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Marcondes NA, Spindler BM, Olivo L, Vieira MS, Fernandes FB. CD19-NEGATIVE B-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA: A CASE REPORT. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.750] [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: 10/20/2022] Open
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Marcondes NA, Spindler BM, Vieira MS, Olivo LD, Fernandes FB. DISTINCTION BETWEEN ACUTE MYELOID LEUKAEMIA WITH MYELODYSPLASIA-RELATED CHANGES AND MIXED-PHENOTYPE ACUTE LEUKAEMIA: A DIAGNOSTIC CHALLENGE. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.755] [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: 11/15/2022] Open
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Olivo L, Spindler BM, Marcondes NA, Vieira MS, Fernandes FB, Moschen M. ALTERAÇÃO DE LINHAGEM APÓS USO DE BLINATUMOMAB – LEUCEMIA/LINFOMA LINFOBLÁSTICO B PARA LEUCEMIA MONOCÍTICA AGUDA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.746] [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: 12/01/2022] Open
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Marcondes NA, Spindler BM, Vieira MS, Olivo LD, Fernandes FB, Almeida DR. CASE REPORT: MANTLE CELL LYMPHOMA WITH ABNORMAL CD117 COEXPRESSION. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.749] [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: 11/25/2022] Open
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Raphael CE, Mitchell F, Kanaganayagam GS, Liew AC, Di Pietro E, Vieira MS, Kanapeckaite L, Newsome S, Gregson J, Owen R, Hsu LY, Vassiliou V, Cooper R, Mrcp AA, Ismail TF, Wong B, Sun K, Gatehouse P, Firmin D, Cook S, Frenneaux M, Arai A, O'Hanlon R, Pennell DJ, Prasad SK. Cardiovascular magnetic resonance predictors of heart failure in hypertrophic cardiomyopathy: the role of myocardial replacement fibrosis and the microcirculation. J Cardiovasc Magn Reson 2021; 23:26. [PMID: 33685501 PMCID: PMC7941878 DOI: 10.1186/s12968-021-00720-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/10/2020] [Accepted: 01/31/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Heart failure (HF) in hypertrophic cardiomyopathy (HCM) is associated with high morbidity and mortality. Predictors of HF, in particular the role of myocardial fibrosis and microvascular ischemia remain unclear. We assessed the predictive value of cardiovascular magnetic resonance (CMR) for development of HF in HCM in an observational cohort study. METHODS Serial patients with HCM underwent CMR, including adenosine first-pass perfusion, left atrial (LA) and left ventricular (LV) volumes indexed to body surface area (i) and late gadolinium enhancement (%LGE- as a % of total myocardial mass). We used a composite endpoint of HF death, cardiac transplantation, and progression to NYHA class III/IV. RESULTS A total of 543 patients with HCM underwent CMR, of whom 94 met the composite endpoint at baseline. The remaining 449 patients were followed for a median of 5.6 years. Thirty nine patients (8.7%) reached the composite endpoint of HF death (n = 7), cardiac transplantation (n = 2) and progression to NYHA class III/IV (n = 20). The annual incidence of HF was 2.0 per 100 person-years, 95% CI (1.6-2.6). Age, previous non-sustained ventricular tachycardia, LV end-systolic volume indexed to body surface area (LVESVI), LA volume index ; LV ejection fraction, %LGE and presence of mitral regurgitation were significant univariable predictors of HF, with LVESVI (Hazard ratio (HR) 1.44, 95% confidence interval (95% CI) 1.16-1.78, p = 0.001), %LGE per 10% (HR 1.44, 95%CI 1.14-1.82, p = 0.002) age (HR 1.37, 95% CI 1.06-1.77, p = 0.02) and mitral regurgitation (HR 2.6, p = 0.02) remaining independently predictive on multivariable analysis. The presence or extent of inducible perfusion defect assessed using a visual score did not predict outcome (p = 0.16, p = 0.27 respectively). DISCUSSION The annual incidence of HF in a contemporary ambulatory HCM population undergoing CMR is low. Myocardial fibrosis and LVESVI are strongly predictive of future HF, however CMR visual assessment of myocardial perfusion was not.
