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Kollmann A, Lohr D, Ankenbrand MJ, Bille M, Terekhov M, Hock M, Elabyad I, Baltes S, Reiter T, Schnitter F, Bauer WR, Hofmann U, Schreiber LM. Cardiac function in a large animal model of myocardial infarction at 7 T: deep learning based automatic segmentation increases reproducibility. Sci Rep 2024; 14:11009. [PMID: 38744988 PMCID: PMC11094053 DOI: 10.1038/s41598-024-61417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
Cardiac magnetic resonance (CMR) imaging allows precise non-invasive quantification of cardiac function. It requires reliable image segmentation for myocardial tissue. Clinically used software usually offers automatic approaches for this step. These are, however, designed for segmentation of human images obtained at clinical field strengths. They reach their limits when applied to preclinical data and ultrahigh field strength (such as CMR of pigs at 7 T). In our study, eleven animals (seven with myocardial infarction) underwent four CMR scans each. Short-axis cine stacks were acquired and used for functional cardiac analysis. End-systolic and end-diastolic images were labelled manually by two observers and inter- and intra-observer variability were assessed. Aiming to make the functional analysis faster and more reproducible, an established deep learning (DL) model for myocardial segmentation in humans was re-trained using our preclinical 7 T data (n = 772 images and labels). We then tested the model on n = 288 images. Excellent agreement in parameters of cardiac function was found between manual and DL segmentation: For ejection fraction (EF) we achieved a Pearson's r of 0.95, an Intraclass correlation coefficient (ICC) of 0.97, and a Coefficient of variability (CoV) of 6.6%. Dice scores were 0.88 for the left ventricle and 0.84 for the myocardium.
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Affiliation(s)
- Alena Kollmann
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - David Lohr
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany.
| | - Markus J Ankenbrand
- Faculty of Biology, Center for Computational and Theoretical Biology (CCTB), University of Würzburg, Würzburg, Germany
| | - Maya Bille
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - Maxim Terekhov
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - Michael Hock
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - Ibrahim Elabyad
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - Steffen Baltes
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
| | - Theresa Reiter
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Florian Schnitter
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Wolfgang R Bauer
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Ulrich Hofmann
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Laura M Schreiber
- Comprehensive Heart Failure Center (CHFC), Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Würzburg, Germany
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Zhang X, Yang S, Hao S, Li J, Qiu M, Chen H, Huang Y. Myocardial fibrosis and prognosis in heart failure with preserved ejection fraction: a pooled analysis of 12 cohort studies. Eur Radiol 2024; 34:1854-1862. [PMID: 37658896 DOI: 10.1007/s00330-023-10218-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/02/2023] [Accepted: 07/15/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Heart failure with preserved ejection fraction (HFpEF) is a syndrome with significant clinical heterogeneity. Myocardial fibrosis has been considered a common pathological process in the development and progress of HFpEF. This study aimed to consolidate data on the prognostic effect of myocardial fibrosis, evaluated by cardiovascular magnetic resonance (CMR) imaging in patients with HFpEF. METHODS Three medical databases were searched for potentially related articles up to February 28, 2023. Cohort studies reporting associations between myocardial fibrosis and risk of all-cause mortality or composite major adverse cardiac outcomes (MACE) were included. Cardiac fibrosis was evaluated by CMR metrics, including late gadolinium enhancement (LGE) or myocardial extracellular volume (ECV). The hazard ratios (HRs) and 95% confidence intervals (CI) of the outcomes for higher myocardial fibrosis were calculated. RESULTS Twelve studies with 2787 patients with HFpEF were included for analysis. After a median follow-up duration of 31.2 months, a higher level of cardiac fibrosis was associated with a significant increase in the risk of MACE (HR = 1.34, 95% CI = 1.14-1.57) and all-cause mortality (HR = 1.74, 95% CI = 1.27-2.39), respectively. Furthermore, the increased risk of outcomes was both observed when cardiac fibrosis was defined according to LGE or ECV, respectively. CONCLUSIONS Higher burden of myocardial fibrosis evaluated by CMR can predict a poor prognosis in patients with HFpEF. Evaluation of LGE or ECV based on CMR could be recommended in these patients for risk stratification and guiding further treatment. CLINICAL RELEVANCE STATEMENT Inclusion of cardiovascular magnetic resonance examination in the diagnostic and risk-evaluation algorithms in patients with heart failure with preserved ejection fraction should be considered in clinical practice and future studies. KEY POINTS • Myocardial fibrosis is a common pathological process in heart failure with preserved ejection fraction. • A higher myocardial fibrosis burden on cardiac magnetic resonance predicts a poor prognosis in patients with heart failure with preserved ejection fraction. • Evaluation of myocardial fibrosis may be useful in patients with heart failure with preserved ejection fraction for risk stratification and treatment guidance.
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Affiliation(s)
- Xiaojie Zhang
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China
| | - Shaomin Yang
- Department of Radiology, Lecong Hospital of Shunde, Foshan, China
| | - Shali Hao
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China
| | - Jiahuan Li
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China
| | - Min Qiu
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China
| | - Haixiong Chen
- Department of Radiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China.
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Jiazhi Road, Lunjiao Town, Shunde District, Foshan, 528300, China.
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
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O’Regan PW, Stevens NE, Logan N, Ryan DJ, Maher MM. Paediatric Thoracic Imaging in Cystic Fibrosis in the Era of Cystic Fibrosis Transmembrane Conductance Regulator Modulation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:256. [PMID: 38397368 PMCID: PMC10888261 DOI: 10.3390/children11020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
Cystic fibrosis (CF) is one of the most common progressive life-shortening genetic conditions worldwide. Ground-breaking translational research has generated therapies that target the primary cystic fibrosis transmembrane conductance regulator (CFTR) defect, known as CFTR modulators. A crucial aspect of paediatric CF disease is the development and progression of irreversible respiratory disease in the absence of clinical symptoms. Accurate thoracic diagnostics have an important role to play in this regard. Chest radiographs are non-specific and insensitive in the context of subtle changes in early CF disease, with computed tomography (CT) providing increased sensitivity. Recent advancements in imaging hardware and software have allowed thoracic CTs to be acquired in paediatric patients at radiation doses approaching that of a chest radiograph. CFTR modulators slow the progression of CF, reduce the frequency of exacerbations and extend life expectancy. In conjunction with advances in CT imaging techniques, low-dose thorax CT will establish a central position in the routine care of children with CF. International guidelines regarding the choice of modality and timing of thoracic imaging in children with CF are lagging behind these rapid technological advances. The continued progress of personalised medicine in the form of CFTR modulators will promote the emergence of personalised radiological diagnostics.
