1
|
Chen H, Erley J, Muellerleile K, Saering D, Jahnke C, Cavus E, Schneider JN, Blankenberg S, Lund GK, Adam G, Tahir E, Sinn M. Contrast-enhanced cardiac MRI is superior to non-contrast mapping to predict left ventricular remodeling at 6 months after acute myocardial infarction. Eur Radiol 2024; 34:1863-1874. [PMID: 37665392 PMCID: PMC10873445 DOI: 10.1007/s00330-023-10100-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Parametric mapping constitutes a novel cardiac magnetic resonance (CMR) technique enabling quantitative assessment of pathologic alterations of left ventricular (LV) myocardium. This study aimed to investigate the clinical utility of mapping techniques with and without contrast agent compared to standard CMR to predict adverse LV remodeling following acute myocardial infarction (AMI). MATERIALS AND METHODS A post hoc analysis was performed on sixty-four consecutively enrolled patients (57 ± 12 years, 54 men) with first-time reperfused AMI. Baseline CMR was obtained at 8 ± 5 days post-AMI, and follow-up CMR at 6 ± 1.4 months. T1/T2 mapping, T2-weighted, and late gadolinium enhancement (LGE) acquisitions were performed at baseline and cine imaging was used to determine adverse LV remodeling, defined as end-diastolic volume increase by 20% at 6 months. RESULTS A total of 11 (17%) patients developed adverse LV remodeling. At baseline, patients with LV remodeling showed larger edema (30 ± 11 vs. 22 ± 10%LV; p < 0.05), infarct size (24 ± 11 vs. 14 ± 8%LV; p < 0.001), extracellular volume (ECVinfarct; 63 ± 12 vs. 47 ± 11%; p < 0.001), and native T2infarct (95 ± 16 vs. 78 ± 17 ms; p < 0.01). ECVinfarct and infarct size by LGE were the best predictors of LV remodeling with areas under the curve (AUCs) of 0.843 and 0.789, respectively (all p < 0.01). Native T1infarct had the lowest AUC of 0.549 (p = 0.668) and was inferior to edema size by T2-weighted imaging (AUC = 0.720; p < 0.05) and native T2infarct (AUC = 0.766; p < 0.01). CONCLUSION In this study, ECVinfarct and infarct size by LGE were the best predictors for the development of LV remodeling within 6 months after AMI, with a better discriminative performance than non-contrast mapping CMR. CLINICAL RELEVANCE STATEMENT This study demonstrates the predictive value of contrast-enhanced and non-contrast as well as conventional and novel CMR techniques for the development of LV remodeling following AMI, which might help define precise CMR endpoints in experimental and clinical myocardial infarction trials. KEY POINTS • Multiparametric CMR provides insights into left ventricular remodeling at 6 months following an acute myocardial infarction. • Extracellular volume fraction and infarct size are the best predictors for adverse left ventricular remodeling. • Contrast-enhanced T1 mapping has a better predictive performance than non-contrast standard CMR and T1/T2 mapping.
Collapse
Affiliation(s)
- Hang Chen
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Jennifer Erley
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Kai Muellerleile
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Dennis Saering
- Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany
| | - Charlotte Jahnke
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ersin Cavus
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Jan N Schneider
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Gunnar K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Martin Sinn
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| |
Collapse
|
2
|
Topriceanu CC, Pierce I, Moon JC, Captur G. T 2 and T 2⁎ mapping and weighted imaging in cardiac MRI. Magn Reson Imaging 2022; 93:15-32. [PMID: 35914654 DOI: 10.1016/j.mri.2022.07.012] [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: 03/07/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
Cardiac imaging is progressing from simple imaging of heart structure and function to techniques visualizing and measuring underlying tissue biological changes that can potentially define disease and therapeutic options. These techniques exploit underlying tissue magnetic relaxation times: T1, T2 and T2*. Initial weighting methods showed myocardial heterogeneity, detecting regional disease. Current methods are now fully quantitative generating intuitive color maps that do not only expose regionality, but also diffuse changes - meaning that between-scan comparisons can be made to define disease (compared to normal) and to monitor interval change (compared to old scans). T1 is now familiar and used clinically in multiple scenarios, yet some technical challenges remain. T2 is elevated with increased tissue water - oedema. Should there also be blood troponin elevation, this oedema likely reflects inflammation, a key biological process. T2* falls in the presence of magnetic/paramagnetic materials - practically, this means it measures tissue iron, either after myocardial hemorrhage or in myocardial iron overload. This review discusses how T2 and T2⁎ imaging work (underlying physics, innovations, dependencies, performance), current and emerging use cases, quality assurance processes for global delivery and future research directions.
