|
1
|
Missed Connections: Identification of Atrial Septal Defect by MRI. Case Rep Cardiol 2023; 2023:2393308. [PMID: 36890877 PMCID: PMC9988386 DOI: 10.1155/2023/2393308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/30/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
In this case report, we describe a 55-year-old female patient with worsening exertional dyspnea who is referred to the cardiology department, due to the appearance of worsening pulmonary vascular disease on computed tomography (CT) of the chest. Previous transthoracic echocardiograms (TTE) identified right ventricle enlargement, but no other structural abnormalities. She completed cardiac magnetic resonance (CMR) imaging, which identified a large secundum atrial septal defect (ASD). She subsequently underwent surgical planning and correction of the lesion with improvement of her symptoms. This case and a growing body of literature support the use of CMR as an alternative imaging modality for the diagnosis of congenital heart disease (CHD).
Collapse
|
|
2
|
Nolte D, Bertoglio C. Inverse problems in blood flow modeling: A review. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3613. [PMID: 35526113 PMCID: PMC9541505 DOI: 10.1002/cnm.3613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/29/2021] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
Mathematical and computational modeling of the cardiovascular system is increasingly providing non-invasive alternatives to traditional invasive clinical procedures. Moreover, it has the potential for generating additional diagnostic markers. In blood flow computations, the personalization of spatially distributed (i.e., 3D) models is a key step which relies on the formulation and numerical solution of inverse problems using clinical data, typically medical images for measuring both anatomy and function of the vasculature. In the last years, the development and application of inverse methods has rapidly expanded most likely due to the increased availability of data in clinical centers and the growing interest of modelers and clinicians in collaborating. Therefore, this work aims to provide a wide and comparative overview of literature within the last decade. We review the current state of the art of inverse problems in blood flows, focusing on studies considering fully dimensional fluid and fluid-solid models. The relevant physical models and hemodynamic measurement techniques are introduced, followed by a survey of mathematical data assimilation approaches used to solve different kinds of inverse problems, namely state and parameter estimation. An exhaustive discussion of the literature of the last decade is presented, structured by types of problems, models and available data.
Collapse
Affiliation(s)
- David Nolte
- Bernoulli InstituteUniversity of GroningenGroningenThe Netherlands
- Center for Mathematical ModelingUniversidad de ChileSantiagoChile
- Department of Fluid DynamicsTechnische Universität BerlinBerlinGermany
| | | |
Collapse
|
|
3
|
Isorni MA, Moisson L, Moussa NB, Monnot S, Raimondi F, Roussin R, Boet A, van Aerschot I, Fournier E, Cohen S, Kara M, Hascoet S. 4D flow cardiac magnetic resonance in children and adults with congenital heart disease: Clinical experience in a high volume center. Int J Cardiol 2020; 320:168-177. [DOI: 10.1016/j.ijcard.2020.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/29/2020] [Accepted: 07/13/2020] [Indexed: 12/25/2022]
|
|
4
|
Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2020; 139:e637-e697. [PMID: 30586768 DOI: 10.1161/cir.0000000000000602] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Karen K Stout
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Curt J Daniels
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Jamil A Aboulhosn
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Biykem Bozkurt
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Craig S Broberg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Jack M Colman
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Stephen R Crumb
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Joseph A Dearani
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Stephanie Fuller
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Michelle Gurvitz
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Paul Khairy
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Michael J Landzberg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Arwa Saidi
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - Anne Marie Valente
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| | - George F Van Hare
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative. §§Former Task Force member; current member during the writing effort
| |
Collapse
|
|
5
|
Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2020; 139:e698-e800. [PMID: 30586767 DOI: 10.1161/cir.0000000000000603] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Karen K Stout
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Curt J Daniels
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Jamil A Aboulhosn
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Biykem Bozkurt
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Craig S Broberg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Jack M Colman
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Stephen R Crumb
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Joseph A Dearani
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Stephanie Fuller
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Michelle Gurvitz
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Paul Khairy
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Michael J Landzberg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Arwa Saidi
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - Anne Marie Valente
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| | - George F Van Hare
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for recusal information. †ACC/AHA Representative. ‡International Society for Adult Congenital Heart Disease Representative. §Society for Cardiovascular Angiography and Interventions Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ¶Society of Thoracic Surgeons Representative. #American Association for Thoracic Surgery Representative. **ACC/AHA Task Force on Performance Measures Liaison. ††American Society of Echocardiography Representative. ‡‡Heart Rhythm Society Representative
| |
Collapse
|
|
6
|
Michaud K, Genet P, Sabatasso S, Grabherr S. Postmortem imaging as a complementary tool for the investigation of cardiac death. Forensic Sci Res 2019; 4:211-222. [PMID: 31489387 PMCID: PMC6713140 DOI: 10.1080/20961790.2019.1630944] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/06/2019] [Accepted: 06/10/2019] [Indexed: 12/26/2022] Open
Abstract
In the past 2 decades, modern radiological methods, such as multiple detector computed tomography (MDCT), MDCT-angiography, and cardiac magnetic resonance imaging (MRI) were introduced into postmortem practice for investigation of sudden death (SD), including cases of sudden cardiac death (SCD). In forensic cases, the underlying cause of SD is most frequently cardiovascular with coronary atherosclerotic disease as the leading cause. There are many controversies about the role of postmortem imaging in establishing the cause of death and especially the value of minimally invasive autopsy techniques. This paper discusses the state of the art for postmortem radiological evaluation of the heart compared to classical postmortem examination, especially in cases of SCD. In SCD cases, postmortem CT is helpful to estimate the heart size and to visualize haemopericardium and calcified plaques and valves, as well as to identify and locate cardiovascular devices. Angiographic methods are useful to provide a detailed view of the coronary arteries and to analyse them, especially regarding the extent and location of stenosis and obstruction. In postsurgical cases, it allows verification and documentation of the patency of stents and bypass grafts before opening the body. Postmortem MRI is used to investigate soft tissues such as the myocardium, but images are susceptible to postmortem changes and further work is necessary to increase the understanding of these radiological aspects, especially of the ischemic myocardium. In postsurgery cases, the value of postmortem imaging of the heart is reportedly for the diagnostic and documentation purposes. The implementation of new imaging methods into routine postmortem practice is challenging, as it requires not only an investment in equipment but, more importantly, investment in the expertise of interpreting the images. Once those requirements are implemented, however, they bring great advantages in investigating cases of SCD, as they allow documentation of the body, orientation of sampling for further analyses and gathering of other information that cannot be obtained by conventional autopsy such as a complete visualization of the vascular system using postmortem angiography.Key pointsThere are no established guidelines for the interpretation of postmortem imaging examination of the heartAt present, postmortem imaging methods are considered as less accurate than the autopsy for cardiac deathsPostmortem imaging is useful as a complementary tool for cardiac deathsThere is still a need to validate postmortem imaging in cardiac deaths by comparing with autopsy findings.