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Affiliation(s)
- Patrick W. O’Regan
- Department of Radiology, Cork University Hospital, T12 DC4A Cork, Ireland
- Department of Radiology, School of Medicine, University College Cork, T12 AK54 Cork, Ireland
| | - Niamh E. Stevens
- Department of Surgery, Mercy University Hospital, T12 WE28 Cork, Ireland
| | - Niamh Logan
- Department of Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland
| | - David J. Ryan
- Department of Radiology, Cork University Hospital, T12 DC4A Cork, Ireland
- Department of Radiology, School of Medicine, University College Cork, T12 AK54 Cork, Ireland
| | - Michael M. Maher
- Department of Radiology, Cork University Hospital, T12 DC4A Cork, Ireland
- Department of Radiology, School of Medicine, University College Cork, T12 AK54 Cork, Ireland
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Stoicescu L, Crişan D, Morgovan C, Avram L, Ghibu S. Heart Failure with Preserved Ejection Fraction: The Pathophysiological Mechanisms behind the Clinical Phenotypes and the Therapeutic Approach. Int J Mol Sci 2024; 25:794. [PMID: 38255869 PMCID: PMC10815792 DOI: 10.3390/ijms25020794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is an increasingly frequent form and is estimated to be the dominant form of HF. On the other hand, HFpEF is a syndrome with systemic involvement, and it is characterized by multiple cardiac and extracardiac pathophysiological alterations. The increasing prevalence is currently reaching epidemic levels, thereby making HFpEF one of the greatest challenges facing cardiovascular medicine today. Compared to HF with reduced ejection fraction (HFrEF), the medical attitude in the case of HFpEF was a relaxed one towards the disease, despite the fact that it is much more complex, with many problems related to the identification of physiopathogenetic mechanisms and optimal methods of treatment. The current medical challenge is to develop effective therapeutic strategies, because patients suffering from HFpEF have symptoms and quality of life comparable to those with reduced ejection fraction, but the specific medication for HFrEF is ineffective in this situation; for this, we must first understand the pathological mechanisms in detail and correlate them with the clinical presentation. Another important aspect of HFpEF is the diversity of patients that can be identified under the umbrella of this syndrome. Thus, before being able to test and develop effective therapies, we must succeed in grouping patients into several categories, called phenotypes, depending on the pathological pathways and clinical features. This narrative review critiques issues related to the definition, etiology, clinical features, and pathophysiology of HFpEF. We tried to describe in as much detail as possible the clinical and biological phenotypes recognized in the literature in order to better understand the current therapeutic approach and the reason for the limited effectiveness. We have also highlighted possible pathological pathways that can be targeted by the latest research in this field.
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Affiliation(s)
- Laurențiu Stoicescu
- Internal Medicine Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (L.S.); or (D.C.); or (L.A.)
- Cardiology Department, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Dana Crişan
- Internal Medicine Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (L.S.); or (D.C.); or (L.A.)
- Internal Medicine Department, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Claudiu Morgovan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Lucreţia Avram
- Internal Medicine Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (L.S.); or (D.C.); or (L.A.)
- Internal Medicine Department, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Steliana Ghibu
- Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
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Kasa G, Bayes-Genis A, Delgado V. Latest Updates in Heart Failure Imaging. Heart Fail Clin 2023; 19:407-418. [PMID: 37714583 DOI: 10.1016/j.hfc.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Heart failure (HF), a challenging and heterogeneous syndrome, still remains a major health problem worldwide, despite all the advances in prevention, diagnosis, and treatment of cardiovascular disease. Cardiac imaging plays a pivotal role in the classification of HF, accurate diagnosis of underlying etiology and decision-making. Integration of other imaging techniques such as cardiac magnetic resonance, nuclear imaging, and exercise imaging testing is important to characterize HF accurately. This article reviews the role of multimodality imaging to diagnose patients with HF.
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Affiliation(s)
- Gizem Kasa
- Cardiovascular Imaging Section, Department of Cardiology, Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Antoni Bayes-Genis
- Cardiovascular Imaging Section, Department of Cardiology, Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Victoria Delgado
- Cardiovascular Imaging Section, Department of Cardiology, Heart Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.
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Becker MAJ, van der Lingen ALCJ, Cornel JH, van de Ven PM, van Rossum AC, Allaart CP, Germans T. Septal Midwall Late Gadolinium Enhancement in Ischemic Cardiomyopathy and Nonischemic Dilated Cardiomyopathy-Characteristics and Prognosis. Am J Cardiol 2023; 201:294-301. [PMID: 37393732 DOI: 10.1016/j.amjcard.2023.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/12/2023] [Accepted: 06/11/2023] [Indexed: 07/04/2023]
Abstract
Septal midwall late gadolinium enhancement (LGE) is a characteristic finding on cardiac magnetic resonance imaging (CMR) in nonischemic dilated cardiomyopathy (DCM) and is associated with adverse events. Its significance in ischemic cardiomyopathy (ICM) is unknown. With this multicenter observational study, we aimed to study the characteristics of septal midwall LGE and evaluate its prognostic value in ICM. A total of 1,084 patients with an impaired left ventricular (LV) ejection fraction (<50%) on LGE-CMR, either because of ICM (53%) or DCM, were included retrospectively. Septal midwall LGE was defined as midmyocardial stripe-like or patchy LGE in septal segments and was present in 10% of patients with ICM compared with 34% of patients with DCM (p <0.001). It was significantly associated with larger LV volumes and lower LV ejection fraction, irrespective of etiology. The primary endpoint was all-cause mortality and secondary endpoint was ventricular arrhythmias (VAs), including resuscitated cardiac arrest, sustained VA, and appropriate implantable cardioverter-defibrillator (ICD) therapy. During a median follow-up of 2.7 years, we found a significant association between septal midwall LGE and mortality in patients with DCM (hazard ratio [HR] 1.92, p = 0.03), but not in patients with ICM (HR 1.35, p = 0.39). Risk of VAs was significantly higher in patients with septal midwall LGE on CMR, both in DCM (HR 2.80, p <0.01) and in ICM (HR 2.70, p <0.01). In conclusion, septal midwall LGE, typically seen in DCM, was also present in 10% of patients with ICM and was associated with increased LV dilation and worse function, irrespective of etiology. When present, septal midwall LGE was associated with adverse outcome.
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Affiliation(s)
- Marthe A J Becker
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Anne-Lotte C J van der Lingen
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan H Cornel
- Department of Cardiology, Northwest Clinics Alkmaar, Alkmaar, The Netherlands; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelis P Allaart
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tjeerd Germans
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Cardiology, Northwest Clinics Alkmaar, Alkmaar, The Netherlands
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O'Brien AT, Gil KE, Varghese J, Simonetti OP, Zareba KM. T2 mapping in myocardial disease: a comprehensive review. J Cardiovasc Magn Reson 2022; 24:33. [PMID: 35659266 PMCID: PMC9167641 DOI: 10.1186/s12968-022-00866-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/27/2022] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for myocardial tissue characterization. Elevated transverse relaxation time (T2) is specific for increased myocardial water content, increased free water, and is used as an index of myocardial edema. The strengths of quantitative T2 mapping lie in the accurate characterization of myocardial edema, and the early detection of reversible myocardial disease without the use of contrast agents or ionizing radiation. Quantitative T2 mapping overcomes the limitations of T2-weighted imaging for reliable assessment of diffuse myocardial edema and can be used to diagnose, stage, and monitor myocardial injury. Strong evidence supports the clinical use of T2 mapping in acute myocardial infarction, myocarditis, heart transplant rejection, and dilated cardiomyopathy. Accumulating data support the utility of T2 mapping for the assessment of other cardiomyopathies, rheumatologic conditions with cardiac involvement, and monitoring for cancer therapy-related cardiac injury. Importantly, elevated T2 relaxation time may be the first sign of myocardial injury in many diseases and oftentimes precedes symptoms, changes in ejection fraction, and irreversible myocardial remodeling. This comprehensive review discusses the technical considerations and clinical roles of myocardial T2 mapping with an emphasis on expanding the impact of this unique, noninvasive tissue parameter.
