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Roller FC, Schüßler A, Kremer N, Harth S, Kriechbaum SD, Wiedenroth CB, Guth S, Breithecker A, Richter M, Tello K, Seeger W, Mayer E, Krombach GA. Value of Right and Left Ventricular T1 and T2 Blood Pool Mapping in Patients with Chronic Thromboembolic Hypertension before and after Balloon Pulmonary Angioplasty. J Clin Med 2023; 12:jcm12062092. [PMID: 36983095 PMCID: PMC10052780 DOI: 10.3390/jcm12062092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Parametric imaging has taken a steep rise in recent years and non-cardiac applications are of increasing interest. Therefore, the aim of our study was to assess right (RV) and left ventricular (LV) blood pool T1 and T2 values in patients with chronic thromboembolic pulmonary hypertension (CTEPH) compared to control subjects and their correlation to pulmonary hemodynamic. METHODS 26 patients with CTEPH (mean age 64.8 years ± 12.8 SD; 15 female), who underwent CMR and right heart catheterization (RHC) before and 6-months after balloon pulmonary angioplasty (BPA), were retrospectively included. Ventricular blood pool values were measured, compared to control subjects (mean age 40.5 years ± 12.8 SD; 16 female) and correlated to invasive measures (CI, mPAP, PVR). RESULTS In both, control subjects and CTEPH patients, RVT1 and RVT2 were significantly reduced compared to LVT1 and LVT2. Compared to control subjects, RVT2 was significantly reduced in CTEPH patients (p = 0.0065) and increased significantly after BPA (p = 0.0048). Moreover, RVT2 was positively correlated with CI and negatively correlated with mPAP and PVR before (r = 0.5155, r = -0.2541, r = -0.4571) and after BPA (r = 0.4769, r = -0.2585, r = -0.4396). CONCLUSION Ventricular blood pool T2 mapping might be novel non-invasive CMR imaging marker for assessment of disease severity, prognosis, follow-up and even therapy monitoring in PH.
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Affiliation(s)
- Fritz C Roller
- Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Klinikstraße 33, 35392 Giessen, Germany
- German Center for Lung Research (DZL), 35392 Giessen, Germany
| | - Armin Schüßler
- Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Klinikstraße 33, 35392 Giessen, Germany
- German Center for Lung Research (DZL), 35392 Giessen, Germany
| | - Nils Kremer
- German Center for Lung Research (DZL), 35392 Giessen, Germany
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), 35392 Giessen, Germany
| | - Sebastian Harth
- Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Klinikstraße 33, 35392 Giessen, Germany
- German Center for Lung Research (DZL), 35392 Giessen, Germany
| | - Steffen D Kriechbaum
- Department of Cardiology, Kerckhoff Heart and Thorax Centre, 61231 Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Rhein-Main, 60323 Frankfurt am Main, Germany
| | - Christoph B Wiedenroth
- Department of Thoracic Surgery, Kerckhoff Heart and Thorax Centre, 61231 Bad Nauheim, Germany
| | - Stefan Guth
- Department of Thoracic Surgery, Kerckhoff Heart and Thorax Centre, 61231 Bad Nauheim, Germany
| | - Andreas Breithecker
- Department of Radiology, Kerckhoff Heart and Thorax Centre, 61231 Bad Nauheim, Germany
| | - Manuel Richter
- German Center for Lung Research (DZL), 35392 Giessen, Germany
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), 35392 Giessen, Germany
| | - Khodr Tello
- German Center for Lung Research (DZL), 35392 Giessen, Germany
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), 35392 Giessen, Germany
| | - Werner Seeger
- German Center for Lung Research (DZL), 35392 Giessen, Germany
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), 35392 Giessen, Germany
| | - Eckhard Mayer
- Department of Thoracic Surgery, Kerckhoff Heart and Thorax Centre, 61231 Bad Nauheim, Germany
| | - Gabriele A Krombach
- Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Klinikstraße 33, 35392 Giessen, Germany
- German Center for Lung Research (DZL), 35392 Giessen, Germany