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Affiliation(s)
- Claire E Raphael
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
- Department of CMR, Royal Brompton Hospital, Sydney Street, Sydney, SW3 6NP, UK.
| | - Frances Mitchell
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | | | - Alphonsus C Liew
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Elisa Di Pietro
- Department of Advanced Biomedical Sciences, University of Naples, Naples, Italy
| | - Miguel Silva Vieira
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Lina Kanapeckaite
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Simon Newsome
- London School of Hygiene & Tropical Medicine, London, UK
| | - John Gregson
- London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth Owen
- London School of Hygiene & Tropical Medicine, London, UK
| | - Li-Yueh Hsu
- Advanced Cardiovascular Imaging Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Vassilis Vassiliou
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Robert Cooper
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Aamir Ali Mrcp
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Tevfik F Ismail
- King's College London & Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Brandon Wong
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Kristi Sun
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Peter Gatehouse
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - David Firmin
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Stuart Cook
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
- National Heart Center, Singapore, Singapore
| | | | - Andrew Arai
- Advanced Cardiovascular Imaging Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Dudley J Pennell
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | - Sanjay K Prasad
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK
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Somensi ML, Monteiro ANTR, Marx FR, Bockor L, Vieira MS, Kessler AM. Can the Fine Wheat Bran be a Betaine Source in Poultry Diets? Braz J Poult Sci 2019. [DOI: 10.1590/1806-9061-2018-0817] [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] [Indexed: 11/22/2022]
Affiliation(s)
- ML Somensi
- Ministry of Education of Brazil, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | | | - FR Marx
- Universidade Federal do Rio Grande do Sul, Brazil
| | - L Bockor
- Universidade Federal do Rio Grande do Sul, Brazil
| | - MS Vieira
- Universidade Federal do Rio Grande do Sul, Brazil
| | - AM Kessler
- Universidade Federal do Rio Grande do Sul, Brazil
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Silva Vieira M, Arthurs CJ, Hussain T, Razavi R, Figueroa CA. Patient-specific modeling of right coronary circulation vulnerability post-liver transplant in Alagille's syndrome. PLoS One 2018; 13:e0205829. [PMID: 30408044 PMCID: PMC6224049 DOI: 10.1371/journal.pone.0205829] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/02/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Cardiac output (CO) response to dobutamine can identify Alagille's syndrome (ALGS) patients at higher risk of cardiovascular complications during liver transplantation. We propose a novel patient-specific computational methodology to estimate the coronary autoregulatory responses during different hemodynamic conditions, including those experienced in a post-reperfusion syndrome (PRS), to aid cardiac risk-assessment. MATERIAL AND METHODS Data (pressure, flow, strain and ventricular volumes) from a 6-year-old ALGS patient undergoing catheter/dobutamine stress MRI (DSMRI) were used to parameterize a closed-loop coupled-multidomain (3D-0D) approach consisting of image-derived vascular models of pulmonary and systemic circulations and a series of 0D-lumped parameter networks (LPN) of the heart chambers and the distal arterial and venous circulations. A coronary microcirculation control model (CMCM) was designed to adjust the coronary resistance to match coronary blood flow (and thus oxygen delivery) with MVO2 requirements during Rest, Stress and a virtual PRS condition. RESULTS In all three simulated conditions, diastolic dominated right coronary artery (RCA) flow was observed, due to high right ventricle (RV) afterload. Despite a measured 45% increase in CO, impaired coronary flow reserve (CFR) (~1.4) at Stress was estimated by the CMCM. During modeled PRS, a marked vasodilatory response was insufficient to match RV myocardial oxygen requirements. Such exhaustion of the RCA autoregulatory response was not anticipated by the DSMRI study. CONCLUSION Impaired CFR undetected by DSMRI resulted in predicted myocardial ischemia in a computational model of PRS. This computational framework may identify ALGS patients at higher risk of complications during liver transplantation due to impaired coronary microvascular responses.
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Affiliation(s)
- Miguel Silva Vieira
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
- * E-mail:
| | - Christopher J. Arthurs
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, United States of America
- Pediatric Cardiology Department, Evelina Children’s Hospital London, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Reza Razavi
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
- Pediatric Cardiology Department, Evelina Children’s Hospital London, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Carlos Alberto Figueroa
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
- Departments of Surgery and Biomedical Engineering, University of Michigan, Michigan, United States of America
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Dedieu N, Silva Vieira M, Fenton M, Wong J, Botnar R, Burch M, Greil G, Hussain T. The importance of qualitative and quantitative regional wall motion abnormality assessment at rest in pediatric coronary allograft vasculopathy. Pediatr Transplant 2018; 22:e13208. [PMID: 29733526 DOI: 10.1111/petr.13208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 11/30/2022]
Abstract
CAV remains one of the main limiting factors for survival in children after heart transplantation. In this study, we explored the incremental value of routine CMR for evaluation and detection of CAV using qualitative and quantitative analysis of regional and global myocardial function and strain. This was a prospective imaging biomarker validation trial. Twenty-two patients (11 male), aged between 10 and 17 years (median 14 years) post-heart transplantation, were prospectively enrolled and underwent CMR in addition to their biennial review workup with Echo, angiography, and IVUS. Nine healthy control patients were enrolled to undergo CMR alone. Echo was used to analyze WMAs and systolic function. CMR images were analyzed qualitatively for RWMA and quantitatively for volumetric analysis, S and SR. All results were compared to IVUS and angiography assessments. Qualitatively, CMR detected RWMA corresponding to angiographic disease in 3 patients that were not detected on Echo. However, quantitative strain analysis suggested RWMA in an extra 9 patients. Detection of regional wall motion abnormality using quantitative strain analysis was associated with a higher mean stenosis grade (P=.04) and reduced graft survival (P=.04) compared to those with no quantitative wall motion abnormality. Overall, only longitudinal stain was abnormal in patients compared with controls, but there was no correlation between any of the global indices of S or SR and IVUS measurements. CMR is more sensitive than Echo for the visual detection of significant WMAs. Quantitative CMR strain analysis at rest may give additional information to discriminate those at greatest risk.
