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Jaspers TJM, Martens B, Crawley R, Jada L, Amirrajab S, Breeuwer M, Holtackers RJ, Chiribiri A, Scannell CM. Deep Learning Synthesis of White-Blood From Dark-Blood Late Gadolinium Enhancement Cardiac Magnetic Resonance. Invest Radiol 2024:00004424-990000000-00213. [PMID: 38687025 DOI: 10.1097/rli.0000000000001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVES Dark-blood late gadolinium enhancement (DB-LGE) cardiac magnetic resonance has been proposed as an alternative to standard white-blood LGE (WB-LGE) imaging protocols to enhance scar-to-blood contrast without compromising scar-to-myocardium contrast. In practice, both DB and WB contrasts may have clinical utility, but acquiring both has the drawback of additional acquisition time. The aim of this study was to develop and evaluate a deep learning method to generate synthetic WB-LGE images from DB-LGE, allowing the assessment of both contrasts without additional scan time. MATERIALS AND METHODS DB-LGE and WB-LGE data from 215 patients were used to train 2 types of unpaired image-to-image translation deep learning models, cycle-consistent generative adversarial network (CycleGAN) and contrastive unpaired translation, with 5 different loss function hyperparameter settings each. Initially, the best hyperparameter setting was determined for each model type based on the Fréchet inception distance and the visual assessment of expert readers. Then, the CycleGAN and contrastive unpaired translation models with the optimal hyperparameters were directly compared. Finally, with the best model chosen, the quantification of scar based on the synthetic WB-LGE images was compared with the truly acquired WB-LGE. RESULTS The CycleGAN architecture for unpaired image-to-image translation was found to provide the most realistic synthetic WB-LGE images from DB-LGE images. The results showed that it was difficult for visual readers to distinguish if an image was true or synthetic (55% correctly classified). In addition, scar burden quantification with the synthetic data was highly correlated with the analysis of the truly acquired images. Bland-Altman analysis found a mean bias in percentage scar burden between the quantification of the real WB and synthetic white-blood images of 0.44% with limits of agreement from -10.85% to 11.74%. The mean image quality of the real WB images (3.53/5) was scored higher than the synthetic white-blood images (3.03), P = 0.009. CONCLUSIONS This study proposed a CycleGAN model to generate synthetic WB-LGE from DB-LGE images to allow assessment of both image contrasts without additional scan time. This work represents a clinically focused assessment of synthetic medical images generated by artificial intelligence, a topic with significant potential for a multitude of applications. However, further evaluation is warranted before clinical adoption.
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Affiliation(s)
- Tim J M Jaspers
- From the Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (T.J.M.J., S.A., M.B., C.M.S.); School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom (T.J.M.J., R.C., L.J., R.J.H., A.C., C.M.S.); Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (T.J.M.J.); Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (B.M., R.J.H.); and Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands (B.M., R.J.H.)
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Ricci F, Khanji MY, Bisaccia G, Cipriani A, Di Cesare A, Ceriello L, Mantini C, Zimarino M, Fedorowski A, Gallina S, Petersen SE, Bucciarelli-Ducci C. Diagnostic and Prognostic Value of Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis. JAMA Cardiol 2023; 8:662-673. [PMID: 37285143 PMCID: PMC10248816 DOI: 10.1001/jamacardio.2023.1290] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/12/2023] [Indexed: 06/08/2023]
Abstract
Importance The clinical utility of stress cardiovascular magnetic resonance imaging (CMR) in stable chest pain is still debated, and the low-risk period for adverse cardiovascular (CV) events after a negative test result is unknown. Objective To provide contemporary quantitative data synthesis of the diagnostic accuracy and prognostic value of stress CMR in stable chest pain. Data Sources PubMed and Embase databases, the Cochrane Database of Systematic Reviews, PROSPERO, and the ClinicalTrials.gov registry were searched for potentially relevant articles from January 1, 2000, through December 31, 2021. Study Selection Selected studies evaluated CMR and reported estimates of diagnostic accuracy and/or raw data of adverse CV events for participants with either positive or negative stress CMR results. Prespecified combinations of keywords related to the diagnostic accuracy and prognostic value of stress CMR were used. A total of 3144 records were evaluated for title and abstract; of those, 235 articles were included in the full-text assessment of eligibility. After