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Sanguineti F, Garot P, Toupin S, Pezel T, Bohbot Y, Tawa C, Poupineau M, Boileve V, Landon V, Duhamel S, Garot J. Feasibility, safety and diagnostic yield of interventional cardiac magnetic resonance for routine right heart catheterization in adults. Arch Cardiovasc Dis 2024; 117:275-282. [PMID: 38472043 DOI: 10.1016/j.acvd.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Real-time cardiac magnetic resonance generates spatially and temporally resolved images of cardiac anatomy and function, without the need for contrast agent or X-ray exposure. Cardiac magnetic resonance-guided right heart catheterization (CMR-RHC) combines the benefits of cardiac magnetic resonance and invasive cardiac catheterization. The clinical adoption of CMR-RHC represents the first step towards the development of cardiac magnetic resonance-guided therapeutic procedures. AIM To describe the feasibility, safety and diagnostic yield of CMR-RHC in consecutive all-comer patients with clinical indications for right heart catheterization. METHODS From December 2018 to May 2021, 35 consecutive patients with prespecified indications for right heart catheterization were scheduled for CMR-RHC via the femoral route under local anaesthesia in a 1.5T cardiac magnetic resonance suite equipped for interventional cardiac magnetic resonance. The duration of various procedural components and safety data were recorded. Success rate (defined by the ability to record all prespecified haemodynamic measurements and imaging metrics), adverse events and patient/physician perprocedural comfort were assessed. RESULTS One patient withdrew his consent before the study, and scanner troubleshooting occurred in one case. Among the 33 remaining patients, prespecified cardiac magnetic resonance imaging metrics were obtained in all patients, whereas full CMR-RHC measurements were obtained in 30 patients (91%). A dedicated cardiac magnetic resonance-compatible wire was used in 25/33 procedures. CMR-RHC was completed in 29±16minutes, and the total duration of the procedure, including conventional cardiac magnetic resonance imaging, was 62±20minutes. There were no adverse events and no femoral haematomas. Procedural comfort was deemed good by the patients and operators for all procedures. CMR-RHC significantly impacted diagnosis or patient management in 28/33 patients (85%). CONCLUSIONS CMR-RHC seems to be a feasible and safe procedure that can be used in routine daily practice in consecutive adults with an impactful clinical yield.
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Affiliation(s)
- Francesca Sanguineti
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Philippe Garot
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Solenn Toupin
- Siemens Healthineers, Scientific Partnership, 93210 Saint-Denis, France
| | - Théo Pezel
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Yohann Bohbot
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Chloé Tawa
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Mathieu Poupineau
- Hôpital Privé Claude Galien, Ramsay Santé, Institut Cardiovasculaire Paris Sud (ICPS), 91480 Quincy-sous-Sénart, France
| | - Victor Boileve
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Valentin Landon
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Suzanne Duhamel
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - Jérôme Garot
- Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France.
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Bohbot Y, Garot J, Hovasse T, Unterseeh T, Di Lena C, Boukefoussa W, Tawa C, Renard C, Limouzineau I, Duhamel S, Garot P, Tribouilloy C, Sanguineti F. Clinical and cardiovascular magnetic resonance predictors of early and long-term clinical outcome in acute myocarditis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
The natural history of acute myocarditis (AM) remains partially unknown and predictors of outcome are debated.
Purpose
We sought to assess the impact of various cardiac magnetic resonance (CMR) parameters on early and long-term prognosis in a population of patients with AM.
Methods
In a two-centre longitudinal study, we included consecutive patients with diagnosis of AM based on CMR and without haemodynamic compromise. The primary endpoint was the occurrence of an event in the acute phase (≤15 days). Secondary endpoints were the occurrence of major adverse cardiac events (MACE) and recurrence of AM during follow-up.
Results
Three hundred and eighty-eight patients were included (mean age 38.5 years, 77.3% male, mean ejection fraction [EF]:56%) of which 82% (317) presented with chest pain. CMR was performed 4±2 days after index presentation. Overall, 38 patients (9.8%) had an event at the acute phase, 41 (10.6%) presented at least one MACE during follow-up (median 7.5 years, 6.6–8.9) and 30 (7.7%) experienced a recurrence of AM. By multivariate analysis, the independent predictors of initial complications were absence of chest pain (OR [95% CI] = 0.35 [0.15–0.82]), presence of syncope/pre-syncope (OR [95% CI] = 3.56 [1.26–10.02]), lower EF (OR [95% CI] = 0.94 [0.91–0.98] per %), myocardial extent of late gadolinium enhancement (LGE) (OR [95% CI] = 1.05 [1.002–1.100] per %) and absence of edema (OR [95% CI] = 0.44 [0.19–0.97]). Only age (HR [95% CI] = 1.021 [1.001–1.041] per year) and an initial alteration of EF (HR [95% CI] = 0.94 [0.91–0.97] per %) were associated with MACE during follow-up. Factors independently associated with AM recurrence were myocarditis prior to the index episodes (HR [95% CI] = 5.74 [1.72–19.22]) and viral syndrome at the index episode (HR [95% CI] = 4.21 [1.91–9.28]).