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Steinkohl E, Olesen SS, Hansen TM, Drewes AM, Frøkjær JB. Quantification of parenchymal fibrosis in chronic pancreatitis: relation to atrophy and pancreatic function. Acta Radiol 2023; 64:936-944. [PMID: 35915988 DOI: 10.1177/02841851221114772] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-invasive modalities for assessing chronic pancreatitis (CP) are needed in clinical practice. PURPOSE To investigate the correlation between magnetic resonance elastography (MRE)-derived stiffness and T1 relaxation times (as proxies of fibrosis) and explore their relationships to gland volume and pancreatic functions in patients with CP and healthy controls (HCs). MATERIAL AND METHODS In 49 patients with CP and 35 HCs, pancreatic stiffness, T1 relaxation times, and gland volume were assessed. Fecal elastase and the presence of diabetes were used to evaluate pancreatic exocrine and endocrine functions. Uni- and multivariable linear regression models were used to analyze correlations between imaging parameters. RESULTS There was a positive correlation between MRE-derived stiffness and T1 relaxation times in patients with CP (R2 = 0.42; P < 0.001) and HCs (R2 = 0.14; P = 0.028). There was no correlation between MRE-derived stiffness and gland volume in patients (R2 = 0.007; P = 0.065) or HCs (R2 = 0.010; P = 0.57). T1 relaxation time was correlated to gland volume (R2 = 0.19; P = 0.002) in patients with CP but not in the HCs (P = 0.056). Severity of pancreatic functional impairment was reflected by increased fibrosis-related parameters in patients without functional impairment, followed by a further increase in fibrosis-related parameters and reduction in gland volume in patients with pancreatic functional impairments. CONCLUSION Pancreatic MRE-derived stiffness and T1 relaxation times might reflect early pathophysiological changes in CP. The dynamic correlation with pancreatic function suggests that these parameters may be useful for the non-invasive and early identification of CP.
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Affiliation(s)
- Emily Steinkohl
- Mech-Sense, Department of Radiology, 53141Aalborg University Hospital, Aalborg, Denmark
- Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, 53141Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, 1004Aalborg University, Aalborg, Denmark
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, 53141Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, 1004Aalborg University, Aalborg, Denmark
| | - Tine Maria Hansen
- Mech-Sense, Department of Radiology, 53141Aalborg University Hospital, Aalborg, Denmark
- Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, 53141Aalborg University Hospital, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, 53141Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, 1004Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Mech-Sense, Department of Radiology, 53141Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, 1004Aalborg University, Aalborg, Denmark
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Bousseau S, Sobrano Fais R, Gu S, Frump A, Lahm T. Pathophysiology and new advances in pulmonary hypertension. BMJ MEDICINE 2023; 2:e000137. [PMID: 37051026 PMCID: PMC10083754 DOI: 10.1136/bmjmed-2022-000137] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/02/2023] [Indexed: 04/14/2023]
Abstract
Pulmonary hypertension is a progressive and often fatal cardiopulmonary condition characterised by increased pulmonary arterial pressure, structural changes in the pulmonary circulation, and the formation of vaso-occlusive lesions. These changes lead to increased right ventricular afterload, which often progresses to maladaptive right ventricular remodelling and eventually death. Pulmonary arterial hypertension represents one of the most severe and best studied types of pulmonary hypertension and is consistently targeted by drug treatments. The underlying molecular pathogenesis of pulmonary hypertension is a complex and multifactorial process, but can be characterised by several hallmarks: inflammation, impaired angiogenesis, metabolic alterations, genetic or epigenetic abnormalities, influence of sex and sex hormones, and abnormalities in the right ventricle. Current treatments for pulmonary arterial hypertension and some other types of pulmonary hypertension target pathways involved in the control of pulmonary vascular tone and proliferation; however, these treatments have limited efficacy on patient outcomes. This review describes key features of pulmonary hypertension, discusses current and emerging therapeutic interventions, and points to future directions for research and patient care. Because most progress in the specialty has been made in pulmonary arterial hypertension, this review focuses on this type of pulmonary hypertension. The review highlights key pathophysiological concepts and emerging therapeutic directions, targeting inflammation, cellular metabolism, genetics and epigenetics, sex hormone signalling, bone morphogenetic protein signalling, and inhibition of tyrosine kinase receptors.