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Affiliation(s)
- Aaron T O'Brien
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| | - Katarzyna E Gil
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Juliet Varghese
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
| | - Orlando P Simonetti
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University, Columbus, Ohio, USA
| | - Karolina M Zareba
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA.
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JG, Coats AJ, Crespo-Leiro MG, Farmakis D, Gilard M, Heyman S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CS, Lyon AR, McMurray JJ, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GM, Ruschitzka F, Skibelund AK. Guía ESC 2021 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.11.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022; 24:4-131. [PMID: 35083827 DOI: 10.1002/ejhf.2333] [Citation(s) in RCA: 821] [Impact Index Per Article: 410.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/11/2022] Open
Abstract
Document Reviewers: Rudolf A. de Boer (CPG Review Coordinator) (Netherlands), P. Christian Schulze (CPG Review Coordinator) (Germany), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Elena Arbelo (Spain), Riccardo Asteggiano (Italy), Johann Bauersachs (Germany), Antoni Bayes-Genis (Spain), Michael A. Borger (Germany), Werner Budts (Belgium), Maja Cikes (Croatia), Kevin Damman (Netherlands), Victoria Delgado (Netherlands), Paul Dendale (Belgium), Polychronis Dilaveris (Greece), Heinz Drexel (Austria), Justin Ezekowitz (Canada), Volkmar Falk (Germany), Laurent Fauchier (France), Gerasimos Filippatos (Greece), Alan Fraser (United Kingdom), Norbert Frey (Germany), Chris P. Gale (United Kingdom), Finn Gustafsson (Denmark), Julie Harris (United Kingdom), Bernard Iung (France), Stefan Janssens (Belgium), Mariell Jessup (United States of America), Aleksandra Konradi (Russia), Dipak Kotecha (United Kingdom), Ekaterini Lambrinou (Cyprus), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Christophe Leclercq (France), Basil S. Lewis (Israel), Francisco Leyva (United Kingdom), AleVs Linhart (Czech Republic), Maja-Lisa Løchen (Norway), Lars H. Lund (Sweden), Donna Mancini (United States of America), Josep Masip (Spain), Davor Milicic (Croatia), Christian Mueller (Switzerland), Holger Nef (Germany), Jens-Cosedis Nielsen (Denmark), Lis Neubeck (United Kingdom), Michel Noutsias (Germany), Steffen E. Petersen (United Kingdom), Anna Sonia Petronio (Italy), Piotr Ponikowski (Poland), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Dimitrios J. Richter (Greece), Evgeny Schlyakhto (Russia), Petar Seferovic (Serbia), Michele Senni (Italy), Marta Sitges (Spain), Miguel Sousa-Uva (Portugal), Carlo G. Tocchetti (Italy), Rhian M. Touyz (United Kingdom), Carsten Tschoepe (Germany), Johannes Waltenberger (Germany/Switzerland) All experts involved in the development of these guidelines have submitted declarations of interest. These have been compiled in a report and published in a supplementary document simultaneously to the guidelines. The report is also available on the ESC website www.escardio.org/guidelines For the Supplementary Data which include background information and detailed discussion of the data that have provided the basis for the guidelines see European Heart Journal online.
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Liu K, Zhang J, Li X, Xie Y, Li Y, Wang X, Jiao X, Xie X, Tang B. Hypochlorous acid-activated two-photon fluorescent probe for evaluation of anticancer drug-induced cardiotoxicity and screening of antioxidant drugs. Org Chem Front 2022. [DOI: 10.1039/d2qo01408d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
THPIC was developed to detect HClO in lysosomes. The results showed that HClO could be used as a biomarker for evaluating drug-induced cardiotoxicity, and THPIC could be applied as a platform for screening drugs to prevent cardiotoxicitys.
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Affiliation(s)
- Kaiqiang Liu
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Jian Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Xinxin Li
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Yingying Xie
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Yong Li
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Xu Wang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Xiaoyun Jiao
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Xilei Xie
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, P. R. China
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Magnetic resonance imaging of cystic fibrosis: Multi-organ imaging in the age of CFTR modulator therapies. J Cyst Fibros 2021; 21:e148-e157. [PMID: 34879996 DOI: 10.1016/j.jcf.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 12/18/2022]
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 1-- gadu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 1-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 8029-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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15
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 8029-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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16
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42:3599-3726. [PMID: 34447992 DOI: 10.1093/eurheartj/ehab368] [Citation(s) in RCA: 5010] [Impact Index Per Article: 1670.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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17
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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18
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 and 1880=1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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19
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McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, de Boer RA, Christian Schulze P, Abdelhamid M, Aboyans V, Adamopoulos S, Anker SD, Arbelo E, Asteggiano R, Bauersachs J, Bayes-Genis A, Borger MA, Budts W, Cikes M, Damman K, Delgado V, Dendale P, Dilaveris P, Drexel H, Ezekowitz J, Falk V, Fauchier L, Filippatos G, Fraser A, Frey N, Gale CP, Gustafsson F, Harris J, Iung B, Janssens S, Jessup M, Konradi A, Kotecha D, Lambrinou E, Lancellotti P, Landmesser U, Leclercq C, Lewis BS, Leyva F, Linhart A, Løchen ML, Lund LH, Mancini D, Masip J, Milicic D, Mueller C, Nef H, Nielsen JC, Neubeck L, Noutsias M, Petersen SE, Sonia Petronio A, Ponikowski P, Prescott E, Rakisheva A, Richter DJ, Schlyakhto E, Seferovic P, Senni M, Sitges M, Sousa-Uva M, Tocchetti CG, Touyz RM, Tschoepe C, Waltenberger J, Adamo M, Baumbach A, Böhm M, Burri H, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gardner RS, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund AK. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab368 order by 8029-- awyx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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20
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Risk stratification for sudden cardiac death in patients with heart failure : Emerging role of imaging parameters. Herz 2021; 46:550-557. [PMID: 33909114 DOI: 10.1007/s00059-021-05032-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 08/25/2020] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Heart failure with reduced ejection fraction is a common condition that has a poor prognosis. Accurate selection of patients with ischemic heart disease and idiopathic dilated cardiomyopathy, who are at risk of sudden cardiac death (SCD), remains a challenge. In these cases, current indications for implantable cardioverter-defibrillators (ICD) rely almost entirely on left ventricular ejection fraction. However, this parameter is insufficient. Recently, noninvasive imaging has provided insight into the mechanism underlying SCD using myocardial deformation on echocardiography and magnetic resonance imaging. The aim of this review article was to underline the emerging role of these novel parameters in identifying high-risk patients. METHODS A literature search was carried out for reports published with the following terms: "sudden cardiac death," "heart failure," "noninvasive imaging," "echocardiography," "deformation," "magnetic resonance imaging," and "ventricular arrhythmia." The search was restricted to reports published in English. RESULTS The findings of this analysis suggest that cardiac magnetic resonance imaging and strain assessment by echocardiography, particularly longitudinal strain, can be promising techniques for cardiovascular risk stratification in patients with heart failure. CONCLUSION In future, risk stratification of arrhythmia and patient selection for ICD placement may rely on a multiparametric approach using combinations of imaging modalities in addition to left ventricular ejection fraction.
