in the updated criteria, whereas early gadolinium enhancement has been superseded by T1 quantification.
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Two nights of recovery sleep restores hippocampal connectivity but not episodic memory after total sleep deprivation.
Sci Rep2020 May;10(1):8774. doi: 10.1038/s41598-020-65086-x.
Chai Ya, Fang Zhuo, Yang Fan Nils, Xu Sihua, Deng Yao, Raine Andrew, Wang Jieqiong, Yu Meichen, Basner Mathias, Goel Namni, Kim Junghoon J, Wolk David A, Detre John A, Dinges David F, Rao Hengyi,
Abstract
Sleep deprivation significantly impairs a range of cognitive and brain function, particularly episodic memory and the underlying hippocampal function. However, it remains controversial whether one or two nights of recovery sleep following sleep deprivation fully restores brain and cognitive function. In this study, we used functional magnetic resonance imaging (fMRI) and examined the effects of two consecutive nights (20-hour time-in-bed) of recovery sleep on resting-state hippocampal connectivity and episodic memory deficits following one night of total sleep deprivation (TSD) in 39 healthy adults in a controlled in-laboratory protocol. TSD significantly reduced memory performance in a scene recognition task, impaired hippocampal connectivity to multiple prefrontal and default mode network regions, and disrupted the relationships between memory performance and hippocampal connectivity. Following TSD, two nights of recovery sleep restored hippocampal connectivity to baseline levels, but did not fully restore memory performance nor its associations with hippocampal connectivity. These findings suggest that more than two nights of recovery sleep are needed to fully restore memory function and hippocampal-memory associations after one night of total sleep loss.
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Imaging diagnosis of aortic stenosis.
Clin Radiol2020 May;():. doi: S0009-9260(20)30160-4.
Mittal T K, Marcus N,
Abstract
Aortic valve stenosis (AS) is the commonest primary valve disorder with increasing prevalence with age. Trans-thoracic echocardiogram is the main imaging technique used to diagnose AS, but discrepancy in diagnosis has been described in almost one third of cases. Other imaging methods, particularly electrocardiogram (ECG)-gated computed tomography, have now emerged to further clarify the diagnosis of AS by both demonstrating the degree of calcification in the valve as well as aortic valve area. Cardiac magnetic resonance imaging allows accurate quantification of ventricular function and evaluation of the myocardium. This paper provides a comprehensive review of the diagnosis of AS for the radiologist.
Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.
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Four-dimensional-flow Magnetic Resonance Imaging of the Aortic Valve and Thoracic Aorta.
Radiol Clin North Am2020 Jul;58(4):753-763. doi: S0033-8389(20)30015-4.
Jamalidinan Fatemehsadat, Hassanabad Ali Fatehi, François Christopher J, Garcia Julio,
Abstract
Blood flow through the heart and great vessels is sensitive to time and multiple velocity directions. The assessment of its three-dimensional nature has been limited. Recent advances in magnetic resonance imaging (MRI) allow the comprehensive visualization and quantification of in vivo flow dynamics using four-dimensional (4D)-flow MRI. In addition, the technique provides the opportunity to obtain advanced hemodynamic measures. This article introduces 4D-flow MRI as it is currently used for blood flow visualization and quantification of cardiac hemodynamic parameters. It discusses its advantages relative to other flow MRI techniques and describes its potential clinical applications.
Copyright © 2020 Elsevier Inc. All rights reserved.
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Metabolic syndrome and myocardium steatosis in subclinical type 2 diabetes mellitus: a H-magnetic resonance spectroscopy study.
Cardiovasc Diabetol2020 May;19(1):70. doi: 10.1186/s12933-020-01044-1.
Gao Yue, Ren Yan, Guo Ying-Kun, Liu Xi, Xie Lin-Jun, Jiang Li, Shen Meng-Ting, Deng Ming-Yan, Yang Zhi-Gang,
Abstract
BACKGROUND:
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that collectively cause an increased risk of type 2 diabetes mellitus (T2DM) and nonatherosclerotic cardiovascular disease. This study aimed to evaluate the role of myocardial steatosis in T2DM patients with or without MetS, as well as the relationship between subclinical left ventricular (LV) myocardial dysfunction and myocardial steatosis.
