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Marçal PC, Braggion-Santos MF, Wada DT, Santos MK, Moreira HT, Volpe GJ, Schmidt A. Cardiac Magnetic Resonance as an Etiological Diagnosis Tool in Recovered Sudden Cardiac Death or Unstable Ventricular Arrhythmia Patients. Arq Bras Cardiol 2023; 120:e20220411. [PMID: 37098988 PMCID: PMC10263419 DOI: 10.36660/abc.20220411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/12/2022] [Accepted: 01/11/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Cardiac magnetic resonance (CMR) has an increasing diagnostic relevance in survivors of sudden cardiac death (SCD) or unstable ventricular arrhythmia (UVA) in developed countries. OBJECTIVE To evaluate retrospectively the additional role of CMR in a developing country where few resources are available, and should be used more effectively. METHODS The study included SCD or UVA survivors admitted between 2009 and 2019 at a tertiary academic institution referred to CMR. Demographic, clinical, and laboratory data were collected from the medical records. CMR images and reports were reviewed and their impact on the final etiological diagnosis was determined. A descriptive analysis was performed and p<0.05 established as significant. RESULTS Sixty-four patients, 54.9±15.4 years old, and 42 (71.9%) males. Most events (81.3%) were out of the hospital and ventricular tachycardia was the most common rhythm. Cardiovascular medications were previously used by 55 patients, and beta-blockers were the most used medications (37.5%). Electrocardiogram had electrical inactive areas in 21.9% and all of them had fibrosis at CMR. Mean left ventricular ejection fraction (LVEF) was 44±14%, with 60.9% ≤50% and only 29.7% ≤35%. Late gadolinium enhancement was identified in 71.9%, with a transmural pattern in 43.8%. Chagas cardiomyopathy was the most common etiology (28.1%), followed by ischemic cardiomyopathy (17.2%). Among 26 without a previously identified etiology, CMR could define it (15 patients - 57%). CONCLUSION In accordance with previous studies in developed countries, CMR was capable of increasing etiological diagnosis and identifying the arrhythmogenic substrate, allowing better care in half of the underdiagnosed patients.
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Affiliation(s)
- Paula C. Marçal
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoCentro de CardiologiaRibeirão PretoSPBrasilUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto – Centro de Cardiologia, Ribeirão Preto, SP – Brasil
| | - Maria Fernanda Braggion-Santos
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoCentro de CardiologiaRibeirão PretoSPBrasilUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto – Centro de Cardiologia, Ribeirão Preto, SP – Brasil
| | - Danilo Tadao Wada
- Hospital das ClínicasFaculdade de Medicina de Ribeirão PretoDepartamento de Imagens Médicas, Hematologia e OncologiaRibeirão PretoSPBrasilHospital das Clínicas da Faculdade de Medicina de Ribeirão Preto – Departamento de Imagens Médicas, Hematologia e Oncologia, Ribeirão Preto, SP – Brasil
| | - Marcel Koenigkam Santos
- Hospital das ClínicasFaculdade de Medicina de Ribeirão PretoDepartamento de Imagens Médicas, Hematologia e OncologiaRibeirão PretoSPBrasilHospital das Clínicas da Faculdade de Medicina de Ribeirão Preto – Departamento de Imagens Médicas, Hematologia e Oncologia, Ribeirão Preto, SP – Brasil
| | - Henrique Turin Moreira
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoCentro de CardiologiaRibeirão PretoSPBrasilUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto – Centro de Cardiologia, Ribeirão Preto, SP – Brasil
| | - Gustavo Jardim Volpe
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoCentro de CardiologiaRibeirão PretoSPBrasilUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto – Centro de Cardiologia, Ribeirão Preto, SP – Brasil
| | - André Schmidt
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoCentro de CardiologiaRibeirão PretoSPBrasilUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto – Centro de Cardiologia, Ribeirão Preto, SP – Brasil
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Moreira HT, Volpe GJ, Mesquita GM, Braggion-Santos MF, Pazin-Filho A, Marin-Neto JA, Schmidt A. Association of left ventricular abnormalities with incident cerebrovascular events and sources of thromboembolism in patients with chronic Chagas cardiomyopathy. J Cardiovasc Magn Reson 2022; 24:52. [PMID: 36329520 PMCID: PMC9632087 DOI: 10.1186/s12968-022-00885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although Chagas cardiomyopathy is related to thromboembolic stroke, data on risk factors for cerebrovascular events in Chagas disease is limited. Thus, we assessed the relationship between left ventricular (LV) impairment and cerebrovascular events and sources of thromboembolism in patients with Chagas cardiomyopathy. METHODS This retrospective cohort included patients with chronic Chagas cardiomyopathy