1
|
Gissler MC, Antiochos P, Ge Y, Heydari B, Gräni C, Kwong RY. Cardiac Magnetic Resonance Evaluation of LV Remodeling Post-Myocardial Infarction: Prognosis, Monitoring and Trial Endpoints. JACC Cardiovasc Imaging 2024:S1936-878X(24)00127-X. [PMID: 38819335 DOI: 10.1016/j.jcmg.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/14/2024] [Indexed: 06/01/2024]
Abstract
Adverse left ventricular remodeling (ALVR) and subsequent heart failure after myocardial infarction (MI) remain a major cause of patient morbidity and mortality worldwide. Overt inflammation has been identified as the common pathway underlying myocardial fibrosis and development of ALVR post-MI. With its ability to simultaneously provide information about cardiac structure, function, perfusion, and tissue characteristics, cardiac magnetic resonance (CMR) is well poised to inform prognosis and guide early surveillance and therapeutics in high-risk cohorts. Further, established and evolving CMR-derived biomarkers may serve as clinical endpoints in prospective trials evaluating the efficacy of novel anti-inflammatory and antifibrotic therapies. This review provides an overview of post-MI ALVR and illustrates how CMR may help clinical adoption of novel therapies via mechanistic or prognostic imaging markers.
Collapse
Affiliation(s)
- Mark Colin Gissler
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Panagiotis Antiochos
- Cardiology and Cardiac MR Centre, University Hospital Lausanne, Lausanne, Switzerland
| | - Yin Ge
- Division of Cardiology, St Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Bobak Heydari
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raymond Y Kwong
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| |
Collapse
|
2
|
Borges RR, Morato TN, Bezerra ASDA, Dias BA, Reinaux JCDF, Monte GU, Farage L. Avaliação de diferentes tempos de trânsito do meio de contraste intravascular em exames de tomografia computadorizada coronariana. Radiol Bras 2022; 55:161-166. [PMID: 35795606 PMCID: PMC9254703 DOI: 10.1590/0100-3984.2021.0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
Objective To measure the transit times (TTs) of contrast agents among the injection
site (antecubital vein), superior vena cava, pulmonary trunk, and ascending
aorta, in coronary computed tomography angiography (CTA) examinations of
outpatients with no history of cardiovascular or lung disease, thus defining
reference values for those TTs. Materials and Methods The contrast TTs from the injection site (antecubital vein) to the superior
vena cava, from the superior vena cava to the pulmonary trunk, and from the
pulmonary trunk to the ascending aorta were measured by monitoring contrast
enhancement in real time (bolus tracking). Cardiac output was measured by
the geometric method during the CTA examination and was correlated with the
contrast TT. Results Forty-three individuals were analyzed. The mean contrast TT was 13.1 s
overall (from the antecubital vein to the ascending aorta), 3.0 s from the
superior vena cava to the pulmonary trunk, and 7.2 s from the pulmonary
trunk to the ascending aorta. There was a tendency toward a correlation
between contrast TT and cardiac output (p = 0.055). Conclusion The reference values established here for contrast TTs among the superior
vena cava, pulmonary trunk, and ascending aorta will serve as a basis for
clinical evaluation.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Luciano Farage
- Radiolinea Centro de Imagens, Brasil; Universidade de Brasília (UnB), Brasil; Instituto de Cardiologia do Distrito Federal (ICDF), Brasil; Centro Universitário Euroamericano (Unieuro), Brasil
| |
Collapse
|
3
|
Chang SA, Kim RJ. The Use of Cardiac Magnetic Resonance in Patients with Suspected Coronary Artery Disease: A Clinical Practice Perspective. J Cardiovasc Ultrasound 2016; 24:96-103. [PMID: 27358697 PMCID: PMC4925404 DOI: 10.4250/jcu.2016.24.2.96] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/20/2016] [Accepted: 05/10/2016] [Indexed: 11/22/2022] Open
Abstract
Cardiac magnetic resonance imaging (CMR) is a useful diagnostic imaging modality in patients with known or suspected coronary artery disease (CAD). It provides unique information not available from other modalities, however, it is complex. CMR is not a single technique. Instead, it consists of multiple distinct techniques and a lack of understanding of which techniques to perform and how to interpret the findings in combination limits its efficacy and widespread use. Conversely, its multiparametric nature can provide a comprehensive assessment with the potential for higher accuracy than is achievable by other modalities. Moreover, its ability to directly assess myopathic processes often contributes insights that change patient management. In this article we provide a brief technical overview and focus on specific clinical scenarios in patients with known or suspected CAD. We highlight the multiparametric nature of CMR and discuss cases which illustrate the unique information that CMR can contribute.
Collapse
Affiliation(s)
- Sung-A Chang
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Raymond J Kim
- Duke Cardiovascular Magnetic Resonance Center, Durham, NC, USA.; Department of Medicine, Duke University Medical Center, Durham, NC, USA.; Department of Radiology, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
5
|
Gerche AL, Claessen G, Van de Bruaene A, Pattyn N, Van Cleemput J, Gewillig M, Bogaert J, Dymarkowski S, Claus P, Heidbuchel H. Cardiac MRI. Circ Cardiovasc Imaging 2013; 6:329-38. [DOI: 10.1161/circimaging.112.980037] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Andre La Gerche
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Guido Claessen
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Alexander Van de Bruaene
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Nele Pattyn
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Johan Van Cleemput
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Marc Gewillig
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Jan Bogaert
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Steven Dymarkowski
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Piet Claus
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| | - Hein Heidbuchel
- From the University Hospital of Leuven, Leuven, Belgium (A.L.G., G.C., A.V.d.B., N.P., J.V.C., M.G., J.B., S.D., P.C., H.H.), and St. Vincent’s Hospital, Department of Medicine, University of Melbourne, Fitzroy, Australia (A.L.G.)
| |
Collapse
|