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21
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Yamagishi M, Tamaki N, Akasaka T, Ikeda T, Ueshima K, Uemura S, Otsuji Y, Kihara Y, Kimura K, Kimura T, Kusama Y, Kumita S, Sakuma H, Jinzaki M, Daida H, Takeishi Y, Tada H, Chikamori T, Tsujita K, Teraoka K, Nakajima K, Nakata T, Nakatani S, Nogami A, Node K, Nohara A, Hirayama A, Funabashi N, Miura M, Mochizuki T, Yokoi H, Yoshioka K, Watanabe M, Asanuma T, Ishikawa Y, Ohara T, Kaikita K, Kasai T, Kato E, Kamiyama H, Kawashiri M, Kiso K, Kitagawa K, Kido T, Kinoshita T, Kiriyama T, Kume T, Kurata A, Kurisu S, Kosuge M, Kodani E, Sato A, Shiono Y, Shiomi H, Taki J, Takeuchi M, Tanaka A, Tanaka N, Tanaka R, Nakahashi T, Nakahara T, Nomura A, Hashimoto A, Hayashi K, Higashi M, Hiro T, Fukamachi D, Matsuo H, Matsumoto N, Miyauchi K, Miyagawa M, Yamada Y, Yoshinaga K, Wada H, Watanabe T, Ozaki Y, Kohsaka S, Shimizu W, Yasuda S, Yoshino H. JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases. Circ J 2021; 85:402-572. [PMID: 33597320 DOI: 10.1253/circj.cj-19-1131] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa Universtiy
| | | | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Atsushi Nohara
- Division of Clinical Genetics, Ishikawa Prefectural Central Hospital
| | | | | | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School
| | - Yuichi Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children's Hospital
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Kinen Hospital
| | - Eri Kato
- Department of Cardiovascular Medicine, Department of Clinical Laboratory, Kyoto University Hospital
| | | | - Masaaki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University
| | - Keisuke Kiso
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Kakuya Kitagawa
- Department of Advanced Diagnostic Imaging, Mie University Graduate School
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School
| | | | | | | | - Akira Kurata
- Department of Radiology, Ehime University Graduate School
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama Nagayama Hospital
| | - Akira Sato
- Department of Cardiology, University of Tsukuba
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Japan
| | | | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Ryoichi Tanaka
- Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
| | | | | | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Hospital
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Naoya Matsumoto
- Division of Cardiology, Department of Medicine, Nihon University
| | | | | | | | - Keiichiro Yoshinaga
- Department of Diagnostic and Therapeutic Nuclear Medicine, Molecular Imaging at the National Institute of Radiological Sciences
| | - Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Plateau A, Bouvet C, Merlin C, Pereira B, Barres B, Clerfond G, Cachin F, Cassagnes L. Assessment of four different cardiac softwares for evaluation of LVEF with CZT-SPECT vs CMR in 48 patients with recent STEMI. J Nucl Cardiol 2020; 27:2017-2026. [PMID: 30426398 DOI: 10.1007/s12350-018-01493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare, vs CMR, four softwares: quantitative gated SPECT (QGS), myometrix (MX), corridor 4DM (4DM), and Emory toolbox (ECTb) to evaluate left ventricular ejection fraction (LVEF), end-systolic (ESV), and end-diastolic volumes (EDVs) by gated MPI CZT-SPECT. METHODS 48 patients underwent MPI CZT-SPECT and CMR 6 weeks after STEMI, LV parameters were measured with four softwares at MPI CZT-SPECT vs CMR. We evaluated (i) concordance and correlation between MPI CZT-SPECT and CMR, (ii) concordance MPI CZT-SPECT/CMR for the categorical evaluation of the left ventricular dysfunction, and (iii) impacts of perfusion defects > 3 segments on concordance. RESULTS LVEF: LCC QGS/CMR = 0.81 [+ 2.2% (± 18%)], LCC MX/CMR = 0.83 [+ 1% (± 17.5%)], LCC 4DM/CMR = 0.73 [+ 3.9% (± 21%)], LCC ECTb/CMR = 0.69 [+ 6.6% (± 21.1%)]. ESV: LCC QGS/CMR = 0.90 [- 8 mL (± 40 mL)], LCC MX/CMR = 0.90 [- 9 mL (± 36 mL)], LCC 4DM/CMR = 0.89 [+ 4 mL (± 45 mL)], LCC ECTb/CMR = 0.87 [- 3 mL (± 45 mL)]. EDV: LCC QGS/CMR = 0.70 [- 16 mL (± 67 mL)], LCC MX/CMR = 0.68 [- 21 mL (± 63 mL], LCC 4DM/CMR = 0.72 [+ 9 mL (± 73 mL)], LCC ECTb/CMR = 0.69 [+ 10 mL (± 70 mL)]. CONCLUSION QGS and MX were the two best-performing softwares to evaluate LVEF after recent STEMI.
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Affiliation(s)
- Antoine Plateau
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Clément Bouvet
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
| | - Charles Merlin
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Bruno Pereira
- DRCI, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Bertrand Barres
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- UMR INSERM 1240 "Molecular Imaging and Theranostic Strategy", Clermont Auvergne University, Clermont-Ferrand, France
| | - Guillaume Clerfond
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France
- Department of Cardiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Florent Cachin
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- UMR INSERM 1240 "Molecular Imaging and Theranostic Strategy", Clermont Auvergne University, Clermont-Ferrand, France
| | - Lucie Cassagnes
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France.
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France.
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23
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Shrivastava A, Haase T, Zeller T, Schulte C. Biomarkers for Heart Failure Prognosis: Proteins, Genetic Scores and Non-coding RNAs. Front Cardiovasc Med 2020; 7:601364. [PMID: 33330662 PMCID: PMC7719677 DOI: 10.3389/fcvm.2020.601364] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/14/2020] [Indexed: 12/13/2022] Open
Abstract
Heart failure (HF) is a complex disease in which cardiomyocyte injury leads to a cascade of inflammatory and fibrosis pathway activation, thereby causing decrease in cardiac function. As a result, several biomolecules are released which can be identified easily in circulating body fluids. The complex biological processes involved in the development and worsening of HF require an early treatment strategy to stop deterioration of cardiac function. Circulating biomarkers provide not only an ideal platform to detect subclinical changes, their clinical application also offers the opportunity to monitor disease treatment. Many of these biomarkers can be quantified with high sensitivity; allowing their clinical application to be evaluated beyond diagnostic purposes as potential tools for HF prognosis. Though the field of biomarkers is dominated by protein molecules, non-coding RNAs (microRNAs, long non-coding RNAs, and circular RNAs) are novel and promising biomarker candidates that encompass several ideal characteristics required in the biomarker field. The application of genetic biomarkers as genetic risk scores in disease prognosis, albeit in its infancy, holds promise to improve disease risk estimation. Despite the multitude of biomarkers that have been available and identified, the majority of novel biomarker candidates are not cardiac-specific, and instead may simply be a readout of systemic inflammation or other pathological processes. Thus, the true value of novel biomarker candidates in HF prognostication remains unclear. In this article, we discuss the current state of application of protein, genetic as well as non-coding RNA biomarkers in HF risk prognosis.