who underwent cardiovascular magnetic resonance (CMR). CMR was performed with a 1.5 T scanner to provide LV volumes, mass, ejection fraction (LVEF), and myocardial fibrosis. The primary outcome was a composite of incident ischemic cerebrovascular events (stroke or transient ischemic attack-TIA) and potential thromboembolic sources (atrial fibrillation (AF), atrial flutter, or intracavitary thrombus) during the follow-up. RESULTS A total of 113 patients were included. Median age was 56 years (IQR: 45-67), and 58 (51%) were women. The median LVEF was 53% (IQR: 41-62). LV aneurysms and LV fibrosis were present in 38 (34%) and 76 (67%) individuals, respectively. The median follow-up time was 6.9 years, with 29 events: 11 cerebrovascular events, 16 had AF or atrial flutter, and two had LV apical thrombosis. In the multivariable model, only lower LVEF remained significantly associated with the outcomes (HR: 0.96, 95% CI: 0.93-0.99). Patients with reduced LVEF lower than 40% had a much higher risk of cerebrovascular events and thromboembolic sources (HR: 3.16 95% CI: 1.38-7.25) than those with normal LVEF. The combined incidence rate of the combined events in chronic Chagas cardiomyopathy patients with reduced LVEF was 13.9 new cases per 100 persons-year. CONCLUSIONS LV systolic dysfunction is an independent predictor of adverse cerebrovascular events and potential sources of thromboembolism in patients with chronic Chagas cardiomyopathy.
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Affiliation(s)
- Henrique Turin Moreira
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - Gustavo Jardim Volpe
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - Gustavo Marques Mesquita
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - Maria Fernanda Braggion-Santos
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - Antonio Pazin-Filho
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - José Antonio Marin-Neto
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
| | - André Schmidt
- Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School, Hospital das Clínicas de Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14048-900 Brazil
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Braggion-Santos MF, Moreira HT, Volpe GJ, Koenigkam-Santos M, Marin-Neto JA, Schmidt A. Electrocardiogram abnormalities in chronic Chagas cardiomyopathy correlate with scar mass and left ventricular dysfunction as assessed by cardiac magnetic resonance imaging. J Electrocardiol 2022; 72:66-71. [PMID: 35344746 DOI: 10.1016/j.jelectrocard.2022.03.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022]
Abstract
Electrocardiographic (ECG) abnormalities are frequently identified in Chronic Chagas cardiomyopathy (CCC) patients and advanced abnormalities are related to a worse prognosis. Cardiac Magnetic Resonance (CMR) can precisely assess ventricular systolic dysfunction and quantify myocardial fibrosis (MF), both identified as prognostic factors. We sought to investigate if ECG abnormalities in CCC patients were associated with more severe myocardial involvement as evaluated by CMR. METHODS CCC patients with 12‑lead ECG and CMR closely obtained were included. ECG analysis evaluated rhythm, presence, and type of intraventricular conduction disturbances (IVCD) and, ventricular premature beats (VPB). CMR short-axis cine and late gadolinium enhancement images were evaluated to obtain left and right ventricular ejection fractions and MF mass, respectively. Statistical significance was set in 5%. RESULTS 194 CCC patients (98 women, 56 ± 14 years) were evaluated, and no IVCD was detected in 71. The most common IVCD was the association of right bundle branch block and left anterior fascicular block (RBBB+LAFB) in 58 patients, followed by isolated RBBB in 34, isolated LAFB in 17, and left bundle branch block (LBBB) in 14 patients. Of patients with no IVCD, 63% had MF and the burden of fibrosis (no IVCD - 7.4 ± 8.6%; RBBB - 6.6 ± 6.5%; p = 1.00), as well as left ventricular ejection fraction (LVEF) (no IVCD - 52 ± 14%; RBBB - 55 ± 10%; p = 1.00) were similar to patients with isolated RBBB. Left conduction system impairment was associated with lower LVEF (LAFB - 39 ± 15%; RBBB+LAFB- 41 ± 15%; and LBBB - 35 ± 15%; p < 0.001) and more MF (RBBB+LAFB - 12.2 ± 10.4%; LBBB - 10.6 ± 7.5%; and LAFB - 12.0 ± 7.0%; p < 0.001). The univariable model showed that the presence of MF was related to RBBB+LAFB (OR 5.0; p = 0.001) and VPB (OR 6.3; p = 0.014). After adjustment for age, gender, and different risk factors in a multivariable model, the same findings were still significantly related to CMR myocardial fibrosis (RBBB+LAFB OR 5.0; p = 0.002 / VPB OR 6.9; p = 0.015). CONCLUSIONS ECG without IVCD does not exclude serious cardiac abnormalities in CCC, and isolated RBBB seems to have a benign course. The presence of VPB and left branch conduction impairment, especially LAFB associated with RBBB, indicate a more severe cardiac involvement.
