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Langenbach MC, Sandstede J, Sieren MM, Barkhausen J, Gutberlet M, Bamberg F, Lehmkuhl L, Maintz D, Nahle CP. [Summery of the DRG and BDR position paper on coronary computed tomography: clinical evidence and quality of patient care in chronic coronary syndrome]. Radiologie (Heidelb) 2023; 63:125-128. [PMID: 36700946 DOI: 10.1007/s00117-022-01105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 01/27/2023]
Affiliation(s)
- M C Langenbach
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland. .,Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard, Medical School, Boston, USA.
| | - J Sandstede
- Radiologische Allianz, Hamburg, Deutschland.,Berufsverband der deutschen Radiologen e. V. (BDR), München, Deutschland
| | - M M Sieren
- Klinik fur Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - J Barkhausen
- Klinik fur Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - M Gutberlet
- Abteilung für Diagnostische und Interventionelle Radiologie, Herzzentrum Leipzig - Universität Leipzig, Leipzig, Deutschland
| | - F Bamberg
- Medizinische Fakultät, Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - L Lehmkuhl
- Abteilung für Diagnostische und Interventionelle Radiologie, RHON Klinik, Campus Bad Neustadt, Bad Neustadt, Deutschland
| | - D Maintz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland
| | - C P Nahle
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland.,Radiologische Allianz, Hamburg, Deutschland
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Langenbach MC, Sandstede J, Sieren MM, Barkhausen J, Gutberlet M, Bamberg F, Lehmkuhl L, Maintz D, Nähle CP. [German Radiological Society and the Professional Association of German Radiologists position paper on coronary computed tomography: clinical evidence and quality of patient care in chronic coronary syndrome]. Radiologie (Heidelb) 2023; 63:1-19. [PMID: 36633613 PMCID: PMC9838426 DOI: 10.1007/s00117-022-01096-2] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 01/13/2023]
Abstract
This position paper is a joint statement of the German Radiological Society (DRG) and the Professional Association of German Radiologists (BDR), which reflects the current state of knowledge about coronary computed tomography (CT). It is based on preclinical and clinical studies that have investigated the clinical relevance as well as the technical requirements and fundamentals of cardiac computed tomography.
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Affiliation(s)
- M. C. Langenbach
- grid.411097.a0000 0000 8852 305XInstitut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland ,grid.32224.350000 0004 0386 9924Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - J. Sandstede
- Radiologische Allianz, Hamburg, Deutschland ,Berufsverband der deutschen Radiologen e. V. (BDR), München, Deutschland
| | - M. M. Sieren
- grid.412468.d0000 0004 0646 2097Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - J. Barkhausen
- grid.412468.d0000 0004 0646 2097Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - M. Gutberlet
- grid.513819.70000 0004 0489 7230Abteilung für Diagnostische und Interventionelle Radiologie, Herzzentrum Leipzig – Universität Leipzig, Leipzig, Deutschland
| | - F. Bamberg
- grid.7708.80000 0000 9428 7911Medizinische Fakultät, Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - L. Lehmkuhl
- Abteilung für Diagnostische und Interventionelle Radiologie, RHÖN Klinik, Campus Bad Neustadt, Bad Neustadt, Deutschland
| | - D. Maintz
- grid.411097.a0000 0000 8852 305XInstitut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland
| | - C. P. Nähle
- grid.411097.a0000 0000 8852 305XInstitut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland ,Radiologische Allianz, Hamburg, Deutschland
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Gohmann R, Pawelka K, Seitz P, Heiser L, Krieghoff C, Lücke C, Gottschling S, Abdel-Wahab M, Gutberlet M. Kombinierte CT-Koronarangiographie und TAVI-Planung zum Ausschluss signifikanter koronarer Herzkrankheit: Zusätzlicher Nutzen der maschinenlernbasierten CT-FFR. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- R Gohmann
- Herzzentrum Leipzig GmbH, Abteilung für Radiologie, Leipzig
| | - K Pawelka
- Radiologie, Herzzentrum Leipzig, Leipzig
| | - P Seitz
- Radiologie, Herzzentrum Leipzig, Leipzig
| | - L Heiser
- Radiologie, Herzzentrum Leipzig, Leipzig
| | | | - C Lücke
- Radiologie, Herzzentrum Leipzig, Leipzig
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Gohmann R, Seitz P, Pawelka K, Heiser L, Krieghoff C, Lücke C, Gottschling S, Abdel-Wahab M, Gutberlet M. Kombinierte CT-Koronarangiographie (cCTA) und TAVI-Planung: CT-FFR bei cCTAs ohne morphologische Anzeichen für obstruktive koronare Herzkrankheit. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- R Gohmann
- Herzzentrum Leipzig GmbH, Abteilung für Radiologie, Leipzig
| | - P Seitz
- Radiologie, Herzzentrum Leipzig, Leipzig
| | - K Pawelka
- Radiologie, Herzzentrum Leipzig, Leipzig
| | - L Heiser
- Radiologie, Herzzentrum Leipzig, Leipzig
| | | | - C Lücke
- Radiologie, Herzzentrum Leipzig, Leipzig
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Foldyna B, Uhlig J, Mayrhofer T, Natale L, Vliegenthart R, Lotz J, Salgado R, Francone M, Nikolaou K, Bamberg F, Maintz D, Maurovich-Horvat P, Thiele H, Hoffmann U, Gutberlet M. Rising utilization of coronary CT angiography across Europe over the last decade: insights from a large prospective European registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0203] [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: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
The recently updated 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes endorse the use of coronary computed tomography angiography (CCTA) for exclusion of obstructive coronary artery disease in patients with a low clinical likelihood (Class I, LOE B). Higher demand for CCTA requires broad availability, inevitably involving smaller healthcare providers, such as non-academic hospitals and private practices. Nevertheless, most published data on CCTA image quality and safety rely on exams performed in high-volume academic centers, and little is known about CCTA in non-academic settings.
Purpose
To investigate the utilization of CCTA across Europe over the last decade, focusing on differences between academic and non-academic centers.
Methods
We included patients with stable chest pain and suspected coronary artery disease (CAD) who received CCTA and were included in the European Society of Cardiovascular Radiology MR/CT registry 01/2010–01/2020. We compared CT equipment, image quality, radiation dose, the incidence of periprocedural adverse events, patient characteristics, and CCTA findings between academic (high volume university hospitals) and non-academic centers (non-academic hospitals and private practices).
Results
Overall, 64,317 patients (41.2% women; age 60±13 years) from 212 sites across 19 European countries were included. Academic centers submitted most cases in 2010—2014 (51.6%), whereas non-academic centers accounted for 71.3% of records in 2015–2020. While non-academic centers used less advanced technology, radiation dose remained low (4.54 [interquartile range (IQR) 2.28–6.76] mSv) with a 30% decline of high-dose scans (>7 mSv) over time. Diagnostic image quality was reported in 97.7% of cases, and the rate of acute scan-related events was low (0.4%) (Figure 1). From 2010–2014 to 2015–2020, CCTA nearly doubled in patients with low to intermediate pretest-probability, women >50, and 40–60 years old men (Figure 2). CAD presence and extent decreased slightly over time (prevalence: 2010–2014: 41.5% vs. 2015–2020: 40.6%), (multi-vessel disease in those with CAD: 2010–2014: 61.9% vs. 2015–2020: 55.9%; all p<0.01).
Conclusion
CCTA expands rapidly to non-academic centers across Europe, increasing availability while maintaining relatively low radiation dose, high diagnostic image quality, and safety. Broad availability of high-quality CCTA is essential for a successfully implementation of the recently updated guidelines for the diagnosis and management of chronic coronary syndromes.
