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Popa OA, Amzulescu M, Bugeac C, Tomescu L, Slavu IM, Gheorghita V, Andrei R, Tulin A. Cardiovascular Magnetic Resonance Imaging in Myocardial Disease. Cureus 2024; 16:e58688. [PMID: 38774162 PMCID: PMC11107957 DOI: 10.7759/cureus.58688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Cardiovascular magnetic resonance (CMR) is the central non-invasive imaging investigation for the evaluation of myocardial disease. It is the well-established gold standard for measuring cardiac chamber volumes, systolic function, and left ventricular mass, and it brings unique information for therapeutic decisions. In addition, its tissue characterization capability, through T1, T2, and T2* mapping, as well as early and late gadolinium enhancement (LGE) sequences, allows to differentiate in many cases among ischemic, inflammatory, and infiltrative heart disease and permits the quantification of myocardial fibrosis, providing valuable diagnostic and prognostic information. This review aims to highlight the main CMR features of different cardiomyopathies.
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Affiliation(s)
- Oana-Andreea Popa
- Cardiology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Mihaela Amzulescu
- Cardiology, Centre Hospitalier Universitaire (CHU) Saint Pierre, Bruxelles, BEL
| | - Claudia Bugeac
- Radiology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Luminita Tomescu
- Radiology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Iulian M Slavu
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Valeriu Gheorghita
- Infectious Disease, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Rosu Andrei
- Cardiology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Adrian Tulin
- Clinic of General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
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Xia R, He B, Zhu T, Zhang Y, Chen Y, Wang L, Zhou Y, Liao J, Zheng J, Li Y, Lv F, Gao F. Low-dose dobutamine cardiovascular magnetic resonance segmental strain study of early phase of intramyocardial hemorrhage rats. BMC Med Imaging 2021; 21:173. [PMID: 34800982 PMCID: PMC8605595 DOI: 10.1186/s12880-021-00709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 11/15/2021] [Indexed: 02/08/2023] Open
Abstract
Background This study investigates the segmental myocardial strain of the early phase of intramyocardial hemorrhage (IMH) caused by reperfused myocardial infarction (MI) in rats by low-dose dobutamine (LDD) cardiovascular magnetic resonance (CMR) feature-tracking. Methods Nine sham rats and nine rats with 60-min myocardial ischemia followed by 48-h reperfusion were investigated using CMR, including T2*-mapping sequence and fast imaging with steady-state precession (FISP)–cine sequence. Another FISP–cine sequence was acquired after 2 min of dobutamine injection; the MI, IMH, and Non-MI (NMI) areas were identified. The values of peak radial strains (PRS) and peak circumferential strains (PCS) of the MI, IMH and NMI segments were acquired. The efficiency of PRS and PCS (EPRS and EPCS, respectively) were calculated on the basis of the time of every single heartbeat. Results The PRS, PCS, EPRS, and EPCS of the sham group increased after LDD injection. However, the PRS, PCS, EPRS, and EPCS of the IMH segment did not increase. Moreover, the PRS and PCS of the MI and NMI segments did not increase, but the EPRS and EPCS of these segments increased. The PRS, PCS, EPRS, and EPCS of the IMH segment were lower than those of the MI and NMI segments before and after LDD injection, but without a significant difference between MI segment and NMI segment before and after LDD injection. Conclusions LDD could help assess dysfunctions in segments with IMH, especially using the efficiency of strain. IMH was a crucial factor that decreased segmental movement and reserved function.
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Affiliation(s)
- Rui Xia
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400016, China
| | - Bo He
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang Road, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Tong Zhu
- Department of Radiology, TongJi Hospital, TongJi Medical College, HuaZhong University of Science & Technology, Hankou, 430030, Wuhan, China
| | - Yu Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang Road, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Yushu Chen
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang Road, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Lei Wang
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang Road, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Yang Zhou
- Department of Pathology, Chongqing Medical University, Yuzhong District, Chongqing, 400016, China
| | - Jichun Liao
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400016, China
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, Saint Louis, MO, 63110, USA
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400016, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400016, China
| | - Fabao Gao
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang Road, Wuhou District, Chengdu, 610041, Sichuan, China.