Collapse
Affiliation(s)
- Katarzyna Michaud
- Lausanne University Hospital and University of Lausanne, University Center of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Pia Genet
- Lausanne University Hospital and University of Lausanne, University Center of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland.,Geneva University Hospital, University Center of Legal Medicine Lausanne-Geneva, Geneva, Switzerland
| | - Sara Sabatasso
- Geneva University Hospital, University Center of Legal Medicine Lausanne-Geneva, Geneva, Switzerland
| | - Silke Grabherr
- Lausanne University Hospital and University of Lausanne, University Center of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland.,Geneva University Hospital, University Center of Legal Medicine Lausanne-Geneva, Geneva, Switzerland
| |
Collapse
|
|
7
|
Azarine A, Garçon P, Stansal A, Canepa N, Angelopoulos G, Silvera S, Sidi D, Marteau V, Zins M. Four-dimensional Flow MRI: Principles and Cardiovascular Applications. Radiographics 2019; 39:632-648. [PMID: 30901284 DOI: 10.1148/rg.2019180091] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In-plane phase-contrast (PC) imaging is now a routine component of MRI of regional blood flow in the heart and great vessels. In-plane PC MRI provides a volumetric, isotropic, time-resolved cine sequence that enables three-directional velocity encoding, a technique known as four-dimensional (4D) flow MRI. Recent advances in 4D flow MRI have shortened imaging times, while progress in big-data processing has improved dataset pre- and postprocessing, thereby increasing the feasibility of 4D flow MRI in clinical practice. Important technical issues include selection of the optimal velocity-encoding sensitivity before acquisition and preprocessing of the raw data for phase-offset corrections. Four-dimensional flow MRI provides unprecedented capabilities for comprehensive analysis of complex blood flow patterns using new visualization tools such as streamlines and velocity vectors. Retrospective multiplanar navigation enables flexible retrospective flow quantification through any plane across the volume with good accuracy. Current flow parameters include forward flow, reverse flow, regurgitation fraction, and peak velocity. Four-dimensional flow MRI also supplies advanced flow parameters of use for research, such as wall shear stress. The vigorous burgeoning of new applications indicates that 4D flow MRI is becoming an important imaging modality for cardiovascular disorders. This article reviews the main technical issues of 4D flow MRI and the different parameters provided by it and describes the main applications in cardiovascular diseases, including congenital heart disease, cardiac valvular disease, aortic disease, and pulmonary hypertension. Online supplemental material is available for this article. ©RSNA, 2019 See discussion on this article by Ordovas .
Collapse
Affiliation(s)
- Arshid Azarine
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Philippe Garçon
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Audrey Stansal
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Nadia Canepa
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Giorgios Angelopoulos
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Stephane Silvera
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Daniel Sidi
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Véronique Marteau
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| | - Marc Zins
- From the Departments of Medical Imaging (A.A., N.C., G.A., S.S., V.M., M.Z.), Cardiology (P.G.), and Vascular Medicine (A.S.), Saint Joseph Hospital, 185 rue Raymond Losserand, 75014 Paris, France; and Department of Pediatric Cardiology, Necker Enfants Malades Hospital, Paris, France (D.S.)