Funding Acknowledgement
Type of funding sources: None. Changes in CCTA utilizationChanges in patient characteristics
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Affiliation(s)
- B Foldyna
- Massachusetts General Hospital - Harvard Medical School, Department of Radiology, Boston, United States of America
| | - J Uhlig
- University Medical Center Goettingen, Department of Diagnostic and Interventional Radiology, Goettingen, Germany
| | - T Mayrhofer
- Stralsund University of Applied Sciences, School of Business Studies, Stralsund, Germany
| | - L Natale
- Catholic University of the Sacred Heart, Radiology, Rome, Italy
| | - R Vliegenthart
- University Medical Center Groningen, Department of Radiology, Groningen, Netherlands (The)
| | - J Lotz
- University Medical Center Goettingen, Department of Diagnostic and Interventional Radiology, Goettingen, Germany
| | - R Salgado
- Antwerp University Hospital, Department of Radiology, Antwerp, Belgium
| | - M Francone
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - K Nikolaou
- University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen, Germany
| | - F Bamberg
- University of Freiburg, Department of Diagnostic and Interventional Radiology, Freiburg, Germany
| | - D Maintz
- University of Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Budapest, Hungary
| | - H Thiele
- Heart Center at University of Leipzig, Department of Cardiology, Leipzig, Germany
| | - U Hoffmann
- Massachusetts General Hospital - Harvard Medical School, Department of Radiology, Boston, United States of America
| | - M Gutberlet
- Heart Center at University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig, Germany
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Laqua FC, Polacin M, Luecke C, Klingel K, Alkadhi H, Manka R, Thiele H, Gutberlet M, Lurz P, Baessler B. Value of cardiac magnetic resonance imaging derived spectral myocardial strain pattern for non-invasive diagnosis of myocarditis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.045] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Society of Radiology European Institute for Biomedical Imaging Research
Background
Traditionally, cardiac function is quantified by measures of peak excursion, for example ejection fraction. However, myocardial strain estimation from cine- cardiac MRI allows quantification of cardiac motion over the whole heart cycle. We propose a spectral decomposition of the strain curves applying Discrete Fourier transformation (DFT).
Purpose
To evaluate a potential additive diagnostic value of spectral temporal strain curve quantification for non-invasive diagnosis of myocarditis using cardiac MRI.
Methods
In the single-center prospective study patients with suspected myocarditis underwent comprehensive cardiac MRI followed by biventricular endomyocardial biopsy (EMB) between 2012 and 2014. DFT was applied to myocardial strain curves extracted from cine-Images. As reference model, a L1- and L2-penalized logistic regression model using global native T1 time, T2 time and presence of late-gadolinium enhancement was trained to predict EMB results and compared to two models which additionally include three orders of DFT coefficients and ejection fraction, respectively. Predictive performance was evaluated in a tournament-leave-pair-out cross-validation approach with a bootstrap correction for testing of multiple hyperparameter configurations.
Results
Out of 100 patients (28 % female, median age 40 [IQR 32 to 56) years) with acute symptom-onset (<30 days) 65 had pathologically proven myocarditis in EMB. The DFT model showed best discrimination (Area under the receiver-operating-curve [AUC] 0.72 [95% CI 52 to 87]). Addition of ejection fraction (AUC 0.60 [95% CI: 0.43 to 0.74]) did not increase AUC compared to the reference (AUC 0.60 [95% CI: 0.43 to 0.74]). Posterior distribution of the bootstrap-corrected AUC difference between DFT and reference model was gaussian (mean 12%, standard deviation 12%) with a posterior probability of 86%, that DFT has a greater AUC.
Conclusions
Discrimination of myocarditis from similar clinical presentations remains challenging. The results support incremental discriminatory value of DFT-decomposed myocardial strain for non-invasive diagnosis of myocarditis. Future research should address the value of the spectral decomposition of cardiac motion trajectories in larger samples and different disease entities.
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Affiliation(s)
- FC Laqua
- University Hospital Zurich, Institute of Diagnostical and Interventional Radiology, Zurich, Switzerland
| | - M Polacin
- University Hospital Zurich, Institute of Diagnostical and Interventional Radiology, Zurich, Switzerland
| | - C Luecke
- Heart Center at University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - K Klingel
- University Hospital of Tuebingen, Department of Molecular Pathology, Tuebingen, Germany
| | - H Alkadhi
- University Hospital Zurich, Institute of Diagnostical and Interventional Radiology, Zurich, Switzerland
| | - R Manka
- University Hospital Zurich, Institute of Diagnostical and Interventional Radiology, Zurich, Switzerland
| | - H Thiele
- Heart Center at University of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - M Gutberlet
- Heart Center at University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - P Lurz
- Heart Center at University of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - B Baessler
- University Hospital Zurich, Institute of Diagnostical and Interventional Radiology, Zurich, Switzerland
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Seitz P, Krieghoff C, Gottschling S, Lücke C, Abdel-Wahab M, Holzhey D, Gohmann RF, Gutberlet M. Pre-procedural high-pitch coronary CT angiography assessment of patients undergoing transcatheter aortic valve implantation (TAVI) without patient-specific adjustment: analysis of diagnostic performance. Clin Radiol 2021; 76:862.e29-862.e36. [PMID: 34261598 DOI: 10.1016/j.crad.2021.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/15/2021] [Indexed: 11/20/2022]
Abstract
AIM To evaluate the ability to assess the coronary arteries using pre-procedural computed tomography (CT; high-pitch mode) in patients referred for transcatheter aortic valve implantation (TAVI). METHODS AND MATERIALS CT and invasive coronary angiography (ICA) were performed pre-TAVI in 100 patients (46 women; 79 ± 5.9 years). CT was performed in prospectively ECG-triggered high-pitch mode after intravenous administration of 70 ml iodinated contrast medium. Image quality was assessed using a four-point scale (graded 0-3). Significant coronary artery stenosis (≥50% diameter) was graded as either present or absent by one observer and in one-third of patients by two observers independently. ICA was the standard of reference. Results were reported per segment and per patient. RESULTS Twenty-two percent of patients had known coronary artery disease (CAD). In two cases, a coronary anomaly was detected. Diagnostic image quality (grade 1-3) was achieved in 30.3% of segments. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 75%, 80.5%, 16%, and 98.5%, respectively. Significant coronary stenosis could be ruled out completely in all segments in three patients. The interrater agreement per patient was excellent (kappa = 1). CONCLUSION Relevant coronary findings can frequently be observed in high-pitch TAVI-planning CT. Despite the limitations of the technique and in patients referred to pre-TAVI evaluation (rapid heart rate, coronary calcifications, etc.), a valid evaluation of coronary arteries is possible in a considerable proportion of segments with a high NPV; however, few studies were completely free of motion artefacts to dependably exclude CAD using this technique in this challenging group of patients.
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Affiliation(s)
- P Seitz
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany.
| | - C Krieghoff
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany
| | - S Gottschling
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany
| | - C Lücke
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany
| | - M Abdel-Wahab
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany; Leipzig Heart Institute, Russenstraße 69a, 04289, Leipzig, Germany
| | - D Holzhey
- Department of Cardiac Surgery, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany
| | - R F Gohmann
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany; Medical Faculty, University of Leipzig, Liebigstraße 27, 04103, Leipzig, Germany
| | - M Gutberlet
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany; Leipzig Heart Institute, Russenstraße 69a, 04289, Leipzig, Germany; Medical Faculty, University of Leipzig, Liebigstraße 27, 04103, Leipzig, Germany
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Gohmann R, Pawelka K, Seitz P, Majunke N, Desch S, Lauten P, Holzhey D, Noak T, Kiefer P, Krieghoff C, Gottschling S, Lücke C, Wilde J, Ebel S, Borger M, Thiele H, Abdel-Wahab M, Gutberlet M. Combined Coronary CT-angiography And TAVI-planning For Ruling-out Significant Coronary Artery Disease: Added Value Of Machine-Learning Based CT-FFR. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lange T, Stiermaier T, Backhaus SJ, Boom P, Kowallick JT, Lotz J, Kutty S, Bigalke B, Gutberlet M, De Waha-Thiele S, Desch S, Hasenfuss G, Thiele H, Eitel I, Schuster A. Fully automated artificial intelligence-based myocardial scar quantification for diagnostic and prognostic stratification in patients following acute myocardial infarction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background Myocardial infarct size (IS) remains one of the strongest predictors of adverse cardiac events following acute myocardial infarction (AMI). Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) can precisely quantify the extent of injury but requires manual post-processing. Whether novel user-independent artificial intelligence (AI) based fully-automated analyses may facilitate clinical workflow and deliver similar information for risk stratification is unknown.
Methods 913 AMI patients from two multi-center trials (AIDA-STEMI n = 704 with ST-elevation myocardial infarction [STEMI] and TATORT-NSTEMI n = 245 with non-ST-elevation-infarction [NSTEMI]) were included in this sub-study. IS was quantified manually using conventional software (Medis, Leiden Netherlands) and fully automated AI-based software (NeoSoft). All automatically detected IS were evaluated visually and corrected if necessary. Analyzed data were tested for agreement and prediction of major adverse clinical events (MACE) within one year after AMI.
Results Automated and manual IS were similarly associated with outcome in cox regression analyses (HR 1.05 [95% CI 1-02-1.07] p < 0.001 for automated IS and HR 1.04 [95% CI 1.02-1.06]; p < 0.001 for manual IS). Comparison of C-statistics derived area under the curve (AUC) resulted in equivalent MACE prediction (AUC 0.65 for automated vs. AUC 0.66 for manual, p = 0.53). Manual correction of the automated scar detection did not lead to an improved risk prediction of MACE (AUC 0.65 to 0.66, p = 0.43). There was good agreement of automated and manually derived IS (intraclass correlation coefficient [ICC] 0.75 [0.07-0.89]) which was further improved after manual correction of the underlying contours (ICC 0.98 [0.97-0.98]).