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Quantification of Myocardial Deformation Applying CMR-Feature-Tracking-All About the Left Ventricle? Curr Heart Fail Rep 2021; 18:225-239. [PMID: 33931818 PMCID: PMC8342400 DOI: 10.1007/s11897-021-00515-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/11/2022]
Abstract
Purpose of Review Cardiac magnetic resonance-feature-tracking (CMR-FT)-based deformation analyses are key tools of cardiovascular imaging and applications in heart failure (HF) diagnostics are expanding. In this review, we outline the current range of application with diagnostic and prognostic implications and provide perspectives on future trends of this technique. Recent Findings By applying CMR-FT in different cardiovascular diseases, increasing evidence proves CMR-FT-derived parameters as powerful diagnostic and prognostic imaging biomarkers within the HF continuum partly outperforming traditional clinical values like left ventricular ejection fraction. Importantly, HF diagnostics and deformation analyses by CMR-FT are feasible far beyond sole left ventricular performance evaluation underlining the holistic nature and accuracy of this imaging approach. Summary As an established and continuously evolving technique with strong prognostic implications, CMR-FT deformation analyses enable comprehensive cardiac performance quantification of all cardiac chambers.
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Emrich T, Halfmann M, Schoepf UJ, Kreitner KF. CMR for myocardial characterization in ischemic heart disease: state-of-the-art and future developments. Eur Radiol Exp 2021; 5:14. [PMID: 33763757 PMCID: PMC7990980 DOI: 10.1186/s41747-021-00208-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/22/2021] [Indexed: 01/25/2023] Open
Abstract
Ischemic heart disease and its sequelae are one of the major contributors to morbidity and mortality worldwide. Over the last decades, technological developments have strengthened the role of noninvasive imaging for detection, risk stratification, and management of patients with ischemic heart disease. Cardiac magnetic resonance (CMR) imaging incorporates both functional and morphological characterization of the heart to determine presence, acuteness, and severity of ischemic heart disease by evaluating myocardial wall motion and function, the presence and extent of myocardial edema, ischemia, and scarring. Currently established clinical protocols have already demonstrated their diagnostic and prognostic value. Nevertheless, there are emerging imaging technologies that provide additional information based on advanced quantification of imaging biomarkers and improved diagnostic accuracy, therefore potentially allowing reduction or avoidance of contrast and/or stressor agents. The aim of this review is to summarize the current state of the art of CMR imaging for ischemic heart disease and to provide insights into promising future developments.
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Affiliation(s)
- Tilman Emrich
- Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckstraße 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. .,Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, 29425, USA.