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Affiliation(s)
- Nathalie Dedieu
- Great Ormond Street Hospital for Children Foundation Trust, London, UK.,King's College London, The Rayne Institute, London, UK
| | | | - Matthew Fenton
- Great Ormond Street Hospital for Children Foundation Trust, London, UK
| | - James Wong
- King's College London, The Rayne Institute, London, UK
| | - Rene Botnar
- King's College London, The Rayne Institute, London, UK
| | - Michael Burch
- Great Ormond Street Hospital for Children Foundation Trust, London, UK
| | - Gerald Greil
- King's College London, The Rayne Institute, London, UK.,UT Southwestern Medical Center, Children's Medical Center, Dallas, TX, USA
| | - Tarique Hussain
- King's College London, The Rayne Institute, London, UK.,UT Southwestern Medical Center, Children's Medical Center, Dallas, TX, USA
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Cecelja M, Jiang B, Keehn L, Hussain T, Silva Vieira M, Phinikaridou A, Greil G, Spector TD, Chowienczyk P. Arterial stiffening is a heritable trait associated with arterial dilation but not wall thickening: a longitudinal study in the twins UK cohort. Eur Heart J 2018; 39:2282-2288. [PMID: 29590330 PMCID: PMC6012080 DOI: 10.1093/eurheartj/ehy165] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/15/2017] [Accepted: 03/07/2018] [Indexed: 01/19/2023] Open
Abstract
Aims Vascular ageing is characterized by arterial stiffening, dilation, and arterial wall thickening. We investigated the extent to which these changes are related and their heritability during 5 year follow-up in the Twins UK cohort. Methods and results Carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) were measured in 762 female twins (mean age 57.9 ± 8.6 years) at two time-points over an average follow-up of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWVaorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. Annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. In regression analysis, predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). Predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. Progression of PWV and distensibility correlated with progression in carotid diameter but not with IMT. Heritability of progression of PWVcf, diameter, and IMT was 55%, 21%, and 8%, respectively. In a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWVaorta. Conclusion Arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. Genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.
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Affiliation(s)
- Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Benyu Jiang
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Tarique Hussain
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Miguel Silva Vieira
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Gerald Greil
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
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Santos AK, Vieira MS, Vasconcellos R, Goulart VAM, Kihara AH, Resende RR. Decoding cell signalling and regulation of oligodendrocyte differentiation. Semin Cell Dev Biol 2018; 95:54-73. [PMID: 29782926 DOI: 10.1016/j.semcdb.2018.05.020] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 12/20/2022]
Abstract
Oligodendrocytes are fundamental for the functioning of the nervous system; they participate in several cellular processes, including axonal myelination and metabolic maintenance for astrocytes and neurons. In the mammalian nervous system, they are produced through waves of proliferation and differentiation, which occur during embryogenesis. However, oligodendrocytes and their precursors continue to be generated during adulthood from specific niches of stem cells that were not recruited during development. Deficiencies in the formation and maturation of these cells can generate pathologies mainly related to myelination. Understanding the mechanisms involved in oligodendrocyte development, from the precursor to mature cell level, will allow inferring therapies and treatments for associated pathologies and disorders. Such mechanisms include cell signalling pathways that involve many growth factors, small metabolic molecules, non-coding RNAs, and transcription factors, as well as specific elements of the extracellular matrix, which act in a coordinated temporal and spatial manner according to a given stimulus. Deciphering those aspects will allow researchers to replicate them in vitro in a controlled environment and thus mimic oligodendrocyte maturation to understand the role of oligodendrocytes in myelination in pathologies and normal conditions. In this study, we review these aspects, based on the most recent in vivo and in vitro data on oligodendrocyte generation and differentiation.
