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Salatzki J, Giannitsis E, Hegenbarth A, Mueller-Hennessen M, André F, Frey N, Biener M. Absence of visible infarction on cardiac magnetic resonance imaging despite the established diagnosis of myocardial infarction by 4th Universal Definition of Myocardial Infarction. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2024; 13:24-35. [PMID: 37875124 DOI: 10.1093/ehjacc/zuad128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/12/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
AIMS Myocardial scarring due to acute myocardial infarction (AMI) can be visualized by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging. However, a recent study revealed a group of Type 1 AMI patients with undetectable myocardial injury on LGE. This study aims to describe these cases in detail and explore possible explanations for this new phenomenon. METHODS AND RESULTS A total of 137 patients diagnosed with either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (non-STEMI) diagnosed according to the 4th Universal Definition of Myocardial Infarction underwent LGE-CMR after invasive coronary angiography. Fourteen of them (10.2%) showed no LGE and were included in the final study population. Most patients presented with acute chest pain, 3 patients were diagnosed as STEMI, and 11 as non-STEMI. Peak high-sensitive cardiac troponin T ranged from 45 to 1173 ng/L. A culprit lesion was identified in 12 patients. Severe coronary stenoses were found in five patients, while seven patients had subtotal to total coronary artery occlusion. Percutaneous coronary intervention was performed in 10 patients, while 2 patients required coronary artery bypass grafting and no intervention was required in 2 patients. Cardiac magnetic resonance was performed 30 (4-140) days after the initial presentation. Most patients showed preserved left ventricular ejection fraction on CMR. No alternative reasons for the rise/fall of high-sensitive cardiac troponin T were found. CONCLUSION The absence of LGE on CMR in patients with Type 1 AMI is a new finding. While insufficient spatial resolution of LGE imaging, delayed CMR performance, spontaneous reperfusion, and coronary collaterals may provide some explanations, further investigations are required to fully understand this phenomenon.
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Affiliation(s)
- Janek Salatzki
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Evangelos Giannitsis
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Anastasia Hegenbarth
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Matthias Mueller-Hennessen
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Florian André
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Moritz Biener
- Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Alkhalil M, De Maria GL, Akbar N, Ruparelia N, Choudhury RP. Prospects for Precision Medicine in Acute Myocardial Infarction: Patient-Level Insights into Myocardial Injury and Repair. J Clin Med 2023; 12:4668. [PMID: 37510783 PMCID: PMC10380764 DOI: 10.3390/jcm12144668] [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: 06/07/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
The past decade has seen a marked expansion in the understanding of the pathobiology of acute myocardial infarction and the systemic inflammatory response that it elicits. At the same time, a portfolio of tools has emerged to characterise some of these processes in vivo. However, in clinical practice, key decision making still largely relies on assessment built around the timing of the onset of chest pain, features on electrocardiograms and measurements of plasma troponin. Better understanding the heterogeneity of myocardial injury and patient-level responses should provide new opportunities for diagnostic stratification to enable the delivery of more rational therapies. Characterisation of the myocardium using emerging imaging techniques such as the T1, T2 and T2* mapping techniques can provide enhanced assessments of myocardial statuses. Physiological measures, which include microcirculatory resistance and coronary flow reserve, have been shown to predict outcomes in AMI and can be used to inform treatment selection. Functionally informative blood biomarkers, including cellular transcriptomics; microRNAs; extracellular vesicle analyses and soluble markers, all give insights into the nature and timing of the innate immune response and its regulation in acute MI. The integration of these and other emerging tools will be key to developing a fuller understanding of the patient-level processes of myocardial injury and repair and should fuel new possibilities for rational therapeutic intervention.