| | - Moritz Halfmann
- Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckstraße 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - U Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, 29425, USA
| | - Karl-Friedrich Kreitner
- Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckstraße 1, 55131, Mainz, Germany
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Souto ALM, Souto RM, Teixeira ICR, Nacif MS. Myocardial Viability on Cardiac Magnetic Resonance. Arq Bras Cardiol 2017; 108:458-469. [PMID: 28591322 PMCID: PMC5444893 DOI: 10.5935/abc.20170056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 10/10/2016] [Indexed: 11/20/2022] Open
Abstract
The study of myocardial viability is of great importance in the orientation and management of patients requiring myocardial revascularization or angioplasty. The technique of delayed enhancement (DE) is accurate and has transformed the study of viability into an easy test, not only for the detection of fibrosis but also as a binary test detecting what is viable or not. On DE, fibrosis equal to or greater than 50% of the segmental area is considered as non-viable, whereas that below 50% is considered viable. During the same evaluation, cardiac magnetic resonance (CMR) may also use other techniques for functional and perfusion studies to obtain a global evaluation of ischemic heart disease. This study aims to highlight the current concepts and broadly emphasize the use of CMR as a method that over the last 20 years has become a reference in the detection of infarction and assessment of myocardial viability. Resumo O estudo de viabilidade miocárdica é de grande importância para a orientação e manejo de pacientes que necessitam de cirurgia de revascularização miocárdica ou angioplastia. A técnica de realce tardio (RT) é precisa e transformou o estudo de viabilidade em um teste fácil, não só para a detecção de fibrose, mas também como um modelo binário para a detecção do que é ou não é viável. Uma fibrose identificada pelo RT é considerada como não viável quando igual ou maior do que 50% da área segmentar e como viável quando menor que 50%. A ressonância magnética cardíaca (RMC) também pode lançar mão de outras técnicas para estudo funcional e de perfusão para uma avaliação global da doença isquêmica do coração no mesmo exame. Este estudo tem como objetivo destacar os conceitos atuais e enfatizar amplamente o uso da RMC como um método que nos últimos 20 anos se tornou referência na detecção de infarto e avaliação de viabilidade miocárdica.
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Affiliation(s)
| | | | | | - Marcelo Souto Nacif
- Universidade Federal Fluminense, Niterói, RJ - Brazil.,Centro de Imagem Complexo Hospitalar de Niterói, Niterói, RJ - Brazil.,Unidade de Radiologia Clínica - Hospital Vivalle - Rede D´Or - São Luiz, São José dos Campo, SP - Brazil
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Role of cardiovascular magnetic resonance in acute and chronic ischemic heart disease. Int J Cardiovasc Imaging 2017; 34:67-80. [PMID: 28315985 PMCID: PMC5797568 DOI: 10.1007/s10554-017-1116-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
Abstract
Cardiovascular magnetic resonance (CMR) is a multi-parametric, multi-planar, non-invasive imaging technique, which allows accurate determination of biventricular function and precise myocardial tissue characterization in a one-stop-shop technique, free from the use of ionizing radiations. Though CMR has been increasingly applied over the last two decades in every-day clinical practice, its widest application has been in the assessment of ischemic cardiomyopathy.
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Ferda J, Hromádka M, Baxa J. Imaging of the myocardium using 18 F-FDG-PET/MRI. Eur J Radiol 2016; 85:1900-1908. [DOI: 10.1016/j.ejrad.2016.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/17/2016] [Accepted: 07/19/2016] [Indexed: 11/24/2022]
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Guaricci AI, Brunetti ND, Marra MP, Tarantini G, di Biase M, Pontone G. Diagnosis and prognosis of ischemic heart disease. J Cardiovasc Med (Hagerstown) 2015; 16:653-62. [DOI: 10.2459/jcm.0000000000000267] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Schuster A, Paul M, Bettencourt N, Hussain ST, Morton G, Kutty S, Bigalke B, Chiribiri A, Perera D, Nagel E, Beerbaum P. Myocardial feature tracking reduces observer-dependence in low-dose dobutamine stress cardiovascular magnetic resonance. PLoS One 2015; 10:e0122858. [PMID: 25848764 PMCID: PMC4388729 DOI: 10.1371/journal.pone.0122858] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 02/15/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To determine whether quantitative wall motion assessment by CMR myocardial feature tracking (CMR-FT) would reduce the impact of observer experience as compared to visual analysis in patients with