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Affiliation(s)
- A K Santos
- Departamento de Bioquímica e Imunologia, Instituto de Ciência Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - M S Vieira
- Departamento de Bioquímica e Imunologia, Instituto de Ciência Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil; Instituto Nanocell, Rua Santo Antônio, 420, 35500-041 Divinópolis, MG, Brazil
| | - R Vasconcellos
- Departamento de Bioquímica e Imunologia, Instituto de Ciência Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil; Instituto Nanocell, Rua Santo Antônio, 420, 35500-041 Divinópolis, MG, Brazil
| | - V A M Goulart
- Departamento de Bioquímica e Imunologia, Instituto de Ciência Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - A H Kihara
- Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - R R Resende
- Departamento de Bioquímica e Imunologia, Instituto de Ciência Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil; Instituto Nanocell, Rua Santo Antônio, 420, 35500-041 Divinópolis, MG, Brazil.
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Silva Vieira M, Henningsson M, Dedieu N, Vassiliou VS, Bell A, Mathur S, Pushparajah K, Figueroa CA, Hussain T, Botnar R, Greil GF. Improved coronary magnetic resonance angiography using gadobenate dimeglumine in pediatric congenital heart disease. Magn Reson Imaging 2018; 49:47-54. [PMID: 29339139 DOI: 10.1016/j.mri.2017.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/27/2017] [Revised: 12/25/2017] [Accepted: 12/29/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. METHODS Forty consecutive patients (mean age 6±2.8years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5-8min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. RESULTS Scan time was similar for both sequences (5.3±1.8 vs 5.2±1.5min, p=.532) and average heart rate (78±14.7 vs 78±14.5bpm, p=.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6±4.4 vs 31.1±7.4, p<.001) and CNR (9.0±1.8 vs 13.5±3.7, p<.001) and provided improved coronary visualization in all coronary territories (VWS A=0.53±0.07 vs B=0.56±0.07, p=.001; and visual scoring A=3.8±0.59 vs B=4.1±0.53, p<.001). The number of non-diagnostic coronary segments was lower for sequence B [A=42 (13.1%) segments vs B=33 (10.3%) segments; p=.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients' age, body surface area and HR. CONCLUSIONS The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
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Affiliation(s)
- Miguel Silva Vieira
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Markus Henningsson
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Nathalie Dedieu
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | | | - Aaron Bell
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Sujeev Mathur
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Kuberan Pushparajah
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Carlos Alberto Figueroa
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Departments of Surgery and Biomedical Engineering, University of Michigan, MI, USA.
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
| | - René Botnar
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile.
| | - Gerald F Greil
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
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12
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Henningsson M, Shome J, Bratis K, Vieira MS, Nagel E, Botnar RM. Diagnostic performance of image navigated coronary CMR angiography in patients with coronary artery disease. J Cardiovasc Magn Reson 2017; 19:68. [PMID: 28893296 PMCID: PMC5594598 DOI: 10.1186/s12968-017-0381-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/17/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of coronary MR angiography (CMRA) in patients with coronary artery disease (CAD) remains limited due to the long scan times, unpredictable and often non-diagnostic image quality secondary to respiratory motion artifacts. The purpose of this study was to evaluate CMRA with image-based respiratory navigation (iNAV CMRA) and compare it to gold standard invasive x-ray coronary angiography in patients with CAD. METHODS Consecutive patients referred for CMR assessment were included to undergo iNAV CMRA on a 1.5 T scanner. Coronary vessel sharpness and a visual score were assigned to the coronary arteries. A diagnostic reading was performed on the iNAV CMRA data, where a lumen narrowing >50% was considered diseased. This was compared to invasive x-ray findings. RESULTS Image-navigated CMRA was performed in 31 patients (77% male, 56 ± 14 years). The iNAV CMRA scan time was 7 min:21 s ± 0 min:28 s. Out of a possible 279 coronary segments, 26 segments were excluded from analysis due to stents or diameter less than 1.5 mm, resulting in a total of 253 coronary segments. Diagnostic image quality was obtained for 98% of proximal coronary segments, 94% of middle segments, and 91% of distal coronary segments. The sensitivity and specificity was 86% and 83% per patient, 80% and 92% per vessel and 73% and 95% per segment. CONCLUSION In this study, iNAV CMRA offered a very good diagnostic performance when compared against invasive x-ray angiography. Due to the short and predictable scan time it can add clinical value as a part of a comprehensive CAD assessment protocol.