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Affiliation(s)
- Apurva Shrivastava
- Clinic for Cardiology, University Heart and Vascular Center, University Medical Center Eppendorf, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, University Medical Center Eppendorf, Hamburg, Germany
| | - Tina Haase
- Clinic for Cardiology, University Heart and Vascular Center, University Medical Center Eppendorf, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, University Medical Center Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- Clinic for Cardiology, University Heart and Vascular Center, University Medical Center Eppendorf, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, University Medical Center Eppendorf, Hamburg, Germany
| | - Christian Schulte
- Clinic for Cardiology, University Heart and Vascular Center, University Medical Center Eppendorf, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, University Medical Center Eppendorf, Hamburg, Germany.,King's British Heart Foundation Centre, King's College London, London, United Kingdom
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24
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Almas T, Saleem H, Ehtesham M, Hussain S, Khedro T, Alsufyani R, Alahmed F, Almubarak D, Zaidi SMJ, Hameed A. The Spectrum of Non-ischemic Cardiac Magnetic Resonance Imaging Findings: A Retrospective Analysis. Cureus 2020; 12:e11354. [PMID: 33304689 PMCID: PMC7720915 DOI: 10.7759/cureus.11354] [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] [Indexed: 11/24/2022] Open
Abstract
Introduction Since cardiac pathologies remain ubiquitous, their prompt diagnosis through the means of innovative technologies, such as cardiac magnetic resonance imaging, remains pivotal. The spectrum of these pathologies varies widely, ranging from ischemic etiologies to rare cardiac malignancies. This study evaluates the prevalence of nonischemic cardiac pathologies, such as infiltrative heart diseases, that often warrant meticulous diagnostic evaluation through the means of cardiac magnetic resonance imaging. Methods We performed a retrospective study in order to analyse the cardiac magnetic resonance imaging records of 250 patients over a period of six months with previously remarkable cardiac histories. Patients with a prior history of ischemic cardiac disease, as determined from past medical and surgical records, were excluded from the study. The prevalence of various nonischemic findings was ascertained. The demographic characteristics and comorbidities of the patients were also tabulated. Results In the present study, 250 patients were included, of which 115 were females and 135 were males, with the mean age hovering at 48.21 ± 11.49 years. The top two most prevalent cardiac magnetic resonance imaging findings were concentric moderate-to-severe left ventricular hypertrophy and patchy subendocardial late gadolinium enhancement of the left ventricle; these were observed in 62.2% and 23.7% of the patients, respectively. Cardiac magnetic resonance imaging also divulged findings typical of rarer pathologies, including cardiac sarcoidosis and primary cardiac lymphoma. Conclusion Pathologies of the heart often mandate extensive diagnostic workup through the means of radiological modalities such as cardiac magnetic resonance imaging. In patients with indications of nonischemic cardiac pathologies, cardiac magnetic resonance imaging can be employed as part of the initial radiological armamentarium. Furthermore, cardiac magnetic resonance remains the imaging modality of choice for detecting infrequent cardiac pathologies, such as cardiac sarcoidosis.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Hassan Saleem
- Radiology, Islamabad Diagnostic Center, Islamabad, PAK
| | - Maryam Ehtesham
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Salman Hussain
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Tarek Khedro
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Fatimah Alahmed
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dana Almubarak
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Aamir Hameed
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, IRL
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25
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Dzhioeva O, Belyavskiy E. Diagnosis and Management of Patients with Heart Failure with Preserved Ejection Fraction (HFpEF): Current Perspectives and Recommendations. Ther Clin Risk Manag 2020; 16:769-785. [PMID: 32904123 PMCID: PMC7450524 DOI: 10.2147/tcrm.s207117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a major global public health problem. Diagnosis of HFpEF is still challenging and built based on the comprehensive echocardiographic analysis. Currently, there are no universally accepted therapies that alter the clinical course of HFpEF. This review attempts to summarize the current advances in the diagnosis of HFpEF and provide future directions of the patients´ management with this very widespread, heterogeneous clinical syndrome.
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Affiliation(s)
- Olga Dzhioeva
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Evgeny Belyavskiy
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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26
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Mitropoulou P, Georgiopoulos G, Figliozzi S, Klettas D, Nicoli F, Masci PG. Multi-Modality Imaging in Dilated Cardiomyopathy: With a Focus on the Role of Cardiac Magnetic Resonance. Front Cardiovasc Med 2020; 7:97. [PMID: 32714942 PMCID: PMC7343712 DOI: 10.3389/fcvm.2020.00097] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/07/2020] [Indexed: 12/20/2022] Open
Abstract
Heart failure (HF) is recognized as a leading cause of morbidity and mortality worldwide. Dilated cardiomyopathy (DCM) is a common phenotype in patients presenting with HF. Timely diagnosis, appropriate identification of the underlying cause, individualized risk stratification, and prediction of clinical response to treatment have improved the prognosis of DCM over the last few decades. In this article, we reviewed the current evidence on available imaging techniques used for DCM patients. In this direction, we evaluated appropriate scenarios for the implementation of echocardiography, nuclear imaging, and cardiac computed tomography, and we focused on the primordial role that cardiac magnetic resonance (CMR) holds in the diagnosis, prognosis, and tailoring of therapeutic options in this population of special clinical interest. We explored the predictive value of CMR toward left ventricular reverse remodeling and prediction of sudden cardiac death, thus guiding the decisions for device therapy. Principles underpinning the use of state-of-the-art CMR techniques such as parametric mapping and feature-tracking strain analysis are also provided, along with expectations for the anticipated future advances in this field. We also attempted to correlate the evidence with clinical practice, with the intent to address questions on selecting the optimal imaging method for different indications and clinical needs. Overall, we recommend a comprehensive assessment of DCM patients at baseline and at follow-up intervals depending on the clinical status, with the addition of CMR as a second-line modality to other imaging techniques. We also provide an algorithm to guide the detailed imaging approach of the patient with DCM. We expect that future guidelines will upgrade their clinical recommendations for the utilization of CMR in DCM, which is expected to further improve the quality of care and the outcomes. This review provides an up-to-date perspective on the imaging of dilated cardiomyopathy patients and will be of clinical value to training doctors and physicians involved in the area of heart failure.
