Segment-by-segment assessment of left ventricular myocardial affection in Anderson-Fabry disease by non-enhanced T1-mapping

Anthropogenic impact on ecosystem service value of urban blue space in Old Malda Municipality of eastern India

Present study attempted to quantify the anthropogenic impact on blue space (BS) and potential ecosystem service value (ESV) and link them. A small urban area of eastern India was taken as a case. To fulfill the purpose, the primary data extracted from the field was used. Firstly, an anthropogenic impact score (AIS) comprising eight components was calculated using rank compositing. ESV was estimated with the help of the Rapid Assessment of Wetland Ecosystem Services (RAWES) approach of the Ramsar convention. Rank correlation was carried out for linking AIS and ESV. Results show that 70% of BS is characterized by moderate to high levels of anthropo-driven impacts. Landscape, habitat, and pollution were detected as prime vectors behind these impacts. The impacts were higher in the core urban area. Contrarily, the potential ESV was found to be higher in the peripheral BS units. Most of the blue space failed to offer remarkable provisions and cultural services. However, the regulating services were recorded to have better status. The study clearly reported a negative association between AIS and ESV in BS. Conversion of BS, habitat alteration, pollution, and lack of restoration were found to have very prominent negative effects on ESV. Minimizing such anthropogenic impacts could improve the ESV credibility of urban blue spaces.

Rare Metabolic and Endocrine Diseases with Cardiovascular Involvement: Insights from Cardiovascular Magnetic Resonance - A Review

The identification of rare diseases with cardiovascular involvement poses significant diagnostic challenges due to the rarity of the diseases, but also due to the lack of knowledge and expertise. Most of them remain underrecognized and undiagnosed, leading to clinical mismanagement and affecting the patients' prognosis, as these diseases are per definition life-threatening or chronic debilitating. This article reviews the cardiovascular involvement of the most well-known rare metabolic and endocrine diseases and their diagnostic approach through the lens of cardiovascular magnetic resonance (CMR) imaging and its prognostic role, highlighting its fundamental value compared to other imaging modalities.

Cardiovascular magnetic resonance native T1 mapping in Anderson-Fabry disease: a systematic review and meta-analysis

BACKGROUND

T1 mapping is an established cardiovascular magnetic resonance (CMR) technique that can characterize myocardial tissue. We aimed to determine the weighted mean native T1 values of Anderson-Fabry disease (AFD) patients and the standardized mean differences (SMD) as compared to healthy control subjects.

METHODS

A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement to retrieve original studies reporting myocardial native T1 values in AFD patients and healthy controls. A random effects model was used to calculate SMD, and meta-regression analysis was conducted to explore heterogeneity sources. Subgroup analysis was also performed according to scanner field strength and sequence type.

RESULTS

From a total of 151 items, 14 articles were included in the final analysis accounting for a total population of 982 subjects. Overall, the weighted mean native T1 values was 984 ± 47 ms in AFD patients and 1016 ± 26 ms in controls (P < 0.0001) with a pooled SMD of - 2.38. In AFD patients there was an inverse correlation between native T1 values and male gender (P = 0.002) and left ventricular hypertrophy (LVH) (P < 0.001). Subgroup analyses confirmed lower T1 values in AFD patients compared to controls with a pooled SMD of -  2.54,  -  2.28, -   2.46 for studies performed on 1.5T with modified Look-Locker inversion recovery (MOLLI), shortened MOLLI and saturation-recovery single-shot acquisition, respectively and of -  2.41 for studies conducted on 3T.

CONCLUSIONS

Our findings confirm a reduction of native T1 values in AFD patients compared to healthy controls and point out that the degree of T1 shortening in AFD is influenced by gender and LVH. Although T1 mapping is useful in proving cardiac involvement in AFD patients, there is need to standardize shreshold values according to imaging equipment and protocols.