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Affiliation(s)
- Simon Bousseau
- Division of Pulmonary, Sleep, and Critical Care Medicine, National Jewish Health, Denver, CO, USA
| | - Rafael Sobrano Fais
- Division of Pulmonary, Sleep, and Critical Care Medicine, National Jewish Health, Denver, CO, USA
| | - Sue Gu
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Cardiovascular Pulmonary Research Lab, University of Colorado School of Medicine, Aurora, CO, USA
| | - Andrea Frump
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tim Lahm
- Division of Pulmonary, Sleep, and Critical Care Medicine, National Jewish Health, Denver, CO, USA
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO, USA
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Abstract
Patients with heart failure (HF) often have pulmonary hypertension (PH), which is mainly post-capillary; however, some of them also develop a pre-capillary component. The exact mechanisms leading to combined pre- and post-capillary PH are not yet clear, but the phenomenon seems to start from a passive transmission of increased pressure from the left heart to the lungs, and then continues with the remodeling of both the alveolar and vascular components through different pathways. More importantly, it is not yet clear which patients are predisposed to develop the disease. These patients have some characteristics similar to those with idiopathic pulmonary arterial hypertension (e.g., young age and frequent incidence in female gender), but they share cardiovascular risk factors with patients with HF (e.g., obesity and diabetes), with both reduced and preserved ejection fraction. Thanks to echocardiography parameters and newly introduced scores, more tools are available to distinguish between idiopathic pulmonary arterial hypertension and combined PH and to guide patients' management. It may be hypothesized to treat patients in whom the pre-capillary component is predominant with specific therapies such as those for idiopathic pulmonary arterial hypertension; however, no adequately powered trials of PH-specific treatment are available in combined PH. Early evidence of clinical benefit has been proven in some trials on phosphodiesterase type 5 inhibitors, while data on prostacyclin analogues, endothelin-1 receptor antagonists, and soluble guanylate cyclase stimulators are still controversial.
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Miao R, Gong J, Guo X, Guo D, Zhang X, Hu H, Zhong J, Yang Y, Li Y. Diagnostic value of miRNA expression and right ventricular echocardiographic functional parameters for chronic thromboembolic pulmonary hypertension with right ventricular dysfunction and injury. BMC Pulm Med 2022; 22:171. [PMID: 35488248 PMCID: PMC9052592 DOI: 10.1186/s12890-022-01962-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background We aimed to establish the relationships between the expression of microRNAs (miRNAs) and echocardiographic right ventricular (RV) function parameters, and to explore the effectiveness and clinical value of miRNA expression in predicting RV injury and dysfunction in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods In this retrospective study, clinical data were collected from eight CTEPH patients and eight healthy individuals. RV parameters on echocardiography were analyzed, and the expression levels of specific miRNAs were measured by quantitative real-time PCR. Correlation analysis was performed on structural and functional RV parameters and five candidate miRNAs (miR-20a-5p, miR-17-5p, miR-93-5p, miR-3202 and miR-665). The diagnostic value of RV functional parameters and miRNAs expression was assessed by receiver operating characteristic (ROC) curve analysis and C statistic. Results Among the tested miRNAs, miR-20a-5p expression showed the best correlation with echocardiographic RV functional parameters (P < 0.05), although the expression levels of miR-93-5p, miR-17-5p and miR-3202 showed positive associations with some RV parameters. ROC curve analysis demonstrated the ability of miR-20a-5p expression to predict RV dysfunction, with a maximum area under the curve of 0.952 (P = 0.003) when the predicted RV longitudinal strain was less than –20%. The C index for RV dysfunction prediction by the combination of miRNAs (miR-20a-5p, miR-93-5p and miR-17-5p) was 1.0, which was significantly larger than the values for miR-93-5p and miR-17-5p individually (P = 0.0337 and 0.0453, respectively). Conclusion Among the tested miRNAs, miR -20a-5p, miR -93-5p and miR -17-5p have potential value in the diagnosis of CTEPH based on the correlation between the abnormal expression of these miRNAs and echocardiographic parameters in CTEPH patients. miR-20a-5p showed the strongest correlation with echocardiographic RV functional parameters. Moreover, expression of a combination of miRNAs seemed to show excellent predictive power for RV dysfunction.
