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Sevilla T, Baladrón C, de Miguel-Álava M, Rojas-Lavado G, González-Bartol E, Revilla-Orodea A, Aristizabal-Duque C, Carrasco-Moraleja M, Fernández-Garrote M, San Román JA. Prognostic value of novel cardiovascular magnetic resonance transit times beyond the pulmonary circulation in patients with ventricular dysfunction. Eur Radiol 2024:10.1007/s00330-024-11045-3. [PMID: 39214894 DOI: 10.1007/s00330-024-11045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/30/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES To evaluate the prognostic value of transit time (TT) assessment in the systemic circulation and organ perfusion in patients with ventricular dysfunction (VD). The primary endpoint was defined as death, heart failure admission, or ventricular arrhythmias, and the secondary endpoint was worsening renal function. METHODS A retrospective study on 139 patients who underwent cardiac magnetic resonance for VD evaluation and 50 controls. TT was measured as peak-to-peak time in signal intensity over time curves obtained at different stages of circulation (right cavities, left cavities, aorta, and peripheral organs) from first-pass perfusion images. Outcomes were monitored over a median follow-up of 15 months. RESULTS A total of 139 patients were included (84% male, age 63 [57-70] years). Patients exhibited significantly prolonged TT compared to controls, with in-patients showing longer times than outpatients. Among the 29 patients reaching the primary endpoint, both PTT and STT were significantly prolonged (PTT: 9.75 s vs 13.4 s, p < 0.01; STT: 4.77 s vs 7.00 s, p < 0.01). Concurrent prolongation of PTT (> 10 s) and STT (> 5 s) was associated with a higher event probability (42.3%), compared to isolated abnormalities (6.3% for PTT, 6.7% for STT). Multivariate analysis revealed that combined PTT and STT alteration independently predicted the combined endpoint (HR IC 95%: 8.685 (2.415-31.236), p = 0.001). Prolonged RPT was independently associated with renal function deterioration (OR IC 95%: 1.129 (1.015-1.256), p = 0.024). CONCLUSIONS Evaluation of TT beyond pulmonary circulation provides prognostic insights into VD. Simultaneous assessment of PTT and STT enhances specificity compared to isolated PTT evaluation, predicting combined adverse events. RPT is independently associated with renal impairment. CLINICAL RELEVANCE STATEMENT For the first time, it is described that transit time can be evaluated in systemic circulation and in peripheral organs and that this assessment can be easily made from conventional CMR perfusion images and holds significant prognostic value. KEY POINTS Pulmonary transit time is a valuable hemodynamic parameter; systemic transit time may also be valuable. Transit time can be measured in the systemic circulation, and is longer in patients with ventricular dysfunction. Systemic transit time assessed by magnetic resonance imaging identifies patients with ventricular dysfunction who will experience events during follow-up.
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Affiliation(s)
- Teresa Sevilla
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain.