Conclusion AI-based software enables automated scar quantification with similar prognostic value compared to conventional methods in patients following AMI.
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Affiliation(s)
- T Lange
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - T Stiermaier
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - SJ Backhaus
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - P Boom
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - JT Kowallick
- University Medical Center Goettingen (UMG), Department of Diagnostic& Interventional Radiology, German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - J Lotz
- University Medical Center Goettingen (UMG), Department of Diagnostic& Interventional Radiology, German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - S Kutty
- Johns Hopkins University School of Medicine, Helen B. Taussig Heart Center, Baltimore, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology , Berlin, Germany
| | - M Gutberlet
- University of Leipzig, Institute of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - S De Waha-Thiele
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - S Desch
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - G Hasenfuss
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - I Eitel
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - A Schuster
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
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10
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Lange T, Stiermaier T, Backhaus SJ, Boom P, Kowallick JT, De Waha-Thiele S, Lotz J, Kutty S, Bigalke B, Gutberlet M, Desch S, Hasenfuss G, Thiele H, Eitel I, Schuster A. CMR feature tracking remote myocardial strain analyses for optimized risk prediction following acute myocardial infarction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.267] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cardiac magnetic resonance myocardial feature tracking (CMR-FT) derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an additional prognostic value in these patients is unknown.
Methods
1052 patients following acute myocardial infarction were included. CMR imaging and strain analyses as well as scar size quantification were performed after reperfusion by primary percutaneous coronary intervention. The occurrence of major adverse cardiac events (MACE) within 12 months after the index event was defined as primary clinical endpoint.
Results
Patients with MACE had significantly lower RM circumferential strain (CS) compared to those without MACE. A cut-off value for RM CS of -25.8% best identified high-risk patients (p < 0.001 on log-rank testing) and impaired RM CS was a strong predictor of MACE (HR 1.05, 95% CI 1.07-1.14, p = 0.003). RM CS provided further risk stratification amongst patients considered at risk according to established CMR parameters for 1.) patients with reduced left ventricular ejection fraction (LVEF) ≤ 35 % (p = 0.002 on log-rank testing), 2.) patients with reduced global circumferential strain (GCS) > -18,3 % (p = 0.015 on log-rank testing), and 3.) patients with large microvascular obstruction ≥ 1.46 % (p = 0.038 on log-rank testing).
Conclusion
CMR-FT derived RM CS is a useful parameter to characterize the response of RM and allows improved stratification following AMI beyond commonly used parameters, especially of high-risk patients.
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Affiliation(s)
- T Lange
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - T Stiermaier
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - SJ Backhaus
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - P Boom
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - JT Kowallick
- University Medical Center Goettingen (UMG), Department of Diagnostic& Interventional Radiology, German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - S De Waha-Thiele
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - J Lotz
- University Medical Center Goettingen (UMG), Department of Diagnostic& Interventional Radiology, German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - S Kutty
- Johns Hopkins University School of Medicine, Helen B. Taussig Heart Center, Baltimore, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology , Berlin, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Institute of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - S Desch
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology , Leipzig, Germany
| | - G Hasenfuss
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology , Leipzig, Germany
| | - I Eitel
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - A Schuster
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
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11
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Yelshibayeva E, Dautov T, Rakhimzhanova R, Gutberlet M, Mardenkyzy D, Kozhakhmetova Z, Saduakasova A. COMPUTED TOMOGRAPHY IN DETECTING FEATURES OF CORONARY ATHEROSCLEROSIS IN DIFFERENT ETHNIC GROUPS OF KAZAKHSTAN POPULATION. Georgian Med News 2021:68-77. [PMID: 33658412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of the study was to identify the features of coronary lesions and to determine the correlation between the main risk factors for coronary artery disease according to the SCORE quality of life scale and the calcium index in MSCT in different age and ethnic groups in men and women living in Kazakhstan. We retrospectively analyzed 935 case histories of patients undergoing MSCT to assess the condition of the coronary arteries. The patients were divided into three groups: Kazakhs (66.9%), Russians (21.4%) and other (11.7%) nationalities. There were statistically significant differences between ethnic groups in BMI (p=0.03), type of chest pain (p<0.01), statin use (p=0.01), and blood glucose (p<0.01). The study showed that the prevalence of coronary atherosclerosis is higher among Russians compared to Kazakhs, even after adjusting for traditional risk factors. In multivariate analysis, the calcium index values were significantly higher in the group of the Russian population by 48% (OR=1.48; 95% CI 0.91-2.40) than in the Kazakh population. In the course of the cross-sectional study, statistically significant differences in the nature of coronary lesions were revealed between ethnic groups, mainly males, living in the Republic. Until now, such studies have not yet been conducted among the inhabitants of Kazakhstan, and data on the ethnic specificity of risk factors for cardiovascular diseases in this geographical region have not been sufficiently studied. Previous studies have shown that East Asians, including Chinese, Koreans, and Japanese, have a lower incidence of coronary artery disease as measured by CI compared to Europeans. A large MESA study also reported observations that study participants of Chinese nationality had a lower CI compared to Europeans. Despite significant differences in dietary habits and living in different climatic conditions between Asians of different countries, lower CI scores appear to be a racial trait of Asians, which was further confirmed by our study. These results are undoubtedly representative, as patients from different regions of Kazakhstan were treated in two clinics of republican significance. In the future, it is necessary to conduct prospective studies with subsequent follow-up of patients after treatment and in identifying the causes of recurrent coronary events, as was done in the MESA study.
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Affiliation(s)
- E Yelshibayeva
- NpJSC «Astana Medical University», Nur-Sultan; RSE «MCH of President's Affairs Administration of the Republic of Kazakhstan»
| | - T Dautov
- National Research Cardiac Surgery Center Nur-Sultan; NpJSC «Astana Medical University», Nur-Sultan; Kazakhstan
| | | | - M Gutberlet
- Heart Centre, Department of Diagnostic and Interventional Radiology, Medical University, Leipzig, Germany
| | - D Mardenkyzy
- RSE «MCH of President's Affairs Administration of the Republic of Kazakhstan»
| | | | - A Saduakasova
- NpJSC «Astana Medical University», Nur-Sultan; RSE «MCH of President's Affairs Administration of the Republic of Kazakhstan»
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12
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Cvitkovic T, Horke A, Avsar M, Bobylev D, Beerbaum P, Boethig D, Gutberlet M, Wacker F, Haverich A, Vogel-Claussen J, Sarikouch S, Czerner C. Can Long Decellularized Homografts Restore Normal Blood Flow in the Ascending Aorta? A 4D-Flow CMR Study. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Wetscherek M, Rutschke W, Frank C, Stehning C, Lurz P, Grothoff M, Thiele H, Gutberlet M, Lücke C. High inter- and intra-observer agreement in mapping sequences compared to classical Lake Louise Criteria assessment of myocarditis by inexperienced observers. Clin Radiol 2020; 75:796.e17-796.e26. [DOI: 10.1016/j.crad.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/08/2020] [Indexed: 11/24/2022]
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14
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Kowallick JT, Backhaus SJ, Stiermaier T, Lange T, Navarra JL, Koschalka A, Rommel KP, Lotz J, Gutberlet M, Kutty S, Hasenfus G, Thiele H, Eitel I, Schuster A. 564 Cardiac magnetic resonance myocardial feature tracking for optimized risk assessment after acute myocardial infarction in patients with type 2 diabetes. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.294] [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: 11/13/2022] Open
Abstract
Abstract
Objective
Type 2 diabetes mellitus (T2DM) associates with worse cardiovascular outcome following acute myocardial infarction (AMI) as compared to non-diabetic patients. Since the mechanisms behind these observations are not fully understood we aimed to quantify the underlying pathophysiology on ventricular and atrial levels and study their prognostic implications using cardiovascular magnetic resonance (CMR) quantitative feature-tracking (FT) and tissue characterization.
Research Design and Methods:
A total of 1147 consecutive patients with AMI (n = 265 with diabetes; n = 882 without diabetes) undergoing cardiac magnetic resonance (CMR) imaging in median 3 days after AMI were included in this multicenter study. Left ventricular (LV) function and volumetry included LV ejection fraction (LV-EF), global longitudinal (GLS), radial (GRS) and circumferential strain (GCS) as well as left atrial (LA) strain and strain rate parameters of LA reservoir, conduit and booster pump function. LV damage assessment included infarct size (IS), edema and microvascular obstruction (MO). The clinical study endpoint was the rate of major adverse cardiovascular events (MACE) at 12 months.