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Affiliation(s)
- Ran Miao
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.,Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Juanni Gong
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiaojuan Guo
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Dichen Guo
- Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Xinyuan Zhang
- Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Huimin Hu
- Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Jiuchang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing, 100020, China
| | - Yuanhua Yang
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yidan Li
- Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
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Xu H, Cheng B, Wang R, Ding M, Gao Y. Portopulmonary hypertension: Current developments and future perspectives. LIVER RESEARCH 2022. [DOI: 10.1016/j.livres.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Dubourg B, Dacher JN, Durand E, Caudron J, Bauer F, Bubenheim M, Eltchaninoff H, Serfaty JM. Single-source dual energy CT to assess myocardial extracellular volume fraction in aortic stenosis before transcatheter aortic valve implantation (TAVI). Diagn Interv Imaging 2021; 102:561-570. [PMID: 33903056 DOI: 10.1016/j.diii.2021.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To assess myocardial extracellular volume fraction (ECV) measurement provided by a single-source dual-energy computed tomography (SSDE-CT) acquisition added at the end of a routine CT examination before transcatether aortic valve implantation (TAVI) compared to cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty-one patients (10 men, 11 women; mean age, 86±4.9 years [SD]; age range: 71-92 years) with severe aortic stenosis underwent standard pre-TAVI CT with additional cardiac SSDE-CT acquisition 7minutes after intravenous administration of iodinated contrast material and myocardial MRI including pre- and post-contrast T1-maps. Myocardial ECV and standard deviation (σECV) were calculated in the 16-segments model. ECV provided by SSDE-CT was compared to ECV provided by MRI, which served as the reference. Analyses were performed on a per-segment basis and on a per-patient involving the mean value of the 16-segments. RESULTS ECV was slightly overestimated by SSDE-CT (29.9±4.6 [SD] %; range: 20.9%-48.3%) compared to MRI (29.1±3.9 [SD] %; range: 22.0%-50.7%) (P<0.0001) with a bias and limits of agreement of +2.3% (95%CI: -16.1%-+20.6%) and +2.5% (95%CI: -2.1%-+7.1%) for per-segment and per-patient-analyses, respectively. Good (r=0.81 for per-segment-analysis) to excellent (r=0.97 for per-patient-analysis) linear relationships (both P<0.0001) were obtained. The σECV was significantly higher at SSDE-CT (P<0.0001). Additional radiation dose from CT was 1.89±0.38 (SD) mSv (range: 1.48-2.47 mSv). CONCLUSION A single additional SSDE-CT acquisition added at the end of a standard pre-TAVI CT protocol can provide ECV measurement with good to excellent linear relationship with MRI.
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Affiliation(s)
- Benjamin Dubourg
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France.
| | - Jean-Nicolas Dacher
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France
| | - Eric Durand
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Jérôme Caudron
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France
| | - Fabrice Bauer
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Michael Bubenheim
- Department of Biostatistics, University Hospital of Rouen, 76031 Rouen, France
| | - Hélène Eltchaninoff
- UNIROUEN, Inserm U1096 EnVI & FHU REMOD-VHF, Normandie Université, Rouen, France; Department of Cardiology, University Hospital of Rouen, 76031 Rouen, France
| | - Jean-Michel Serfaty
- Department of Radiology, Institut du Thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, 44000 Nantes, France
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Le Ven F, Dacher JN, Pontana F, Barone-Rochette G, Macron L, Garot J, Genée O, Mandry D, Christiaens LP, Gilard M, Boyer L, Furber A, Jacquier A. Position paper on stress cardiac magnetic resonance imaging in chronic coronary syndrome: Endorsed by the Société française de radiologie (SFR), the Société française d'imagerie cardiovasculaire (SFICV) and the Société française de cardiologie (SFC). Arch Cardiovasc Dis 2021; 114:325-335. [PMID: 33888446 DOI: 10.1016/j.acvd.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 12/20/2022]
Abstract
This paper is intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging in chronic coronary syndrome, published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, the procedure (with patient preparation), stress-inducing drugs, the acquisition protocol, interpretation and risk stratification by stress magnetic resonance imaging.