exclusions, 64 studies (74 470 total patients) published from October 29, 2002, through October 19, 2021, were included. Data Extraction and Synthesis This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Main Outcomes and Measures Diagnostic odds ratios (DORs), sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), odds ratio (OR), and annualized event rate (AER) for all-cause death, CV death, and major adverse cardiovascular events (MACEs) defined as the composite of myocardial infarction and CV death. Results A total of 33 diagnostic studies pooling 7814 individuals and 31 prognostic studies pooling 67 080 individuals (mean [SD] follow-up, 3.5 [2.1] years; range, 0.9-8.8 years; 381 357 person-years) were identified. Stress CMR yielded a DOR of 26.4 (95% CI, 10.6-65.9), a sensitivity of 81% (95% CI, 68%-89%), a specificity of 86% (95% CI, 75%-93%), and an AUROC of 0.84 (95% CI, 0.77-0.89) for the detection of functionally obstructive coronary artery disease. In the subgroup analysis, stress CMR yielded higher diagnostic accuracy in the setting of suspected coronary artery disease (DOR, 53.4; 95% CI, 27.7-103.0) or when using 3-T imaging (DOR, 33.2; 95% CI, 19.9-55.4). The presence of stress-inducible ischemia was associated with higher all-cause mortality (OR, 1.97; 95% CI, 1.69-2.31), CV mortality (OR, 6.40; 95% CI, 4.48-9.14), and MACEs (OR, 5.33; 95% CI, 4.04-7.04). The presence of late gadolinium enhancement (LGE) was associated with higher all-cause mortality (OR, 2.22; 95% CI, 1.99-2.47), CV mortality (OR, 6.03; 95% CI, 2.76-13.13), and increased risk of MACEs (OR, 5.42; 95% CI, 3.42-8.60). After a negative test result, pooled AERs for CV death were less than 1.0%. Conclusion and Relevance In this study, stress CMR yielded high diagnostic accuracy and delivered robust prognostication, particularly when 3-T scanners were used. While inducible myocardial ischemia and LGE were associated with higher mortality and risk of MACEs, normal stress CMR results were associated with a lower risk of MACEs for at least 3.5 years.
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Affiliation(s)
- Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- William Harvey Research Institute, Barts Biomedical Research Centre, National Institute for Health and Care Research, Queen Mary University London, Charterhouse Square, London, United Kingdom
| | - Mohammed Y. Khanji
- William Harvey Research Institute, Barts Biomedical Research Centre, National Institute for Health and Care Research, Queen Mary University London, Charterhouse Square, London, United Kingdom
- Newham University Hospital, Barts Health NHS Trust, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
| | - Giandomenico Bisaccia
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Annamaria Di Cesare
- Cardiology Unit, Rimini Hospital, Local Health Authority of Romagna, Rimini, Italy
| | - Laura Ceriello
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Marco Zimarino
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Steffen E. Petersen
- Newham University Hospital, Barts Health NHS Trust, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
- The Alan Turing Institute, London, United Kingdom
- Health Data Research UK, London, United Kingdom
| | - Chiara Bucciarelli-Ducci
- Royal Brompton and Harefield Hospitals, Guys and St Thomas NHS Trust London, London, United Kingdom
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, United Kingdom
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Hamilton-Craig C, Ugander M, Greenwood JP, Kozor R. Stress perfusion cardiovascular magnetic resonance imaging: a guide for the general cardiologist. Heart 2023; 109:428-433. [PMID: 36371659 DOI: 10.1136/heartjnl-2022-321630] [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: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 11/04/2022] Open
Abstract
Stress cardiovascular magnetic resonance (CMR) is an emerging non-invasive imaging technique for the assessment of known or suspected ischaemic heart disease (IHD). Stress CMR provides information on myocardial perfusion, wall motion, ventricular dimensions and volumes, as well as late gadolinium enhancement (LGE) scar imaging in a single test without ionising radiation. Data from numerous multicentre randomised studies show high diagnostic and prognostic utility, its efficacy as a gatekeeper to invasive coronary angiography and use for guiding coronary revascularisation decisions. Stress CMR is cost-effective across multiple healthcare settings, yet its uptake and usage varies worldwide and is an underutilised technology. New developments include rapid acquisition protocols, automated quantification of perfusion and myocardial blood flow, and artificial intelligence-aided automated analysis and reporting. Stress CMR is becoming more accessible and standardised around the globe and is ready for 'prime time' use in the non-invasive assessment of patients with suspected IHD.