ischemic cardiomyopathy (ICM). METHODS 15 consecutive patients with ICM referred for assessment of hibernating myocardium were studied at 3 Tesla using SSFP cine images at rest and during low dose dobutamine stress (5 and 10 μg/kg/min of dobutamine). Conventional visual, qualitative analysis was performed independently and blinded by an experienced and an inexperienced reader, followed by post-processing of the same images by CMR-FT to quantify subendocardial and subepicardial circumferential (Eccendo and Eccepi) and radial (Err) strain. Receiver operator characteristics (ROC) were assessed for each strain parameter and operator to detect the presence of inotropic reserve as visually defined by the experienced observer. RESULTS 141 segments with wall motion abnormalities at rest were eligible for the analysis. Visual scoring of wall motion at rest and during dobutamine was significantly different between the experienced and the inexperienced observer (p<0.001). All strain values (Eccendo, Eccepi and Err) derived during dobutamine stress (5 and 10 μg/kg/min) showed similar diagnostic accuracy for the detection of contractile reserve for both operators with no differences in ROC (p>0.05). Eccendo was the most accurate (AUC of 0.76, 10 μg/kg/min of dobutamine) parameter. Diagnostic accuracy was worse for resting strain with differences between operators for Eccendo and Eccepi (p<0.05) but not Err (p>0.05). CONCLUSION Whilst visual analysis remains highly dependent on operator experience, quantitative CMR-FT analysis of myocardial wall mechanics during DS-CMR provides diagnostic accuracy for the detection of inotropic reserve regardless of operator experience and hence may improve diagnostic robustness of low-dose DS-CMR in clinical practice.
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Affiliation(s)
- Andreas Schuster
- Department of Cardiology and Pulmonology, Georg-August-University and German Center for Cardiovascular Research (DZHK, Partner Site), Göttingen, Germany
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
- * E-mail:
| | - Matthias Paul
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
| | - Nuno Bettencourt
- Cardiology Department—Centro Hospitalar de Gaia/Espinho, Porto, Portugal
| | - Shazia T. Hussain
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
| | - Geraint Morton
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
| | - Shelby Kutty
- Joint Division of Pediatric Cardiology, University of Nebraska/Creighton University, Children’s Hospital and Medical Center, Omaha, Nebraska, United States of America
| | - Boris Bigalke
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
- Department of Cardiology, Campus Benjamin Franklin, Charité Berlin, Hindenburgdamm 30, Berlin, Germany
| | - Amedeo Chiribiri
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
| | - Divaka Perera
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Eike Nagel
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
| | - Philipp Beerbaum
- King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences and Biomedical Engineering; The Rayne Institute, St. Thomas´ Hospital, London, United Kingdom
- Department of Paediatric Cardiology, Hannover Medical School, Hannover, Germany
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Schuster A, Zarinabad N, Ishida M, Sinclair M, van den Wijngaard JP, Morton G, Hautvast GL, Bigalke B, van Horssen P, Smith N, Spaan JA, Siebes M, Chiribiri A, Nagel E. Quantitative assessment of magnetic resonance derived myocardial perfusion measurements using advanced techniques: microsphere validation in an explanted pig heart system. J Cardiovasc Magn Reson 2014; 16:82. [PMID: 25315438 PMCID: PMC4195947 DOI: 10.1186/s12968-014-0082-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/11/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cardiovascular Magnetic Resonance (CMR) myocardial perfusion imaging has the potential to evolve into a method allowing full quantification of myocardial blood flow (MBF) in clinical routine. Multiple quantification pathways have been proposed. However at present it remains unclear which algorithm is the most accurate. An isolated perfused, magnetic resonance (MR) compatible pig heart model allows very accurate titration of MBF and in combination with high-resolution assessment of fluorescently-labeled microspheres represents a near optimal platform for validation. We sought to investigate which algorithm is most suited to quantify myocardial perfusion by CMR at 1.5 and 3 Tesla using state of the art CMR perfusion techniques and quantification algorithms. METHODS First-pass perfusion CMR was performed in an MR compatible blood perfused pig heart model. We acquired perfusion images at physiological flow ("rest"), reduced flow ("ischaemia") and during adenosine-induced hyperaemia ("hyperaemia") as well as during coronary occlusion. Perfusion