| |
Collapse
|
|
8
|
Hamilton RB, Scalzo F, Baldwin K, Dorn A, Vespa P, Hu X, Bergsneider M. Opposing CSF hydrodynamic trends found in the cerebral aqueduct and prepontine cistern following shunt treatment in patients with normal pressure hydrocephalus. Fluids Barriers CNS 2019; 16:2. [PMID: 30665428 PMCID: PMC6341759 DOI: 10.1186/s12987-019-0122-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/11/2019] [Indexed: 01/22/2023] Open
Abstract
Background This study investigated cerebrospinal fluid (CSF) hydrodynamics using cine phase-contrast MRI in the cerebral aqueduct and the prepontine cistern between three distinct groups: pre-shunt normal pressure hydrocephalus (NPH) patients, post-shunt NPH patients, and controls. We hypothesized that the hyperdynamic flow of CSF through the cerebral aqueduct seen in NPH patients was due to a reduction in cisternal CSF volume buffering. Both hydrodynamic (velocity, flow, stroke volume) and peak flow latency (PFL) parameters were investigated. Methods Scans were conducted on 30 pre-treatment patients ranging in age from 58 to 88 years along with an additional 12 controls. Twelve patients also received scans following either ventriculoatrial (VA) or ventriculoperitoneal (VP) shunt treatment (9 VP, 3 VA), ranging in age from 74 to 89 years with a mean follow up time of 6 months. Results Significant differences in area, velocity, flow, and stroke volume for the cerebral aqueduct were found between the pre-treatment NPH group and the healthy controls. Shunting caused a significant decrease in both caudal and cranial mean flow and stroke volume in the cerebral aqueduct. No significant changes were found in the prepontine cistern between the pre-treatment group and healthy controls. For the PFL, no significant differences were seen in the cerebral aqueduct between any of the three groups; however, the prepontine cistern PFL was significantly decreased in the pre-treatment NPH group when compared to the control group. Conclusions Although several studies have quantified the changes in aqueductal flow between hydrocephalic groups and controls, few studies have investigated prepontine cistern flow. Our study was the first to investigate both regions in the same patients for NPH pre- and post- treatment. Following shunt treatment, the aqueductal CSF metrics decreased toward control values, while the prepontine cistern metrics trended up (not significantly) from the normal values established in this study. The opposing trend of the two locations suggests a redistribution of CSF pulsatility in NPH patients. Furthermore, the significantly decreased latency of the prepontine cisternal CSF flow suggests additional evidence for CSF pulsatility dysfunction.
Collapse
Affiliation(s)
- Robert B Hamilton
- Neural Systems and Dynamics Laboratory, Department of Neurosurgery, The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.,Biomedical Engineering Graduate Program, Henry Samueli School of Engineering and Applied Science, University of California-Los Angeles, 7400 Boelter Hall, Los Angeles, CA, 90095, USA.,Neural Analytics, Inc., 2440 S Sepulveda Blvd, Suite 115, Los Angeles, CA, 90064, USA
| | - Fabien Scalzo
- Neural Systems and Dynamics Laboratory, Department of Neurosurgery, The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.,Neural Analytics, Inc., 2440 S Sepulveda Blvd, Suite 115, Los Angeles, CA, 90064, USA
| | - Kevin Baldwin
- Neural Systems and Dynamics Laboratory, Department of Neurosurgery, The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Amber Dorn
- Neural Analytics, Inc., 2440 S Sepulveda Blvd, Suite 115, Los Angeles, CA, 90064, USA.
| | - Paul Vespa
- The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Xiao Hu
- Neural Systems and Dynamics Laboratory, Department of Neurosurgery, The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.,Biomedical Engineering Graduate Program, Henry Samueli School of Engineering and Applied Science, University of California-Los Angeles, 7400 Boelter Hall, Los Angeles, CA, 90095, USA
| | - Marvin Bergsneider
- Neural Systems and Dynamics Laboratory, Department of Neurosurgery, The David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.,Biomedical Engineering Graduate Program, Henry Samueli School of Engineering and Applied Science, University of California-Los Angeles, 7400 Boelter Hall, Los Angeles, CA, 90095, USA
| |
Collapse
|
|
9
|
Claretti M, Pradelli D, Borgonovo S, Boz E, Bussadori CM. Clinical, echocardiographic and advanced imaging characteristics of 13 dogs with systemic-to-pulmonary arteriovenous fistulas. J Vet Cardiol 2018; 20:415-424. [PMID: 30526957 DOI: 10.1016/j.jvc.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 09/10/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective is to describe the clinical, radiographic, echocardiographic and angiographic findings in dogs with systemic-to-pulmonary arteriovenous fistula (SPAVF). ANIMALS Thirteen medical records of client-owned dogs with a diagnosis of SPAVF were reviewed/analysed. METHODS This is a retrospective study of case records. Thoracic radiography, transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), three-dimensional TEE, intracardiac echocardiography, fluoroscopy-guided or computed tomography (CT) angiography were carried out. RESULTS Based on the TTE, SPAVF was identified in seven of the included dogs. In eight cases, TEE and angiography were both performed and confirmed the diagnosis. Computed tomography angiography was performed in three dogs. A case was diagnosed by TEE alone, another one by three-dimensional TEE and the latter by intracardiac echocardiography. CONCLUSIONS Transthoracic echocardiography identified seven cases of SPAVF, while definitive diagnosis in the remaining dogs required selective angiography or computed tomography angiography.
Collapse
Affiliation(s)
- M Claretti
- Department of Cardiology of Clinica Veterinaria Gran Sasso, Via Donatello 26, 20131, Milano, Italy
| | - D Pradelli
- Department of Cardiology of Clinica Veterinaria Gran Sasso, Via Donatello 26, 20131, Milano, Italy.