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Affiliation(s)
- Mohammad Alkhalil
- Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | | | - Naveed Akbar
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Neil Ruparelia
- Cardiology Department, Hammersmith Hospital, Imperial College London, London W12 0HS, UK
| | - Robin P Choudhury
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
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3
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Valente FX, Gavara J, Gutierrez L, Rios-Navarro C, Rello P, Maymi M, Fernandez-Galera R, Monmeneu JV, Sao-Aviles A, Lopez-Lereu MP, Gonzalez-Alujas MT, Moratal D, Cuellar H, Barrabés J, Otaegui I, Evangelista A, Ferreira I, Bodi V, Rodriguez-Palomares J. Predictive Value of Cardiac Magnetic Resonance Feature Tracking after Acute Myocardial Infarction: A Comparison with Dobutamine Stress Echocardiography. J Clin Med 2021; 10:jcm10225261. [PMID: 34830543 PMCID: PMC8624532 DOI: 10.3390/jcm10225261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
In acute ST-segment elevation myocardial infarction (STEMI) late gadolinium enhancement (LGE) may underestimate segmental functional recovery. We evaluated the predictive value of cardiac magnetic resonance (CMR) feature-tracking (FT) for functional recovery and whether it incremented the value of LGE compared to low-dose dobutamine stress echocardiography (LDDSE) and speckle-tracking echocardiography (STE). Eighty patients underwent LDDSE and CMR within 5–7 days after STEMI and segmental functional recovery was defined as improvement in wall-motion at 6-months CMR. Optimal conventional and FT parameters were analyzed and then also applied to an external validation cohort of 222 STEMI patients. Circumferential strain (CS) was the strongest CMR-FT predictor and addition to LGE increased the overall accuracy to 74% and was especially relevant in segments with 50–74% LGE (AUC 0.60 vs. 0.75, p = 0.001). LDDSE increased the overall accuracy to 71%, and in the 50–74% LGE subgroup improved the AUC from 0.60 to 0.69 (p = 0.039). LGE + CS showed similar value as LGE + LDDSE. In the validation cohort, CS was also the strongest CMR-FT predictor of recovery and addition of CS to LGE improved overall accuracy to 73% although this difference was not significant (AUC 0.69, p = 0.44). Conclusion: CS is the strongest CMR-FT predictor of segmental functional recovery after STEMI. Its incremental value to LGE is comparable to that of LDDSE whilst avoiding an inotropic stress agent. CS is especially relevant in segments with 50–74% LGE where accuracy is lower and further testing is frequently required to clarify the potential for recovery.
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Affiliation(s)
- Filipa X. Valente
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
- Correspondence:
| | - José Gavara
- Centro de Biomateriales y Ingeniería de Tejidos, Universitat Politècnica de Valencia, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Laura Gutierrez
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Cesar Rios-Navarro
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (C.R.-N.); (V.B.)
| | - Pau Rello
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Manel Maymi
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Ruben Fernandez-Galera
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - José V. Monmeneu
- Unidad de Resonancia Magnética Cardiovascular, Exploraciones Radiológicas Especiales (ERESA), 46015 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - Augusto Sao-Aviles
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Maria P. Lopez-Lereu
- Unidad de Resonancia Magnética Cardiovascular, Exploraciones Radiológicas Especiales (ERESA), 46015 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - M. Teresa Gonzalez-Alujas
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - David Moratal
- Centro de Biomateriales y Ingeniería de Tejidos, Universitat Politècnica de Valencia, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Hug Cuellar
- Radiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;
| | - José Barrabés
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Imanol Otaegui
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Artur Evangelista
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Ignacio Ferreira
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
| | - Vicente Bodi
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (C.R.-N.); (V.B.)
- Cardiology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
- Centrode Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28029 Madrid, Spain
- Medicine Department, Facultad de Medicina y Odontología, Universidad de Valencia, 46010 Valencia, Spain
| | - José Rodriguez-Palomares
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.); (P.R.); (M.M.); (R.F.-G.); (A.S.-A.); (M.T.G.-A.); (J.B.); (I.O.); (A.E.); (I.F.); (J.R.-P.)
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Rodríguez-Palomares JF. Why do we need metabolic information in cardiovascular diseases? REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:290-292. [PMID: 33478914 DOI: 10.1016/j.rec.2020.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 06/12/2023]
Affiliation(s)
- José F Rodríguez-Palomares
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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5
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Rodríguez-Palomares JF. ¿Por qué necesitamos la información metabólica en las enfermedades cardiovasculares? Rev Esp Cardiol (Engl Ed) 2021. [DOI: 10.1016/j.recesp.2020.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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6
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Effect of COMBinAtion therapy with remote ischemic conditioning and exenatide on the Myocardial Infarct size: a two-by-two factorial randomized trial (COMBAT-MI). Basic Res Cardiol 2021; 116:4. [PMID: 33495853 DOI: 10.1007/s00395-021-00842-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
Remote ischemic conditioning (RIC) and the GLP-1 analog exenatide activate different cardioprotective pathways and may have additive effects on infarct size (IS). Here, we aimed to assess the efficacy of RIC as compared with sham procedure, and of exenatide, as compared with placebo, and the interaction between both, to reduce IS in humans. We designed a two-by-two factorial, randomized controlled, blinded, multicenter, clinical trial. Patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention (PPCI) within 6 h of symptoms were randomized to RIC or sham procedure and exenatide or matching placebo. The primary outcome was IS measured by late gadolinium enhancement in cardiac magnetic resonance performed 3-7 days after PPCI. The secondary outcomes were myocardial salvage index, transmurality index, left ventricular ejection fraction and relative microvascular obstruction volume. A total of 378 patients were randomly allocated, and after applying exclusion criteria, 222 patients were available for analysis. There were no significant interactions between the two randomization factors on the primary or secondary outcomes. IS was similar between groups for the RIC (24 ± 11.8% in the RIC group vs 23.7 ± 10.9% in the sham group, P = 0.827) and the exenatide hypotheses (25.1 ± 11.5% in the exenatide group vs 22.5 ± 10.9% in the placebo group, P = 0.092). There were no effects with either RIC or exenatide on the secondary outcomes. Unexpected adverse events or side effects of RIC and exenatide were not observed. In conclusion, neither RIC nor exenatide, or its combination, were able to reduce IS in STEMI patients when administered as an adjunct to PPCI.
