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Xue W, Li J, Hu Z, Kerfoot E, Clough J, Oksuz I, Xu H, Grau V, Guo F, Ng M, Li X, Li Q, Liu L, Ma J, Grinias E, Tziritas G, Yan W, Atehortúa A, Garreau M, Jang Y, Debus A, Ferrante E, Yang G, Hua T, Li S. Left Ventricle Quantification Challenge: A Comprehensive Comparison and Evaluation of Segmentation and Regression for Mid-Ventricular Short-Axis Cardiac MR Data. IEEE J Biomed Health Inform 2021; 25:3541-3553. [PMID: 33684050 PMCID: PMC7611810 DOI: 10.1109/jbhi.2021.3064353] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Automatic quantification of the left ventricle (LV) from cardiac magnetic resonance (CMR) images plays an important role in making the diagnosis procedure efficient, reliable, and alleviating the laborious reading work for physicians. Considerable efforts have been devoted to LV quantification using different strategies that include segmentation-based (SG) methods and the recent direct regression (DR) methods. Although both SG and DR methods have obtained great success for the task, a systematic platform to benchmark them remains absent because of differences in label information during model learning. In this paper, we conducted an unbiased evaluation and comparison of cardiac LV quantification methods that were submitted to the Left Ventricle Quantification (LVQuan) challenge, which was held in conjunction with the Statistical Atlases and Computational Modeling of the Heart (STACOM) workshop at the MICCAI 2018. The challenge was targeted at the quantification of 1) areas of LV cavity and myocardium, 2) dimensions of the LV cavity, 3) regional wall thicknesses (RWT), and 4) the cardiac phase, from mid-ventricle short-axis CMR images. First, we constructed a public quantification dataset Cardiac-DIG with ground truth labels for both the myocardium mask and these quantification targets across the entire cardiac cycle. Then, the key techniques employed by each submission were described. Next, quantitative validation of these submissions were conducted with the constructed dataset. The evaluation results revealed that both SG and DR methods can offer good LV quantification performance, even though DR methods do not require densely labeled masks for supervision. Among the 12 submissions, the DR method LDAMT offered the best performance, with a mean estimation error of 301 mm 2 for the two areas, 2.15 mm for the cavity dimensions, 2.03 mm for RWTs, and a 9.5% error rate for the cardiac phase classification. Three of the SG methods also delivered comparable performances. Finally, we discussed the advantages and disadvantages of SG and DR methods, as well as the unsolved problems in automatic cardiac quantification for clinical practice applications.
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Affiliation(s)
- Wufeng Xue
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; Department of Medical Imaging, Western University, London, ON N6A 3K7, Canada
| | - Jiahui Li
- Beijing University of Post and Telecommunication, Beijing, China
| | | | - Eric Kerfoot
- School of Biomedical Engineering & Imaging Sciences, King’s College London, UK
| | - James Clough
- School of Biomedical Engineering & Imaging Sciences, King’s College London, UK
| | - Ilkay Oksuz
- School of Biomedical Engineering & Imaging Sciences, King’s College London, UK
| | - Hao Xu
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Vicente Grau
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Fumin Guo
- Sunnybrook Research Institute, Department of Medical Biophysics, University of Toronto, Canada
| | - Matthew Ng
- Sunnybrook Research Institute, Department of Medical Biophysics, University of Toronto, Canada
| | - Xiang Li
- Department of Radiology, Massachusetts General Hospital, Boston, USA
| | - Quanzheng Li
- Department of Radiology, Massachusetts General Hospital, Boston, USA
| | - Lihong Liu
- Pingan Technology (Shenzhen) Co.Ltd. Elias Grinias and Georgios Tziritas are with Department of Computer Science, University of Crete, Heraklion, Greece
| | - Jin Ma
- Pingan Technology (Shenzhen) Co.Ltd. Elias Grinias and Georgios Tziritas are with Department of Computer Science, University of Crete, Heraklion, Greece
| | - Elias Grinias
- Department of Computer Science, University of Crete, Heraklion, Greece
| | - Georgios Tziritas
- Department of Computer Science, University of Crete, Heraklion, Greece
| | - Wenjun Yan
- Department of Electrical Engineering, Fudan University, Shanghai, China
| | - Angélica Atehortúa
- LTSI UMR 1099, F-35000 Rennes, France; Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Yeonggul Jang
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University
| | - Alejandro Debus
- Research Institute for Signals, Systems and Computational Intelligence, sinc(i), FICH-UNL/CONICET, Santa Fe, Argentina
| | - Enzo Ferrante
- Research Institute for Signals, Systems and Computational Intelligence, sinc(i), FICH-UNL/CONICET, Santa Fe, Argentina
| | - Guanyu Yang
- Centre de Recherche en Information Biomédicale Sino-Français (CRIBs), Southeast University, Nanjing, China; LIST, Key Laboratory of Computer Network and Information Integration (Southeast University), Ministry of Education, Nanjing, China
| | - Tiancong Hua
- Centre de Recherche en Information Biomedicale Sino-Francais (CRIBs), Southeast University, Nanjing, China
| | - Shuo Li
- Department of Medical Imaging, Western University, London, ON N6A 3K7, Canada
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Xue W, Islam A, Bhaduri M, Li S. Direct Multitype Cardiac Indices Estimation via Joint Representation and Regression Learning. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:2057-2067. [PMID: 28574348 DOI: 10.1109/tmi.2017.2709251] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cardiac indices estimation is of great importance during identification and diagnosis of cardiac disease in clinical routine. However, estimation of multitype cardiac indices with consistently reliable and high accuracy is still a great challenge due to the high variability of cardiac structures and the complexity of temporal dynamics in cardiac MR sequences. While efforts have been devoted into cardiac volumes estimation through feature engineering followed by a independent regression model, these methods suffer from the vulnerable feature representation and incompatible regression model. In this paper, we propose a semi-automated method for multitype cardiac indices estimation. After the manual labeling of two landmarks for ROI cropping, an integrated deep neural network Indices-Net is designed to jointly learn the representation and regression models. It comprises two tightly-coupled networks, such as a deep convolution autoencoder for cardiac image representation, and a multiple output convolution neural network for indices regression. Joint learning of the two networks effectively enhances the expressiveness of image representation with respect to cardiac indices, and the compatibility between image representation and indices regression, thus leading to accurate and reliable estimations for all the cardiac indices. When applied with five-fold cross validation on MR images of 145 subjects, Indices-Net achieves consistently low estimation error for LV wall thicknesses (1.44 ± 0.71 mm) and areas of cavity and myocardium (204 ± 133 mm2). It outperforms, with significant error reductions, segmentation method (55.1% and 17.4%), and two-phase direct volume-only methods (12.7% and 14.6%) for wall thicknesses and areas, respectively. These advantages endow the proposed method a great potential in clinical cardiac function assessment.