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Affiliation(s)
- Florent Le Ven
- Department of Cardiology, Brest University Hospital, EA3878GETBO, Université de Bretagne Occidentale, 29609 Brest, France.
| | - Jean-Nicolas Dacher
- Normandy University, UNIROUEN, INSERM U1096, Department of Medical Imaging, Cardiac Imaging Unit, Rouen University Hospital, 76000 Rouen, France
| | - François Pontana
- Université de Lille, U1011-EGID, 59045 Lille, France; INSERM U1011, 59019 Lille, France; Institut Pasteur de Lille, 59000 Lille, France; Department of Cardiovascular Radiology, CHU de Lille, 59000 Lille, France
| | - Gilles Barone-Rochette
- Department of Cardiology, CHU Grenoble Alpes, 38700 La Tronche, France; Radiopharmaceutiques Biocliniques, INSERM U1039, Grenoble Alpes University, 38700 La Tronche, France; French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 75018 Paris, France
| | - Laurent Macron
- Department of Imaging, Centre Cardiologique du Nord de Saint-Denis, 93200 Saint-Denis, France
| | - Jerome Garot
- Cardiac MRI-Institut Cardiovasculaire Paris Sud, Jacques-Cartier Private Hospital-Ramsay Health, 91300 Massy, France
| | - Olivier Genée
- Pôle Santé Oréliance, Centre Cardiologique d'Orléans, 45770 Saran, France
| | - Damien Mandry
- Lorraine University, IADI, INSERM U1254, 54000 Nancy, France; Department of Radiology, Brabois, CHRU Nancy, 54000 Nancy, France
| | | | - Martine Gilard
- Department of Cardiology, Brest University Hospital, EA 4324 ORPHY, Université de Bretagne Occidentale, 29609 Brest, France
| | - Louis Boyer
- Pôle Imagerie Diagnostique et Radiologie Interventionnelle, CHU Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Alain Furber
- Institut MITOVASC, UMR INSERM U1083, CNRS 6015, Équipe Physiopathologie Cardiovasculaire, Service de Cardiologie, CHU d'Angers, Université d'Angers, 49000 Angers, France
| | - Alexis Jacquier
- Aix-Marseille Université, Department of Radiology and Cardiovascular Imaging, Hôpital Timone, AP-HM, CNRS, Centre de Résonance Magnétique Biologique et Médicale (CRMBM), 13385 Marseille, France
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Alabed S, Saunders L, Garg P, Shahin Y, Alandejani F, Rolf A, Puntmann VO, Nagel E, Wild JM, Kiely DG, Swift AJ. Myocardial T1-mapping and extracellular volume in pulmonary arterial hypertension: A systematic review and meta-analysis. Magn Reson Imaging 2021; 79:66-75. [PMID: 33745961 DOI: 10.1016/j.mri.2021.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Elevated myocardial T1-mapping and extracellular volume (ECV) measured on cardiac MR (CMR) imaging is associated with myocardial abnormalities such as oedema or fibrosis. This meta-analysis aims to provide a summary of T1-mapping and ECV values in pulmonary arterial hypertension (PAH) and compare their values with controls. METHODS We searched CENTRAL, MEDLINE, Embase, and Web of Science in August 2020. We included CMR studies reporting T1-mapping or ECV values in adults with any type of PAH. We calculated the mean difference of T1-values and ECV between PAH and controls. RESULTS We included 12 studies with 674 participants. T1-values were significantly higher in PAH with the highest mean difference (MD) recorded at the RV insertion points (RVIP) (108 milliseconds (ms), 95% confidence intervals (CI) 89 to 128), followed by the RV free wall (MD 91 ms, 95% CI 56 to 126). The pooled mean T1-value in PAH at the RVIP was 1084, 95% CI (1071 to 1097) measured using 1.5 Tesla Siemens systems. ECV was also higher in PAH with an MD of 7.5%, 95% CI (5.9 to 9.1) at the RV free wall. CONCLUSION T1 mapping values in PAH patients are on average 9% higher than healthy controls when assessed under the same conditions including the same MRI system, magnetic field strength or sequence used for acquisition. The highest T1 and ECV values are at the RVIP. T1 mapping and ECV values in PH are higher than the values reported in cardiomyopathies and were associated with poor RV function and RV dilatation.
