1
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Silva TQAC, Pezel T, Jerosch-Herold M, Coelho-Filho OR. The Role and Advantages of Cardiac Magnetic Resonance in the Diagnosis of Myocardial Ischemia. J Thorac Imaging 2023; 38:235-246. [PMID: 36917509 DOI: 10.1097/rti.0000000000000701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Ischemic heart disease continues to be the leading cause of death and disability worldwide. For the diagnosis of ischemic heart disease, some form of cardiac stress test involving exercise or pharmacological stimulation continues to play an important role, despite advances within modalities like computer tomography for the noninvasive detection and characterization of epicardial coronary lesions. Among noninvasive stress imaging tests, cardiac magnetic resonance (CMR) combines several capabilities that are highly relevant for the diagnosis of ischemic heart disease: assessment of wall motion abnormalities, myocardial perfusion imaging, and depiction of replacement and interstitial fibrosis markers by late gadolinium enhancement techniques and T1 mapping. On top of these qualities, CMR is also well tolerated and safe in most clinical scenarios, including in the presence of cardiovascular implantable devices, while in the presence of renal disease, gadolinium-based contrast should only be used according to guidelines. CMR also offers outstanding viability assessment and prognostication of cardiovascular events. The last 2019 European Society of Cardiology guidelines for chronic coronary syndromes has positioned stress CMR as a class I noninvasive imaging technique for the diagnosis of coronary artery disease in symptomatic patients. In the present review, we present the current state-of-the-art assessment of myocardial ischemia by stress perfusion CMR, highlighting its advantages and current shortcomings. We discuss the safety, clinical, and cost-effectiveness aspects of gadolinium-based CMR-perfusion imaging for ischemic heart disease assessment.
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Affiliation(s)
- Thiago Quinaglia A C Silva
- Discipline of Cardiology, Faculty of Medical Science-State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Théo Pezel
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Cardiology, University of Paris, CHU Lariboisière, Inserm, UMRS 942, Paris, France
| | - Michael Jerosch-Herold
- Noninvasive Cardiovascular Imaging Program and Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | - Otávio R Coelho-Filho
- Discipline of Cardiology, Faculty of Medical Science-State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
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2
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Ge Y, Antiochos P, Steel K, Bingham S, Abdullah S, Chen YY, Mikolich JR, Arai AE, Bandettini WP, Shanbhag SM, Patel AR, Farzaneh-Far A, Heitner JF, Shenoy C, Leung SW, Gonzalez JA, Shah DJ, Raman SV, Ferrari VA, Schulz-Menger J, Stuber M, Simonetti OP, Kwong RY. Prognostic Value of Stress CMR Perfusion Imaging in Patients With Reduced Left Ventricular Function. JACC Cardiovasc Imaging 2020; 13:2132-2145. [PMID: 32771575 PMCID: PMC10823343 DOI: 10.1016/j.jcmg.2020.05.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/18/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the prognostic value of stress cardiac magnetic resonance imaging (CMR) in patients with reduced left ventricular (LV) systolic function. BACKGROUND Patients with ischemic cardiomyopathy are at risk from both myocardial ischemia and heart failure. Invasive testing is often used as the first-line investigation, and there is limited evidence as to whether stress testing can effectively provide risk stratification. METHODS In this substudy of a multicenter registry from 13 U.S. centers, patients with reduced LV ejection fraction (<50%), referred for stress CMR for suspected myocardial ischemia, were included. The primary outcome was cardiovascular death or nonfatal myocardial infarction. The secondary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, hospitalization for unstable angina or congestive heart failure, and unplanned late coronary artery bypass graft surgery. RESULTS Among 582 patients (mean age 62 ± 12 years, 34% women), 40% had a history of congestive heart failure, and the median LV ejection fraction was 39% (interquartile range: 28% to 45%). At median follow-up of 5.0 years, 97 patients had experienced the primary outcome, and 182 patients had experienced the secondary outcome. Patients with no CMR evidence of ischemia or late gadolinium enhancement (LGE) experienced an annual primary outcome event rate of 1.1%. The presence of ischemia, LGE, or both was associated with higher event rates. In a multivariate model adjusted for clinical covariates, ischemia and LGE were independent predictors of the primary (hazard ratio [HR]: 2.63; 95% confidence interval [CI]: 1.68 to 4.14; p < 0.001; and HR: 1.86; 95% CI: 1.05 to 3.29; p = 0.03) and secondary (HR: 2.14; 95% CI: 1.55 to 2.95; p < 0.001; and HR 1.70; 95% CI: 1.16 to 2.49; p = 0.007) outcomes. The addition of ischemia and LGE led to improved model discrimination for the primary outcome (change in C statistic from 0.715 to 0.765; p = 0.02). The presence and extent of ischemia were associated with higher rates of use of downstream coronary angiography, revascularization, and cost of care spent on ischemia testing. CONCLUSIONS Stress CMR was effective in risk-stratifying patients with reduced LV ejection fractions. (Stress CMR Perfusion Imaging in the United States [SPINS] Study; NCT03192891).