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Demirkiran A, Everaars H, Amier RP, Beijnink C, Bom MJ, Götte MJW, van Loon RB, Selder JL, van Rossum AC, Nijveldt R. Cardiovascular magnetic resonance techniques for tissue characterization after acute myocardial injury. Eur Heart J Cardiovasc Imaging 2020; 20:723-734. [PMID: 31131401 DOI: 10.1093/ehjci/jez094] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/19/2019] [Accepted: 04/26/2019] [Indexed: 12/22/2022] Open
Abstract
The annual incidence of hospital admission for acute myocardial infarction lies between 90 and 312 per 100 000 inhabitants in Europe. Despite advances in patient care 1 year mortality after ST-segment elevation myocardial infarction (STEMI) remains around 10%. Cardiovascular magnetic resonance imaging (CMR) has emerged as a robust imaging modality for assessing patients after acute myocardial injury. In addition to accurate assessment of left ventricular ejection fraction and volumes, CMR offers the unique ability of visualization of myocardial injury through a variety of imaging techniques such as late gadolinium enhancement and T2-weighted imaging. Furthermore, new parametric mapping techniques allow accurate quantification of myocardial injury and are currently being exploited in large trials aiming to augment risk management and treatment of STEMI patients. Of interest, CMR enables the detection of microvascular injury (MVI) which occurs in approximately 40% of STEMI patients and is a major independent predictor of mortality and heart failure. In this article, we review traditional and novel CMR techniques used for myocardial tissue characterization after acute myocardial injury, including the detection and quantification of MVI. Moreover, we discuss clinical scenarios of acute myocardial injury in which the tissue characterization techniques can be applied and we provide proposed imaging protocols tailored to each scenario.
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Affiliation(s)
- Ahmet Demirkiran
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Henk Everaars
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Raquel P Amier
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Casper Beijnink
- Department of Cardiology, Radboudumc, Geert Grooteplein Zuid 10, GA, Nijmegen, the Netherlands
| | - Michiel J Bom
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Marco J W Götte
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Ramon B van Loon
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Jasper L Selder
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Robin Nijveldt
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands.,Department of Cardiology, Radboudumc, Geert Grooteplein Zuid 10, GA, Nijmegen, the Netherlands
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Reindl M, Eitel I, Reinstadler SJ. Role of Cardiac Magnetic Resonance to Improve Risk Prediction Following Acute ST-Elevation Myocardial Infarction. J Clin Med 2020; 9:E1041. [PMID: 32272692 PMCID: PMC7231095 DOI: 10.3390/jcm9041041] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiac magnetic resonance (CMR) imaging allows comprehensive assessment of myocardial function and tissue characterization in a single examination after acute ST-elevation myocardial infarction. Markers of myocardial infarct severity determined by CMR imaging, especially infarct size and microvascular obstruction, strongly predict recurrent cardiovascular events and mortality. The prognostic information provided by a comprehensive CMR analysis is incremental to conventional risk factors including left ventricular ejection fraction. As such, CMR parameters of myocardial tissue damage are increasingly recognized for optimized risk stratification to further ameliorate the burden of recurrent cardiovascular events in this population. In this review, we provide an overview of the current impact of CMR imaging on optimized risk assessment soon after acute ST-elevation myocardial infarction.