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Affiliation(s)
- Christian Hamilton-Craig
- Faculty of Medicine and Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia .,School of Medicine, Griffith University, Sunshine Coast, Queensland, Australia
| | - Martin Ugander
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Clinical Physiology, Karolinska Institute, Stockholm, Stockholm, Sweden
| | - John P Greenwood
- Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Rebecca Kozor
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Zhang Q, Burrage MK, Shanmuganathan M, Gonzales RA, Lukaschuk E, Thomas KE, Mills R, Leal Pelado J, Nikolaidou C, Popescu IA, Lee YP, Zhang X, Dharmakumar R, Myerson SG, Rider O, Channon KM, Neubauer S, Piechnik SK, Ferreira VM. Artificial Intelligence for Contrast-Free MRI: Scar Assessment in Myocardial Infarction Using Deep Learning-Based Virtual Native Enhancement. Circulation 2022; 146:1492-1503. [PMID: 36124774 PMCID: PMC9662825 DOI: 10.1161/circulationaha.122.060137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/17/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Myocardial scars are assessed noninvasively using cardiovascular magnetic resonance late gadolinium enhancement (LGE) as an imaging gold standard. A contrast-free approach would provide many advantages, including a faster and cheaper scan without contrast-associated problems. METHODS Virtual native enhancement (VNE) is a novel technology that can produce virtual LGE-like images without the need for contrast. VNE combines cine imaging and native T1 maps to produce LGE-like images using artificial intelligence. VNE was developed for patients with previous myocardial infarction from 4271 data sets (912 patients); each data set comprises slice position-matched cine, T1 maps, and LGE images. After quality control, 3002 data sets (775 patients) were used for development and 291 data sets (68 patients) for testing. The VNE generator was trained using generative adversarial networks, using 2 adversarial discriminators to improve the image quality. The left ventricle was contoured semiautomatically. Myocardial scar volume was quantified using the full width at half maximum method. Scar transmurality was measured using the centerline chord method and visualized on bull's-eye plots. Lesion quantification by VNE and LGE was compared using linear regression, Pearson correlation (R), and intraclass correlation coefficients. Proof-of-principle histopathologic comparison of VNE in a porcine model of myocardial infarction also was performed. RESULTS VNE provided significantly better image quality than LGE on blinded analysis by 5 independent operators on 291 data sets (all P<0.001). VNE correlated strongly with LGE in quantifying scar size (R, 0.89; intraclass correlation coefficient, 0.94) and transmurality (R, 0.84; intraclass correlation coefficient, 0.90) in 66 patients (277 test data sets). Two cardiovascular magnetic resonance experts reviewed all test image slices and reported an overall accuracy of 84% for VNE in detecting scars when compared with LGE, with specificity of 100% and sensitivity of 77%. VNE also showed excellent visuospatial agreement with histopathology in 2 cases of a porcine model of myocardial infarction. CONCLUSIONS VNE demonstrated high agreement with LGE cardiovascular magnetic resonance for myocardial scar assessment in patients with previous myocardial infarction in visuospatial distribution and lesion quantification with superior image quality. VNE is a potentially transformative artificial intelligence-based technology with promise in reducing scan times and costs, increasing clinical throughput, and improving the accessibility of cardiovascular magnetic resonance in the near future.
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Affiliation(s)
- Qiang Zhang
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Matthew K. Burrage
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Faculty of Medicine, University of Queensland, Brisbane, Australia (M.K.B.)
| | - Mayooran Shanmuganathan
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Ricardo A. Gonzales
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Elena Lukaschuk
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Katharine E. Thomas
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Rebecca Mills
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Joana Leal Pelado
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Chrysovalantou Nikolaidou
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Iulia A. Popescu
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Yung P. Lee
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Xinheng Zhang
- Krannert Cardiovascular Research Center, Indiana School of Medicine/IU Health Cardiovascular Institute, Indianapolis (X.Z., R.D.)