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Affiliation(s)
| | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, London, United Kingdom.,Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefano Figliozzi
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, London, United Kingdom
| | - Dimitrios Klettas
- First Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Flavia Nicoli
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, London, United Kingdom
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, London, United Kingdom
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27
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Hu L, Wang Q, Gregory BP, Ouyang RZ, Sun A, Guo C, Han T, Zhong Y. Quantitative comparison of two-dimensional and three-dimensional strain measurement using MRI feature tracking in repair Fontan patients and normal child volunteers. BMC Med Imaging 2020; 20:8. [PMID: 31992224 PMCID: PMC6988298 DOI: 10.1186/s12880-020-0413-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 01/15/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The accuracy of 2D and 3D strain analyses was evaluated by comparing strain and cardiac function parameters in Fontan repair patients and normal child volunteers. METHODS We retrospectively enrolled 32 patients with Fontan circulation and 32 child volunteers who had undergone clinical cardiac magnetic resonance (CMR) assessment of the dominant ventricle with a 1.5-Tesla MRI scanner. Global and regional strain (2D and 3D) of the dominant ventricle in both groups was assessed using CMR feature-tracking. Correlations between cardiac function and strain data were assessed using Pearson's correlation coefficient values. The intraclass correlation coefficient (ICC) and coefficient of variation (CoV) were determined to evaluate repeatability and agreement. RESULTS The 2D GLS showed significant differences between the Fontan repair patients and volunteers (- 16.49 ± 5.00 vs. -19.49 ± 2.03; p = 0.002). The 2D GRS and 2D GCS showed no significant differences between two groups. 2D GRS: 38.96 ± 14.48 vs. 37.46 ± 7.77; 2D GCS: - 17.64 ± 5.00 vs. -16.89 ± 2.96, respectively; p > 0.05). The 3D global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) showed significant differences between the Fontan repair patients and volunteers (3D GRS: 36.35 ± 16.72 vs. 44.96 ± 9.98; 3D GLS: - 8.86 ± 6.84 vs. -13.67 ± 2.44; 3D GCS: - 13.70 ± 7.84 vs. -18.01 ± 1.78; p < 0.05, respectively). The ejection fraction (EF) and 3D GCS were significantly associated (r = - 0.491, p = 0.004). The 3D GCS showed correlations with the indexed end-diastolic volume (EDV) (r = 0.523, p = 0.002) and indexed end-systolic volume (ESV) (r = 0.602, p < 0.001). 3D strain showed good reproducibility, with GCS showing the best inter-observer agreement (ICC = 0.87 and CoV = 5.15), followed by GLS (ICC = 0.84 and CoV = 5.36). CONCLUSIONS 3D GCS is feasible, highly reproducible, and strongly correlated with conventional cardiac function measures. 3D GCS assessments may be useful for monitoring abnormal myocardial motion in patients with Fontan circulation.
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Affiliation(s)
- Liwei Hu
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China
| | - Qian Wang
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China
| | - Barton P Gregory
- Radiology, University of Wisconsin-Madison, Madison, WI, USA.,Pediatrics, University of Wisconsin-Madison, Madison, WI, USA
| | - Rong Zhen Ouyang
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China
| | - Aimin Sun
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China
| | - Chen Guo
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China
| | - Tongtong Han
- Circle Cardiovascular Imaging, 250, 815 8th Ave SW, Calgary, Canada
| | - Yumin Zhong
- Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China.
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28
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Schiau C, Schiau Ş, Dudea SM, Manole S. Cardiovascular magnetic resonance: contribution to the exploration of cardiomyopathies. Med Pharm Rep 2019; 92:326-336. [PMID: 31750431 PMCID: PMC6853046 DOI: 10.15386/mpr-1343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/14/2019] [Accepted: 07/31/2019] [Indexed: 01/10/2023] Open
Abstract
Background and aims Magnetic resonance imaging is a non-invasive and non-irradiating imaging method, complementary to cardiac ultrasound in the assessment of cardiovascular disease and implicitly of cardiomyopathies. Although it is not a first intention imaging method, it is superior in the assessment of cardiac volumes, left ventricular ejection fraction, in the analysis of cardiac wall dyskinesia and myocardial tissue characteristics with and without using a contrast agent. The purpose of this paper is to review the current knowledge regarding cardiovascular magnetic resonance imaging (CMR) and its applications in cardiomyopathy analysis. Methods In order to create this review, relevant articles were searched and analyzed by using MeSH terms such as: “cardiac magnetic resonance imaging”, “cardiomyopathy”, “myocardial fibrosis”. Three main international databases PubMed, Web of Science and Medscape were searched. We carried out a narrative review focused on the current indications of cardiovascular magnetic resonance imaging in cardiomyopathies, both common and raret, of ischemic and nonischemic types. Results Cardiac magnetic resonance imaging has a very important role in the diagnosis, assessment and prognosis of common cardiomyopathies (the dilated, hypertrophic and inflammatory types) or other more rare ones such as (amyloidosis, arrhythmogenic right ventricular, non-compaction or Takotsubo cardiomyopathy), as it represents the gold standard for evaluating the ejection fraction, ventricular volumes and mass. CMR techniques, such as late gadolinium enhancement, T1 and T2 mapping have proven their usefulness, helping differentiate between ischemic (subendocardial enhancement) and nonischemic cardiomyopathy (varied pattern) or also establish the etiology. Another important feature of this imaging technique is that it can establish the myocardial viability, thus the chance of contractile recovery after revascularization. This feature is based on the transmural extent of LGE, left ventricle wall thickness and the assessment of the contractile reserve after administration of low dose dobutamine. Conclusions Cardiovascular magnetic resonance imaging is an indispensable tool, with proven efficiency, capable of providing the differential diagnosis between ischemic and nonischemic cardiomyopathy or establishing the etiology in the nonischemic type. In addition, these findings have a prognostic value, they may guide the patient management plan and, if necessary, can evaluate treatment response. Therefore, this technique should be part of any routine investigation of various cardiomyopathies.
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Affiliation(s)
- Călin Schiau
- Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Şerban Schiau
- "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania
| | - Sorin M Dudea
- Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Radiology Department, Emergency Clinical County Hospital, Cluj-Napoca, Romania
| | - Simona Manole
- Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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29
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Gronda E, Sacchi S, Benincasa G, Vanoli E, Napoli C. Unresolved issues in left ventricular postischemic remodeling and progression to heart failure. J Cardiovasc Med (Hagerstown) 2019; 20:640-649. [DOI: 10.2459/jcm.0000000000000834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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30
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Savino K, Bagliani G, Crusco F, Padeletti M, Lombardi M. Electrocardiogram and Imaging: An Integrated Approach to Arrhythmogenic Cardiomyopathies. Card Electrophysiol Clin 2019; 10:413-429. [PMID: 29784492 DOI: 10.1016/j.ccep.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cardiovascular imaging has radically changed the management of patients with arrhythmogenic cardiomyopathies. This article focuses on the role of echocardiography and MRI in the diagnosis of these structural diseases. Cardiomyopathies with hypertrophic pattern (hypertrophic cardiomyopathy, restrictive cardiomyopathies, amyloidosis, Anderson-Fabry disease, and sarcoidosis), cardiomyopathies with dilated pattern, inflammatory cardiac diseases, and right ventricular arrhythmogenic cardiomyopathy are analyzed. Finally, anatomic predictors of arrhythmias and sudden cardiac death are discussed. Each paragraph is attended by clinical cases that are discussed on the electrocardiogram, after integrated with the anatomic, functional, and hemodynamic modifications of cardiovascular imaging.