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Kuo AH, Li C, Li J, Huber HF, Nathanielsz PW, Clarke GD. Cardiac remodelling in a baboon model of intrauterine growth restriction mimics accelerated ageing. J Physiol 2017; 595:1093-1110. [PMID: 27988927 PMCID: PMC5309359 DOI: 10.1113/jp272908] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/15/2016] [Indexed: 12/15/2022] Open
Abstract
KEY POINTS Rodent models of intrauterine growth restriction (IUGR) successfully identify mechanisms that can lead to short-term and long-term detrimental cardiomyopathies but differences between rodent and human cardiac physiology and placental-fetal development indicate a need for models in precocial species for translation to human development. We developed a baboon model for IUGR studies using a moderate 30% global calorie restriction of pregnant mothers and used cardiac magnetic resonance imaging to evaluate offspring heart function in early adulthood. Impaired diastolic and systolic cardiac function was observed in IUGR offspring with differences between male and female subjects, compared to their respective controls. Aspects of cardiac impairment found in the IUGR offspring were similar to those found in normal controls in a geriatric cohort. Understanding early cardiac biomarkers of IUGR using non-invasive imaging in this susceptible population, especially taking into account sexual dimorphisms, will aid recognition of the clinical presentation, development of biomarkers suitable for use in humans and management of treatment strategies. ABSTRACT Extensive rodent studies have shown that reduced perinatal nutrition programmes chronic cardiovascular disease. To enable translation to humans, we developed baboon offspring cohorts from mothers fed ad libitum (control) or 70% of the control ad libitum diet in pregnancy and lactation, which were growth restricted at birth. We hypothesized that intrauterine growth restriction (IUGR) offspring hearts would show impaired function and a premature ageing phenotype. We studied IUGR baboons (8 male, 8 female, 5.7 years), control offspring (8 male, 8 female, 5.6 years - human equivalent approximately 25 years), and normal elderly (OLD) baboons (6 male, 6 female, mean 15.9 years). Left ventricular (LV) morphology and systolic and diastolic function were evaluated with cardiac MRI and normalized to body surface area. Two-way ANOVA by group and sex (with P < 0.05) indicated ejection fraction, 3D sphericity indices, cardiac index, normalized systolic volume, normalized LV wall thickness, and average filling rate differed by group. Group and sex differences were found for normalized LV wall thickening and normalized myocardial mass, without interactions. Normalized peak LV filling rate and diastolic sphericity index were not correlated in control but strongly correlated in OLD and IUGR baboons. IUGR programming in baboons produces myocardial remodelling, reduces systolic and diastolic function, and results in the emergence of a premature ageing phenotype in the heart. To our knowledge, this is the first demonstration of the specific characteristics of cardiac programming and early life functional decline with ageing in an IUGR non-human primate model. Further studies across the life span will determine progression of cardiac dysfunction.
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Affiliation(s)
- Anderson H. Kuo
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Cun Li
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
| | - Jinqi Li
- Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | | | - Peter W. Nathanielsz
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate CenterSan AntonioTXUSA
| | - Geoffrey D. Clarke
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Southwest National Primate CenterSan AntonioTXUSA
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de Zan M, Carrascosa P, Deviggiano A, Capuñay C, Rodríguez-Granillo GA. [Myocardial regional thickness in patients with and without cardiomyopathy assessed by cardiac magnetic resonance]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2016; 86:305-312. [PMID: 27156043 DOI: 10.1016/j.acmx.2016.03.003] [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: 09/17/2015] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To explore regional differences in myocardial wall thickness (WT) among the most prevalent cardiomyopathies and in individuals without structural heart disease using cardiac magnetic resonance. METHODS Patients older than 18 years referred to cardiac magnetic resonance during the period between January 2014 and September 2014, with a diagnosis of hypertrophic cardiomyopathy, idiopathic dilated cardiomyopathy, ischemic cardiomyopathy, and myocarditis were retrospectively selected from our database. RESULTS One hundred twenty patients patients were included. The control group had an average WT of 5.9±1.1mm, with a WT index of 2.9±0.8. Significantly lower mean WT in the apical segments were identified in both the control group (basal 6.7±1.3 vs. mid 6.0±1.3 vs. apical 4.6±1.0mm, P<.0001) and in all evaluated cardiomyopathies (hypertrophic cardiomyopathy: basal 10.5±2.4 vs. mid 10.8±2.7 vs. apical 7.3±3.3mm, P<.0001; idiopathic dilated cardiomyopathy: basal 7.7±1.7 vs. mid 7.6±1.3 vs. apical 5.4±1.3mm, P<.0001; ischemic cardiomyopathy: basal 7.4±1.7 vs. mid 7.5±1.9 vs. apical 5.5±1.8mm, P<.0001; myocarditis: basal 7.1±1.5 vs. mid 6.4±1.1 vs. apical 5.1±0.8, P<.0001). Significant gender differences were also evident regarding the mean WT both in the control group (male 6.5±2.1 vs. female 5.2±1.7mm, P<.0001), as in hypertrophic cardiomyopathy (10.5±5.3 vs. 8.5±5.7mm, P<.0001) and myocarditis (6.6±2.0 vs. 5.2±1.6mm, P<.0001). CONCLUSION We found a relatively high prevalence of segments commonly deemed thinned among patients without structural heart disease. We also observed a marked asymmetry and longitudinal gradient in wall thickness both in controls and in the various cardiomyopathies evaluated.
