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Gao Y, Pu C, Li Q, Guo Y, Shi J, Zhang Z, Xiang P, Hu X, Wu Y, Zeng Q, Yu R, Hu H, Xu M. Assessment of Right Atrial Function Measured with Cardiac MRI Feature Tracking for Predicting Outcomes in Patients with Dilated Cardiomyopathy. Radiology 2024; 310:e232388. [PMID: 38470238 DOI: 10.1148/radiol.232388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Background Right atrial (RA) function strain is increasingly acknowledged as an important predictor of adverse events in patients with diverse cardiovascular conditions. However, the prognostic value of RA strain in patients with dilated cardiomyopathy (DCM) remains uncertain. Purpose To evaluate the prognostic value of RA strain derived from cardiac MRI (CMR) feature tracking (FT) in patients with DCM. Materials and Methods This multicenter, retrospective study included consecutive adult patients with DCM who underwent CMR between June 2010 and May 2022. RA strain parameters were obtained using CMR FT. The primary end points were sudden or cardiac death or heart transplant. Cox regression analysis was used to determine the association of variables with outcomes. Incremental prognostic value was evaluated using C indexes and likelihood ratio tests. Results A total of 526 patients with DCM (mean age, 51 years ± 15 [SD]; 381 male) were included. During a median follow-up of 41 months, 79 patients with DCM reached the primary end points. At univariable analysis, RA conduit strain was associated with the primary end points (hazard ratio [HR], 0.82 [95% CI: 0.76, 0.87]; P < .001). In multivariable Cox analysis, RA conduit strain was an independent predictor for the primary end points (HR, 0.83 [95% CI: 0.77, 0.90]; P < .001). A model combining RA conduit strain with other clinical and conventional imaging risk factors (C statistic, 0.80; likelihood ratio, 92.54) showed improved discrimination and calibration for the primary end points compared with models with clinical variables (C statistic, 0.71; likelihood ratio, 37.12; both P < .001) or clinical and imaging variables (C statistic, 0.75; likelihood ratio, 64.69; both P < .001). Conclusion CMR FT-derived RA conduit strain was an independent predictor of adverse outcomes among patients with DCM, providing incremental prognostic value when combined in a model with clinical and conventional CMR risk factors. Published under a CC BY 4.0 license. Supplemental material is available for this article.
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Affiliation(s)
- Yiyuan Gao
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Cailing Pu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Qian Li
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Yifan Guo
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Jingjing Shi
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Zhen Zhang
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Ping Xiang
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Xi Hu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Yan Wu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Qingze Zeng
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Risheng Yu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Hongjie Hu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Maosheng Xu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
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Yang W, Wang Y, Zhu L, Xu J, Wu W, Zhou D, Sirajuddin A, Arai AE, Zhao S, Lu M. Unravelling the intricacies of left ventricular haemodynamic forces: age and gender-specific normative values assessed by cardiac MRI in healthy adults. Eur Heart J Cardiovasc Imaging 2024; 25:229-239. [PMID: 37724746 PMCID: PMC11046054 DOI: 10.1093/ehjci/jead234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
AIMS Haemodynamic forces (HDFs) provided a feasible method to early detect cardiac mechanical abnormalities by estimating the intraventricular pressure gradients. The novel advances in assessment of HDFs using routine cardiac magnetic resonance (CMR) cines shed new light on detection of preclinical dysfunction. However, definition of normal values for this new technique is the prerequisite for application in the clinic. METHODS AND RESULTS A total of 218 healthy volunteers [38.1 years ± 11.1; 111 male (50.9%)] were recruited and underwent CMR examinations with a 3.0T scanner. Balanced steady state free precession breath hold cine images were acquired, and HDF assessments were performed based on strain analysis. The normal values of longitudinal and transversal HDF strength [root mean square (RMS)] and ratio of transversal to longitudinal HDF were all evaluated in overall population as well as in both genders and in age-specific groups. The longitudinal RMS values (%) of HDFs were significantly higher in women (P < 0.05). Moreover, the HDF amplitudes significantly decreased with ageing in entire heartbeat, systole, diastole, systolic/diastolic transition, and diastolic deceleration, while increased in atrial thrust. In multivariable linear regression analysis, age, heart rate, and global longitudinal strain emerged as independent predictors of the amplitudes of longitudinal HDFs in entire heartbeat and systole, while left ventricular end-diastole volume index was also independently associated with longitudinal HDFs in diastole and diastolic deceleration (P < 0.05 for all). CONCLUSION Our study provided comprehensive normal values of HDF assessments using CMR as well as presented with specific age and sex stratification. HDF analyses can be performed with excellent intra- and inter-observer reproducibility.