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Affiliation(s)
- Maria Fernanda Braggion-Santos
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Henrique T Moreira
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Gustavo J Volpe
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Marcel Koenigkam-Santos
- Department of Radiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - José Antonio Marin-Neto
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - André Schmidt
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil.
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Amaral F, Valente AM, Manso PH, Gali LG, Braggion-Santos MF, Rocha JM, Vicente WVDA, Schmidt A. Congenitally Corrected Transposition of the Great Arteries in the Adult. Braz J Cardiovasc Surg 2022; 37:534-545. [PMID: 35895985 PMCID: PMC9423792 DOI: 10.21470/1678-9741-2021-0528] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Congenitally corrected transposition of the great arteries (CCTGA) is a rare
anomaly. Current data available regarding adult cases is derived from small
series, information simultaneously presented in pediatric publications, and
one classical multicenter study. This review, not aimed to exhaust the
subject, has the purpose to examine the literature addressing presentation,
diagnostic methodology, and management of afflicted adult patients. Methods A comprehensive search was undertaken in three major databases (PubMed,
Cochrane, SciELO), using the keywords “congenitally corrected transposition
of the great arteries” and “adults”. Relevant articles in English, Spanish,
and Portuguese were extracted and critically appraised in this review. Steps
for study selection were: (1) identification of titles of records through
databases searching, (2) removal of duplicates, (3) screening and selection
of abstracts, (4) final inclusion in the study. Results Four hundred sixty-five publications on CCTGA in adult patients were
retrieved, and 166 were excluded; 299 studies were used for this review
including 76 full-text articles, 70 studies related to general aspects of
the subject, and, due to the small number of publications, 153 case reports.
Sixty-one articles referring to combined experiences in pediatric and adult
patients and judged to be relevant, but retrieved from another sources, were
also included. Conclusion Albeit clinical presentation and diagnostic criteria have been well
stablished, there seems to be room for discussion related to clinical and
surgical management of CCTGA in adults. Considering the rarity of the
disease, well designed multicenter studies may provide answers.
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Volpe GJ, Moreira HT, Trad HS, Wu KC, Braggion-Santos MF, Santos MK, Maciel BC, Pazin-Filho A, Marin-Neto JA, Lima JA, Schmidt A. Left Ventricular Scar and Prognosis in Chronic Chagas Cardiomyopathy. J Am Coll Cardiol 2018; 72:2567-2576. [DOI: 10.1016/j.jacc.2018.09.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/12/2018] [Accepted: 09/18/2018] [Indexed: 01/16/2023]
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Trad HS, Gali AMA, Santos MK, Braggion-Santos MF, Volpe GJ, Maciel BC, Schmidt A. Aortic Regurgitation Quantification using Cardiac Magnetic Resonance. Is there a best imaging plane for flow quantification? A single center clinical trial. J Cardiovasc Magn Reson 2016. [PMCID: PMC5032757 DOI: 10.1186/1532-429x-18-s1-p340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Trad HS, Gali AMA, Santos MK, Braggion-Santos MF, Volpe GJ, Maciel BC, Schmidt A. Late gadolinium enhancement is not related to the severity of aortic regurgitation. A single center study. J Cardiovasc Magn Reson 2016. [PMCID: PMC5032339 DOI: 10.1186/1532-429x-18-s1-q55] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Miranda CH, Braggion-Santos MF, Schmidt A, Filho AP, Cupo P. Evolution of the electrocardiogram QRS complexes voltage in scorpion envenomation–induced Takotsubo syndrome. Am J Emerg Med 2015; 33:837-8. [DOI: 10.1016/j.ajem.2015.02.039] [Citation(s) in RCA: 3] [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: 02/19/2015] [Accepted: 02/21/2015] [Indexed: 01/14/2023] Open
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Braggion-Santos MF, Volpe GJ, Pazin-Filho A, Maciel BC, Marin-Neto JA, Schmidt A. Sudden cardiac death in Brazil: a community-based autopsy series (2006-2010). Arq Bras Cardiol 2014; 104:120-7. [PMID: 25424162 PMCID: PMC4375655 DOI: 10.5935/abc.20140178] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 03/28/2014] [Accepted: 06/27/2014] [Indexed: 11/20/2022] Open
Abstract
Background Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause,
that occurs in less than one hour after the symptoms onset, in a person without
any previous condition that would seem fatal or who was seen without any symptoms
24 hours before found dead. Although it is a relatively frequent event, there are
only few reliable data in underdeveloped countries. Objective We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000
residents) according to Coroners’ Office autopsy reports. Methods We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to
identify cases of SCD. Specific cause of death as well as demographic information,
date, location and time of the event, comorbidities and whether cardiopulmonary
resuscitation (CPR) was attempted were collected. Results We identified 899 cases of SCD (20%); the rate was 30/100000 residents per year.