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Affiliation(s)
- Samer Alabed
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Department of Clinical Radiology, Sheffield Teaching Hospitals, Sheffield, UK.
| | - Laura Saunders
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Pankaj Garg
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Yousef Shahin
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Department of Clinical Radiology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Faisal Alandejani
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andreas Rolf
- Department of Cardiology, Kerckhoff-Heart Center, Bad Nauheim, Germany
| | - Valentina O Puntmann
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; INSIGNEO, Institute for in silico medicine, University of Sheffield, UK
| | - David G Kiely
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK
| | - Andrew J Swift
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Department of Clinical Radiology, Sheffield Teaching Hospitals, Sheffield, UK; Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK
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Le Ven F, Pontana F, Barone-Rochette G, Macron L, Garot J, Genée O, Mandry D, Christiaens L, Furber A, Dacher JN, Jacquier A. Position paper on stress cardiac MRI in chronic coronary syndrome: Endorsed by the Société Française de Radiologie (SFR) the Société Française d'Imagerie CardioVasculaire (SFICV) and the Société Française de Cardiologie (SFC). Diagn Interv Imaging 2021; 102:337-345. [PMID: 33712412 DOI: 10.1016/j.diii.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/30/2021] [Accepted: 02/05/2021] [Indexed: 01/20/2023]
Abstract
This position paper was intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging (MRI) in chronic coronary syndrome published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, procedure with patient preparation, stress inducing drugs, acquisition protocol, interpretation and risk stratification by stress MRI.
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Affiliation(s)
- Florent Le Ven
- Department of Cardiology, University Hospital, 29000 Brest, France. EA3878-GETBO-West Brittany study Group on Thrombosis-University of West Brittany, 29000 Brest, France
| | - François Pontana
- Université de Lille, U1011 - EGID, Lille, France; Inserm, U1011, Institut Pasteur de Lille, Department of Cardiovascular Radiology, CHU de Lille, 59000 Lille, France
| | - Gilles Barone-Rochette
- Department of Cardiology, University Hospital, INSERM, U1039, Radiopharmaceutiques Biocliniques, Grenoble Alpes University, French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 38000 Grenoble, France
| | - Laurent Macron
- Department of Imaging, Centre Cardiologique du Nord de Saint-Denis, 93200 Paris, France
| | - Jérome Garot
- Cardiac MRI - ICPS, Jacques Cartier Private Hospital - Ramsay Health, 91300 Massy, France
| | - Olivier Genée
- Cardioréliance, Centre Cardiologique d'Orléans, Pôle Santé Oréliance, 45770 Saran, France
| | - Damien Mandry
- Lorraine Université de Lorraine, IADI, INSERM U1254, Department of Radiology, Brabois, CHRU Nancy, 54000 Nancy, France
| | - Luc Christiaens
- Department of Cardiology, Centre Hospitalier Universitaire de Poitiers, 86000 Poitiers, France
| | - Alain Furber
- Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Équipe Physiopathologie Cardiovasculaire, Service de Cardiologie, CHU d'Angers, Université Angers, 49000 Angers, France
| | - Jean Nicolas Dacher
- Normandy University, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Medical Imaging (Cardiac Imaging Unit), 76000 Rouen, France
| | - Alexis Jacquier
- Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Department of Radiology and Cardiovascular Imaging, Hôpital Timone, CNRS, CRMBM (Centre de Résonance Magnétique Biologique et Médicale) CEMEREM (Centre d'Exploration Métaboliques par Résonance Magnétique), 13385 Marseille, France.
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11
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de Laforcade L, Bobot M, Bellin MF, Clément O, Grangé S, Grenier N, Wynckel A, Guerrot D. Kidney and contrast media: Common viewpoint of the French Nephrology societies (SFNDT, FIRN, CJN) and the French Radiological Society (SFR) following ESUR guidelines. Diagn Interv Imaging 2021; 102:131-139. [PMID: 33531265 DOI: 10.1016/j.diii.2021.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/29/2022]
Abstract
Contrast medium administration is classically considered to cause or worsen kidney failure, but recent data may moderate this assertion. The European Society of Urogenital Radiology recently published guidelines re-evaluating the precautions before administering contrast media. Kidney injury does not constitute a contra-indication to the administration of iodinated contrast medium, as long as the benefit-risk ratio justifies it. Intravenous hydration with 0.9% NaCl or 1.4% sodium bicarbonate is the only validated measure for the prevention of post-iodine contrast nephropathy. This is necessary for intravenous or intra-arterial administration of iodinated contrast agent without first renal pass when the glomerular filtration rate is less than 30mL/min/1.73m2, for intra-arterial administration of iodinated contrast agent with first renal passage when the glomerular filtration rate is less than 45mL/min/1.73m2, or in patients with acute renal failure. The use of iodinated contrast medium should allow the carrying out of relevant examinations based on an analysis of the benefit-risk ratio and the implementation of measures to prevent toxicity when necessary.