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Affiliation(s)
- Wenjing Yang
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Yining Wang
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Leyi Zhu
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Jing Xu
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Weichun Wu
- Departments of Echocardiography, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beilishi Road, Xicheng District, Beijing 100037, China
| | - Di Zhou
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Arlene Sirajuddin
- Department of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Shihua Zhao
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
| | - Minjie Lu
- Departments of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, China
- Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing, China
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Deng W, Wang Z, Jia Z, Liu F, Wu J, Yang J, An S, Yu Y, Han Y, Zhao R, Li X. Cardiac T1ρ Mapping Values Affected by Age and Sex in a Healthy Chinese Cohort. J Magn Reson Imaging 2024. [PMID: 38168067 DOI: 10.1002/jmri.29196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To facilitate the clinical use of cardiac T1ρ, it is important to understand the impact of age and sex on T1ρ values of the myocardium. PURPOSE To investigate the impact of age and gender on myocardial T1ρ values. STUDY TYPE Cross-sectional. POPULATION Two hundred ten healthy Han Chinese volunteers without cardiovascular risk factors (85 males, mean age 34.4 ± 12.5 years; 125 females, mean age 37.9 ± 14.8 years). FIELD STRENGTH/SEQUENCE 1.5 T; T1ρ-prepared steady-state free precession (T1ρ mapping) sequence. ASSESSMENT Basal, mid, and apical short-axis left ventricular T1ρ maps were acquired. T1ρ maps acquired with spin-lock frequencies of 5 and 400 Hz were subtracted to create a myocardial fibrosis index (mFI) map. T1ρ and mFI values across different age decades, sex, and slice locations were compared. STATISTICAL TESTS Shapiro-Wilk test, Student's t test, Mann-Whitney U test, linear regression analysis, one-way analysis of variance and intraclass correlation coefficient. SIGNIFICANCE P value <0.05. RESULTS Women had significantly higher T1ρ and mFI values than men (50.3 ± 2.0 msec vs. 47.7 ± 2.4 msec and 4.7 ± 1.0 msec vs. 4.3 ± 1.1 msec, respectively). Additionally, in males and females combined, there was a significant positive but weak correlation between T1ρ values and age (r = 0.27), while no correlation was observed between the mFI values and age (P = 0.969). DATA CONCLUSION We report potential reference values for cardiac T1ρ by sex, age distribution, and slice location in a Chinese population. T1ρ was significantly correlated with age and sex, while mFI was only associated with sex. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Wei Deng
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
| | - Zhen Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
| | - Zhuoran Jia
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Fang Liu
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian Wu
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jinxiu Yang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
| | - Shutian An
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
| | - Yuchi Han
- Cardiovascular Division, Wexner Medical Center, College of Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Ren Zhao
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, Anhui, China
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Ishida M. Editorial for "Healthy Adult Left and Right Ventricular Torsion and Torsion Rates With MR-Feature Tracking". J Magn Reson Imaging 2024. [PMID: 38165087 DOI: 10.1002/jmri.29204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Masaki Ishida
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
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Zhang Z, Li G, Gao Y, Zhou S, Xie J, Liu S, Zhao Z, Zhu C, Ordovas K, Pohost GM, Sun K, Li K. Healthy Adult Left and Right Ventricular Torsion and Torsion Rates With MR-Feature Tracking. J Magn Reson Imaging 2023. [PMID: 38156373 DOI: 10.1002/jmri.29201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND The clinical value of myocardial torsion quantification in prognostic assessment and risk stratification of various cardiovascular diseases is gradually being recognized. However, normal values of left and right ventricular (LV and RV) torsion and torsion rates (TRs) have not been fully determined, and their correlation with age and gender has not been well studied. PURPOSE To establish normal ranges of biventricular torsion, peak systolic and diastolic TRs using magnetic resonance feature tracking (MR-FT) technique based on a large sample of healthy adults, and further investigate their relationship with age and gender. STUDY TYPE Retrospective. POPULATION 