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Affiliation(s)
- Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria;
| | - Ingo Eitel
- University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, D-23538 Lübeck, Germany
| | - Sebastian Johannes Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria;
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Bulluck H, Dharmakumar R, Arai AE, Berry C, Hausenloy DJ. Cardiovascular Magnetic Resonance in Acute ST-Segment-Elevation Myocardial Infarction: Recent Advances, Controversies, and Future Directions. Circulation 2019; 137:1949-1964. [PMID: 29712696 DOI: 10.1161/circulationaha.117.030693] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although mortality after ST-segment elevation myocardial infarction (MI) is on the decline, the number of patients developing heart failure as a result of MI is on the rise. Apart from timely reperfusion by primary percutaneous coronary intervention, there is currently no established therapy for reducing MI size. Thus, new cardioprotective therapies are required to improve clinical outcomes after ST-segment-elevation MI. Cardiovascular magnetic resonance has emerged as an important imaging modality for assessing the efficacy of novel therapies for reducing MI size and preventing subsequent adverse left ventricular remodeling. The recent availability of multiparametric mapping cardiovascular magnetic resonance imaging has provided new insights into the pathophysiology underlying myocardial edema, microvascular obstruction, intramyocardial hemorrhage, and changes in the remote myocardial interstitial space after ST-segment-elevation MI. In this article, we provide an overview of the recent advances in cardiovascular magnetic resonance imaging in reperfused patients with ST-segment-elevation MI, discuss the controversies surrounding its use, and explore future applications of cardiovascular magnetic resonance in this setting.
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Affiliation(s)
- Heerajnarain Bulluck
- Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.).,Royal Papworth Hospital, Cambridge, United Kingdom (H.B.)
| | - Rohan Dharmakumar
- Biomedical Imaging Research Institute and Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.D.).,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (R.D.)
| | - Andrew E Arai
- Laboratory for Advanced Cardiovascular Imaging, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (A.E.A.)
| | - Colin Berry
- British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (C.B.)
| | - Derek J Hausenloy
- Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.). .,National Institute of Health Research University College London Hospitals Biomedical Research Centre, United Kingdom (D.J.H.).,Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom (D.J.H.).,National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (D.J.H.).,Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore (D.J.H.).,Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.)
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Hausenloy DJ, Bulluck H. Risk Stratification by Cardiovascular Magnetic Resonance After Reperfused ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Imaging 2018; 11:826-828. [DOI: 10.1016/j.jcmg.2017.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
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11
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Hausenloy DJ, Garcia-Dorado D, Bøtker HE, Davidson SM, Downey J, Engel FB, Jennings R, Lecour S, Leor J, Madonna R, Ovize M, Perrino C, Prunier F, Schulz R, Sluijter JPG, Van Laake LW, Vinten-Johansen J, Yellon DM, Ytrehus K, Heusch G, Ferdinandy P. Novel targets and future strategies for acute cardioprotection: Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart. Cardiovasc Res 2018; 113:564-585. [PMID: 28453734 DOI: 10.1093/cvr/cvx049] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 03/15/2017] [Indexed: 02/06/2023] Open
Abstract
Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic-however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI.
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Affiliation(s)
- Derek J Hausenloy
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, 8 College Road, Singapore 169857; National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, Singapore 169609, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore; Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - David Garcia-Dorado
- Department of Cardiology, Vall d Hebron University Hospital and Research Institute. Universitat Autònoma, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital Skejby, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK
| | - James Downey
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, 5851 USA Dr. N., MSB 3074, Mobile, AL 36688, USA
| | - Felix B Engel
- Experimental Renal and Cardiovascular Research, Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nßrnberg, Schloßplatz 4, 91054 Erlangen, Germany
| | - Robert Jennings
- Department of Cardiology, Duke University, Durham, NC 27708, USA
| | - Sandrine Lecour
- Department of Medicine, Hatter Institute for Cardiovascular Research in Africa and South African Medical Research Council Inter-University Cape Heart Group, Faculty of Health Sciences, University of Cape Town, Chris Barnard Building, Anzio Road, Observatory, 7925, Cape Town, Western Cape, South Africa
| | - Jonathan Leor
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel Hashomer, Israel; Neufeld Cardiac Research Institute, Tel-Aviv University, Sheba Medical Center, Tel Hashomer, 5265601, Israel; Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Tel Hashomer, 5265601, Israel
| | - Rosalinda Madonna
- Center of Aging Sciences and Translational Medicine - CESI-MeT, "G. d'Annunzio" University, Chieti, Italy; Institute of Cardiology, Department of Neurosciences, Imaging, and Clinical Sciences, "G. d'Annunzio University, Chieti, Italy; Texas Heart Institute and University of Texas Medical School in Houston, Department of Internal Medicine, 6770 Bertner Avenue, Houston, Texas 77030 USA
| | - Michel Ovize
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, 28 Avenue du Doyen Jean Lépine, 69500 Bron, France; UMR 1060 (CarMeN), Université Claude Bernard Lyon, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University Corso Umberto I, 40, 80138 Napoli, Italy