- Centro de Investigación Biomédica en Red, CIBER-CV, Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Carlos Baladrón
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
- Centro de Investigación Biomédica en Red, CIBER-CV, Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - María de Miguel-Álava
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Gino Rojas-Lavado
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Esther González-Bartol
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Ana Revilla-Orodea
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
- Centro de Investigación Biomédica en Red, CIBER-CV, Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Cristhian Aristizabal-Duque
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Manuel Carrasco-Moraleja
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
- Centro de Investigación Biomédica en Red, CIBER-CV, Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Miguel Fernández-Garrote
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
| | - J Alberto San Román
- Cardiology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain
- Centro de Investigación Biomédica en Red, CIBER-CV, Monforte de Lemos 3-5, 28029, Madrid, Spain
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Cao JJ, Nashta NF, Weber J, Bano R, Passick M, Cheng YJ, Schapiro W, Grgas M, Gliganic K. Association of pulmonary transit time by cardiac magnetic resonance with heart failure hospitalization in a large prospective cohort with diverse cardiac conditions. J Cardiovasc Magn Reson 2023; 25:57. [PMID: 37821911 PMCID: PMC10568762 DOI: 10.1186/s12968-023-00963-8] [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: 12/14/2022] [Accepted: 09/13/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Longer pulmonary transit time (PTT) is closely associated with hemodynamic abnormalities. However, the implications on heart failure (HF) risk have not been investigated broadly in patients with diverse cardiac conditions. In this study we examined the long-term risk of HF hospitalization associated with longer PTT in a large prospective cohort with a broad spectrum of cardiac conditions. METHODS All subjects were prospectively recruited to undergo cardiac magnetic resonance (CMR). The dynamic images of first-pass perfusion were acquired to assess peak-to-peak pulmonary transit time (PTT) which was subsequently normalized to RR interval duration. The risk of HF was examined using Cox proportional hazards models adjusted for baseline confounding risk factors. RESULTS Among 506 consecutively consented patients undergoing clinical cardiac MR with diverse cardiac conditions, the mean age was 63 ± 14 years and 373 (73%) were male. After a mean follow up duration of 4.5 ± 3.0 years, 70 (14%) patients developed hospitalized HF and of these 6 died. A normalized PTT ≥ 8.2 was associated with a significantly increased adjusted HF hazard ratio of 3.69 (95% CI 2.02, 6.73). The HF hazard ratio was 1.26 (95% CI 1.18, 1.33) for each 1 unit increase in PTT which was higher among those preserved (1.70, 95% CI 1.20, 2.41) compared to those with reduced left ventricular ejection fraction (< 50%) (1.18, 95% CI 1.09, 1.27). PTT remained a significant risk factor of hospitalized HF after additional adjustment for N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) or left ventricular global longitudinal strain with additionally demonstrated incremental model improvement through likelihood ratio testing. CONCLUSIONS Our findings support the role of PTT in assessing HF risk among patients with broad spectrum of cardiac conditions with reduced as well as preserved ejection fraction. Longer PTT duration is an incremental risk factor for HF when baseline global longitudinal strain and NT-proBNP are taken into consideration.
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Affiliation(s)
- J Jane Cao
- Division of Cardiac Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd., Roslyn, NY, 11576, USA.
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA.
| | - Niloofar Fouladi Nashta
- Sol Price School of Public Policy and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
| | - Jonathan Weber
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - Ruqiyya Bano
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - Michael Passick
- Division of Cardiac Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd., Roslyn, NY, 11576, USA
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - Y Joshua Cheng
- Division of Cardiac Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd., Roslyn, NY, 11576, USA
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - William Schapiro
- Division of Cardiac Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd., Roslyn, NY, 11576, USA
| | - Marie Grgas
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - Kathleen Gliganic
- Division of Cardiac Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd., Roslyn, NY, 11576, USA
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Guo X, Gong C, Song R, Wan K, Han Y, Chen Y. First-pass perfusion cardiovascular magnetic resonance parameters as surrogate markers for left ventricular diastolic dysfunction: a validation against cardiac catheterization. Eur Radiol 2022; 32:8131-8139. [PMID: 35779091 DOI: 10.1007/s00330-022-08938-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The non-invasive assessment of left ventricular (LV) diastolic dysfunction remains a challenge. The role of first-pass perfusion cardiac magnetic resonance (CMR) parameters in quantitative hemodynamic analyses has been reported. We therefore aimed to validate the diagnostic ability and accuracy of such parameters against cardiac catheterization for LV diastolic dysfunction in patients with left heart disease (LHD). METHODS We retrospectively enrolled 77 LHD patients who underwent CMR imaging and cardiac catheterization. LV diastolic dysfunction was defined as pulmonary capillary wedge pressure (PCWP) or LV end-diastolic pressure (LVEDP) > 12 mmHg on catheterization. On first-pass perfusion CMR imaging, pulmonary transit time (PTT) was measured as the time for blood to pass from the left ventricle to the right ventricle (RV) through the pulmonary vasculature. Pulmonary transit beat (PTB) was the number of cardiac cycles within the interval, and pulmonary blood volume indexed to body surface area (PBVi) was the product of PTB and RV stroke volume index (RVSVi). RESULTS Of the 77 LHD patients, 53 (68.83%) were found to have LV diastolic dysfunction, and showed significantly higher PTTc, PTB, and PBVi (p < 0.05) compared with those without. In multivariate analyses, only PTTc and PTB were identified as independent predictors of LV diastolic dysfunction (p < 0.05). With an optimal cutoff of 11.9 s, PTTc yielded the best diagnostic performance for LV diastolic dysfunction (area under the curve = 0.83, p < 0.001). CONCLUSIONS PTTc may represent a non-invasive quantitative surrogate marker for the detection and assessment of diastolic dysfunction in LHD patients. KEY POINTS • PTTc yielded the best diagnostic accuracy for diastolic dysfunction, with an optimal cutoff of 11.9 s, and a specificity of 100%. • PTTc and PTB were found to be independent predictors of LV diastolic dysfunction across different multivariate models with high reproducibility. • PTTc is a promising non-invasive surrogate marker for the detection and assessment of diastolic dysfunction in LHD patients.