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Affiliation(s)
- Macarena de Zan
- Departamento de Estudios Cardiovasculares No Invasivos de Diagnóstico Maipú, Buenos Aires, Argentina
| | - Patricia Carrascosa
- Departamento de Estudios Cardiovasculares No Invasivos de Diagnóstico Maipú, Buenos Aires, Argentina
| | - Alejandro Deviggiano
- Departamento de Estudios Cardiovasculares No Invasivos de Diagnóstico Maipú, Buenos Aires, Argentina
| | - Carlos Capuñay
- Departamento de Estudios Cardiovasculares No Invasivos de Diagnóstico Maipú, Buenos Aires, Argentina
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Paulis LE, Klein AM, Ghanem A, Geelen T, Coolen BF, Breitbach M, Zimmermann K, Nicolay K, Fleischmann BK, Roell W, Strijkers GJ. Embryonic cardiomyocyte, but not autologous stem cell transplantation, restricts infarct expansion, enhances ventricular function, and improves long-term survival. PLoS One 2013; 8:e61510. [PMID: 23585908 PMCID: PMC3621863 DOI: 10.1371/journal.pone.0061510] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 03/10/2013] [Indexed: 01/08/2023] Open
Abstract
AIMS Controversy exists in regard to the beneficial effects of transplanting cardiac or somatic progenitor cells upon myocardial injury. We have therefore investigated the functional short- and long-term consequences after intramyocardial transplantation of these cell types in a murine lesion model. METHODS AND RESULTS Myocardial infarction (MI) was induced in mice (n = 75), followed by the intramyocardial injection of 1-2×10(5) luciferase- and GFP-expressing embryonic cardiomyocytes (eCMs), skeletal myoblasts (SMs), mesenchymal stem cells (MSCs) or medium into the infarct. Non-treated healthy mice (n = 6) served as controls. Bioluminescence and fluorescence imaging confirmed the engraftment and survival of the cells up to seven weeks postoperatively. After two weeks MRI was performed, which showed that infarct volume was significantly decreased by eCMs only (14.8±2.2% MI+eCM vs. 26.7±1.6% MI). Left ventricular dilation was significantly decreased by transplantation of any cell type, but most efficiently by eCMs. Moreover, eCM treatment increased the ejection fraction and cardiac output significantly to 33.4±2.2% and 22.3±1.2 ml/min. In addition, this cell type exclusively and significantly increased the end-systolic wall thickness in the infarct center and borders and raised the wall thickening in the infarct borders. Repetitive echocardiography examinations at later time points confirmed that these beneficial effects were accompanied by better survival rates. CONCLUSION Cellular cardiomyoplasty employing contractile and electrically coupling embryonic cardiomyocytes (eCMs) into ischemic myocardium provoked significantly smaller infarcts with less adverse remodeling and improved cardiac function and long-term survival compared to transplantation of somatic cells (SMs and MSCs), thereby proving that a cardiomyocyte phenotype is important to restore myocardial function.
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Affiliation(s)
- Leonie E. Paulis
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Alexandra M. Klein
- Institute of Physiology I, Life and Brain Centre, University of Bonn, Bonn, Germany
| | - Alexander Ghanem
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | - Tessa Geelen
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bram F. Coolen
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Martin Breitbach
- Institute of Physiology I, Life and Brain Centre, University of Bonn, Bonn, Germany
| | - Katrin Zimmermann
- Department of Pharmacology and Toxicology, Biomedical Center, University of Bonn, Bonn, Germany
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bernd K. Fleischmann
- Institute of Physiology I, Life and Brain Centre, University of Bonn, Bonn, Germany
| | - Wilhelm Roell
- Institute of Physiology I, Life and Brain Centre, University of Bonn, Bonn, Germany
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
- * E-mail: (WR); (GJS)
| | - Gustav J. Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- * E-mail: (WR); (GJS)
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Kawel N, Turkbey EB, Carr JJ, Eng J, Gomes AS, Hundley WG, Johnson C, Masri SC, Prince MR, van der Geest RJ, Lima JAC, Bluemke DA. Normal left ventricular myocardial thickness for middle-aged and older subjects with steady-state free precession cardiac magnetic resonance: the multi-ethnic study of atherosclerosis. Circ Cardiovasc Imaging 2012; 5:500-8. [PMID: 22705587 DOI: 10.1161/circimaging.112.973560] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Increased left ventricular myocardial thickness (LVMT) is a feature of several cardiac diseases. The purpose of this study was to establish standard reference values of normal LVMT with cardiac magnetic resonance and to assess variation with image acquisition plane, demographics, and left ventricular function. METHODS AND RESULTS End-diastolic LVMT was measured on cardiac magnetic resonance steady-state free precession cine long and short axis images in 300 consecutive participants free of cardiac disease (169 women; 65.6 ± 8.5 years) of the Multi-Ethnic Study of Atherosclerosis cohort. Mean LVMT on short axis images at the mid-cavity level was 5.3 ± 0.9 mm and 6.3 ± 1.1 mm for women and men, respectively. The average of the maximum LVMT at the mid-cavity for women/men was 7/9 mm (long axis) and 7/8 mm (short axis). Mean LVMT was positively associated with weight (0.02 mm/kg; P=0.01) and body surface area (1.1 mm/m(2); P<0.001). No relationship was found between mean LVMT and age or height. Greater mean LVMT was associated with lower left ventricular end-diastolic volume (0.01 mm/mL; P<0.01), a lower left ventricular end-systolic volume (-0.01 mm/mL; P=0.01), and lower left ventricular stroke volume (-0.01 mm/mL; P<0.05). LVMT measured on long axis images at the basal and mid-cavity level were slightly greater (by 6% and 10%, respectively) than measurements obtained on short axis images; apical LVMT values on long axis images were 20% less than those on short axis images. CONCLUSIONS Normal values for wall thickness are provided for middle-aged and older subjects. Normal LVMT is lower for women than men. Observed values vary depending on the imaging plane for measurement.