Results
T2DM patients had impaired LA reservoir (19.8 vs. 21.2%, p < 0.01) and conduit strains 7.6 vs. 9.0%, p < 0.01) but no differences in ventricular function or myocardial damage. They were at higher risk of MACE than non-diabetic patients (10.2% vs. 5.8%, p < 0.01) with the majority of MACE occurring in patients with LVEF ≥ 35%. Whilst LVEF was an independent predictor of adverse events in non-diabetic patients (p = 0.04 on multivariable analysis), LV GLS as well as LA strain emerged as independent predictors of poor prognosis in patients with diabetes (p < 0.02 on multivariable analysis). Considering patients with diabetes and LVEF ≥35% (n = 237), GLS and LA reservoir strain below median were significantly associated with higher 12-month event rates.
Conclusions
In patients with diabetes, LA and LV longitudinal strain permit optimized risk assessment early after reperfused AMI with incremental prognostic value over and above LVEF.
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Affiliation(s)
- J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - S J Backhaus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - T Stiermaier
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - T Lange
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J L Navarra
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - A Koschalka
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - K P Rommel
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Department of Radiology, Leipzig, Germany
| | - S Kutty
- Children"s Hospital and Medical Center, Omaha, United States of America
| | - G Hasenfus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - I Eitel
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - A Schuster
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
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15
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Schuster A, Backhaus SJ, Navarra JL, Stiermaier T, Rommel KP, Koschalka A, Kowallick JT, Lotz J, Bigalke B, Kutty S, Gutberlet M, Hasenfus G, Thiele H, Eitel I. 565 Impact of right atrial physiology on heart failure and adverse events after myocardial infarction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.295] [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: 11/13/2022] Open
Abstract
Abstract
Background
Right ventricular (RV) function is a known predictor of adverse events in heart failure and following acute myocardial infarction (AMI). While right atrial (RA) involvement is well characterized in pulmonary arterial hypertension, its relative contributions to adverse events following AMI especially in patients with heart failure and congestion needs further evaluation.
Methods
1235 MI patients underwent CMR after primary percutaneous coronary intervention (PCI) in 15 centers across Germany (n = 795 with ST-elevation MI and 440 with non ST-elevation MI). Right atrial (RA) performance was evaluated using cardiac magnetic resonance myocardial feature tracking (CMR-FT) for the assessment of RA reservoir (total strain εs), conduit (passive strain εe), booster pump function (active strain εa) and associated strain rates (SR) in a blinded core-laboratory. The primary clinical endpoint was the occurrence of major adverse cardiac events (MACE) 12 months post MI.
Results
RA reservoir (εs p = 0.061, SRs p = 0.049) and conduit functions (εe p = 0.006, SRe p = 0.030) were impaired in patients with MACE as opposed to RA booster pump (εa p = 0.579, SRa p = 0.118) and RA volume index (p = 0.866). RA conduit function was associated with clinical onset of heart failure and MACE independently of RV systolic function (multi-variable analysis HR 0.95, 95% CI 0.91-0.99, p = 0.006) while RV systolic function was no independent prognosticator (HR 0.98, 95% CI 0.96-1.00, p = 0.055). Furthermore, RA conduit strain identified low- and high-risk groups within patients with relatively preserved and reduced RV and LV systolic functions (p < 0.019 on log rank testing).
Conclusions
Right atrial impairment is a distinct feature and independent risk factor in patients following AMI and can be easily assessed using CMR-FT derived quantification of RA strain.
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Affiliation(s)
- A Schuster
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - S J Backhaus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J L Navarra
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - T Stiermaier
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - K P Rommel
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - A Koschalka
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology and Pneumology, Berlin, Germany
| | - S Kutty
- Children"s Hospital and Medical Center, Omaha, United States of America
| | - M Gutberlet
- Heart Center of Leipzig, Department of Radiology, Leipzig, Germany
| | - G Hasenfus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - I Eitel
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
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16
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Backhaus SJ, Kowallick JT, Stiermaier T, Lange T, Koschalka A, Navarra JL, Lotz J, Kutty S, Bigalke B, Gutberlet M, Feistritzer HJ, Hasenfus G, Thiele H, Eitel I, Schuster A. 567 Interplay of infarct territory related myocardial mechanics and prognostic implications following acute myocardial infarction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.297] [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: 11/14/2022] Open
Abstract
Abstract
Background
Prognosis in acute myocardial infarction (AMI) depends on the amount of infarct related artery (IRA) subtended myocardium and associated damage but has not been described in great detail. Consequently, we sought to describe IRA associated pathophysiological consequences using cardiac magnetic resonance (CMR).
Methods
1235 AMI patients (n = 795 ST-elevation (STEMI) and 440 non-STEMI) underwent CMR following percutaneous coronary intervention. Blinded core-laboratory data were compared according to left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA) regarding major adverse clinical events (MACE) within 12 months. Left ventricular (LV) global longitudinal/circumferential/radial (GLS/GCS/GRS) as well as left atrial (LA) total (εs), passive (εe) and active (εa) strains were determined using CMR-feature tracking. Tissue characterisation included infarct size (IS) and microvascular obstruction.
Results
LAD and LCx were associated with higher mortality compared to RCA lesions (4.6% and 4.4% vs 1.6%). LAD lesions showed largest IS (16.8%), largest ventricular (LV ejection fraction (EF) 47.4%, GLS -13.2%, GCS -20.8%) and atrial (εs 20.2%) impairment. There was less impairment in LCx (IS 11.8%, LVEF 50.8%, GLS -17.4%, GCS -25.0%, εs 20.7%) followed by RCA lesions (IS 11.3%, LVEF 50.8%, GLS -19.1%, GCS -26.6%, εs 21.7%). In AUC analyses εs (LAD, RCA) and GLS (LCx) best predicted MACE (AUC > 0.69). Multivariate analyses identified εs (p = 0.017) in LAD and GLS (p = 0.034) in LCx infarcts as independent predictors of MACE.
Conclusions
CMR allows IRA specific phenotyping and characterisation of morphologic and functional changes. These alterations carry infarct specific prognostic implications and may represent novel diagnostic and therapeutic targets following AMI.
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Affiliation(s)
- S J Backhaus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - T Stiermaier
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II, Luebeck, Germany
| | - T Lange
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - A Koschalka
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J L Navarra
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - S Kutty
- Children"s Hospital and Medical Center, Omaha, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology , Berlin, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Institute of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - H J Feistritzer
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology , Leipzig, Germany
| | - G Hasenfus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology , Leipzig, Germany
| | - I Eitel
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II, Luebeck, Germany
| | - A Schuster
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
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17
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Stiermaier T, Backhaus SJ, Lange T, Koschalka A, Navarra JL, Boom P, Lamata P, Kowallick JT, Lotz J, Hasenfus G, Gutberlet M, Thiele H, Eitel I, Schuster A. 566 Myocardial left ventricular mechanical uniformity and adverse cardiac events following myocardial infarction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.296] [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: 11/13/2022] Open
Abstract
Abstract
Background
Despite limitations as a standalone parameter, left ventricular ejection fraction (LVEF) is the preferred measure of myocardial function and marker for post-infarction risk stratification. LV myocardial uniformity may provide superior prognostic information after acute myocardial infarction (AMI), which was subject of this study.
Methods and Results:
Consecutive patients with AMI (n = 1082; median age 63 years; 75% male) undergoing cardiac magnetic resonance (CMR) in median 3 days after infarction were included in this multicenter, observational study. Circumferential and radial uniformity ratio estimates (CURE and RURE) were derived from CMR feature-tracking as markers of mechanical uniformity (values between 0 and 1 with 1 reflecting perfect uniformity). The clinical endpoint was the 12-month rate of major adverse cardiac events (MACE), consisting of all-cause death, re-infarction, and new congestive heart failure.
Patients with MACE (n = 73) had significantly impaired CURE [0.76 (IQR 0.67-0.86) versus 0.84 (IQR 0.76-0.89); p < 0.001] and RURE [0.69 (IQR 0.60-0.79) versus 0.76 (IQR 0.67-0.83); p < 0.001] compared to patients without events. While uniformity estimates did not provide independent prognostic information in the overall cohort, CURE below the median of 0.84 emerged as an independent predictor of outcome in post-infarction patients with LVEF >35% (n = 959) even after adjustment for established prognostic markers (hazard ratio 1.99; 95% confidence interval 1.06-3.74; p = 0.033 in stepwise multivariable Cox regression analysis). In contrast, LVEF was not associated with adverse events in this subgroup of AMI patients.