| | - S Borgonovo
- Department of Cardiology of Clinica Veterinaria Gran Sasso, Via Donatello 26, 20131, Milano, Italy
| | - E Boz
- Department of Cardiology of Clinica Veterinaria Gran Sasso, Via Donatello 26, 20131, Milano, Italy
| | - C M Bussadori
- Department of Cardiology of Clinica Veterinaria Gran Sasso, Via Donatello 26, 20131, Milano, Italy
| |
Collapse
|
|
10
|
Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 73:e81-e192. [PMID: 30121239 DOI: 10.1016/j.jacc.2018.08.1029] [Citation(s) in RCA: 487] [Impact Index Per Article: 81.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
|
11
|
2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 73:1494-1563. [PMID: 30121240 DOI: 10.1016/j.jacc.2018.08.1028] [Citation(s) in RCA: 320] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
|
12
|
Broda CR, Shugh SB, Parikh RB, Wang Y, Schlingmann TR, Noel CV. Post-operative Assessment of the Arterial Switch Operation: A Comparison of Magnetic Resonance Imaging and Echocardiography. Pediatr Cardiol 2018; 39:1036-1041. [PMID: 29564521 DOI: 10.1007/s00246-018-1858-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/03/2018] [Indexed: 11/25/2022]
Abstract
After an arterial switch operation (ASO), serial imaging is necessary to monitor for maladaptive changes. We compared cardiac magnetic resonance imaging (CMR) to 2-D transthoracic echocardiography (TTE) in assessing post-operative ASO patients. We performed a retrospective review of patients at a single tertiary care center who underwent an ASO and subsequently had a CMR performed from 7/2010 to 7/2016. Those with single ventricle anatomy, congenitally corrected transposition of the great arteries, or previous atrial switch operation were excluded. TTE obtained within 6 months of the CMR was used for comparison. Parameters compared included ventricular size and systolic function, semilunar valve regurgitation, neo-aortic root dimension, and the presence of branch pulmonary artery (PA) stenosis (on CMR by the Nakata index or right/left flow differential; on TTE by peak velocity > 2 m/s or PA diameter Z score < - 2). Forty-seven patients with 90 CMR and 86 TTE studies met inclusion criteria. CMR and TTE assessment of right ventricular (RV) and left ventricular function did not statistically differ. RV dilation was overdetected by TTE (p = 0.046). Right pulmonary artery and left pulmonary artery (LPA) visualization by TTE was worse than CMR (p < 0.01). There was no statistically significant difference between CMR and TTE assessment of branch PA stenosis; however, there was poor agreement between the use of Z score and velocity when determining branch PA stenosis by TTE (κ < 0). Assessment of neo-pulmonary regurgitation (PR) and neo-aortic regurgitation (AR) was significantly different between CMR and TTE (p < 0.05). Assessment for delayed enhancement was performed in 18% of CMR studies (n = 16), with perfusion defects appreciated in three patients. Substantial differences between CMR and TTE exist when examining the post-operative ASO patient. CMR was superior for evaluation of the branch PAs, which commonly require re-intervention. TTE failed to recognize altered ventricular function in several cases. Differences between TTE and CMR could alter management is some cases. Incorporation of CMR into the routine surveillance of patients who received an ASO is warranted.
Collapse
Affiliation(s)
- Christopher R Broda
- Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric and Congenital Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St. MC 19345C, Houston, TX, 77030, USA
| | - Svetlana B Shugh
- Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric and Congenital Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St. MC 19345C, Houston, TX, 77030, USA
| | - Rohan B Parikh
- Department of Internal Medicine, Western Reserve Health Education, Youngstown, OH, USA
| | - YunFei Wang
- Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric and Congenital Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St. MC 19345C, Houston, TX, 77030, USA
| | - Tobias R Schlingmann
- Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric and Congenital Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St. MC 19345C, Houston, TX, 77030, USA
| | - Cory V Noel
- Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric and Congenital Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St. MC 19345C, Houston, TX, 77030, USA.
| |
Collapse
|
|
13
|
Cordero L, Rodríguez J, Zuluaga J, Mendoza F, Pérez O. Utilidad de la ecocardiografía en la detección de la insuficiencia cardiaca en un adulto joven con síndrome de origen anómalo de la arteria coronaria izquierda del tronco de la arteria pulmonar y válvula mitral asimétrica similar al paracaídas. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2017.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
|
14
|
Ota H, Higuchi S, Sun W, Ueda T, Takase K, Tamura H. Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application. ACTA ACUST UNITED AC 2018. [DOI: 10.22468/cvia.2018.00045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Satoshi Higuchi
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Wenyu Sun
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Takuya Ueda
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Hajime Tamura
- Division of Medical Physics, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
|
15
|
|
|
16
|
Hasan BS, Lunze FI, Alvi N, Shafer KM, Rhodes J. Feasibility of exercise stress echocardiography and myocardial response in patients with repaired congenital heart disease. Am Heart J 2017; 188:1-10. [PMID: 28577664 DOI: 10.1016/j.ahj.2017.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/18/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exercise stress echocardiography (ESE) can unmask ventricular dysfunction in asymptomatic patients with congenital heart disease (CHD), but its acquisition and interpretation is often challenging, and the method has not been validated in CHD. This study aimed to evaluate the feasibility of ESE using Doppler imaging and to assess myocardial response to exercise in patients with biventricular (BiV) and univentricular (UniV) circulation after CHD repair. METHODS In this single-center prospective study, we recruited 55 participants (17 females), median age 14 years (8-22 years). Our analysis categorized participants in these three groups: with structurally normal hearts as controls (n=21), with BiV circulation (n=20) and with UniV circulation (n=14). We acquired ESE images of the systemic ventricle including pulsed-wave flow and spectral tissue Doppler imaging (TDI) of lateral free wall before and immediately after standard, symptom-limited exercise tests on an electronically braked cycle ergometer. RESULTS During ESE we obtained inflow E-wave and TDI systolic (S') and early diastolic (E') velocities in 93% to 100% of participants at rest and in 90% to 100% of participants post exercise. Feasibility to obtain Doppler imaging parameter was the same across study groups. The myocardial response to exercise was increase in heart rate (HR), S' and inflow E-wave velocity in all participants. Patients with BiV circulation had preserved ventricular function at rest. While patients with UniV circulation had low S', E', and E-wave velocities at rest in comparison to controls and to BiV group (all P<.001), both patients with BiV and UniV circulation showed significant increases in HR, S' velocity and inflow E-wave velocity post exercise, with magnitudes of these increases higher in controls than in the BiV and UniV group. The S' and E' velocities were strongly associated with lower percent predicted peak oxygen consumption VO2 (rs=0.614 and rs=0.64, respectively, both P<.001). CONCLUSION ESE with Doppler imaging is a practical noninvasive diagnostic method and sufficiently robust for the assessment of morphologic LV/systemic ventricles under exercise in patients after biventricular and univentricular CHD repair. Although patients with BiV and UniV circulation had both preserved myocardial response to exercise, the magnitude of this response was the lowest in patients with UniV circulation.