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Affiliation(s)
- Nadine Kawel
- Radiology and Imaging Sciences Department and National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA
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van der Wall EE, Delgado V, Holman ER, Bax JJ. Speckle tracking: distinction of physiologic from pathologic LVH? Int J Cardiovasc Imaging 2010; 27:101-4. [PMID: 20734233 PMCID: PMC3035794 DOI: 10.1007/s10554-010-9689-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 08/13/2010] [Indexed: 11/03/2022]
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van der Wall EE, Holman ER, Scholte AJ, Bax JJ. Echocardiography in Takotsubo cardiomyopathy; a useful approach? Int J Cardiovasc Imaging 2010; 26:537-40. [PMID: 20390358 PMCID: PMC2868168 DOI: 10.1007/s10554-010-9629-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 04/02/2010] [Indexed: 11/24/2022]
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van der Wall EE, Scholte AJ, Holman ER, Bax JJ. Stress imaging in patients with diabetes; routine practice? Int J Cardiovasc Imaging 2010; 27:939-42. [PMID: 20454930 PMCID: PMC3182325 DOI: 10.1007/s10554-010-9639-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 04/26/2010] [Indexed: 11/29/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - A. J. Scholte
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - E. R. Holman
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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van der Wall EE. Tissue characterization in Takotsubo cardiomyopathy; a valuable approach? Int J Cardiovasc Imaging 2010; 26:233-6. [PMID: 20175295 PMCID: PMC2817074 DOI: 10.1007/s10554-009-9534-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 10/29/2009] [Indexed: 11/26/2022]
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Signal intensity enhances diagnostic capacity in myocardial infarction. Int J Cardiovasc Imaging 2009; 25:545-7. [PMID: 19291422 DOI: 10.1007/s10554-009-9452-3] [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: 02/20/2009] [Accepted: 02/20/2009] [Indexed: 10/21/2022]
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12
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van der Wall EE. Pharmacological stress: a useful exercise? Int J Cardiovasc Imaging 2009; 25:285-8. [PMID: 19145471 DOI: 10.1007/s10554-008-9420-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 12/12/2008] [Indexed: 10/21/2022]
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13
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Mulder BJM, van der Wall EE. Tetralogy of Fallot: in good shape? Int J Cardiovasc Imaging 2008; 25:271-5. [PMID: 19085086 DOI: 10.1007/s10554-008-9399-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 11/25/2008] [Indexed: 11/29/2022]
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Sarwar A, Shapiro MD, Abbara S, Cury RC. Cardiac Magnetic Resonance Imaging for the Evaluation of Ventricular Function. Semin Roentgenol 2008; 43:183-92. [DOI: 10.1053/j.ro.2008.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dorfman TA, Levine BD, Tillery T, Peshock RM, Hastings JL, Schneider SM, Macias BR, Biolo G, Hargens AR. Cardiac atrophy in women following bed rest. J Appl Physiol (1985) 2007; 103:8-16. [PMID: 17379748 DOI: 10.1152/japplphysiol.01162.2006] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Both chronic microgravity exposure and long-duration bed rest induce cardiac atrophy, which leads to reduced standing stroke volume and orthostatic intolerance. However, despite the fact that women appear to be more susceptible to postspaceflight presyncope and orthostatic hypotension than male astronauts, most previous high-resolution studies of cardiac morphology following microgravity have been performed only in men. Because female athletes have less physiological hypertrophy than male athletes, we reasoned that they also might have altered physiological cardiac atrophy after bed rest. Magnetic resonance imaging was performed in 24 healthy young women (32.1 +/- 4 yr) to measure left ventricular (LV) and right ventricular (RV) mass, volumes, and morphology accurately before and after 60 days of 6 degrees head-down tilt (HDT) bed rest. Subjects were matched and then randomly assigned to sedentary bed rest (controls, n = 8) or two treatment groups consisting of 1) exercise training using supine treadmill running within lower body negative pressure plus resistive training (n = 8), or 2) protein (0.45 g x kg(-1) x day(-1) increase) plus branched-chain amino acid (BCAA) (7.2 g/day) supplementation (n = 8). After sedentary bed rest without nutritional supplementation, there were significant reductions in LV (96 +/- 26 to 77 +/- 25 ml; P = 0.03) and RV volumes (104 +/- 33 to 86 +/- 25 ml; P = 0.02), LV (2.2 +/- 0.2 to 2.0 +/- 0.2 g/kg; P = 0.003) and RV masses (0.8 +/- 0.1 to 0.6 +/- 0.1 g/kg; P < 0.001), and the length of the major axis of the LV (90 +/- 6 to 84 +/- 7 mm. P < 0.001), similar to what has been observed previously in men (8.0%; Perhonen MA, Franco F, Lane LD, Buckey JC, Blomqvist Zerwekh JE, Peshock RM, Weatherall PT, Levine BD. J Appl Physiol 91: 645-653, 2001). In contrast, there were no significant reductions in LV or RV volumes in the exercise-trained group, and the length of the major axis was preserved. Moreover, there were significant increases in LV (1.9 +/- 0.4 to 2.3 +/- 0.3 g/kg; P < 0.001) and RV masses (0.7 +/- 0.1 to 0.8 +/- 0.2 g/kg; P = 0.002), as well as mean wall thickness (9 +/- 2 to 11 +/- 1 mm; P = 0.02). The interaction between sedentary and exercise LV and RV masses was highly significant (P < 0.0001). Protein and BCAA supplementation led to an intermediate phenotype with no change in LV or RV mass after bed rest, but there remained a significant reduction in LV volume (103 +/- 14 to 80 +/- 16 ml; P = 0.02) and major-axis length (91 +/- 5 to 88 +/- 7 mm; P = 0.003). All subjects lost an equivalent amount of body mass (3.4 +/- 0.2 kg control; 3.1 +/- 0.04 kg exercise; 2.8 +/- 0.1 kg protein). Cardiac atrophy occurs in women similar to men following sedentary 60 days HDT bed rest. However, exercise training and, to a lesser extent, protein supplementation may be potential countermeasures to the cardiac atrophy associated with chronic unloading conditions such as in spaceflight and prolonged bed rest.