- Department of Bioengineering, University of California in Los Angeles (X.Z.)
| | - Rohan Dharmakumar
- Krannert Cardiovascular Research Center, Indiana School of Medicine/IU Health Cardiovascular Institute, Indianapolis (X.Z., R.D.)
| | - Saul G. Myerson
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Oliver Rider
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Keith M. Channon
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Stefan K. Piechnik
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
| | - Vanessa M. Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Division of Cardiovascular Medicine (Q.Z., M.K.B., M.S., R.A.G., E.L., K.E.T., R.M., J.L.P., C.N., I.A.P., Y.P.L., S.G.M., O.R., K.M.C., S.N., S.K.P., V.M.F.), Radcliffe Department of Medicine, University of Oxford, United Kingdom
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Blankstein R, Shaw LJ, Gulati M, Atalay MK, Bax J, Calnon DA, Dyke CK, Ferencik M, Heitner JF, Henry TD, Hung J, Knuuti J, Lindner JR, Phillips LM, Raman SV, Rao SV, Rybicki FJ, Saraste A, Stainback RF, Thompson RC, Williamson E, Nieman K, Tremmel JA, Woodard PK, Di Carli MF, Chandrashekhar YS. Implications of the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Chest Pain Guideline for Cardiovascular Imaging: A Multisociety Viewpoint. JACC Cardiovasc Imaging 2022; 15:912-926. [PMID: 35512960 DOI: 10.1016/j.jcmg.2022.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Ron Blankstein
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | - Leslee J Shaw
- Departments of Medicine (Cardiology) and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Martha Gulati
- Cedars-Sinai Heart Institute, Los Angeles, California, USA
| | - Michael K Atalay
- Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Jeroen Bax
- Heart Center, Turku University Hospital, Turku, Finland; Leiden University Medical Centre, Leiden, the Netherlands
| | - Dennis A Calnon
- Ohio Health Heart & Vascular Physicians, Columbus, Ohio, USA
| | | | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Timothy D Henry
- The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio, USA
| | - Judy Hung
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Juhani Knuuti
- Heart Center, Turku University Hospital, Turku, Finland
| | - Jonathan R Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Subha V Raman
- Indiana University CV Institute and Krannert CV Research Center, Indianapolis, Indiana, USA
| | - Sunil V Rao
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Frank J Rybicki
- University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
| | - Antti Saraste
- Heart Center, Turku University Hospital, Turku, Finland; Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Raymond F Stainback
- Texas Heart Institute and Baylor College of Medicine, Division of Cardiology, Houston, Texas, USA
| | - Randall C Thompson
- St. Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri, USA
| | | | - Koen Nieman
- Stanford University, Palo Alto, California, USA
| | | | - Pamela K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Marcelo F Di Carli
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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6
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Menacho KD, Ramirez S, Perez A, Dragonetti L, Perez de Arenaza D, Katekaru D, Illatopa V, Munive S, Rodriguez B, Shimabukuro A, Cupe K, Bansal R, Bhargava V, Rodriguez I, Seraphim A, Knott K, Abdel-Gadir A, Guerrero S, Lazo M, Uscamaita D, Rivero M, Amaya N, Sharma S, Peix A, Treibel T, Manisty C, Mohiddin S, Litt H, Han Y, Fernandes J, Jacob R, Westwood M, Ntusi N, Herrey A, Walker JM, Moon J. Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance. Eur Heart J 2022; 43:2496-2507. [PMID: 35139531 PMCID: PMC9259377 DOI: 10.1093/eurheartj/ehac035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/30/2021] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
AIMS To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by a partner education programme on the management of cardiomyopathy (CMP) in low- and middle-income countries (LMICs). METHODS AND RESULTS Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees-potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2* scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1-2 days per week, 30 min slots). CONCLUSIONS Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time.