| | - Fabrice Prunier
- Department of Cardiology, University of Angers, University Hospital of Angers, 4 Rue Larrey, 49100 Angers, France
| | - Rainer Schulz
- Institute of Physiology, Justus-Liebig, University of Giessen, Ludwigstraße 23, 35390 Gießen, Germany
| | - Joost P G Sluijter
- Cardiology and UMC Utrecht Regenerative Medicine Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - Linda W Van Laake
- Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - Jakob Vinten-Johansen
- Division of Cardiothoracic Surgery, Department of Surgery, Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - Derek M Yellon
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK
| | - Kirsti Ytrehus
- Cardiovascular Research Group, Department of Medical Biology, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Gerd Heusch
- Institute for Pathophysiology, West-German Heart and Vascular Center, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Nagyvárad tér 4, 1089 Hungary; Pharmahungary Group, Graphisoft Park, 7 Záhony street, Budapest, H-1031, Hungary
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Pöyhönen P, Kylmälä M, Vesterinen P, Kivistö S, Holmström M, Lauerma K, Väänänen H, Toivonen L, Hänninen H. Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural myocardial infarction - a prospective CMR study. BMC Cardiovasc Disord 2018; 18:27. [PMID: 29422025 PMCID: PMC5806273 DOI: 10.1186/s12872-018-0767-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/01/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Large myocardial infarction (MI) is associated with adverse left ventricular (LV) remodeling (LVR). We studied the nature of LVR, with specific attention to non-transmural MIs, and the association of peak CK-MB with recovery and chronic phase scar size and LVR. METHODS Altogether 41 patients underwent prospectively repeated cardiovascular magnetic resonance at a median of 22 (interquartile range 9-29) days and 10 (8-16) months after the first revascularized MI. Transmural MI was defined as ≥75% enhancement in at least one myocardial segment. RESULTS Peak CK-MB was 86 (40-216) μg/L in median, while recovery and chronic phase scar size were 13 (3-23) % and 8 (2-19) %. Altogether 33 patients (81%) had a non-transmural MI. Peak CK-MB had a strong correlation with recovery and chronic scar size (r ≥ 0.80 for all, r ≥ 0.74 for non-transmural MIs; p < 0.001). Peak CK-MB, recovery scar size, and chronic scar size, were all strongly correlated with chronic wall motion abnormality index (WMAi) (r ≥ 0.75 for all, r ≥ 0.73 for non-transmural MIs; p < 0.001). There was proportional scar size and LV mass resorption of 26% (0-50%) and 6% (- 2-14%) in median. Young age (< 60 years, median) was associated with greater LV mass resorption (median 9%vs.1%, p = 0.007). CONCLUSIONS Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural MI. Considerable infarct resorption happens after the first-month recovery phase. LV mass resorption is related to age, being more common in younger patients.
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Affiliation(s)
- Pauli Pöyhönen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Minna Kylmälä
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Paula Vesterinen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Sari Kivistö
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Miia Holmström
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Lauerma
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Heikki Väänänen
- Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
| | - Lauri Toivonen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Helena Hänninen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
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13
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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14
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Bulluck H, Hammond-Haley M, Weinmann S, Martinez-Macias R, Hausenloy DJ. Myocardial Infarct Size by CMR in Clinical Cardioprotection Studies: Insights From Randomized Controlled Trials. JACC Cardiovasc Imaging 2017; 10:230-240. [PMID: 28279370 PMCID: PMC5348096 DOI: 10.1016/j.jcmg.2017.01.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this study was to review randomized controlled trials (RCTs) using cardiac magnetic resonance (CMR) to assess myocardial infarct (MI) size in reperfused patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND There is limited guidance on the use of CMR in clinical cardioprotection RCTs in patients with STEMI treated by primary percutaneous coronary intervention. METHODS All RCTs in which CMR was used to quantify MI size in patients with STEMI treated with primary percutaneous coronary intervention were identified and reviewed. RESULTS Sixty-two RCTs (10,570 patients, January 2006 to November 2016) were included. One-third did not report CMR vendor or scanner strength, the contrast agent and dose used, and the MI size quantification technique. Gadopentetate dimeglumine was most commonly used, followed by gadoterate meglumine and gadobutrol at 0.20 mmol/kg each, with late gadolinium enhancement acquired at 10 min; in most RCTs, MI size was quantified manually, followed by the 5 standard deviation threshold; dropout rates were 9% for acute CMR only and 16% for paired acute and follow-up scans. Weighted mean acute and chronic MI sizes (≤12 h, initial TIMI [Thrombolysis in Myocardial Infarction] flow grade 0 to 3) from the control arms were 21 ± 14% and 15 ± 11% of the left ventricle, respectively, and could be used for future sample-size calculations. Pre-selecting patients most likely to benefit from the cardioprotective therapy (≤6 h, initial TIMI flow grade 0 or 1) reduced sample size by one-third. Other suggested recommendations for standardizing CMR in future RCTs included gadobutrol at 0.15 mmol/kg with late gadolinium enhancement at 15 min, manual or 6-SD threshold for MI quantification, performing acute CMR at 3 to 5 days and follow-up CMR at 6 months, and adequate reporting of the acquisition and analysis of CMR. CONCLUSIONS There is significant heterogeneity in RCT design using CMR in patients with STEMI. The authors provide recommendations for standardizing the assessment of MI size using CMR in future clinical cardioprotection RCTs.