The vast majority of cases of SCD involved a coronary artery disease (CAD) (64%)
and occurred in men (67%), between the 6th and the 7th
decades of life. Most events occurred during the morning in the home setting
(53.3%) and CPR was attempted in almost half of victims (49.7%). The most
prevalent comorbidity was systemic hypertension (57.3%). Chagas’ disease was
present in 49 cases (5.5%). Conclusion The majority of victims of SCD were men, in their sixties and seventies and the
main cause of death was CAD. Chagas’ disease, an important public health problem
in Latin America, was found in about 5.5% of the cases.
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Affiliation(s)
| | - Gustavo Jardim Volpe
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Antonio Pazin-Filho
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Benedito Carlos Maciel
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - José Antonio Marin-Neto
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - André Schmidt
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Volpe GJ, Moreira HT, Trad HS, Wu K, Braggion-Santos MF, Santos MK, Maciel BC, Pazin AT, Marin-Neto JA, Lima JA, Schmidt A. Presence of scar by late gadolinium enhancement is a strong predictor of events in Chagas Heart Disease. J Cardiovasc Magn Reson 2014. [PMCID: PMC4044384 DOI: 10.1186/1532-429x-16-s1-p343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Braggion-Santos MF, Koenigkam-Santos M, Teixeira SR, Volpe GJ, Trad HS, Schmidt A. Magnetic resonance imaging evaluation of cardiac masses. Arq Bras Cardiol 2013; 101:263-72. [PMID: 23887734 PMCID: PMC4032307 DOI: 10.5935/abc.20130150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 04/23/2013] [Indexed: 11/30/2022] Open
Abstract
Background Cardiac tumors are extremely rare; however, when there is clinical suspicion,
proper diagnostic evaluation is necessary to plan the most appropriate treatment.
In this context, cardiovascular magnetic resonance imaging (CMRI) plays an
important role, allowing a comprehensive characterization of such lesions. Objective To review cases referred to a CMRI Department for investigation of cardiac and
paracardiac masses. To describe the positive case series with a brief review of
the literature for each type of lesion and the role of cardiovascular magnetic
resonance imaging in evaluation. Methods Between August 2008 and December 2011, all cases referred for CMRI with suspicion
of tumor involving the heart were reviewed. Cases with positive histopathological
diagnosis, clinical evolution or therapeutic response compatible with the clinical
suspicion and imaging findings were selected. Results Among the 13 cases included in our study, eight (62%) had histopathological
confirmation. We describe five benign tumors (myxomas, rhabdomyoma and fibromas),
five malignancies (sarcoma, lymphoma, Richter syndrome involving the heart and
metastatic disease) and three non-neoplastic lesions (pericardial cyst,
intracardiac thrombus and infectious vegetation). Conclusion CMRI plays an important role in the evaluation of cardiac masses of non-neoplastic
and neoplastic origin, contributing to a more accurate diagnosis in a noninvasive
manner and assisting in treatment planning, allowing safe clinical follow-up with
good reproducibility.
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Affiliation(s)
- Maria Fernanda Braggion-Santos
- Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das
Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão
Preto, SP - Brasil
- Hospital Universitário - Universidade de Heidelberg, Heidelberg,
Alemanha
- Mailing Address: Maria Fernanda Braggion Santos, Neuenheimer Feld 370,
69120 Heidelberg, Germany E-mail:
| | - Marcel Koenigkam-Santos
- Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto,
SP - Brasil
- Hospital Universitário - Universidade de Heidelberg, Heidelberg,
Alemanha
| | - Sara Reis Teixeira
- Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto,
SP - Brasil
| | - Gustavo Jardim Volpe
- Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das
Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão
Preto, SP - Brasil
- Divisão de Cardiologia - Universidade Johns Hopkins, Baltimore, Estados
Unidos
| | - Henrique Simão Trad
- Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto,
SP - Brasil
| | - André Schmidt
- Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das
Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão
Preto, SP - Brasil
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Braggion-Santos MF, Abdel-Aty H, Hofmann N, Katus HA, Steen H. Cardiac cystic echinococcosis: a long-term follow-up case report. Clin Res Cardiol 2012; 102:85-8. [PMID: 22868693 DOI: 10.1007/s00392-012-0497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 07/24/2012] [Indexed: 11/25/2022]
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