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Affiliation(s)
- Markus Henningsson
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Joy Shome
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Konstantinos Bratis
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Miguel Silva Vieira
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Eike Nagel
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Institute for Experimental and Translational Cardiovascular Imaging, Goethe University, Frankfurt/Main, Germany
- DZHK (German Centre for Cardiovascular Research, Standort RheinMain), Berlin, Germany
| | - Rene M. Botnar
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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van Engelen A, Silva Vieira M, Rafiq I, Cecelja M, Schneider T, de Bliek H, Figueroa CA, Hussain T, Botnar RM, Alastruey J. Aortic length measurements for pulse wave velocity calculation: manual 2D vs automated 3D centreline extraction. J Cardiovasc Magn Reson 2017; 19:32. [PMID: 28270208 PMCID: PMC5341448 DOI: 10.1186/s12968-017-0341-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 02/16/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Pulse wave velocity (PWV) is a biomarker for the intrinsic stiffness of the aortic wall, and has been shown to be predictive for cardiovascular events. It can be assessed using cardiovascular magnetic resonance (CMR) from the delay between phase-contrast flow waveforms at two or more locations in the aorta, and the distance on CMR images between those locations. This study aimed to investigate the impact of different distance measurement methods on PWV. We present and evaluate an algorithm for automated centreline tracking in 3D images, and compare PWV calculations using distances derived from 3D images to those obtained from a conventional 2D oblique-sagittal image of the aorta. METHODS We included 35 patients from a twin cohort, and 20 post-coarctation repair patients. Phase-contrast flow was acquired in the ascending, descending and diaphragmatic aorta. A 3D centreline tracking algorithm is presented and evaluated on a subset of 30 subjects, on three CMR sequences: balanced steady-state free precession (SSFP), black-blood double inversion recovery turbo spin echo, and contrast-enhanced CMR angiography. Aortic lengths are subsequently compared between measurements from a 2D oblique-sagittal plane, and a 3D geometry. RESULTS The error in length of automated 3D centreline tracking compared with manual annotations ranged from 2.4 [1.8-4.3] mm (mean [IQR], black-blood) to 6.4 [4.7-8.9] mm (SSFP). The impact on PWV was below 0.5m/s (<5%). Differences between 2D and 3D centreline length were significant for the majority of our experiments (p < 0.05). Individual differences in PWV were larger than 0.5m/s in 15% of all cases (thoracic aorta) and 37% when studying the aortic arch only. Finally, the difference between end-diastolic and end-systolic 2D centreline lengths was statistically significant (p < 0.01), but resulted in small differences in PWV (0.08 [0.04 - 0.10]m/s). CONCLUSIONS Automatic aortic centreline tracking in three commonly used CMR sequences is possible with good accuracy. The 3D length obtained from such sequences can differ considerably from lengths obtained from a 2D oblique-sagittal plane, depending on aortic curvature, adequate planning of the oblique-sagittal plane, and patient motion between acquisitions. For accurate PWV measurements we recommend using 3D centrelines.
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Affiliation(s)
- Arna van Engelen
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
| | - Miguel Silva Vieira
- Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
| | - Isma Rafiq
- Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
| | - Marina Cecelja
- Department of Clinical Pharmacology, St Thomas’ Hospital, Westminster Bridge Road, London, SE17EH UK
| | | | | | - C. Alberto Figueroa
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
- Department of Bioengineering and Surgery, University of Michigan, Ann Arbor, MI USA
| | - Tarique Hussain
- Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
- Department of Pediatrics, Pediatric Cardiology, UT Southwestern Medical Center, Dallas, USA
| | - Rene M. Botnar
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
- Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Jordi Alastruey
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, 4th floor Lambeth Wing, Westminster Bridge Road, London, SE17EH UK
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Abstract
Three-dimensional (3D) whole heart techniques form a cornerstone in cardiovascular magnetic resonance imaging of congenital heart disease (CHD). It offers significant advantages over other CHD imaging modalities and techniques: no ionizing radiation; ability to be run free-breathing; ECG-gated dual-phase imaging for accurate measurements and tissue properties estimation; and higher signal-to-noise ratio and isotropic voxel resolution for multiplanar reformatting assessment. However, there are limitations, such as potentially long acquisition times with image quality degradation. Recent advances in and current applications of 3D whole heart imaging in CHD are detailed, as well as future directions.