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Affiliation(s)
- Heerajnarain Bulluck
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom; The National Institute of Health Research University College London Hospitals Biomedical Research Center, London, United Kingdom; National Heart Research Institute Singapore, National Heart Center Singapore, Singapore, Singapore
| | - Matthew Hammond-Haley
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom
| | - Shane Weinmann
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom
| | - Roberto Martinez-Macias
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom
| | - Derek J Hausenloy
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom; The National Institute of Health Research University College London Hospitals Biomedical Research Center, London, United Kingdom; National Heart Research Institute Singapore, National Heart Center Singapore, Singapore, Singapore; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore, Singapore.
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15
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Bulluck H, Rosmini S, Abdel-Gadir A, White SK, Bhuva AN, Treibel TA, Fontana M, Ramlall M, Hamarneh A, Sirker A, Herrey AS, Manisty C, Yellon DM, Kellman P, Moon JC, Hausenloy DJ. Residual Myocardial Iron Following Intramyocardial Hemorrhage During the Convalescent Phase of Reperfused ST-Segment-Elevation Myocardial Infarction and Adverse Left Ventricular Remodeling. Circ Cardiovasc Imaging 2017; 9:CIRCIMAGING.116.004940. [PMID: 27894068 PMCID: PMC5068185 DOI: 10.1161/circimaging.116.004940] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/11/2016] [Indexed: 12/16/2022]
Abstract
Supplemental Digital Content is available in the text. Background— The presence of intramyocardial hemorrhage (IMH) in ST-segment–elevation myocardial infarction patients reperfused by primary percutaneous coronary intervention has been associated with residual myocardial iron at follow-up, and its impact on adverse left ventricular (LV) remodeling is incompletely understood and is investigated here. Methods and Results— Forty-eight ST-segment–elevation myocardial infarction patients underwent cardiovascular magnetic resonance at 4±2 days post primary percutaneous coronary intervention, of whom 40 had a follow-up scan at 5±2 months. Native T1, T2, and T2* maps were acquired. Eight out of 40 (20%) patients developed adverse LV remodeling. A subset of 28 patients had matching T2* maps, of which 15/28 patients (54%) had IMH. Eighteen of 28 (64%) patients had microvascular obstruction on the acute scan, of whom 15/18 (83%) patients had microvascular obstruction with IMH. On the follow-up scan, 13/15 patients (87%) had evidence of residual iron within the infarct zone. Patients with residual iron had higher T2 in the infarct zone surrounding the residual iron when compared with those without. In patients with adverse LV remodeling, T2 in the infarct zone surrounding the residual iron was also higher than in those without (60 [54–64] ms versus 53 [51–56] ms; P=0.025). Acute myocardial infarct size, extent of microvascular obstruction, and IMH correlated with the change in LV end-diastolic volume (Pearson’s rho of 0.64, 0.59, and 0.66, respectively; P=0.18 and 0.62, respectively, for correlation coefficient comparison) and performed equally well on receiver operating characteristic curve for predicting adverse LV remodeling (area under the curve: 0.99, 0.94, and 0.95, respectively; P=0.19 for receiver operating characteristic curve comparison). Conclusions— The majority of ST-segment–elevation myocardial infarction patients with IMH had residual myocardial iron at follow-up. This was associated with persistently elevated T2 values in the surrounding infarct tissue and adverse LV remodeling. IMH and residual myocardial iron may be potential therapeutic targets for preventing adverse LV remodeling in reperfused ST-segment–elevation myocardial infarction patients.
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Affiliation(s)
- Heerajnarain Bulluck
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Stefania Rosmini
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Amna Abdel-Gadir
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Steven K White
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Anish N Bhuva
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Thomas A Treibel
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Marianna Fontana
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Manish Ramlall
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Ashraf Hamarneh
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Alex Sirker
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Anna S Herrey
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Charlotte Manisty
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Derek M Yellon
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Peter Kellman
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - James C Moon
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Derek J Hausenloy
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.).