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Affiliation(s)
- Yin Ge
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division of Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Panagiotis Antiochos
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division of Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kevin Steel
- Cardiology Division, San Antonio Military Medical Center, San Antonio, Texas
| | | | - Shuaib Abdullah
- Veteran Administration North Texas Healthcare System, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yi-Yun Chen
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division of Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - J Ronald Mikolich
- Department of Cardiovascular Medicine, Sharon Regional Health System, Sharon, Pennsylvania
| | - Andrew E Arai
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - W Patricia Bandettini
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit R Patel
- Cardiology Division, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Afshin Farzaneh-Far
- Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois
| | - John F Heitner
- Division of Cardiology, New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, New York
| | - Chetan Shenoy
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Steve W Leung
- Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky
| | - Jorge A Gonzalez
- Division of Cardiology and Radiology, Scripps Clinic, La Jolla, California
| | - Dipan J Shah
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| | - Subha V Raman
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Victor A Ferrari
- Cardiovascular Division, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Berlin, and Helios Clinics, Berlin, Germany
| | - Matthias Stuber
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Raymond Y Kwong
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division of Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
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3
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Pezel T, Sanguineti F, Kinnel M, Landon V, Bonnet G, Garot P, Hovasse T, Unterseeh T, Champagne S, Louvard Y, Claude Morice M, Garot J. Safety and Prognostic Value of Vasodilator Stress Cardiovascular Magnetic Resonance in Patients With Heart Failure and Reduced Ejection Fraction. Circ Cardiovasc Imaging 2020; 13:e010599. [DOI: 10.1161/circimaging.120.010599] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background:
Patients with heart failure with reduced ejection fraction (HFrEF; heart failure with reduced left ventricular ejection fraction <40%) referred for stress cardiovascular magnetic resonance (CMR) may have a less optimal hemodynamic response to intravenous vasodilator. The aim was to assess the prognostic value of vasodilator stress perfusion CMR in patients with HFrEF.
Methods:
Between 2008 and 2018, consecutive patients with HFrEF defined by left ventricular ejection fraction <40% prospectively referred for vasodilator stress perfusion CMR were followed for the occurrence of major adverse cardiovascular events (MACE), defined by cardiovascular death or nonfatal myocardial infarction. Univariable and multivariable Cox regressions were performed to determine the prognostic value of inducible ischemia or late gadolinium enhancement by CMR.
Results:
Of 1053 patients with HFrEF (65±11 years, median [interquartile range] left ventricular ejection fraction 38.7% [37.2–39.0]), 1018 (97%) completed the CMR protocol and 950 (93%) completed the follow-up (median [interquartile range], 5.6 [3.6–7.3] years); 117 experienced a MACE (12.3%). Stress CMR was well tolerated without any adverse events. Patients without ischemia or late gadolinium enhancement experienced a lower annual event rate of MACE (1.8%) than those with both ischemia and late gadolinium enhancement (12.0%;
P
<0.001). Using Kaplan-Meier analysis, inducible ischemia and late gadolinium enhancement were significantly associated with the occurrence of MACE (hazard ratio, 2.46 [95% CI, 1.69–3.60]; and hazard ratio, 2.92 [95% CI, 1.77–4.83], respectively, both
P
<0.001). In multivariable Cox regression, inducible ischemia was an independent predictor of a higher incidence of MACE (hazard ratio, 2.26 [95% CI, 1.52–3.35];
P
<0.001).
Conclusions:
Stress CMR is safe and has a good discriminative prognostic value to predict the occurrence of MACE in patients with HFrEF.
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Affiliation(s)
- Théo Pezel
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Francesca Sanguineti
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Marine Kinnel
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Valentin Landon
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Guillaume Bonnet
- Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Center, France (G.B.)
| | - Philippe Garot
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Thomas Hovasse
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Thierry Unterseeh
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Stéphane Champagne
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Yves Louvard
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Marie Claude Morice
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
| | - Jérôme Garot
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques CARTIER, Ramsay Santé, Massy, France (T.P., F.S., M.K., V.L., P.G., T.H., T.U., S.C., Y.L., M.C.M., J.G.)