Collapse
Affiliation(s)
- Constantin-Cristian Topriceanu
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK; UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Iain Pierce
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK
| | - James C Moon
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Gabriella Captur
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK; UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK; The Royal Free Hospital, Centre for Inherited Heart Muscle Conditions, Cardiology Department, Pond Street, Hampstead, London, UK.
| |
Collapse
|
3
|
Predictive value of major adverse cardiac events by T2-mapping texture analysis of the myocardial remote zone in patients with acute myocardial infarction. Clin Radiol 2022; 77:e241-e249. [DOI: 10.1016/j.crad.2021.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/16/2021] [Indexed: 01/16/2023]
|
4
|
Sinn MR, Lund GK, Muellerleile K, Freiwald E, Saeed M, Avanesov M, Lenz A, Starekova J, von Kodolitsch Y, Blankenberg S, Adam G, Tahir E. Prognosis of early pre-discharge and late left ventricular dilatation by cardiac magnetic resonance imaging after acute myocardial infarction. Int J Cardiovasc Imaging 2021; 37:1711-1720. [PMID: 33433745 PMCID: PMC8105219 DOI: 10.1007/s10554-020-02136-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022]
Abstract
To study the long-term prognosis of early pre-discharge and late left ventricular (LV) dilatation in patients with first ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI) and contemporary medical therapy. Long-term follow-up > 15 years was available in 53 consecutive patients (55 ± 13 years) with first STEMI. Late gadolinium enhanced (LGE) cardiac magnetic resonance imaging (CMR) was obtained at baseline 5 ± 3 days and follow-up 8 ± 3 months after STEMI to measure LV function, volumes and infarct size. Early pre-discharge dilatation was defined as increased left ventricular end-diastolic volume index (LVEDVi) at baseline CMR with > 97 ml/m2 for males and > 90 ml/m2 for females. Late dilatation was defined as initially normal LVEDVi, which increased ≥ 20% at follow-up. Early dilatation was present in 7 patients (13%), whereas late dilatation occurred in 11 patients (21%). Patients with early LV dilatation had highest mortality (57%), whereas patients with late dilatation had similar mortality (27%) compared to patients without dilatation (26%). Multivariate Cox analysis showed that age (P < 0.001), ejection fraction at baseline (P < 0.01) and early dilatation (P < 0.01) were independent predictors of death. Early dilatation qualified as an exclusive independent predictor of long-term mortality after adjustment for age and ejection fraction (P < 0.05, hazard ratio: 2.2, 95% confidence interval: 1.2 to 7.9). Early pre-discharge LV dilatation by CMR enabled strong long-term risk stratification after STEMI. The high mortality of early LV dilatation underscores the clinical importance of this post-infarction complication, which occurred despite PCI and contemporary medical therapy.
Collapse
Affiliation(s)
- Martin R Sinn
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Gunnar K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Kai Muellerleile
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Eric Freiwald
- Institute for Medical Biometry and Epidemiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Maythem Saeed
- Department of Radiology and Biomedical Imaging, UCSF School of Medicine, 185 Berry Street, San Francisco, CA, 94143, USA
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Alexander Lenz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Jitka Starekova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Yskert von Kodolitsch
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| |
Collapse
|
5
|
Manning WJ. Journal of Cardiovascular Magnetic Resonance 2017. J Cardiovasc Magn Reson 2018; 20:89. [PMID: 30593280 PMCID: PMC6309095 DOI: 10.1186/s12968-018-0518-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 02/07/2023] Open
Abstract
There were 106 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2017, including 92 original research papers, 3 reviews, 9 technical notes, and 1 Position paper, 1 erratum and 1 correction. The volume was similar to 2016 despite an increase in manuscript submissions to 405 and thus reflects a slight decrease in the acceptance rate to 26.7%. The quality of the submissions continues to be high. The 2017 JCMR Impact Factor (which is published in June 2018) was minimally lower at 5.46 (vs. 5.71 for 2016; as published in June 2017), which is the second highest impact factor ever recorded for JCMR. The 2017 impact factor means that an average, each JCMR paper that were published in 2015 and 2016 was cited 5.46 times in 2017.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in continuus fashion and in the chronologic order of acceptance, 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 theme, so that readers can view areas of interest in a single article in relation to each other and other contemporary JCMR articles. In this publication, the manuscripts are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought within the journal. In addition, I have elected to use this format to convey information regarding the editorial process to the readership.I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your very best, high quality manuscripts to JCMR for consideration. I thank our very dedicated Associate Editors, Guest Editors, and Reviewers for their efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the forefront journal of our field. And finally, I thank you for entrusting me with the editorship of the JCMR as I begin my 3rd year as your editor-in-chief. It has been a tremendous learning experience for me and the opportunity to review manuscripts that reflect the best in our field remains a great joy and highlight of my week!