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Affiliation(s)
- Todd A Dorfman
- Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, Dallas, TX 75231, USA
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Durand JL, Tang B, Gutstein DE, Petkova S, Teixeira MM, Tanowitz HB, Jelicks LA. Dyskinesis in Chagasic myocardium: centerline analysis of wall motion using cardiac-gated magnetic resonance images of mice. Magn Reson Imaging 2006; 24:1051-7. [PMID: 16997075 PMCID: PMC2654323 DOI: 10.1016/j.mri.2006.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Accepted: 04/07/2006] [Indexed: 11/28/2022]
Abstract
We report on the use of centerline analysis of cardiac-gated magnetic resonance images to measure wall motion abnormalities in mice infected with Trypanosoma cruzi. To our knowledge, this is the first report of segmental wall motion abnormalities in an animal model of Chagas' disease. Chagas' disease patients with severe cardiac involvement exhibit mild hypokinesis in an extensive region of the left ventricle and dyskinesis in the apical region. We observed dyskinetic segments in a similar region of the hearts of infected wild-type mice. Dyskinesis was not observed in infected mice lacking macrophage inflammatory protein-1alpha, a chemokine that may play an important role in the cardiac remodeling that is normally observed in mouse models of Chagas' disease and in human patients. This study aimed to demonstrate the utility of cardiac-gated magnetic resonance imaging and centerline analysis as a straightforward method for monitoring regional left ventricular wall motion in transgenic and/or diseased mice.
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Affiliation(s)
- Jorge L. Durand
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Baiyu Tang
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - David E. Gutstein
- Departments of Medicine (Cardiology) and Cell Biology, New York University School of Medicine, New York, NY 10016, USA
| | - Stefka Petkova
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mauro M. Teixeira
- Departamento de Bioquimica e Imunologia, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, 31270−901 Belo Horizonte MG, Brazil
| | - Herbert B. Tanowitz
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Division of Infectious Disease, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Linda A. Jelicks
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Corresponding author. Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY 10461, USA. Tel.: +1 718 430 2722; fax: 718 430 8819. E-mail address: (L.A. Jelicks)
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17
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Rickers C, Wilke NM, Jerosch-Herold M, Casey SA, Panse P, Panse N, Weil J, Zenovich AG, Maron BJ. Utility of cardiac magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy. Circulation 2006; 112:855-61. [PMID: 16087809 DOI: 10.1161/circulationaha.104.507723] [Citation(s) in RCA: 357] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Two-dimensional echocardiography is currently the standard test for the clinical diagnosis of hypertrophic cardiomyopathy (HCM). The present study was undertaken to determine whether cardiac MRI (CMR) affords greater accuracy than echocardiography in establishing the diagnosis and assessing the magnitude of left ventricular (LV) hypertrophy in HCM. METHODS AND RESULTS Forty-eight patients (age 34+/-16 years) suspected of having HCM (or with a confirmed diagnosis) were imaged by both echocardiography and CMR to assess LV wall thickness in 8 anatomic segments (total n=384 segments) and compared in a blinded fashion. Maximum LV thickness was similar by echocardiography (21.7+/-9.1 mm) and CMR (22.5+/-9.6 mm; P=0.21). However, in 3 (6%) of the 48 patients, echocardiography did not demonstrate LV hypertrophy, and CMR identified otherwise undetected areas of wall thickening in the anterolateral LV free wall (17 to 20 mm), which resulted in a new diagnosis of HCM. In the overall study group, compared with CMR, echocardiography also underestimated the magnitude of hypertrophy in the basal anterolateral free wall (by 20+/-6%; P=0.001), as well as the presence of extreme LV wall thickness (> or =30 mm) in 10% of patients (P<0.05). CONCLUSIONS CMR is capable of identifying regions of LV hypertrophy not readily recognized by echocardiography and was solely responsible for diagnosis of the HCM phenotype in an important minority of patients. CMR enhances the assessment of LV hypertrophy, particularly in the anterolateral LV free wall, and represents a powerful supplemental imaging test with distinct diagnostic advantages for selected HCM patients.