Collapse
Affiliation(s)
- Babar S Hasan
- Department of Pediatrics and Child Health, Aga Khan Medical University, Pakistan.
| | - Fatima I Lunze
- Department of Cardiology Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Najveen Alvi
- Department of Pediatrics and Child Health, Aga Khan Medical University, Pakistan
| | - Keri M Shafer
- Department of Cardiology Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jonathan Rhodes
- Department of Cardiology Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
|
17
|
McDowell K, Carrick D, Weir RA. Near drowning in a 48-year-old man. Heart 2017; 103:1302. [PMID: 28522657 DOI: 10.1136/heartjnl-2016-311043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/22/2017] [Accepted: 04/09/2017] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - David Carrick
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
| | - Robin A Weir
- Hairmyres Hospital, Cardiology, East Kilbride, UK
| |
Collapse
|
|
18
|
Update on the Role of Cardiac Magnetic Resonance Imaging in Congenital Heart Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:2. [PMID: 28144782 DOI: 10.1007/s11936-017-0504-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OPINION STATEMENT Cardiac magnetic resonance imaging (CMR) is an important imaging modality in the evaluation of congenital heart diseases (CHD). CMR has several strengths including good spatial and temporal resolutions, wide field-of-view, and multi-planar imaging capabilities. CMR provides significant advantages for imaging in CHD through its ability to measure function, flow and vessel sizes, create three-dimensional reconstructions, and perform tissue characterization, all in a single imaging study. Thus, CMR is the most comprehensive imaging modality available today for the evaluation of CHD. Newer MRI sequences and post-processing tools will allow further development of quantitative methods of analysis, and opens the door for risk stratification in CHD. CMR also can interface with computer modeling, 3D printing, and other methods of understanding the complex anatomic and physiologic relationships in CHD.
Collapse
|
|
19
|
Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic Evaluation of the Right Heart. J Cardiovasc Ultrasound 2016; 24:183-190. [PMID: 27721944 PMCID: PMC5050302 DOI: 10.4250/jcu.2016.24.3.183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 05/03/2016] [Accepted: 07/26/2016] [Indexed: 12/23/2022] Open
Abstract
The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.
Collapse
Affiliation(s)
- Roshanak R Markley
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Asghar Ali
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Jonathan Potfay
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Walter Paulsen
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Ion S Jovin
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| |
Collapse
|
|
20
|
Bhat V, Belaval V, Gadabanahalli K, Raj V, Shah S. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part I: Clinical Perspective, Anatomy and Imaging Techniques. J Clin Diagn Res 2016; 10:TE01-6. [PMID: 27376034 DOI: 10.7860/jcdr/2016/16779.7871] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 04/02/2016] [Indexed: 12/26/2022]
Abstract
Rapid evolution in technology in the recent years has lead to availability of multiple options for cardiac imaging. Availability of multiple options of varying capability, poses a challenge for optimal imaging choice. While new imaging choices are added, some of the established methods find their role re-defined. State of the art imaging practices are limited to few specialist cardiac centres, depriving many radiologists and radiologist in-training of optimal exposure to the field. This presentation is aimed at providing a broad idea about complexity of clinical problem, imaging options and a large library of images of congenital heart disease. Some emphasis is made as to the need of proper balance between performing examination with technical excellence in an ideal situation against the need of the majority of patients who are investigated with less optimal resources. Cases of congenital cardiac disease are presented in an illustrative way, showing imaging appearances in multiple modalities, highlighting specific observations in given instance.
Collapse
Affiliation(s)
- Venkatraman Bhat
- Director of Imaging Services, HOD, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vinay Belaval
- Junior Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Karthik Gadabanahalli
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vimal Raj
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Sejal Shah
- Senior Consultant, Department of Paediatric Cardiology, Narayana Health, Narayana Hrudayalaya , Bengaluru, India
| |
Collapse
|
|
21
|
Bhat V, Belaval V, Gadabanahalli K, Raj V, Shah S. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part III: Cyanotic Heart Diseases and Complex Congenital Anomalies. J Clin Diagn Res 2016; 10:TE01-10. [PMID: 27630924 DOI: 10.7860/jcdr/2016/21443.8210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 04/02/2016] [Indexed: 11/24/2022]
Abstract
From the stand point of radiographic analysis most of the complex cyanotic congenital heart diseases (CHD), can be divided into those associated with decreased or increased pulmonary vascularity. Combination of a specific cardiac configuration and status of lung vasculature in a clinical context allows plain film diagnosis to be predicted in some CHD. Correlation of the position of the cardiac apex in relation to the visceral situs is an important information that can be obtained from the plain film. This information helps in gathering information about the atrio-ventricular, ventricular arterial concordance or discordance. Categorization of the cyanotic heart disease based on vascularity is presented below. Thorough understanding of cardiac anatomy by different imaging methods is essential in understanding and interpreting complex cardiac disease. Basic anatomical details and background for interpretation are provided in the previous parts of this presentation.