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16
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Impact of knowledge-based iterative model reconstruction on myocardial late iodine enhancement in computed tomography and comparison with cardiac magnetic resonance. Int J Cardiovasc Imaging 2017; 33:1609-1618. [DOI: 10.1007/s10554-017-1137-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/08/2017] [Indexed: 01/08/2023]
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17
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Spieker M, Haberkorn S, Gastl M, Behm P, Katsianos S, Horn P, Jacoby C, Schnackenburg B, Reinecke P, Kelm M, Westenfeld R, Bönner F. Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis. J Cardiovasc Magn Reson 2017; 19:38. [PMID: 28351402 PMCID: PMC5370450 DOI: 10.1186/s12968-017-0350-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/01/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to increase diagnostic accuracy. However, prognostic implications of T2 values in this cohort are unknown. The purpose of the study was to investigate the prognostic relevance of elevated CMR T2 values in patients with sAMC. METHODS AND RESULTS We carried out a prospective study in 46 patients with sAMC defined by current ESC recommendations. A combined endpoint was defined by the occurrence of at least one major adverse cardiac event (MACE) and hospitalisation for heart failure. Event rate was 24% (n = 11) for 1-year-MACE and hospitalisation. A follow-up after 11 ± 7 months was performed in 98% of the patients. Global T2 values were significantly increased at acute stage of disease compared to controls and decreased over time. During acute disease, elevated global T2 time (odds ratio 6.3, p < 0.02) as well as myocardial fraction with T2 time >80 ms (odds ratio 4.9, p < 0.04) predicted occurrence of the combined endpoint. Patients with clinical recovery revealed significantly decreased T2 relaxation times at follow-up examinations; however, T2 values were still elevated compared to healthy controls. CONCLUSION Assessment of myocardial T2 relaxation times at initial presentation facilitates CMR-based risk stratification in patients with acute myocarditis. T2 Mapping may emerge as a new tool to monitor inflammatory myocardial injuries during the course of disease.
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Affiliation(s)
- Maximilian Spieker
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Sebastian Haberkorn
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Mareike Gastl
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Patrick Behm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Stratis Katsianos
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Patrick Horn
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Christoph Jacoby
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | | | - Petra Reinecke
- Institute of Pathology, Heinrich Heine University, Duesseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- CARID, Cardiovascular Research Institute Düsseldorf, Duesseldorf, Germany
| | - Ralf Westenfeld
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Florian Bönner
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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18
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Kawaji K, Tanaka A, Patel MB, Wang H, Maffessanti F, Ota T, Patel AR. 3D late gadolinium enhanced cardiovascular MR with CENTRA-PLUS profile/view ordering: Feasibility of right ventricular myocardial damage assessment using a swine animal model. Magn Reson Imaging 2017; 39:7-14. [PMID: 28131907 DOI: 10.1016/j.mri.2017.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/27/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
AIMS To develop a high-resolution, 3D late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (MRI) technique for improved assessment of myocardial scars, and evaluate its performance against 2D breath-held (BH) LGE MRI using a surgically implanted animal scar model in the right ventricle (RV). METHODS AND RESULTS A k-space segmented 3D LGE acquisition using CENTRA-PLUS (Contrast ENhanced Timing Robust Acquisition with Preparation of LongitUdinal Signal; or CP) ordering is proposed. 8 pigs were surgically prepared with cardiac patch implantation in the RV, followed in 60days by 1.5T MRI. LGE with Phase-Sensitive Inversion Recovery (PSIR) were performed as follows: 1) 2DBH using pneumatic control, and 2) navigator-gated, 3D free-breathing (3DFB)-CP-LGE with slice-tracking. The animal heart was excised immediately after cardiac MR for scar volume quantification. RV scar volumes were also delineated from the 2DBH and 3DFB-CP-LGE images for comparison against the surgical standard. Apparent scar/normal tissue signal-to-noise ratio (aSNR) and contrast-to-noise ratio (aCNR) were also calculated. 3DFB-CP-LGE technique was successfully performed in all animals. No difference in aCNR was noted, but aSNR was significantly higher using the 3D technique (p<0.05). Against the surgical reference volume, the 3DFB-CP-LGE-derived delineation yielded significantly less volume quantification error compared to 2DBH-derived volumes (15±10% vs 55±33%; p<0.05). CONCLUSION Compared to conventional 2DBH-LGE, 3DFB-LGE acquisition using CENTRA-PLUS provided superior scar volume quantification and improved aSNR.