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Affiliation(s)
- Gerald Greil
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Animesh Aashoo Tandon
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Miguel Silva Vieira
- Division of Imaging Sciences and Biomedical Engineering, King's College London , London , UK
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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Kowallick J, Vieira MS, Kutty S, Lotz J, Hasenfuss G, Chiribiri A, Schuster A. LEFT ATRIAL PERFORMANCE IN THE COURSE OF HYPERTROPHIC CARDIOMYOPATHY: RELATION TO LEFT VENTRICULAR HYPERTROPHY AND FIBROSIS. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31828-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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16
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Bazal P, Nastase OA, Vieira MS, Maceira Gonzalez AM, Kowal J, Ramos V, Ozer N, Kammerer I, Von Knobelsdorff F, Castillo E, Olaz F, Alvarez V, Sadaba R, Ciriza M, Arrieta V, Escribano E, Beunza MT, G Solana S, Lopez N, Amzulescu M, Boileu L, Page M, De Meester C, Boulif J, Lazam S, Pouleur AC, Vanoverschelde JL, Gerber BL, Kowallick J, Rafiq I, Chabiniok R, Figueroa A, Carr R, Hussain T, Igual B, Monmeneu JV, Lopez-Lereu P, Garcia MP, Cosin-Sales JV, Bigaj J, Hazik A, Kulisiewicz Z, Slupska M, Bitt J, Silva J, Ferreira N, Bettencourt N, Gama V, Canpolat U, Aytemir K, Hazirolan T, Yorgun H, Oto A, Layer G, Kiessling AH, Sack FU, Hennig P, Menza M, Dieringer MA, Foell D, Jung B, Schulz-Menger J, Maceira A, Llopis A, Velez O, Tebar L. Moderated Posters session: cardiovascular magnetic resonanceP967Simplified segmental calculation of extracellular volume with T1 mapping for evaluation of diffuse interstitial fibrosisP968Diffuse myocardial fibrosis quantification by magnetic resonance imaging in patients with aortic valve diseasesP969Occult anthracycline cardiac injury in adolescents and young adults cancer survivors with normal left ventricular ejection fractionP970Reference values for regional and global myocardial T2 mapping with cardiovascular magnetic resonance at 1.5T vs 3TP971The accuracy of a real-time MR method in the assessment of right ventricular volume and functionP972Can blunted heart rate response to adenosine vasodilator stress have prognostic implications on myocardial perfusion imaging by cardiovascular magnetic resonance?P973Association of vitamin d with left atrial fibrosis in patients with lone AF undergoing cryoablationP974Left ventricular remodelling after mitral valve reconstruction: a 1-year prospective cMRI studyP975Abnormal regional myocardial motion in patients with left ventricular pressure overload detected by MR tissue phase mapping at rest and during stressP976Potential utility of splenic switch-off to improve the diagnostic performance of vasodilator stress cardiac magnetic resonance. Preliminary study. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev273] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rafiq I, Morgan G, Silva Vieira M, Qureshi S, Hussain T. Chronic Occlusion of the Superior Vena Cava Resulting in Cyanosis in an Adult: Unusual Case Highlighting the Value of Collaboration Between Adult and Congenital Cardiology Services. Circ Cardiovasc Interv 2015; 8:e002163. [PMID: 26286739 DOI: 10.1161/circinterventions.114.002163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Isma Rafiq
- From the Norfolk and Norwich University Hospital, Norwich, United Kingdom (I.R.); Guys and St Thomas's Hospital, London, United Kingdom (I.R.); The Rayne Institute, Kings College London (I.R., M.S.V., T.H.), Evelina Hospital (G.M., S.Q.), St Thomas Hospital, London, United Kingdom
| | - Gareth Morgan
- From the Norfolk and Norwich University Hospital, Norwich, United Kingdom (I.R.); Guys and St Thomas's Hospital, London, United Kingdom (I.R.); The Rayne Institute, Kings College London (I.R., M.S.V., T.H.), Evelina Hospital (G.M., S.Q.), St Thomas Hospital, London, United Kingdom
| | - Miguel Silva Vieira
- From the Norfolk and Norwich University Hospital, Norwich, United Kingdom (I.R.); Guys and St Thomas's Hospital, London, United Kingdom (I.R.); The Rayne Institute, Kings College London (I.R., M.S.V., T.H.), Evelina Hospital (G.M., S.Q.), St Thomas Hospital, London, United Kingdom
| | - Shakeel Qureshi
- From the Norfolk and Norwich University Hospital, Norwich, United Kingdom (I.R.); Guys and St Thomas's Hospital, London, United Kingdom (I.R.); The Rayne Institute, Kings College London (I.R., M.S.V., T.H.), Evelina Hospital (G.M., S.Q.), St Thomas Hospital, London, United Kingdom
| | - Tarique Hussain
- From the Norfolk and Norwich University Hospital, Norwich, United Kingdom (I.R.); Guys and St Thomas's Hospital, London, United Kingdom (I.R.); The Rayne Institute, Kings College London (I.R., M.S.V., T.H.), Evelina Hospital (G.M., S.Q.), St Thomas Hospital, London, United Kingdom.