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Affiliation(s)
- Louis de Laforcade
- Department of Nephrology, Bourgoin-Jallieu Hospital, 38300 Bourgoin-Jallieu, France.
| | - Mickaël Bobot
- Department of Nephrology and Renal Transplantation, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France; C2VN, INSERM 1263, INRAE 1260, Aix-Marseille Univ, 13005 Marseille, France
| | - Marie-France Bellin
- Department of Radiology, Bicêtre Hospital, APHP, University Paris-Saclay, BioMaps, 94043 Le Kremlin Bicêtre, France
| | - Olivier Clément
- Department of Radiology, Hopital Européen Georges Pompidou, AP-HP, Centre, 75015 Paris, France; Université de Paris, 75006 Paris, France
| | - Steven Grangé
- Medical Intensive Care Unit, Rouen University Hospital, 76000 Rouen, France
| | - Nicolas Grenier
- Radiology Department, Bordeaux University Hospital, 33000 Bordeaux, France
| | - Alain Wynckel
- Nephrology Department, Reims University Hospital, 51100 Reims, France
| | - Dominique Guerrot
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, 76000 Rouen, France
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12
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Longère B, Chavent MH, Coisne A, Gkizas C, Pagniez J, Simeone A, Silvestri V, Schmidt M, Forman C, Montaigne D, Pontana F. Single breath-hold compressed sensing real-time cine imaging to assess left ventricular motion in myocardial infarction. Diagn Interv Imaging 2020; 102:297-303. [PMID: 33308957 DOI: 10.1016/j.diii.2020.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the reliability of a real-time compressed sensing (CS) cine sequence for the detection of left ventricular wall motion disorders after myocardial infarction in comparison with the reference steady-state free precession cine sequence. MATERIALS AND METHODS One hundred consecutive adult patients referred for either initial work-up or follow-up by cardiac magnetic resonance (CMR) in the context of myocardial infarction were prospectively included. There were 77 men and 23 women with a mean age of 63.12±11.3 (SD) years (range: 29-89 years). Each patient underwent the reference segmented multi-breath-hold steady-state free precession cine sequence including one short-axis stack and both vertical and horizontal long-axis slices (SSFPref) and the CS real-time single-breath-hold evaluated sequence (CSrt) providing the same slices. Wall motion disorders were independently and blindly assessed with both sequences by two radiologists, using the American Heart Association left ventricle segmentation. Paired Wilcoxon signed-rank test was used to search for differences in wall motion disorders conspicuity between both sequences and receiver operating characteristic curve (ROC) analysis was performed to assess the diagnosis performance of CSrt sequence using SSFPref as the reference method. RESULTS Each patient had at least one cardiac segment with wall motion abnormality on SSFPref and CSrt images. The 1700 segments analyzed with SSFPref were classified as normokinetic (360/1700; 21.2%), hypokinetic (783/1700; 46.1%), akinetic (526/1700; 30.9%) or dyskinetic (31/1700; 1.8%). Sensitivity and specificity of the CS sequence were 99.6% (95% CI: 99.1-99.9%) and 99.7% (95% CI: 98.5-100%), respectively. Area under ROC of CSrt diagnosis performance was 0.997 (95% CI: 0.993-0.999). CONCLUSION CS real-time cine imaging significantly reduces acquisition time without compromising the conspicuity of left ventricular -wall motion disorders in the context of myocardial infarction.
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Affiliation(s)
- Benjamin Longère
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France; INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France
| | - Marc-Henry Chavent
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Augustin Coisne
- INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France; Department of Clinical Physiology and Echocardiography, CHU de Lille, Lille, France
| | - Christos Gkizas
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Julien Pagniez
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Arianna Simeone
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | - Valentina Silvestri
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France
| | | | | | - David Montaigne
- INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France; Department of Clinical Physiology and Echocardiography, CHU de Lille, Lille, France
| | - François Pontana
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, Boulevard du Pr Jules Leclercq, 59037 Lille Cedex, France; INSERM UMR 1011, Institut Pasteur de Lille, EGID (European Genomic Institute for Diabetes), FR3508, Univ. Lille, 59000 Lille, France.
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