CMR was performed at 1.5 Tesla (n = 4 animals) and at 3 Tesla (n = 4 animals). Fluorescently-labeled microspheres and externally controlled coronary blood flow served as reference standards for comparison of different quantification strategies, namely Fermi function deconvolution (Fermi), autoregressive moving average modelling (ARMA), exponential basis deconvolution (Exponential) and B-spline basis deconvolution (B-spline). RESULTS All CMR derived MBF estimates significantly correlated with microsphere results. The best correlation was achieved with Fermi function deconvolution both at 1.5 Tesla (r = 0.93, p < 0.001) and at 3 Tesla (r = 0.9, p < 0.001). Fermi correlated significantly better with the microspheres than all other methods at 3 Tesla (p < 0.002). B-spline performed worse than Fermi and Exponential at 1.5 Tesla and showed the weakest correlation to microspheres (r = 0.74, p < 0.001). All other comparisons were not significant. At 3 Tesla exponential deconvolution performed worst (r = 0.49, p < 0.001). CONCLUSIONS CMR derived quantitative blood flow estimates correlate with true myocardial blood flow in a controlled animal model. Amongst the different techniques, Fermi function deconvolution was the most accurate technique at both field strengths. Perfusion CMR based on Fermi function deconvolution may therefore emerge as a useful clinical tool providing accurate quantitative blood flow assessment.
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Affiliation(s)
- Andreas Schuster
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
- Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK, Partner Site Göttingen), Georg-August-University, Göttingen, Germany.
| | - Niloufar Zarinabad
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | - Masaki Ishida
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | - Matthew Sinclair
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | | | - Geraint Morton
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | | | - Boris Bigalke
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
- Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
| | - Pepijn van Horssen
- Department of Biomedical Engineering & Physics, Academic Medical Centre, Amsterdam, The Netherlands.
| | - Nicolas Smith
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | - Jos Ae Spaan
- Department of Biomedical Engineering & Physics, Academic Medical Centre, Amsterdam, The Netherlands.
| | - Maria Siebes
- Department of Biomedical Engineering & Physics, Academic Medical Centre, Amsterdam, The Netherlands.
| | - Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
| | - Eike Nagel
- Division of Imaging Sciences and Biomedical Engineering; King's College London British Heart Foundation (BHF) Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas´ Hospital, London, UK.
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Sammut E, Zarinabad N, Vianello PF, Chiribiri A. Quantitative Assessment of Perfusion – Where Are We Now? CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9278-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Protti A, Dong X, Andia ME, Yu B, Dokukina K, Chaubey S, Phinikaridou A, Vizcay-Barrena G, Taupitz M, Botnar RM, Shah AM. Assessment of inflammation with a very small iron-oxide particle in a murine model of reperfused myocardial infarction. J Magn Reson Imaging 2013; 39:598-608. [PMID: 24006053 DOI: 10.1002/jmri.24191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 04/03/2013] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To investigate a very small iron-oxide particle (VSOP) in a mouse model of acute ischemia-reperfusion to access the mechanism of such particles in areas of myocardial inflammation. MATERIALS AND METHODS Animals were injected with VSOP at several time points, in a mouse model of acute myocardial infarction (MI), before and after MI. MRI was used to localize areas of VSOP enhancement, evaluate VSOP areas extension, and determine the related T2* values. Histology, electron microscopy, macrophage counting, and Evan's Blue staining were also performed. RESULTS We found that areas of VSOP uptake decreased from 1 to 8 days post-MI while the related T2* values increased. T2* and VSOP areas, defined from MRI data, correlated well between 1 and 3 days post-MI but not at 7 days after injection. Histological analysis and electron microscopy showed colocalization of macrophages with areas of VSOP staining. However, there was no correlation between number of macrophages and the extension of the VSOP areas achieved by MR. We found that only areas of increased permeability (assessed by Evan's Blue staining) showed colocalization of macrophages and VSOP uptake. CONCLUSION This study demonstrates that VSOP allows the assessment of myocardial inflammation associated with increased permeability during infarct healing in a mouse model of ischemia-reperfusion.