METHODS AND MATERIALS:
We recruited 53 T2DM patients and 20 healthy controls underwent cardiac magnetic resonance examination. All T2DM patients were subdivide into two group: MetS group and non-MetS. LV deformation, perfusion parameters and myocardial triglyceride (TG) content were measured and compared among these three groups. Pearson's and Spearman analysis were performed to investigate the correlation between LV cardiac parameters and myocardial steatosis. The receiver operating characteristic curve (ROC) was performed to illustrate the relationship between myocardial steatosis and LV subclinical myocardial dysfunction.
RESULTS:
An increase in myocardial TG content was found in the MetS group compared with that in the other groups (MetS vs. non-MetS: 1.54?±?0.63% vs. 1.16?±?0.45%; MetS vs. normal: 1.54?±?0.63% vs. 0.61?±?0.22%; all p?
CONCLUSION:
Myocardial TG content increased in T2DM patients with concurrent MetS. Myocardial steatosis was positively associated with decreased myocardial deformation and perfusion dysfunction, which may be an indicator for predicting diabetic cardiomyopathy.
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Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance imaging.
J Headache Pain2020 May;21(1):59. doi: 10.1186/s10194-020-01126-1.
Mungoven Tiffani J, Meylakh Noemi, Marciszewski Kasia K, Macefield Vaughan G, Macey Paul M, Henderson Luke A,
Abstract
BACKGROUND:
There is histological evidence of microstructural changes in the zygomaticotemporal branch of the trigeminal nerve in migraineurs. This raises the possibility that altered trigeminal nerve properties contribute to migraine pathophysiology. Whilst it is not possible to explore the anatomy of small trigeminal nerve branches it is possible to explore the anatomy of the trigeminal root entry zone using magnetic resonance imaging in humans. The aim of this investigation is to assess the microstructure of the trigeminal nerve in vivo to determine if nerve alterations occur in individuals with episodic migraine.
METHODS:
In 39 migraineurs and 39 matched controls, T1-weighted anatomical images were used to calculate the volume (mm) and maximal cross-sectional area of the trigeminal nerve root entry zone; diffusion tensor images were used to calculate fractional anisotropy, mean diffusion, axial diffusion and radial diffusion.
RESULTS:
There were significant differences between the left and right nerve of controls and migraineurs with respect to volume and not cross-sectional area. Migraineurs displayed reduced axial diffusion in the right nerve compared to the left nerve, and reduced fractional anisotropy in the left nerve compared to left controls. Furthermore, although there were no differences in mean diffusion or radial diffusion, regional analysis of the nerve revealed significantly greater radial diffusion in the middle and rostral portion of the left trigeminal nerve in migraineurs compared with controls.
CONCLUSIONS:
Migraine pathophysiology is associated with microstructural abnormalities within the trigeminal nerve that are consistent with histological evidence of altered myelin and/or organization. These peripheral nerve changes may provide further insight into migraine pathophysiology and enable a greater understanding for targeted treatments of pain alleviation.
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Cardiovascular and abdominal flow alterations in adults with morphologic evidence of liver disease post Fontan palliation.
Int J Cardiol2020 May;():. doi: S0167-5273(19)36270-9.
Bavil Elyar Abbasi, Yang Hyun Kyung, Doyle Matthew G, Kim Tae Kyoung, Karur Gauri, Bhagra Catriona, Bhagra Sai, Oechslin Erwin, Ross Heather, Roche S Lucy, Gonzalez Rafael Alonso, Amon Cristina H, Mertens Luc, Wald Rachel M,
Abstract
BACKGROUND:
Although morphologic abnormalities in the liver are commonly encountered post Fontan palliation, the relationships between hepatic morphology, vascular flows, and clinical status remain incompletely understood. We therefore aimed to explore flow characteristics in hepatic and intestinal vessels and to examine cardiovascular associations with liver disease.
METHODS:
This was a retrospective study of adults post Fontan palliation undergoing clinically indicated cardiovascular magnetic resonance imaging (MRI). Patients were included if MRI flow quantification was available for cardiac, hepatic and intestinal vessels; patients were excluded if phase-contrast flow imaging was insufficient for analysis.