566 Healthy adults (312 males, aged 43 ± 10 years; 254 females, aged 43 ± 11 years). FIELD STRENGTH/SEQUENCE 1.5T/gradient echo. ASSESSMENT Biventricular torsion, peak systolic, and diastolic TRs. STATISTICAL TESTS Shapiro-Wilk test, Student's t-test, Mann-Whitney-U test, linear regression, intraclass correlation coefficient, Bland-Altman analysis. Differences were regarded as statistically significant at P < 0.05. RESULTS Women demonstrated greater magnitudes of left ventricle (LV) torsion (1.23 ± 0.44 vs. 1.00 ± 0.42°/cm), peak systolic TR (9.69 ± 3.70 vs. 8.27 ± 3.73°/cm*sec), peak diastolic TR (-7.78 ± 2.82 vs. -6.06 ± 2.44°/cm*sec), and RV torsion (2.20 ± 1.23 vs. 1.65 ± 1.11°/cm*sec), peak systolic TR (16.07 ± 8.18 vs. 12.62 ± 7.08°/cm*sec), peak diastolic TR (-15.39 ± 6.53 vs. -11.70 ± 6.03°/cm*sec). For both genders, the magnitudes of LV and RV torsion, peak systolic, and diastolic TRs increased linearly with age. All the measurements of biventricular torsion, peak systolic and diastolic TRs achieved good to excellent intraobserver and interobserver reproducibility, with all intraclass correlation coefficients >0.70. DATA CONCLUSION The present study systematically provided age- and sex-stratified reference values for LV and RV torsion and TRs using MR-FT technique. Women and aging are associated with greater magnitudes of biventricular torsion, peak systolic, and diastolic TRs. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhen Zhang
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Gengxiao Li
- Department of Radiology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yiyuan Gao
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shanshan Zhou
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Jianan Xie
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Shurong Liu
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Zhiwei Zhao
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Gerald M Pohost
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kai Sun
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Kuncheng Li
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Zheng Y, Liu H, Zhao L, Guan S, Huo H, Li H, Guo J, Peng X, Hao Y, Jin S, Hou Y, Dai X, Liu T, Zhang X. Serial Cardiac MRI for Quantification of the Dynamics of Anthracycline-Induced Subclinical Myocardial Injury. J Magn Reson Imaging 2023; 58:1533-1541. [PMID: 36912379 DOI: 10.1002/jmri.28667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Anthracyclines are known to be associated with chemotherapy-induced cardiotoxicity. Limited data focus on dynamic myocardial injury during the course of chemotherapy in patients with breast cancer. PURPOSE To investigate the variation of tissue characterization and myocardial deformation derived by cardiac MRI during anthracycline chemotherapy. STUDY TYPE Prospective. POPULATION Fifty-eight female breast cancer patients (mean age: 52.82 ± 2.61 years) were enrolled. FIELD STRENGTH/SEQUENCE A 3.0-T, cardiac MRI including cine balanced steady-state free precession, a modified Looker-Locker inversion recovery (MOLLI), and a fast spin echo (FSE) T2-weighted sequences were performed. ASSESSMENT Cardiac MRI was performed baseline and after two, four, and six cycles of chemotherapy. Assessment of global longitudinal strain (GLS), global circumstance strain (GCS), global radial strain (GRS), and strain rate (GLS-s, GCS-s, GRS-s) and T1, T2 and T2* were accomplished by CVI42. The anthracycline dose and risk factors were also collected before each cardiac MRI. STATISTICAL TESTS Analysis of variance (ANOVA) for repeated measures was used to compare the changes in LVEF cardiac function, strain and T1/T2/T2* parameters over time. Pearson correlation analyses were performed to estimate the potential associations between differences in myocardial characteristics (∆) and the chemotherapy cycle. A P value <0.05 was considered statistically significant. RESULTS LVEF was not significantly different from pretreatment MRI regarding each cycle of chemotherapy (P = 0.54). Compared with baseline, patients had significantly lower GLS (-15.85% ± 0.83%, -14.50% ± 0.88%, -12.34% ± 1.01% vs. -18.82% ± 0.92%) and GLS-s (-0.71% ± 0.07%, -0.65% ± 0.05%, -0.64% ± 0.04% vs. -0.95 ± 0.06%) and increased T2 values (57.21 ± 4.27 msec, 58.60 ± 3.93 msec, 58.10 ± 3.17 msec vs. 43.88 ± 3.28 msec) at two, four and six cycles of chemotherapy treatment. ∆GLS and ∆GLS-s were significantly associated with the chemotherapy cycle (correlation coefficients for GLS = 0.75, GLS-s = 0.75). DATA CONCLUSION Cardiac MRI can precisely detect the dynamic changes of anthracycline-induced subclinical myocardial injury that is represented as a gradually decrease in GLS and GLS-s. These parameters may provide new insight for monitoring risk and therapy in patients with breast cancer. EVIDENCE LEVEL 2. TECHNICAL EFFICACY Stage 1.