Collapse
Affiliation(s)
- Warren J Manning
- Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
| |
Collapse
|
6
|
Krumm P, Mangold S, Gatidis S, Nikolaou K, Nensa F, Bamberg F, la Fougère C. Clinical use of cardiac PET/MRI: current state-of-the-art and potential future applications. Jpn J Radiol 2018. [PMID: 29524169 DOI: 10.1007/s11604-018-0727-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Combined PET/MRI is a novel imaging method integrating the advances of functional and morphological MR imaging with PET applications that include assessment of myocardial viability, perfusion, metabolism of inflammatory tissue and tumors, as well as amyloid deposition imaging. As such, PET/MRI is a promising tool to detect and characterize ischemic and non-ischemic cardiomyopathies. To date, the greatest benefit may be expected for diagnostic evaluation of systemic diseases and cardiac masses that remain unclear in cardiac MRI, as well as for clinical and scientific studies in the setting of ischemic cardiomyopathies. Diagnosis and therapeutic monitoring of cardiac sarcoidosis has the potential of a possible 'killer-application' for combined cardiac PET/MRI. In this article, we review the current evidence and discuss current and potential future applications of cardiac PET/MRI.
Collapse
Affiliation(s)
- Patrick Krumm
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Stefanie Mangold
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Sergios Gatidis
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabian Bamberg
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Christian la Fougère
- Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University of Tübingen, Tübingen, Germany
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Tahir E, Sinn M, Bohnen S, Avanesov M, Säring D, Stehning C, Schnackenburg B, Eulenburg C, Wien J, Radunski UK, Blankenberg S, Adam G, Higgins CB, Saeed M, Muellerleile K, Lund GK. Acute versus Chronic Myocardial Infarction: Diagnostic Accuracy of Quantitative Native T1 and T2 Mapping versus Assessment of Edema on Standard T2-weighted Cardiovascular MR Images for Differentiation. Radiology 2017; 285:83-91. [DOI: 10.1148/radiol.2017162338] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Enver Tahir
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Martin Sinn
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Sebastian Bohnen
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Maxim Avanesov
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Dennis Säring
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Christian Stehning
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Bernhard Schnackenburg
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Christine Eulenburg
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Joshua Wien
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Ulf K. Radunski
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Stefan Blankenberg
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Gerhard Adam
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Charles B. Higgins
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Maythem Saeed
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Kai Muellerleile
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| | - Gunnar K. Lund
- From the Department of Diagnostic and Interventional Radiology (E.T., M. Sinn, M.A., J.W., G.A., G.K.L.), University Heart Center, Department of General and Interventional Cardiology (S. Bohnen, U.K.R., S. Blankenberg, K.M.), and Department for Medical Biometry and Epidemiology (C.E.), University Hospital Eppendorf, Martinistr 52, 20246 Hamburg, Germany; Department of Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany (D.S.); Philips Research Hamburg, Hamburg,
| |
Collapse
|
9
|
Full left ventricular coverage is essential for the accurate quantification of the area-at-risk by T1 and T2 mapping. Sci Rep 2017; 7:4871. [PMID: 28687810 PMCID: PMC5501789 DOI: 10.1038/s41598-017-05127-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 05/24/2017] [Indexed: 01/04/2023] Open
Abstract
T2-weighted cardiovascular magnetic resonance (CMR) using a 3-slice approach has been shown to accurately quantify the edema-based area-at-risk (AAR) in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the performance of a 3-slice approach to full left ventricular (LV) coverage for the AAR by T1 and T2 mapping and MI size. Forty-eight STEMI patients were prospectively recruited and underwent a CMR at 4 ± 2 days. There was no difference between the AARfull LV and AAR3-slices by T1 (P = 0.054) and T2-mapping (P = 0.092), with good correlations but small biases and wide limits of agreements (T1-mapping: N = 30, R2 = 0.85, bias = 1.7 ± 9.4% LV; T2-mapping: N = 48, R2 = 0.75, bias = 1.7 ± 12.9% LV). There was also no significant difference between MI size3-slices and MI sizefull LV (P = 0.93) with an excellent correlation between the two (R2 0.92) but a small bias of 0.5% and a wide limit of agreement of ±7.7%. Although MSI was similar between the 2 approaches, MSI3-slices performed poorly when MSI was <0.50. Furthermore, using AAR3-slices and MI sizefull LV resulted in ‘negative’ MSI in 7/48 patients. Full LV coverage T1 and T2 mapping are more accurate than a 3-slice approach for delineating the AAR, especially in those with MSI < 0.50 and we would advocate full LV coverage in future studies.
