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Saito N, Kato S, Azuma M, Horita N, Utsunomiya D. Prognostic impact of MRI-derived feature tracking myocardial strain in patients with non-ischaemic dilated cardiomyopathy: a systematic review and meta-analysis. Clin Radiol 2024; 79:e702-e714. [PMID: 38402086 DOI: 10.1016/j.crad.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/15/2023] [Accepted: 12/04/2023] [Indexed: 02/26/2024]
Abstract
AIM To evaluate the clinical utility of feature tracking (FT)-derived myocardial strain in patients with non-ischaemic dilated cardiomyopathy (NIDCM). MATERIALS AND METHODS Electronic database searches of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE were performed. Studies on NIDCM were divided into categories according to left ventricular ejection fraction (LVEF; <30%, 30-40%, >40%), and correlations between strains and prevalence of late gadolinium enhancement (LGE) were evaluated by weighted correlation coefficients. Global longitudinal strain (GLS) hazard ratios were also integrated for prediction of future adverse events. RESULTS The present meta-analysis analysed data from 5,767 patients with NIDCM from 30 eligible studies. GLS and global circumferential strain significantly differed across the three LVEF categories (all p<0.05); however, global radial strain did not. Only GLS showed a strong correlation with the prevalence of LGE (Spearman's correlation coefficient = 0.61). The pooled HR of GLS for predicting adverse events was 1.15 (95% confidence interval [CI]: 1.07-1.23, p<0.001). CONCLUSION In this meta-analysis, FT-derived GLS was strongly correlated with myocardial fibrosis and was an important predictor of future adverse events. These results suggest that FT-derived GLS may be useful in the pathological evaluation and risk stratification of NIDCM.
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Affiliation(s)
- N Saito
- Department of Clinical Laboratory, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - S Kato
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
| | - M Azuma
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan
| | - N Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - D Utsunomiya
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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2
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Zhang H, Sheng J, Li G, Liu F, Bian H, Niu X, Kang L. The value of CMR Left ventricular strain analysis in evaluating ICM. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:651-657. [PMID: 36460876 DOI: 10.1007/s10554-022-02761-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022]
Abstract
The purpose of this article is to investigate the value of cardiac magnetic resonance imaging (CMR) derived left ventricular strain parameters in evaluation of ischemic cardiomyopathy (ICM). Thirty-one ICM patients and nineteen non-cardiomyopathy (non-CM) patients who performed CMR examinations during the same period were selected for this retrospective study. The basic clinical data, CMR left ventricular function parameters, left ventricular strain parameters were compared among the left ventricular ejection fraction (LVEF) preserved ICM group, the LVEF impaired ICM group and the non-CM group. The differences of MyoGCS (-21.9 ± 1.9 vs. -18.9 ± 2.7 P<0.001), MyoGLS (-20.8 ± 2.3 vs. -17.0 ± 2.9 P<0.001) and EndoGLS (-22.2 ± 3.1 vs. -17.6 ± 3.7 P<0.001) between LVEF preserved ICM group and non-CM group were statistically significant, while the differences of left heart function parameters between the two groups were not statistically significant (P > 0.05). The left ventricular strain analysis can be used to assess cardiac functional and morphological alterations in ICM patients prior to changes of left ventricular function parameters, which has high clinical significance.
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Affiliation(s)
- Houning Zhang
- Graduate School, Tianjin Medical University, Tianjin, China.,Department of Magnetic Resonance Imaging, North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Jiaxi Sheng
- Graduate School, Tianjin Medical University, Tianjin, China.,Department of Endocrinology, North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Guoce Li
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, China
| | - Fenghai Liu
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, China
| | - Hao Bian
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, China
| | - Xiqing Niu
- Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, China
| | - Liqing Kang
- Graduate School, Tianjin Medical University, Tianjin, China. .,Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, China.
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Vietheer J, Lehmann L, Unbehaun C, Fischer-Rasokat U, Wolter JS, Kriechbaum S, Weferling M, von Jeinsen B, Hain A, Liebetrau C, Hamm CW, Keller T, Rolf A. CMR-derived myocardial strain analysis differentiates ischemic and dilated cardiomyopathy-a propensity score-matched study. Int J Cardiovasc Imaging 2022; 38:863-872. [PMID: 34839396 PMCID: PMC11130031 DOI: 10.1007/s10554-021-02469-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/05/2021] [Indexed: 01/31/2023]
Abstract
Left ventricular (LV) longitudinal, circumferential, and radial motion can be measured using feature tracking of cardiac magnetic resonance (CMR) images. The aim of our study was to detect differences in LV mechanics between patients with dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) who were matched using a propensity score-based model. Between April 2017 and October 2019, 1224 patients were included in our CMR registry, among them 141 with ICM and 77 with DCM. Propensity score matching was used to pair patients based on their indexed end-diastolic volume (EDVi), ejection fraction (EF), and septal T1 relaxation time (psmatch2 module L Feature tracking provided six parameters for global longitudinal, circumferential, and radial strain with corresponding strain rates in each group. Strain parameters were compared between matched pairs of ICM and DCM patients using paired t tests. Propensity score matching yielded 72 patients in each group (DCM mean age 58.6 ± 11.6 years, 15 females; ICM mean age 62.6 ± 13.2 years, 11 females, p = 0.084 and 0.44 respectively; LV-EF 32.2 ± 13.5% vs. 33.8 ± 12.1%, p = 0.356; EDVi 127.2 ± 30.7 ml/m2 vs. 121.1 ± 41.8 ml/m2, p = 0.251; native T1 values 1165 ± 58 ms vs. 1167 ± 70 ms, p = 0.862). There was no difference in global longitudinal strain between DCM and ICM patients (- 10.9 ± 5.5% vs. - 11.2 ± 4.7%, p = 0.72), whereas in DCM patients there was a significant reduction in global circumferential strain (- 10.0 ± 4.5% vs. - 12.2 ± 4.7%, p = 0.002) and radial strain (17.1 ± 8.51 vs. 21.2 ± 9.7%, p = 0.039). Our data suggest that ICM and DCM patients have inherently different myocardial mechanics, even if phenotypes are similar. Our data show that GCS is significantly more impaired in DCM patients. This feature may help in more thoroughly characterizing cardiomyopathy patients.