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Affiliation(s)
- Xinli Guo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China
| | - Chao Gong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China
| | - Rizhen Song
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China
| | - Ke Wan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China
| | - Yuchi Han
- Department of Medicine (Cardiovascular Division), University of Pennsylvania, Philadelphia, PA, USA
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China.
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Houard L, Amzulescu MS, Colin G, Langet H, Militaru S, Rousseau MF, Ahn SA, Vanoverschelde JLJ, Pouleur AC, Gerber BL. Prognostic Value of Pulmonary Transit Time by Cardiac Magnetic Resonance on Mortality and Heart Failure Hospitalization in Patients With Advanced Heart Failure and Reduced Ejection Fraction. Circ Cardiovasc Imaging 2021; 14:e011680. [PMID: 33438438 DOI: 10.1161/circimaging.120.011680] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary transit time (PTT) from first-pass perfusion imaging is a novel parameter to evaluate hemodynamic congestion by cardiac magnetic resonance (cMR). We sought to evaluate the additional prognostic value of PTT in heart failure with reduced ejection fraction over other well-validated predictors of risk including the Meta-Analysis Global Group in Chronic Heart Failure risk score and ischemic cause. METHODS We prospectively followed 410 patients with chronic heart failure with reduced ejection fraction (61±13 years, left ventricular (LV) ejection fraction 24±7%) who underwent a clinical cMR to assess the prognostic value of PTT for a primary endpoint of overall mortality and secondary composite endpoint of cardiovascular death and heart failure hospitalization. Normal reference values of PTT were evaluated in a population of 40 asymptomatic volunteers free of cardiovascular disease. Results PTT was significantly increased in patients with heart failure with reduced ejection fraction as compared to controls (9±6 beats and 7±2 beats, respectively, P<0.001), and correlated not only with New York Heart Association class, cMR-LV and cMR-right ventricular (RV) volumes, cMR-RV and cMR-LV ejection fraction, and feature tracking global longitudinal strain, but also with cardiac output. Over 6-year median follow-up, 182 patients died and 200 reached the secondary endpoint. By multivariate Cox analysis, PTT was an independent and significant predictor of both endpoints after adjustment for Meta-Analysis Global Group in Chronic Heart Failure risk score and ischemic cause. Importantly in multivariable analysis, PTT in beats had significantly higher additional prognostic value to predict not only overall mortality (χ2 to improve, 12.3; hazard ratio, 1.35 [95% CI, 1.16-1.58]; P<0.001) but also the secondary composite endpoints (χ2 to improve=20.1; hazard ratio, 1.23 [95% CI, 1.21-1.60]; P<0.001) than cMR-LV ejection fraction, cMR-RV ejection fraction, LV-feature tracking global longitudinal strain, or RV-feature tracking global longitudinal strain. Importantly, PTT was independent and complementary to both pulmonary artery pressure and reduced RV ejection fraction<42% to predict overall mortality and secondary combined endpoints. CONCLUSIONS Despite limitations in temporal resolution, PTT derived from first-pass perfusion imaging provides higher and independent prognostic information in heart failure with reduced ejection fraction than clinical and other cMR parameters, including LV and RV ejection fraction or feature tracking global longitudinal strain. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03969394.