Collapse
Affiliation(s)
- Venkatraman Bhat
- Director and Head, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, Karnataka, India
| | - Vinay Belaval
- Junior Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, Karnataka, India
| | - Karthik Gadabanahalli
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, Karnataka, India
| | - Vimal Raj
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, Karnataka, India
| | - Sejal Shah
- Senior Consultant, Department of Pediatric Cardiology, Narayana Health, Narayana Hrudayalaya , Bengaluru, Karnataka, India
| |
Collapse
|
|
22
|
Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT). J Cardiovasc Comput Tomogr 2015; 9:475-92. [DOI: 10.1016/j.jcct.2015.07.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
|
|
23
|
Abstract
Many novel cardiac MR sequences can be used for assessment of adult patients with congenital heart disease. Although most of these techniques are still primarily used in the research arena, there are many potential applications in clinical practice. Advanced cardiac MR assessment of myocardial tissue characterization, flow hemodynamics, and myocardial strain are promising tools for diagnostic and prognostic assessment late after repair of congenital heart diseases.
Collapse
|
|
24
|
Abid D, Daoud E, Ben Kahla S, Mallek S, Abid L, Fourati H, Mnif Z, Kammoun S. Unrepaired persistent truncus arteriosus in a 38-year-old woman with an uneventful pregnancy. Cardiovasc J Afr 2015; 26:e6-8. [PMID: 26407331 PMCID: PMC4683288 DOI: 10.5830/cvja-2015-005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 01/11/2015] [Indexed: 11/25/2022] Open
Abstract
Persistent truncus arteriosus (PTA) is a rare conotruncal defect, defined as a single arterial vessel arising from the heart, which gives origin to the systemic, pulmonary and coronary circulations. It has an extremely poor prognosis and carries a high mortality rate during the early years of life unless surgically repaired. A few known cases have been reported of patients reaching maturity, and exceptionally, patients suffering from this disease having lived into the fourth decade. The purpose of this report was to present a new case of PTA type 1, diagnosed by echocardiography and MRI, in a 41-year-old woman, with the peculiarity of long survival into adult life. She had also experienced a full-term pregnancy and delivery of a normal infant three years prior to her diagnosis. Pulmonary vascular disease made her condition inoperable but she was doing well with medical management after a follow up of 15 months. Based on this work, we concluded that pulmonary arterial hypertension is deleterious for life in some cardiovascular diseases, but in others, allows survival, as occurred in these patients with PTA. The patient’s clinical course and anatomical findings are reported, along with factors that may have contributed to her longevity.
Collapse
Affiliation(s)
- Dorra Abid
- Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.
| | - Emna Daoud
- Department of Radiology, Hedi Chaker Hospital, Sfax, Tunisia
| | | | - Souad Mallek
- Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Leila Abid
- Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Hela Fourati
- Department of Radiology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Zeineb Mnif
- Department of Radiology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia
| |
Collapse
|
|
25
|
Meyersohn NM, Ghemigian K, Shapiro MD, Shah SV, Ghoshhajra BB, Ferencik M. Role of Computed Tomography in Assessment of the Thoracic Aorta. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:395. [DOI: 10.1007/s11936-015-0395-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
|
26
|
Bhatt AB, Foster E, Kuehl K, Alpert J, Brabeck S, Crumb S, Davidson WR, Earing MG, Ghoshhajra BB, Karamlou T, Mital S, Ting J, Tseng ZH. Congenital Heart Disease in the Older Adult. Circulation 2015; 131:1884-931. [DOI: 10.1161/cir.0000000000000204] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
|
27
|
Abstract
OBJECTIVE. The purpose of this article is to summarize the roles of CT and MRI in the diagnosis and follow-up of patients with aortic coarctation. CONCLUSION. Aortic coarctation is a common congenital heart disease accounting for approximately 6-8% of congenital heart defects. Despite its deceptively simple anatomic presentation, it is a complex medical problem with several associated anatomic and physiologic abnormalities. CT and MRI may provide very accurate information of the coarctation anatomy and other associated cardiac abnormalities.
Collapse
|
|
28
|
Park SH, Choi JY, Park EJ, Kim HD, Choi MJ, Choi SI, Kim JB, Lee S, Na JO. A typical case of L-transposition of the great arteries initially presented as complete atrioventricular block in middle-aged man. J Cardiovasc Ultrasound 2015; 23:36-9. [PMID: 25883755 PMCID: PMC4398783 DOI: 10.4250/jcu.2015.23.1.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 09/06/2014] [Accepted: 02/27/2015] [Indexed: 01/03/2023] Open
Abstract
L-transposition of the great arteries (L-TGA) is a rare congenital anomaly and could cause complete atrioventricular (AV) block at relatively younger age. We present a case of 43-year-old male who complained of dizziness due to complete AV block. We confirmed L-TGA using transthoracic echocardiography and cardiac computed tomography. Permanent pacemaker was inserted without complications. No invasive treatment including corrective surgery was performed because patient's cardiac function was almost normal and the symptom was completely resolved after pacemaker insertion.