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Affiliation(s)
- Yue Zheng
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Hui Liu
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Li Zhao
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Shu Guan
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Huaibi Huo
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Han Li
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Jie Guo
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Xin Peng
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yuetong Hao
- Department of Breast Surgery, Cancer Hospital of China Medical University, Shenyang, China
- Department of Breast Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Shiqi Jin
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xu Dai
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Ting Liu
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Xinfeng Zhang
- Department of Breast Surgery, Cancer Hospital of China Medical University, Shenyang, China
- Department of Breast Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China
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7
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Barison A, Ceolin R, Palmieri A, Tamborrino PP, Todiere G, Grigoratos C, Gueli IA, De Gori C, Clemente A, Pistoia L, Pepe A, Aquaro GD, Positano V, Emdin M, Cademartiri F, Meloni A. Biventricular Tissue Tracking with Cardiovascular Magnetic Resonance: Reference Values of Left- and Right-Ventricular Strain. Diagnostics (Basel) 2023; 13:2912. [PMID: 37761278 PMCID: PMC10527573 DOI: 10.3390/diagnostics13182912] [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: 07/18/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
We derived reference values of left-ventricular (LV) and right-ventricular (RV) strain parameters in a cohort of 100 healthy subjects by feature tracking cardiac magnetic resonance (FT-CMR). Global and regional strain values were calculated for the LV; circumferential and radialSAX strain parameters were derived from the short-axis (SAX) stack, while longitudinal and radialLAX strain parameters were assessed in three long-axis (LAX) views. Only global longitudinal strain (GLS) was calculated for the RV. Peak global LV circumferential strain was -16.7% ± 2.1%, LV radialSAX strain was 26.4% ± 5.1%, LV radialLAX strain was 31.1% ± 5.2%, LV GLS was -17.7% ± 1.9%, and RV GLS was -23.9% ± 4.1%. Women presented higher global LV and RV strain values than men; all strain values presented a weak relationship with body surface area, while there was no association with age or heart rate. A significant association was detected between all LV global strain measures and LV ejection fraction, while RV GLS was correlated to RV end-diastolic volume. The intra- and inter-operator reproducibility was good for all global strain measures. In the regional analysis, circumferential and radial strain values resulted higher at the apical level, while longitudinal strain values were higher at the basal level. The assessment of cardiac deformation by FT-CMR is feasible and reproducible and gender-specific reference values should be used.
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Affiliation(s)
- Andrea Barison
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Roberto Ceolin
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, 34128 Trieste, Italy
| | - Alessandro Palmieri
- Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy
| | - Pietro Paolo Tamborrino
- Cardiology Division, Cardiothoracic and Vascular Department, Pisa University Hospital, 56124 Pisa, Italy
| | - Giancarlo Todiere
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Chrysanthos Grigoratos
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Ignazio Alessio Gueli
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Carmelo De Gori
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Alberto Clemente
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Laura Pistoia
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Clinical Research Unit, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Alessia Pepe
- Institute of Radiology, Department of Medicine, University of Padua, 35128 Padova, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy
| | - Vincenzo Positano
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Michele Emdin
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Antonella Meloni
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
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8
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Soghomonian A, Dutour A, Kachenoura N, Thuny F, Lasbleiz A, Ancel P, Cristofari R, Jouve E, Simeoni U, Kober F, Bernard M, Gaborit B. Is increased myocardial triglyceride content associated with early changes in left ventricular function? A 1H-MRS and MRI strain study. Front Endocrinol (Lausanne) 2023; 14:1181452. [PMID: 37424866 PMCID: PMC10323751 DOI: 10.3389/fendo.2023.1181452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background Type 2 diabetes (T2D) and obesity induce left ventricular (LV) dysfunction. The underlying pathophysiological mechanisms remain unclear, but myocardial triglyceride content (MTGC) could be involved. Objectives This study aimed to determine which clinical and biological factors are associated with increased MTGC and to establish whether MTGC is associated with early changes in LV function. Methods A retrospective study was conducted using five previous prospective cohorts, leading to 338 subjects studied, including 208 well-phenotyped healthy volunteers and 130 subjects living with T2D and/or obesity. All the subjects underwent proton magnetic resonance spectroscopy and feature tracking cardiac magnetic resonance imaging to measure myocardial strain. Results MTGC content increased with age, body mass index (BMI), waist circumference, T2D, obesity, hypertension, and dyslipidemia, but the only independent correlate found in multivariate analysis was BMI (p=0.01; R²=0.20). MTGC was correlated to LV diastolic dysfunction, notably with the global peak early diastolic circumferential strain rate (r=-0.17, p=0.003), the global peak late diastolic circumferential strain rate (r=0.40, p<0.0001) and global peak late diastolic longitudinal strain rate (r=0.24, p<0.0001). MTGC was also correlated to systolic dysfunction via end-systolic volume index (r=-0.34, p<0.0001) and stroke volume index (r=-0.31, p<0.0001), but not with longitudinal strain (r=0.009, p=0.88). Interestingly, the associations between MTGC and strain measures did not persist in multivariate analysis. Furthermore, MTGC was independently associated with LV end-systolic volume index (p=0.01, R²=0.29), LV end-diastolic volume index (p=0.04, R²=0.46), and LV mass (p=0.002, R²=0.58). Conclusions Predicting MTGC remains a challenge in routine clinical practice, as only BMI independently correlates with increased MTGC. MTGC may play a role in LV dysfunction but does not appear to be involved in the development of subclinical strain abnormalities.