Conclusions
CMR-derived estimates of mechanical uniformity are novel markers for risk assessment after AMI and CURE provides independent prognostic information in patients with preserved or only moderately reduced LVEF.
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Affiliation(s)
- T Stiermaier
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - S J Backhaus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - T Lange
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - A Koschalka
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - J L Navarra
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - P Boom
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - P Lamata
- King"s College London, Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - G Hasenfus
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - M Gutberlet
- University of Leipzig, Heart Center Leipzig, Department of Radiology, Leipzig, Germany
| | - H Thiele
- University of Leipzig, Heart Center Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - I Eitel
- University Medical Center of Schleswig-Holstein, University Heart Center Lübeck, Medical Clinic II, Luebeck, Germany
| | - A Schuster
- University Medical Center Göttingen, Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
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18
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Backhaus SJ, Kowallick JT, Stiermaier T, Lange T, Koschalka A, Navarra JL, Lotz J, Kutty S, Bigalke B, Gutberlet M, Feistritzer HJ, Hasenfuss G, Thiele H, Eitel I, Schuster A. P5255Culprit vessel related myocardial mechanics and prognostic implications following acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0226] [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: 11/14/2022] Open
Abstract
Abstract
Background
Prognosis in acute myocardial infarction (AMI) depends on the amount of infarct related artery (IRA) subtended myocardium and associated damage but has not been described in great detail. Consequently, we sought to describe IRA associated pathophysiological consequences using cardiac magnetic resonance (CMR).
Methods
1235 AMI patients (n=795 ST-elevation (STEMI) and 440 non-STEMI) underwent CMR following percutaneous coronary intervention. Blinded core-laboratory data were compared according to left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA) regarding major adverse clinical events (MACE) within 12 months. Left ventricular (LV) global longitudinal/circumferential/radial (GLS/GCS/GRS) as well as left atrial (LA) total (εs), passive (εe) and active (εa) strains were determined using CMR-feature tracking. Tissue characterisation included infarct size (IS) and microvascular obstruction.
Results
LAD and LCx were associated with higher mortality compared to RCA lesions (4.6% and 4.4% vs 1.6%). LAD lesions showed largest IS (16.8%), largest ventricular (LV ejection fraction (EF) 47.4%, GLS −13.2%, GCS −20.8%) and atrial (εs 20.2%) impairment. There was less impairment in LCx (IS 11.8%, LVEF 50.8%, GLS −17.4%, GCS −25.0%, εs 20.7%) followed by RCA lesions (IS 11.3%, LVEF 50.8%, GLS −19.1%, GCS −26.6%, εs 21.7%). In AUC analyses εs (LAD, RCA) and GLS (LCx) best predicted MACE (AUC>0.69). Multivariate analyses identified εs (p=0.017) in LAD and GLS (p=0.034) in LCx infarcts as independent predictors of MACE.
Conclusions
CMR allows IRA specific phenotyping and characterisation of morphologic and functional changes. These alterations carry infarct specific prognostic implications and may represent novel diagnostic and therapeutic targets following AMI.
Acknowledgement/Funding
DZHK - German Centre for Cardiovascular Research
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Affiliation(s)
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - T Stiermaier
- Medical University, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lübeck, Germany
| | - T Lange
- Heart Centre Goettingen, Goettingen, Germany
| | - A Koschalka
- Heart Centre Goettingen, Goettingen, Germany
| | - J L Navarra
- Heart Centre Goettingen, Goettingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - S Kutty
- Children's Hospital and Medical Center, Omaha, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology, Berlin, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Institute of Diagnostic and Interventional Radiology, Leipzig, Germany
| | | | - G Hasenfuss
- Heart Centre Goettingen, Goettingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Leipzig, Germany
| | - I Eitel
- Medical University, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lübeck, Germany
| | - A Schuster
- Heart Centre Goettingen, Goettingen, Germany
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19
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Backhaus SJ, Kowallick JT, Stiermaier T, Lange T, Koschalka A, Navarra JL, Lotz J, Kutty S, Bigalke B, Gutberlet M, Hasenfuss G, Thiele H, Eitel I, Schuster A. P3097Atrioventricular mechanical coupling and major adverse cardiac events in female patients following acute ST elevation myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0173] [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: 11/14/2022] Open
Abstract
Abstract
Background
Data on sex-specific outcomes following myocardial infarction (MI) are inconclusive with some evidence suggesting association of female sex and increased major adverse clinical events (MACE). Since underlying mechanisms remain elusive, we aimed to quantify the underlying phenotype using cardiovascular magnetic resonance (CMR) quantitative deformation imaging and tissue characterisation.
Methods
Amongst 8 centres across Germany, 795 ST-elevation MI (STEMI) patients underwent post-interventional CMR imaging. CMR feature-tracking (FT) was performed in a blinded core-laboratory. Left ventricular function was quantified using ejection fraction (LVEF) and global longitudinal/circumferential/radial strains (GLS/GCS/GRS). Left atrial function was assessed by reservoir (εs), conduit (εe) and booster pump function (εa). Tissue characterisation included infarct size (IS), microvascular obstruction (MO), area at risk and myocardial salvage index (MSI). Primary endpoint was the occurrence of major adverse clinical events (MACE) within 1 year.
Results
Female sex was associated with increased MACE (HR 1.96, 95% CI 1.13–3.42, p=0.017) but not independently of baseline confounders (p=0.526) with women being older, more often diabetic and hypertensive (p<0.001) and of higher Killip-class (p=0.010). Tissue characterisation was similar between sexes. Women showed impaired atrial (εs p=0.011, εe p<0.001) but increased systolic ventricular mechanics (GLS p=0.001, LVEF p=0.048). Ventricular strain was associated with MACE irrespective of all univariate significant baseline characteristics (GLS HR 1.08, 95% CI 1.01–1.16, p=0.036 and GCS HR 1.07, 95% CI 1.00–1.14, p=0.040).
Conclusion
Atrial function is reduced in women following STEMI, while ventricular systolic function is increased. This may reflect ventricular diastolic failure with systolic compensation, which is independently associated with MACE and may add to sex-specific prognosis evaluation.
Acknowledgement/Funding
DZHK - German Centre for Cardiovascular Research
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Affiliation(s)
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - T Stiermaier
- Medical University, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lübeck, Germany
| | - T Lange
- Heart Centre Goettingen, Goettingen, Germany
| | - A Koschalka
- Heart Centre Goettingen, Goettingen, Germany
| | - J L Navarra
- Heart Centre Goettingen, Goettingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - S Kutty
- Children's Hospital and Medical Center, Omaha, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology, Berlin, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Institute of Diagnostic and Interventional Radiology, Leipzig, Germany
| | - G Hasenfuss
- Heart Centre Goettingen, Goettingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Leipzig, Germany
| | - I Eitel
- Medical University, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lübeck, Germany
| | - A Schuster
- Heart Centre Goettingen, Goettingen, Germany
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20
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Klimeš F, Voskrebenzev A, Gutberlet M, Kern A, Behrendt L, Kaireit TF, Czerner C, Renne J, Wacker F, Vogel-Claussen J. Free-breathing quantification of regional ventilation derived by phase-resolved functional lung (PREFUL) MRI. NMR Biomed 2019; 32:e4088. [PMID: 30908743 DOI: 10.1002/nbm.4088] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE To test the feasibility of regional fully quantitative ventilation measurement in free breathing derived by phase-resolved functional lung (PREFUL) MRI in the supine and prone positions. In addition, the influence of T2 * relaxation time on ventilation quantification is assessed. METHODS Twelve healthy volunteers underwent functional MRI at 1.5 T using a 2D triple-echo spoiled gradient echo sequence allowing for quantitative measurement of T2 * relaxation time. Minute ventilation (ΔV) was quantified by conventional fractional ventilation (FV) and the newly introduced regional ventilation (VR), which corrects volume errors due to image registration. ΔVFV versus ΔVVR and ΔVVR versus ΔVVR with T2 * correction were compared using Bland-Altman plots and correlation analysis. The repeatability and physiological plausibility of all measurements were tested in the supine and prone positions. RESULTS On global and regional scales a strong correlation was observed between ΔVFV versus ΔVVR and ΔVVR versus ΔVVRT2* (r > 0.93); however, regional Bland-Altman analysis showed systematic differences (p < 0.0001). Unlike ΔVVRT2* , ΔVVR and ΔVFV showed expected physiologic anterior-posterior gradients, which decreased in the supine but not in the prone position at second measurement during 3 min in the same position. For all quantification methods a moderate repeatability (coefficient of variation <20%) of ventilation was found. CONCLUSION A fully quantified regional ventilation measurement using ΔVVR in free breathing is feasible and shows physiologically plausible results. In contrast to conventional ΔVFV, volume errors due to image registration are eliminated with the ΔVVR approach. However, correction for the T2 * effect remains challenging.