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4
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Stress cardiac MRI in stable coronary artery disease. Curr Opin Cardiol 2020; 35:566-573. [PMID: 32649360 DOI: 10.1097/hco.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Non-invasive testing is often the first step in the evaluation of stable coronary artery disease (CAD). Stress cardiac magnetic resonance imaging (CMR) is an established modality with high diagnostic accuracy and prognostic value. This review will focus on the recent advances in understanding how stress CMR can help guide patient care. RECENT FINDINGS Diagnostic accuracy of stress CMR has been validated against coronary angiography with fractional flow reserve (FFR) in patients with stable CAD. Large registry data have shown stress CMR to have important prognostic importance and that its cost-effectiveness compares favorably to alternatives. In patients with stable CAD, guidance using a CMR based strategy led to equivalent outcomes when compared to coronary angiography with FFR. SUMMARY In persons with stable CAD, Stress CMR is an accurate and cost-effective imaging modality that should be considered in patients at intermediate pre-test probability of CAD. Prognostic studies have shown it to have excellent negative predictive value and that it can safely serve as a "gatekeeper" for invasive angiography.
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5
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Miñana G, Cardells I, Palau P, Llàcer P, Fácila L, Almenar L, López-Lereu MP, Monmeneu JV, Amiguet M, González J, Serrano A, Montagud V, López-Vilella R, Valero E, García-Blas S, Bodí V, de la Espriella-Juan R, Sanchis J, Chorro FJ, Bayés-Genís A, Núñez J. Changes in myocardial iron content following administration of intravenous iron (Myocardial-IRON): Study design. Clin Cardiol 2018; 41:729-735. [PMID: 29607528 DOI: 10.1002/clc.22956] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 12/19/2022] Open
Abstract
Treatment with intravenous ferric carboxymaltose (FCM) has been shown to improve symptoms, functional capacity, and quality of life in patients with heart failure and iron deficiency. However, the underlying mechanisms for these beneficial effects remain undetermined. The aim of this study is to quantify cardiac magnetic resonance changes in myocardial iron content after administration of intravenous FCM in patients with heart failure and iron deficiency and contrast them with parameters of heart failure severity. This is a multicenter, double-blind, randomized study. Fifty patients with stable symptomatic heart failure, left ventricular ejection fraction <50%, and iron deficiency will be randomly assigned 1:1 to receive intravenous FCM or placebo. Intramyocardial iron will be evaluated by T2* and T1 mapping cardiac magnetic resonance sequences before and at 7 and 30 days after FCM. After 30 days, patients assigned to placebo will receive intravenous FCM in case of persistent iron deficiency. The main endpoint will be changes from baseline in myocardial iron content at 7 and 30 days. Secondary endpoints will include the correlation of these changes with left ventricular ejection fraction, functional capacity, quality of life, and cardiac biomarkers. The results of this study will add important knowledge about the effects of intravenous FCM on myocardial tissue and cardiac function. We hypothesize that short-term (7 and 30 days) myocardial iron content changes after intravenous FCM, evaluated by cardiac magnetic resonance, will correlate with simultaneous changes in parameters of heart failure severity. The study is registered at http://www.clinicaltrials.gov (NCT03398681).