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Affiliation(s)
- Astrid Soghomonian
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Anne Dutour
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Nadjia Kachenoura
- Sorbonne Université, INSERM, CNRS, Laboratoire d’Imagerie Biomédicale, Paris, France
| | - Franck Thuny
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Adele Lasbleiz
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Patricia Ancel
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
| | | | - Elisabeth Jouve
- UPCET, Clinical Pharmacology, Assistance-Publique Hôpitaux de Marseille, Marseille, France
| | - Umberto Simeoni
- Division of Pediatrics & DOHaD Laboratory, CHUV University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Frank Kober
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France
| | | | - Bénédicte Gaborit
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
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9
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Popielarz-Grygalewicz A, Stelmachowska-Banaś M, Raczkiewicz D, Czajka-Oraniec I, Zieliński G, Kochman W, Dąbrowski M, Zgliczyński W. Effects of acromegaly treatment on left ventricular systolic function assessed by speckle tracking echocardiography in relation to sex differences: results from a prospective single center study. Front Endocrinol (Lausanne) 2023; 14:1154615. [PMID: 37223021 PMCID: PMC10200955 DOI: 10.3389/fendo.2023.1154615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Background Despite the preserved LVEF, patients with acromegaly are characterized by subclinical systolic dysfunction i.e., abnormal global longitudinal strain (GLS) assessed by speckle tracking echocardiography (STE). The effect of acromegaly treatment on LV systolic function assessed by STE, has not been evaluated so far. Patients and methods Thirty-two naïve acromegalic patients without detectable heart disease were enrolled in a prospective, single-center study. 2D-Echocardiography and STE were performed at diagnosis, 3&6 months on preoperative somatostatin receptor ligand (SRL) treatment and 3 months after transsphenoidal surgery (TSS). Results Treatment with SRL resulted in reduction in median (IQR) GH&IGF-1 levels after 3 months, from 9.1(3.2-21.9) to 1.8(0.9-5.2) ng/mL (p<0.001) and from 3.2(2.3-4.3) to 1.5(1.1-2.5) xULN (p<0.001), respectively. Biochemical control on SRL was achieved in 25.8% of patients after 6 months and complete surgical remission was achieved in 41.7% of patients. TSS resulted in decrease in median (IQR) IGF-1 compared to IGF-1 levels on SRL treatment: from 1.5(1.2-2.5) to 1.3(1.0-1.6) xULN (p=0.003). Females had lower IGF-1 levels at baseline, on SRL and after TSS compared to males. The median end diastolic and end systolic left ventricle volumes were normal. Almost half of the patients (46.9%) had increased LVMi, however the median value of LVMi was normal in both sex groups: 99g/m2 in males and 94g/m2 in females. Most patients (78.1%) had increased LAVi and the median value was 41.8mL/m2. At baseline 50% of patients, mostly men (62.5% vs. 37.5%) had GLS values higher than -20%. There was a positive correlation between baseline GLS and BMI r=0.446 (p=0.011) and BSA r=0.411 (p=0.019). The median GLS significantly improved after 3 months of SRL treatment compared to baseline: -20.4% vs. -20.0% (p=0.045). The median GLS was lower in patients with surgical remission compared to patients with elevated GH&IGF-1 levels: -22.5% vs. -19.8% (p=0.029). There was a positive correlation between GLS and IGF-1 levels after TSS r=0.570 (p=0.007). Conclusion The greatest beneficial effect of acromegaly treatment on LV systolic function is visible already after 3 months of preoperative SRL treatment, especially in women. Patients with surgical remission have better GLS compared to patients with persistent acromegaly.
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Affiliation(s)
| | | | - Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Grzegorz Zieliński
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Wacław Kochman
- Department of Cardiology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marek Dąbrowski
- Department of Cardiology, Bielanski Hospital, Warsaw, Poland
| | - Wojciech Zgliczyński
- Department of Endocrinology, The Centre of Postgraduate Medical Education, Warsaw, Poland
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