The history of magnetic resonance imaging and its reflections in Acta Radiologica

The first reports in Acta Radiologica on magnetic resonance imaging (MRI) were published in 1984, four years after the first commercial MR scanners became available. For the first two years, all MR papers originated from the USA. Nordic contributions started in 1986, and until 2020, authors from 44 different countries have published MR papers in Acta Radiologica. Papers on MRI have constituted, on average, 30%-40% of all published original articles in Acta Radiologica, with a high of 49% in 2019. The MR papers published since 1984 document tremendous progress in several areas such as magnet and coil design, motion compensation techniques, faster image acquisitions, new image contrast, contrast-enhanced MRI, functional MRI, and image analysis. In this historical review, all of these aspects of MRI are discussed and related to Acta Radiologica papers.

Myocardial T1 Values at 1.5 T: Normal Values for General Electric Scanners and Sex-Related Differences

BACKGROUND

No data are available about normal ranges for native T1 in human myocardium using General Electric (GE) scanners.

PURPOSE

To establish normal ranges for myocardial T1 values and evaluate regional variability and the influence of physiological factors.

STUDY TYPE

Prospective.

SUBJECTS

One hundred healthy volunteers with normal electrocardiogram, no cardiovascular/systemic diseases, or risk factors (age range: 20-70 years; 50 females).

FIELD STRENGTH/SEQUENCE

1.5 T/Steady-state free precession cine and a modified Look-Locker inversion recovery sequence in diastole (also in systole for 61 volunteers).

ASSESSMENT

Image analysis was performed by operators with >10 years experience in cardiac MR using commercially available software. T1 values were calculated for 16 myocardial segments, and the global value was the mean. Segments were grouped according to circumferential region (anterior, septal, inferior, and lateral) and to level (basal, medial, apical). Twenty images were analyzed twice by the same operator and by a different operator to assess reproducibility.

STATISTICAL TESTS

Independent-samples t-test or Mann-Whitney test; paired sample t-test or Wilcoxon signed-rank test; one-way repeated measures ANOVA or Friedman tests; Pearson's or Spearman's correlation. Reproducibility evaluated using coefficient of variability (CoV).

RESULTS

Due to artifacts and/or partial-volume effects, 45/1600 (2.8%) segments were excluded. A good intra- and inter-operator reproducibility was detected (CoV < 5%). There were significant differences in segmental T1 values (P < 0.05). A significant circumferential variability was present (P < 0.05): the mean native T1 value over the lateral region was significantly lower than in the other three regions. An increasing gradient from basal to apical slices was detected (P < 0.05). Segmental and global T1 values were not associated with age (range P = 0.052-0.911) but were significantly lower in males than in females (global: 993 ± 32 vs. 1037 ± 27 ms; P < 0.05) and significantly correlated with heart rate (range R for segmental values = 0.247-0.920; P < 0.05). Almost all segmental T1 values were inversely correlated with wall thickness (R from -0.233 to -0.514; P < 0.05). Systolic T1 values were significantly lower than diastolic values in basal anteroseptal segment, in all medial segments except the inferior one, and in all apical segments (P < 0.05).

DATA CONCLUSION

Myocardial T1 values differ among myocardial regions, are influenced by sex, heart rate, and wall thickness and vary according to the cardiac cycle in healthy adults.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY: Stage 2.

Multimodality Imaging Assessment of Fabry Disease

Fabry disease is a lysosomal storage disease with a variety of cardiac manifestations. Although not specific for a diagnosis of Fabry disease, certain cardiac imaging findings may be highly suggestive of the diagnosis of Fabry disease in previously undiagnosed patients or cardiac involvement for patients with a known diagnosis of Fabry disease. In this review, we explore the current applications of multimodality cardiac imaging in the diagnosis and monitoring of patients with Fabry disease. Additionally, data regarding tissue characterization by cardiac magnetic resonance imaging and novel nuclear imaging techniques and their role in evaluating phenotype development is discussed.