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Affiliation(s)
- Carsten Rickers
- Department of Radiology, Fairview-University Medical Center, Minneapolis, MN, USA
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18
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Tops LF, Roest AAW, Lamb HJ, Vliegen HW, Helbing WA, van der Wall EE, de Roos A. Intraatrial Repair of Transposition of the Great Arteries: Use of MR Imaging after Exercise to Evaluate Regional Systemic Right Ventricular Function. Radiology 2005; 237:861-7. [PMID: 16251393 DOI: 10.1148/radiol.2373041347] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively assess regional systemic right ventricular (RV) function at rest and in response to exercise by using magnetic resonance (MR) imaging in patients who have undergone surgical correction at the atrial level for transposition of the great arteries (TGA). MATERIALS AND METHODS Informed consent was obtained, and the medical review board approved this study. In 25 adult patients (mean age, 25.8 years +/- 4.7 [standard deviation]; 13 men) who had undergone correction for TGA (23.4 years +/- 4.9 after surgery) and 11 healthy volunteers (mean age, 27.4 years +/- 2.7; six men), systemic ventricular function was assessed with MR imaging (turbo field echo-planar imaging) at rest and during supine bicycle exercise. Regional wall thickness and wall thickening of the systemic RV were assessed and compared with those of the left ventricle in healthy volunteers by two investigators working together. Regional wall parameters were calculated by using the three-dimensional centerline method. Independent-samples t test and paired-samples t test were used for statistical analysis. RESULTS Ejection fraction of the systemic RV did not increase after exercise (56% +/- 8 at rest to 55% +/- 7 after exercise, P = .196). Mean RV wall thickening was impaired in patients with TGA at all levels both at rest and in response to exercise (P < .05). Moreover, the free wall and the anterior wall of the systemic RV had a smaller end-systolic thickness and a diminished thickening at rest and after exercise compared with findings in the normal left ventricle (P < .05). CONCLUSION The systemic RV of patients after intraatrial correction for TGA reveals regional functional disturbances at rest and in response to exercise.
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Affiliation(s)
- Laurens F Tops
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, C2-S, 2333 ZA Leiden, The Netherlands
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19
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De Souza AP, Cohen AW, Park DS, Woodman SE, Tang B, Gutstein DE, Factor SM, Tanowitz HB, Lisanti MP, Jelicks LA. MR imaging of caveolin gene-specific alterations in right ventricular wall thickness. Magn Reson Imaging 2005; 23:61-8. [PMID: 15733789 DOI: 10.1016/j.mri.2004.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Accepted: 11/05/2004] [Indexed: 11/24/2022]
Abstract
Caveolin-1 and caveolin-3 are expressed in the mammalian heart. Mice deficient in caveolin 1 or 3 exhibit cardiac abnormalities including left ventricular hypertrophy and reduced fractional shortening. Cardiac imaging technologies such as transthoracic echocardiography and cardiac-gated magnetic resonance imaging (MRI) are effective tools for the study of left ventricular morphology and function in mice; however, there has not been widespread use of these technologies in studies of right ventricular morphology. In particular, right ventricular wall thickness has been difficult to assess using cardiac imaging technologies. We report here the use of centerline analysis of cardiac-gated MR images to more accurately determine right ventricular wall thickness in the mouse heart. Right ventricular wall thickness was evaluated in Cav-1 null, Cav-3 null and Cav-1/3 null mice, as well as wild-type control mice. Using this technique, we find that caveolin null mice exhibit significant thickening of the right ventricular wall as compared with age-matched wild-type controls. Interestingly, right ventricular wall thickening is greatest in the Cav-1/3 null mice. Furthermore, significant right ventricular wall thickening is also seen in the Cav-1 null mice. Histological analyses revealed right ventricular hypertrophy consistent with the imaging results. These studies demonstrate the utility of MRI in determining right ventricular wall thickness and underscore the severity of the right ventricular hypertrophy in caveolin null mice.
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Affiliation(s)
- Andrea Pereira De Souza
- Department of Physiology and Biophysics, Albert Einstein College of Medicine and Montefiore Medical Center. Bronx, NY 10461, USA
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20
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Swingen C, Seethamraju RT, Jerosch-Herold M. An approach to the three-dimensional display of left ventricular function and viability using MRI. Int J Cardiovasc Imaging 2004; 19:325-36. [PMID: 14598902 DOI: 10.1023/a:1025450211508] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cardiac MRI was performed in human volunteers to determine the magnitude of the misregistration (MSR) of cardiac landmarks due to variability in the diaphragm position for repeated breath-holds. Seven normal volunteers underwent MR imaging of the left ventricle (LV) to evaluate the magnitude of the endocardial centroid MSR. The MSR for a mid-ventricle short-axis image was 3.01 +/- 1.68 mm through-plane and 4.16 +/- 1.62 mm in-plane. A second order polynomial fit through the LV centroid coordinates minimized the in-plane component of the MSR error. Short-axis cine images, corrected for MSR, provided high-resolution 2D data from which an accurate anatomical model of the LV was generated. Anatomical landmarks were used to register parametric maps of myocardial perfusion and viability to the three-dimensional (3D) model, with the corresponding parameters displayed as color-encoded values on the endo- and epicardial surfaces of the LV. Registration of regional wall motion, perfusion and viability to the 3D model was performed for three patients with a history of cardiovascular disease. The proposed 3D reconstruction technique allows visualization in 3D of the LV anatomy, in combination with parametric mapping of its functional status.