Collapse
Affiliation(s)
- Sung-Hun Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Ja Yeon Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Eun Jin Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Hee Dong Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Min Joo Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Sue In Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Ji Bak Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Sunki Lee
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| |
Collapse
|
|
29
|
Yasukochi S. Assessment of Intracardiac Anatomy by Magnetic Resonance Imaging. CONGENIT HEART DIS 2015. [DOI: 10.1007/978-4-431-54355-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
|
30
|
Khairy P, Van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, Daniels CJ, Deal BJ, Dearani JA, Groot ND, Dubin AM, Harris L, Janousek J, Kanter RJ, Karpawich PP, Perry JC, Seslar SP, Shah MJ, Silka MJ, Triedman JK, Walsh EP, Warnes CA. PACES/HRS expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD). Can J Cardiol 2014; 30:e1-e63. [PMID: 25262867 DOI: 10.1016/j.cjca.2014.09.002] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
|
31
|
Chen X, Qu Y, Peng ZY, Lu J, Ma X, Hu W. Clinical value of multi-slice spiral computed tomography angiography and three-dimensional reconstruction in the diagnosis of double aortic arch. Exp Ther Med 2014; 8:623-627. [PMID: 25009630 PMCID: PMC4079402 DOI: 10.3892/etm.2014.1763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 04/29/2014] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the clincal value of multi-slice spiral computed tomography (MSCT) in the diagnosis of double aortic arch (DAA) and analyze the associated angiography and 3D reconstruction imaging to increase the accuracy of DAA diagnosis. Clinical and imaging data from 15 patients diagnosed with DAA by MSCT were summarized and compared with the corresponding surgical observations. The DAA diagnosis by MSCT for the 15 patients was confirmed by the surgical observations. A total of 13 cases were categorized as type I (double arches are open), including nine with a larger right arch, two with a larger left arch and two with balanced arches. Two cases were categorized as type II (one atretic arch), characterized by left atretic arch. Among the 15 patients, ultrasound diagnosis succeeded in nine cases and failed in the rest. A single malformation was identified in only two cases, whereas the rest had single or multiple combination(s) of intracardiac and extracardiac malformations, including seven with different levels of tracheobronchial stenosis. MSCT was demonstrated to precisely diagnose DAA complicated by malformation and tracheobronchial stenosis. MSCT is an essential therapeutic strategy and serves as a primary method in DAA diagnosis.
Collapse
Affiliation(s)
- Xin Chen
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Yanjuan Qu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Zhi-Yuan Peng
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Jingguo Lu
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Xiaojing Ma
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Wenjuan Hu
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| |
Collapse
|
|
32
|
Long-term natural history and postoperative outcome of double-chambered right ventricle—Experience from two tertiary adult congenital heart centres and review of the literature. Int J Cardiol 2014; 174:662-8. [DOI: 10.1016/j.ijcard.2014.04.177] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/29/2022]
|
|
33
|
Stankovic Z, Allen BD, Garcia J, Jarvis KB, Markl M. 4D flow imaging with MRI. Cardiovasc Diagn Ther 2014; 4:173-92. [PMID: 24834414 DOI: 10.3978/j.issn.2223-3652.2014.01.02] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/21/2013] [Indexed: 12/22/2022]
Abstract
Magnetic resonance imaging (MRI) has become an important tool for the clinical evaluation of patients with cardiovascular disease. Since its introduction in the late 1980s, 2-dimensional phase contrast MRI (2D PC-MRI) has become a routine part of standard-of-care cardiac MRI for the assessment of regional blood flow in the heart and great vessels. More recently, time-resolved PC-MRI with velocity encoding along all three flow directions and three-dimensional (3D) anatomic coverage (also termed '4D flow MRI') has been developed and applied for the evaluation of cardiovascular hemodynamics in multiple regions of the human body. 4D flow MRI allows for the comprehensive evaluation of complex blood flow patterns by 3D blood flow visualization and flexible retrospective quantification of flow parameters. Recent technical developments, including the utilization of advanced parallel imaging techniques such as k-t GRAPPA, have resulted in reasonable overall scan times, e.g., 8-12 minutes for 4D flow MRI of the aorta and 10-20 minutes for whole heart coverage. As a result, the application of 4D flow MRI in a clinical setting has become more feasible, as documented by an increased number of recent reports on the utility of the technique for the assessment of cardiac and vascular hemodynamics in patient studies. A number of studies have demonstrated the potential of 4D flow MRI to provide an improved assessment of hemodynamics which might aid in the diagnosis and therapeutic management of cardiovascular diseases. The purpose of this review is to describe the methods used for 4D flow MRI acquisition, post-processing and data analysis. In addition, the article provides an overview of the clinical applications of 4D flow MRI and includes a review of applications in the heart, thoracic aorta and hepatic system.