RESULTS:
Thirty patients were studied (median age at MRI 28.5?years [range 19-47]). Eighteen subjects (60%) were classified as having morphologic liver disease according to validated criteria based on available MRI imaging. Abdominal and cardiovascular flows were quantified. Patients with morphologic liver disease had a 41% reduction in superior mesenteric artery (211?±?124 versus 358?±?181?mL/min/m, p?=?.004), a 36% reduction in hepatic vein (496?±?247 versus 778?±?220?mL/min/m, p?=?.01), a 31% reduction in portal vein (399?±?133 versus 580?±?159?mL/min/m, p?=?.004), and an 18% reduction in Fontan pathway flows (1358?±?429 versus 1651?±?270?mL/min/m, p?=?.04) compared with the remaining population. Adverse cardiovascular events were not associated with morphologic liver disease.
CONCLUSION:
Morphologic liver disease appears to be associated with flow alterations within the heart, liver and intestine post Fontan palliation. These novel observations suggest that a potential relationship exists between morphologic disease and vascular flows thereby providing further insights into the pathophysiology of liver disease in this high-risk population.
Copyright © 2020. Published by Elsevier B.V.
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A Regions of Interest Voxel-based morphometry study of the human brain during high-frequency spinal cord stimulation in patients with Failed Back Surgery Syndrome.
Pain Pract2020 May;():. doi: 10.1111/papr.12922.
De Groote Sander, Goudman Lisa, Linderoth Bengt, Buyck Félix, Rigoard Philippe, De Jaeger Mats, Van Schuerbeek Peter, Peeters Ronald, Sunaert Stefan, Moens Maarten,
Abstract
INTRODUCTION:
The effectiveness of Spinal Cord Stimulation (SCS) as pain-relieving treatment for Failed Back Surgery Syndrome (FBSS) has already been demonstrated. However, potential structural and functional brain alterations resulting from subsensory SCS are less clear. The aim of this study is to test structural volumetric changes in a priori chosen regions of interest related to chronic pain after 1 month and 3 months of high-frequency SCS, in patients with FBSS.
METHODS:
Eleven patients with FBSS, scheduled for SCS implantation were included in this study. All patients underwent a magnetic resonance imaging protocol before SCS implantation, 1 month and 3 months after high frequency SCS. Pain intensity, pain catastrophizing and sleep quality were also measured. Regions of Interest Voxel-based morphometry was used to explore GM volumetric changes over time. Additionally, volumetric changes were correlated with changes in pain intensity, catastrophizing and sleep quality.
RESULTS:
Significant decreases were found in volume in the left and right hippocampus over time. More specifically, a significant difference was revealed between volumes before SCS implantation and after 3 months of SCS. Repeated measures correlations revealed a significant positive correlation between volumetric changes in the left hippocampus and changes in back pain score over time and between volumetric changes in the right hippocampus and changes in back pain score over time.
CONCLUSION:
In patients with FBSS, high-frequency SCS influences structural brain regions over time. The volume of the hippocampus was decreased bilaterally after 3 months of high-frequency SCS with a positive correlation with back pain intensity.
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Nuclear cardiology: an overview of radioisotope techniques used in the diagnosis of cardiovascular disorders.
Kardiol Pol2020 May;():. doi: 10.33963/KP.15396.
Ceg?a Paulina, Ciep?ucha Aleksandra, Pachowicz Marcin, Chrapko Beata, Piotrowski Tomasz, Lesiak Maciej,
Abstract
Cardiovascular diseases are the most common cause of death in patients over 60 years old. Imaging methods of a pivotal role in cardiological diagnostic processes are echocardiography, magnetic resonance, multi-row-detector computed tomography, coronary angiography, and radioisotope tests. In this paper, we summarize the techniques of nuclear medicine (positron emission tomography, single-photon emission computed tomography, radionuclide ventriculography) that could be implemented in the cardiovascular diagnostic algorithms. Despite being acknowledged and positioned in a few cardiological guidelines, these imaging methods are still underestimated by practitioners. Nevertheless, noninvasive diagnostic tools are of increasing potential and should be implemented whenever possible. We discuss the usefulness of particular techniques in the management of patients with obstructive and non-obstructive coronary artery disease, including assessment of myocardial perfusion, contractility, viability, and detection of unstable atherosclerotic plaques. Radioisotope imaging can also be valuable in the diagnosis of infective endocarditis, as well as cardiac sarcoidosis and amyloidosis. Apart from presenting the theoretical principles of nuclear cardiology, this paper also provides three case reports illustrating a practical implementation of these imaging modalities.
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