Collapse
|
10
|
Prediction of the estimated 5-year risk of sudden cardiac death and syncope or non-sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy using late gadolinium enhancement and extracellular volume CMR. Eur Radiol 2017; 27:5136-5145. [PMID: 28616729 DOI: 10.1007/s00330-017-4869-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/28/2017] [Accepted: 04/27/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the ability of late gadolinium enhancement (LGE) and mapping cardiac magnetic resonance (CMR) including native T1 and global extracellular volume (ECV) to identify hypertrophic cardiomyopathy (HCM) patients at risk for sudden cardiac death (SCD) and to predict syncope or non-sustained ventricular tachycardia (VT). METHODS A 1.5-T CMR was performed in 73 HCM patients and 16 controls. LGE size was quantified using the 3SD, 5SD and full width at half maximum (FWHM) method. T1 and ECV maps were generated by a 3(3)5 modified Look-Locker inversion recovery sequence. Receiver-operating curve analysis evaluated the best parameter to identify patients with increased SCD risk ≥4% and patients with syncope or non-sustained VT. RESULTS Global ECV was the best predictor of SCD risk with an area under the curve (AUC) of 0.83. LGE size was significantly inferior to global ECV with an AUC of 0.68, 0.70 and 0.70 (all P < 0.05) for 3SD-, 5SD- and FWHM-LGE, respectively. Combined use of the SCD risk score and global ECV significantly improved the diagnostic accuracy to identify HCM patients with syncope or non-sustained VT. CONCLUSIONS Combined use of the SCD risk score and global ECV has the potential to improve HCM patient selection, benefiting most implantable cardioverter defibrillators. KEY POINTS • Global ECV identified the best HCM patients with increased SCD risk. • Global ECV performed equally well compared to a SCD risk score. • Combined use of the SCD risk score and global ECV improved test accuracy. • Combined use potentially improves selection of HCM patients for ICD implantation.
Collapse
|
11
|
Chen WR, Chen YD, Tian F, Yang N, Cheng LQ, Hu SY, Wang J, Yang JJ, Wang SF, Gu XF. Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment-Elevation Myocardial Infarction. Circ Cardiovasc Imaging 2017; 9:CIRCIMAGING.116.005146. [PMID: 27940956 DOI: 10.1161/circimaging.116.005146] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/06/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Liraglutide, a glucagon-like peptide-1 analog, was reported to reduce reperfusion injury in mice. We planned to evaluate the effects of liraglutide on reperfusion injury in patients with acute ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. METHODS AND RESULTS A total of 96 patients with ST-segment-elevation myocardial infarction undergoing emergency primary percutaneous coronary intervention were randomized to receive either subcutaneous liraglutide or placebo. Study treatment was commenced 30 minutes before intervention (1.8 mg) and maintained for 7 days after the procedure (0.6 mg for 2 days, 1.2 mg for 2 days, followed by 1.8 mg for 3 days). The salvage index was calculated from myocardial area at risk, measured during the index admission (35±12 hours), and final infarct size measured at 91±5 days after primary percutaneous coronary intervention by cardiac magnetic resonance. At 3 months, the primary end point, a higher salvage index was found in the liraglutide group than in the placebo group in 77 patients evaluated with cardiac magnetic resonance (0.66±0.14 versus 0.55±0.15; P=0.001). The final infarct size was lower in the liraglutide group than that in the placebo group (15±12 versus 21±15 g; P=0.05). Serum high-sensitivity C-reactive protein level was lower in the liraglutide group (P<0.001). During a 6-month follow-up period, no difference was observed in the incidence of major adverse cardiovascular event. Safety and tolerability were similar among the 2 groups. CONCLUSIONS Our study provides evidence that liraglutide improves myocardial salvage and infarct size after ST-segment-elevation myocardial infarction, possibly by reducing reperfusion injury, making it a promising treatment for evaluation in larger trials. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT02001363.
Collapse
Affiliation(s)
- Wei Ren Chen
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Yun Dai Chen
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China.
| | - Feng Tian
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Na Yang
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Liu Quan Cheng
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Shun Ying Hu
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Jing Wang
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Jun Jie Yang
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Shi Feng Wang
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| | - Xiao Fang Gu
- From the Department of Cardiology (W.R.C., Y.D.C., F.T., S.Y.H., J.W., J.J.Y., S.F.W., X.F.G.) and Division of MRI, Department of Radiology (N.Y., L.Q.C.), PLA General Hospital at Beijing, China
| |
Collapse
|