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Silva Vieira M, Hussain T, Alberto Figueroa C. Patient-Specific Image-Based Computational Modeling in Congenital Heart Disease: A Clinician Perspective. ACTA ACUST UNITED AC 2015. [DOI: 10.17554/j.issn.2309-6861.2015.02.96] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Silva Vieira M, Alpendurada F, Babu-Narayan S, Kilner P. Criss-cross heart: twisted anatomy by cardiovascular magnetic resonance. Rev Port Cardiol 2013; 32:947-9. [PMID: 24246720 DOI: 10.1016/j.repc.2013.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 05/20/2013] [Indexed: 11/18/2022] Open
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Silva Vieira M, Alpendurada F, Babu-Narayan S, Kilner P. Criss-cross heart: Twisted anatomy by cardiovascular magnetic resonance. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2013.05.013] [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: 10/25/2022] Open
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21
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Vieira MS, Lazoura O, Padley S. Incidental post-surgical pseudoaneurysm of the left ventricle: an unexpected finding. Eur Heart J Cardiovasc Imaging 2013; 14:1215. [PMID: 23733437 DOI: 10.1093/ehjci/jet109] [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: 11/13/2022] Open
Affiliation(s)
- Miguel Silva Vieira
- Radiology Department, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK
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22
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Vieira MS, Luz A, Anjo D, Antunes N, Santos M, Carvalho H, Torres S. Triple, simultaneous, very late coronary stent thrombosis. Rev Port Cardiol 2013; 32:247-52. [PMID: 23465386 DOI: 10.1016/j.repc.2012.06.019] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 06/04/2012] [Indexed: 10/27/2022] Open
Abstract
Coronary artery stent thrombosis is an uncommon but potentially catastrophic complication. The risk of very late stent thrombosis (VLST) raises important safety issues regarding the first generation of drug-eluting stents (DES). Although several complex mechanisms for VLST have been suggested and various predictors have been described, its pathophysiology is not completely understood and it is not known whether longer-term dual antiplatelet therapy reduces the risk. We present a rare case of simultaneous very late DES thrombosis in the three vascular territories, following discontinuation of antiplatelet therapy seven years after stent placement, presenting as cardiogenic shock.
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Affiliation(s)
- Miguel Silva Vieira
- Cardiology Department, Santo António Hospital- Centro Hospitalar do Porto, Porto, Portugal.
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23
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Vieira MS, Luz A, Anjo D, Antunes N, Santos M, Carvalho H, Torres S. Triple, simultaneous, very late coronary stent thrombosis. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2013.04.004] [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: 11/29/2022] Open
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24
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Vieira MS, Antunes N, Anjo D, Palma P, Carvalho H, Torres S. Coronary artery fistula presenting as unstable angina. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2013.02.009] [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: 11/16/2022] Open
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25
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Vieira MS, Antunes N, Anjo D, Palma P, Carvalho H, Torres S. Coronary artery fistula presenting as unstable angina. Rev Port Cardiol 2013; 32:165-7. [PMID: 23286995 DOI: 10.1016/j.repc.2012.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 06/18/2012] [Indexed: 11/19/2022] Open
Affiliation(s)
- Miguel Silva Vieira
- Cardiology Department, Hospital Santo António, Centro Hospitalar do Porto, Portugal.
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26
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Vieira MS. Tailoring Antiplatelet Therapy in Acute Coronary Syndromes: The Thin Red Line. Cardiology 2013; 126:230-2. [DOI: 10.1159/000355174] [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] [Received: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 11/19/2022]
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Silva Vieira M, Anjo D, Antunes N, Carvalho H, Torres S. Pulmonary embolism with thromboembolus in transit. Rev Port Cardiol 2013; 32:71-2. [DOI: 10.1016/j.repc.2012.07.008] [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] [Received: 06/10/2012] [Accepted: 07/02/2012] [Indexed: 11/30/2022] Open
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Silva Vieira M, Anjo D, Antunes N, Carvalho H, Torres S. Pulmonary embolism with thromboembolus in transit. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2013.01.007] [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: 10/27/2022] Open
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29
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Silva Vieira M, Drivas P, Mohiaddin RH. Becker's muscular dystrophy cardiomyopathy: Insights from imaging modalities. Revista Portuguesa de Cardiologia (English Edition) 2012. [DOI: 10.1016/j.repce.2012.11.014] [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: 11/16/2022] Open
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Affiliation(s)
- Miguel Silva Vieira
- Cardiology Department, Hospital Santo António - Centro Hospitalar do Porto, Porto, Portugal.