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Affiliation(s)
- Laura Houard
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Mihaela S Amzulescu
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Geoffrey Colin
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Helene Langet
- Philips Clinical Research Board, Suresnes, France (H.L.)
| | - Sebastian Militaru
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Michel F Rousseau
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Sylvie A Ahn
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Jean-Louis J Vanoverschelde
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Anne-Catherine Pouleur
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc (L.H., M.S.A., G.C., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.).,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium (L.H., M.S.A., S.M., M.F.R., S.A.A., J.-L.J.V., A.-C.P., B.L.G.)
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Colin GC, Pouleur AC, Gerber BL, Poncelet PA, de Meester C, D’Hondt AM, Vlassenbroek A, Houard L, Gevenois PA, Ghaye B. Pulmonary hypertension detection by computed tomography pulmonary transit time in heart failure with reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2019; 21:1291-1298. [DOI: 10.1093/ehjci/jez290] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/25/2019] [Accepted: 11/11/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
To evaluate the relationships between pulmonary transit time (PTT), cardiac function, and pulmonary haemodynamics in patients with heart failure with reduced ejection fraction (HFrEF) and to explore how PTT performs in detecting pulmonary hypertension (PH).
Methods and results
In this prospective study, 57 patients with advanced HFrEF [49 men, 51 years ± 8, mean left ventricular (LV) ejection fraction 26% ± 8] underwent echocardiography, right heart catheterization, and cardiac computed tomography (CT). PTT was measured as the time interval between peaks of attenuation in right ventricle (RV) and LV and was compared between patients with or without PH and 15 controls. PTT was significantly longer in HFrEF patients with PH (21 s) than in those without PH (11 s) and controls (8 s) (P < 0.001) but not between patients without PH and controls (P = 0.109). PTT was positively correlated with pulmonary artery wedge pressure (PAWP) (r = 0.74), mean pulmonary artery pressure (r = 0.68), N-terminal pro-B-type natriuretic peptide (r = 0.60), mitral (r = 0.54), and tricuspid (r = 0.37) regurgitation grades, as well as with LV, RV, and left atrial volumes (r from 0.39 to 0.64) (P < 0.01). PTT was negatively correlated with cardiac index (r = −0.63) as well as with LV (r = −0.66) and RV (r = −0.74) ejection fractions. PAWP, cardiac index, mitral regurgitation grade, and RV end-diastolic volume were all independent predictors of PTT. PTT value ≥14 s best-detected PH with 91% sensitivity and 88% specificity (area under the receiver operating characteristic curve: 0.95).
Conclusion
In patients with HFrEF, PTT correlates with cardiac function and pulmonary haemodynamics, is determined by four independent parameters, and performs well in detecting PH.
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Affiliation(s)
- Geoffrey C Colin
- Division of Radiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Anne-Catherine Pouleur
- Division of Cardiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Bernhard L Gerber
- Division of Cardiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Pierre-Antoine Poncelet
- Division of Radiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Christophe de Meester
- Division of Cardiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Anne-Marie D’Hondt
- Division of Cardiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | | | - Laura Houard
- Division of Cardiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | | | - Benoit Ghaye
- Division of Radiology, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate 10, 1200 Brussels, Belgium
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Fernández-Pérez G, Franco López Á, García Fernández M, Corral de la Calle M, Encinas de la Iglesia J, Velasco Casares M. Función sistólica del ventrículo izquierdo: cómo comprenderla y analizarla. RADIOLOGIA 2014; 56:505-14. [DOI: 10.1016/j.rx.2013.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 09/09/2013] [Accepted: 09/20/2013] [Indexed: 11/29/2022]
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