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Affiliation(s)
- Andrea Protti
- King's College London British Heart Foundation Centre of Excellence, Cardiovascular Division, King's College London, London, United Kingdom; King's College London British Heart Foundation Centre of Excellence, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
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Comparison of MR and CT for the Assessment of the Significance of Coronary Artery Disease: a Review. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-012-9186-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Schuster A, Chiribiri A, Ishida M, Morton G, Paul M, Hussain ST, Bigalke B, Perera D, Schaeffter T, Nagel E. Cardiovascular magnetic resonance imaging of isolated perfused pig hearts in a 3T clinical MR scanner. Interv Med Appl Sci 2012; 4:186-92. [PMID: 24265875 DOI: 10.1556/imas.4.2012.4.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 07/11/2012] [Indexed: 11/19/2022] Open
Abstract
PURPOSE An isolated perfused pig heart model has recently been proposed for the development of novel methods in standard clinical magnetic resonance (MR) scanners. The original set-up required the electrical system to be within the safe part of the MR-room, which introduced significant background noise. The purpose of the current work was to refine the system to overcome this limitation so that all electrical parts are completely outside the scanner room. METHODS Four pig hearts were explanted under terminal anaesthesia from large white cross landrace pigs. All hearts underwent cardiovascular magnetic resonance (CMR) scanning in the MR part of a novel combined 3T MR and x-ray fluoroscopy (XMR) suite. CMR scanning included real-time k-t SENSE functional imaging, k-t SENSE accelerated perfusion imaging and late gadolinium enhancement imaging. Interference with image quality was assessed by spurious echo imaging and compared to noise levels acquired while operating the electrical parts within the scanner room. RESULTS Imaging was performed successfully in all hearts. The system proved suitable for isolated heart perfusion in a novel 3T XMR suite. No significant additional noise was introduced into the scanner room by our set-up. CONCLUSIONS We have substantially improved a previous version of an isolated perfused pig heart model and made it applicable for MR imaging in a state of the art clinical 3T XMR imaging suite. The use of this system should aid novel CMR sequence development and translation into clinical practice.
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Pennell DJ, Carpenter JP, Firmin DN, Kilner PJ, Mohiaddin RH, Prasad SK. Review of Journal of Cardiovascular Magnetic Resonance 2011. J Cardiovasc Magn Reson 2012; 14:78. [PMID: 23158097 PMCID: PMC3519784 DOI: 10.1186/1532-429x-14-78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 12/15/2022] Open
Abstract
There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, we remain very pleased with the progress of the journal's impact over the last 5 years. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors feel it is useful to summarize the papers for the readership into broad areas of interest or theme, which we feel would be useful, so that areas of interest from the previous year can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
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Affiliation(s)
- Dudley J Pennell
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - John Paul Carpenter
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - David N Firmin
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Philip J Kilner
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Raad H Mohiaddin
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
| | - Sanjay K Prasad
- CMR Unit Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, Exhibition Road, London, SW7 2AZ, UK
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Cardiac magnetic resonance myocardial perfusion imaging for detection of functionally significant obstructive coronary artery disease: a prospective study. Int J Cardiol 2012; 168:765-73. [PMID: 23102601 DOI: 10.1016/j.ijcard.2012.09.231] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 09/17/2012] [Accepted: 09/30/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI) is considered a state of the art non-invasive modality for the detection of reversible ischemia. Recent studies have shown its utility in the diagnosis of coronary artery disease (CAD) and superiority over other established techniques. However, only a few studies compared CMR-MPI against the invasive standard including fractional flow reserve (FFR) and clinical validation in non-specialized centers is scarce. The aim of this study was to validate CMR-MPI in a real-world clinical environment and to test its diagnostic accuracy in symptomatic patients with suspected CAD versus FFR as the reference standard of functionally significant disease. METHODS AND RESULTS 103 symptomatic consecutive patients (62 ± 8.0 years, 66% males) with suspected CAD and intermediate or high probability of disease underwent sequential CMR and invasive coronary angiography (XA). The CMR protocol included stress-rest adenosine perfusion, SSFP cine imaging and late-enhancement imaging. Functionally significant CAD was defined as occlusive/sub-occlusive stenoses on XA or non-occlusive stenoses with a FFR measurement of <0.80 in vessels >2mm. On a patient-based model, CMR-MPI had sensitivity, specificity, positive and negative predictive values of 89%, 88%, 85%, and 91%, respectively, with a global accuracy of 88%. On a vessel-based analysis, these values were 80%, 93%, 79% and 94%, respectively, with a global accuracy of 90%. CONCLUSIONS CMR-MPI had a very high accuracy for detection of functionally significant CAD as assessed by FFR in patients with intermediate to high pretest probability.