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Affiliation(s)
- Cory Swingen
- Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
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21
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Swingen CM, Seethamraju RT, Jerosch-Herold M. Feedback-assisted three-dimensional reconstruction of the left ventricle with MRI. J Magn Reson Imaging 2003; 17:528-37. [PMID: 12720262 DOI: 10.1002/jmri.10290] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To develop and test a new technique for rapid, accurate three-dimensional (3D) reconstruction of the left ventricle (LV) and calculation of its volume parameters, with images from multiple orientations and interactive feedback. MATERIALS AND METHODS The ventricular surface was fit to a number of user-placed guide points in magnetic resonance (MR) images using bivariate smoothing splines. A 3D model was reconstructed and the LV volumes were calculated at both end diastole (ED) and end systole (ES). This technique was validated using a phantom, and applied to studies of 18 patients and four volunteers (N = 22) imaged on a 1.5-T clinical scanner. The results of the 3D method were compared to the standard 2D short-axis slice summation technique, which is widely used for the analysis of cardiac function. RESULTS There was excellent agreement between the computed volume of the phantom using the 3D modeling method and the actual volume (190.50 mL +/- 3.06 mL, and 191.0 mL +/- 2.5 mL, respectively). There was good correlation between the volumes calculated with our 3D model and the slice summation technique (ED volume (EDV) difference, 6.36% +/- 8.99% [mean +/- SD]; ES volume (ESV), 0.92% +/- 14.75%; stroke volume (SV), 10.54% +/- 13.95%; ejection fraction (EF), 4.22% +/- 9.16%). The 3D method was found to be more accurate than the slice summation technique for calculating LV volumes and mass from images of different slice orientations. Variations in the parameters between the two separate orientations using the 3D model vs. the slice summation method were as follows: EDV: 2.11% +/- 1.52% vs. 10.36% +/- 9.33%; ES volume: 2.76% +/- 1.64% vs. 6.39% +/- 3.62%; SV, 3.02% +/- 4.38% vs. 18.84% +/- 15.30%; EF, 2.03% +/- 2.16% vs. 8.58% +/- 6.73%; and LV mass: 4.77% +/- 2.41% vs. 24.59% +/- 6.41%. Differences in the ES volume due to the inclusion or exclusion of the most basal slice were found to be lower with the 3D model (6.90% +/- 3.83%) compared to the slice summation method (25.04% +/- 6.15%). CONCLUSION 3D models can be used to accurately determine ventricular volume parameters. Results can be obtained using images from a variety of orientations, providing greater flexibility during image acquisition and possibly reducing the number of images needed for analysis. Feedback is provided to assist the analysis by providing a continuous update of the LV shape and volume. This feature allows the user to determine LV parameters to a predefined accuracy or to terminate the analysis when the parameters are not changing. This method is not restricted to multislice cine imaging in a single or prescribed slice orientation, and can be used for quick, accurate, and interactive analysis of cardiac function.
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Affiliation(s)
- Cory M Swingen
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Verduyn SC, Ramakers C, Snoep G, Leunissen JD, Wellens HJ, Vos MA. Time course of structural adaptations in chronic AV block dogs: evidence for differential ventricular remodeling. Am J Physiol Heart Circ Physiol 2001; 280:H2882-90. [PMID: 11356649 DOI: 10.1152/ajpheart.2001.280.6.h2882] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To determine the nature and time course of biventricular hypertrophy and concomitant electrical and mechanical changes after creation of complete atrioventricular block (CAVB), six adult dogs (22–30 kg) were subjected to serial magnetic resonance imaging (MRI) and electrocardiography. After 6 days of CAVB, left ventricular (LV) mass, ejection fraction (EF), and Q-T time at a paced rhythm of 60 beats/min were already significantly increased. Maximal values were reached within 14–21 days of CAVB: LV mass, from 116 ± 11 to 143 ± 12 g; right ventricular (RV) mass, from 40 ± 3 to 55 ± 6 g; EF, from 68 ± 6% to 86 ± 5%; and Q-T time, from 285 ± 25 to 330 ± 35 ms, all P < 0.05. Cardiac output returned to baseline at day 14. End-diastolic wall thickness increased only in the RV, in which angiotensin type 1 (AT1) receptor mRNA expression was significantly greater. The autopsy correlated well with the MRI results ( r = 0.98, P≤ 0.01). In conclusion, electrophysiological, mechanical, and structural adaptation processes after bradycardia-induced volume overload develop rapidly and are completed within 3 wk. The degree of hypertrophy was greater in the RV, which was associated with an increase in AT1receptor mRNA.
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MESH Headings
- Animals
- Body Weight
- Cardiac Output
- Chronic Disease
- Disease Models, Animal
- Disease Progression
- Dogs
- Electrocardiography
- Female
- Heart Block/complications
- Heart Block/pathology
- Heart Block/physiopathology
- Heart Ventricles/metabolism
- Heart Ventricles/pathology
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/diagnosis
- Hypertrophy, Right Ventricular/etiology
- Hypertrophy, Right Ventricular/physiopathology
- Magnetic Resonance Imaging
- Male
- Myocardium/metabolism
- Myocardium/pathology
- Organ Size
- RNA, Messenger/metabolism
- Receptor, Angiotensin, Type 1
- Receptor, Angiotensin, Type 2
- Receptors, Angiotensin/genetics
- Receptors, Angiotensin/metabolism
- Reproducibility of Results
- Stroke Volume
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Remodeling
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Affiliation(s)
- S C Verduyn
- Department of Cardiology, Academic Hospital Maastricht, Cardiovascular Research Institute Maastricht, 6202 AZ Maastricht, The Netherlands
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van der Geest RJ, Lelieveldt BP, Reiber JH. Quantification of global and regional ventricular function in cardiac magnetic resonance imaging. Top Magn Reson Imaging 2000; 11:348-58. [PMID: 11153702 DOI: 10.1097/00002142-200012000-00004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
One of the strong assets of cardiac magnetic resonance (CMR) is its ability to assess myocardial anatomy, structure, function, flow, and perfusion within a single examination. Quantification of global and regional function from magnetic resonance imaging (MRI) studies was shown to be accurate and reproducible in experimental and clinical research studies. With the advent of high-performance MRI scanners and newly developed pulse sequences, image acquisition times have been reduced considerably in recent years. However, the clinical use of CMR remains limited for various reasons. Among these limitations is that the amount of images obtained in a typical cardiac examination is so large that visual and especially quantitative image analysis is tedious and time consuming. There is an urgent need for optimized dedicated software tools featuring highly automated contour detection and optimized display capabilities to present the quantitative results to the physician in an orderly fashion, thus facilitating clinical decision making. This article focuses on the state of the art in CMR postprocessing techniques for quantitative assessment of global and regional function.