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Affiliation(s)
- Julia Vietheer
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Lena Lehmann
- Medical Clinic I, Justus-Liebig-University Giessen, Giessen, Germany
| | - Claudia Unbehaun
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Ulrich Fischer-Rasokat
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Jan Sebastian Wolter
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Steffen Kriechbaum
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Maren Weferling
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Beatrice von Jeinsen
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Andreas Hain
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Christoph Liebetrau
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Christian W Hamm
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- Medical Clinic I, Justus-Liebig-University Giessen, Giessen, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Till Keller
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany
| | - Andreas Rolf
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
- Medical Clinic I, Justus-Liebig-University Giessen, Giessen, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Frankfurt am Main, Germany.
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Chen JH, Wang LL, Tao L, Qi B, Wang Y, Guo YJ, Miao L. Identification of MYH6 as the potential gene for human ischaemic cardiomyopathy. J Cell Mol Med 2021; 25:10736-10746. [PMID: 34697898 PMCID: PMC8581323 DOI: 10.1111/jcmm.17015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022] Open
Abstract
The present study aimed to explore the potential hub genes and pathways of ischaemic cardiomyopathy (ICM) and to investigate the possible associated mechanisms. Two microarray data sets (GSE5406 and GSE57338) were downloaded from the Gene Expression Omnibus (GEO) database. The limma package was used to analyse the differentially expressed genes (DEGs). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, Disease Ontology (DO) and Gene Ontology (GO) annotation analyses were performed. A protein‐protein interaction (PPI) network was set up using Cytoscape software. Significant modules and hub genes were identified by the Molecular Complex Detection (MCODE) app. Then, further functional validation of hub genes in other microarrays and survival analysis were performed to judge the prognosis. A total of 1065 genes were matched, with an adjusted p < 0.05, and 17 were upregulated and 25 were downregulated with|log2 (fold change)|≥1.2. After removing the lengthy entries, GO identified 12 items, and 8 pathways were enriched at adjusted p < 0.05 (false discovery rate, FDR set at <0.05). Three modules with a score >8 after MCODE analysis and MYH6 were ultimately identified. When validated in GSE23561, MYH6 expression was lower in patients with CAD than in healthy controls (p < 0.05). GSE60993 data suggested that MYH6 expression was also lower in AMI patients (p < 0.05). In the GSE59867 data set, MYH6 expression was lower in CAD patients than in AMI patients and lower in heart failure (HF) patients than in non‐HF patients. However, there was no difference at different periods within half a year, and HF was increased when MYH6 expression was low (p < 0.05–0.01). We performed an integrated analysis and validation and found that MYH6 expression was closely related to ICM and HF. However, whether this marker can be used as a predictor in blood samples needs further experimental verification.
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Affiliation(s)
- Jian-Hong Chen
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
| | - Lei-Li Wang
- Department of Oncology, Liuzhou People's Hospital, Liuzhou, China
| | - Lin Tao
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
| | - Bin Qi
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
| | - Yong Wang
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
| | - Yu-Jie Guo
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
| | - Liu Miao
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou, China
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5
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Mancio J, Pashakhanloo F, El-Rewaidy H, Jang J, Joshi G, Csecs I, Ngo L, Rowin E, Manning W, Maron M, Nezafat R. Machine learning phenotyping of scarred myocardium from cine in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2021; 23:532-542. [PMID: 33779725 DOI: 10.1093/ehjci/jeab056] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS Cardiovascular magnetic resonance (CMR) with late-gadolinium enhancement (LGE) is increasingly being used in hypertrophic cardiomyopathy (HCM) for diagnosis, risk stratification, and monitoring. However, recent data demonstrating brain gadolinium deposits have raised safety concerns. We developed and validated a machine-learning (ML) method that incorporates features extracted from cine to identify HCM patients without fibrosis in whom gadolinium can be avoided. METHODS AND RESULTS An XGBoost ML model was developed using regional wall thickness and thickening, and radiomic features of myocardial signal intensity, texture, size, and shape from cine. A CMR dataset containing 1099 HCM patients collected using 1.5T CMR scanners from different vendors and centres was used for model development (n=882) and validation (n=217). Among the 2613 radiomic features, we identified 7 features that provided best discrimination between +LGE and -LGE using 10-fold stratified cross-validation in the development cohort. Subsequently, an XGBoost model was developed using these radiomic features, regional wall thickness and thickening. In the independent validation cohort, the ML model yielded an area under the curve of 0.83 (95% CI: 0.77-0.89), sensitivity of 91%, specificity of 62%, F1-score of 77%, true negatives rate (TNR) of 34%, and negative predictive value (NPV) of 89%. Optimization for sensitivity provided sensitivity of 96%, F2-score of 83%, TNR of 19% and NPV of 91%; false negatives halved from 4% to 2%. CONCLUSION An ML model incorporating novel radiomic markers of myocardium from cine can rule-out myocardial fibrosis in one-third of HCM patients referred for CMR reducing unnecessary gadolinium administration.