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Affiliation(s)
- F Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - A Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - M Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - A Kern
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - L Behrendt
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - T F Kaireit
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - C Czerner
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - J Renne
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - F Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - J Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
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21
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Glasenapp A, Derlin K, Gutberlet M, Kropf S, Wester HJ, Ross TL, Bengel FM, Thackeray JT. 251Pressure overload evokes cardiac chemokine receptor CXCR4 upregulation, which predicts subsequent progression of heart failure. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez150.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Glasenapp
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - K Derlin
- Hannover Medical School, Department of Radiology, Hannover, Germany
| | - M Gutberlet
- Hannover Medical School, Department of Radiology, Hannover, Germany
| | - S Kropf
- Scintomics GmbH, Fürstenfeldbruck, Germany
| | - H J Wester
- Technical University of Munich, Lehrstuhl für Pharmazeutische Radiochemie, Munich, Germany
| | - T L Ross
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - F M Bengel
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - J T Thackeray
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
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22
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Voskrebenzev A, Greer M, Gutberlet M, Schönfeld C, Renne J, Hinrichs J, Kaireit T, Welte T, Wacker F, Gottlieb J, Vogel-Claussen J. Detection of chronic lung allograft dysfunction using ventilation-weighted Fourier decomposition MRI. Am J Transplant 2018; 18:2050-2060. [PMID: 29607606 DOI: 10.1111/ajt.14759] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 03/04/2018] [Accepted: 03/25/2018] [Indexed: 01/25/2023]
Abstract
Chronic lung allograft dysfunction (CLAD) remains the leading cause of morbidity and mortality after lung transplantation. Diagnosis requires spirometric change, which becomes increasingly difficult with advancing CLAD. Fourier decomposition magnetic resonance imaging (FD-MRI) permits acquisition of ventilated-weighted images during free-breathing. This study evaluates FD-MRI in detecting CLAD in selected patients after bilateral lung transplantation (DLTx). DLTx recipients demonstrating CLAD at various stages participated. Radiologists remained blinded to clinical status until completion of image analysis. Image acquisition used a 1.5-T MR scanner using a spoiled gradient echo sequence. After FD processing and regional fractional ventilation (RFV) quantification, the volume defect percentage at 2 thresholds (VDP1,2 ), median lung RFV and quartile coefficient of dispersion (QCD) were calculated. Sixty-two patients participated. CLAD was present in 29/62 (47%) patients, of whom 17/62 (27%) had forced expiratory volume in 1 second ≤65% at image acquisition. VDP1 was higher among these participants compared to other groups (P < .001). Increased VDP1 was associated with subsequent graft loss, with values >2% showing reduced survival, independent of degree of graft dysfunction (P = .005). VDP2 discriminated between presence or absence of CLAD (area under the curve = 0.71; P = .03). QCD increased significantly with advancing disease (P < .001). In conclusion, FD-MRI-derived parameters demonstrate potential in quantitative CLAD diagnosis and assessment after DLTx.
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Affiliation(s)
- A Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - M Greer
- Department of Respiratory Medicine, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - M Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - C Schönfeld
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - J Renne
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - J Hinrichs
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - T Kaireit
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - T Welte
- Department of Respiratory Medicine, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - F Wacker
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - J Gottlieb
- Department of Respiratory Medicine, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
| | - J Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Hanover, Germany.,Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hanover, Germany
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23
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Obradovic D, Besler C, Rommel KP, Blazek S, Roeder MV, Klinge K, Gutberlet M, Linke A, Lurz P. P4531Predictive value of plasma level of soluble ST2 receptor in setting of inflammatory cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Obradovic
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
| | - C Besler
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
| | - K P Rommel
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
| | - S Blazek
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
| | - M V Roeder
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
| | - K Klinge
- Institute for Pathology and Neuropathology, Department of Molecular Pathology, Tuebingen, Germany
| | - M Gutberlet
- Heart Center of Leipzig, Department of Radiology, Leipzig, Germany
| | - A Linke
- University Hospital Dresden, Dresden, Germany
| | - P Lurz
- Heart Center of Leipzig, Cardiology, Leipzig, Germany
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24
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Khalil NH, Anders R, Flo Forner A, Gutberlet M, Ender J. Radiological incidence of unilateral pulmonary edema after minimally invasive cardiac surgery. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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Mehl S, Fröhlich M, Hausmann H, Plotkin M, Ruf J, Denecke T, Spors B, Grothoff M, Hetzer R, Felix R, Amthauer H, Gutberlet M. Determination of ventricular volumes in coronary artery disease. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1623936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: Comparison of two gated SPECT analysis tools – gated SPECT quantification (GSQ) and emory cardiac toolbox (ECT) – in patients with coronary artery disease (CAD) and severely impaired left ventricular function (preoperative: EF <35% by cardiac catheter). Patients, methods: A total of 56 gatedSPECT examinations (oneday hybrid-protocol with 201Tl-chloride for rest and 99mTcsestamibi for stress applied during low-dose dobutamine stress MR-examination; temporal resolution; 8 phases per cardiac cycle) were performed in 36 patients (31 preoperatively, 25 postoperatively) and compared with MRI in 48 cases. Left ventricular end-diastolic (LV-EDV) and end-systolic (LV-ESV) volumes as well as the left ventricular ejection fraction (LV-EF) were calculated. Results: The total volumetric assessment by both analysis algorithms (n = 56) showed good intraclass correlation coefficients preoperatively (n=31), but even better postoperatively (n=25). The mean reconstruction time was approximately 3 minutes (±2 SD) for GSQ and 15 minutes (±5 SD) for ECT. In comparison to MRI the results of both analysis tools also correlated well, but the agreement decreased in the presence of scared tissue. The mean LV-EF (MRI) preoperatively was 30.4%, in 6/36 patients above the values calculated from cardiac catheter, postoperatively 34.6%. Conclusion: Both gated SPECT analysis tools showed reliable volumetric assessments in high-risk patients with CAD and severely reduced LV-EF in comparison to MRI, with advantages for GSQ in terms of postprocessing time. However, for the calculation of LV-EF a markedly lower concordance with MR-results was observed for both methods depending on the presence of myocardial scars.
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26
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Denecke T, Hildebrandt B, Rühl R, Miersch A, Nicolaou A, Ruf J, Plotkin M, Hänninen EL, Stroszczynski C, Gutberlet M, Langrehr J, Riess H, Ricke J, Amthauer H. Evaluation of patients with liver metastases from colorectal cancer for locally ablative treatment with laser induced thermotherapy. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryPurpose: Before locally ablative treatment of colorectal liver metastases, patients have to be carefully evaluated to decide whether this is the adequate therapy. In this study we determined the value of FDG-PET in comparison to conventional staging procedures. Patients, methods: In 68 consecutive patients referred for laser induced thermotherapy (LITT) of liver metastases from colorectal cancer, pretherapeutic staging with conventional imaging (thoracic and abdominal CT, liver MRI, chest X-ray) and FDG-PET was performed. The examinations were analysed separately and blinded. Based on the staging information, therapeutic decisions were made by an interdisciplinary review board according to a standardized algorithm. The results were compared between conventional imaging and FDG-PET, and were validated by clinical follow up data and histopathology, respectively. Results: On FDG-PET 210 lesions were interpreted as tumour manifestations. 48 of these were not seen on conventional imaging (true positive, n=46). In contrast, 24 lesions were visualized by conventional imaging only (true positive, n=12). Compared to conventional imaging, discrepant findings on FDG-PET led to treatment modifications in 25 patients (37%); these were correct in 20/25 patients. According to the actual treatment course, the inadequate treatment modifications in the remaining 5 patients were avoided by further diagnostic procedures (i.e. biopsies). Conclusion: In the evaluation of patients with known liver metastases from colorectal cancer before LITT, FDG-PET depicts relevant findings subsidiary to conventional imaging and thus is of high value for therapeutic decision making.