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Mielniczuk LM, Beanlands RS. Imaging-Guided Selection of Patients With Ischemic Heart Failure for High-Risk Revascularization Improves Identification of Those With the Highest Clinical Benefit. Circ Cardiovasc Imaging 2012; 5:262-70; discussion 270. [DOI: 10.1161/circimaging.111.964668] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Lisa M. Mielniczuk
- From the Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Rob S. Beanlands
- From the Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Schuster A, Grünwald I, Chiribiri A, Southworth R, Ishida M, Hay G, Neumann N, Morton G, Perera D, Schaeffter T, Nagel E. An isolated perfused pig heart model for the development, validation and translation of novel cardiovascular magnetic resonance techniques. J Cardiovasc Magn Reson 2010; 12:53. [PMID: 20849589 PMCID: PMC2950014 DOI: 10.1186/1532-429x-12-53] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 09/17/2010] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Novel cardiovascular magnetic resonance (CMR) techniques and imaging biomarkers are often validated in small animal models or empirically in patients. Direct translation of small animal CMR protocols to humans is rarely possible, while validation in humans is often difficult, slow and occasionally not possible due to ethical considerations. The aim of this study is to overcome these limitations by introducing an MR-compatible, free beating, blood-perfused, isolated pig heart model for the development of novel CMR methodology. METHODS 6 hearts were perfused outside of the MR environment to establish preparation stability. Coronary perfusion pressure (CPP), coronary blood flow (CBF), left ventricular pressure (LVP), arterial blood gas and electrolyte composition were monitored over 4 hours. Further hearts were perfused within 3T (n = 3) and 1.5T (n = 3) clinical MR scanners, and characterised using functional (CINE), perfusion and late gadolinium enhancement (LGE) imaging. Perfusion imaging was performed globally and selectively for the right (RCA) and left coronary artery (LCA). In one heart the RCA perfusion territory was determined and compared to infarct size after coronary occlusion. RESULTS All physiological parameters measured remained stable and within normal ranges. The model proved amenable to CMR at both field strengths using typical clinical acquisitions. There was good agreement between the RCA perfusion territory measured by selective first pass perfusion and LGE after coronary occlusion (37% versus 36% of the LV respectively). CONCLUSIONS This flexible model allows imaging of cardiac function in a controllable, beating, human-sized heart using clinical MR systems. It should aid further development, validation and clinical translation of novel CMR methodologies, and imaging sequences.
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Affiliation(s)
- Andreas Schuster
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | | | - Amedeo Chiribiri
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | - Richard Southworth
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | - Masaki Ishida
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | | | | | - Geraint Morton
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | - Divaka Perera
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Tobias Schaeffter
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
| | - Eike Nagel
- King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK
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Springeling T, Rossi A, Moelker A, van Geuns RJM. Cardiovascular MRI in acute myocardial infarction. Interv Cardiol 2010. [DOI: 10.2217/ica.10.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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