Conclusion
In routine consecutive hemodynamically stable patients with diagnosis of AM based on CMR, absence of edema, reduced EF, and extent of LGE were associated with early adverse outcome. Only age and EF were associated with long-term events.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Bohbot
- University Hospital of Amiens , Amiens , France
| | - J Garot
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - T Hovasse
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - T Unterseeh
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - C Di Lena
- University Hospital of Amiens , Amiens , France
| | | | - C Tawa
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - C Renard
- University Hospital of Amiens , Amiens , France
| | | | - S Duhamel
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - P Garot
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | | | - F Sanguineti
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
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Bohbot Y, Garot J, Hovasse T, Unterseeh T, Di Lena C, Boukefoussa W, Tawa C, Renard C, Limouzineau I, Duhamel S, Garot P, Tribouilloy C, Sanguineti F. Clinical and Cardiovascular Magnetic Resonance Predictors of Early and Long-Term Clinical Outcome in Acute Myocarditis. Front Cardiovasc Med 2022; 9:886607. [PMID: 35571177 PMCID: PMC9098834 DOI: 10.3389/fcvm.2022.886607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/12/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The natural history of acute myocarditis (AM) remains partially unknown and predictors of outcome are debated. We sought to assess the impact of various cardiac magnetic resonance (CMR) parameters on early and long-term prognosis in a population of patients with AM. Materials and Methods In a two-center longitudinal study, we included consecutive patients with diagnosis of AM based on CMR and without hemodynamic compromise. The primary endpoint was the occurrence of an event in the acute phase (≤15 days). Secondary endpoints were the occurrence of major adverse cardiac events (MACE) and recurrence of AM during follow-up. Results Three hundred and eighty-eight patients were included [mean age 38.5 years, 77.3% male, mean ejection fraction (EF):56%] of which 82% (317) presented with chest pain. CMR was performed 4 ± 2 days after index presentation. Overall, 38 patients (9.8%) had an event at the acute phase, 41 (10.6%) presented at least one MACE during follow-up (median 7.5 years, 6.6–8.9) and 30 (7.7%) experienced a recurrence of AM. By multivariate analysis, the independent predictors of initial complications were absence of chest pain (OR [95%CI] = 0.35 [0.15–0.82]), presence of syncope/pre-syncope (OR [95%CI] = 3.56 [1.26–10.02]), lower EF (OR [95%CI] = 0.94 [0.91–0.98] per%), myocardial extent of late gadolinium enhancement (LGE) (OR [95%CI] = 1.05 [1.002–1.100] per%) and absence of edema (OR [95%CI] = 0.44 [0.19–0.97]). Only age (HR [95%CI] = 1.021 [1.001–1.041] per year) and an initial alteration of EF (HR [95%CI] = 0.94 [0.91–0.97] per%) were associated with MACE during follow-up. Factors independently associated with AM recurrence were myocarditis prior to the index episodes (HR [95%CI] = 5.74 [1.72–19.22]) and viral syndrome at the index episode (HR [95%CI] = 4.21 [1.91–9.28]). Conclusion In routine consecutive hemodynamically stable patients with diagnosis of AM based on CMR, absence of edema, reduced EF, and extent of LGE were associated with early adverse outcome. Only age and EF were associated with long-term events.
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Affiliation(s)
- Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, Amiens, France
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Jérôme Garot
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
- *Correspondence: Jérôme Garot,
| | - Thomas Hovasse
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Thierry Unterseeh
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Chloé Di Lena
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | | | - Chloé Tawa
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Cédric Renard
- Department of Radiology, Amiens University Hospital, Amiens, France
| | | | - Suzanne Duhamel
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Philippe Garot
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
| | | | - Francesca Sanguineti
- Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hôpital Privé Jacques Cartier, Ramsay Santé, Massy, France
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