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27
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Amthauer H, Merschhemke M, Lüdemann L, Hartkop E, Ruf J, Gutberlet M, Bertram H, Meencke HJ, Felix R, Venz S, Plotkin M. Use of statistical parametric mapping of 18F-FDG-PET in frontal lobe epilepsy. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary:
Aim: Evaluation of the use of statistical parametrical mapping (SPM) of FDG-PET for seizure lateralization in frontal lobe epilepsy. Patients: 38 patients with suspected frontal lobe epilepsy supported by clinical findings and video-EEG monitoring. Method: Statistical parametrical maps were generated by subtraction of individual scans from a control group, formed by 16 patients with negative neurological/psychiatric history and no abnormalities in the MR scan. The scans were also analyzed visually as well as semiquantitatively by manually drawn ROIs. Results: SPM showed a better accordance to the results of surface EEG monitoring compared with visual scan analysis and ROI quantification. In comparison with intracranial EEG recordings, the best performance was achieved by combining the ROI based quantification with SPM analysis. Conclusion: These findings suggest that SPM analysis of FDG-PET data could be a useful as complementary tool in the evaluation of seizure focus lateralization in patients with supposed frontal lobe epilepsy.
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28
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Lopez Hänninen E, Steinmüller T, Rohlfing T, Bertram H, Gutberlet M, Lemke AJ, Felix R, Amthauer H, Ruf J. Preoperative localization of parathyroid glands. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625596] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: Minimally invasive resection of hyperfunctional parathyroid glands is an alternative to open surgery. However, it requires a precise preoperative localization. This study evaluated the diagnostic use of magnetic resonance (MR) imaging, parathyroid scintigraphy, and consecutive image fusion. Patients, methods: 17 patients (9 women, 8 men; age: 29-72 years; mean: 51.2 years) with primary hyperparathyroidism were included. Examination by MRI used unenhanced T1- and T2-weighted sequences as well as contrast-enhanced T1-weighted sequences. 99mTc-MIBI scintigraphy consisted of planar and SPECT (single photon emission tomography) imaging techniques. In order to improve the anatomical localization of a scintigraphic focus, SPECT-data were fused with the corresponding MR-data using a modified version of the Express 5.0 software (Advanced Visual Systems, Waltham, MA). Results of image fusion were then compared to histopathology. Results: In 14/17 patients, a single parathyroid adenoma was found. There were 3 cases with hyperplastic glands. MRI detected 10 (71%), scintigraphy 12 (86%) adenomas. Both modalities detected 1/3 patients with hyperplasia. Image fusion improved the anatomical assignment of the 13 scintigraphic foci in five patients and was helpful in the interpretation of inconclusive MR-findings in two patients. Conclusions: Both MRI and 99mTc-MIBI scintigraphy sensitively detect parathyroid adenomas but are less reliable in case of hyperplastic glands. In case of a scintigraphic focus, image fusion considerably improves its topographic assignment. Furthermore, it facilitates the evaluation of inconclusive MRI findings.
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29
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Lücke C, Oppolzer B, Werner P, Foldyna B, Lurz P, Jochimsen T, Brenneis B, Lehmkuhl L, Sattler B, Grothoff M, Barthel H, Sabri O, Gutberlet M. Comparison of volumetric and functional parameters in simultaneous cardiac PET/MR: feasibility of volumetric assessment with residual activity from prior PET/CT. Eur Radiol 2017; 27:5146-5157. [PMID: 28631080 PMCID: PMC5674117 DOI: 10.1007/s00330-017-4896-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/24/2017] [Accepted: 05/12/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare cardiac left ventricular (LV) parameters in simultaneously acquired hybrid fluorine-18-fluorodeoxyglucose ([18F] FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with residual tracer activity of upstream PET/CT. METHODS Twenty-nine patients (23 men, age 58±17 years) underwent cardiac PET/MRI either directly after a non-cardiac PET/CT with homogenous cardiac [18F] FDG uptake (n=20) or for viability assessment (n=9). Gated cardiac [18F] FDG PET and cine MR sequences were acquired simultaneously and evaluated blinded to the cross-imaging results. Image quality (IQ), end-diastolic (LVEDV), end-systolic volume (LVESV), ejection fraction (LVEF) and myocardial mass (LVMM) were measured. Pearson correlation and intraclass correlation coefficient (ICC), regression and a Bland-Altman analysis were assessed. RESULTS Except LVMM, volumetric and functional LV parameters demonstrated high correlations (LVESV: r=0.97, LVEDV: r=0.95, LVEF: r=0.91, LVMM: r=0.87, each p<0.05), but wide limits of agreement (LOA) for LVEDV (-25.3-82.5ml); LVESV (-33.1-72.7ml); LVEF (-18.9-14.8%) and LVMM (-78.2-43.2g). Intra- and interobserver reliability were very high (ICC≥0.95) for all parameters, except for MR-LVEF (ICC=0.87). PET-IQ (0-3) was high (mean: 2.2±0.9) with significant influence on LVMM calculations only. CONCLUSION In simultaneously acquired cardiac PET/MRI data, LVEDV, LVESV and LVEF show good agreement. However, the agreement seems to be limited if cardiac PET/MRI follows PET/CT and only the residual activity is used. KEY POINTS • [ 18 F] FDG PET-MRI is feasible with residual [ 18 F] FDG activity in patients with homogenous cardiac uptake. • Cardiac volumes and function assessed by PET/MRI show good agreement. • LVEDV and LVESV are underestimated; PET overestimates LVMM and LVEF. • Cardiac PET and MRI data correlate better when acquired simultaneously than sequentially. • PET and MRI should not assess LV parameters interchangeably.
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Affiliation(s)
- C Lücke
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany.
| | - B Oppolzer
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - P Werner
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - B Foldyna
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
- Cardiac MR PET CT Program, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - P Lurz
- Clinic for Internal Medicine/Cardiology, University Leipzig - Heart Center, Leipzig, Germany
| | - T Jochimsen
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - B Brenneis
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - L Lehmkuhl
- Radiologische Klinik, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany
| | - B Sattler
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - M Grothoff
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - H Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - M Gutberlet
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
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30
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Reinstadler S, Stiermaier T, Liebetrau J, Fuernau G, Eitel C, De Waha S, Desch S, Reil J, Poess J, Metzler B, Luecke C, Gutberlet M, Schuler G, Thiele H, Eitel I. P1070Prognostic significance of remote myocardium alterations assessed by quantitative non-contrast T1 mapping in ST-elevation myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Ruppert J, Hartung D, Gutberlet M, Westhoff-Bleck M, Kahl K. Cardiac adipose tissue, intra-abdominal adipose tissue, and risk for cardio-metabolic diseases in patients with schizophrenia. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionSchizophrenia is associated with increased physical morbidity and mortality. In particular, cardio-metabolic diseases are more frequent. Several underlying reasons have been discussed, including adverse lifestyle behaviors, or adverse effects of neuroleptic treatment. However, little is known about changes of cardiac and intra-abdominal adipose tissue, both are risk factors for the development of cardio-metabolic diseases.Objectives/aimsTo compare, cardiac and intra-abdominal adipose tissue between patients with schizophrenia and healthy controls.MethodsTen physically healthy patients with schizophrenia according to DSM-V were included, and compared to healthy control subjects. Cardiac and intra-abdominal adipose tissue was quantified using magnetic resonance tomography. Further factors assessed comprise the metabolic syndrome, physical activity, smoking behavior, and scores for the assessment of cardio-metabolic diseases (FINDRISK score and modified ESC score).ResultsCardiac adipose tissue and intra-abdominal adipose tissue was increased in patients with schizophrenia. Further findings were higher diastolic blood pressure, more smoking, less physical activity, and an increase for diabetes and cardiovascular disease risk according to the modified ESC and FINDRISK score.ConclusionsThe new finding in our study is an increase of cardiac adipose tissue, a risk factor for the development of cardiovascular disorders, in physically healthy patients with schizophrenia. Furthermore, the risk for the development of type-2 diabetes mellitus is increased, indicated by higher amount of intra-abdominal adipose tissue, and the results of the FINDRISK score. We conclude that lifestyle alterations, particularly exercise training that has been shown to reduce cardiac and intra-abdominal adipose tissue, should be recommended in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Schmidbauer M, Chen R, Wang L, Gutberlet M, Bräsen J, Meier M, Madyaningrana K, Vijith V, Wacker F, Immenschuh S, Gueler F, Hueper K. Einfluss des freien Hämoglobins auf die Manifestation des akuten Nierenversagens im Mausmodell – nicht-invasive Untersuchung mittels ASL und T2-Mapping. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Schmidbauer
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - R Chen
- Medizinische Hochschule Hannover, Institut für Nephrologie, Hannover
| | - L Wang
- Medizinische Hochschule Hannover, Institut für Nephrologie, Hannover
| | - M Gutberlet
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - J Bräsen
- Medizinische Hochschule Hannover, Institut für Pathologie, Hannover
| | - M Meier