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Affiliation(s)
- Keigo Kawaji
- Department of Medicine, Section of Cardiology, The University of Chicago, Chicago, IL, United States.
| | - Akiko Tanaka
- Department of Radiology, The University of Chicago, Chicago, IL, United States
| | - Mita B Patel
- Department of Medicine, Section of Cardiology, The University of Chicago, Chicago, IL, United States
| | - Hui Wang
- Philips, Gainesville, FL, United States
| | - Francesco Maffessanti
- Department of Medicine, Section of Cardiology, The University of Chicago, Chicago, IL, United States
| | - Takeyoshi Ota
- Department of Radiology, The University of Chicago, Chicago, IL, United States
| | - Amit R Patel
- Department of Medicine, Section of Cardiology, The University of Chicago, Chicago, IL, United States; Department of Surgery, Section of Cardiothoracic Surgery, The University of Chicago, Chicago, IL, United States
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Pennell DJ, Baksi AJ, Prasad SK, Mohiaddin RH, Alpendurada F, Babu-Narayan SV, Schneider JE, Firmin DN. Review of Journal of Cardiovascular Magnetic Resonance 2015. J Cardiovasc Magn Reson 2016; 18:86. [PMID: 27846914 PMCID: PMC5111217 DOI: 10.1186/s12968-016-0305-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022] Open
Abstract
There were 116 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2015, which is a 14 % increase on the 102 articles published in 2014. The quality of the submissions continues to increase. The 2015 JCMR Impact Factor (which is published in June 2016) rose to 5.75 from 4.72 for 2014 (as published in June 2015), which is the highest impact factor ever recorded for JCMR. The 2015 impact factor means that the JCMR papers that were published in 2013 and 2014 were cited on average 5.75 times in 2015. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25 % and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.
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Affiliation(s)
- D. J. Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - A. J. Baksi
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. K. Prasad
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - R. H. Mohiaddin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - F. Alpendurada
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. V. Babu-Narayan
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - J. E. Schneider
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - D. N. Firmin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
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Miranda B, Barrabés JA, Figueras J, Pineda V, Rodríguez-Palomares J, Lidón RM, Sambola A, Bañeras J, Otaegui I, García-Dorado D. Plasma bilirubin values on admission and ventricular remodeling after a first anterior ST-segment elevation acute myocardial infarction. Ann Med 2016; 48:1-9. [PMID: 26631587 DOI: 10.3109/07853890.2015.1112027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Bilirubin may elicit cardiovascular protection and heme oxygenase-1 overexpression attenuated post-infarction ventricular remodeling in experimental animals, but the association between bilirubin levels and post-infarction remodeling is unknown. MATERIALS AND METHODS In 145 patients with a first anterior ST-segment elevation acute myocardial infarction (STEMI), we assessed whether plasma bilirubin on admission predicted adverse remodeling (left ventricular end-diastolic volume [LVEDV] increase ≥20% between discharge and 6 months, estimated by magnetic resonance imaging). RESULTS Patients' baseline characteristics and management were comparable among bilirubin tertiles. LVEDV increased at 6 months (P < 0.001) with respect to the initial exam, but the magnitude of this increase was similar across increasing bilirubin tertiles (10.8 [30.2], 10.1 [22.9], and 12.7 [24.3]%, P = 0.500). Median (25-75 percentile) bilirubin values in patients with and without adverse remodeling were 0.75 (0.60-0.93) and 0.73 (0.60-0.92) mg/dL (P = 0.693). Absence of final TIMI flow grade 3 (odds ratio 3.92, 95% CI 1.12-13.66) and a history of hypertension (2.04, 0.93-4.50), but not admission bilirubin, were independently associated with adverse remodeling. Bilirubin also did not predict the increase in ejection fraction at 6 months. CONCLUSIONS Admission bilirubin values are not related to LVEDV or ejection fraction progression after a first anterior STEMI and do not predict adverse ventricular remodeling. Key messages Bilirubin levels are inversely related to cardiovascular disease, and overexpression of heme oxygenase-1 (the enzyme that determines bilirubin production) has prevented post-infarction ventricular remodeling in experimental animals, but the association between bilirubin levels and the progression of ventricular volumes and function in patients with acute myocardial infarction remained unexplored. In this cohort of patients with a first acute anterior ST-segment elevation myocardial infarction receiving contemporary management, bilirubin levels on admission were not predictive of the changes in left ventricular volumes or ejection fraction at 6 months measured by serial cardiac magnetic resonance imaging. The data are contrary to a significant protective effect of bilirubin against post-infarction ventricular remodeling.
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Affiliation(s)
- Berta Miranda
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - José A Barrabés
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Jaume Figueras
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Victor Pineda
- b Servicio de Radiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - José Rodríguez-Palomares
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Rosa-Maria Lidón
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Antonia Sambola
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Jordi Bañeras
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Imanol Otaegui
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - David García-Dorado
- a Servicio de Cardiología, Hospital Universitari Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona , Barcelona , Spain
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Dastidar AG, Rodrigues JCL, Baritussio A, Bucciarelli-Ducci C. MRI in the assessment of ischaemic heart disease. Heart 2015; 102:239-52. [DOI: 10.1136/heartjnl-2014-306963] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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