Normal myocardial native T1 values in children using single-point saturation recovery and modified look-locker inversion recovery (MOLLI)

BACKGROUND

T₁ mapping is useful to quantify diffuse myocardial processes such as fibrosis, edema, storage disorders, or hemochromatosis. Normal pediatric myocardial T₁ values are scarce using modified Look-Locker inversion recovery (MOLLI) sequences and unavailable using Smart1Map, a single-point saturation recovery sequence that measures true T₁ .

PURPOSE/HYPOTHESIS

To establish normal pediatric myocardial T₁ values by Smart1Map and to compare them with T₁ by MOLLI.

STUDY TYPE

Prospective cohort study.

SUBJECTS

Thirty-four children and adolescents aged 8-18 years (14 males) without cardiovascular or inflammatory diseases.

FIELD STRENGTH/SEQUENCES

1.5T, MOLLI, Smart1Map.

ASSESSMENT

Mean T₁ values of the left ventricular myocardium, the interventricular septum, and the blood pool were measured with MOLLI and Smart1Map in basal, mid-ventricular, and apical short axis slices.

STATISTICAL TESTS

T₁ values were compared between locations and methods by paired samples t-tests, Wilcoxon signed ranks test, repeated-measures analysis of variance (ANOVA), or Friedman's test. Pearson's correlation coefficient was calculated. For interobserver variability, intraclass correlation coefficients and coefficients of variation were calculated, and Bland-Altman analyses were performed.

RESULTS

T₁ values were longer by Smart1Map than by MOLLI in all measured locations (myocardium: 1191-1221 vs. 990-1042 msec; all P < 0.001). T₁ in basal vs. mid-ventricular slices differed both by MOLLI and by Smart1Map for myocardium and for blood (all P < 0.001). Myocardial T₁ did not correlate with age, heart rate, right or left ventricular ejection fraction (all P > 0.05) by either method. Septal vs. total myocardial T₁ values in each slice did not differ by MOLLI (basal P = 0.371; mid-ventricular P = 0.08; apical P = 0.378) nor by Smart1Map (basal P = 0.056; mid-ventricular P = 0.918; apical P = 0. 392), after artifacts had been carefully excluded.

DATA CONCLUSION

We established pediatric normal native T₁ values using the Smart1Map sequence and compared the results with T₁ mapping with MOLLI. Septal T₁ values did not differ from total myocardial T₁ values in each of the myocardial slices.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:897-903.

Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications

Non-invasive identification and differentiation of myocardial diseases represents the primary objectives of cardiac magnetic resonance (CMR) longitudinal relaxation time (T1) and extracellular volume (ECV) mapping. Given the fact that myocardial T1 and ECV values overlap throughout and within left ventricular phenotypes, a central issue to be addressed is whether and to what extent myocardial T1 and ECV mapping provides additional or superior diagnostic information to standard CMR imaging, and whether native T1 mapping could be employed as a non-contrast alternative to late gadolinium enhancement (LE) imaging. The present review aims to summarize physiological and pathophysiological alterations in native T1 and ECV values and summarized myocardial T1 and ECV alterations associated with cardiac diseases to support the translation of research findings into routine CMR imaging.

Storage diseases with hypertrophic cardiomyopathy phenotype

Never judge a book by its cover, nor assume hypertrophic cardiomyopathy (HCM) as sarcomeric, as appearances can deceive. HCM phenocopies account for a 5–10% of the cases, mainly represented by storage diseases, flagged by the increasing prevalence of senile cardiac amyloid in developing countries. Multisystemic and heterogeneous presentation of these entities is a challenge for clinicians, and time delay in diagnosis is a major concern. Promising drugs and gene-specific tailored therapies are under development, therefore, more than ever, appropriate understanding of these conditions is mandatory for adequate early treatment and counselling.

In this review, storage disorders will be classified as extracellular and intracellular deposit storage diseases, focusing our attention on the most prevalent conditions from the cardiologist’s perspective.