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Affiliation(s)
- R J van der Geest
- Department of Radiology, Leiden University Medical Center, The Netherlands
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24
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Niezen RA, Helbing WA, van Der Wall EE, van Der Geest RJ, Vliegen HW, de Roos A. Left ventricular function in adults with mild pulmonary insufficiency late after Fallot repair. Heart 1999; 82:697-703. [PMID: 10573497 PMCID: PMC1729208 DOI: 10.1136/hrt.82.6.697] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess left ventricular function in adult Fallot patients with residual pulmonary regurgitation. SETTING The radiology department of a tertiary referral centre. PATIENTS 14 patients with chronic pulmonary regurgitation and right ventricular volume overload after repair of tetralogy of Fallot and 10 healthy subjects were studied using magnetic resonance imaging. MAIN OUTCOME MEASURES Biventricular volumes, global biventricular function, and regional left ventricular function were assessed in all subjects. RESULTS The amount of pulmonary regurgitation in patients (mean (SD)) was 25 (18)% of forward flow and correlated significantly with right ventricular enlargement (p < 0.05). Left ventricular end diastolic volume was decreased in patients (78 (11) v 88 (10) ml/m(2); p < 0.05), ejection fraction was not significantly altered (59 (5)% v 55 (7)%; NS). No significant correlation was found between pulmonary regurgitation and left ventricular function. Overall left ventricular end diastolic wall thickness was significantly lower in patients (5.06 (0.72) v 6.06 (1.06) mm; p < 0. 05), predominantly in the free wall. At the apical level, left ventricular systolic wall thickening was 20% higher in Fallot patients (p < 0.05). Left ventricular shape was normal. CONCLUSIONS Adult Fallot patients with mild chronic pulmonary regurgitation and subsequent right ventricular enlargement showed a normal left ventricular shape and global function. Although the left ventricular free wall had reduced wall thickness, compensatory hypercontractility of the apex may contribute to preserved global function.
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Affiliation(s)
- R A Niezen
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 AA Leiden, Netherlands
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25
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Ichida F, Hashimoto I, Tsubata S, Hamamichi Y, Uese K, Murakami A, Futatsuya R, Miyawaki T. A novel technique using biplane cine magnetic resonance imaging to evaluate left ventricular volume in children. INTERNATIONAL JOURNAL OF CARDIAC IMAGING 1999; 15:465-71. [PMID: 10768741 DOI: 10.1023/a:1006352217295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of the study is to determine the feasibility of a novel simplified technique using cine magnetic resonance imaging (MRI) to assess left ventricular (LV) volume and ejection fraction (EF) validated by comparison with biplane LV angiography. Previous MRI studies to assess LV volumes have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, we developed a simplified imaging approach using biplane cine MRI and imaging planes aligned with the intrinsic cardiac axes of the LV. We studied 20 children (aged 4 months to 10 years) with various heart diseases. The accuracy of cine MRI was compared with that of LV angiography in all patients. LV volumes were calculated using Simpson's rule algorithm, for both MRI and LV angiography. LV volumes determined from MRI were slightly underestimated but correlated reasonably well with angiographic volumes (LVEDV: Y = 0.88X + 1.58, r = 0.99, LVESV: Y = 0.73X + 1.03, r = 0.98). Most importantly, even in patients who had abnormal ventricular curvature such as in tetralogy of Fallot, MRI determined LV volumes correlated well with angiographic values. The MR study was completed within 35 min in all patients. In conclusion, simplified biplane cine MRI, using the intrinsic LV axis planes, permits noninvasive assessment of LV volumes in views comparable to standard angiographic projections and appears practical for clinical use in childhood heart disease since the scan and analysis times are relatively short.
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Affiliation(s)
- F Ichida
- Department of Pediatrics, Toyama Medical & Pharmaceutical University, Sugitani, Japan
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Abstract
Magnetic resonance imaging (MRI) offers several acquisition techniques for precise and highly reproducible assessment of global and regional ventricular function, flow, and perfusion at rest and under pharmacological or physical stress conditions. Recent advances in hardware and software have resulted in strong improvement of image quality and in a significant decrease in the required imaging time for each of these acquisitions. Several aspects of heart disease can be studied by combining multiple MRI techniques in a single examination. Such a comprehensive examination could replace a number of other imaging procedures, such as diagnostic X-ray angiography, echocardiography, and scintigraphy, which would be beneficial for the patient and cost effective. Despite the advances in MRI, quantitative image analysis often still relies on manual tracing of contours in the images, which is a time-consuming and tedious procedure that limits the clinical applicability of cardiovascular MRI. Reliable automated or semi-automated image analysis software would be very helpful to overcome the limitations associated with manual image processing. In this paper the developments directed toward automated quantitative image analysis and semi-automated contour detection for cardiovascular MR imaging are reviewed. J. Magn. Reson. Imaging 1999; 10:602-608.
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Affiliation(s)
- R J van der Geest
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, RC Leiden, The Netherlands
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27
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van der Wall EE, Bax J. Current clinical relevance of cardiovascular magnetic resonance and its relationship to nuclear cardiology. J Nucl Cardiol 1999; 6:462-9. [PMID: 10461614 DOI: 10.1016/s1071-3581(99)90013-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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