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Affiliation(s)
- Katia Devorha Menacho
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | | | - Aylen Perez
- Cardiology and Cardiovascular Surgery National Institute, La Havana, Cuba
| | | | | | - Diana Katekaru
- Military National Hospital, Cardiac Imaging Department, Lima, Peru
| | | | - Sara Munive
- National Cardiovascular Institute—INCOR, Lima, Peru
| | | | - Ana Shimabukuro
- Guillermo Almenara Irigoyen Hospital, National Hospital, Lima, Peru
| | - Kelly Cupe
- Guillermo Almenara Irigoyen Hospital, National Hospital, Lima, Peru
| | - Rajiv Bansal
- Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, India
| | | | | | - Andreas Seraphim
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Kris Knott
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Amna Abdel-Gadir
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Marco Lazo
- Ramiro Priale National Hospital, Huancayo, Peru
| | - David Uscamaita
- Edgardo Rebagliati Hospital, MRI and CT Department, Lima, Peru
| | | | - Neil Amaya
- Edgardo Rebagliati Hospital, MRI and CT Department, Lima, Peru
| | - Sanjiv Sharma
- AlI India Institute of Medical Sciences, New Delhi, India
| | - Amelia Peix
- Cardiology and Cardiovascular Surgery National Institute, La Havana, Cuba
| | - Thomas Treibel
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Sam Mohiddin
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Harold Litt
- Department of Medicine (Cardiovascular Division), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuchi Han
- Department of Medicine (Cardiovascular Division), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Ron Jacob
- Lancaster General Health Hospital, Lancaster, USA
| | - Mark Westwood
- St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Ntobeko Ntusi
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna Herrey
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - John Malcolm Walker
- Institute of Cardiovascular Science, University College London, London, UK,The Hatter Cardiovascular Institute, University College London Hospital, London, UK
| | - James Moon
- Corresponding author. Tel: +44 203 8870566,
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7
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Torlasco C, Castelletti S, Soranna D, Volpato V, Figliozzi S, Menacho K, Cernigliaro F, Zambon A, Kellman P, Moon JC, Badano LP, Parati G. Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol. J Am Heart Assoc 2021; 11:e022605. [PMID: 34970923 PMCID: PMC9075206 DOI: 10.1161/jaha.121.022605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A “one‐size‐fits‐all” shortened, focused protocol (eg, only function and late‐gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question‐driven CMR and stress‐CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. Methods and Results Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late‐gadolinium enhancement imaging, native T1‐mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in‐line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was <30 minutes for a CMR and <35 minutes for a stress‐CMR. CMR was considered impactful when its results drove changes in diagnosis or management. Advanced tissue characterization was considered impactful when it changed the confidence level in the diagnosis. The quality of the images was assessed. A control group of 137 patients was identified among scans performed before February 2020. Compared with standard protocols, the average scan duration dropped by >30% (CMR: from 42±8 to 28±6 minutes; stress‐CMR: from 50±10 to 34±6 minutes, both P<0.0001). Independent on the protocol, CMR was impactful in ≈60% cases, and advanced tissue characterization was impactful in >45% of cases. Quality grading was similar between the 2 protocols. Tailored protocols did not require additional staff. Conclusions Tailored CMR and stress‐CMR protocols including advanced tissue characterization are accurate and time‐effective for cardiomyopathies and ischemic heart disease.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences IRCCS Istituto Auxologico Italiano Milan Italy
| | | | - Davide Soranna
- Biostatistics Unit IRCCS Istituto Auxologico Italiano Milan Italy
| | - Valentina Volpato
- Department of Cardiovascular, Neural and Metabolic Sciences IRCCS Istituto Auxologico Italiano Milan Italy.,Department of Medicine and Surgery University of Milano-Bicocca Milan Italy
| | - Stefano Figliozzi
- Department of Cardiovascular, Neural and Metabolic Sciences IRCCS Istituto Auxologico Italiano Milan Italy
| | - Katia Menacho
- Institute of Cardiovascular Science University College London London UK.,Barts Heart Centre St Bartholomew's Hospital London UK
| | - Franco Cernigliaro
- Radiodiagnostic Department IRCCS Istituto Auxologico Italiano Milan Italy
| | - Antonella Zambon
- Biostatistics Unit IRCCS Istituto Auxologico Italiano Milan Italy.,Department of Statistics and Quantitative Method University of Milano-Bicocca Milan Italy
| | - Peter Kellman
- National Heart, Lung and Blood InstituteNational Institutes of Health Bethesda MD