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Affiliation(s)
- Ketty Savino
- Cardiology and Cardiovascular Physiopathology, University of Perugia, Piazza Menghini, 1, Perugia 06129, Italy.
| | - Giuseppe Bagliani
- Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, Foligno 06034, Italy
| | - Federico Crusco
- Radiology, Foligno Hospital, Via Massimo Arcamone, Foligno 06034, Italy
| | - Margherita Padeletti
- Cardiology, Mugello Hospital, Viale della Resistenza, 60, 50032 Borgo San Lorenzo FI, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, Policlinico San Donato, San Donato Milanese, Piazza Edmondo Malan, 2, 20097 San Donato Milanese MI, Italy
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31
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Alherbish A, Becher H, Alemayehu W, Paterson DI, Butler CR, Anderson TJ, Ezekowitz JA, Shanks M. Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging. Echocardiography 2018; 35:1746-1754. [DOI: 10.1111/echo.14152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/06/2018] [Accepted: 09/04/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Aws Alherbish
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
| | - Harald Becher
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
| | - Wendimagegn Alemayehu
- Canadian VIGOUR Centre; University of Alberta; Edmonton Alberta Canada
- Li Ka Shing Centre for Health Research Innovation; University of Alberta; Edmonton Alberta Canada
| | - D. Ian Paterson
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
| | - Craig R. Butler
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
| | - Todd J. Anderson
- Department of Cardiac Sciences; Libin Cardiovascular Institute of Alberta; Cumming School of Medicine; University of Calgary; Calgary Alberta Canada
| | - Justin A. Ezekowitz
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
- Canadian VIGOUR Centre; University of Alberta; Edmonton Alberta Canada
| | - Miriam Shanks
- Division of Cardiology; Department of Medicine; Mazankowski Alberta Heart Institute; University of Alberta; Edmonton Alberta Canada
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32
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Joubert M, Manrique A, Cariou B, Prieur X. Diabetes-related cardiomyopathy: The sweet story of glucose overload from epidemiology to cellular pathways. DIABETES & METABOLISM 2018; 45:238-247. [PMID: 30078623 DOI: 10.1016/j.diabet.2018.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/28/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023]
Abstract
Type 2 diabetes (T2D) is a major risk factor for heart failure (HF). Although the number of cases of myocardial infarction in the T2D population has been reduced by 25% over the last 10 years, the incidence of HF is continuously increasing, making it the most worrying diabetes complication. This strongly reinforces the urgent need for innovative therapeutic interventions to prevent cardiac dysfunction in T2D patients. To this end, epidemiological, imaging and animal studies have aimed to highlight the mechanisms involved in the development of diabetic cardiomyopathy. Epidemiological observations clearly show that hyperglycaemia correlates with severity of cardiac dysfunction and mortality in T2D patients. Both animal and cellular studies have demonstrated that, in the context of diabetes, the heart loses its ability to utilize glucose, therefore leading to glucose overload in cardiomyocytes that, in turn, promotes oxidative stress, accumulation of advanced glycation end-products (AGEs) and chronic activation of the hexosamine pathway. These have all been found to activate apoptosis and to alter heart contractility, calcium signalling and mitochondrial function. Although, in the past, tight glycaemic control has failed to improve cardiac function in T2D patients, recent clinical trials have reported cardiovascular benefit with hypoglycaemic antidiabetic drugs of the SGLT2-inhibitor family. This review, based on clinical evidence from mechanistic studies as well as several large clinical trials, covers 15 years of research, and strongly supports the idea that hyperglycaemia and glucose overload play a central role in the pathophysiology of diabetic cardiomyopathy.
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Affiliation(s)
- M Joubert
- Diabetes care unit, Caen university hospital, 14033 Caen cedex, France; EA4650, UNICAEN, 14000 Caen, France
| | - A Manrique
- Nuclear medicine unit, Caen university hospital, 14033 Caen cedex, France; EA4650, UNICAEN, 14000 Caen, France
| | - B Cariou
- Institut du thorax, Inserm, CNRS, University of Nantes, CHU Nantes, 44000 Nantes, France
| | - X Prieur
- Institut du thorax, Inserm, CNRS, University of Nantes, 44000 Nantes, France.
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33
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Pi SH, Kim SM, Choi JO, Kim EK, Chang SA, Choe YH, Lee SC, Jeon ES. Prognostic value of myocardial strain and late gadolinium enhancement on cardiovascular magnetic resonance imaging in patients with idiopathic dilated cardiomyopathy with moderate to severely reduced ejection fraction. J Cardiovasc Magn Reson 2018; 20:36. [PMID: 29898740 PMCID: PMC6001169 DOI: 10.1186/s12968-018-0466-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 05/25/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been reported that left ventricular (LV) myocardial strain and late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging have prognostic value in patients with heart failure (HF). However, previous studies included patients with various systolic functions. This study aimed to investigate the prognostic value of LV myocardial strain and LGE on CMR imaging in patients with idiopathic dilated cardiomyopathy (DCM) with reduced ejection fraction (EF < 40%). METHODS From a prospectively followed cohort who underwent CMR between November 2008 and December 2015, subjects with LV EF < 40% and a diagnosis of idiopathic DCM were eligible for this study. The CMR images were analyzed for LV and right ventricular (RV) function, presence and extent of LGE, and LV myocardial strain. The primary outcome was a composite of all-cause death and heart transplantation. The secondary outcome was hospitalization for HF. RESULTS A total of 172 patients were included, in whom mean LV EF was 23.7 ± 7.9% (EF 30-40% n = 47; EF < 30% n = 125). During a median follow-up of 47 months, the primary outcome occurred in 43 patients (16 heart transplantations, 29 all-cause deaths), and there were 41 hospitalizations for HF. Univariate Cox proportional hazard regression analysis showed that mean arterial pressure, serum sodium concentration, log of plasma NT-proBNP level, and presence of LGE (HR 2.277, 95% CI: 1.221-4.246) were significantly associated with the primary outcome. However, LV strain had no significant association (HR 1.048, 95% CI: 0.945-1.163). Multivariable analysis showed that presence of LGE (HR 4.73, 95% CI: 1.11-20.12) and serum sodium (HR 0.823, 95% CI: 0.762-0.887) were independently associated with the primary outcome. CONCLUSIONS LGE in CMR imaging was a good predictor of adverse outcomes for patients with idiopathic DCM and reduced EF. Identification of LGE could thus improve risk stratification in high-risk patients. LV strain had no significant prognostic value in patients with moderate to severe systolic dysfunction.