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Affiliation(s)
- Jennifer Mancio
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Farhad Pashakhanloo
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Hossam El-Rewaidy
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.,Department of Computer Science, Technical University of Munich, Arcisstraße 21, 80333 Munich, Germany
| | - Jihye Jang
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.,Department of Computer Science, Technical University of Munich, Arcisstraße 21, 80333 Munich, Germany
| | - Gargi Joshi
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Ibolya Csecs
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Long Ngo
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Ethan Rowin
- HCM Institute, Division of Cardiology, Tufts Medical Centre, 860 Washington St Building, 6th Floor, Boston, MA 02111, USA
| | - Warren Manning
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.,Department of Radiology, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Martin Maron
- HCM Institute, Division of Cardiology, Tufts Medical Centre, 860 Washington St Building, 6th Floor, Boston, MA 02111, USA
| | - Reza Nezafat
- Department of Medicine, Beth Israel Deaconess Medical Centre and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
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6
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Edvardsen T, Haugaa KH, Petersen SE, Gimelli A, Donal E, Maurer G, Popescu BA, Cosyns B. The year 2018 in the European Heart Journal - Cardiovascular Imaging: Part I. Eur Heart J Cardiovasc Imaging 2019; 20:858-865. [PMID: 31211353 DOI: 10.1093/ehjci/jez133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/17/2019] [Indexed: 12/18/2022] Open
Abstract
The European Heart Journal - Cardiovascular Imaging has become one of the leading multimodality cardiovascular imaging journal, since it was launched in 2012. The impact factor is an impressive 8.366 and it is now established as one of the top 10 cardiovascular journals. The journal is the most important cardiovascular imaging journal in Europe. The most important studies from 2018 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.
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Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Nydalen, Sognsvannsveien 20, NO-0424Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 20, Oslo, Norway
| | - Kristina H Haugaa
- Department of Cardiology, Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Nydalen, Sognsvannsveien 20, NO-0424Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 20, Oslo, Norway
| | - Steffen E Petersen
- Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Alessia Gimelli
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi 1, Pisa, Italy
| | - Erwan Donal
- Cardiology Department and CIC-IT1414, CHU Rennes, 6 Rue H Le Guillou, Rennes, France.,LTSI INSERM 1099, University Rennes-1, Rue H Le Guillou, Rennes, France
| | - Gerald Maurer
- Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, Wien, Austria
| | - Bogdan A Popescu
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Department of Cardiology, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair Ziekenhuis Brussel, 109 Laarbeeklaan, Brussels, Belgium
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7
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Edvardsen T, Haugaa KH, Gerber BL, Maurovich-Horvat P, Donal E, Maurer G, Popescu BA. The year 2017 in the European Heart Journal-Cardiovascular Imaging: Part II. Eur Heart J Cardiovasc Imaging 2018; 19:1222-1229. [PMID: 30084988 DOI: 10.1093/ehjci/jey110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
European Heart Journal - Cardiovascular Imaging was launched in 2012 as a multimodality cardiovascular imaging journal. It has gained an impressive impact factor of 8.366 during its first 5 years and is now established as one of the top 10 cardiovascular journals and has become the most important cardiovascular imaging journal in Europe. The most important studies from 2017 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.
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Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, NO-0027 Oslo, Norway and Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 20, Oslo, Norway
| | - Kristina H Haugaa
- Department of Cardiology, Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, NO-0027 Oslo, Norway and Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 20, Oslo, Norway
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires St. Luc, Université Catholique de Louvain, Av Hippocrate 10/2803, Woluwe St. Lambert, Belgium
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group (CIRG), Heart and Vascular Center, Semmelweis University, 68 Varosmajor u., Budapest, Hungary
| | - Erwan Donal
- Cardiologie Department and CIC-IT 1414 - CHU Rennes - Hôpital Pontchaillou, LTSI INSERM U 1099 - University Rennes-1, Rennes, France
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, Wien, Austria
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila" - Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, sector 2, Bucharest, Romania
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