| | - James C Moon
- Institute of Cardiovascular Science University College London London UK.,Barts Heart Centre St Bartholomew's Hospital London UK
| | - Luigi P Badano
- Department of Cardiovascular, Neural and Metabolic Sciences IRCCS Istituto Auxologico Italiano Milan Italy.,Department of Medicine and Surgery University of Milano-Bicocca Milan Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences IRCCS Istituto Auxologico Italiano Milan Italy.,Department of Medicine and Surgery University of Milano-Bicocca Milan Italy
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8
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Plein S, Kozerke S. Are We There Yet?: The Road to Routine Rapid CMR Imaging. JACC Cardiovasc Imaging 2021; 14:1755-1757. [PMID: 34419389 DOI: 10.1016/j.jcmg.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Sven Plein
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
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9
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Menacho Medina K, Seraphim A, Katekaru D, Abdel-Gadir A, Han Y, Westwood M, Walker JM, Moon JC, Herrey AS. Noninvasive rapid cardiac magnetic resonance for the assessment of cardiomyopathies in low-middle income countries. Expert Rev Cardiovasc Ther 2021; 19:387-398. [PMID: 33836619 DOI: 10.1080/14779072.2021.1915130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Cardiac Magnetic Resonance (CMR) is a crucial diagnostic imaging test that redefines diagnosis and enables targeted therapies, but the access to CMR is limited in low-middle Income Countries (LMICs) even though cardiovascular disease is an emergent primary cause of mortality in LMICs. New abbreviated CMR protocols can be less expensive, faster, whilst maintaining accuracy, potentially leading to a higher utilization in LMICs.Areas covered: This article will review cardiovascular disease in LMICs and the current role of CMR in cardiac diagnosis and enable targeted therapy, discussing the main obstacles to prevent the adoption of CMR in LMICs. We will then review the potential utility of abbreviated, cost-effective CMR protocols to improve cardiac diagnosis and care, the clinical indications of the exam, current evidence and future directions.Expert opinion: Rapid CMR protocols, provided that they are utilized in potentially high yield cases, could reduce cost and increase effectiveness. The adoption of these protocols, their integration into care pathways, and prioritizing key treatable diagnoses can potentially improve patient care. Several LMIC countries are now pioneering these approaches and the application of rapid CMR protocols appears to have a bright future if delivered effectively.
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Affiliation(s)
- Katia Menacho Medina
- Institute of Cardiovascular Science, University College London, London, UK.,Barts Heart Centre, Saint Bartholomew's Hospital, London, UK
| | - Andreas Seraphim
- Institute of Cardiovascular Science, University College London, London, UK.,Barts Heart Centre, Saint Bartholomew's Hospital, London, UK
| | | | - Amna Abdel-Gadir
- Institute of Cardiovascular Science, University College London, London, UK
| | - Yuchi Han
- Departments of Medicine (Cardiovascular Division) and Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Westwood
- Barts Heart Centre, Saint Bartholomew's Hospital, London, UK
| | - J Malcolm Walker
- Institute of Cardiovascular Science, University College London, London, UK.,Cardiology Department, University College London Hospitals NHS Foundation Trust, London, UK.,The Hatter Cardiovascular Institute, University College London Hospital, London, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK.,Barts Heart Centre, Saint Bartholomew's Hospital, London, UK
| | - Anna S Herrey
- Institute of Cardiovascular Science, University College London, London, UK.,Barts Heart Centre, Saint Bartholomew's Hospital, London, UK
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10
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Sanghvi SK, Schwarzman LS, Nazir NT. Cardiac MRI and Myocardial Injury in COVID-19: Diagnosis, Risk Stratification and Prognosis. Diagnostics (Basel) 2021; 11:130. [PMID: 33467705 PMCID: PMC7830889 DOI: 10.3390/diagnostics11010130] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023] Open
Abstract
Myocardial injury is a common complication of the COVID-19 illness and is associated with a worsened prognosis. Systemic hyperinflammation seen in the advanced stage of COVID-19 likely contributes to myocardial injury. Cardiac magnetic resonance imaging (CMR) is the preferred imaging modality for non-invasive evaluation in acute myocarditis, enabling risk stratification and prognostication. Modified scanning protocols in the pandemic setting reduce risk of exposure while providing critical data regarding cardiac tissue inflammation and fibrosis, chamber remodeling, and contractile function. The growing use of CMR in clinical practice to assess myocardial injury will improve understanding of the acute and chronic sequelae of myocardial inflammation from various pathological etiologies.