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MESH Headings
- Adult
- Aged
- Biomechanical Phenomena
- Cardiomyopathy, Dilated/diagnostic imaging
- Cardiomyopathy, Dilated/mortality
- Cardiomyopathy, Dilated/physiopathology
- Cardiomyopathy, Dilated/surgery
- Contrast Media/administration & dosage
- Female
- Heart Failure/diagnostic imaging
- Heart Failure/mortality
- Heart Failure/physiopathology
- Heart Failure/surgery
- Heart Transplantation
- Hospitalization
- Humans
- Magnetic Resonance Imaging, Cine
- Male
- Middle Aged
- Myocardial Contraction
- Organometallic Compounds/administration & dosage
- Predictive Value of Tests
- Prognosis
- Prospective Studies
- Reproducibility of Results
- Risk Factors
- Stroke Volume
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/mortality
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Left/surgery
- Ventricular Function, Left
- Ventricular Function, Right
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Affiliation(s)
- Seung-Hoon Pi
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Sung Mok Kim
- Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin-Oh Choi
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Eun Kyoung Kim
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Sung-A Chang
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Yeon Hyeon Choe
- Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Chol Lee
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Eun-Seok Jeon
- Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 Republic of Korea
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Mishra S, Mohan JC, Nair T, Chopra VK, Harikrishnan S, Guha S, Ramakrishnan S, Ray S, Sethi R, Samal UC, Sarat Chandra K, Hiremath MS, Banerjee AK, Kumar S, Das MK, Deb PK, Bahl VK. Management protocols for chronic heart failure in India. Indian Heart J 2018; 70:105-127. [PMID: 29455764 PMCID: PMC5903070 DOI: 10.1016/j.ihj.2017.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient's quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management.
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Affiliation(s)
- S Mishra
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - J C Mohan
- Department of Cardiology, Fortis Hospital, Shalimar Bagh, New Delhi, 110088, India
| | - Tiny Nair
- Department of Cardiology, PRS Hospital, Thiruvananthapuram, 695002, India
| | - V K Chopra
- Department of Clinical and Preventive Cardiology, Medanta - The Medicity, Gurugram, Haryana, 122001, India
| | - S Harikrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, 695011, India
| | - S Guha
- Department of Cardiology, Medical College, Kolkata, 700073, India
| | - S Ramakrishnan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - S Ray
- Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, 70026, India
| | - R Sethi
- Department of Cardiology, King George's Medical University, Ludhiana, Uttar Pradesh, 226003, India
| | - U C Samal
- Heart Failure Subspecialty, Cardiological Society of India, Kolkata, India
| | - K Sarat Chandra
- Department of Cardiology, Institute of Post Graduate Medical Education & Research and Memorial Hospital, Kolkata, 700020, India
| | - M S Hiremath
- Department of Cardiology, Ruby Hall Clinic, Pune, 411001, India
| | - A K Banerjee
- Department of Cardiology, Institute of Post Graduate Medical Education & Research and Memorial Hospital, Kolkata, 700020, India
| | - S Kumar
- Cardiological Society of India, Kolkata, India
| | - M K Das
- Cardiological Society of India, Kolkata, India
| | - P K Deb
- Cardiological Society of India, Kolkata, India
| | - V K Bahl
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India
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Ramírez R, Durán M, Márquez J. Miocardiopatía diabética: un punto de vista retrospectivo. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2017.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Schelbert EB, Elkayam U, Cooper LT, Givertz MM, Alexis JD, Briller J, Felker GM, Chaparro S, Kealey A, Pisarcik J, Fett JD, McNamara DM. Myocardial Damage Detected by Late Gadolinium Enhancement Cardiac Magnetic Resonance Is Uncommon in Peripartum Cardiomyopathy. J Am Heart Assoc 2017; 6:JAHA.117.005472. [PMID: 28373243 PMCID: PMC5533034 DOI: 10.1161/jaha.117.005472] [Citation(s) in RCA: 26] [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] [Indexed: 01/11/2023]
Abstract
BACKGROUND In peripartum cardiomyopathy, the prevalence of focal myocardial damage detected by late gadolinium enhancement (LGE) cardiovascular magnetic resonance is important to elucidate mechanisms of myocardial injury and cardiac dysfunction. LGE equates irreversible myocardial injury, but LGE prevalence in peripartum cardiomyopathy is uncertain. METHODS AND RESULTS Among 100 women enrolled within the Investigations of Pregnancy Associated Cardiomyopathy cohort, we recruited 40 women at 13 centers to undergo LGE cardiovascular magnetic resonance, enrolled within the first 13 weeks postpartum. Follow-up scans occurred at 6 months postpartum, and death/transplant rates at 12 months. Baseline characteristics did not differ significantly in the parent cohort according to cardiovascular magnetic resonance enrollment except for mechanical circulatory support. LGE was noted only in 2 women (5%) at baseline. While left ventricular dysfunction with enlargement was prevalent at baseline cardiovascular magnetic resonance scans (eg, ejection fraction 38% [Q1-Q3 31-50%], end diastolic volume index=108 mL/m2 [Q1-Q3 83-134 mL/m2]), most women demonstrated significant improvements at 6 months, consistent with a low prevalence of LGE. LGE was not related to baseline clinical variables, ejection fraction, New York Heart Association heart failure class, or mortality. Neither of the 2 women who died exhibited LGE. LGE was inversely associated with persistent left ventricular ejection fraction at 6 months (P=0.006). CONCLUSIONS Factors other than focal myocardial damage detectable by LGE explain the initial transient depressions in baseline left ventricular ejection fraction, yet focal myocardial damage may contribute to persistent myocardial dysfunction and hinder recovery in a small minority. Most women exhibit favorable changes in ventricular function over 6 months. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01085955.
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Affiliation(s)
| | - Uri Elkayam
- University of Southern California, Los Angeles, CA
| | | | | | - Jeffrey D Alexis
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | | | | | | | | | - James D Fett
- University of Pittsburgh Medical Center, Pittsburgh, PA
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 1-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 8029-- awyx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37:2129-2200. [PMID: 27206819 DOI: 10.1093/eurheartj/ehw128] [Citation(s) in RCA: 8873] [Impact Index Per Article: 1109.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 and 1880=1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 8029-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 8029-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016. [DOI: 10.1093/eurheartj/ehw128 order by 1-- gadu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail 2016; 18:891-975. [DOI: 10.1002/ejhf.592] [Citation(s) in RCA: 4631] [Impact Index Per Article: 578.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Ishibashi K, Kubo T, Kitabata H, Takarada S, Shimamura K, Tanimoto T, Orii M, Shiono Y, Yamano T, Ino Y, Yamaguchi T, Hirata K, Tanaka A, Imanishi T, Akasaka T. Reply to Letter Regarding Article, “Improvement of Cardiac Function by Increasing Stimulus Strength during Left Ventricular Pacing in Cardiac Resynchronization Therapy”. Int Heart J 2015; 56:580. [DOI: 10.1536/ihj.15-262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kohei Ishibashi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Shigeho Takarada
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Makoto Orii
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Yamano
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Wakayama Medical University
| | | | - Kumiko Hirata
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Toshio Imanishi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
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