- Medizinische Hochschule Hannover, Zentrum für Kleintierbildgebung, Hannover
| | - K Madyaningrana
- Medizinische Hochschule Hannover, Institut für Transfusionsmedizin, Hannover
| | - V Vijith
- Medizinische Hochschule Hannover, Institut für Transfusionsmedizin, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - S Immenschuh
- Medizinische Hochschule Hannover, Institut für Transfusionsmedizin, Hannover
| | - F Gueler
- Medizinische Hochschule Hannover, Institut für Nephrologie, Hannover
| | - K Hueper
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
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Getzin T, May M, Schmidbauer M, Gutberlet M, Wacker F, Schindler C, Hueper K. Funktionelle MRT zur Quantifizierung des pharmakotherapeutischen Effektes eines ACE-Hemmers auf die Nierenperfusion und die T1-Relaxationszeit. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T Getzin
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - M May
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - M Schmidbauer
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - M Gutberlet
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - C Schindler
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - K Hueper
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
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Kaireit T, Voskrebenzev A, Gutberlet M, Freise J, Welte T, Wacker F, Vogel-Claussen J. Validierung der ventilations-gewichteten Fourier Dekompositions MRT bei COPD Patienten zur Messung der regionalen Lungenfunktion. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T Kaireit
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - A Voskrebenzev
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - M Gutberlet
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - J Freise
- Medizinische Hochschule Hannover, Klinik für Pneumologie, Hannover
| | - T Welte
- Medizinische Hochschule Hannover, Klinik für Pneumologie, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
| | - J Vogel-Claussen
- Medizinische Hochschule Hannover, Institut für Diagnostische und Interventionelle Radiologie, Hannover
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Teren A, Kirsten H, Beutner F, Scholz M, Holdt LM, Teupser D, Gutberlet M, Thiery J, Schuler G, Eitel I. Alteration of Multiple Leukocyte Gene Expression Networks is Linked with Magnetic Resonance Markers of Prognosis After Acute ST-Elevation Myocardial Infarction. Sci Rep 2017; 7:41705. [PMID: 28155873 PMCID: PMC5290530 DOI: 10.1038/srep41705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/09/2016] [Accepted: 12/21/2016] [Indexed: 02/02/2023] Open
Abstract
Prognostic relevant pathways of leukocyte involvement in human myocardial ischemic-reperfusion injury are largely unknown. We enrolled 136 patients with ST-elevation myocardial infarction (STEMI) after primary angioplasty within 12 h after onset of symptoms. Following reperfusion, whole blood was collected within a median time interval of 20 h (interquartile range: 15-25 h) for genome-wide gene expression analysis. Subsequent CMR scans were performed using a standard protocol to determine infarct size (IS), area at risk (AAR), myocardial salvage index (MSI) and the extent of late microvascular obstruction (lateMO). We found 398 genes associated with lateMO and two genes with IS. Neither AAR, nor MSI showed significant correlations with gene expression. Genes correlating with lateMO were strongly related to several canonical pathways, including positive regulation of T-cell activation (p = 3.44 × 10-5), and regulation of inflammatory response (p = 1.86 × 10-3). Network analysis of multiple gene expression alterations associated with larger lateMO identified the following functional consequences: facilitated utilisation and decreased concentration of free fatty acid, repressed cell differentiation, enhanced phagocyte movement, increased cell death, vascular disease and compensatory vasculogenesis. In conclusion, the extent of lateMO after acute, reperfused STEMI correlated with altered activation of multiple genes related to fatty acid utilisation, lymphocyte differentiation, phagocyte mobilisation, cell survival, and vascular dysfunction.
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Affiliation(s)
- A Teren
- Department of Cardiology/Internal Medicine, Heart Center, University of Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany
| | - H Kirsten
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Medical Informatics, Statistic and Epidemiology, University of Leipzig, Germany.,IZI, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - F Beutner
- Department of Cardiology/Internal Medicine, Heart Center, University of Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany
| | - M Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Medical Informatics, Statistic and Epidemiology, University of Leipzig, Germany
| | - L M Holdt
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Laboratory Medicine, University Hospital Munich (LMU) and Ludwig-Maximilian- University Munich, Germany
| | - D Teupser
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Laboratory Medicine, University Hospital Munich (LMU) and Ludwig-Maximilian- University Munich, Germany
| | - M Gutberlet
- Department of Diagnostic and Interventional Radiology, Heart Center, University of Leipzig, Germany
| | - J Thiery
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany
| | - G Schuler
- Department of Cardiology/Internal Medicine, Heart Center, University of Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - I Eitel
- University Heart Center Lübeck, University of Lübeck, Medical Clinic II (Cardiology, Angiology and Intensive Care Medicine), Lübeck, Germany
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Rommel K, Noack T, Besler C, Ender J, Seeburger J, von Röder M, Blazek S, Gutberlet M, Schuler G, Mohr F, Linke A, Lurz P. Early Hemodynamic Effects of Transcatheter Tricuspid Valve Repair - Insights from Cardiac Magnetic Resonance. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K.P. Rommel
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - T. Noack
- Heart Center, Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany
| | - C. Besler
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - J. Ender
- Heart Center, Department of Anesthesiology, University of Leipzig, Leipzig, Germany
| | - J. Seeburger
- Heart Center, Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany
| | - M. von Röder
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - S. Blazek
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - M. Gutberlet
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - G. Schuler
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - F.W. Mohr
- Heart Center, Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany
| | - A. Linke
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
| | - P. Lurz
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
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Hüper K, Kühn B, Gutberlet M. MRT-Perfusionsmessung mit Arterial Spin Labelling – Anwendung für die Niere und Transplantatniere. ACTA ACUST UNITED AC 2016. [DOI: 10.1055/s-0042-105420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Foldyna B, Lücke C, Fischer J, Garbade J, Müller M, Gutberlet M, Lehmkuhl L. Kardiale Transplantatvaskulopathie in der Computertomografie: Koronarsegmentvolumetrie und virtuelle Histologie der Koronararterienwand. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lehmkuhl L, Fischer A, Andres C, Foldyna B, Lücke C, Grothoff M, Gutberlet M. Dynamische CT-Angiografie bei Patienten mit infrarenalem Bauchaortenaneurysma nach endovaskulärer Stentgraftimplantation (EVAR): Klinische Relevanz von Typ-II-Endoleaks im Langzeitverlauf. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lang H, Rong S, Hartung D, Chen R, Gutberlet M, Meier M, Wacker F, Gueler F, Hueper K. T2-Mapping der Leber zur Beurteilung des Gewebeödems nach partieller Leberischämie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tewes S, Greite R, Hartung D, Chen R, Rong S, Bräsen J, Meier M, Jang M, Gutberlet M, Hensen B, Wacker F, Güler F, Hüper K. Diffusionsbildgebung und T2 mapping können renale Pathologien im Rahmen eines akuten Nierenversagens charakterisieren und eine Vorhersage zum renalen Outcome geben. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Esmer E, Al-Saadi N, Noutsias M, Kühl U, Schultheiss H, Gutberlet M. Semiquantitative „first-pass“-Myokardperfusionsmessung mit der Magnetresonanztomografie bei Patienten mit Verdacht auf Myokarditis. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gutberlet M. Myokarditis. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gutberlet M. Aus der Praxis des ACS: Wann hilft das MRT bei der Differenzialdiagnose? ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hartung D, Chen R, Gutberlet M, Rong S, Bräsen J, Meier M, Haller H, Wacker F, Gueler F, Hueper K. T2-Mapping zur nicht-invasiven Beurteilung der akuten Abstoßung nach heterotoper Herztransplantation im Mausmodell. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vo Chieu V, Jan Hinrich B, Gutberlet M, Jang M, Lehner F, Peperhove M, Tewes S, Warnecke G, Fegbeutel C, Gwinner W, Hartung D, Wacker F, Güler F, Hüper K. T1-Mapping zur Beurteilung von Nierenschäden nach Organtransplantation. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lücke C, Rutschke W, Lurz P, Pershina E, Grothoff M, Stiermaier T, Foldyna B, Schuler G, Lehmkuhl L, Eitel I, Gutberlet M. Diagnostischer Wert von T1- und T2-Mapping zur Differenzialdiagnose bei akutem Koronarsyndrom. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Müller M, Foldyna B, Lücke C, Nitzsche S, Etz C, Gutberlet M, Lehmkuhl L. Computertomografie-basierte Differenzierung der akuten Mediastinitis von postoperativen Residuen nach Sternotomie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gutberlet M, Hunold P. Klinische Fälle mit Quiz. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Grothoff M, Mende M, Gräfe D, Dähnert I, Kostelka M, Hoffmann J, Freyhardt P, Lehmkuhl L, Gutberlet M, Mahler A. Dimensions of the Ascending Aorta in Children and Adolescents with Repaired Tetralogy of Fallot Obtained by Cardiac Magnetic Resonance Angiography. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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