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Affiliation(s)
- Saagar K. Sanghvi
- Division of Cardiology, University of Illinois College of Medicine at Chicago, Chicago, IL 60612, USA;
| | - Logan S. Schwarzman
- Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL 60612, USA;
| | - Noreen T. Nazir
- Division of Cardiology, University of Illinois College of Medicine at Chicago, Chicago, IL 60612, USA;
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11
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Allen BD, Wong TC, Bucciarelli-Ducci C, Bryant J, Chen T, Dall'Armellina E, Finn JP, Fontana M, Francone M, Han Y, Hays AG, Jacob R, Lawton C, Manning WJ, Ordovas K, Parwani P, Plein S, Powell AJ, Raman SV, Salerno M, Carr JC. Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic. J Cardiovasc Magn Reson 2020; 22:58. [PMID: 32772930 PMCID: PMC7415346 DOI: 10.1186/s12968-020-00654-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/12/2020] [Indexed: 12/23/2022] Open
Abstract
During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers.
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Affiliation(s)
- Bradley D Allen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Timothy C Wong
- Department of Medicine (Cardiology), University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Jennifer Bryant
- National Heart Research Institute Singapore, National Heart Center Singapore, 5 Hospital Drive, Singapore, Singapore
| | - Tiffany Chen
- Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Dall'Armellina
- Leeds Institute of Cardiovascular and Metabolic Medicine, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - J Paul Finn
- Departments of Radiology and Medicine, UCLA, Los Angeles, California, USA
| | | | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Yuchi Han
- Departments of Medicine (Cardiovascular Division) and Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Allison G Hays
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ron Jacob
- The Heart and Vascular Institute, Lancaster General Health/PENN Medicine, Lancaster, PA, USA
| | - Chris Lawton
- Bristol Heart Institute, Bristol NIHR Biomedical Research Centre, University Hospitals Bristol and University of Bristol, Bristol, UK
| | - Warren J Manning
- Departments of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Karen Ordovas
- Departments of Radiology and Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Purvi Parwani
- Department of Medicine (Cardiology), Loma Linda University, Loma Linda, California, USA
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael Salerno
- Departments of Medicine, Radiology, and Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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12
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Greenwood JP, Walker S. Stress CMR Imaging for Stable Chest Pain Syndromes. JACC Cardiovasc Imaging 2020; 13:1518-1520. [DOI: 10.1016/j.jcmg.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 02/04/2023]
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13
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Zoghbi WA, DiCarli MF, Blankstein R, Choi AD, Dilsizian V, Flachskampf FA, Geske JB, Grayburn PA, Jaffer FA, Kwong RY, Leipsic JA, Marwick TH, Nagel E, Nieman K, Raman SV, Salerno M, Sengupta PP, Shaw LJ, Chandrashekhar YS. Multimodality Cardiovascular Imaging in the Midst of the COVID-19 Pandemic: Ramping Up Safely to a New Normal. JACC Cardiovasc Imaging 2020; 13:1615-1626. [PMID: 32646721 PMCID: PMC7290215 DOI: 10.1016/j.jcmg.2020.06.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- William A Zoghbi
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas.
| | - Marcelo F DiCarli
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ron Blankstein
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew D Choi
- Department of Medicine, George Washington University, Washington, DC; Department of Radiology, George Washington University, Washington, DC
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Frank A Flachskampf
- Clinical Physiology and Cardiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jeffrey B Geske
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Paul A Grayburn
- Department of Medicine, Baylor Scott and White Heart and Vascular Hospital, Dallas Texas
| | - Farouc A Jaffer
- Cardiovascular Center, Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raymond Y Kwong
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jonathan A Leipsic
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thomas H Marwick
- Department of Medicine, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Eike Nagel
- Institute of Experimental and Translational Cardiac Imaging, German Centre for Cardiovascular Research (DZHK) Centre for Cardiovascular Imaging, University Hospital Frankfurt, Frankfurt AM Main, Germany
| | - Koen Nieman
- Department of Medicine, Stanford University, Stanford, California; Department of Radiology, Stanford University, Stanford, California
| | - Subha V Raman
- Division of Cardiology, Indiana University School of Medicine, Bloomington, Indiana
| | - Michael Salerno
- Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia
| | - Partho P Sengupta
- Department of Medicine, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Y S Chandrashekhar
- Department of Medicine, University of Minnesota and VA Medical Center, Minneapolis, Minnesota
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14
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Raman SV, Jarori U. Strain and Long-Term Prognosis After Heart Transplantation: A Necessary Advance in the Pursuit of Sufficient Understanding. JACC Cardiovasc Imaging 2020; 13:1943-1944. [PMID: 32563651 DOI: 10.1016/j.jcmg.2020.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Subha V Raman
- Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana.
| | - Upasana Jarori
- Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
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