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Affiliation(s)
- Gema Miñana
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Ingrid Cardells
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Patricia Palau
- Servicio de Cardiología, Hospital General de Castellón, Universitat Jaume I, Castellón, Spain
| | - Pau Llàcer
- Servicio de Medicina Interna, Hospital de Manises, Manises, Spain
| | - Lorenzo Fácila
- Servicio de Cardiología, Hospital General Universitario de Valencia, Valencia, Spain
| | - Luis Almenar
- Servicio de Cardiología, Hospital Universitario La Fe de Valencia, Valencia, Spain
| | - Maria Pilar López-Lereu
- Unidad de Imagen Cardiaca (ERESA) Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Jose V Monmeneu
- Unidad de Imagen Cardiaca (ERESA) Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Martina Amiguet
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Jessika González
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Alicia Serrano
- Servicio de Cardiología, Hospital General de Castellón, Universitat Jaume I, Castellón, Spain
| | - Vicente Montagud
- Servicio de Cardiología, Hospital General Universitario de Valencia, Valencia, Spain
| | - Raquel López-Vilella
- Servicio de Cardiología, Hospital Universitario La Fe de Valencia, Valencia, Spain
| | - Ernesto Valero
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Sergio García-Blas
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Vicent Bodí
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Rafael de la Espriella-Juan
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Juan Sanchis
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Francisco J Chorro
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
| | - Antoni Bayés-Genís
- CIBER Cardiovascular.,Servicio de Cardiología y Unidad de Insuficiencia Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Spain, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Julio Núñez
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, INCLIVA, Valencia, Spain.,CIBER Cardiovascular
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6
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Núñez-Gil IJ, Martín-Reyes R, Bardají A, Alonso JJ, Abu-Assi E, Vivas D, Sionis A, Almendro-Delia M, Lidón RM. Ischemic Heart Disease and Acute Cardiac Care 2015: A Selection of Topical Issues. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:408-414. [PMID: 26948391 DOI: 10.1016/j.rec.2015.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/15/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Iván J Núñez-Gil
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
| | | | - Alfredo Bardají
- Servicio de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Joaquín J Alonso
- Servicio de Cardiología, Hospital Universitario de Getafe, Madrid, Spain
| | - Emad Abu-Assi
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - David Vivas
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - Alessandro Sionis
- Servicio de Cardiología, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Rosa María Lidón
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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7
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Núñez-Gil IJ, Martín-Reyes R, Bardají A, Alonso JJ, Abu-Assi E, Vivas D, Sionis A, Almendro-Delia M, Lidón RM. Selección de temas de actualidad en cardiopatía isquémica y cuidados agudos cardiológicos 2015. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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The Role of Cardiac Imaging in the Evaluation of Newly Diagnosed Heart Failure. Am J Cardiol 2016; 117:488-9. [PMID: 26708690 DOI: 10.1016/j.amjcard.2015.11.021] [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: 10/30/2015] [Revised: 11/01/2015] [Accepted: 11/23/2015] [Indexed: 11/22/2022]
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9
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10
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Pérez del Villar C, Yotti R, Bermejo J. Imaging Techniques in Acute Heart Failure. ACTA ACUST UNITED AC 2015; 68:612-23. [PMID: 26002273 DOI: 10.1016/j.rec.2015.02.021] [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: 01/30/2015] [Accepted: 02/16/2015] [Indexed: 12/01/2022]
Abstract
In recent years, imaging techniques have revolutionized the diagnosis of heart failure. In patients with a clinical picture of acute decompensation, prognosis is largely determined by early implementation of general measures and treatment of the underlying cause. Given its diagnostic yield and portability, ultrasound has become an essential tool in the setting of acute heart failure, and is currently found in all medical departments involved in the care of the critically ill patient. Cardiac magnetic resonance and computed tomography allow detailed characterization of multiple aspects of cardiac structure and function that were previously unavailable. This helps guide and monitor many of the treatment decisions in the acute heart failure population in an entirely noninvasive way. This article aims to review the usefulness of the imaging techniques that are clinically relevant in the context of an episode of acute heart failure. We discuss the indications and limitations of these techniques in detail and describe the general principles for the appropriate interpretation of results.
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Affiliation(s)
- Candelas Pérez del Villar
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Raquel Yotti
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Bermejo
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
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11
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Sionis A, Ruiz-Nodar JM, Fernández-Ortiz A, Marín F, Abu-Assi E, Díaz-Castro O, Nuñez-Gil IJ, Lidón RM. Actualización en cardiopatía isquémica y cuidados críticos cardiológicos. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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12
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Update on ischemic heart disease and intensive cardiac care. ACTA ACUST UNITED AC 2015; 68:234-41. [PMID: 25670216 DOI: 10.1016/j.rec.2014.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 11/12/2014] [Indexed: 01/11/2023]
Abstract
This article summarizes the main developments reported in 2014 on ischemic heart disease, together with the most important innovations in intensive cardiac care.
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13
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Pons Lladó G. Sobre el carácter integral de la cardiorresonancia magnética en el proceso diagnóstico de la cardiopatía isquémica. Rev Esp Cardiol (Engl Ed) 2014. [DOI: 10.1016/j.recesp.2014.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Pons Lladó G. The integral nature of cardiac magnetic resonance imaging in the work-up for ischemic heart disease. ACTA ACUST UNITED AC 2014; 67:683-4. [PMID: 25172061 DOI: 10.1016/j.rec.2014.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/30/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Guillem Pons Lladó
- Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
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