Collapse
Affiliation(s)
- Zoran Stankovic
- 1 Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, USA ; 2 Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, USA
| | - Bradley D Allen
- 1 Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, USA ; 2 Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, USA
| | - Julio Garcia
- 1 Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, USA ; 2 Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, USA
| | - Kelly B Jarvis
- 1 Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, USA ; 2 Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, USA
| | - Michael Markl
- 1 Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, USA ; 2 Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, USA
| |
Collapse
|
|
34
|
Khairy P, Van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, Daniels CJ, Deal BJ, Dearani JA, Groot ND, Dubin AM, Harris L, Janousek J, Kanter RJ, Karpawich PP, Perry JC, Seslar SP, Shah MJ, Silka MJ, Triedman JK, Walsh EP, Warnes CA. PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD). Heart Rhythm 2014; 11:e102-65. [PMID: 24814377 DOI: 10.1016/j.hrthm.2014.05.009] [Citation(s) in RCA: 371] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Indexed: 02/07/2023]
|
|
35
|
Harrild DM, Marcus E, Hasan B, Alexander ME, Powell AJ, Geva T, McElhinney DB. Impact of transcatheter pulmonary valve replacement on biventricular strain and synchrony assessed by cardiac magnetic resonance feature tracking. Circ Cardiovasc Interv 2013; 6:680-7. [PMID: 24300136 DOI: 10.1161/circinterventions.113.000690] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transcatheter pulmonary valve (TPV) replacement is an emerging therapy intended to restore pulmonary valve function in patients with right ventricular outflow tract conduit dysfunction; the impact of this technique on ventricular strain and synchrony is not known. METHODS AND RESULTS Cardiac magnetic resonance and ECG data acquired at 1 center as part of the US Melody TPV trial were analyzed. Biventricular strain and mechanical synchrony measurements were made based on short-axis and 4-chamber steady-state free precession images using feature tracking software. Post- versus pre-TPV replacement findings were compared for all patients (n=31) and subgroups with predominant pulmonary regurgitation (n=13) or stenosis (n=18). Most patients had tetralogy of Fallot (18/31). After TPV replacement, left ventricular (LV) circumferential strain increased for the whole cohort (P<0.001) and both subgroups (pulmonary regurgitation P=0.01; pulmonary stenosis P=0.02). LV longitudinal strain increased for the whole cohort (P=0.02) and pulmonary regurgitation subgroup (P=0.05); circumferential right ventricular strain increased for the pulmonary stenosis group only (P=0.05). LV longitudinal synchrony improved significantly in the pulmonary regurgitation group (maximum wall delay P=0.03; cross-correlation delay P=0.01). Electric measures of synchrony did not improve. CONCLUSIONS In patients with right ventricular outflow tract conduit dysfunction, TPV replacement is associated with improved global LV strain, as well as improved right ventricular strain and LV synchrony in subgroups. Given the associations between strain and synchrony and clinical outcomes, these findings support potential long-term benefits of TPV replacement.
Collapse
Affiliation(s)
- David M Harrild
- From the Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | |
Collapse
|
|
36
|
Han BK, Lesser AM, Vezmar M, Rosenthal K, Rutten-Ramos S, Lindberg J, Caye D, Lesser JR. Cardiovascular imaging trends in congenital heart disease: a single center experience. J Cardiovasc Comput Tomogr 2013; 7:361-6. [PMID: 24331931 DOI: 10.1016/j.jcct.2013.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 10/04/2013] [Accepted: 11/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cardiac magnetic resonance imaging (MRI) and CT are available in the recent era at many pediatric cardiac centers. OBJECTIVE The aim was to provide a contemporary description of diagnostic imaging trends for definition of congenital heart disease (CHD). METHODS Echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT use in patients with congenital heart disease at a single institution was retrospectively recorded (2005-2012). Surgical procedures were recorded. Total and modality-specific rates were estimated by Poisson regression and compared. The median age, studies in patients aged >17 years, and referral diagnosis were tabulated for the last year of review. RESULTS An average of 11,940 cardiovascular diagnostic tests was performed annually. The number of total studies, echocardiograms, catheterizations, and surgical procedures, did not change significantly across time. Echocardiography comprised 95% to 97% of all studies performed during each year of review. The use of cardiac MRI (2%) and cardiac CT (1%) increased linearly (P < .001), and the use of diagnostic catheterization decreased (0.7%; P = .0005). The median age was 3 years for echocardiography, 15 years for MRI, 11 years for CT, and 3 years for catheterization. The percentage of patients aged >17 years was 9% for echocardiography, 33% for cardiac MRI, 29% for cardiac CT, and 8% for catheterization. Most patients undergoing CT, MRI, and diagnostic catheterization had moderate or complex CHD. CONCLUSION Cardiac CT is used increasingly in the recent era for evaluation of CHD. The increased use of both cardiac CT and cardiac MRI are temporally associated with a decrease in diagnostic cardiac catheterization.
Collapse
Affiliation(s)
- B Kelly Han
- The Children's Heart Clinic at The Children's Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA; The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA.
| | - Andrew M Lesser
- The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA
| | - Marko Vezmar
- The Children's Heart Clinic at The Children's Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA
| | - Kristi Rosenthal
- The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA
| | | | - Jana Lindberg
- The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA
| | - David Caye
- The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA
| | - John R Lesser
- The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA
| |
Collapse
|
|
37
|
Cardiac imaging in adults with congenital heart disease: unknowns and issues related to diagnosis. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2013; 15:663-74. [PMID: 24101413 DOI: 10.1007/s11936-013-0270-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OPINION STATEMENT Many adults with simple and complex congenital heart disease (CHD) survive to adulthood. The goal of imaging is to diagnose the underlying anomalies and to detect late complications of their CHD and past surgical repair, in order to assess the need for further intervention and better prepare for endovascular or open-heart surgery. Cardiac magnetic resonance imaging (MRI) and computerized tomography (CT) are increasingly utilized in this patient population, due to the technical advances made to these modalities in the past decade regarding image acquisition and reconstruction, spatial and temporal resolution, and radiation dose reduction. Here, we aim to review the role of cardiac MR in initial diagnosis, pre-treatment planning and post-surgical follow-up of adults with CHD, and to discuss the ancillary role of cardiac CT in these patients.
Collapse
|
|
38
|
Uemura H. Surgical and catheter procedures in adult congenital heart disease: simple national statistics of the UK tell us something. Gen Thorac Cardiovasc Surg 2013; 61:376-89. [DOI: 10.1007/s11748-013-0266-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Indexed: 01/08/2023]
|