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Vieira MS, Meireles A, Gomes C, Antunes N, Sá I, Cabral S, Carvalho H, Torres S. The importance of multimodality cardiac imaging: Echocardiography and cardiovascular magnetic resonance imaging contributions to the diagnosis and management of a right ventricular mass. J Cardiol Cases 2012; 6:e109-e111. [DOI: 10.1016/j.jccase.2012.06.005] [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] [Received: 05/26/2011] [Revised: 04/15/2012] [Accepted: 06/15/2012] [Indexed: 10/28/2022] Open
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Affiliation(s)
- Miguel Silva Vieira
- Cardiology Department, Hospital Santo António, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.
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Pires de Morais G, Paulo N, Vieira MS, Sampaio F, Bettencourt N, Cabral S, Ribeiro J, Fonseca C, Torres S, Vouga L, Gama V. Complex ventricular septal rupture with dissection of the right ventricular wall in ischemic context. Echocardiography 2012; 29:E112-4. [PMID: 22329409 DOI: 10.1111/j.1540-8175.2011.01636.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A 72-year-old man was admitted to the local hospital with non-ST elevation myocardial infarction. In the first 24 hours, a new onset apical murmur was heard. Transthoracic and transesophageal echocardiography showed interventricular septal (IVS) rupture and dissection of the right ventricle (RV) wall forming an echolucent pseudocavity that partially occupied the RV and communicated with the true RV cavity. Multislice computed tomography characterized in detail the IVS and RV wall dissection, and further showed the right coronary artery in the outer border of the RV and pseudocavity, excluding pericardial fluid. Despite surgical correction, progression to cardiogenic shock and death occurred 33 days after admission.
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Affiliation(s)
- Gustavo Pires de Morais
- Cardiovascular Interventional Unit, Department of Cardiology, Gaia Hospital Center, Vila Nova de Gaia, Portugal.
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Freitas PCM, Pucci LL, Vieira MS, Lino RS, Oliveira CMA, Cunha LC, Paula JR, Valadares MC. Diuretic activity and acute oral toxicity of Palicourea coriacea (Cham.) K Schum. J Ethnopharmacol 2011; 134:501-503. [PMID: 21185931 DOI: 10.1016/j.jep.2010.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 10/27/2010] [Accepted: 12/07/2010] [Indexed: 05/30/2023]
Abstract
AIM OF THE STUDY Palicourea coriacea (Cham.) K Schum, is an endemic plant used in the Midwestern Region of Brazil, popularly known as "douradinha do campo" and "congonha do campo". This plant has been used in traditional medicine for several ailments, especially to treat kidney diseases. Since no formal studies on the biological activities and medicinal properties of the ethanolic extract of Palicourea coriacea (PCEE) have been carried out previously, the present study represents the first research into the efficacy of this plant as a diuretic agent employing laboratory rats as test animals. MATERIALS AND METHODS For diuretic activity evaluation we assayed three doses of PCEE (20, 40 and 80mg/kg) and measurement of the urinary volume and electrolytes (Na(+), K(+)) concentration were taken. The acute oral toxicity of PCEE was investigated according to OECD Guideline 423. RESULTS The oral administration of a single dose of PCEE significantly increased the urinary volume in 24h. Additionally, the treatment with PCEE increased, in a dose-dependent manner, the excretion of both, Na(+) and K(+). No sign of toxicity was observed in the animals. CONCLUSIONS The present study confirmed the ethnopharmacological use of Palicourea coriacea as a diuretic agent in the experimental condition tested here. Additionally, this work supports the importance of the preservation of local knowledge as well as the conservation of Brazilian biodiversity.
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Affiliation(s)
- P C M Freitas
- Laboratório de Farmacologia e Toxicologia Celular, Faculdade de Farmácia, Universidade Federal de Goiás, UFG, Goiânia, GO, Brazil
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Abstract
The authors analyzed a family in which three descendants presented with adenocarcinoma of the colon. In two of them the presence of colonic adenomatosis was observed. Another family member, a 13-year-old girl, presented with Turcot syndrome, that is, brain tumor associated with colonic adenomatosis. The nature of the hereditary transmission of Turcot syndrome is hence analyzed, discussing whether it happens through an autosomal recessive or a dominant gene. Undoubtedly the family has colonic adenomatosis, a disease considered of autosomal dominant transmission. Based on the clinical observation, the authors suggest that Turcot syndrome may be determined by an autosomal gene with a pleiotropic effect and variable expressivity.
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